• Title/Summary/Keyword: Interventional procedures

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Evaluation of Diagnostic Reference Level in Interventional Procedures (인터벤션시술 진단참고수준 평가)

  • Kang, Byung-Sam;Park, Hyung-Shin
    • Journal of radiological science and technology
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    • v.44 no.5
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    • pp.451-457
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    • 2021
  • Recently, the number of interventional procedures has increased dramatically as an alternative of invasive surgical procedure and patient radiation exposure is also increasing accordingly. In this study, we evaluated the patient dose of major interventional procedures nationwide and we established our Korean database. With these results, we tried to suggest the reference dose level for major interventional procedures. We evaluated patent dose data in the field of interventional radiology from foreign countries. Measurement of radiation dose exposure for 11 major interventional procedures was conducted using embedded DAP meters in 10,006 patients from 47 hospitals, and reference level of each interventional procedure was suggested. The DRLs of each intervenional procedure are as follows: TACE 206(Gy·cm2), AVF 12(Gy·cm2), LE intervention 43(Gy·cm2), TFCA 122(Gy·cm2), Cerebral aneurysm coil embolization 214(Gy·cm2), PTBD 22(Gy·cm2), Biliary stent 60(Gy·cm2), PCN 7(Gy·cm2), Hickman catheter 2.1(Gy·cm2), Chemoport 1.4(Gy·cm2), BAE 104(Gy·cm2). Compared with the previously established DRL in 2012, the radiation dose decreased in all 10 interventional procedures. In the future, continuous publicity and education on the radiation dose reduction will be needed.

Initial experience with Scepter Mini dual lumen balloon for embolization of cerebrovascular diseases

  • Muhammad U Manzoor;Ibrahim A. Almulhim;Abdullah A. Alrashed;Shorog Althubait;Abdulrahman Y. Alturki;Sultan M. Al-Qahtani
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.2
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    • pp.175-181
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    • 2023
  • Objective: Endovascular treatment of cerebrovascular diseases is often challenging due to small caliber, tortuous distal vessels. Several devices and techniques have evolved to overcome these challenges. Recently, a low profile dual lumen microballoon catheter, specifically designed for distal navigation is employed for neurovascular procedures. Due to its recent advent, scarce data is available on clinical utility and safety of Scepter Mini. The aim of this case series is to report our initial experience with Scepter Mini in the management of various cerebrovascular diseases. Methods: All interventional neurovascular cases performed using Scepter Mini between January 2020 till April 2021 were included. Data regarding patient demographics, procedural details and complications was retrospectively collected from patient's electronic medical record and procedure reports. Results: Total twelve embolization procedures were performed in eleven patients, including six brain arteriovenous malformation, two dural arteriovenous fistula, one vein of Galen malformation and three hyper-vascular glomus tumor embolizations. All procedures were successfully performed with adequate penetration of the embolic agent. Complete embolization was performed in six procedures, while intended partial embolization was performed in the rest of procedures. Scepter Mini was solely used in ten procedures, however in the other two embolization procedures it was used as an additional conjunct tool to complete the intended embolization. No balloon related complication was observed in any procedure. Conclusions: Scepter Mini dual lumen microballoon catheter is safe and feasible for delivery of liquid embolic agents for cerebrovascular embolization procedures.

Factors Associated with Psychological Characteristics in Patients with Hepatic Malignancy before Interventional Procedures

  • Wang, Zi-Xuan;Yuan, Chang-Qing;Guan, Jun;Liu, Si-Liang;Sun, Chun-Hui;Kim, Seong-Hwan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.309-314
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    • 2012
  • Objective: To investigate the psychological characteristics of hepatic malignancy patients before interventional procedures and assess associations with related factors. Methods: Two hundred and thirteen patients requiring interventional procedure for hepatic malignancy were asked to complete a survey of health knowledge and psychological symptom on health knowledge questionnaire and SCL-90 before interventional procedure. Logistic regression analysis was employed to determine the association of various demographic, clinical and health knowledge factors with the presence of psychological symptoms in patients. Results: Eight psychological symptom scores, i.e. somatization, obsessive-compulsive tendencies, depression, anxiety, hostility, phobia, paranoid ideations and psychotic states, were significantly higher than the normal range (P< 0.001). Of 213 cases in the study, 49 families (23.00%) concealed the diagnoses of hepatic carcinoma from patients; 135 patients (63.38%) described the prognosis of the disease correctly. It was demonstrated that the correlations between psychological symptoms and related factors, i.e. age, gender, education, interventional procedure times and health knowledge, were statistically significant (P<0.05). Conclusion: Psychological distress is severe in hepatic malignancy patients before interventional procedures. Age, gender, education, interventional procedure times and health knowledge are associated with psychological symptoms which are significant different from the normal range in Chinese.

Radiation Exposure to Physicians During Interventional Pain Procedures

  • Kim, Tae-Wan;Jung, Jang-Hwan;Jeon, Hyun-Joo;Yoon, Kyung-Bong;Yoon, Duck-Mi
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.24-27
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    • 2010
  • Background: Fluoroscopy has been an integral part of modern interventional pain management. Yet fluoroscopy can be associated with risks for the patients and clinicians unless it is managed with appropriate understanding, skill and vigilance. Therefore, this study was designed to determine the amount of radiation received by a primary operator and an assistant during interventional pain procedures that involve the use of fluoroscopy. Methods: In order to examine the amount of radiation, the physicians were monitored by having them wear three thermoluminescent badges during each single procedure, with one under a lead apron, one under the apron collar and one on the leg during each single procedure. The data obtained from each thermoluminescent badge was reviewed from September 2008 to November 2008 and the annual radiation exposure was subsequently calculated. Results: A total of 505 interventional procedures were performed with C-arm fluoroscopy during three months. The results of this study revealed that the annual radiation exposure was relatively low for both the operator and assistant. Conclusions: With proper precautions, the use of fluoroscopy during interventional pain procedures is a safe practice.

Development and evaluation of modified lead gloves to reduce hand radiation dose during interventional radiological procedures

  • Hyun-Jun Park;Byungdu Jo;Seung-Jae Lee
    • Nuclear Engineering and Technology
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    • v.56 no.7
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    • pp.2781-2789
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    • 2024
  • We developed lead gloves that minimize radiation dose to the operator's hands during interventional radiological procedures and that do not impede the operator's surgical capabilities. Existing lead gloves can protect the operator's hands by shielding radiation, but use of such gloves may impair preception sensitivity, resulting in a reduction in the operator's surgical ability. Accordingly, in this study, we developed modified lead gloves that can reduce radiation dose while maintaining operator sensitivity during procedures by modifying the operator's main surgical finger area in existing lead gloves. To evaluate the performance of developed modified lead gloves, radiation was applied in surgical conditions without gloves and with surgical gloves, lead gloves, and modified lead gloves. The radiation dose was evaluated for each condition. When the modified lead gloves were worn, the degree of shielding was similar to when conventional lead gloves were worn. Based on these results, if the operator wears modified lead gloves during interventional radiological procedures, they will protect the hands from radiation while maintaining physical sensitivity in the hands.

Interventional cardiology in small animals

  • Hyun, Chang-Baig
    • Proceedings of the Korean Society of Veterinary Clinics Conference
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    • 2009.04a
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    • pp.134-136
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    • 2009
  • Interventional cardiology is a branch of the medical specialty of cardiology that deals specifically with the catheter based treatment of structural heart diseases. A large number of procedures can be performed on the heart by catheterization. Although many cardiac diseases requiring open heart surgery are currently treated with cardiac interventions in human medicine, interventional cardiology is relatively recently introduced in veterinary medicine. Therefore, in this lecture, several interventional methods for various diseases of small animals, more focusing on interventional methods in heart diseases will be discussed.

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Role of Interventional Radiologists in Trauma Centers (외상센터에서의 인터벤션 영상의학 의사의 역할)

  • Jeong Ho Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.784-791
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    • 2023
  • Based on statistics available in Korea, trauma centers play a critical role in treatment of patients with trauma. Interventional radiologists in trauma centers perform various procedures, including embolization, which constitutes the basic treatment for control of hemorrhage, although interventions such as stent graft insertion may also be used. Although emergency interventional procedures have been used conventionally, rapid and effective hemorrhage control is important in patients with trauma. Therefore, it is important to accurately understand and implement the concept of damage control interventional radiology, which has gained attention in recent times, to reduce preventable trauma-induced mortality rates.

A Study on the Evaluation of Patient Dose in Interventional Radiology (중재적방사선검사에서 환자 피폭선량에 관한 연구)

  • Park, Hyung-Sin;Lim, Cheong-Hwan;Kang, Byung-Sam;You, In-Gyu;Jung, Hong-Ryang
    • Journal of radiological science and technology
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    • v.35 no.4
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    • pp.299-308
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    • 2012
  • To perform patient dose surveys in major interventional radiography procedures as a mean of inter-institutional comparison and of establishing reference dose levels with the ultimate goal of optimizing patient doses in the field of interventional radiography. We reviewed international patient dose survey data in the literature and measured patient dose in major interventional radiography procedures (TACE, AVF, PTBD, TFCA, GDC embolization). ESD(Entrance Skin Dose) was measured using TLD chips attached to the patient skin and ED(Effective Dose) was calculated using angiography unit-derived DAP. A survey of patient dose in interventional radiography procedures were also performed with a questionnaire for interventional radiologists and we proposed a guideline for optimizing patient doses in the field of interventional radiology. The patient dose survey data in interventional radiography procedures were very rare in literature compared with those in diagnostic radiography procedures. In TACE, the mean ED was 25.43 mSv and the mean ESD was 511.75 mGy. The mean ED of TACE was not high, but the cumulative dose should be checked, due to longer procedure TACE. In TFCA, the mean ED was 22.6 mSv and it was relatively high compared with data of other countries. In GDC embolization, the mean ED was not available, because GDC embolization was performed with old Image-Intensifier-type unit and there has no unit-installed ionization chamber. Also, the mean ESD of GDC embolization was up to 2,264 mGy and further studies are needed to calculate the net ED of GDC embolization. Patient dose occurred during interventional radiography procedures are high related with the difficulty of the procedure, fluoroscopy time, the number of angiographies and the treatment protocol. Therefore, continuous education and efforts should be made to optimize the patient dose in the field of interventional radiology.

Review of National Diagnostic Reference Levels for Interventional Procedures

  • Lee, Min Young;Kwon, Jae;Ryu, Gang Woo;Kim, Ki Hoon;Nam, Hyung Woo;Kim, Kwang Pyo
    • Progress in Medical Physics
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    • v.30 no.4
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    • pp.75-88
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    • 2019
  • Diagnostic reference level (DRL) is employed to optimize the radiation doses of patients. The objective of this study is to review the DRLs for interventional procedures in Korea and abroad. Literature review was performed to investigate radiation dose index and measurement methodology commonly used in DRL determination. Dose area product (DAP) and fluoroscopy time within each major procedure category were systematically abstracted and analyzed. A wide variation was found in the radiation dose. The DAP values and fluoroscopy times ranged 0.01-3,081 Gy·㎠ and 2-16,878 seconds for all the interventional procedures, 8.5-1,679 Gy·㎠ and 32-5,775 seconds for the transcatheter arterial chemoembolization (TACE), and 0.1-686 Gy·㎠ and 16-6,636 seconds for the transfemoral cerebral angiography (TFCA), respectively. The DRL values of the DAP and fluoroscopy time were 238 Gy·㎠ and 1,224 seconds for the TACE and 189 Gy·㎠ and 686 seconds for the TFCA, respectively. Generally, the DRLs of Korea were lower than those of other developed countries, except for the percutaneous transluminal angioplasty with stent in arteries of the lower extremity (LE PTA and stent), aneurysm coil embolization, and Hickman insertion procedures. The wide variation in the radiation doses of the different procedures suggests that more attention must be paid to reduce unnecessary radiation exposure from medical imaging. Furthermore, periodic nationwide survey of medical radiation exposures is necessary to optimize the patient dose for radiation protection, which will ultimately contribute to patient dose reduction and radiological safety.

Measurement of Spatial Dose Distribution for evaluation operator dose during Neuro-interventional Procedures (두경부 질환의 인터벤션 시술 시 시술자의 피폭선량평가를 위한 공간선량측정에 관한 연구)

  • Han, Su-Chul;Hong, Dong-Hee
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.323-328
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    • 2016
  • The spatial dose distribution was measured with ionization chamber as preliminary study to evaluate operator dose and to study dose reduction during neuro-interventional procedures. The zone of operators was divided into four area (45, 135, 225, and 315 degree).We supposed that operator exist on the four area and indicated location of critical organs(eyes, breast, gonad). The spatial doses were measured depending on distance( 80, 100, 120, and 140 cm) and location of critical organs. The spatial doses of area of 225 degree were 114.5 mR/h (eyes location), 143.1 mR/h (breast location) and 147 mR/h (gonad location) in 80 cm. When changed location of x-ray generator, spatial dose increased in $18.1{\pm}10.5%$, averagely. We certified spatial dose in the operator locations, Using the results of this study, It is feasible to protect operator from radiation in neuro-interventional procedures.