Poul Erik Andersen is a Professor and Interventional Radiologist at the University of Southern Denmark,Odense and Odense University Hospital,Denmark.His innovative and expertise is primarily in vascular interventions ...Poul Erik Andersen is a Professor and Interventional Radiologist at the University of Southern Denmark,Odense and Odense University Hospital,Denmark.His innovative and expertise is primarily in vascular interventions where he has introduced and developed many procedures at Odense University Hospital.His significant experience and extensive scientific work has led to many posts in the Danish Society of Interventional Radiology,the European Society of Radiology and the Cardiovascular and Interventional Radiological Society of Europe,where he is a fellow and has passed the European Board of Interventional Radiology-The European qualification in Interventional Radiology.展开更多
Transcatheter arterial embolization as treatment of upper nonvariceal gastrointestinal bleeding is increasingly being used after failed primary endoscopic treatment.The results after embolization have become better an...Transcatheter arterial embolization as treatment of upper nonvariceal gastrointestinal bleeding is increasingly being used after failed primary endoscopic treatment.The results after embolization have become better and surgery still has a high mortality.Embolization is a safe and effective procedure,but its use is has been limited because of relatively high rates of rebleeding and high mortality,both of which are associated with gastrointestinal bleeding and non-gastrointestinal related mortality causes.Transcatheter arterial embolization is a valuable minimal invasive method in the treatment of early rebleeding and does not involve a high risk of treatment associated complications.A multidisciplinary approach is necessary in the treatment of these patients and should comprise gastroenterologists,interventional radiologists,anaesthesiologists,and surgeons to achieve the best possible results.展开更多
The prevalence of chronic kidney disease and peripheral arterial disease is increasing.Thus,it is increasingly problematic to image these patients as the number of patients needing a vascular examination is increasing...The prevalence of chronic kidney disease and peripheral arterial disease is increasing.Thus,it is increasingly problematic to image these patients as the number of patients needing a vascular examination is increasing accordingly.In high-risk patients with impaired kidney function,intravascular administration of iodinated contrast media can result in contrast-induced acute kidney injury and Gadolinium can induce nephrogenic systemic fibrosis(NSF).It is important to identify these highrisk patients by means of se-creatinine/e glomerular filtration rate.The indication for contrast examination should counterbalance the increased risk.One or more alternative examination methods without contrast media,such as CO 2 angiography,Ultrasound/Doppler examination or magnetic resonance angiography without contrast should be considered,but at the same time,allow for a meaningful outcome of the examination.If contrast is deemed essential,the patient should be well hydrated,the amount of contrast should be restricted,the examination should be focused,metformin and diuretics stopped,and renal function monitored.Sodium bicarbonate and N-acetylcysteine are popular but their efficiency is not evidence-based.There is no evidence that dialysis protects patients with impaired renal function from contrast-induced nephropathy or NSF.展开更多
Pulmonary arteriovenous malformations(PAVM) are congenital vascular communications in the lungs.They act as right to left shunts so that the blood running through these malformations is not oxygenated or filtered.Thes...Pulmonary arteriovenous malformations(PAVM) are congenital vascular communications in the lungs.They act as right to left shunts so that the blood running through these malformations is not oxygenated or filtered.These patients are typically hypoxaemic with exercise intolerance and are at high risk of paradoxical emboli to the brain and other organs.These malformations are most commonly seen in hereditary haemorrhagic telangiectasia(HHT)(Mb.Osler-Weber-Rendu syndrome).Nowadays,the generally accepted treatment strategy of first choice is embolization of the afferent arteries to the arteriovenous malformations.It is a minimally invasive procedure and at the same time a lung preserving treatment with a very high technical success,high effectiveness and low morbidity and mortality.Embolization prevents cerebral stroke and abscess as well as pulmonary haemorrhage and further raises the functional level.Embolization is a well-established method of treating PAVM,with a significant effect on oxygenation of the blood.Screening for PAVM in patients at risk is recommended,especially in patients with HHT.展开更多
文摘Poul Erik Andersen is a Professor and Interventional Radiologist at the University of Southern Denmark,Odense and Odense University Hospital,Denmark.His innovative and expertise is primarily in vascular interventions where he has introduced and developed many procedures at Odense University Hospital.His significant experience and extensive scientific work has led to many posts in the Danish Society of Interventional Radiology,the European Society of Radiology and the Cardiovascular and Interventional Radiological Society of Europe,where he is a fellow and has passed the European Board of Interventional Radiology-The European qualification in Interventional Radiology.
文摘Transcatheter arterial embolization as treatment of upper nonvariceal gastrointestinal bleeding is increasingly being used after failed primary endoscopic treatment.The results after embolization have become better and surgery still has a high mortality.Embolization is a safe and effective procedure,but its use is has been limited because of relatively high rates of rebleeding and high mortality,both of which are associated with gastrointestinal bleeding and non-gastrointestinal related mortality causes.Transcatheter arterial embolization is a valuable minimal invasive method in the treatment of early rebleeding and does not involve a high risk of treatment associated complications.A multidisciplinary approach is necessary in the treatment of these patients and should comprise gastroenterologists,interventional radiologists,anaesthesiologists,and surgeons to achieve the best possible results.
文摘The prevalence of chronic kidney disease and peripheral arterial disease is increasing.Thus,it is increasingly problematic to image these patients as the number of patients needing a vascular examination is increasing accordingly.In high-risk patients with impaired kidney function,intravascular administration of iodinated contrast media can result in contrast-induced acute kidney injury and Gadolinium can induce nephrogenic systemic fibrosis(NSF).It is important to identify these highrisk patients by means of se-creatinine/e glomerular filtration rate.The indication for contrast examination should counterbalance the increased risk.One or more alternative examination methods without contrast media,such as CO 2 angiography,Ultrasound/Doppler examination or magnetic resonance angiography without contrast should be considered,but at the same time,allow for a meaningful outcome of the examination.If contrast is deemed essential,the patient should be well hydrated,the amount of contrast should be restricted,the examination should be focused,metformin and diuretics stopped,and renal function monitored.Sodium bicarbonate and N-acetylcysteine are popular but their efficiency is not evidence-based.There is no evidence that dialysis protects patients with impaired renal function from contrast-induced nephropathy or NSF.
文摘Pulmonary arteriovenous malformations(PAVM) are congenital vascular communications in the lungs.They act as right to left shunts so that the blood running through these malformations is not oxygenated or filtered.These patients are typically hypoxaemic with exercise intolerance and are at high risk of paradoxical emboli to the brain and other organs.These malformations are most commonly seen in hereditary haemorrhagic telangiectasia(HHT)(Mb.Osler-Weber-Rendu syndrome).Nowadays,the generally accepted treatment strategy of first choice is embolization of the afferent arteries to the arteriovenous malformations.It is a minimally invasive procedure and at the same time a lung preserving treatment with a very high technical success,high effectiveness and low morbidity and mortality.Embolization prevents cerebral stroke and abscess as well as pulmonary haemorrhage and further raises the functional level.Embolization is a well-established method of treating PAVM,with a significant effect on oxygenation of the blood.Screening for PAVM in patients at risk is recommended,especially in patients with HHT.
