BackgroundSeveral peritoneal dialysis catheter (PDC) placement techniques have been described. The objective of this study was to compare the fluoroscopy and ultrasound guidance technique with the laparoscopic technique.MethodsWe retrospectively reviewed the medical records of 260 patients who had their first PDC placed between January 2005 and June 2016. We compared the outcomes of the fluoroscopic and ultrasound-guided catheter placement technique (radiologic group, n = 50) with the laparoscopic catheter placement technique (laparoscopic group, n = 190). The primary endpoint was complication-free catheter survival at 365 days. Secondary endpoints were complication-free catheter survival at 90 days, overall catheter survival at 90 and 365 days, median days to first complication and median days to catheter removal.ResultsIn the radiologic group, the complication-free catheter survival at 90 and 365 days was 64% and 48%, respectively, while in the laparoscopic group it was 71% (P = 0.374) and 53% (P = 0.494), respectively. Catheter malfunction was significantly higher in the laparoscopic group (30%) compared with the radiologic group (16%, P = 0.048). The overall catheter survival at 90 and 365 days was 76% and 52%, respectively, in the radiologic group, while in the laparoscopic group it was 88% (P = 0.0514) an 48% (P = 0.652), respectively. There was no significant difference in the median days to first complication and the median days to catheter removal between the two groups (P = 0.71).ConclusionThe technique of fluoroscopic and ultrasound-guided PDC placement is a clinically effective and safe alternative to laparoscopic catheter placement with similar survival and complication rates.

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Background Computed tomography (CT) perfusion was found to be useful in assessing treatment response in a variety of cancers through the evaluation in the arterial perfusion changes. We investigated the performance of CT perfusion parameters for assessment of hepatocellular carcinoma (HCC) response to radiofrequency ablation (RFA) and trans-arterial chemoembolization (TACE). We conducted a prospective diagnostic test accuracy study that recruited 70 HCC patients who were scheduled to undergo TACE or RFA. For each dynamic CT scan acquisition, four single perfusion CT image maps were generated, including functional maps of blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). Results In TACE-treated lesions, the BV achieved a sensitivity and specific of 100% and 83.3%, at a cutoff level of ≤ 122 ml/min/100 gm, for responders. Likewise, at a cutoff level of > 10 s, transit time had a sensitivity of 90.5% and specificity of 100%. At a cutoff level of ≤ 14 ml/min/100 gm, the PS had a sensitivity of 100% and specificity of 83.33% for responders. In RFA-treated lesions, at a cutoff level of ≤ 170 ml/min/100 gm and ≤ 11 ml/100 gm, the BF and BV had a sensitivity of 100% and specificity 100%, respectively, for responders. At a cutoff level of ≤ 11 ml/min/100 gm, PS had a sensitivity 77.27% and specificity 80%. Conclusions The present study confirms the feasibility of CT perfusion for assessment of response to TACE and RFA among patients with HCC.

Conclusions: Declotting procedures were significantly more effective in AVFs improving their PAPP results over time. None of the main categorical methods described in literature had significantly better results over the other.

Conclusions: Declotting procedures were significantly more effective in AVFs improving their PAPP results over time. None of the main categorical methods described in literature had significantly better results over the other.