The Experts below are selected from a list of 108 Experts worldwide ranked by ideXlab platform
Noboru Tanigawa - One of the best experts on this subject based on the ideXlab platform.
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sclerotherapy for rectal varices by a small bore needle puncture through the Greater Sciatic Foramen
CardioVascular and Interventional Radiology, 2018Co-Authors: Shuji Kariya, Miyuki Nakatani, Takuji Maruyama, Yasuyuki Ono, Yutaka Ueno, Hiroshi Shimizu, Atsushi Komemushi, Noboru TanigawaAbstract:To report a sclerotherapy technique for rectal varices consisting of direct puncture of the superior rectal vein with a small-bore sheathed needle via the Greater Sciatic Foramen without insertion of a sheath or catheter. The subjects of this retrospective study were three consecutive patients who underwent embolization of rectal varices, two for rupture of rectal varices and one for hepatic encephalopathy and hyperammonemia. A 5% solution of ethanolamine oleate with iodinated contrast agent (5% EOI) was injected through puncture of the superior rectal vein and carried in the blood flow, after which n-butyl cyanoacrylate mixed with lipiodol (NBCA-Lip) was immediately injected to stop the blood flow. The 5% EOI and NBCA-Lip were successfully injected in all three patients. There was no movement of NBCA-Lip on plain radiographs or computed tomography (CT) immediately after injection, and the 5% EOI remained within the rectal varices. The mean procedure time was 53 min (42–60 min). On contrast-enhanced CT 1 month after the procedure, there was no contrast enhancement of the rectal varices that had been seen on preoperative CT in any of the three patients, confirming that the rectal varices had disappeared. Sclerotherapy for rectal varices using an approach for puncture of the superior rectal vein with a small-bore sheathed needle via the Greater Sciatic Foramen was technically feasible and clinically effective.
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balloon occluded antegrade transvenous sclerotherapy to treat rectal varices a direct puncture approach to the superior rectal vein through the Greater Sciatic Foramen under ct fluoroscopy guidance
CardioVascular and Interventional Radiology, 2015Co-Authors: Yasuyuki Ono, Shuji Kariya, Miyuki Nakatani, Yutaka Ueno, Atsushi Komemushi, Rie Yoshida, Yumiko Kono, Naoki Kan, Noboru TanigawaAbstract:Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the Greater Sciatic Foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.
R. Shane Tubbs - One of the best experts on this subject based on the ideXlab platform.
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Division of Sacrospinous and Sacrotuberous Ligaments Expands Access Through Greater Sciatic Foramen: Anatomic Study with Application to Resection of Greater Sciatic Foramen Tumors.
World Neurosurgery, 2019Co-Authors: Joe Iwanaga, Ross C. Puffer, Koichi Watanabe, Robert J. Spinner, R. Shane TubbsAbstract:Objective Tumors of the Greater Sciatic Foramen remain difficult to treat. They often have both intrapelvic and extrapelvic components that may limit visualization and make safe resection of the tumor difficult. Therefore the goal of the present anatomic study was to quantitate how much additional surgical working space could be gained by transection of the sacrospinous and sacrotuberous ligaments. Methods Sixteen sides from 9 fresh-frozen Caucasian cadaveric torsos underwent transgluteal dissection and exposure of the Greater Sciatic Foramen and associated liagments. With the piriformis in place, the vertical and horizontal diameters of the Greater Sciatic Foramen were measured. Next, the sacrotuberous and sacrospinous ligaments were cut at their ischial attachments. The vertical diameter of the now confluent Greater and lesser Sciatic foramina (V2) was measured. Results The mean vertical diameter of the Greater Sciatic Foramen (V1) was 54.8 ± 9.7 mm. The horizontal diameter of the Greater Sciatic Foramen had a mean of 44.3 ± 6.1 mm with a range of 30–52 mm. After transection of the sacrotuberous and sacrospinous ligaments, the vertical distance of the Greater and lesser Sciatic foramina (V2) had a mean of 74.8 ± 6.8 mm with a range of 60.1–90 mm. The mean ratio of V2 to V1 was 1.40. Conclusions The vertical length of the Greater Sciatic Foramen increased, on average, 40% after resection of the sacrotuberous and sacrospinous ligaments. The results of this study support an alternative technique for resecting large intrapelvic tumors via a transgluteal approach.
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Neurovascular Relationships of S2AI Screw Placement: Anatomic Study
World Neurosurgery, 2018Co-Authors: Amir Abdul-jabbar, Thomas Armin Schildhauer, Emre Yilmaz, Tamir Tawfik, Thomas M O'lynnger, Joe Iwanaga, Jens R Chapman, Rod J. Oskouian, R. Shane TubbsAbstract:Introduction The S2 alar-iliac (S2AI) screw is a modification of the traditional iliac fixation technique and has surgical and biomechanical benefits. However, there are significant regional neurovascular structures along the path of such screws. Therefore the current anatomic study was performed to better elucidate these relationships. Methods Using fluoroscopy, S2AI screws were placed in 2 adult cadavers through a standard posterior midline exposure. The screw insertion point was placed 10 mm lateral to a line bisecting the S1 and S2 foramina, adjacent to the sacroiliac joint. Using 30- to 40-degree lateral angulation from the midline and 20- to 30-degree caudal angulation, a pedicle probe was directed toward the anterior inferior iliac spine. The final trajectory was positioned to sit 1−2 cm superior to the Greater Sciatic Foramen. Lastly, the screws and surrounding bone were drilled in order to visualize both lateral and medial neurovascular relationships. Results Removing the bone around the S2AI-screw illustrated the close relationship to the medial (internal) neurovascular structures including the obturator nerve, lumbosacral trunk, sacral plexus and, specifically, the S1 ventral ramus and iliac vein and artery. By removing the outer cortex of the ilium, the close relationship to the superior gluteal artery, vein, and nerve was observed. In addition, we were able to identify the proximity to the iliopsoas muscle and internal iliac vessels. Conclusions A comprehensive knowledge of the surrounding neurovascular anatomy relevant to S2AI screw placement can decrease patient morbidity and allow spine surgeons to better diagnose potential postoperative complications.
Shuji Kariya - One of the best experts on this subject based on the ideXlab platform.
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sclerotherapy for rectal varices by a small bore needle puncture through the Greater Sciatic Foramen
CardioVascular and Interventional Radiology, 2018Co-Authors: Shuji Kariya, Miyuki Nakatani, Takuji Maruyama, Yasuyuki Ono, Yutaka Ueno, Hiroshi Shimizu, Atsushi Komemushi, Noboru TanigawaAbstract:To report a sclerotherapy technique for rectal varices consisting of direct puncture of the superior rectal vein with a small-bore sheathed needle via the Greater Sciatic Foramen without insertion of a sheath or catheter. The subjects of this retrospective study were three consecutive patients who underwent embolization of rectal varices, two for rupture of rectal varices and one for hepatic encephalopathy and hyperammonemia. A 5% solution of ethanolamine oleate with iodinated contrast agent (5% EOI) was injected through puncture of the superior rectal vein and carried in the blood flow, after which n-butyl cyanoacrylate mixed with lipiodol (NBCA-Lip) was immediately injected to stop the blood flow. The 5% EOI and NBCA-Lip were successfully injected in all three patients. There was no movement of NBCA-Lip on plain radiographs or computed tomography (CT) immediately after injection, and the 5% EOI remained within the rectal varices. The mean procedure time was 53 min (42–60 min). On contrast-enhanced CT 1 month after the procedure, there was no contrast enhancement of the rectal varices that had been seen on preoperative CT in any of the three patients, confirming that the rectal varices had disappeared. Sclerotherapy for rectal varices using an approach for puncture of the superior rectal vein with a small-bore sheathed needle via the Greater Sciatic Foramen was technically feasible and clinically effective.
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balloon occluded antegrade transvenous sclerotherapy to treat rectal varices a direct puncture approach to the superior rectal vein through the Greater Sciatic Foramen under ct fluoroscopy guidance
CardioVascular and Interventional Radiology, 2015Co-Authors: Yasuyuki Ono, Shuji Kariya, Miyuki Nakatani, Yutaka Ueno, Atsushi Komemushi, Rie Yoshida, Yumiko Kono, Naoki Kan, Noboru TanigawaAbstract:Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the Greater Sciatic Foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.
Yasuyuki Ono - One of the best experts on this subject based on the ideXlab platform.
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sclerotherapy for rectal varices by a small bore needle puncture through the Greater Sciatic Foramen
CardioVascular and Interventional Radiology, 2018Co-Authors: Shuji Kariya, Miyuki Nakatani, Takuji Maruyama, Yasuyuki Ono, Yutaka Ueno, Hiroshi Shimizu, Atsushi Komemushi, Noboru TanigawaAbstract:To report a sclerotherapy technique for rectal varices consisting of direct puncture of the superior rectal vein with a small-bore sheathed needle via the Greater Sciatic Foramen without insertion of a sheath or catheter. The subjects of this retrospective study were three consecutive patients who underwent embolization of rectal varices, two for rupture of rectal varices and one for hepatic encephalopathy and hyperammonemia. A 5% solution of ethanolamine oleate with iodinated contrast agent (5% EOI) was injected through puncture of the superior rectal vein and carried in the blood flow, after which n-butyl cyanoacrylate mixed with lipiodol (NBCA-Lip) was immediately injected to stop the blood flow. The 5% EOI and NBCA-Lip were successfully injected in all three patients. There was no movement of NBCA-Lip on plain radiographs or computed tomography (CT) immediately after injection, and the 5% EOI remained within the rectal varices. The mean procedure time was 53 min (42–60 min). On contrast-enhanced CT 1 month after the procedure, there was no contrast enhancement of the rectal varices that had been seen on preoperative CT in any of the three patients, confirming that the rectal varices had disappeared. Sclerotherapy for rectal varices using an approach for puncture of the superior rectal vein with a small-bore sheathed needle via the Greater Sciatic Foramen was technically feasible and clinically effective.
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balloon occluded antegrade transvenous sclerotherapy to treat rectal varices a direct puncture approach to the superior rectal vein through the Greater Sciatic Foramen under ct fluoroscopy guidance
CardioVascular and Interventional Radiology, 2015Co-Authors: Yasuyuki Ono, Shuji Kariya, Miyuki Nakatani, Yutaka Ueno, Atsushi Komemushi, Rie Yoshida, Yumiko Kono, Naoki Kan, Noboru TanigawaAbstract:Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the Greater Sciatic Foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.
Yutaka Ueno - One of the best experts on this subject based on the ideXlab platform.
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sclerotherapy for rectal varices by a small bore needle puncture through the Greater Sciatic Foramen
CardioVascular and Interventional Radiology, 2018Co-Authors: Shuji Kariya, Miyuki Nakatani, Takuji Maruyama, Yasuyuki Ono, Yutaka Ueno, Hiroshi Shimizu, Atsushi Komemushi, Noboru TanigawaAbstract:To report a sclerotherapy technique for rectal varices consisting of direct puncture of the superior rectal vein with a small-bore sheathed needle via the Greater Sciatic Foramen without insertion of a sheath or catheter. The subjects of this retrospective study were three consecutive patients who underwent embolization of rectal varices, two for rupture of rectal varices and one for hepatic encephalopathy and hyperammonemia. A 5% solution of ethanolamine oleate with iodinated contrast agent (5% EOI) was injected through puncture of the superior rectal vein and carried in the blood flow, after which n-butyl cyanoacrylate mixed with lipiodol (NBCA-Lip) was immediately injected to stop the blood flow. The 5% EOI and NBCA-Lip were successfully injected in all three patients. There was no movement of NBCA-Lip on plain radiographs or computed tomography (CT) immediately after injection, and the 5% EOI remained within the rectal varices. The mean procedure time was 53 min (42–60 min). On contrast-enhanced CT 1 month after the procedure, there was no contrast enhancement of the rectal varices that had been seen on preoperative CT in any of the three patients, confirming that the rectal varices had disappeared. Sclerotherapy for rectal varices using an approach for puncture of the superior rectal vein with a small-bore sheathed needle via the Greater Sciatic Foramen was technically feasible and clinically effective.
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balloon occluded antegrade transvenous sclerotherapy to treat rectal varices a direct puncture approach to the superior rectal vein through the Greater Sciatic Foramen under ct fluoroscopy guidance
CardioVascular and Interventional Radiology, 2015Co-Authors: Yasuyuki Ono, Shuji Kariya, Miyuki Nakatani, Yutaka Ueno, Atsushi Komemushi, Rie Yoshida, Yumiko Kono, Naoki Kan, Noboru TanigawaAbstract:Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the Greater Sciatic Foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.
