1. Transarterial embolization of the external carotid artery in the treatment of life-threatening haemorrhage following blunt maxillofacial traumaČrt Langel, Dimitrij Lovrič, Urša Boneš, Tomislav Mirković, Primož Gradišek, Anita Mrvar Brečko, Katarina Šurlan Popović, 2020, review article Abstract: Background. Severe bleeding after blunt maxillofacial trauma is a rare but life-threatening event. Non-responders to conventional treatment options with surgically inaccessible bleeding points can be treated by transarterial embolization (TAE) of the external carotid artery (ECA) or its branches. Case series on such embolizations are small; considering the relatively high incidence of maxillofacial trauma, the ECA TAE procedure has been hypothesized either underused or underreported. In addition, the literature on the ECA TAE using novel non-adhesive liquid embolization agents is remarkably scarce.Patients and methods. PubMed review was performed to identify the ECA TAE literature in the context of blunt maxillofacial trauma. If available, the location of the ECA injury, the location of embolization, the chosen embolization agent, and efficacy and safety of the TAE were noted for each case. Survival prognostic factors were also reviewed. Additionally, we present an illustrative TAE case using a precipitating hydrophobic injectable liquid (PHIL) to safely and effectively control a massive bleeding originating bilaterally in the ECA territories.Results and conclusions. Based on a review of 205 cases, the efficacy of TAE was 79.4-100%, while the rate of major complications was about 2-4%. Successful TAE haemostasis, Glasgow Coma Scale score >- 8 at presentation, injury severity score <- 32, shock index <- 1.1 before TAE and <- 0.8 after TAE were significantly correlated with higher survival rate. PHIL allowed for fast yet punctilious application, thus saving invaluable time in life-threatening situations while simultaneously diminishing the possibility of inadvertent injection into the ECA-internal carotid artery (ICA) anastomoses.
Keywords: maxillofacial trauma, external carotid artery injury, intractable bleeding
Published in DiRROS: 12.07.2024; Views: 62; Downloads: 33
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4. Dynamic susceptibility contrast enhanced (DSC) MRI perfusion and plasma cytokine levels in patients after tonic-clonic seizuresTatjana Filipovič, Katarina Šurlan Popović, Alojz Ihan, David B. Vodušek, 2017, original scientific article Abstract: Background Inflammatory events in brain parenchyma and glial tissue are involved in epileptogenesis. Blood concentration of cytokines is shown to be elevated after tonic-clonic seizures. As a result of inflammation, blood-brain barrier leakage occurs. This can be documented by imaging techniques, such is dynamic susceptibility contrast enhanced (DSC) MRI perfusion. Our aim was to check for postictal brain inflammation by studying DSC MRI perfusion and plasma level of cytokines. We looked for correlations between number and type of introducing seizures, postictal plasma level of cytokines and parameters of DSC MRI perfusion. Furthermore, we looked for correlation of those parameters and course of the disease over one year follow up. Patients and methods We prospectively enrolled 30 patients, 8%24 hours after single or repeated tonic-clonic seizures. Results 25 of them had normal perfusion parameters, while 5 had hyperperfusion. Patients with hyperperfusion were tested again, 3 months later. Two of 5 had hyperperfusion also on control measurements. Number of index seizures negatively correlated with concentration of proinflammatory cytokines IL-10, IFN-[gamma] and TNF-[alpha] in a whole cohort. In patients with hyperperfusion, there were significantly lower concentrations of antiinflammatory cytokine IL-4 and higher concentrations of proinflammatory TNF-[alpha]. Conclusions Long lasting blood- brain barrier disruption may be crucial for epileptogenesis in selected patients.
Keywords: cytokines, blood-brain barrier, tonic-clonic seizures
Published in DiRROS: 03.06.2024; Views: 162; Downloads: 124
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5. Non-contrast computed tomography in the diagnosis of cerebral venous sinus thrombosisJernej Avsenik, Janja Pretnar-Oblak, Katarina Šurlan Popović, 2016, original scientific article Abstract: Due to the diversity of underlying factors and the absence of a uniform treatment approach, diagnosis and management of patients with cerebral venous sinus thrombosis (CVST) remain a challenging task.1 CVST represents 0.5% to 1% of all strokes and affects approximately 5 patients per million every year, but has a higher frequency among younger patients. Typical acquired risk factors include recent surgery, trauma, pregnancy, postpartum state, antiphospholipid syndrome, cancer and use of oral contraceptives. Cases of inherited thrombophilia include Antithrombin III, Protein C and Protein S deficiency, factor V Leiden positivity, prothrombin gene mutation and hyperhomocisteinemia. Infection of parameningeal spaces (ears, paranasal sinuses, oral cavity, face and neck) is common cause of CVST in pediatric population but rare in adults. The symptoms of CVST are not specific. The most common complaint is headache which occurs in up to 90% of patients. Additionally, abnormal vision, any of the symptoms of stroke and seizures have been described. In the past D-dimer levels appeared to be of value as an initial screening test. A study in 2004 evaluated the sensitivity of D-dimer to be 97.1% and specificity 99.1%.8 However, later studies showed that up to 10% of patients with CVST have a normal D-dimer. As it is fast, affordable and widely available, non-contrast computed tomography (NCCT) is the most frequently performed imaging study for evaluation of patients with new headache, focal neurological abnormalities, seizure, or change in mental status. A typical imaging finding in patients with CVST is direct visualization of a hyperattenuating thrombus in the occluded sinus (dense sinus sign). Occasionally, NCCT may only show indirect signs of thrombosis, including diffuse brain edema and parenchymal hemorrhage. Sensitivity of NCCT in the diagnosis of CVST was previously considered rather poor. However, using modern multidetector row CT scanners, recent studies report higher sensitivity and specificity values. In addition, Buyck et al. suggest measurement of the venous sinus attenuation to increase the diagnostic yield of the examination. Therefore, the goal of the present study was to evaluate the diagnostic accuracy of NCCT in the diagnosis of CVST in the emergency setting
Keywords: cerebral venous sinus thrombosis, computed tomography, stroke, radiologija, računalniška tomografija, diagnostika, možganski venski sinusi
Published in DiRROS: 09.05.2024; Views: 162; Downloads: 136
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8. Analysis of risk factors for perifocal oedema after endovascular embolization of unruptured intracranial arterial aneurysmsSnezana Lukic, Slobodan Janković, Katarina Šurlan Popović, Dušan Dragič Banković, Peter Popović, Milan Mijailović, 2015, original scientific article Keywords: intracranial aneurysms, enovascular embolization, perianeurysmal oedema, hypertension
Published in DiRROS: 16.04.2024; Views: 215; Downloads: 77
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9. Imaging findings in bisphosphonate-induced osteonecrosis of the jawsKatarina Šurlan Popović, Miha Kočar, 2010, original scientific article Keywords: rak (medicina), bisfosfonati, radiologija, zdravljenje, čeljustnica, nekroze, diagnostika
Published in DiRROS: 18.03.2024; Views: 236; Downloads: 67
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10. Interventional radiological management of complications in renal transplantationPeter Popović, Katarina Šurlan Popović, 2004, review article Abstract: Background. The most frequent radiologically evaluated and treated complications in renal transplantation are perirenal and renal fluid collection and abnormalities of the vasculature and collecting system. Renal and perirenal fluid collection is usually treated successfully with percutaneous drainage. Doppler US, MRA and digital subtraction angiography (DSA) are most important in the evaluation of vascular complications of renal transplantation and management of the endovaseular therapy. Conclusions. Stenosis, the most common vascular complication, occurs in 1% to 12% of transplanted renal arteries and represents a potentially curable cause of hypertension following transplantation and/or renal dysfunction. Treatment with percutaneous transluntinal renal angioplasty (PTRA) or PTRA with stent has been technically successful in 82 to 92% of the cases, and graft salvage rate has ranged from 80-100%. Complications such as arterial and vein thrombosis are uncommon. Intrarenal A/V fistulas and pseudoaneurysms are occasionally seen after biopsy, the treatment reguires superselective embolisation. Urologic complications are relatively uncommon; they consist predominantly of the urinary leaks and urethral obstruction. Interventional treatment consists of percutaneous nephrostomy, balloon dilation, insertion ofthe double J stents, metallic stent placement and external drainage of the extrarenal collections. The aim of the paper is to review the role of interventional radiology in the management of complications in renal transplantation.
Published in DiRROS: 13.02.2024; Views: 245; Downloads: 66
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