Search

Your search keyword '"Michael D. Darcy"' showing total 5 results
Start Over Author "Michael D. Darcy" Language english
5 results on '"Michael D. Darcy"'

1. Cryoablation of low-flow vascular malformations

Author

Raja S. Ramaswamy, Tatulya Tiwari, Michael D. Darcy, Seung K. Kim, Olaguoke Akinwande, Niloy Dasgupta, and Carlos J. Guevara

Subjects
Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

PURPOSEWe aimed to evaluate the safety and effectiveness of cryoablation in the treatment of low-flow malformations, specifically venous malformation (VM) and fibroadipose vascular anomaly (FAVA).METHODSWe conducted a retrospective review of 11 consecutive patients with low-flow malformations (14 lesions; 9 VM, 5 FAVA), median lesion volume 10.8 cm3, (range, 1.8–55.6 cm3) with a median age of 19 years (range, 10–50 years) who underwent cryoablation to achieve symptomatic control. Average follow-up was at a median of 207 days postprocedure (range, 120–886 days). Indications for treatment included focal pain and swelling. Technical success was achieved if the cryoablation ice ball covered the region of the malformation that corresponded to the patient’s symptoms. Clinical success was considered complete if all symptoms resolved and partial if some symptoms persisted but did not necessitate further treatment.RESULTSThe technical success rate was 100%. At 1-month follow-up, 13 of 14 lesions (93%) had a complete response and one (7%) had a partial response. At 6-month follow-up 12 of 13 (92%) had a complete response and 1 (8%) had a partial response. A total of 6 patients underwent primary cryoablation. Out of 9 VM cases, 7 had prior sclerotherapy and 2 had primary cryoablation. Out of the 5 FAVA cases, 1 had prior sclerotherapy and the remaining 4 cases underwent primary cryoablation. There were 3 minor complications following cryoablation including 2 cases of skin blisters and 1 case of transient numbness. These complications resolved with conservative management.CONCLUSIONCryoablation is safe and effective in the treatment of low-flow vascular malformations, either after sclerotherapy or as primary treatment.

Published
2019
Full Text
View/download PDF

2. Hemobilia Due to Cystic Artery Pseudoaneurysm: A Rare Late Complication of Laparoscopic Cholecystectomy

Author

Ricardo Badillo, Vladimir Kushnir, and Michael D. Darcy

Subjects
medicine.medical_specialty, Percutaneous, medicine.medical_treatment, Cystic artery pseudoaneurysm, Case Report, Cystic artery, 03 medical and health sciences, Pseudoaneurysm, 0302 clinical medicine, medicine.artery, medicine, Embolization, cardiovascular diseases, Computed tomography angiography, Endoscopic retrograde cholangiopancreatography, medicine.diagnostic_test, business.industry, Biliary, General Medicine, medicine.disease, Surgery, 030220 oncology & carcinogenesis, cardiovascular system, 030211 gastroenterology & hepatology, Cholecystectomy, business
Abstract

We discuss a patient with late presentation of hemobilia following cholecystectomy, which is unusual because pseudoaneurysm caused by vascular injury during surgery typically presents soon after surgery. Endoscopic retrograde cholangiopancreatography revealed a large blood clot arising from the biliary orifice with subsequent computed tomography angiography diagnosing a large pseudoaneurysm in the region of the cystic artery adjacent to the cholecystectomy clips. Embolization was performed via direct percutaneous puncture of the pseudoaneurysm.

Published
2017

3. Error by Distraction

Author

Michael D. Darcy

Subjects
Information retrieval, Text mining, Computer science, business.industry, Distraction, MEDLINE, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, business, Article
Published
2012

5. Management of excluded bile ducts in paediatric orthotopic liver transplant recipients of technical variant allografts

Author

Michelle Nadler, Christopher D. Anderson, Kendra D. Conzen, Michael D. Darcy, William C. Chapman, Yumirle P. Turmelle, Jeffrey A. Lowell, James R. Duncan, and Ross W. Shepherd

Subjects
Male, Reoperation, medicine.medical_specialty, Orthotopic liver transplantation, medicine.medical_treatment, Liver transplantation, biliary complications, Catheterization, Cholangiography, Cholestasis, excluded bile duct, medicine, Humans, Transplantation, Homologous, Child, Retrospective Studies, Missouri, Hepatology, medicine.diagnostic_test, Bile duct, business.industry, technical variant allograft, Graft Survival, Gastroenterology, Orthotopic Liver Transplant, Infant, Retrospective cohort study, Original Articles, medicine.disease, Decompression, Surgical, Tissue Donors, Surgery, Liver Transplantation, Transplantation, medicine.anatomical_structure, Treatment Outcome, surgical procedures, operative, Child, Preschool, Drainage, Female, Stents, business, paediatric liver transplantation
Abstract

BackgroundA strategy to increase the number of size- and weight-appropriate organs and decrease the paediatric waiting list mortality is wider application of sectional orthotopic liver transplantation (OLT). These technical variants consist of living donor, deceased donor reduced and split allografts. However, these grafts have an increased risk of biliary complications. An unusual and complex biliary complication which can lead to graft loss is inadvertent exclusion of a major segmental bile duct. We present four cases and describe an algorithm to correct these complications.MethodsA retrospective review of the paediatric orthotopic liver transplantation database (2000–2010) at Washington University in St. Louis/St. Louis Children's Hospital was conducted.ResultsSixty-eight patients (55%) received technical variant allografts. Four complications of excluded segmental bile ducts were identified. Percutaneous cholangiography provided diagnostic confirmation and stabilization with external biliary drainage. All patients required interval surgical revision of their hepaticojejunostomy for definitive drainage. Indwelling biliary stents aided intra-operative localization of the excluded ducts. All allografts were salvaged.DiscussionAggressive diagnosis, percutaneous decompression and interval revision hepaticojejunostomy are the main tenets of management of an excluded bile duct. Careful revision hepaticojejunostomy over a percutaneous biliary stent can result in restoration of biliary continuity and allograft survival.

Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results