Seminars in Interventional Radiology最新文献

Primer on Embolic Agents and Sclerosants for the Treatment of Vascular Malformations. 治疗血管畸形的栓塞剂和硬化剂入门。

IF 1 4区医学

Seminars in Interventional Radiology Pub Date : 2024-11-07 eCollection Date: 2024-08-01 DOI: 10.1055/s-0044-1791278

Junaid Raja, Dakota Williams, Rachel Oser

{"title":"Primer on Embolic Agents and Sclerosants for the Treatment of Vascular Malformations.","authors":"Junaid Raja, Dakota Williams, Rachel Oser","doi":"10.1055/s-0044-1791278","DOIUrl":"https://doi.org/10.1055/s-0044-1791278","url":null,"abstract":"Vascular malformations (VMs) are a heterogeneous group of arterial, venous, capillary, and/or lymphatic networks that typically are present at birth and grow with the patient. Signs and symptoms associated with VM range from absent to severe, with a broad spectrum of pain, cosmetic disfigurement, and local tissue destruction. Treatment options for these malformations extend from observation to surgical reconstruction. Each treatment modality has a role in the management of vascular anomalies, but also has specific challenges. Observation is not always sufficient, medical therapies may only be available for a subset of patients and are ultimately not curative, and surgical excision may itself be disfiguring or incomplete/not definitive. Sclerotherapy and/or embolotherapy have become a cornerstone of treatment for many types of VMs. These techniques are applicable to a wide range of VMs, are less invasive, have a shorter recovery period, and are repeatable. Although some VMs may not be amenable to percutaneous or endovascular treatment given their location, and multiple sessions may be required for select large and complex VMs, these minimally invasive treatments are often first line and may be definitive in treating VMs. Various agents may be used in sclerotherapy and embolotherapy, each with their own risks and benefits. Although there is a paucity of Level 1 evidence supporting the superiority of one agent over another, longstanding case series and expert experience exist, informing our knowledge of the safety and efficacy of sclerotherapy and embolotherapy. A brief overview of the most used sclerotherapy and embolotherapy agents and their uses is provided.","PeriodicalId":48689,"journal":{"name":"Seminars in Interventional Radiology","volume":"41 4","pages":"370-375"},"PeriodicalIF":1.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transjugular Random Renal Biopsy: How We Do It. 经颈静脉随机肾活检：我们是如何做到的？

IF 1 4区医学

Seminars in Interventional Radiology Pub Date : 2024-11-07 eCollection Date: 2024-08-01 DOI: 10.1055/s-0044-1791192

Dan F Laney Iv, Hector Ferral

引用次数: 0

Pearls and Pitfalls in the Management of Vascular Anomalies. 血管畸形管理中的珍珠和陷阱。

IF 1 4区医学

Seminars in Interventional Radiology Pub Date : 2024-11-07 eCollection Date: 2024-08-01 DOI: 10.1055/s-0044-1791279

Omar Sanon, Andrew Henderson, Robert J Rosen

{"title":"Pearls and Pitfalls in the Management of Vascular Anomalies.","authors":"Omar Sanon, Andrew Henderson, Robert J Rosen","doi":"10.1055/s-0044-1791279","DOIUrl":"https://doi.org/10.1055/s-0044-1791279","url":null,"abstract":"Recent advancements in endovascular techniques have transformed the management of vascular malformations, shifting away from traditional surgical resections to less invasive methods like embolization and sclerotherapy. Vascular malformations are congenital anomalies resulting from embryonic angiogenesis failures, often misdiagnosed but manageable through a multidisciplinary approach. These malformations range from high-flow arteriovenous connections to low-flow venous, lymphatic, or mixed lesions, each requiring specific diagnostic and treatment strategies. Specific syndromes like Klippel-Trenaunay and Parkes-Weber require tailored approaches due to their unique presentations. Diagnosis relies on a combination of physical examination and advanced imaging techniques, including ultrasound and MRI. Treatment is focused on symptomatic relief and improving the patient's quality of life. Interventional treatment is indicated when conservative and/or medical management is insufficient. Surgical interventions remain relevant for select cases, often in a multidisciplinary context. Newer therapies, such as sirolimus, are emerging for complex, treatment-resistant cases.","PeriodicalId":48689,"journal":{"name":"Seminars in Interventional Radiology","volume":"41 4","pages":"363-369"},"PeriodicalIF":1.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High-Flow Arteriovenous Malformations: Treatment Using a Venous Approach. 高流量动静脉畸形：使用静脉方法治疗。

IF 1 4区医学

Seminars in Interventional Radiology Pub Date : 2024-11-07 eCollection Date: 2024-08-01 DOI: 10.1055/s-0044-1791187

Brian Funaki

引用次数: 0

Venous Malformations: Diagnosis, Management, and Future Directions. 静脉畸形：诊断、管理和未来方向。

IF 1 4区医学

Seminars in Interventional Radiology Pub Date : 2024-11-07 eCollection Date: 2024-08-01 DOI: 10.1055/s-0044-1791280

Arun Kamireddy, Clifford R Weiss

引用次数: 0

What the Interventional Radiologist Needs to Know about the Genetics of Vascular Anomalies. 介入放射科医生需要了解的血管异常遗传学知识。

IF 1 4区医学

Seminars in Interventional Radiology Pub Date : 2024-11-07 eCollection Date: 2024-08-01 DOI: 10.1055/s-0044-1791204

Shellie Josephs, Lynne Martin, Travis Josephs, David Hovsepian

{"title":"What the Interventional Radiologist Needs to Know about the Genetics of Vascular Anomalies.","authors":"Shellie Josephs, Lynne Martin, Travis Josephs, David Hovsepian","doi":"10.1055/s-0044-1791204","DOIUrl":"https://doi.org/10.1055/s-0044-1791204","url":null,"abstract":"The purpose of this article is to familiarize the reader with the basic genetics and vascular biology behind the array of vascular anomalies they may encounter in their practice. Individuals with vascular malformations are often referred to multidisciplinary clinics composed of diverse specialists all with the same goal: how to provide the best care possible. The team is typically composed of physicians, nurses, social workers, and technical staff from multiple specialties including diagnostic and interventional radiology, dermatology, hematology/oncology, otolaryngology, plastic surgery, and several additional subspecialties. Imaging plays a crucial role in diagnosis and treatment planning, but increasingly biopsies are needed for more accurate histopathological and genetic information to inform the plan of treatment, as well as for counseling patients and their families on the natural history, heritability, and long-term prognosis of the condition. Understanding the molecular mechanism that gives rise to vascular anomalies is crucial for arriving at the proper diagnosis and choosing among treatment options. As oncological medications are being increasingly repurposed to treat vascular malformations, it is vital for those caring for patients with vascular anomalies to understand how these anomalies develop, and which drug may be appropriate to repurpose for this benign disease.","PeriodicalId":48689,"journal":{"name":"Seminars in Interventional Radiology","volume":"41 4","pages":"350-362"},"PeriodicalIF":1.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lymphatic Malformations: Review of Diagnosis and Management for the Interventional Radiologist. 淋巴畸形：介入放射医师的诊断和处理回顾。

IF 1 4区医学

Seminars in Interventional Radiology Pub Date : 2024-11-07 eCollection Date: 2024-08-01 DOI: 10.1055/s-0044-1791281

Shimwoo Lee, Aarti Luhar, Joseph Miller

{"title":"Lymphatic Malformations: Review of Diagnosis and Management for the Interventional Radiologist.","authors":"Shimwoo Lee, Aarti Luhar, Joseph Miller","doi":"10.1055/s-0044-1791281","DOIUrl":"https://doi.org/10.1055/s-0044-1791281","url":null,"abstract":"Lymphatic malformations (LMs) arise from errors in lymphatic vascular development during embryogenesis and encompass an array of conditions that span from common cystic LMs to complex lymphatic anomalies (CLAs). Manifestations of LMs are wide-ranging, from clinically inconsequential to life-threatening. Proper diagnosis and management can be challenging and often benefit from an experienced multidisciplinary team. Cystic LMs are localized entities for which percutaneous sclerotherapy is the mainstay treatment. CLAs, on the other hand, are more diffuse in involvement and typically require multimodal therapy. With advances in the genetic understanding of LMs, targeted systemic therapies have been increasingly utilized with promising results. Thoracic duct interventions, both surgical and percutaneous, have a limited role in CLAs and should be approached cautiously to avoid significant complications. In this review, we discuss the genetic basis, imaging findings, and management options for LMs, with a particular focus on relevant interventional radiology techniques.","PeriodicalId":48689,"journal":{"name":"Seminars in Interventional Radiology","volume":"41 4","pages":"389-403"},"PeriodicalIF":1.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges in Management of the Adult Vascular Anomalies Population: A Case Report and Review of the Literature. 成人血管异常人群管理中的挑战：病例报告和文献综述。

IF 1 4区医学

Seminars in Interventional Radiology Pub Date : 2024-11-07 eCollection Date: 2024-08-01 DOI: 10.1055/s-0044-1791193

David Strain, Kari J Nelson

引用次数: 0

Imaging of Vascular Anomalies. 血管异常成像。

IF 1 4区医学

Seminars in Interventional Radiology Pub Date : 2024-11-07 eCollection Date: 2024-08-01 DOI: 10.1055/s-0044-1791205

Edward Gayou, Alex Chau, Shellie Josephs

引用次数: 0

The Role of Medical Management in Vascular Anomalies. 医疗管理在血管异常中的作用。

IF 1 4区医学

Seminars in Interventional Radiology Pub Date : 2024-11-07 eCollection Date: 2024-08-01 DOI: 10.1055/s-0044-1791538

Michael H White, C Matthew Hawkins

{"title":"The Role of Medical Management in Vascular Anomalies.","authors":"Michael H White, C Matthew Hawkins","doi":"10.1055/s-0044-1791538","DOIUrl":"https://doi.org/10.1055/s-0044-1791538","url":null,"abstract":"Historically, the care for patients with vascular anomalies has been challenging due to the complex nature and diversity of these anomalies with a wide array of symptomatology. In the recent past, most therapies for vascular anomalies focused on surgical, procedural, and supportive care measures to treat local symptoms, but many patients still experienced significant disease with excess morbidity and mortality. Today, the pharmacotherapeutic options available for treating vascular anomalies have greatly expanded due to the increased understanding of the genetic and molecular pathways causing these anomalies, with the subsequent development of more targeted pharmacotherapies. In addition to the growth in targeted medications available to treat patients with vascular anomalies, there has been an improved understanding of the hematologic abnormalities related to these diseases and how to manage them. While interventional radiologists do not typically primarily manage systemic medications to treat vascular anomalies, a baseline understanding of the medical management of these diseases is essential to ensuring that a contemporary, multidisciplinary, multimodal approach to treatment is pursued when appropriate. Ultimately, patients are now benefitting from having multiple modalities of treatments available to them and are experiencing improved quality of life and less morbidity.","PeriodicalId":48689,"journal":{"name":"Seminars in Interventional Radiology","volume":"41 4","pages":"404-412"},"PeriodicalIF":1.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0