The Arab Journal of Interventional Radiology最新文献

{"title":"Percutaneous Cholecystostomy: A Bridge to Less Morbidity","authors":"A. Singh","doi":"10.1055/s-0042-1744213","DOIUrl":"https://doi.org/10.1055/s-0042-1744213","url":null,"abstract":"Percutaneous cholecystostomy (PC) is a minimally invasive procedure for decompressing gall bladder (GB) or biliary system in emergency settings, performed in patients with GB or biliary diseases who are at high risk for surgical exploration. Indications range from acute cholecystitis in seriously ill patients to overdistended GB with impending perforation to overt GB perforation. This procedure, by allowing biliary drainage, helps in controlling the infection and optimizing the patient's condition for definitive treatment in the form of elective surgery if possible, thus acting as a bridge to a definitive treatment option. In some cases, such as acute acalculous cholecystitis, it may obviate the need for surgery, and in malignant biliary obstruction, it may be used as a palliative measure to keep GB decompressed. This review article focuses on and revisits many aspects of PC including technical aspects, clinical indications, outcomes, and safety of the procedure, in addition to its role as bridge therapy versus definitive therapy versus palliative option. It includes observations based on the author's own work experience and review of the literature.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41602653","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":"Establishment of a Percutaneous Nephrostomy Service to Treat Obstructive Uropathy Secondary to Cervical Cancer in Tanzania","authors":"I. Rukundo, E. Mbuguje, A. Naif, Manishaben. J. Patel, F. Laage-gaupp, M. Asch, V. Ramalingam","doi":"10.1055/s-0042-1744507","DOIUrl":"https://doi.org/10.1055/s-0042-1744507","url":null,"abstract":"\u0000 Background Cervical cancer is the fourth most common cancer among women globally. Age-standardized cervical cancer mortality is higher in East Africa than anywhere else in the world. Prior to October 2018, patients presenting with obstructive uropathy secondary to late-stage cervical cancer in Tanzania who were no longer eligible for palliative chemoradiation therapy were discharged home without intervention. The purpose of this study was to evaluate whether the establishment of a percutaneous nephrostomy service in a quaternary hospital in Dar es Salaam, Tanzania, a resource-limited country, benefits patients who have late-stage cancer induced obstructive uropathy.\u0000 Materials and Methods A retrospective study was performed on patients who presented with obstructive uropathy secondary to late-stage cervical cancer and have undergone percutaneous nephrostomy at Muhimbili National Hospital and Ocean Road Cancer Institute from October 2018 to May 2021. Twenty-one interventional radiology (IR) teaching teams consisting of IR attendings, IR technologists, and nurses travelled to Tanzania from North America on monthly 2-week trips during that period. A review of preprocedural, procedural, and follow-up data was performed using Research Electronic Data Capture. Statistical analysis and comparison were performed on patients' creatinine levels preprocedure, 7 days and 30 days postprocedure.\u0000 Results Sixty-two patients qualified to be included in this study. In addition to the initial 62 nephrostomy placements, 14 follow-up procedures were performed either under visiting faculty supervision or independently by the Tanzanian IR fellows. Technical success rate was 98.7%. Complications (SIR Class A and B) occurred in eight cases. The average preprocedure creatinine (1051.48 ± 704.08µmol/L) decreased by 59% 7 days postprocedure and by 77% 30 days postintervention. Postprocedural clinical information was obtained for 28 (45.2%) patients and 18 were able to restart chemotherapy following nephrostomy.\u0000 Conclusion Prior to 2018, percutaneous nephrostomy placement was not available in Tanzania. This study presented the initial safety, technical feasibility, and clinical benefit of establishing a percutaneous nephrostomy service in such a resource-limited setting.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49568555","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":"Direct Fluoroscopic-Guided Sclerotherapy for Vulvoperineal Varices: An Experience in 70 Patients","authors":"Karim Tawab, Mohamed A. A. Hagag, Rana Khafagy","doi":"10.1055/s-0042-1744214","DOIUrl":"https://doi.org/10.1055/s-0042-1744214","url":null,"abstract":"Purpose The aim of this study was to assess the safety and effectiveness of percutaneous vulvoperineal varices sclerotherapy using 2% polidocanol foam under fluoroscopic guidance. Subjects and Methods This is a retrospective review of prospectively collected data of 70 patients treated between June 2020 and November 2021, with a mean age of 31 years (range: 24–42 years). All patients were not pregnant with residual vulvoperineal varices after embolization of their refluxing tributaries of the ovarian vein and/or internal iliac veins presenting with vulvoperineal heaviness/pain with or without lower limb varicosities. Technical and clinical successes together with procedural complications were assessed. Results The technical success rate was 100%. No minor or major complications have been reported. Follow-up was at 1 week, 2 weeks, 6 months, and 12 months post sclerotherapy. Clinical success was observed in all patients with improvement in their symptoms. Conclusion Direct fluoroscopic-guided sclerotherapy for vulvoperineal varices offers a safe and effective treatment option with the ability of visualization and embolization of the pelvic leak points to avoid recurrence.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46332506","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":"Systemic Arterial Supply to the Basal Part of the Right Lung without Sequestration: Treatment by Coil Embolization","authors":"G. Chidiac, E. Ammanouil, F. Tannouri, Céline El Haddad, Rayan El Amine","doi":"10.1055/s-0042-1745712","DOIUrl":"https://doi.org/10.1055/s-0042-1745712","url":null,"abstract":"Systemic arterial supply to the base of the lung without sequestration is a rare congenital anomaly. In this entity, the anomalous artery arises from the aorta with no bronchial structural defect. Most of the patients are asymptomatic but few may present with hemoptysis or sometimes in severe cases with left-sided heart failure. The treatment of choice is usually a surgical resection of the affected portion of the lung, especially when pulmonary artery (PA) supply is ab-sent. However, transarterial embolization (TAE) has been recently considered especially in cases where the lung base has normal PA anatomy.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43076275","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":"Inferior Mesenteric Artery Associated Type II Endoleaks: Are They Predictable?","authors":"Harun Jalil, S. Mahmood, I. Zaman, Asaad Osman, Syed Mustafa, Abdullah Saeed","doi":"10.1055/s-0042-1742655","DOIUrl":"https://doi.org/10.1055/s-0042-1742655","url":null,"abstract":"\u0000 Purpose: This study aims to evaluate the relationship between inferior mesenteric artery (IMA) diameter and risk of type II endoleak.\u0000 Subjects and Methods: A retrospective study design to review all EVARs performed over a 4-year period at a tertiary care center. Out of the total cohort of 400 patients who underwent EVAR, 41 patients (10.3%) developed type II endoleak. The mean IMA ostial diameter for patients with type II endoleak secondary to IMA contributories was 4mm, while the mean IMA diameter for patients with lumbar arteries contributing to the type II endoleak was 3.7mm.\u0000 Results: Statistical analysis using a paired t-test did not show a statistically significant difference in the IMA ostial diameter between the two groups.\u0000 Conclusion: There is no significant correlation between preprocedural IMA ostium diameter and type II endoleak development and hence, preprocedural IMA embolization is not an appropriate prophylactic management strategy.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44775918","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":"Ablative Volume of Radiofrequency Ablation Related to Intrahepatic Recurrence-Free Survival of Hepatocellular Carcinoma","authors":"Nakarin Inmutto, Siripong Thaimai, Tanop Srisuwan, Thanate Kattipathanapong, Natthaphong Nimitrungtawee","doi":"10.1055/s-0042-1742654","DOIUrl":"https://doi.org/10.1055/s-0042-1742654","url":null,"abstract":"\u0000 Purpose The aim of this study was to evaluate intrahepatic recurrence-free survival of hepatocellular carcinoma (HCC) after Radiofrequency ablation (RFA)\u0000 Methods A retrospective cohort study of single HCC treated by RFA between 2015 and 2017. Fifty patients were enrolled in the study. Tumor volume and ablative volume were measured by using Syngo.via application (Siemen Healthineers, United States). Ablative volume classified into small and large ablative volumes. Ablative margin was evaluated by visual comparison between pre- and post-RFA images and classified into two groups: closed ablative margin (<0.5cm) and large ablative margin (>0.5 cm). The recurrence tumor was classified as local tumor progression (LTP) and intrahepatic distant recurrence (IDR). The recurrence-free survival rate and independent risk for tumor recurrence were analyzed.\u0000 Results Recurrence-free survival rate at the first, second, third, and fourth year after RFA was 83, 56, 44, and 44%, respectively. The average recurrence-free survival time in large ablative volume group was significantly longer than small ablative volume group (31.57 vs. 8.50 months, p = 0.003). A significant independent risk factor for tumor recurrence was large ablative volume (hazard ratio = 0.12, 95% confidence interval = 0.02–0.84, p = 0.033). The IDR group had ratio of actual ablative volume by ideal ablative volume (ablative ratio) higher than LTP group and nonrecurrent group.\u0000 Conclusion The large ablative volume prevented tumor recurrence and increased recurrence-free survival rate. But aggressive ablation with high ablative volume ratio could increase risk of IDR.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44861937","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 Revascularization as a Treatment Option for Peripheral Arterial Disease due to Diabetes in Saudi Arabia: Public Awareness Survey","authors":"A. A. Alshammari, Noura Hamad Rasheed Alshurtan, Amirah Fahad Mohammed Alshammeri, A. Alharbi","doi":"10.1055/s-0041-1741113","DOIUrl":"https://doi.org/10.1055/s-0041-1741113","url":null,"abstract":"\u0000 Objectives Diabetic foot disease is a common and serious complication of diabetes that represents a major global health concern with high mortality and morbidity rates. Successful revascularization and improved perfusion have had fundamental roles in reducing the rate of amputation in diabetic foot patients over the last decade. Creating public awareness plays a key role in early treatment and prevention of amputation. The aim of this study was to determine if people are aware of endovascular revascularization as a therapeutic option for diabetes-related peripheral artery disease.\u0000 Methods The study is a community-based observational descriptive cross-sectional study that was conducted to assess Saudi population knowledge and awareness about endovascular revascularization as a treatment option of diabetic foot disease through interventional radiology. The self-administered online survey was randomly distributed with a maximum of 20 multiple choice questions through social media channels.\u0000 Results Endovascular revascularization as a treatment of diabetes-related peripheral artery disease through interventional radiology was unknown to 90.2% of the participants. Awareness has been influenced by many factors including age, occupation, and family history.\u0000 Conclusion This study highlights the importance of raising public awareness about endovascular revascularization as a treatment option for diabetes-related peripheral arterial disease in suitable patients.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46246047","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":"Prostatic Artery Embolization for Benign Prostatic Hyperplasia—A Primer for Interventional Radiologists","authors":"T. Bilhim, N. Costa, D. Torres","doi":"10.1055/s-0041-1739302","DOIUrl":"https://doi.org/10.1055/s-0041-1739302","url":null,"abstract":"Male patients over 50 years with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) are potential candidates for prostatic artery embolization (PAE). PAE is not a perfect fit for all BPH patients. Careful pre- and postpostprocedural evaluation/consultation with correct selection of patients should be tailored on an individual basis. Evaluated parameters include the following: LUTS severity quantification with validated questionnaires as the international prostate symptom score (IPSS) and quality of life (QoL), erectile and ejaculatory evaluation with validated questionnaires, blood tests including full blood count, coagulation profile, renal function and total/free prostate-specific antigen (PSA), prostate volume measured by multiparametric magnetic resonance (mpMR) of the prostate and/or transrectal ultrasound, uroflowmetry measuring the peak urinary flowrate (Qmax), and postvoid residual urine (PVR). Correct arterial anatomy identification with either computed tomography (CT) angiography, MR angiography, or intraprocedural cone-beam CT (CBCT) are suggested for a confident procedure and avoiding potential complications. The minimally invasive nature of PAE with a faster recovery, preserving the sexual function, and comparable results to standard prostatic surgery make the procedure an attractive choice for many male patients suffering with this condition. Patients should be informed about the potential for higher retreatment rates and shorter duration of treatment effect when compared with standard prostatic surgery. In this comprehensive review, we provide an updated toolbox for all interventional radiologists interested in the PAE practice for patients with BPH. We explain how to evaluate patients during consultation before and after PAE, describe the preprocedural imaging required, explain the technique, and narrate how to optimize outcomes. Finally, we review the level of evidence of PAE for BPH.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49209656","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":"Safety and Effectiveness of Transthoracic Core Needle Biopsy in a Newly Established Interventional Radiology Program in Tanzania","authors":"E. Mbuguje, J. Alswang, I. Rukundo, A. Naif, Fabian M Laage Gaupp, V. Ramalingam, M. Asch","doi":"10.1055/s-0041-1742220","DOIUrl":"https://doi.org/10.1055/s-0041-1742220","url":null,"abstract":"\u0000 Background Transthoracic core needle biopsy (TTCNB) became a routinely offered procedure in Tanzania in October 2018. This study evaluates the safety and effectiveness of establishing a TTCNB program in a resource-limited setting.\u0000 Methodology A single center, prospective, observational cohort study was conducted at Muhimbili National Hospital on 90 patients who underwent computed tomography-guided TTCNB from October 2018 to May 2021. Patient and procedural data, including demographic information, complications, pathology results, and clinical outcomes, were stored in a Research Electronic Data Capture (REDCap) database. Follow-up was conducted at 4 weeks postprocedure by phone. Descriptive analysis was performed using Statistical Package for Social Sciences.\u0000 Results A total of 90 patients underwent TTCNB. Seven samples were lost or never processed. In total, 68/83 (81.9%) of processed samples were diagnostic, with 89.7% (n = 61) classified as malignant and 10.3% (n = 7) classified as benign. Overall, 82.4% (n = 56) were classified as primary malignancies, 7.4% (n = 5) as metastatic malignancies, 5.9% (n = 4) as benign tumors, and 4.4% (n = 3) as infectious. Reasons for nondiagnostic samples were crashed/insufficient samples in 53.3% (n = 8) and nonspecific chronic inflammation in 46.7% (n = 7). Minor (Society of Interventional Radiology [SIR] class A and B) complications occurred in 8 cases (8.9%), while there was 1 (1.1%) major complication (SIR class F). A total of 44/90 (48.9%) patients could be reached for follow-up at 4 weeks postprocedure. In addition, 31/44 (70.5%) of these patients had a diagnosis of malignancy. Of these, 20 received chemotherapy, 8 died prior to receiving any treatment, 2 declined any further medical or surgical intervention, and 1 was treated with surgical excision and adjuvant chemotherapy.\u0000 Conclusion Although recently introduced in Tanzania, TTCNB has been performed with 81.9% diagnostic accuracy and a complication rate comparable to existing literature.","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44186683","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":"The Interventional Radiology Residency: Is It Time Saudi Radiology Residency Programs Contemplate the Idea?","authors":"Abdullah Abohimed, Y. Zahrani, M. Arabi","doi":"10.1055/s-0041-1742087","DOIUrl":"https://doi.org/10.1055/s-0041-1742087","url":null,"abstract":"It would be an understatement to say that interventional radiology (IR) is advancing at an exponential rate. The minimally invasive nature of procedures provided by IR has proven to be cost-effective, favored by patients, and an excellent alternative to conventional surgery. This has led to higher demand for the services provided by IR by many medical specialties. Despite this, ambiguity and confusion still loom large when it comes to the perception and awareness of IR among medical faculty and medical students, respectively. This could be attributed to many factors.1,2 In Saudi Arabia, the inaugural IR fellowship training program had begun in the year 2000. It was structured as a 1-year fellowship program after the completion of a 4-year Diagnostic Radiology (DR) residency. Four years later, the Saudi Commission for Health Specialties (SCFHS) had approved a 2-year fellowship program for IR after the prior single year program was met with much criticism.3 Today, there are a total of 8 IR fellowship training centers in the Kingdom and 24 fellows practicing IR. Other neighboring countries such as Egypt4 also offer a 2-year IR fellowship program. IR has yet to achieve specialty independence in the Kingdom. In a recent study, Makris et.al had found considerable heterogeneity both in exposure during IR training and training satisfaction on a global scale.5 The United States no longer offers a classic IR fellowship post DR residency. Instead, there exists three separate pathways to becoming an IRs in the United States.6 The “integrated” IR residency is a 5-year program that includes 3 initial years of DR followed by 2 years of IR. The “independent” IR residency is a 2-year residency that is independent and taken after the DR residency. The independent pathway also has its own matching process after the completion of a DR residency. The third pathway is known as “Early Specialization in IR” (ESIR). Here, DR residents who develop an early desire to specialize in IR can join the ESIR program. The ESIR resident would naturally have a different residency structure to his DR peers. Theminimum requirements to graduate as an ESIR resident are 12 IR or IR-related rotations during the postgraduate year (PGY) 2–5; and one intensive care unit rotation. During said rotations, the ESIR residentmust complete a minimum of 500 procedures and is required to maintain a logbook of such cases. ESIR residents are then eligible to match for the second year of the independent residency, lowering the number of years in training to 6. An extraordinary amount of effort was put in place when considering this drastic shift in training.7 Ultimately, the rationale behind it stems from a few important factors: First, although DR and IR share similar competencies in imaging and procedures, postprocedural patient care is a unique competency to IR. Second, the complexity of procedures offered by IR is increasing, necessitating more years of training. And third, more focused training in ","PeriodicalId":32940,"journal":{"name":"The Arab Journal of Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45295236","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}