Sandor Kovacs

Cesarean scar pregnancies: experience of 60 cases.

To evaluate the management, clinical courses, and outcomes of cesarean scar pregnancies diagnosed in the first trimester.

G2 Inferior Vena Cava Filter: Retrievability and Safety

PURPOSE To assess the retrievability of the G2 inferior vena cava (IVC) filter and factors influencing the safety and technical success of retrieval. MATERIALS AND METHODS From October 2006 through June 2008, G2 IVC filters were placed in 140 consecutive patients who needed prophylaxis against pulmonary embolism (PE). General indications for filter placement included history of thromboembolic disease (n = 98) and high risk for PE (n = 42); specific indications included contraindication to anticoagulation (n = 120), prophylaxis in addition to anticoagulation (n = 16), and failure of anticoagulation (n = 4). Filter dwell time, technical success of filter retrieval, and complications related to placement or retrieval were retrospectively evaluated in patients who underwent filter removal. RESULTS Twenty-seven attempts at G2 filter removal were made in 26 patients (12 men; age range, 24-88 years; mean age, 55.4 y) after a mean period of 122 days (range, 11-260 d). Data were collected retrospectively with institutional review board approval. Filter removal was successful in all 27 attempts (100%). Tilting of the filter (> or =15 degrees ) occurred in five cases (18.5%), with probable filter incorporation into the right lateral wall of the IVC in one. Other complications of retrieval such as filter thrombosis, significant filter migration, filter fracture, and caval occlusion were not observed. CONCLUSIONS G2 IVC filter retrieval has a high technical success rate and a low complication rate. Technical success appears to be unaffected by the dwell time within the reported range.

Percutaneous Drainage of Aortic Aneurysm Sac Abscesses Following Endovascular Aneurysm Repair

Purpose: To report preliminary experiences with the treatment of aortic aneurysm sac abscesses following prior endovascular aortic aneurysm repair (EVAR) using computerized tomography (CT)-guided percutaneous drainage. Case Reports: Three patients aged 73 to 78 years with aortic aneurysm sac infections following prior EVAR, 2 of which were associated with aortoduodenal fistula, underwent CT-guided percutaneous drainage and catheter placement. One patient had complete resolution of the aortic aneurysm sac abscess following percutaneous drainage; 1 patient was stabilized to eventual extraanatomic bypass, graft explantation, and fistula repair; and 1 patient was temporized to debridement and fistula repair with endograft preservation. Conclusion: CT-guided percutaneous drainage may be a helpful therapy in selected patients for the treatment of aortic aneurysm sac infections following EVAR.

Chest Port Placement with Use of the Single-incision Insertion Technique

PURPOSE To evaluate the single-incision technique for the placement of subcutaneous chest ports. Advantages, technical success, and complications were assessed. MATERIALS AND METHODS From March 2007 through May 2008, 161 consecutive chest ports were placed with a modified single-incision technique and sonographic and fluoroscopic guidance via the right internal jugular vein (IJV; n = 130), right external jugular vein (n = 1), right subclavian vein (n = 1), or left IJV (n = 28). The primary indication was for long-term chemotherapy; all patients had malignancy. RESULTS All single-incision chest port insertions were technically successful. Ports were placed in patients 19 months to 93 years of age (mean, 56.3 y), with a mean follow-up of 203.6 device-days per patient and a total of 32,779 catheter access days. No procedure-related complications, pocket hematomas, venous thromboses, or pneumothoraces were observed. Minor delayed complications occurred in three patients. Premature catheter removal was required for two patients (1.2%; 0.006 per 100 catheter-days). One port was removed less than 30 days after implantation for infection of the pocket (0.61%; 0.003 per 100 catheter-days). Another catheter was removed because of patient dissatisfaction and unconfirmed concerns with arrhythmia (0.61%; 0.003 per 100 catheter-days). One minor superficial wound infection was successfully treated with oral antibiotics, with the port kept in place. CONCLUSIONS Use of a single-incision technique for chest port implantation in adult and pediatric oncology patients is feasible. This may be the preferred method of subcutaneous port placement, as it has a very low complication rate and a high success rate. Prospective evaluation is needed to compare it versus the conventional two-incision technique.

Unilateral axillary adenopathy caused by Kikuchi-Fujimoto disease.

Journal compilation ©2006, Blackwell Publishing, Inc., 1075-122X/06 The Breast Journal, Volume 12 Number 1, 2006 77–79 Address correspondence and reprint requests to: Sandor Kovacs, MD, Department of Radiology, Saint Barnabas Medical Center, 94 Old Short Hills Rd., Livingston, NJ 07039, USA, or e-mail: hakkyung@optonline.net. Blackwell Publishing Inc M lden, USA TBJ he Breast Journal 1075-122X 2 06 Blackwel Publishing Janua y/February 2006 2 Original Artic e U il ter l Axi lary Adenopathy Kovacs et al. BREAST IMAGES

Sclerosing hemangioma: A diagnostic dilemma in fine needle aspiration cytology

Sclerosing hemangioma of the lung is a benign neoplasm with a widely debated histogenesis. It has a polymorphic histomorphology characterized by a biphasic cell population of “surface cells” and “round cells” arranged in four general patterns: Papillary, solid, angiomatous, and sclerotic. This variability in histomorphology makes it difficult to diagnose sclerosing hemangioma by fine needle aspiration (FNA). We present a case of sclerosing hemangioma diagnosed on FNA with immunohistochemistry performed on an accompanied cell block. The clinical presentation, cytomorphology, immunohistochemistry, and differential diagnoses are discussed.