Marco Cura - Academia.edu (original) (raw)

Papers by Marco Cura

Research paper thumbnail of Catheter-Directed Therapies for Deep Venous Thrombosis

Contemporary Diagnostic Radiology, 2007

Research paper thumbnail of Transjugular intrahepatic portosystemic shunt creation using a three-dimensional fluoroscopy guidance system in patients with the Budd-Chiari syndrome

Proceedings (Baylor University. Medical Center), 2015

When performed for Budd-Chiari syndrome (BCS), transjugular intrahepatic portosystemic shunt (TIP... more When performed for Budd-Chiari syndrome (BCS), transjugular intrahepatic portosystemic shunt (TIPS) creation can be technically difficult due to hepatic congestion and asymmetric hypertrophy. We present three female patients with decompensated BCS in whom TIPS were created using a three-dimensional fluoroscopy guidance system. On a dedicated workstation using three-dimensional volumes of computed tomography imaging, a virtual needle path was created by the operator extending from the needle entry point (hepatic vein stump or inferior vena cava) to the target portal vein. Subsequently, the virtual needle path was overlaid on the fluoroscopy image for guidance of portal venous cannulation. This technology can be used for TIPS procedures in patients with BCS and other complex TIPS cases, as it may help delimit the trajectory of the needle pass and optimally result in more efficient procedures with decreased radiation dose.

Research paper thumbnail of Comparison of fluoroscopic operator eye exposures when working from femoral region, side, or head of patient

Proceedings (Baylor University. Medical Center), 2013

Operator radiation exposure is an important occupational hazard compounded over the course of an ... more Operator radiation exposure is an important occupational hazard compounded over the course of an interventional radiologist's career. This study compared operator radiation dose to the eye and head for different positions around the patient. Compared with cases performed from the femoral region, exposures were 1.8 times higher at the side, and 1.6 times higher at the head, using conventional aprons, table shields, and mobile suspended shields. Exposures were 99% lower when using a suspended personal radiation protection system in all positions. In conclusion, standing at the side or head results in higher head exposures in a conventional setup.

Research paper thumbnail of Valor predictivo de lesiones mamográficas en pacientes con examen clínico mamario normal: revisión de 52 casos

Rev Chil Obstet Ginecol, 1997

Research paper thumbnail of Utility of cardiac computed tomography for inflow cannula patency assessment and prediction of clinical outcome in patients with the HeartMate II left ventricular assist device

Interactive CardioVascular and Thoracic Surgery, 2015

Proper inflow cannula orientation during implantation of the HeartMate II (HMII) left ventricular... more Proper inflow cannula orientation during implantation of the HeartMate II (HMII) left ventricular assist device (LVAD) is important for optimal pump function. This article describes our experience with cardiac computed tomography (CCT) to evaluate inflow cannula patency and predict future adverse outcomes (AE) after HMII LVAD implantation. Ninety-three patients underwent HMII LVAD implantation for end-stage cardiomyopathy from January 2010 until March 2014. A total of 25 consecutive patients had CCT after the implantation; 3 patients were excluded from the analysis due to associated abnormality of the outflow graft. The 22 patients with CCT after HMII LVAD were censored for adverse events related to LVAD malfunction after HMII LVAD implantation. The maximum percentage of inflow cannula obstruction on CCT was recorded. We analysed the predictive value of CCT in addition to other clinical and diagnostic variables for future AEs. Seven of the 22 patients (32%) experienced AEs after HMII LVAD implantation. The degree of inflow cannula obstruction was higher in the group of patients who experienced an AE (70 vs 14%; P < 0.001). Inflow cannula obstruction >30% showed excellent correlation with AE longitudinally based on receiver operating curve (0.829). The group with AEs more frequently experienced CHF symptoms (P = 0.054). Inflow cannula obstruction >30% on CCT predicts future adverse events in patients with HMII LVAD; the need for surgical intervention in terms of LVAD exchange or urgent listing for heart transplantation should be considered in good surgical risk patients. Cardiac computed tomography should be considered routinely postoperatively in patients with HMII LVAD.

Research paper thumbnail of MDCT Angiography of Mesenteric Bypass Surgery for the Treatment of Chronic Mesenteric Ischemia

Ajr American Journal of Roentgenology, Nov 1, 2009

Chronic mesenteric ischemia (CMI) is a serious condition that requires surgical or endovascular i... more Chronic mesenteric ischemia (CMI) is a serious condition that requires surgical or endovascular intervention. Surgical revascularization for the treatment of CMI uses different operative techniques including endarterectomy, vessel reimplantation, and mesenteric bypass. A basic understanding of the operative techniques is essential for the adequate interpretation of imaging studies in patients who have undergone surgery for CMI. In this article, we review the different operative techniques used in the treatment of CMI, discuss the results of surgical intervention for CMI, and illustrate how MDCT angiography (MDCTA) can be used for follow-up and for the detection of early and late complications after surgery. MDCTA is a powerful tool for the postoperative evaluation of patients with CMI. Early detection of graft dysfunction is critical to prevent graft occlusion and the development of potentially fatal mesenteric ischemia. MDCTA can detect early and late complications after surgery and guide additional surgical or endovascular interventions.

Research paper thumbnail of Diagnostic and In- terventional Radiology for Budd-Chiari Syndrome

Radiographics, 2009

Budd-Chiari syndrome is a heterogeneous group of disorders characterized by hepatic venous outflo... more Budd-Chiari syndrome is a heterogeneous group of disorders characterized by hepatic venous outflow obstruction that involves one or more draining hepatic veins. Its occurrence in populations in the western hemisphere is commonly associated with hypercoagulative states. Clinical manifestations in many cases are nonspecific, and imaging may be critical for early diagnosis of venous obstruction and accurate assessment of the extent of disease. If Budd-Chiari syndrome is not treated promptly and appropriately, the outcome may be dismal. Comprehensive imaging evaluations, in combination with pathologic analyses and clinical testing, are essential for determining the severity of disease, stratifying risk, selecting the appropriate therapy, and objectively assessing the response. The main goal of treatment is to alleviate hepatic congestion, thereby improving hepatocyte function and allowing resolution of portal hypertension. Various medical, endovascular, and surgical treatment options are available. Percutaneous and endovascular procedures, when performed in properly selected patients, may be more effective than medical treatment methods for preserving liver function and arresting disease progression in the long term. In addition, such procedures are associated with lower morbidity and mortality than are open surgical techniques.

Research paper thumbnail of Recognizing Pitfalls in Early and Late Migration of Clip Markers after Imaging-guided Directional Vacuum-assisted Biopsy1

Radiographics a Review Publication of the Radiological Society of North America Inc, 2004

Directional vacuum-assisted biopsy has become an irreplaceable tool in the management of suspicio... more Directional vacuum-assisted biopsy has become an irreplaceable tool in the management of suspicious mammographic lesions. Often, the entire lesion is removed and clips are used to localize the biopsy site. Postbiopsy mammograms are used to determine the adequacy of clip placement and the location of the clip. Clip displacement from the site of deployment is not an uncommon finding. Clips may migrate within the same quadrant where the lesion was located or to another quadrant of the breast. Clip migration may occur immediately after biopsy or may be seen on later follow-up mammograms. Clip migration can affect interpretation of mammographic findings and localization for future surgery. It should not be assumed that the clip is correctly located at the biopsy site on subsequent mammograms. It is essential to recognize the relationship of the clip to the targeted lesion to ensure accurate localization of lesions that require surgical excision.

Research paper thumbnail of Infrainguinal Chronic Total Occlusions in Critical Limb Ischemia: Evidence-based Review of Endovascular Interventions

Research paper thumbnail of Infrainguinal and Inframalleolar Endovascular Interventions: The New and Evolving Frontier in the Management of Critical Limb Ischemia

Research paper thumbnail of Vascular Closure Devices: Are We There Yet?

Research paper thumbnail of Diabetes Mellitus (DM) and Peripheral Vascular Disease (PAD): Imaging Evaluation and Interventions for Critical Limb Ischemia in the 21st Century Revisited

Research paper thumbnail of Immediate and Delayed Biliary and Vascular Complications Post Segmental Liver Transplant in the Pediatric Population: Imaging Spectrum and the Role of Image-guided Minimal Invasive Percutaneous/Endovascular Interventions

Research paper thumbnail of Role of Interventional Radiology (IR) in Budd Chiari Syndrome (BCS)

Research paper thumbnail of Transplant Free Survival and Cox Regression of Predictors of Survival after Viatorr TIPS Creation

Research paper thumbnail of Value of Computed Tomography (CT) Contrast Extravasation and American Association for the Surgery of Trauma (AAST) Splenic Injury CT Grade in Patients with Blunt Spleen Trauma and Acute Arterial Injury by Angiography

Research paper thumbnail of Correlation of Computed Tomography CT Findings with Splenic Angiography in Blunt Spleen Trauma

Research paper thumbnail of Effect of Transjugular Intrahepatic Portosystemic Shunt (TIPS) Creation on Renal Function

Search Article Keyword：. ...

Research paper thumbnail of Aneurysms and Pseudoaneurysms of the Ascending Aorta and Aortic Arch: A Pictorial Essay

PURPOSE/AIM 1. To briefly review the anatomy and embryology of the thoracic aorta. 2. Discuss the... more PURPOSE/AIM 1. To briefly review the anatomy and embryology of the thoracic aorta. 2. Discuss the most appropriate techniques to image the aortic arch and their pitfalls. 3. Describe several cases illustrating diverse aortic arch pathology encountered in patients with or without prior surgical instrumentation. CONTENT ORGANIZATION A. Embryology and anatomy of the aortic arch B. Imaging techniques for aortic disease: 1. Transesophageal echocardiography. 2. Conventional aortogram. 3. CT angiography. 4. MR Angiography. 5. Pitfalls and artifacts in aortic disease. C. Etiology of aortic arch aneurysms: 1. Congenital Sinus of Valsalva aneurysm. 2. Acquired Sinus of valsalva aneurysm. 3. Ascending aortic aneurysm. 4. Aneurysms of the arch. 5. Stanford Type A aortic dissection 6. Traumatic aortic injury. SUMMARY The thoracic aorta can be affected by a myriad of pathologies leading to dissection or aneurysm formation that are uniformly associated with high morbidity, mortality and medical co...

Research paper thumbnail of Aneurysms and Pseudoaneurysms of the Pulmonary: Imaging and Intervention

PURPOSE/AIM 1. To review the different conditions that may result in aneurysms or pseudoaneurysms... more PURPOSE/AIM 1. To review the different conditions that may result in aneurysms or pseudoaneurysms of the pulmonary vasculature, either from the pulmonary or bronchial circulation. 2. To discuss the imaging findings on the different imaging modalities currently available for the evaluation of such conditions. 3. To define the treatment options available. CONTENT ORGANIZATION Definition and classification. Congenital conditions: pulmonic valve stenosis, left to right shunts. Acquired conditions: pulmonary hypertension, vasculitis (Hughes-Stovin and Behcet syndromes), mycotic aneurysms and pseudoaneurysms, Rasmussen aneurysms, tumoral and traumatic pseudoaneurysms, connective tissue disorders, tuberous sclerosis. Mimics (arteriovenous malformation, Osler-Weber-Rendu syndrome), pulmonary vein varix. Imaging and clinical manifestations. Angio and endovascular therapy. SUMMARY Pulmonary artery aneurysms and pseudoaneurysms may develop from several different conditions. Trauma, infection, ...

Research paper thumbnail of Catheter-Directed Therapies for Deep Venous Thrombosis

Contemporary Diagnostic Radiology, 2007

Research paper thumbnail of Transjugular intrahepatic portosystemic shunt creation using a three-dimensional fluoroscopy guidance system in patients with the Budd-Chiari syndrome

Proceedings (Baylor University. Medical Center), 2015

When performed for Budd-Chiari syndrome (BCS), transjugular intrahepatic portosystemic shunt (TIP... more When performed for Budd-Chiari syndrome (BCS), transjugular intrahepatic portosystemic shunt (TIPS) creation can be technically difficult due to hepatic congestion and asymmetric hypertrophy. We present three female patients with decompensated BCS in whom TIPS were created using a three-dimensional fluoroscopy guidance system. On a dedicated workstation using three-dimensional volumes of computed tomography imaging, a virtual needle path was created by the operator extending from the needle entry point (hepatic vein stump or inferior vena cava) to the target portal vein. Subsequently, the virtual needle path was overlaid on the fluoroscopy image for guidance of portal venous cannulation. This technology can be used for TIPS procedures in patients with BCS and other complex TIPS cases, as it may help delimit the trajectory of the needle pass and optimally result in more efficient procedures with decreased radiation dose.

Research paper thumbnail of Comparison of fluoroscopic operator eye exposures when working from femoral region, side, or head of patient

Proceedings (Baylor University. Medical Center), 2013

Operator radiation exposure is an important occupational hazard compounded over the course of an ... more Operator radiation exposure is an important occupational hazard compounded over the course of an interventional radiologist's career. This study compared operator radiation dose to the eye and head for different positions around the patient. Compared with cases performed from the femoral region, exposures were 1.8 times higher at the side, and 1.6 times higher at the head, using conventional aprons, table shields, and mobile suspended shields. Exposures were 99% lower when using a suspended personal radiation protection system in all positions. In conclusion, standing at the side or head results in higher head exposures in a conventional setup.

Research paper thumbnail of Valor predictivo de lesiones mamográficas en pacientes con examen clínico mamario normal: revisión de 52 casos

Rev Chil Obstet Ginecol, 1997

Research paper thumbnail of Utility of cardiac computed tomography for inflow cannula patency assessment and prediction of clinical outcome in patients with the HeartMate II left ventricular assist device

Interactive CardioVascular and Thoracic Surgery, 2015

Proper inflow cannula orientation during implantation of the HeartMate II (HMII) left ventricular... more Proper inflow cannula orientation during implantation of the HeartMate II (HMII) left ventricular assist device (LVAD) is important for optimal pump function. This article describes our experience with cardiac computed tomography (CCT) to evaluate inflow cannula patency and predict future adverse outcomes (AE) after HMII LVAD implantation. Ninety-three patients underwent HMII LVAD implantation for end-stage cardiomyopathy from January 2010 until March 2014. A total of 25 consecutive patients had CCT after the implantation; 3 patients were excluded from the analysis due to associated abnormality of the outflow graft. The 22 patients with CCT after HMII LVAD were censored for adverse events related to LVAD malfunction after HMII LVAD implantation. The maximum percentage of inflow cannula obstruction on CCT was recorded. We analysed the predictive value of CCT in addition to other clinical and diagnostic variables for future AEs. Seven of the 22 patients (32%) experienced AEs after HMII LVAD implantation. The degree of inflow cannula obstruction was higher in the group of patients who experienced an AE (70 vs 14%; P < 0.001). Inflow cannula obstruction >30% showed excellent correlation with AE longitudinally based on receiver operating curve (0.829). The group with AEs more frequently experienced CHF symptoms (P = 0.054). Inflow cannula obstruction >30% on CCT predicts future adverse events in patients with HMII LVAD; the need for surgical intervention in terms of LVAD exchange or urgent listing for heart transplantation should be considered in good surgical risk patients. Cardiac computed tomography should be considered routinely postoperatively in patients with HMII LVAD.

Research paper thumbnail of MDCT Angiography of Mesenteric Bypass Surgery for the Treatment of Chronic Mesenteric Ischemia

Ajr American Journal of Roentgenology, Nov 1, 2009

Chronic mesenteric ischemia (CMI) is a serious condition that requires surgical or endovascular i... more Chronic mesenteric ischemia (CMI) is a serious condition that requires surgical or endovascular intervention. Surgical revascularization for the treatment of CMI uses different operative techniques including endarterectomy, vessel reimplantation, and mesenteric bypass. A basic understanding of the operative techniques is essential for the adequate interpretation of imaging studies in patients who have undergone surgery for CMI. In this article, we review the different operative techniques used in the treatment of CMI, discuss the results of surgical intervention for CMI, and illustrate how MDCT angiography (MDCTA) can be used for follow-up and for the detection of early and late complications after surgery. MDCTA is a powerful tool for the postoperative evaluation of patients with CMI. Early detection of graft dysfunction is critical to prevent graft occlusion and the development of potentially fatal mesenteric ischemia. MDCTA can detect early and late complications after surgery and guide additional surgical or endovascular interventions.

Research paper thumbnail of Diagnostic and In- terventional Radiology for Budd-Chiari Syndrome

Radiographics, 2009

Budd-Chiari syndrome is a heterogeneous group of disorders characterized by hepatic venous outflo... more Budd-Chiari syndrome is a heterogeneous group of disorders characterized by hepatic venous outflow obstruction that involves one or more draining hepatic veins. Its occurrence in populations in the western hemisphere is commonly associated with hypercoagulative states. Clinical manifestations in many cases are nonspecific, and imaging may be critical for early diagnosis of venous obstruction and accurate assessment of the extent of disease. If Budd-Chiari syndrome is not treated promptly and appropriately, the outcome may be dismal. Comprehensive imaging evaluations, in combination with pathologic analyses and clinical testing, are essential for determining the severity of disease, stratifying risk, selecting the appropriate therapy, and objectively assessing the response. The main goal of treatment is to alleviate hepatic congestion, thereby improving hepatocyte function and allowing resolution of portal hypertension. Various medical, endovascular, and surgical treatment options are available. Percutaneous and endovascular procedures, when performed in properly selected patients, may be more effective than medical treatment methods for preserving liver function and arresting disease progression in the long term. In addition, such procedures are associated with lower morbidity and mortality than are open surgical techniques.

Research paper thumbnail of Recognizing Pitfalls in Early and Late Migration of Clip Markers after Imaging-guided Directional Vacuum-assisted Biopsy1

Radiographics a Review Publication of the Radiological Society of North America Inc, 2004

Directional vacuum-assisted biopsy has become an irreplaceable tool in the management of suspicio... more Directional vacuum-assisted biopsy has become an irreplaceable tool in the management of suspicious mammographic lesions. Often, the entire lesion is removed and clips are used to localize the biopsy site. Postbiopsy mammograms are used to determine the adequacy of clip placement and the location of the clip. Clip displacement from the site of deployment is not an uncommon finding. Clips may migrate within the same quadrant where the lesion was located or to another quadrant of the breast. Clip migration may occur immediately after biopsy or may be seen on later follow-up mammograms. Clip migration can affect interpretation of mammographic findings and localization for future surgery. It should not be assumed that the clip is correctly located at the biopsy site on subsequent mammograms. It is essential to recognize the relationship of the clip to the targeted lesion to ensure accurate localization of lesions that require surgical excision.

Research paper thumbnail of Infrainguinal Chronic Total Occlusions in Critical Limb Ischemia: Evidence-based Review of Endovascular Interventions

Research paper thumbnail of Infrainguinal and Inframalleolar Endovascular Interventions: The New and Evolving Frontier in the Management of Critical Limb Ischemia

Research paper thumbnail of Vascular Closure Devices: Are We There Yet?

Research paper thumbnail of Diabetes Mellitus (DM) and Peripheral Vascular Disease (PAD): Imaging Evaluation and Interventions for Critical Limb Ischemia in the 21st Century Revisited

Research paper thumbnail of Immediate and Delayed Biliary and Vascular Complications Post Segmental Liver Transplant in the Pediatric Population: Imaging Spectrum and the Role of Image-guided Minimal Invasive Percutaneous/Endovascular Interventions

Research paper thumbnail of Role of Interventional Radiology (IR) in Budd Chiari Syndrome (BCS)

Research paper thumbnail of Transplant Free Survival and Cox Regression of Predictors of Survival after Viatorr TIPS Creation

Research paper thumbnail of Value of Computed Tomography (CT) Contrast Extravasation and American Association for the Surgery of Trauma (AAST) Splenic Injury CT Grade in Patients with Blunt Spleen Trauma and Acute Arterial Injury by Angiography

Research paper thumbnail of Correlation of Computed Tomography CT Findings with Splenic Angiography in Blunt Spleen Trauma

Research paper thumbnail of Effect of Transjugular Intrahepatic Portosystemic Shunt (TIPS) Creation on Renal Function

Search Article Keyword：. ...

Research paper thumbnail of Aneurysms and Pseudoaneurysms of the Ascending Aorta and Aortic Arch: A Pictorial Essay

PURPOSE/AIM 1. To briefly review the anatomy and embryology of the thoracic aorta. 2. Discuss the... more PURPOSE/AIM 1. To briefly review the anatomy and embryology of the thoracic aorta. 2. Discuss the most appropriate techniques to image the aortic arch and their pitfalls. 3. Describe several cases illustrating diverse aortic arch pathology encountered in patients with or without prior surgical instrumentation. CONTENT ORGANIZATION A. Embryology and anatomy of the aortic arch B. Imaging techniques for aortic disease: 1. Transesophageal echocardiography. 2. Conventional aortogram. 3. CT angiography. 4. MR Angiography. 5. Pitfalls and artifacts in aortic disease. C. Etiology of aortic arch aneurysms: 1. Congenital Sinus of Valsalva aneurysm. 2. Acquired Sinus of valsalva aneurysm. 3. Ascending aortic aneurysm. 4. Aneurysms of the arch. 5. Stanford Type A aortic dissection 6. Traumatic aortic injury. SUMMARY The thoracic aorta can be affected by a myriad of pathologies leading to dissection or aneurysm formation that are uniformly associated with high morbidity, mortality and medical co...

Research paper thumbnail of Aneurysms and Pseudoaneurysms of the Pulmonary: Imaging and Intervention

PURPOSE/AIM 1. To review the different conditions that may result in aneurysms or pseudoaneurysms... more PURPOSE/AIM 1. To review the different conditions that may result in aneurysms or pseudoaneurysms of the pulmonary vasculature, either from the pulmonary or bronchial circulation. 2. To discuss the imaging findings on the different imaging modalities currently available for the evaluation of such conditions. 3. To define the treatment options available. CONTENT ORGANIZATION Definition and classification. Congenital conditions: pulmonic valve stenosis, left to right shunts. Acquired conditions: pulmonary hypertension, vasculitis (Hughes-Stovin and Behcet syndromes), mycotic aneurysms and pseudoaneurysms, Rasmussen aneurysms, tumoral and traumatic pseudoaneurysms, connective tissue disorders, tuberous sclerosis. Mimics (arteriovenous malformation, Osler-Weber-Rendu syndrome), pulmonary vein varix. Imaging and clinical manifestations. Angio and endovascular therapy. SUMMARY Pulmonary artery aneurysms and pseudoaneurysms may develop from several different conditions. Trauma, infection, ...