The Arab Journal of Interventional Radiology最新文献

{"title":"Thyroid Ablation: Past, Present, and Future","authors":"James Clark, Spencer Muscelli, Sameer Rehman","doi":"10.1055/s-0042-1757784","DOIUrl":"https://doi.org/10.1055/s-0042-1757784","url":null,"abstract":"commissur-otomy (PTMC) with 88% ef fi cacy under the above-de fi ned parameters. 3 Patients with severe tumor burden may also receive palliative RFA. 3 Data shows a major complication rate of 1.4% predominantly due to voice changes. 3,8 The minor complications reported are pain, skin burns, and vasovagal reactions. 8","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":"06 1","pages":"053 - 055"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46657725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Aortic Aneurysm Repair: A Narrative Review","authors":"Zi Rehman","doi":"10.1055/s-0042-1750105","DOIUrl":"https://doi.org/10.1055/s-0042-1750105","url":null,"abstract":"Endovascular aortic aneurysm repair (EVAR) has evolved as minimally invasive method of treating infrarenal abdominal aortic aneurysms (AAA) with perioperatively mortality of less than 1% compared with 5% with open AAA repair as suggested by many randomized control trials. Computed tomography angiography is the imaging of choice for appropriate selection of a patient with EVAR. For patients with unsuitable anatomy, advanced EVARs techniques, such as fenestrated, branch, and chimney EVARs, are also increasingly being offered to patients with equal success. Patients with ruptured AAA are treated with this minimally invasive procedure. Percutaneous EVAR emerged with less of wound-related complications. Endoleaks are the most common complications peculiar to this procedure, and most are preventable by preoperative planning. They are detected on completion angiogram or on the surveillance imaging. This review discusses indications of EVAR, its selection criteria, procedural steps, and common complications associated with this procedure and advanced EVARs.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49450344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulnerable Carotid Artery Plaques in Asymptomatic Patients—A Narrative Review","authors":"Zi Rehman","doi":"10.1055/s-0042-1750108","DOIUrl":"https://doi.org/10.1055/s-0042-1750108","url":null,"abstract":"Over the last two decades, medical management of carotid artery patients has improved significantly. Most patients remain stable on best medical therapy (BMT), making interventions unnecessary in all patients. “Selective” intervention is advocated for only those few patients who are having vulnerable or unstable carotid artery plaques. Literature search was done to explore current concept and role of available investigations to identify vulnerable carotid plaques. Vulnerable plaque is defined as those plaques having active inflammation, high large necrotic lipid content, neovascularity, thin capsule, surface irregularity, or intraplaque hemorrhage. Ultrasound (US) is the simple, noninvasive, cost-effective investigation to differentiate soft (echolucent) from fibrocalcified (echogenic) plaques. It can also comment on other high-risk plaque features such as plaque volume and area. Contrast-enhanced US can visualize neovascularization and plaque surface irregularities better than conventional US. Computed tomography is limited in identifying most high-risk plaque features and is not useful. High-resolution magnetic resonance imaging is the most accurate and externally validated investigation to characterize most high-risk plaque components. Positron emission tomography has emerged as the most promising dynamic investigation to identify and quantify inflammatory plaques and will be clinically very useful in decision making.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48574631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Lung Ablation Practice: Experience from a Mid-Size City in the United States","authors":"Jabre Millon, Sameer Rehman","doi":"10.1055/s-0042-1750109","DOIUrl":"https://doi.org/10.1055/s-0042-1750109","url":null,"abstract":"According to the American Cancer Society, primary lung cancers (both small cell and non-small cell) are the second most common cancers in bothmen andwomen in the United States. For 2021, they estimate approximately 235,000 new cases of lung cancer and approximately 132,000 deaths.1 The treatment of lung cancers traditionally requires a multidisciplinary approach including thoracic surgery, radiation, and chemotherapy. Recently, percutaneous ablation has proven to be a promising modality in the treatment of primary lung cancer as well as metastatic disease. With a growing body of evidence, there are several percutaneous ablation therapies being utilized for the treatment of lung cancers including radio frequency ablation, microwave ablation, and cryoablation. Newer literature suggests that percutaneous imageguided ablationmay be amore cost-effective optionwith less severe complications and shorter recovery times, all while preserving pulmonary function.2 As with most novel treatments, there are certain challenges associated with incorporating the new treatment into an existing practice. A technology-driven field like interventional radiology (IR) is constantly developing new treatment modalities and thus constantly tasked with incorporating them into existing practices. This article will address some of these challenges and how to overcome them. Ultimately, the success of any new service line depends on the need for the service provided. As we have mentioned, lung cancer is one of the leading causes of cancer deaths in the United States. Surgical resection is one of the gold standard therapies; however, approximately 20% of patients are poor surgical candidates due to comorbidities or insufficient lung reserve.3 While these numbers reflect the entire nation, it is best to examine the numbers associated with your potential target region. For example, in 2018 Osuoha et al determined that Southern Nevadans receive disproportionately fewer surgical resections than patients in Northern Nevada. They conclude that patient comorbidities and overall shortage of doctors may be contributing to this disparity. They also mention the increased rate of uninsured and low socioeconomic status of patients should be taken into account when considering accessibility to treatment.4 Nonetheless, this has left a need for a cost-effective alternative treatment to surgical resection. Based on our experiences, the next challenge is establishing the infrastructure necessary to perform the indicated treatment. For our purposes, we will discuss the process of augmenting an existing hospital-based IR suite with percutaneous image-guided ablation capabilities. As with any proposed change within a hospital, administration should be involved. The best approach is to provide a brief overview of the proposed treatment and the data highlighting the need for the new service. As discussions progress, it will eventually be necessary to provide a list of relevant Current Procedural Term","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42011054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Radio Frequency Ablation for Benign Thyroid Nodules: Initial Clinical Experience in United Arab Emirates","authors":"K. Lee, E. Jeon, S. Jang","doi":"10.1055/s-0042-1750110","DOIUrl":"https://doi.org/10.1055/s-0042-1750110","url":null,"abstract":"\u0000 Objectives Radio frequency ablation (RFA) to treat thyroid nodules is well known as one of alternative therapeutic modalities. This study aimed to investigate the efficacy and complications of RFA to treat symptomatic benign thyroid nodules in United Arab Emirates.\u0000 Materials and Methods Eight-nine benign thyroid nodules of 63 patients were enrolled, who were treated by percutaneous ultrasound (US)-guided RFA from 2017 to 2020, and had following US examinations during 12 months after RFA procedure. Symptomatic score with 10-cm visual scale, cosmetic score with four-point scale, and US findings (nodule diameter, volume, composition and vascularity) were compared before and after RFA procedures. RFA-related complications (hematoma, voice change, hypothyroidism, and hyperthyroidism) were assessed.\u0000 Statistical Analysis Paired t test was applied to compare laboratory findings before and after RFA procedure. Multiple linear regression analysis was applied to determine significant factors to predict the efficacy of RFA. One-way analysis of variance was applied to compare volume reduction rate (VRR) at 3, 6, and 12 months.\u0000 Results Symptomatic and cosmetic scores were significantly improved (pre-RFA vs. post-RFA; 6.07 ± 1.89 vs. 2.06 ± 1.09, 2.94 ± 0.84 vs. 1.27 ± 0.51, p< 0.001). Nodule diameter (cm), volume (mL) at pre-RFA, post-RFA 3 months, 6 months, and 12 months were 3.86 ± 1.26, 2.64 ± 1.14, 2.06 ± 1.09, 1.82 ± 1.14, and 18.8 ± 18.79, 8.82 ± 12.42, 4.47 ± 5.59, 4.11 ± 9.17 (p< 0.001). VRR (%) was 52.81 ± 23.48 at post-RFA 3 months, 79.77 ± 16.91 at 6 months, and 82.08 ± 19.54 at 12 months. Composition of solidity was a significant predictive factor, related to VRR at post-RFA 12 months (p = 0.003). Complication rate was 12.7% (8 of 63 patients). Major complications did not occur.\u0000 Conclusion RFA can be an effective and safe alternative modality to treat benign thyroid nodules, and be preferable to treat symptomatic cystic thyroid nodules in Middle East population.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48291000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipiodol Lymphangiography and Glue Embolization for Vulvar and Vaginal Lymphorrhea","authors":"Meshari Alali, Rohee Park, J. Shin, Chengshi Chen, Jeoung I. Shin","doi":"10.1055/s-0042-1750106","DOIUrl":"https://doi.org/10.1055/s-0042-1750106","url":null,"abstract":"A 26-year-old woman patient had an 18-year long history of vulvar and vaginal lymphorrhea and multiple millet-like lesions on her vulva. On magnetic resonance image, multiple T2 high signal intensities were noted at the bilateral vulvar areas and pelvic cavity. Conventional lipiodol lymphangiography showed lymphatic reflux to the vulvar areas, possibly originating from prominent tubular lymphatics in the right lower abdominal wall. After percutaneous puncture of this tubular lymphatic structure, its distal portion was embolized using microcoils to prevent upward glue propagation; this was followed by glue embolization of the tubular lymphatic structure. The patient was without skin lesions or symptoms at follow-up of 1 year after the procedure.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43172001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiology Technologists Performing Peritoneal Drainage, Local Experience","authors":"I. Aljediea, M. Alshehri, K. Alenazi, A. Memesh, M. Fleet","doi":"10.1055/s-0042-1750107","DOIUrl":"https://doi.org/10.1055/s-0042-1750107","url":null,"abstract":"\u0000 Purpose We conducted this study to review our experience of peritoneal drainages (paracentesis) performed by interventional radiology technologists.\u0000 Materials and Methods This is a retrospective study of peritoneal drainages performed by interventional radiology technologists.\u0000 Results We reviewed all peritoneal drainages performed in interventional radiology between November 2018 and November 2021. The review process included success rate, volume drained, catheter duration, and complications.\u0000 Conclusion Interventional radiology technologists can safely perform ultrasound-guided peritoneal drainages. Extending Interventional radiology technologists' role to perform ultrasound-guided peritoneal drainages allows interventional radiologists to do more complex procedures, enhances the workflow, and increases the efficiency of the interventional radiology team.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45725557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embolic Materials: Understanding the Ocean of Choices","authors":"S. Young, A. Larson, P. Torkian, J. Golzarian","doi":"10.1055/s-0042-1746412","DOIUrl":"https://doi.org/10.1055/s-0042-1746412","url":null,"abstract":"Embolization is a fundamental procedure that interventional radiologists perform on a daily basis to treat a variety of diseases. The disease processes for which embolization is considered a safe and effective treatment are continuously expanding, as are the embolization materials available for use. To achieve optimal clinical outcomes and minimize complications, it is imperative that the interventional radiologist understands the properties, strengths, and weaknesses of each class of embolic and specific embolic products. This is a continuous process as new materials are always becoming available. This article reviews the different classes of embolic materials, discusses strengths and weaknesses, and reviews areas of innovation.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45839535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate Artery Embolization in Patients above Eighty Years Old: Clinical Efficacy and Safety","authors":"H. Saro, M. T. Solyman, Mohammed Zaki, M. A. Hasan, N. Thulasidasan, S. Clovis, O. Elhage, R. Popert, T. Sabharwal","doi":"10.1055/s-0042-1748758","DOIUrl":"https://doi.org/10.1055/s-0042-1748758","url":null,"abstract":"Abstract Objectives  Prostate artery embolization (PAE) has been established as an effective treatment option for benign prostate hyperplasia or hematuria of prostatic origin. We aim to confirm the effectiveness and safety of PAE in elderly patients aged ≥ 80 years old. Materials and Methods  Between January 2014 and August 2020, PAE was attempted on 54 elderly patients with lower urinary tract symptoms (LUTS) or prostatic hematuria who were unfit for surgical treatment or opted for PAE. Outcome parameters (International Prostate Symptom Score [IPSS], quality of life [QoL] score, International Index of Erectile Function score (IIEF), maximal urinary flow rate, postvoid residual, and prostate volume) were collected and analyzed at baseline, 6 months, 1, 2, and 3 years. Results  The mean patient age was 85.29 years (range: 80–98). Technical success was achieved in 50 patients (92.6%). Mean IPSS improved from 18 at baseline to 7.7, 8.5, 8.6, and 9.1 at 6 months, 1, 2, and 3 years. Mean QoL improved from 4.9 at baseline to 2.8, 1.7, and 1.5 at 6 months, 1, and 2 years. Mean prostate volume reduced from a baseline of 152.7 to 123.5 mL within 6 months and 120.5 mL after 7 months of PAE. Urinary catheter removal was successful in 13 out of 19 patients with urinary retention. PAE succeeded in stopping bleeding in 16 out of 17 patients with prostate-induced hematuria. Conclusion  PAE is a feasible low-risk treatment for LUTS with or without urinary retention or prostatic hematuria in elderly patients.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":"06 1","pages":"063 - 071"},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46217701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Outcomes in Transcatheter Embolization for the Management of Penetrating versus Blunt Trauma","authors":"W. Wahood, W. Badar, B. Funaki, J. Leef, Osman Ahmed","doi":"10.1055/s-0042-1758041","DOIUrl":"https://doi.org/10.1055/s-0042-1758041","url":null,"abstract":"Abstract Objectives  This article assesses potential factors associated with successful embolization and/or mortality benefit among patients with penetrating (PT) compared to those with blunt abdominal trauma (BT) undergoing emergent angiography. Materials and Methods  A retrospective study of arterial embolization for BT and PT at a tertiary care academic center in an urban setting between 2018 and 2020 was conducted. Fischer's exact and Student's t -tests were used to assess differences between PT and BT, regarding technical success, in-hospital mortality, number of vessels embolized, and requirement of Operating Room (OR) for bleeding control after embolization. Results  Forty-three patients underwent embolization. Twenty-three presented with BT versus 20 with PT. There was no difference in the rate of success between the two groups (91.3% vs. 100%; p  = 0.49). No difference was observed in mean days of survival among BT and PT patients treated by embolization (mean [standard deviation]: 13.7 [2.6] vs. 19.1 [2.79] days; p  = 0.160). There was no difference in mortality between the two groups (13.0% vs. 10.5%; p  = 1.00). Mean number of vessels embolized was higher in the BT group compared to PT (2.26 [1.32] vs. 1.44 [1.03], p  = 0.044). The rate of BT patients who required subsequent OR intervention for hemorrhage control after embolization was similar to those with PT (8.7% vs. 10.5%; p  = 0.84). Conclusion  The rate of mortality, technical success, and requirement of subsequent OR intervention for hemorrhage control was comparable between BT and PT. BT was associated with a higher mean number of vessels embolized compared to PT. Our case series may provide insight in the use of embolization for PT, but further investigation is needed with larger cohorts.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":"06 1","pages":"076 - 081"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49365991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}