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01 octubre 2016

RADIOLOGY. Predictors of Clinical Outcome after Prostate Artery Embolization with Spherical and Nonspherical Polyvinyl Alcohol Particles in Patients with Benign Prostatic Hyperplasia

Tiago Bilhim, João Pisco, José A. Pereira, Nuno Vasco Costa, Lúcia Fernandes, Luís Campos Pinheiro, Marisa Duarte, António G. Oliveira

Purpose: To assess predictors of outcome after prostate artery embolization (PAE) for benign prostatic hyperplasia with spherical particle polyvinyl alcohol (sPVA) and compare outcomes with the use of nonspherical particle polyvinyl alcohol (nsPVA).

01 septiembre 2016

RADIOLOGY. Management of Uterine Fibroids: A Focus on Uterine-sparing Interventional Techniques

James E. Silberzweig, Daniel K. Powell, Alan H. Matsumoto, James B. Spies

Uterine fibroids occur in approximately 50% of women over the age of 40 years, and an estimated 50% of those are symptomatic. Menorrhagia is the most common symptom and the primary indication for treatment, although bulk symptoms often occur and can be treated. Pharmacotherapy is typically inadequate unless it can be expected to successfully bridge to menopause or allow for a less-invasive intervention. However, hormonal therapies have risks. Hysterectomy is still the most commonly performed procedure for symptomatic fibroids and has the lowest rate of reintervention (compared with myomectomy or uterine artery embolization [UAE]), but rates of more serious complications are higher and patient satisfaction and ability to return to normal activities may also be less favorable. Myomectomy is not necessarily less morbid than hysterectomy and may have a greater failure rate than UAE. Techniques and devices vary with little standardization, and operator experience is crucial to success. The largest studies of UAE show very low rates of serious complications and rapid recovery. UAE significantly improves symptoms related to uterine fibroids in 85%–90% of patients. Herein, this article will discuss the nature of fibroids and their diagnosis, pharmacotherapy, surgical treatment, and nonsurgical interventional treatment, including UAE and magnetic resonance–guided focused ultrasound.

01 septiembre 2016

RADIOLOGY. Colorectal Cancer Liver Metastases: Biopsy of the Ablation Zone and Margins Can Be Used to Predict Oncologic Outcome

Vlasios S. Sotirchos, Lydia M. Petrovic, Mithat Gönen, David S. Klimstra, Richard K. G. Do, Elena N. Petre, Alessandra R. Garcia, Afsar Barlas, Joseph P. Erinjeri, Karen T. Brown, Anne M. Covey, William Alago, Lynn A. Brody, Ronald P. DeMatteo, Nancy E. Kemeny, Stephen B. Solomon, Katia O. Manova-Todorova, Constantinos T. Sofocleous

Purpose: To establish the prognostic value of biopsy of the central and marginal ablation zones for time to local tumor progression (LTP) after radiofrequency (RF) ablation of colorectal cancer liver metastasis (CLM).

01 noviembre 2017

DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY. Does neoadjuvant doxorubicin drug-eluting bead transarterial chemoembolization improve survival in patients undergoing liver transplant for hepatocellular carcinoma?

Dimitri Dorcaratto, Venkatesha Udupa, Niamh M. Hogan, David P. Brophy, Jeffrey W. McCann, Donal Maguire, Justin Geoghegan, Colin P. Cantwell, Emir Hoti

PURPOSE: We aimed to compare the overall (OS) and disease-free survival (DFS) of patients undergoing orthotopic liver transplant (OLT) for hepatocellular carcinoma who did and did not have neoadjuvant doxorubicin drug-eluting bead transarterial chemoembolization (DEB-TACE).

01 noviembre 2017

DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY. Percutaneous transhepatic techniques for retrieving fractured and intrahepatically dislodged percutaneous transhepatic biliary drainage catheters

Liu Hsien-Tzu, Tseng Hsiuo-Shan, Chiu Nai-Chi, Lin Yi-Yang, Chiou Yi-You, Liu Chien-An

Dislodged intrabiliary drainage devices, including catheters, endoprostheses, and stents, may further impair drainage and cause various local reactions, vascular and gastrointestinal tract complications. Endoscopic approaches for management of plastic biliary endoprostheses have been extensively discussed. However, in rare cases of fracture of percutaneous transhepatic biliary drainage (PTBD) catheters, only a percutaneous transhepatic technique for retrieving should be applied to avoid further damage by its rigid fragment. We present the adjusted techniques using either a goose neck snare, over-the-wire balloon catheter, or biopsy forceps with image demonstration and reviews. We encountered two patients with PTBD tube fracture and intrahepatic dislodgment. In both patients, percutaneous approaches were used for successfully retrieving and removing the fractured catheter through transhepatic tract: one with the use of a biopsy forceps, another with an inflatable balloon catheter.

01 noviembre 2017

DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY. Mechanical recanalization in ischemic anterior circulation stroke within an 8-hour time window: a real-world experience

Dagmar Krajícková, Antonín Krajina, Roman Herzig, Miroslav Lojík, Vendelín Chovanec, Jan Raupach, Eva Vítková, Jan Waishaupt, Oldrich Vysata, Martin Valis

PURPOSE: We aimed to assess the safety and effectiveness of mechanical recanalization in patients with ischemic stroke in the anterior circulation within 8 h since symptoms onset and with unknown onset time. We compared time intervals <6 h vs. 6–8 h/unknown onset time, as only limited data are available for a time window beyond 6 h.

01 octubre 2017

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Comparison of Ultrasound-Accelerated versus Pigtail Catheter–Directed Thrombolysis for the Treatment of Acute Massive and Submassive Pulmonary Embolism

Assaf Graif, MD, Christopher J. Grilli, DO, George Kimbiris, MD, Demetrios J. Agriantonis, MD, Omar Z. Chohan, DO, Charles R. Fedele, DO, Mandip S. Gakhal, MD, Ansar Z. Vance, MD, Daniel A. Leung, MD

Purpose: To compare the technical and clinical effectiveness of ultrasound-accelerated endovascular thrombolysis (USAT) versus pigtail catheter–directed thrombolysis (PCDT) for the treatment of acute pulmonary embolism (PE).

01 octubre 2017

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Single-Center Comparison of Overall Survival and Toxicities in Patients with Infiltrative Hepatocellular Carcinoma Treated with Yttrium-90 Radioembolization or Drug-Eluting Embolic Transarterial Chemoembolization

Joseph L. McDevitt, MD, MBA, Ali Alian, MD, Baljendra Kapoor, MD, Stacy Bennett, RN, Amanjit Gill, MD, Abraham Levitin, MD, Mark Sands, MD, K.V. Narayanan Menon, MD, Federico N. Aucejo, MD, Bassam Estfan, MD, Anil K. Pillai, MD, Sanjeeva P. Kalva, MD, Gordon McLennan, MD

Purpose: To compare overall survival and toxicities after yttrium-90 (90Y) radioembolization and chemoembolization with drug-eluting embolics (DEE) in patients with infiltrative hepatocellular carcinoma (HCC).

01 octubre 2017

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Proposal of a New Adverse Event Classification by the Society of Interventional Radiology Standards of Practice Committee

Omid Khalilzadeh, MD, MPH, Mark O. Baerlocher, MD, Paul B. Shyn, MD, Bairbre L. Connolly, MB, MCh, FRCPC, FRCSI, A. Michael Devane, MD, Christopher S. Morris, MD, Alan M. Cohen, MD, Mehran Midia, MD, Raymond H. Thornton, MD, Kathleen Gross, MSN, BS, Drew M. Caplin, MD, Gunjan Aeron, MBBS, MD, Sanjay Misra, MD, Nilesh H. Patel, MD, T. Gregory Walker, MD, Gloria Martinez-Salazar, MD, James E. Silberzweig, MD, Boris Nikolic, MD, MBA

Purpose: To develop a new adverse event (AE) classification for the interventional radiology (IR) procedures and evaluate its clinical, research, and educational value compared with the existing Society of Interventional Radiology (SIR) classification via an SIR member survey.

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