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ACR appropriateness criteria® thoracic venous occlusions-suspected superior vena cava syndrome
No full textSuperior vena cava (SVC) syndrome occurs in approximately 15,000 people in the United States each year. It most commonly occurs secondary to thoracic malignancies, mostly primary lung cancer and lymphoma. The cause is occlusion of the SVC or brachiocephalic veins. The following recommendations for initial imaging evaluation of acute or chronic SVC syndrome are presented. Contrast-enhanced chest CT scans, particularly CT angiography/venography, with or without simultaneous inclusion of the neck are recommended studies. MRI with contrast and MR venography/MRA chest with or without contrast are also recommended studies. The recommended CT and MR studies work well to diagnose and evaluate the cause and extent of superior vena cava or brachiocephalic vein occlusion. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation
Leadless versus transvenous dual-chamber pacemakers: Real-world evidence from AVEIR DR coverage with evidence development study
No full textBackground: AVEIR DR, an industry-first dual-chamber leadless pacemaker (LP), provides continuous atrioventricular synchrony through implant-to-implant (i2i) communication between atrial and ventricular LP devices. It is important to evaluate the early real-world comparative safety of AVEIR DR LP.
Objective: To compare complications and mortality between AVEIR DR LP and dual-chamber transvenous pacemakers (TP).
Methods: De novo LP and TP patients were identified in Medicare Fee-for-Service claims (October 2023 and December 2024). Outcomes were 30-day and 6-month complications, reinterventions, heart failure hospitalizations, and all-cause mortality. Comparisons were adjusted for demographics, comorbidities, and hospital encounter characteristics.
Results: Compared to TP (N = 77 422, age = 79.6 ± 7.5), LP patients (N = 759, age = 78.5 ± 7.8) had a higher comorbidity index, more dialysis dependence, end-stage renal disease, and atrial fibrillation. Adjusted 30-day overall complications (7.9% vs. 9.2%; odds ratio [OR] 0.85, p = 0.36) and mortality (1.8% vs. 1.5%; hazard ratio [HR] 1.21, p = 0.47) were comparable, while device-related complications (2.0% vs. 3.9%; OR 0.50, p \u3c 0.01) were lower with LP. Adjusted 6-month overall complications (4.1% vs. 6.9%; HR 0.59, p \u3c 0.01), device-related complications (2.8% vs. 5.9%; HR 0.48, p \u3c 0.01), and device reinterventions (2.1% vs. 4.3%; HR 0.49, p \u3c 0.01) were reduced with LP, with no difference in mortality (6.6% vs. 5.6%; HR 1.18, p = 0.43) and heart failure hospitalizations (3.8% vs. 4.1%; HR 0.91, p = 0.65).
Conclusion: Despite a higher comorbidity burden, AVEIR DR LP had significantly fewer device-related complications, overall 6-month complications, and device reinterventions compared to TP, with similar overall 30-day complications, mortality, and heart failure hospitalizations
Flow gradients in severe aortic stenosis and preserved ejection fraction: A 10-year transcatheter aortic valve replacement study
No full textInside Aurora Sinai Medical Center, 2002 December
No full textAurora Sinai Medical Center, Milwaukee, WI: Internal employee newsletter with workplace anniversaries, news, and events.https://institutionalrepository.aah.org/alldocuments/2246/thumbnail.jp
Inside Aurora Sinai Medical Center, 2002 July
No full textAurora Sinai Medical Center, Milwaukee, WI: Internal employee newsletter with workplace anniversaries, news, and events.https://institutionalrepository.aah.org/alldocuments/2243/thumbnail.jp
Inside Aurora Sinai Medical Center, 2004 April
No full textAurora Sinai Medical Center, Milwaukee, WI: Internal employee newsletter with workplace anniversaries, news, and events.https://institutionalrepository.aah.org/alldocuments/2260/thumbnail.jp
Lung tumors marked percutaneously with indocyanine green dye-soaked embolization coils: A visual beacon for accurate intraoperative localization during lung sparing surgery
No full textThoracic surgeons utilizing minimally invasive techniques for lung nodule resection often rely on localization markers to determine precise nodule location intraoperatively. Transbronchial or transthoracic injection of indocyanine green (ICG) dye has become a popular technique. However, surgery must be performed immediately as dye will dissipate to surrounding tissue. This multicenter retrospective study evaluated the efficacy of CT guided transthoracic placement of ICG dye-soaked coils (CT ICG-C) for preoperative lung nodule localization. Nineteen adult patients with 21 nodules underwent CT ICG-C placement from 03/01/2023 until 02/28/2025 at two medical centers. There were no adverse events. Median time from localization to surgery was 1 day (IQR 0-4 days), with 57.1% undergoing surgery \u3e24 hours later. Localization success rate was 100%. CT ICG-C is a novel technique that allows for accurate nodule localization, delayed surgical resection, and the preservation of healthy lung tissue
