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Background and Objectives: Non-O ABO blood groups have been linked to higher coronary risk, plausibly via hemostatic and lipid pathways. However, evidence in Japanese populations and imaging-defined disease is limited. We examined whether ABO status relates to serum lipids and coronary CT imaging findings in Japanese adults. Materials and Methods: We reviewed adults who underwent coronary CT angiography (CCTA) at our institution. After prespecified exclusions, 865 patients comprised the imaging cohort. For lipid analyses, we excluded patients receiving lipid-lowering therapy at the time of blood sampling, leaving 636 patients (lipid subset). ABO blood group was obtained from the medical record as recorded at registration (patient-reported) and was not re-confirmed by laboratory testing for this study. Outcomes were any coronary artery calcium (Agatston score > 0) and ≥50% luminal stenosis on CCTA. Results: In the lipid subset (n = 636), coronary calcium was present in 44–54% of patients across the four ABO groups and did not differ across groups (p = 0.33). Among assessable scans in the imaging cohort, ≥50% stenosis did not differ across the four ABO groups. In multivariable models (n = 636), older age, male sex, hypertension, and diabetes were independently associated with both outcomes (CAC presence and ≥50% stenosis) (all p < 0.05). For ≥50% stenosis, higher High-Density Lipoprotein-cholesterol (HDL-C) was additionally associated with lower odds (p < 0.05). ABO status (O vs. non-O) was not independently associated with either outcome. Conclusions: In Japanese adults undergoing CCTA, type O blood was tied to lower HDL-C and higher diastolic pressure—features that track with cardiometabolic risk—yet ABO type did not independently relate to coronary calcium or CT-defined stenosis once standard risk factors were considered. These data suggest that, in this setting, ABO adds little beyond conventional risk profiling.

PurposeTo investigate safety and efficacy of intra-aortic balloon occlusion (IABO) versus internal iliac artery balloon occlusion (IIABO) for cesarean delivery in coexisting placenta accreta and placenta previa.Materials and MethodsFrom 2006 to 2019, 60 pregnant women who had undergone preoperative IABO (n = 28) and IIABO (n = 32) for cesarean delivery in coexisting placenta accreta and placenta previa were retrospectively identified, and their medical records and relevant imaging were reviewed.ResultsMaternal characteristics (age, gravidity, previous cesarean delivery, gestational age, and neonatal weight) were similar in both groups. Estimated blood loss, volume of blood transfusion, length of hospitalization, and rate of hysterectomy were not significantly different between the groups. Operation time (the duration of cesarean delivery and hysterectomy, p < 0.05), total time of balloon occlusion (p < 0.01), and fetal radiation dose (p < 0.001) in the IABO group were less than in the IIABO group. No severe complications related to the balloon occlusion procedure were noted in either group.ConclusionIABO and IIABO are safe and effective options for cesarean delivery in patients with combined placenta accreta and placenta previa. The average operation time, balloon occlusion time, and fetal radiation dose in patients with IABO are less than in patients with IIABO. There were no complications related to balloon occlusion of the aorta or internal iliac artery.

Herein, we present the case of a 52-year-old female with a history of hepatic surgery who developed gastric varices. Owing to the risk of rupture, a balloon-occluded retrograde transvenous obliteration (BRTO) procedure was performed using a coaxial double-balloon catheter system. Subsequently, the outer balloon catheter was advanced into the gastrorenal shunt. However, venography failed to visualize the varices. Attempts to advance the inner catheter into the varices have been unsuccessful. The inner catheter was advanced into the left gastric vein, establishing a closed circuit around the gastric varices using an outer balloon catheter. A sclerosing agent was subsequently injected through the gap between the outer and inner balloon catheters and via the outer balloon catheter, successfully embolizing the gastric varices. The coaxial double-balloon catheter system is a viable and effective method for treating gastric varices, particularly in cases where traditional BRTO techniques may be challenging owing to their complex vascular anatomy.

We examined the utility of regional oxygen saturation (rSO2) measurement using near-infrared spectroscopy (NIRS) for monitoring lower-limb blood flow and estimate the safe balloon occlusion/deflation time in patients with PAS who underwent prophylactic balloon occlusion of the abdominal artery (PBOA) during cesarean section (CS). During CS, the NIRS probes were positioned on either of the anterior tibial muscles. rSO2 was measured continuously during balloon occlusion/deflation. A cycle consisted of inflating the aortic balloon for 30 min and deflating it for 5 min. The rSO2 before/during balloon occlusion and after 5 min of balloon deflation were evaluated. Sixty-two lower limbs (fifteen women and data from 31 sessions of balloon inflation/deflation) were evaluated. rSO2 during balloon occlusion was significantly lower than rSO2 before balloon occlusion (57.9% ± 9.6% vs. 80.3% ± 6.0%; p < 0.01). There were no significant differences between rSO2 before balloon occlusion and rSO2 after 5 min of balloon deflation (80.3% ± 6.0% vs. 78.7% ± 6.6%; p = 0.07). Postoperatively, the lower limbs showed no ischemic symptoms. NIRS can assess lower-limb rSO2 during PBOA for PAS in real time to determine ischemia severity, duration, and recovery capacity.

We report the case of a 65-year-old man with a history of hypertension and diabetes who experienced cardiac arrest during MRI for acute brainstem infarction. Initial imaging revealed right vertebral artery occlusion and brainstem infarction. During follow-up MRI because of worsening symptoms, magnetic resonance angiography revealed an absence of cerebral arterial flow, and T2*-weighted imaging revealed arterial and venous engorgement, which were later recognized as early signs of cardiac arrest. Cardiopulmonary resuscitation was initiated, but hypoxic encephalopathy persisted. This case highlights the importance of continuous vital sign monitoring and real-time image evaluation during MRI, particularly in high-risk patients with stroke.

Background If mechanical complications associated with a central venous port (CVP) system are suspected, evaluation with a flow confirmation study (FCS) using fluorescence fluoroscopy or digital subtraction angiography should be performed. Evaluations of mechanical complications related to CVP of the chest wall using FCS performed via the subclavian vein have been reported. However, the delayed complications of a CVP placed in the upper arm have not been sufficiently evaluated in a large population. We evaluated the effectiveness of FCS of CVPs implanted following percutaneous cannulation of the subclavian (chest wall group) or brachial (upper arm group) vein. Methods A CVP was implanted in patients with advanced cancer requiring chemotherapy. FCS was performed if there were complaints suggestive of CVP dysfunction when initiating chemotherapy. Results CVPs were placed in the brachial vein in 390 patients and in the subclavian vein in 800 patients. FCS was performed in 26/390 (6.7%) patients in the upper arm group and 40/800 (5.0%) patients in the chest wall group. The clinical characteristics of the patients were similar in both groups. The duration of CVP implantation until FCS was significantly shorter in the upper arm group (136 ± 96.6 vs. 284 ± 260, p = 0.022). After FCS, the incidence of CVP removal/reimplantation being deemed unnecessary was higher in the upper arm group (21/26 [80.8%] vs. 26/40 [65.0%], p = 0.27). In the upper arm group, no cases of catheter kinking or catheter-related injury were observed, and the incidence of temporary obstruction because of blood clots that could be continued using CVP was significantly higher than that in the chest wall group (10/26 [38.5%] vs. 4/40 [10.0%], p = 0.012). Conclusions FCS was effective in evaluating CVP system-related mechanical complications and deciding whether removal and reimplantation were required in both groups.

Life-threatening bleeding after oocyte retrieval is unusual. We report a case of massive vaginal bleeding requiring transcatheter arterial embolization (TAE) after transvaginal US-directed follicle aspiration for oocyte retrieval and provide a brief review of cases in which the pseudoaneurysm of the injured artery was managed with a TAE approach. A 40-year-old woman presented massive vaginal bleeding after transvaginal ultrasonography-directed follicle aspiration for oocyte retrieval. Contrast-enhanced computed tomography revealed active bleeding from the uterine ostium. Transcatheter arterial embolization was performed for a pseudoaneurysm of the right pudendal artery to manage the hemorrhage. Potentially life-threatening bleeding should be recognized as a rare complication after oocyte retrieval to promptly establish the diagnosis and preserve the uterus.

This case report delves into a unique occurrence of MRI-induced headaches attributed to an unsuspected intracranial foreign body. A male patient, presenting persistent headaches, experienced exacerbation of pain upon entering the MRI suite, hindering the imaging procedure. A subsequent head CT scan revealed a nail within the cranial cavity, stemming from a previous nail gun injury. Surgical removal was deemed unsafe, leading to continued observation. This case emphasizes the need for cautious exploration of abnormal symptoms in the MRI suite, urging healthcare professionals to consider potential foreign bodies. The incident underscores the risk of metallic fragments causing complications during MRI procedures and highlights the importance of thorough patient assessment before resorting to MRI imaging.

Meckel's diverticulum (MD) is a rare but important differential diagnosis for adult intussusception, particularly when presenting with atypical imaging features, such as a tumor-like mass. Inverted MD with hemorrhagic necrosis is exceedingly rare and may mimic neoplastic lesions. A 65-year-old man presented with acute abdominal pain and distension. He had experienced intermittent abdominal discomfort and a single episode of hematochezia two months prior to presentation. Abdominal computed tomography revealed an ileo-ileal intussusception with a round, high-attenuation mass at the lead point. Surgical resection was performed owing to concerns regarding malignancy. Intraoperatively, an inverted MD with hemorrhagic necrosis was identified. Histology confirmed ectopic gastric mucosa in the MD. The patient's postoperative recovery was uneventful. This case highlights a rare presentation of adult intussusception caused by an inverted necrotic MD mimicking an intraluminal tumor. Recognizing this condition is crucial, especially in patients with unexplained abdominal pain or prior gastrointestinal bleeding. MD should be considered in the differential diagnosis of distal ileal masses to ensure an accurate diagnosis and timely management.

This report presents a case of primary central nervous system vasculitis (PCNSV), emphasizing the need for precise diagnosis and individualized treatment. PCNSV is a rare inflammatory condition confined to the central nervous system (CNS) that affects small- to medium-sized vessels and can cause severe neurological damage if left untreated. A 73-year-old woman with no previous medical history presented with rapidly progressive right-sided hemiparesis and cognitive impairment. Magnetic resonance imaging (MRI) findings revealed new hyperintense lesions on diffusion-weighted imaging (DWI), meningeal enhancement, and vascular wall thickening, raising suspicion of vasculitis. Cerebral angiography showed left middle cerebral artery (MCA) stenosis, and a brain biopsy confirmed perivascular lymphocytic infiltration, supporting the diagnosis of PCNSV. High-dose corticosteroids and azathioprine were administered to stabilize the symptoms. This case highlights the diagnostic value of MRI findings in PCNSV and the importance of histopathological confirmation and immunosuppressive therapy in managing this condition.