Chronic venous insufficiency (CVI) as an advanced stage of chronic venous disease is a common problem that occurs in approximately 1–5 % of the adult population. CVI has either a nonthrombotic (primary) or postthrombotic (secondary) cause involving reflux, obstruction, or a combination of both. The role of venous obstruction is increasingly recognized as a major cause of CVI, with obstructive lesions in the iliocaval segment being markedly more relevant than lesions at the levels of the crural and femoral veins. Approximately 70–80 % of iliac veins develop a variable degree of obstruction following an episode of acute deep venous thrombosis. Nonthrombotic iliac vein obstruction also known as May-Thurner or Cockett’s syndrome is the most common cause of nonthrombotic iliac vein occlusion. While compression therapy is the basis of therapy in CVI, in many cases, venous recanalization or correction of obstructive iliac vein lesions may result in resolution of symptoms. This document reviews the current evidence on iliocaval vein recanalization and provides standards of practice for iliocaval stenting in primary and secondary causes of chronic venous disease.
Purpose: This study was designed to assess the effect of calcium on the efficacy of DEB during revascularization of steno-obstructive SFA lesions.
The rapid growth of interventional radiology (IR) during the past 20 years has led to the formation of IR societies in most European countries. However, in many European countries, IR is hampered by a lack of specialty status, which would allow it to determine its own future in terms of clinical practice, governance, training, and certification. In 2009, the Union of European Medical Specialists (UEMS) recognized IR as a distinct specialty of radiology. This landmark vote by the UEMS to recognize IR as a specialty has resulted in a number of European countries pursuing the same objective. Now is the time to seek specialty status for IR throughout Europe, within the house of radiology.
Purpose: To evaluate the perioperative safety and mid-term prognosis (≤12 months) of HydroSoft coils in treating ruptured aneurysms at the anterior circulation compared with bare platinum coils.
Purpose: This systematic review and meta-analysis aimed to evaluate the risks of complications (infectious and non-infectious) including the need for device removal associated with centrally inserted external catheters compared with totally implantable ports in patients undergoing chemotherapy.
Modern advances in interventional radiology and nuclear medicine may now allow for safe and effective 90Y radioembolization to sites other than the liver. A general theory of predictive dosimetry based on the MIRD schema is proposed, adapted from the original partition model for liver 90Y radioembolization.
We fully approve the content of this Letter, as it provides a comprehensive roadmap on predictive dosimetry and aims at standardisation and good clinical practice for 90Y-radioembolization to sites other than the liver. The field of application is well defined in the dosimetric assumptions and general points. The formulas are clear and applicable at any site.
We have read the comments to our recently published article about Y90-radioembolization of lung metastases via the bronchial artery with great interest, and we welcome the additional perspective on dosimetry for Y90-radioembolization outside the liver [1, 2]. However, some thoughts must be added. First, it should be noted that the authors of the letter deduce their approach from a systematic description of the compartmental distribution as utilized in radioembolization of liver malignancies [2]. This model is then extended to cater different application scenarios (lung, kidney). However, other than implied in the letter dosimetry for Y90-radioembolization of the liver generally remains highly controversial with no uniform conclusions between numerous research groups [3–6].
Purpose: Patency after percutaneous transluminal angioplasty of native hemodialysis arteriovenous fistulae (AVFs) is highly variable. This study aimed to identify predictors of patency following angioplasty in native AVFs.
Percutaneous tumor ablation requires intraprocedural imaging both to guide electrode placement and to determine the technical effectiveness and endpoint of the procedure (1). Placement of the ablation electrode is typically performed with ultrasonographic (US), computed tomographic (CT), or magnetic resonance (MR) imaging guidance. However, when the ablation target has the same echogenicity, attenuation, or signal intensity as the tissue that surrounds it, the lesion may be better visualized on fluorine 18 fluorodeoxyglucose (FDG) positron emission tomographic (PET) images. In these cases, investigators have fused, or registered, previously acquired PET scans with CT images obtained during the procedure (2). This approach is limited by challenges in accurate image registration, especially because procedural images are often obtained with the patient in positions and respiratory phases that differ substantially from prior diagnostic PET examinations.
Bleeding caused by gastroesophageal varices is a major complication of portal hypertension in patients with cirrhosis (1). Although bleeding occurs less often if caused by gastric varices (GV) than by esophageal varices, bleeding from GV has a poorer prognosis and is associated with more severe blood loss, a higher rebleeding rate, and a higher mortality rate (1–3). As most of the fundal GV drain into the left renal vein via a gastrorenal shunt (4), the concept of retrograde injection of sclerosing agents into the GV after balloon occlusion of the gastrorenal shunt has been introduced (5). Therefore, balloon-occluded retrograde transvenous obliteration (BRTO) has now become the method of choice for the control of fundal GV and hepatic encephalopathy (HE) (5–17).
Ultrasonographically (US) guided fine-needle aspiration (FNA) is a safe and accurate approach for diagnosing the malignancy of thyroid nodules, but approximately 10%–33.6% of FNA procedures generate a nondiagnostic result (1–4). Most guidelines recommend repeat FNA for any nodule for which previous FNA results are nondiagnostic (1,5–7). However, after an initial nondiagnostic result, repeat FNA may still have a 9.9%–47.8% incidence of nondiagnostic results (8–10). The American Thyroid Association and American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association guidelines recommend that solid nodules with repeat nondiagnostic results be managed with diagnostic surgery (1,7).
Splenic injury is a serious potential consequence of blunt abdominal trauma, and the spleen is a frequently mentioned injured abdominal organ in most reported series (1). Prompt, accurate diagnosis and characterization of splenic injury are key goals of imaging after abdominal trauma.
Many patients with hepatic malignancies are not amenable to surgical resection because of comorbidities, limited hepatic function, or unfavorable anatomic conditions (1). Over the years, ablative therapies have become an established treatment option in this patient population, with radiofrequency (RF) ablation being the most popular representative of this group (2–4). With the advent of microwave (MW) ablation, emission of electromagnetic waves into the tissue without relevant power loss and critical heating of the cable and antenna have been the central issues. However, after having overcome these problems, MW ablation has become a promising alternative with several advantages: MW ablation can generate very high temperatures, as this technique is independent of the impedance of the surrounding tissue. Thus, MW ablation has a tendency to create larger ablation zones in a shorter time (5,6). MW ablation is also less susceptible to the heat-sink effect of peritumoral vessels, which is often the reason for local tumor recurrence after RF ablation (7–9). Several groups have also revealed that MW ablation induces more circular ablation zones than does RF ablation, which is of particular importance in the treatment of larger tumors (10,11).
Coronary plaque rupture with subsequent thrombosis is the major recognized pathogenic event in acute coronary syndrome (ACS) (1,2). Identification of plaques prone to rupture might, therefore, help identify a patient at high risk for future occurrence of ACS. Coronary plaque and its vulnerability can be examined with intravascular ultrasonography (US) (3) or optical coherence tomography (4). However, because these techniques are invasive they may not be practical for routine use in the treatment and risk assessment of patients with coronary artery disease (CAD). Computed tomography (CT) enables visualization of not only coronary artery stenosis but also coronary artery plaque of various texture, and coronary artery calcifications detected with CT have been used to predict coronary events (5,6). Recent studies have demonstrated the hypothesis that plaque vulnerability might occur systemically in not only the coronary arteries but also in peripheral arteries (7–9). In a large-scale cohort study, the European Carotid Surgery Trial (7) reported that patients with an angiographically irregular carotid plaque surface are at an increased risk of future acute myocardial infarction and sudden cardiac death. Previous studies have shown an association between the carotid intima-media thickness and the presence of CAD, and the intima-media thickness has been identified as an independent predictor of future coronary events (10,11). Carotid plaque echogenicity has been reported to be associated with an increased risk for ACS (8,9,12,13).
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