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Articles by Brian Funaki
RENAL TRANSPLANT ARTERY GUIDEWIRE PERFORATION LEADING TO HEMATOMA AND GRAFT FAILURE
This paper is only available as a PDF. To read, Please Download here. Adapted from a case was originally submitted to SIR Fellow’s Spring Symposium © 2023 Published by Elsevier, Inc., on behalf of SIR.
SVC RUPTURE AND PERICARDIAL TAMPONADE
This paper is only available as a PDF. To read, Please Download here. No funding for this submission Adapted from a case was originally submitted to SIR Fellow’s Spring Symposium Disclosures (none of which have relevance to this submission): Balt – Peripheral Advisory Board, Okami Medical - Consulting © 2023 Published by Elsevier, Inc., on behalf of SIR.
ACUTE HYPERTENSIVE CRISIS AFTER FINE NEEDLE ASPIRATION
Disclosures (none of which have relevance to this submission): Balt – Peripheral Advisory Board, Okami Medical - Consulting No funding for this submission
Commentary on “Carbon Dioxide Angiography for the Detection of Lower Gastrointestinal Arterial Bleeding Initially Occult to Angiography with Iodinated Contrast Media”
In their study titled “Carbon Dioxide Angiography for the Detection of Lower Gastrointestinal Arterial Bleeding Initially Occult to Angiography with Iodinated Contrast Media,” Sawada et al ( 1 Sawada Y. Shimohira M. Nagai K. et al. Carbon dioxide angiography for the detection of lower gastrointestinal arterial bleeding initially occult to angiography with iodinated contrast media.
A Review of Professional Liability in IR: Sweeping the Mines
Medical professional liability (MPL) is becoming a substantial issue in interventional radiology (IR), given both the impact on healthcare costs and the negative psychological effects on physicians. MPL presents special challenges within IR because of the field’s complex and innovative therapies provided to a diverse group of patients, and complicated by the use of off-label devices and drugs that is prevalent in the field.
Inferior Vena Cava Filter Litigation Review: An Analysis of Medicolegal Cases Pertaining to IVC Filters
Objective To identify and analyze all medical malpractice and product liability lawsuits pertaining to inferior vena cava (IVC) filters published within a well-recognized legal research database. Materials and Methods LexisNexis, a legal research database, was used to retrieve cases which mentioned harm from IVC filters, or lack thereof, as the cause for legal action.
Pulmonary Arteriovenous Malformation Embolization: So Much Left to Learn
Embolization of pulmonary arteriovenous malformations (PAVMs) has been utilized effectively for more than 40 years. Initially performed using conventional coils and/or detachable balloons in the era of cut-film angiography, currently, there is an armamentarium of embolic devices and methods for effecting therapy.
Bilioenteric Fistula Following Segmental Transarterial Radioembolization
Manish Patel, BS Brian Funaki, MD Thuong Van Ha, MD Steven Zangan, MD Helen Te, MD Osman Ahmed, MD Osman Ahmed Correspondence Corresponding Author: Osman Ahmed, MD, University of Chicago Medical Center, Department of Interventional Radiology, Chicago, IL, USA. Affiliations Division of Interventional Radiology, University of Chicago Medical Center, Chicago, IL, USA Search for articles by this author This paper is only available as a PDF. To read, Please Download here.
An Unusual Case of Resistant Hypertension Secondary to Fibromuscular Dysplasia:
Abstract A 28-year-old woman with resistant hypertension was given a diagnosis of fibromuscular dysplasia with 100% occlusion of a right renal artery branch supplying an atrophied lower pole, collateralized by the right adrenal artery. Successful adrenal collateral coil embolization restored normotension, but hypertension recurred, necessitating right partial heminephrectomy with blood pressure normalization off medications.
Improved Utilization Following Conversion of a Fluoroscopy Suite to Hybrid CT/Angiography System
Abstract Purpose To assess changes in operational utilization following conversion of a single IR suite to a hybrid CT/angiography (Angio-CT) system at an academic tertiary care center. Materials and Methods The total number of interventional procedures and diagnostic CT examinations performed in 29 rooms (20 diagnostic radiology, 7 IR, 2 shared between divisions) was calculated in the 24 months before conversion of an IR suite to Angio-CT and 12 months after conversion.
Lack of Technique Standardization Limits Evaluation of Toxicity following Transarterial Chemoembolization
The article by Khalaf et al ( 1 Khalaf M.H. Shah R.P. Green V. Vezeridis A.M. Liang T. Kothary N. Comparison of opioid medication use after conventional chemoembolization versus drug-eluting embolic chemoembolization. J Vasc Interv Radiol. 2020; 31 : 1292-1299 ) highlights the underinvestigated topic of opioid use (and potential for misuse) among patients undergoing transarterial chemoembolization for hepatocellular carcinoma.
Mine the Gap: Medical Malpractice in Vascular and Interventional Radiology
To view the full text, please login as a subscribed user or purchase a subscription. Click here to view the full text on ScienceDirect. Medical malpractice litigation in vascular and interventional radiology is increasingly common yet rarely studied in the medical literature. The primary reason for this disparity lies in the limited public data available for examination. The most comprehensive database, the National Physician Database, is confidential.
Rebuttal From Drs Funaki and Haskal
Lessne and Sing raise important considerations regarding the utilization of inferior vena cava (IVC) filters in the United States. A key premise of their argument concerns indications for caval filtration, and they maintain that most filters are currently placed for prophylactic reasons. The references to support this contention are nebulous, and given the huge variability of filter insertion even within similar geographic areas, we doubt that this is known.
POINT: Do the Benefits Outweigh the Risks for Most Patients Under Consideration for Inferior Vena Cava Filters? Yes
It is logical that an inferior vena cava (IVC) filter can catch clots—like a pasta chef draining noodles through a colander. We have seen them catch these clots, thank goodness. Studies have characterized the comparative clot trapping efficacies of caval filters; however, there are few randomized prospective studies comparing caval filtration with no therapy. Given decades of research, would a patient with DVT and a contraindication to anticoagulation wish to be randomized to the nonfilter group?
Legal issues, or how to stay out of trouble
Many malpractice lawsuits are filed because of an unexpected, adverse outcome. This underscores the importance of communication between physicians and patients. Informed consent is paramount, and an excellent patient-physician relationship deters litigation because people generally do not sue people they like, write Brian Funaki and Hector Ferral. Complications are common in medicine. Fortunately, most do not represent medical malpractice. Several conditions are required to establish malpractice.
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