01 junio 2012

JVIR. Pancreatic Islet Cell Transplantation: An Update for Interventional Radiologists

Ron C. Gaba, MD, Raquel Garcia-Roca, MD, and Jose Oberholzer, MD

Pancreatic islet cell transplantation is a promising cellular-based therapy for type 1 diabetes mellitus. This procedure involves portal venous injection of islet cells and affords 1-year insulin independence in as many as 80% of recipients. Although transplant surgeons represent historical drivers of islet therapy, requirement for image guidance and transcatheter techniques has fostered collaboration with interventional radiologists, who are positioned to play a significant role in clinical performance of islet transplantation and in basic science research in this field. This review article aims to familiarize interventional radiologists with islet cell transplantation patient selection, procedure technique, clinical outcomes, and future clinical and research avenues. Journal of Vascular and Interventional Radiology Volume 23, Issue 5 , Pages 583-594, May 2012. Copiryght © SIR, 2012

01 febrero 2012

JVIR. Endovascular Therapy for Acute Pulmonary Embolism

William T. Kuo, MD

Acute pulmonary embolism (PE) is the third most common cause of death among hospitalized patients. Treatment escalation beyond anticoagulation therapy is necessary in patients with massive PE (defined by hemodynamic shock) as well as in many patients with submassive PE (defined by right ventricular strain). The best current evidence suggests that modern catheter-directed therapy to achieve rapid central clot debulking should be considered as an early or first-line treatment option for patients with acute massive PE; and emerging evidence suggests a catheter-directed thrombolytic infusion should be considered as adjunctive therapy for many patients with acute submassive PE. This article reviews the current approach to endovascular therapy for acute PE in the context of appropriate diagnosis, risk stratification, and management of acute massive and acute submassive PE. Journal of Vascular and Interventional Radiology Volume 23, Issue 2 , Pages 167-179.e4, February 2012. Copiryght © SIR, 2012

01 agosto 2011

JVIR. Imaging the Intraluminal Thrombus of Abdominal Aortic Aneurysms: Techniques, Findings, and Clinical Implications

Fausto Labruto, MD, PhD, Lennart Blomqvist, MD, PhD, and Jesper Swedenborg, MD, PhD

Intraluminal thrombus (ILT) is known to influence the natural history of abdominal aortic aneurysms, and its effect on the arterial wall may predict the risks of rupture. The main features of ILT believed to be associated with aneurysm growth and increased rupture risk are size; presence of fissures, dissections, or calcifications in the ILT; and inhomogeneity in its internal structure. Modern imaging allows for detailed depiction of the ILT. This review describes the techniques, findings, clinical implications, advantages, and disadvantages of imaging the ILT by ultrasound, contrast-enhanced computed tomography, and magnetic resonance imaging. Journal of Vascular and Interventional Radiology Volume 22, Issue 8 , Pages 1069-1075, August 2011. Copiryght © SIR, 2011

01 junio 2011

JVIR. Bland Embolization in the Treatment of Hepatic Adenomas: Preliminary Experience

Ajita Deodhar, MD, Lynn A. Brody, MD, Anne M. Covey, MD, Karen T. Brown, MD, and George I. Getrajdman, MD

The study presents preliminary, retrospective experience with bland embolization for hepatic adenomas (HAs) with the use of tris-acryl gelatin microspheres. Eight patients underwent bland embolization for biopsy-proven HAs. A biopsy specimen was taken from only one lesion when multiple lesions were present. Seventeen embolizations were performed for abdominal pain, active bleeding, or prophylaxis against bleeding. Five patients underwent multiple procedures. Technical success rate was 100%. Median follow-up was 24 months (range, 10–40 mo). No growth was observed at follow-up in any treated lesion, and many lesions (13 of 16) regressed. Bland embolization may be safely used for treatment of abdominal pain and bleeding from HAs. Journal of Vascular and Interventional Radiology Volume 22, Issue 6 , Pages 795-799, June 2011. Copiryght © SIR, 2011

01 marzo 2011

JVIR. Outcomes of Thrombectomy Procedures Performed in Hemodialysis Grafts with Early Failure

Alexandra Yurkovic, AB, Raphael D. Cohen, MD, Mark P. Mantell, MD, Sidney Kobrin, MD, Michael C. Soulen, MD, Jesse Chittams, MS, and Scott O. Trerotola, MD

Purpose: Percutaneous declotting is usually not offered for hemodialysis access grafts clotting
30 days after placement because of concerns regarding safety of percutaneous transluminal angioplasty in fresh anastomoses, potential need for surgical correction of the underlying cause, and poor outcomes. The authors sought to determine acute and long-term outcomes of declotting of grafts with early failure. Journal of Vascular and Interventional Radiology Volume 22, Issue 3 , Pages 317-324, March 2011. Copiryght © SIR, 2011

01 febrero 2011

JVIR. Percutaneous Mechanical and Pharmacomechanical Thrombolysis for Occlusive Deep Vein Thrombosis of the Proximal Limb in Adolescent Subjects: Findings from an Institution-based Prospective Inception Cohort Study of Pediatric Venous Thromboembolism

Neil A. Goldenberg, MD, PhD, Brian Branchford, MD, Michael Wang, MD, Charles Ray, Jr, MD, Janette D. Durham, MD, and Marilyn J. Manco-Johnson, MD

Purpose: Young individuals with occlusive, proximal-limb deep vein thrombosis (DVT) who have acutely increased plasma levels of factor VIII and D-dimer are at high risk for postthrombotic syndrome (PTS) when treated with conventional anticoagulation alone. The present report is an evaluation of experience with adjunctive percutaneous mechanical thrombolysis (PMT) and/or percutaneous pharmacomechanical thrombolysis (PPMT) in such patients. Journal of Vascular and Interventional Radiology Volume 22, Issue 2 , Pages 121-132, February 2011. Copiryght © SIR, 2011

01 enero 2011

JVIR. Prostatic Arterial Embolization to Treat Benign Prostatic Hyperplasia

João M. Pisco, MD, PhD, Luis C. Pinheiro, MD, PhD, Tiago Bilhim, MD, Marisa Duarte, MD, Jorge R. Mendes, MD, and Antonio G. Oliveira, MD, PhD

PURPOSE: To evaluate whether prostatic arterial embolization (PAE) might be a feasible procedure to treat lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). Journal of Vascular and Interventional Radiology Volume 22, Issue 1 , Pages 11-19, January 2011. Copiryght © SIR, 2011

01 noviembre 2011

JVIR. Imaging Guidance with C-arm CT: Prospective Evaluation of Its Impact on Patient Radiation Exposure during Transhepatic Arterial Chemoembolization

Nishita Kothary, MD, Mohamed H. K. Abdelmaksoud, MD, MS, Alessia Tognolini, MD, Rebecca Fahrig, PhD, Jarrett Rosenberg, PhD, David M. Hovsepian, MD, Arundhuti Ganguly, PhD, John D. Louie, MD, William T. Kuo, MD, Gloria L. Hwang, MD, Alison Holzer, PhD, Daniel Y. Sze, MD, PhD, and Lawrence V. Hofmann, MD

Purpose: To prospectively evaluate the impact of C-arm CT on radiation exposure to hepatocellular carcinoma (HCC) patients treated by chemoembolization. Journal of Vascular and Interventional Radiology Volume 22, Issue 11 , Pages 1535-1543, November 2011. Copiryght © SIR, 2011

01 febrero 2011

RADIOLOGY. Evaluation of an Active Vena Cava Filter for MR Imaging in a Swine Model

Nils A. Kraemer, MD, Erwin Immel, MSc, Hank C. W. Donker, PhD, Andreas Melzer, MSc, PhD, Christina Ocklenburg, MSc, Rolf W. Guenther, MD, Arno Buecker, MD, MSc, Gabriele A. Krombach, MD and Elmar Spuentrup, MD

Purpose: To evaluate the feasibility of magnetic resonance (MR) imaging–guided placement of an active vena cava filter (AVCF) in a swine model, the effectiveness of the system in filtering thrombi, and the detection of thrombi with MR imaging. February 2011 Radiology: 258, 446-454. Copiryght © RSNA, 2011

01 enero 2012

JVIR. Pathogenesis of Varicose Veins

Rahmi Oklu, MD, PhD, Roy Habito, MD, Manuel Mayr, MD, PhD, Amy R. Deipolyi, MD, PhD, Hassan Albadawi, MD, Robin Hesketh, PhD, T. Gregory Walker, MD, Katy R. Linskey, MD, Chandler A. Long, MD, Stephan Wicky, MD, Julianne Stoughton, MD, and Michael T. Watkins, MD

Despite the high prevalence of varicose veins and the recent surge in research on the condition, the precise mechanisms underlying their development remain uncertain. In the past decade, there has been a shift from initial theories based on purely mechanical factors to hypotheses pointing to complex molecular changes causing histologic alterations in the vessel wall and extracellular matrix. Despite progress in understanding the molecular aspects of venous insufficiency, therapies for symptomatic varicose veins are directed toward anatomic and physical interventions. The present report reviews current evidence identifying the underlying biochemical alterations in the pathogenesis of varicose veins. Journal of Vascular and Interventional Radiology Volume 23, Issue 1 , Pages 33-39, January 2012. Copiryght © SIR, 2012

01 julio 2011

JVIR. Uterine Artery Embolization for the Treatment of Adenomyosis: A Review

Martin Popovic, BSc, Stefan Puchner, MD, Dominik Berzaczy, MD, Johannes Lammer, MD, and Robert A. Bucek, MD

During the past 10 years, uterine artery embolization (UAE) has been investigated as a possible therapy for adenomyosis. All publications available from 1999 through 2010 are included in this report. Levels of evidence and trial classifications were evaluated according to the guidelines developed by the United States Preventive Services Task Force. Long-term data are available from 511 affected women from 15 studies. Improvements were reported by 387 patients (75.7%). The median follow-up was 26.9 months. UAE as treatment for adenomyosis shows significant clinical and symptomatic improvements on a short- and long-term basis. Journal of Vascular and Interventional Radiology Volume 22, Issue 7 , Pages 901-909, July 2011. Copiryght © SIR, 2011

01 junio 2011

JVIR. Safety and Efficacy of Radiofrequency Ablation for Hepatocellular Adenoma

Mark G. van Vledder, MD, Sanne M. van Aalten, MD, Turkan Terkivatan, MD, Robert A. de Man, MD, Trude Leertouwer, MD, and Jan N.M. IJzermans, MD

Purpose: To investigate the safety and efficacy of radiofrequency (RF) ablation for the treatment of hepatocellular adenoma (HCA). Journal of Vascular and Interventional Radiology Volume 22, Issue 6 , Pages 787-793, June 2011. Copiryght © SIR, 2011

01 mayo 2011

JVIR. Malfunctioning and Infected Tunneled Infusion Catheters: Over-the-Wire Catheter Exchange versus Catheter Removal and Replacement

David M. Guttmann, BS, Scott O. Trerotola, MD, Timothy W. Clark, MD, Mandeep Dagli, MD, Richard D. Shlansky-Goldberg, MD, Maxim Itkin, MD, Michael C. Soulen, MD, Jeffrey I. Mondschein, MD, and S. William Stavropoulos, MD

Purpose: To compare the safety and effectiveness of over-the-wire catheter exchange (catheter-exchange) with catheter removal and replacement (removal-replacement) at a new site for infected or malfunctioning tunneled infusion catheters. Journal of Vascular and Interventional Radiology Volume 22, Issue 5 , Pages 642-646, May 2011. Copiryght © SIR, 2011

01 marzo 2011

JVIR. Research Reporting Standards for Radioembolization of Hepatic Malignancies

Riad Salem, MD, MBA, Robert J. Lewandowski, MD, Vanessa L. Gates, MS, Charles W. Nutting, DO, Ravi Murthy, MD, Steven C. Rose, MD, Michael C. Soulen, MD, Jean-Francois H. Geschwind, MD, Laura Kulik, MD, Yun Hwan Kim, MD, Carlo Spreafico, MD, Marco Maccauro, MD, Lourens Bester, MD, Daniel B. Brown, MD, Robert K.W. Ryu, MD, Daniel Y. Sze, MD, PhD, William S. Rilling, MD, Kent T. Sato, MD, Bruno Sangro, MD, Jose Ignacio Bilbao, MD, Tobias F. Jakobs, MD, Samer Ezziddin, MD, Suyash Kulkarni, MD, Aniruddha Kulkarni, MD, David M. Liu, MD, David Valenti, MD, Philip Hilgard, MD, Gerald Antoch, MD, Stefan P. Muller, MD, Hamad Alsuhaibani, MD, Mary F. Mulcahy, MD, Marta Burrel, MD, Maria Isabel Real, MD, Stewart Spies, MD, Abdulredha A. Esmail, MD, Jean-Luc Raoul, MD, Etienne Garin, MD, PhD, Mathew S. Johnson, MD, Al B. Benson, III, MD, Ricky A. Sharma, MD, Harpreet Wasan, MD, Bieke Lambert, MD, Khairuddin Memon MD, Andrew S. Kennedy, MD, and Ahsun Riaz, MD, for the Technology Assessment Committee and Interventional Oncology Task Force of the Society of Interventional Radiology

RATIONALE: Radioembolization is a field of interventional oncology that continues to evolve. The number of institutions adopting this approach is increasing; this trend is paralleled by a greater number of research investigations reported in the peer-reviewed literature. Therefore, developing standardization and reporting criteria therefore becomes of paramount importance in order to facilitate clear communications between investigators. The vehicle of a standards document provides the framework for reporting various aspects of the technique, including classification of methodology, descriptors of toxicities and complications, imaging guidance, and appropriate terminology that require specific attention when reporting clinical studies. It is the standpoint of the group that adherence to the recommendations will facilitate the main objective: improved precision and communication for reporting the various aspects of radioembolization. This approach should translate to more accurate comparison of data across centers and, ultimately, to enhanced research methodology. Journal of Vascular and Interventional Radiology Volume 22, Issue 3 , Pages 265-278, March 2011. Copiryght © SIR, 2011

01 enero 2012

DIR. Interventional radiological retrieval of embolized vascular access device fragments

Baran Önal, Bilgen Coşkun, Ramazan Karabulut, Erhan T. Ilgıt, Zafer Türkyılmaz, Kaan Sönmez

Vascular access device fragment embolization is a relatively rare but potentially serious complication. The purpose of this study was to report our experience with endovascular retrieval of embolized vascular access device fragments by interventional radiological means. Diagnostic and Interventional Radiology; January 2012 18:87–91. Copyright © Turkish Society of Radiology 2012