bluuebunny/crossref_metadata_2025_split huggingface dataset:
Luxação total fechada do tálus sem fratura de tornozelo: Relato de caso
Authors: Arellano Rubén Daniel , Arellano Daniel Orlando , Arellano Diego Fernando , Becerra José Ángel , Ramírez José Arturo 
Published: April 2024

ResumoRelatamos o caso de uma mulher de 61 anos que deu entrada no pronto-socorro após cair de uma escada. A paciente foi diagnosticada com luxação talar total fechada, sem fratura do tálus ou do tornozelo. O cirurgião indicou uma redução aberta após uma tentativa frustrada de redução fechada. Aos seis meses de acompanhamento, a paciente relata dor branda e descarga parcial de peso sem desconforto; exames de tomografia computadorizada e ressonância magnética não mostraram evidências de necrose avascular ou colapso ósseo.
Safety and Efficacy of Overdilation of 10 mm Viatorr Transjugular Intrahepatic Portosystemic Shunt Stents Using 12 mm Balloons
Authors: Tahir Muhammad Mohid , Lewis Trevor K. , Ali Aamir , Hsu Michael , Weinstein Jeffrey L. , Ahmed Muneeb , Sarwar Ammar 
Published: April 2024

Abstract
Objective The aim of this study was to evaluate overdilation of 10-mm standard and 8–10 mm controlled-expansion Viatorr stents to 12 mm during transjugular intrahepatic portosystemic shunt (TIPS) placement when insufficient reduction (<50%) in portosystemic gradient (PSG) is achieved with standard 10 mm dilation.
Materials and Methods It is a single-institution, institutional review board-approved, retrospective review of TIPS (2013–2022) to identify patients in the overdilation group (12 mm dilation of a 10-mm stent) and a control group (10 mm dilation of a 10-mm stent) matched for age, indication, stent type, Model for End-Stage Liver Disease (MELD) score, pre-TIPS PSG, and variceal embolization. Stent diameter, technical success, clinical outcomes, and adverse events were assessed for both groups.
Results TIPS was created for the overdilation group (n = 35, 57 ± 11 years, 69% male; MELD: 14 ± 5) and control group (n = 35, 57 ± 11 years, 83% male; MELD: 14 ± 5). Overdilation to 12 mm adequately reduced PSG by more than 50% (55 vs. 65% in the control group, p = 0.11). The stent diameter was larger in the overdilation group on cross-sectional imaging (9.8 ± 0.2 vs. 9.5 ± 0.4 mm, p < 0.001), with an estimated 57% higher volume flow rate (p = 0.002). Patients were followed for a median of 11.3 months (range: 0.03–75) and 15.6 months (range: 0.03–106) in the overdilation and control groups, respectively. There was an equivalent rate of ascites resolution (56 vs. 63%, p = 0.68) and rebleeding (13 vs. 17%, p = 0.82) in the overdilation and control groups, with a similar risk of new-onset hepatic encephalopathy (41 vs. 33%, p = 0.51) and TIPS occlusion (11 vs. 9%, p = 0.69). Overdilation did not result in any instance of stent fracture.
Conclusion Overdilation of 10-mm Viatorr stents with 12 mm balloons may provide benefit by potentially reducing PSG further for patients initially having inadequate PSG reduction with short-term safety.
Exploring the Potentials of Large Language Models in Vascular and Interventional Radiology: Opportunities and Challenges
Authors: Togunwa Taofeeq Oluwatosin , Ajibade Abdulquddus , Uche-Orji Christabel , Olatunji Richard 
Published: April 2024

AbstractThe increasing integration of artificial intelligence (AI) in healthcare, particularly in vascular and interventional radiology (VIR), has opened avenues for enhanced efficiency and precision. This narrative review delves into the potential applications of large language models (LLMs) in VIR, with a focus on Chat Generative Pre-Trained Transformer (ChatGPT) and similar models. LLMs, designed for natural language processing, exhibit promising capabilities in clinical decision-making, workflow optimization, education, and patient-centered care. The discussion highlights LLMs' ability to analyze extensive medical literature, aiding radiologists in making informed decisions. Moreover, their role in improving clinical workflow, automating report generation, and intelligent patient scheduling is explored. This article also examines LLMs' impact on VIR education, presenting them as valuable tools for trainees. Additionally, the integration of LLMs into patient education processes is examined, highlighting their potential to enhance patient-centered care through simplified and accurate medical information dissemination. Despite these potentials, this paper discusses challenges and ethical considerations, including AI over-reliance, potential misinformation, and biases. The scarcity of comprehensive VIR datasets and the need for ongoing monitoring and interdisciplinary collaboration are also emphasized. Advocating for a balanced approach, the combination of LLMs with computer vision AI models addresses the inherently visual nature of VIR. Overall, while the widespread implementation of LLMs in VIR may be premature, their potential to improve various aspects of the discipline is undeniable. Recognizing challenges and ethical considerations, fostering collaboration, and adhering to ethical standards are essential for unlocking the full potential of LLMs in VIR, ushering in a new era of healthcare delivery and innovation.
Combined Treatment of Native Femoropopliteal Occlusions in Chronic Limb-Threatening Ischemia Using Atherectomy Debulking and a New Sirolimus Drug-Coated Balloon (SELUTION SLR)
Authors: Sumner Joseph , Patel Sajal , Theodoulou Iakovos , Thulasidasan Narayanan , Gkoutzios Panos , Ahmed Irfan , Saratzis Athanasios , Diamantopoulos Athanasios 
Published: April 2024

Abstract
Objective The aim of this study was to report the primary outcomes of a pilot study investigating the safety and efficacy of sirolimus drug-coated balloons (SELUTION) for endovascular postatherectomy treatment of native occluded femoropopliteal lesions in patients with chronic limb-threatening ischemia (CLTI).
Materials and Methods This study analyzes a cohort of CLTI patients with femoropopliteal artery occlusions treated with combined rotational atherectomy and postatherectomy angioplasty using the SELUTION device. The primary outcome measures were amputation-free survival (AFS) defined as time to major limb (above ankle) amputation of the index leg or death from any cause. Secondary outcome measures included technical success, overall survival, major amputation of the index leg, major adverse limb event (MALE) defined as major amputation or any further major revascularization intervention of the treated segment during the follow-up period and primary patency at 12 months.
Results Between April 2021 and January 2022, nine patients (mean age: 64.0 ± 8.4, 66.7% male) with femoropopliteal occlusive lesions (mean lesion length: 141.1mm, range: 40–400) were treated with the above-combined approach. Technical success was 100%. At 12 months, the AFS was 88.9%, with one death and zero major amputations (88.9% survival and 100% limb salvage, respectively); only two patients (22.2%) suffered a MALE; primary patency was 75%. No adverse events related to the sirolimus drug-coated balloon nor to the atherectomy device were observed.
Conclusion Combining sirolimus drug-coated balloon and atherectomy for treatment of femoropopliteal occlusions in CLTI patients is a safe and effective approach achieving satisfactory patency and adverse event rates.
Wide-Neck Renal Artery Aneurysm Managed with Neuro-Retrievable Stent-Assisted Coil Embolization
Authors: Choksi Eshani J. , Kaushik Shivam , Tummala Venkat 
Published: April 2024

AbstractEndovascular management of narrow-necked aneurysms has traditionally been with coil embolization; however, wide-necked aneurysms have been more difficult to treat due to risk of distal coil migration or intrusion into a parent vessel. We describe the case of a 76-year-old female who presented with a left-sided renal artery aneurysm and 11 mm aneurysm neck. Renal arteriography of the superior pole branch was performed, lower pole was stented, and a retrievable stent was placed in the inferior branch for the purpose of stent-assisted coiling. Penumbra detachable coils were deposited through the stent struts to jail them in with successful embolization of the aneurysm. Endovascular treatment of wide-neck renal artery aneurysms has the potential to be a successful treatment alternative in patients where surgical intervention is contraindicated. Additional studies should be performed to determine the versatility and extent of success in coil embolization for wide-neck aneurysms.
Outcome of Secondary Interval Rheolytic Thrombectomy after Localized Intra-Arterial Catheter-Directed Thrombolysis through Power-Pulse Spray Technique in Cases of Partially Successful or Failed Primary Rheolytic Thrombectomy
Authors: Sahoo Biswajit , Mohanty Satyapriya , Sathia Siddhartha , Mahapatra Rudra Pratap , Nayak Manoj Kumar , Panda Ritesh , Panigrahi Manas Kumar , Mishra Sourav Kumar , Sasmal Prakash Kumar , Kumar Pankaj , Ali S. Manawar , Deep Bag Nerbadyswari , Majumdar Saroj Kumar Das , Barik Sandip Kumar , Devi Sujata , Pitchaimuthu Arunprakash 
Published: April 2024

Abstract
Objectives The aim of this study was to evaluate the safety and effectiveness of secondary interval AngioJet rheolytic thrombectomy after localized intra-arterial catheter-directed thrombolysis (CDT) through power-pulse spray (PPS) technique in partially successful or failed primary AngioJet rheolytic thrombectomy cases of acute and subacute peripheral artery thrombosis.
Materials and Methods This retrospective study included 12 acute (< 2 weeks) and subacute (2–4 weeks) peripheral arterial thrombosis patients who underwent primary thrombectomy alone without CDT and patients who received secondary thrombectomy after CDT through PPS at our institute between May 2022 and December 2022. Technical success, procedure-related complications (local and systemic), amputations, and 1-year patency were evaluated.
Results The angiographic success after primary thrombectomy was evaluated in 12 patients (9 acute and 3 subacute), and the results were categorized into three groups. Of 12 patients, complete success, partial success, and failure were noted in three (25%), five (41.7%), and four (33.3%) patients, respectively, after primary thrombectomy alone. Complete luminal patency was restored in all nine cases of partial success and failure in postprimary thrombectomy through adjunctive PPS thrombolysis and secondary thrombectomy. Technical and clinical success was achieved in all patients (100%). Transient hemoglobinuria was seen in five (41.7%) patients, and all had long-segment occlusion. At 1 year follow-up, no reocclusion, limb loss, or death was noted.
Conclusion Complete success after primary thrombectomy was more likely in the setting of short-segment occlusion and small-caliber arteries. In patients with partial success or failure after the primary thrombectomy alone, secondary thrombectomy may be performed after the adjuvant PPS thrombolysis to achieve complete recanalization.
Antithrombotic Therapy for Inferior Vena Cava Stenting of Malignant Inferior Vena Cava Syndrome: A Questionnaire Study of Japan Interventional Radiology Study Group (JIVROSG)
Authors: Ozawa Mizuki , Sone Miyuki , Sugawara Shunsuke , Arai Yasuaki , Kusumoto Masahiko 
Published: April 2024

Abstract
Purpose The aim of this study was to evaluate the differences in antithrombotic therapy policies for inferior vena cava (IVC) stent placement among institutions and interventional radiologists in Japan.
Materials and Methods The cross-sectional online-based questionnaire was conducted between December 2022 and January 2023, and a total of 114 institutions were included in this study. The questionnaire contained eight questions that were grouped into three sections: (1) whether IVC stents have been performed or not, (2) the number of IVC stent placements, and (3) the basic strategy of antithrombotic therapy for pre-, intra-, and post-IVC stent placement.
Results Of the 114 institutions, 38 responses (33%) were collected. Twenty-four of the 38 institutions (63%) had performed IVC stent placement during the study period. The mean number of IVC stent placements during the study period was 3.4 cases per institution. The most frequently selected antithrombotic therapeutic strategies pre-, intra-, and post-stenting were no antithrombotic therapy (62.5%), anticoagulation therapy (54.2%), and no antithrombotic therapy (41.7%).
Conclusion This study has revealed there is no consensus regarding antithrombotic therapy for IVC stent placement in Japan. The results of this study may contribute to our understanding of the status of antithrombotic therapy for IVC stent placement. Future prospective studies are warranted to clarify the periprocedural antithrombotic therapy for IVC stent placement.
Pharmacokinetics of Edoxaban 15 mg in Very Elderly Patients with Nonvalvular Atrial Fibrillation: A Subanalysis of the ELDERCARE-AF Study
Authors: Yamashita Takeshi , Igawa Yoshiyuki , Fukuzawa Masayuki , Hayashi Takuya , Hennig Stefanie , Okumura Ken 
Published: April 2024

Background We evaluated the pharmacokinetics (PK) of low-dose (15 mg) edoxaban in very elderly patients (≥80 years) with nonvalvular atrial fibrillation (NVAF) and high bleeding risk.
Methods This subanalysis of the phase 3, randomized, double-blind, placebo-controlled, multicenter ELDERCARE-AF study evaluated edoxaban plasma concentrations and compared them with the Japanese population of the ENGAGE AF-TIMI 48 and Japanese severe renal impairment (SRI) studies.
Results The PK analysis population included 451 patients, 53.8% of whom concomitantly used antiplatelet drugs, 41.0% had SRI, and 38.0% had low body weight. Edoxaban plasma concentrations at trough and 1 to 3 hours post-dose in ELDERCARE-AF were 17.3 ± 13.9 (n = 427) and 93.3 ± 57.8 ng/mL (n = 447), respectively. These values were slightly higher than the 15 mg group in ENGAGE AF-TIMI 48 (n = 79; 12.4 ± 12.1 and n = 115; 78.7 ± 45.0 ng/mL, respectively), lower than the ENGAGE AF-TIMI 48 high-dose reduced to 30 mg group (n = 83; 25.1 ± 36.6 and n = 111; 150 ± 91.6 ng/mL, respectively), but similar to the Japanese SRI study (n = 39; 18.4 ± 11.2 and n = 40; 96.8 ± 48.3 ng/mL, respectively). ELDERCARE-AF patients with SRI and low body weight (≤45 kg) had higher concentrations than those without, and those taking antiplatelet drugs had lower concentrations than those who were not.
Conclusion PK data support edoxaban 15 mg once daily for very elderly NVAF patients with high bleeding risk, with caution for patients with SRI and/or low body weight.
Trans-splenic Approach for Transjugular Intrahepatic Portosystemic Shunt (TIPS) Creation in Patients with Portal Vein Thrombosis
Authors: Boumezrag Maryam , Lynskey George , Sabri Saher 
Published: April 2024

Abstract
Purpose The aim of this study was to evaluate the safety and efficacy of using a trans-splenic approach for transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with portal vein thrombosis. (PVT).
Material and Methods A retrospective review was performed on 36 consecutive patients with PVT who underwent TIPS using a trans-splenic approach from February 2018 to June 2021. Preprocedural data including demographic information and Model for End-Stage Liver Disease (MELD) scores were obtained. Outcomes measured included technical success, clinical success, complications, and survival.
Results Technical success was achieved in 32 of 36 patients (89%). During the follow-up period, 16 of 32 (50%) required secondary TIPS interventions, most of which were planned as part of a staged procedure. 30/32 (94%) had stent patency on their most recent follow-up, with a median follow-up of 164 days. No patients had variceal bleeding following TIPS. 12 of 32 (38%) patients underwent successful transplant after TIPS. Anatomical portal vein end-to-end anastomosis was achieved in 11/12 (92%) patients.
Conclusion The trans-splenic approach to TIPS is a reliable alternative to traditional TIPS in patients with PVT and provides high technical and clinical success rates. This technique can also be utilized to improve future liver transplant outcomes by facilitating anatomic portal vein end-to-end anastomoses.
Effects of onabotulinum toxin type A injections in patients with Meige's syndrome
Authors: Duarte Alexia , Coutinho Léo , Germiniani Francisco Manoel Branco , Teive Hélio Afonso Ghizoni 
Published: April 2024

Abstract
Background Meige's syndrome is a type of facial dystonia characterized by the simultaneous occurrence of blepharospasm and oromandibular dystonia. Although botulinum toxin type A (OBTA) injections are the standard treatment, evidence of their effectiveness and safety in this scenario is still lacking.
Objective Our research aimed to evaluate the improvement and occurrence of side effects following injections of onabotulinum toxin type A (OBTA) in patients with Meige's syndrome.
Methods Patients with Meige's syndrome undergoing botulinum toxin injections were enrolled in this study. We assessed dystonia intensity before and 14 days after OBTA injection using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) to measure the response of symptoms in the eyes (blepharospasm) and mouth (oromandibular dystonia). Other variables, such as dosage, side effects, and demographic data, were also recorded.
Results The study included 41 participants, with a mean age of 67.7 years and a female-to-male ratio of 3.5:1. The mean BFMDRS score before the injections was 8.89, and after 14 days, it was 2.88. The most reported side effect was ptosis, with a 7.3% incidence. OBTA significantly reduced dystonia severity (p < 0.0001). The clinical response for the blepharospasm component was superior to the oromandibular dystonia component.
Conclusion Our results support that OBTA seems to be an effective and safe therapeutic option for treating Meige's syndrome. The effect of OBTA was more pronounced in the treatment of blepharospasm than in oromandibular dystonia.
The sural-sparing pattern in clinical variants and electrophysiological subtypes of Guillain-Barré syndrome
Authors: Castro Vinicius Furtado da Silva , Oliveira Roberto Teodoro Gurgel de , Santos João Daniel Lima dos , Mendes Ramon de Souza , Pessoa Neto Agábio Diógenes , Fidelix Emanuela Coriolano , Dourado Júnior Mário Emílio Teixeira 
Published: April 2024

Abstract
Background Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis worldwide and can be classified into electrophysiological subtypes and clinical variants.
Objective This study aimed to compare the frequency of the sural-sparing pattern (SSP) in subtypes and variants of GBS.
Methods This retrospective cohort study analyzed clinical and electrophysiological data of 171 patients with GBS hospitalized in public and private hospitals of Natal, Rio Grande do Norte, Brazil, between 1994 and 2018; all cases were followed up by the same neurologist in a reference neurology center. Patients were classified according to electrophysiological subtypes and clinical variants, and the SSP frequency was compared in both categories. The exact Fisher test and Bonferroni correction were used for statistical analysis.
Results The SSP was present in 53% (57 of 107) of the patients with acute inflammatory demyelinating polyradiculoneuropathy (AIDP), 8% (4 of 48) of the patients with axonal subtypes, and 31% (5 of 16) of the equivocal cases. The SSP frequency in the AIDP was significantly higher than in the axonal subtypes (p < 0.0001); the value was kept high after serial electrophysiological examinations. Only the paraparetic subtype did not present SSP.
Conclusion The SSP may be present in AIDP and axonal subtypes, including acute motor axonal neuropathy, but it is significantly more present in AIDP. Moreover, the clinical variants reflect a specific pathological process and are correlated to its typical electrophysiological subtype, affecting the SSP frequency.
Changing Nature of Endoleak in a Patient of Superior Mesenteric Artery Aneurysm Treated with Endovascular Stent Graft
Authors: Nandi Debanjan , Malhi Amarinder Singh , Kumar Sanjeev 
Published: April 2024

AbstractA man in his early thirties with complaints of abdominal pain for 1 week was diagnosed with a fusiform, partially thrombosed aneurysm of the superior mesenteric artery (SMA), which was treated with an endovascular stent graft. Three months later, when the patient again presented with abdominal pain, there was an endoleak of type III as detected by computed tomography and digital subtraction angiography. This was treated by in-stent balloon angioplasty with complete resolution of the endoleak. The patient again presented 1 month later with abdominal pain, with a residual sac posterior to the stent, detected on digital subtraction angiography, which was confirmed to be type II endoleak as it was getting filled by one of the jejunal branches of SMA. This was treated by glue embolization of the patent component of the aneurysm after selectively cannulating the branch vessel. This case highlights changing nature of endoleak as a complication of SMA stenting.
Bilateral Uterine Artery Embolization as a Rescue Method in a Rare Case of Cervical Ectopic Pregnancy
Authors: Gupta Pooja , Rekha B. S. V. B. , Yadav Deep , Rasheed Mohd , Jain Charu 
Published: April 2024

AbstractCervical pregnancy, being the second rarest form of ectopic pregnancy after abdominal pregnancy, is a difficult clinical entity to diagnose and manage in a young primigravida with no identifiable risk factors or associated symptoms. Further, early intervention is of utmost importance owing to the deleterious complications and high mortality associated with it if not addressed to. It is also difficult to choose a particular management approach for this out of the available options. We report a case of 23-year-old primigravida with 8 weeks of gestation, asymptomatic and with no underlying risk factors, diagnosed with cervical pregnancy during a routine antenatal scan. She was successfully managed with bilateral uterine artery embolization in conjunction with systemic methotrexate followed by suction and evacuation.
Understanding Caudal Dysplasia Sequence: Three Case Reports
Authors: Kansal Monica , Dasgupta Sanheeta , Aujla Tanveer , Gupta Manju , Kumar Gaurav 
Published: April 2024

AbstractCaudal dysplasia or caudal regression sequence is a congenital malformation that is characterized by maldevelopment of the lower half of the body with variable involvement of the gastrointestinal, genitourinary, skeletal, and nervous system. Most cases are sporadic and associated with the presence of a single umbilical artery. We report three cases with varying morphological spectrum of caudal dysplasia diagnosed during the first trimester ultrasound.