Publications by authors named "Marc L Friedman"

8 Publications

  • Page 1 of 1

Effect of scheduling inferior vena cava filter removal during the placement encounter on filter removal rate.

J Vasc Surg Venous Lymphat Disord 2020 Sep 15. Epub 2020 Sep 15.

Section of Interventional Radiology, Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, Calif. Electronic address:

Objective: In the present study, we sought to determine whether early preemptive scheduling of inferior vena cava filter (IVCF) removal during the preoperative IVCF placement visit would affect the IVCF removal rate.

Methods: All electronically documented IVCF placements at a single institution were reviewed from April 2015 to July 2019. The baseline characteristics included age, the clinical indications for IVCF placement, inpatient/outpatient status, and type of IVCF placed. Statistical analysis was performed using the χ for discrete variables and the two-tailed paired t test for continuous variables.

Results: A total of 599 patients (mean age, 68 years; 273 women and 326 men) had undergone technically successful IVCF placement. During the preoperative consent process for placement, 232 patients had been scheduled for IVCF removal within 3 months after placement. However, 367 patients had not been scheduled for removal at the preoperative consent process. The indications for placement included failure of anticoagulation, a contraindication to anticoagulation (eg, bleeding), preoperative prophylaxis, and others. Of the 232 patients scheduled for IVCF removal during preoperative consent for IVCF placement, 103 (44%) had undergone successful IVCF removal (mean interval from placement, 107 ± 100 days). Of the 367 nonscheduled patients, 89 (24%) had undergone successful IVCF removal (mean time, 184 ± 215 days). We found a significant improvement in the IVCF removal rate between the scheduled and nonscheduled patients (P < .0001). Three patients (all from the scheduled group) had a clot burden within the IVCF, which meant they were inappropriate for removal. These patients were rescheduled and had eventually undergone uncomplicated removal.

Conclusions: Scheduling IVCF removal during the placement encounter significantly increased the IVCF removal rate. This approach could be a viable option for institutions where clinic time and/or resources are limited or unavailable and for patients who have difficulty traveling for clinical evaluations.
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http://dx.doi.org/10.1016/j.jvsv.2020.09.004DOI Listing
September 2020

Complications and retrieval characteristics of Celect Platinum inferior vena cava filters.

J Vasc Surg Venous Lymphat Disord 2018 03 9;6(2):163-172. Epub 2017 Dec 9.

Division of Interventional Radiology, S. Mark Taper Foundation Imaging Center, Cedars-Sinai Medical Center, Los Angeles, Calif.

Background: The purpose of this study was to retrospectively assess the retrieval characteristics and rate of filter-related complications associated with use of the Celect Platinum (Cook Medical, Bloomington, Ind) inferior vena cava filter (IVCF).

Methods: A single-center, retrospective review was conducted to identify patients who received a Celect Platinum IVCF between June 2013 and February 2016. The patients' charts and imaging records (computed tomography [CT] and cavography) associated with filter placement, follow-up, and filter retrieval procedures were assessed for attempted and successful retrieval rates and filter-related complications.

Results: During the review period, 562 Celect Platinum filters were placed in 556 patients. Outcome and evaluable imaging data (CT and cavography) were available from 335 patients, with median CT follow-up time of 45 days (average, 126 days) and median cavography follow-up time of 90 days (average, 102 days). IVCF leg perforation of the inferior vena cava wall >3 mm was identified in 65 cases (19.4%) on follow-up imaging (64 cases). In addition, filter tilt >15 degrees was identified in 4 filters (1.2%), filter migration >2 cm in 1 filter (0.3%), and occlusive filter or inferior vena cava or iliac vein thrombus in 11 filters; no filter fracture was observed. One case of breakthrough pulmonary embolism and two additional indeterminate cases were identified on follow-up CT pulmonary angiography (2.6%-7.7%). Retrieval was successful in 155 of 155 patients (median indwell time, 90 days; range, 1-445 days); an advanced retrieval technique was used in 11 retrievals.

Conclusions: The outcomes for the Celect Platinum filter were comparable to those previously reported for the first-generation Celect filter in all categories assessed.
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http://dx.doi.org/10.1016/j.jvsv.2017.09.006DOI Listing
March 2018

The Clinicopathological Aspects of Primary Presacral Neuroendocrine Neoplasms: One Center Experience.

Pancreas 2018 01;47(1):122-129

Objectives: Presacral neuroendocrine neoplasms (NENs) are rare entities that are found at the presacral space. We report our experience in the diagnosis, management, and outcomes of primary presacral NENs.

Methods: This was an institutional review board-approved retrospective review of medical records and surgical pathology specimens of patients with a diagnosis of NENs at Cedars-Sinai Medical Center between January 2000 and April 2016.

Results: Ten patients were identified. The median age at presentation was 38 years (range, 20-77 years), and 8 were women. One patient presented with carcinoid-like symptoms, 2 were diagnosed incidentally, and 7 presented with symptoms related to mass effect. The median size of the tumor was 7.0 cm (range, 3-12 cm). On pathologic review, 3 of 10 were low-grade and well-differentiated, 5 of 10 were intermediate-grade and well-differentiated, 2 of 10 were grade 3 and classified as high-grade and poorly differentiated neuroendocrine tumors. Seven cases were metastatic on presentation with lymph node, liver, lung, or skeletal metastasis. Seven of 8 cases were detectable using Octreoscan. Eight patients were treated with a somatostatin analog and 5 patients were treated surgically.

Conclusions: Presacral NENs are clinically similar to gastroenteropancreatic tumors. Octreoscan imaging and somatostatin analog therapies were frequently applied. Further biologic characterization of this rare subtype is needed.
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http://dx.doi.org/10.1097/MPA.0000000000000954DOI Listing
January 2018

Embolization of portosystemic shunts for treatment of medically refractory hepatic encephalopathy.

Liver Transpl 2016 12;22(12):1734-1735

Department of Medicine, Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA.

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http://dx.doi.org/10.1002/lt.24636DOI Listing
December 2016

Metastatic Epithelioid Angiosarcoma after Thrombolysis of an Occluded Ulnar Artery.

J Vasc Interv Radiol 2016 Sep;27(9):1458-1461

Department of Radiology, 8700 Beverly Blvd, Suite M-335, Los Angeles, CA 90048.

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http://dx.doi.org/10.1016/j.jvir.2016.06.009DOI Listing
September 2016

Transjugular liver biopsy in a patient with a total artificial heart.

J Vasc Interv Radiol 2014 Sep;25(9):1480-2

Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, S. Mark Taper Imaging Suite M-335., Los Angeles, CA 90048.

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http://dx.doi.org/10.1016/j.jvir.2014.03.029DOI Listing
September 2014

Pancreatic neuroendocrine tumors: presentation, management, and outcomes.

Am Surg 2009 Oct;75(10):1025-9

Department of Surgery, Center for Liver Diseases and Transplantation, Cedars-Sinai Medical Center, 8635 W 3rd Street, Suite 590W, Los Angeles, CA 90048, USA.

Pancreatic neuroendocrine tumors (pNETs) are an uncommon pancreatic neoplasm. We reviewed the presentation, management, and outcome of patients with pNETs treated at a single center by a multidisciplinary approach between 2004 and 2008. Over this time period, 154 patients with carcinoid and neuroendocrine tumors were treated, which included 46 patients (30% of total) with pNETs. The most common presentations included abdominal pain (20 of 46 [43%]), systemic symptoms such as hypoglycemia (15 of 46 [33%]), and incidental mass (7 of 46 [15%]). Fourteen patients had functional tumors. At the time of diagnosis, 22 patients (48%) presented without metastases and 24 (52%) had metastatic disease. Median follow up for the entire group was 42 months. All patients with nonmetastatic pNET underwent pancreatic resection with 95 per cent postoperative survival. Overall survival in this group at 3 years was 86 per cent and disease-free survival was 81 per cent. In patients presenting with metastatic pNET, multiple treatment modalities were used, including liver resection or ablation (n = 15), hepatic chemoembolization (n = 17), pancreatic resection (n = 12), and systemic treatments (n = 7). Three-year survival was 70 per cent. Pancreatic resection results in greater than 80 per cent 3-year survival in nonmetastatic pNET. In patients presenting with metastatic pNET, excellent survival rates are also achievable using a multidisciplinary multimodal approach.
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October 2009