01 septiembre 2017

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Quality Improvement Guidelines for Transarterial Chemoembolization and Embolization of Hepatic Malignancy

Ron C. Gaba, MD, R. Peter Lokken, MD, MPH, Ryan M. Hickey, MD, Andrew J. Lipnik, MD, Robert J. Lewandowski, MD, Riad Salem, MD, MBA, Daniel B. Brown, MD, T. Gregory Walker, MD, James E. Silberzweig, MD, Mark Otto Baerlocher, MD, Ana Maria Echenique, MD, Mehran Midia, MD, Jason W. Mitchell, MD, MPH, MBA, Siddharth A. Padia, MD, Suvranu Ganguli, MD, Thomas J. Ward, MD, Jeffrey L. Weinstein, MD, Boris Nikolic, MD, MBA, Sean R. Dariushnia, MD

Transcatheter liver-directed intraarterial therapy represents an important therapeutic approach in individuals with liver-dominant neoplasms. Transarterial chemoembolization and embolization—the archetypical transarterial embolotherapies in interventional oncology locoregional therapy (LRT)—have gained acceptance and application during the past 4 decades for treatment of various primary hepatic malignancies and secondary cancers and are widely employed in current interventional radiology (IR) practice. As such, quality assurance in case selection, procedure performance, and patient outcomes through establishment of threshold levels for therapy indication adherence, procedure success rates, and adverse event incidence is critical in ensuring delivery of high quality, effective, and value-driven care in IR. These updated guidelines—which build on prior versions of this document—have thus been developed for use in QI programs assessing transarterial chemoembolization and embolization outcomes in clinical practice.

01 julio 2017

RADIOLOGY. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017

Heber MacMahon, David P. Naidich, Jin Mo Goo, Kyung Soo Lee, Ann N. C. Leung, John R. Mayo, Atul C. Mehta, Yoshiharu Ohno, Charles A. Powell, Mathias Prokop, Geoffrey D. Rubin, Cornelia M. Schaefer-Prokop, William D. Travis, Paul E. Van Schil, Alexander A. Bankier

The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013. Since then, new information has become available; therefore, the guidelines have been revised to reflect current thinking on nodule management. The revised guidelines incorporate several substantive changes that reflect current thinking on the management of small nodules. The minimum threshold size for routine follow-up has been increased, and recommended follow-up intervals are now given as a range rather than as a precise time period to give radiologists, clinicians, and patients greater discretion to accommodate individual risk factors and preferences. The guidelines for solid and subsolid nodules have been combined in one simplified table, and specific recommendations have been included for multiple nodules. These guidelines represent the consensus of the Fleischner Society, and as such, they incorporate the opinions of a multidisciplinary international group of thoracic radiologists, pulmonologists, surgeons, pathologists, and other specialists. Changes from the previous guidelines issued by the Fleischner Society are based on new data and accumulated experience.

01 enero 2017

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Radioembolization of Hepatic Malignancies: Background, Quality Improvement Guidelines, and Future Directions

Siddharth A. Padia, MD, Robert J. Lewandowski, MD, Guy E. Johnson, MD, Daniel Y. Sze, MD, PhD, Thomas J. Ward, MD, Ron C. Gaba, MD, Mark O. Baerlocher, MD, Vanessa L. Gates, MS, Ahsun Riaz, MD, Daniel B. Brown, MD, Nasir H. Siddiqi, MD, T. Gregory Walker, MD, James E. Silberzweig, MD, Jason W. Mitchell, MD, MPH, MBA, Boris Nikolic, MD, MBA, Riad Salem, MD, MBA

The mission of the Society of Interventional Radiology (SIR) is to improve patient care through image-guided therapy. The Society was founded in 1973, and is recognized today as the primary specialty society for physicians who provide minimally invasive image-guided therapies. The Standards Division of SIR writes a number of different types of standards documents to reflect the current clinical paradigm and evolution in the treatment of a specific disease state or a procedure. The Standards Division currently produces four different types of documents.

01 marzo 2017

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. CIRSE Guidelines on Percutaneous Vertebral Augmentation

Georgia Tsoumakidou, Chow Wei Too, Guillaume Koch, Jean Caudrelier, Roberto Luigi Cazzato, Julien Garnon, Afshin Gangi

Vertebral compression fracture (VCF) is an important cause of severe debilitating back pain, adversely affecting quality of life, physical function, psychosocial performance, mental health and survival. Different vertebral augmentation procedures (VAPs) are used in order to consolidate the VCFs, relief pain,and whenever posible achieve vertebral body height restoration. In the present review we give the indications, contraindications, safety profile and outcomes of the existing percutaneous VAPs.

01 febrero 2017

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. CIRSE Guidelines on Percutaneous Ablation of Small Renal Cell Carcinoma

Miltiadis E. Krokidis, Franco Orsi, Konstantinos Katsanos, Thomas Helmberger, Andy Adam

Renal cell carcinoma (RCC) comprises approximately 3.8% of all new cancers in the western world; the detection rate of RCC has been increasing in the past 10 years by approximately 1.7% per year. This rise is attributed to the increased number of diagnostic cross-sectional scans in which asymptomatic renal tumours are incidentally detected. The median age at diagnosis is 64 years.

01 marzo 2015

JOURNAL OF VASCULAR SURGERY. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication

Society for Vascular Surgery Lower Extremity Guidelines Writing Group , Michael S. Conte, MD ((Co-Chair)) , Frank B. Pomposelli, MD ((Co-Chair)) , Daniel G. Clair, MD , Patrick J. Geraghty, MD , James F. McKinsey, MD , Joseph L. Mills, MD , Gregory L. Moneta, MD , M. Hassan Murad, MD , Richard J. Powell, MD , Amy B. Reed, MD , Andres Schanzer, MD , Anton N. Sidawy, MD, MPH

Peripheral arterial disease (PAD) continues to grow in global prevalence and consumes an increasing amount of resources in the United States health care system. Overall rates of intervention for PAD have been rising steadily in recent years. Changing demographics, evolution of technologies, and an expanding database of outcomes studies are primary forces influencing clinical decision making in PAD. The management of PAD is multidisciplinary, involving primary care physicians and vascular specialists with varying expertise in diagnostic and treatment modalities. PAD represents a broad spectrum of disease from asymptomatic through severe limb ischemia.

01 febrero 2015

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Occupational Radiation Protection of Pregnant or Potentially Pregnant Workers in IR: A Joint Guideline of the Society of Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe

Lawrence T. Dauer, PhD, Donald L. Miller, MD , Beth Schueler, PhD , James Silberzweig, MD , Stephen Balter, PhD , Gabriel Bartal, MD , Charles Chambers, MD , Jeremy D. Collins, MD , John Damilakis, PhD , Robert G. Dixon, MD , M. Victoria Marx, MD , Michael S. Stecker, MD , Eliseo Vañó, PhD , Aradhana M. Venkatesan, MD , Boris Nikolic, MD, MBA for the Society of Interventional Radiology Safety and Health Committee for the Cardiovascular and Interventional Radiological Society of Europe Standards of Practice Committee

The memberships of the Society of Interventional Radiology (SIR) Safety and Health Committee and the Cardiovascular and Radiological Society of Europe (CIRSE) Standards of Practice Committee represent experts in a broad spectrum of interventional procedures from both the private and academic sectors of medicine. Generally, these Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid broad expert constituency of the subject matter under consideration. In addition, the authors also include other experts in radiation safety.

01 diciembre 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Quality Improvement Guidelines for Diagnostic Arteriography

Sean R. Dariushnia, MD , Anne E. Gill, MD , Louis G. Martin, MD , Wael E. Saad, MD , Kevin M. Baskin, MD , Drew M. Caplin, MD , Sanjeeva P. Kalva, MD , Mark J. Hogan, MD , Mehran Midia, MD, FRCPC , Nasir H. Siddiqi, MD , T. Gregory Walker, MD , Boris Nikolic, MD, MBA for the Society of Interventional Radiology Standards of Practice Committee

The membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee represents experts in a broad spectrum of interventional procedures from the private and academic sectors of medicine. Generally, Standards of Practice Committee member dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid, broad expert constituency of the subject matter under consideration for standards production.

01 diciembre 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Quality Improvement Guidelines for Pediatric Gastrostomy and Gastrojejunostomy Tube Placement

John J. Crowley, MB , Mark J. Hogan, MD , Richard B. Towbin, MD , Wael E. Saad, MD , Kevin M. Baskin, MD , Anne Marie Cahill, MD , Drew M. Caplin, MD , Bairbre L. Connolly, MB , Sanjeeva P. Kalva, MD , Venkataramu Krishnamurthy, MD , Francis E. Marshalleck, MD , Derek J. Roebuck, MD , Nael E. Saad, MD , Gloria M. Salazar, MD , Leann S. Stokes, MD , Michael J. Temple, MD , T. Gregory Walker, MD , Boris Nikolic, MD, MBA for the Society of Interventional Radiology Standards of Practice Committee and the Society for Pediatric Radiology Interventional Radiology Committee

The membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee represents experts in a broad spectrum of interventional procedures from the private and academic sectors of medicine. Generally, Standards of Practice Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid, broad expert constituency of the subject matter under consideration for standards production.

01 noviembre 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Image-Guided Tumor Ablation: Standardization of Terminology and Reporting Criteria—A 10-Year Update

Muneeb Ahmed, MD, Luigi Solbiati, MD , Christopher L. Brace, PhD , David J. Breen, MD , Matthew R. Callstrom, MD, PhD , J. William Charboneau, MD , Min-Hua Chen, MD , Byung Ihn Choi, MD , Thierry de Baère, MD , Gerald D. Dodd III, MD , Damian E. Dupuy, MD , Debra A. Gervais, MD , David Gianfelice, MD , Alice R. Gillams, MD , Fred T. Lee Jr, MD , Edward Leen, FRCR, MD , Riccardo Lencioni, MD , Peter J. Littrup, MD , Tito Livraghi, MD , David S. Lu, MD , John P. McGahan, MD , Maria Franca Meloni, MD , Boris Nikolic, MD , Philippe L. Pereira, MD , Ping Liang, MD , Hyunchul Rhim, MD , Steven C. Rose, MD , Riad Salem, MD, MBA , Constantinos T. Sofocleous, MD , Stephen B. Solomon, MD , Michael C. Soulen, MD , Masatoshi Tanaka, MD , Thomas J. Vogl, MD , Bradford J. Wood, MD , S. Nahum Goldberg, MD , International Working Group on Image-Guided Tumor Ablation , Interventional Oncology Sans Frontières Expert Panel , Technology Assessment Committee of the Society of Interventional Radiology , the Standard of Practice Committee of the Cardiovascular and Interventional Radiological Society of Europe

Image-guided tumor ablation has become a well-established hallmark of local cancer therapy. The breadth of options available in this growing field increases the need for standardization of terminology and reporting criteria to facilitate effective communication of ideas and appropriate comparison among treatments that use different technologies, such as chemical (eg, ethanol or acetic acid) ablation, thermal therapies (eg, radiofrequency, laser, microwave, focused ultrasound, and cryoablation) and newer ablative modalities such as irreversible electroporation. This updated consensus document provides a framework that will facilitate the clearest communication among investigators regarding ablative technologies. An appropriate vehicle is proposed for reporting the various aspects of image-guided ablation therapy including classification of therapies, procedure terms, descriptors of imaging guidance, and terminology for imaging and pathologic findings. Methods are addressed for standardizing reporting of technique, follow-up, complications, and clinical results. As noted in the original document from 2003, adherence to the recommendations will improve the precision of communications in this field, leading to more accurate comparison of technologies and results, and ultimately to improved patient outcomes.

01 noviembre 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Quality Improvement Guidelines for Uterine Artery Embolization for Symptomatic Leiomyomata

Sean R. Dariushnia, MD, Boris Nikolic, MD, MBA , LeAnn S. Stokes, MD , James B. Spies, MD, MPH , Society of Interventional Radiology Standards of Practice Committee

The membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee represents experts in a broad spectrum of interventional procedures from both the private and academic sectors of medicine. Generally, Standards of Practice Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid broad expert constituency of the subject matter under consideration for standards production.

01 septiembre 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Society of Interventional Radiology Position Statement: Prostate Artery Embolization for Treatment of Benign Disease of the Prostate

Justin P. McWilliams, MD , Michael D. Kuo, MD , Steven C. Rose, MD , Sandeep Bagla, MD , Drew M. Caplin, MD , Emil I. Cohen, MD , Salomao Faintuch, MD, MSc , James B. Spies, MD, MPH , Wael E. Saad, MD , Boris Nikolic, MD, MBA

BPH is the most common benign neoplasm in men, with more than 50% of men aged 60–69 years and as many as 90% aged 70–89 years having some symptoms of BPH. As life expectancy increases, so does the occurrence of BPH. In 2000, there were 4.5 million visits to physicians for BPH in the United States, with a direct cost of $1.1 billion (1).

01 septiembre 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Quality Improvement Guidelines for the Treatment of Lower-Extremity Deep Vein Thrombosis with Use of Endovascular Thrombus Removal

Suresh Vedantham, MD , Akhilesh K. Sista, MD , Seth J. Klein, MD , Lina Nayak, MD , Mahmood K. Razavi, MD , Sanjeeva P. Kalva, MD , Wael E. Saad, MD , Sean R. Dariushnia, MD , Drew M. Caplin, MD , Christine P. Chao, MD , Suvranu Ganguli, MD , T. Gregory Walker, MD , Boris Nikolic, MD, MBA , Society of Interventional Radiology and Cardiovascular and Interventional Radiological Society of Europe Standards of Practice Committees

The membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee represents experts in a broad spectrum of interventional procedures from the private and academic sectors of medicine. Generally, Standards of Practice Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid broad expert constituency of the subject matter under consideration for standards production.

01 abril 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Proceedings from the Society of Interventional Radiology Foundation Research Consensus Panel on Renal Sympathetic Denervation

John F. Angle, MD , Ethan A. Prince, MD , Alan H. Matsumoto, MD , Thomas E. Lohmeier, PhD , Andrew M. Roberts, PhD , Sanjay Misra, MD , Mahmood K. Razavi, MD , Richard E. Katholi, MD , Shawn N. Sarin, MD , Domenic A. Sica, MD , Kalyanam Shivkumar , Kamran Ahrar, MD

In 1948, Smithwick and others (1, 2) reported on operative thoracolumbar sympathectomy to treat hypertension (HTN). In a study of patients with uncontrolled HTN who underwent thoracolumbar sympathectomy, 45% of 1,266 patients maintained significant improvement in blood pressure (BP) 5 years later (3). However, this procedure was also associated with significant morbidity and orthostatic hypotension and was abandoned in the 1960s with the widespread advancements in, and availability of, effective pharmacologic therapy. In the 1970s, operative ligation of the sympathetic fibers in the perirenal space was considered a contributor to the benefits of renal artery surgery for treatment of renovascular HTN or chronic kidney disease (4). More recently, convincing evidence has emerged that chronic elevation of sympathetic nervous system activity is a major contributor to the complex pathophysiology of essential HTN and in particular resistant HTN (5, 6).

01 febrero 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Occupational Exposure to Bloodborne Pathogens in IR—Risks, Prevention, and Recommendations: A Joint Guideline of the Society of Interventional Radiology and Cardiovascular and Interventional Radiological Society of Europe

Eric M. Walser, MD , Robert G. Dixon, MD , James E. Silberzweig, MD , Gabriel Bartal, MD , Christine P. Chao, MD , Kathleen Gross, MSN, RN, BC, CRN , Michael S. Stecker, MD , Boris Nikolic, MD, MBA

Introduction: In 2003, the Society of Interventional Radiology (SIR) published a policy and position statement concerning the occupational risks of bloodborne pathogens (BBPs) (1). The members of the SIR subcommittee on human immunodeficiency virus (HIV) and BBPs constructed this document, which detailed the risks of BBP infection in the interventional radiology (IR) environment (patient–to–health care worker [HCW] transmission as well as vice-versa) and proposed various methods to reduce risk, including use of personal protective equipment, adherence to the philosophy of universal precautions (2), and observance of various preventative measures related to performance of procedures, use of equipment, and specimen handling. This subcommittee promoted postexposure prophylaxis (PEP) guidelines and exposure control measures approved by the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) at the time of draft approval.