Moises Roizental - Academia.edu (original) (raw)

Papers by Moises Roizental

Radiology, Sep 1, 1995

To mark the portal vein prior to transjugular intrahepatic portosystemic shunt (TIPS) placement, ... more To mark the portal vein prior to transjugular intrahepatic portosystemic shunt (TIPS) placement, metallic coils adjacent to (n = 18) and a wire within (n = 18) the portal vein were placed with ultrasonographic (US) guidance. The mean number of punctures for successful portal vein entry was 3.0 with coils and 2.9 with a wire, and the mean total procedure time was 127.5 and 110.0 minutes, respectively (differences, not significant), and mean time at US was 20 and 10 minutes, respectively.

El hepatocarcinoma (HCC) constituye aproximadamente el 90 % de los tumores primarios del h&iacute... more El hepatocarcinoma (HCC) constituye aproximadamente el 90 % de los tumores primarios del hígado, cursando en la amplia mayoría de los casos con enfermedad hepática crónica –usualmente en fase de cirrosis-, la cual a su vez puede encontrarse en diferentes estadios de severidad acorde a las diferentes clasificaciones diseñadas a tal fin. En este trabajo se establecen las pautas en el manejo del hepatocarcinoma.&nbsp

Objective. To review the postoperatory arterial complications after hepatic transplantation, and ... more Objective. To review the postoperatory arterial complications after hepatic transplantation, and its diagnosis and treatment through multimodal imaging approach, at the Policlinica Metropolitana. Patients and Methods. 49 hepatic trasplant recipients were included between april 2005 and december 2009. If clinical or arterial flow alterations in doppler were found, an angiotomographic study was carried out, and if the alteration was confirmed, endovascular treatment was performed. Results. Post-transplant Doppler revealed abnormal arterial flow in 4 patients. Another two patients did not show abnormalities in doppler, but in the blood biochemistry. Arterial angiotomography demonstrated stenosis in five patients, and thrombosis in one. Endovascular treatment achieved flow recovery in all cases. Doppler sensibility and specificity in the diagnosis of hepatic post-transplantation arterial complications, were 100% and 95,5 %, respectively, and for angiotomography was 100% for both. Conclu...

Radiology, 1995

$Research paper thumbnail of Vertebroplastia, tratamiento actual de elección de las fracturas por compresión de los cuerpos vertebrales$

Vertebroplasty is a new radiologic procedure for treating painful compression fractures of the th... more Vertebroplasty is a new radiologic procedure for treating painful compression fractures of the thoracic and lumbar spine. The technique involves the injection of radio ¿ opaque polymethylmethacrylate (PMMA) liquid cement through a needle into a compressed and painful vertebral body using a posterior transpedicular approach. The percutaneous injection of PMMA into the spine was first reported in France almost 15 years ago for treatment of painful osteolytic metastases, multiple myeloma and symptomatic spinal hemangiomas (1). During the past five to six years the procedure has been further refined and broadened un scope to include patients with painful osteoporotic compression fractures. The examination has proved to be safe and effective with a very low complication rate. The majority of patients treated have reported improvement in their quality of life in terms of decreased pain, increased mobility, and decreased reliance on narcotic analgesics. Vertebroplastia es un nuevo procedim...

G.E.N.: organo oficial de la Sociedad Venezolana de Gastroenterología, Endocrinología y Nutrición

Introducción: Muchos trabajos han sido publicados tratando de evaluar el pronóstico y sobrevida d... more Introducción: Muchos trabajos han sido publicados tratando de evaluar el pronóstico y sobrevida de pacientes con carcinoma hepatocelular (HCC). Hepatitis B es una de las causas más importantes de HCC y falla hepática en algunas partes del mundo. El objetivo principal de esta trabajo era evaluar la sobrevida del paciente con HCC después del tratamiento no quirúrgico y si la etiología de la enfermedad hepática tenia algún efecto sobre la respuesta al tratamiento. Pacientes y métodos:

Journal of Vascular and Interventional Radiology, 1995

... The Misplaced Central Venous Catheter: A Long Loop Technique for Repositioning ... From the D... more ... The Misplaced Central Venous Catheter: A Long Loop Technique for Repositioning ... From the Department of Radiological Sciences, Deaconess Hospital, 1 Deaconess ... guarantee or endorsement by the journal, Association, or publisher of the quality or value of such product or ...

Journal of Hepatology, 2010

score≥11 were independent risk factors of 30-day mortality. 5. The area under curve (AUC) for CTP... more score≥11 were independent risk factors of 30-day mortality. 5. The area under curve (AUC) for CTP, MELDNa, and MELD in predicting 30-day mortality were 0.866, 0.814, 0.732, and pairwise test with a critical ratio z showed no statistically significant difference among three scoring systems (CTP and MELD, adjusted p = 0.053: MELD and MELDNa, adjusted p = 0.151: CTP and MELDNa, adjusted p = 0.661). 6. The AUC for CTP, MELDNa, and MELD in predicting 90-day mortality were 0.859, 0.811, 0.730, and pairwise test with a critical ratio z showed that CTP score was superior to MELD score (adjusted p = 0.008) and MELDNa score was superior to MELD score (adjusted p = 0.028) in predicting postoperative 90day mortality (CTP and MELDNa, adjusted p = 0.543). Conclusions: All three scoring systems predicted postoperative mortality in patients with cirrhosis. The predictability of 30-day mortality was equal among three systems. CTP score and MELDNa score were superior to MELD score in predicting postoperative 90day mortality.

Journal of Computer Assisted Tomography, 1995

Vitae: Academia …, 2010

Utilidad de las modalidades imaginológicas en complicaciones vasculares arteriales del trasplante... more Utilidad de las modalidades imaginológicas en complicaciones vasculares arteriales del trasplante hepático Fecha de recepción: 30/03/2010 Fecha de aceptación: 23/06/2010 Objetivo. Revisar las complicaciones arteriales post-trasplante hepático, su diagnóstico y tratamiento mediante abordaje multimodal de imágenes, en la Policlínica Metropolitana. Pacientes y Métodos. Se incluyeron los 49 trasplantados hepáticos entre abril 2005 y diciembre 2009. De haber alteraciones clínicas o en el flujo doppler arterial, se realizó angiotomografía, y de confirmar la alteración, se realizó tratamiento endovascular. Resultados. El Doppler mostró flujo arterial anormal en 4 pacientes. Otros dos no mostraron anomalía en doppler, sino en la química sanguínea. La angiotomografía arterial hepática reveló estenosis en cinco pacientes y trombosis en uno. El tratamiento endovascular permitió recuperar el flujo en todos. La sensibilidad y especificidad del Doppler para el diagnóstico de las complicaciones arteriales post-trasplante hepático fueron de 100% y 95,5 %, respectivamente, y para la tomografía, de 100% para ambos. Conclusión. Proponemos que sólo aquellos pacientes con complicación arterial hepática demostrada mediante angiotomografia, sean llevados a procedimiento endovascular. Palabras Claves:trasplante hepático, trombosis arteria hepática, estenosis arteria hepática.

European Journal of Radiology, 1994

In order to highlight the role of magnetic resonance angiography [MRA] in the assessment of patie... more In order to highlight the role of magnetic resonance angiography [MRA] in the assessment of patients pre-transjugular intrahepatic portosystemic shunt (TIPS) stenting, the MRA images of portal and hepatic veins of 21 patients were compared with the images from contrast portal and hepatic venograms performed on the same patients at the time of TIPS stenting (20 patients). MRA enabled accurate, non-invasive, multiplanar imaging of portal and systemic venous anatomy in each of the patients studied. MRA facilitated accurate determination of vessel patency and flow direction, images correlating exactly with contrast venograms of hepatic and portal veins in each case. In one patient, identification of occult hepatocellular carcinoma extending to the portal vein lead to the postponement of the TIPS procedure.

Cardiovascular and Interventional Radiology, 1994

Complications following venous punctures are unusual. We describe a case of a false common femora... more Complications following venous punctures are unusual. We describe a case of a false common femoral vein aneurysm following right heart catheterization in a patient with systemic venous hypertension due to tricuspid regurgitation. The initial interpretation of the Doppler ultrasound study lead to a digital subtraction femoral arteriogram which was normal. Magnetic resonance venography demonstrated a femoral venous pseudoaneurysm.

American Journal of Roentgenology, 1995

Journal of Vascular Surgery, 2008

Objective: This study evaluated the safety and clinical and anatomic effectiveness of endovenous ... more Objective: This study evaluated the safety and clinical and anatomic effectiveness of endovenous laser therapy (EVLT) and microphlebectomy in the treatment of varicose veins secondary to saphenous reflux. Methods: From January 1, 2005, to December 31, 2007, 1985 EVLT procedures were performed in 1559 eligible patients (1263 women) with a mean age of 52.8 years (range, 18-89 years). A 810-nm diode laser and microphlebectomy were used. All sites of superficial axial reflux above and below the knee were ablated. Symptoms of venous insufficiency were present in 97%, and 102 patients (6.54%) had an open ulcer when they underwent operation. Patients had clinical follow-up visits, including duplex ultrasound examination, at 1 week, 1 month, 3 months, and yearly and were assessed for deep venous thrombosis (DVT), recanalization of the ablated vein, nerve injury, ulcer healing, and resolution of symptoms. Results: A total of 1652 great saphenous veins (83.22%), 285 small saphenous veins (14.36%), 40 anterolateral tributaries (2.02%), and 8 posteromedial tributaries (0.40%) were ablated. An average of 19 phlebectomies were performed per case treated (range, 1-58). The primary ablation rate at 15 and 30 months was 91.26% and 78.25% by Kaplan-Meier analysis. Recanalization occurred in 35 veins (1.76%); in this group, 15 (42.9%) exhibited symptoms of venous insufficiency and were successfully closed with a second EVLT. Body mass index >30 kg/m 2 and a vein diameter >8.5 mm were the only factors predictive of recanalization. Postoperatively, the 102 ulcers showed healing at a mean of 5.2 weeks (range, 2-10 weeks), and only three reopened (2.94%). No major complications occurred. Two DVT (0.13%) occurred, but no pulmonary emboli or skin burns. Local transient paresthesia at the ankle and midcalf level occurred in 38 patients (2.43%). Conclusions: EVLT of all sites of superficial axial reflux above and below the knee and microphlebectomy demonstrated that the combined approach is safe and effective at eliminating reflux, affording symptomatic relief, and healing ulcers. It offers the additional advantage of resolving varicose veins and its cause in just one visit, leading to immediate better cosmetic results. ( J Vasc Surg 2008;48:947-52.) From Unidad de Intervencionismo Cardiovascular, Policlínica Metropolitana.

JCR: Journal of Clinical Rheumatology, 2003

Gastrointestinal Endoscopy, 2013