Journal of Vascular and Interventional Radiology最新文献

{"title":"Clinical Outcomes following Mechanical Thrombectomy in Pulmonary Embolism Response Team-Consulted Patients: A Retrospective Analysis.","authors":"Ryan Nolan, Maanasi Samant, Suresh Vedantham, Westley Ohman, Nathan Droz, Kristen Sanfilippo, Pavan Kavali","doi":"10.1016/j.jvir.2025.09.008","DOIUrl":"10.1016/j.jvir.2025.09.008","url":null,"abstract":"<p><strong>Purpose: </strong>To determine if use of mechanical thrombectomy (MT) impacts survival and additional outcomes in patients with acute intermediate-high-risk and high-risk pulmonary embolism (PE) who were evaluated by a Pulmonary Embolism Response Team (PERT).</p><p><strong>Methods: </strong>This retrospective, single-center study included patients with intermediate-high-risk and high-risk PE who received PERT evaluation over 3.5 years and were treated with anticoagulation (AC) alone or MT + AC. The primary outcome was 30-day all-cause mortality, measured with inverse probability of treatment weighting. Exploratory outcomes included survival during the study period, PE-associated/caused mortality, hospital length of stay (LOS), supplemental oxygen at discharge, and MT-related metrics.</p><p><strong>Results: </strong>Of 335 patients, 259 received AC alone and 76 received MT + AC. The use of MT was associated with reduced odds of 30-day all-cause mortality (odds ratio, 0.49; 95% CI, 0.27-0.76; P = .002). There were no significant differences in PE-associated/caused mortality. Hospital LOS was 2 days shorter in the MT + AC cohort (P < .001). Of patients receiving MT + AC, those with high-risk PE had a 4.5-day shorter stay (P < .001), whereas those with intermediate-high-risk PE had a 2-day shorter stay (P < .001). The proportion of patients receiving supplemental oxygen at discharge was lower in the MT + AC group (MT + AC vs AC, 4.1% vs 18.5%; P < .001), without significant differences in 30-day readmission rates (MT + AC vs AC, 9.5% vs 20.6%; P = .115). MT resulted in an 8.7-mm Hg reduction in mean pulmonary artery pressure, had a technical success rate of 100% (76 of 76), and an adverse event rate of 6.6% (5 of 76).</p><p><strong>Conclusions: </strong>MT reduced 30-day all-cause mortality, hospital LOS, and supplemental oxygen at discharge in the intermediate-high-risk and high-risk PE population.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-Absorbed Dose, Metabolic Response, and Survival after Yttrium-90 Radioembolization in Patients with Breast Cancer Liver Metastases.","authors":"Osman Melih Topcuoğlu, Türkay Toklu, Nalan Alan Selçuk, Betül Uzunoğlu","doi":"10.1016/j.jvir.2025.08.045","DOIUrl":"10.1016/j.jvir.2025.08.045","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the association between tumor-absorbed dose (TAD) relative to response and survival among patients with breast cancer liver metastasis (BCLM) treated with yttrium-90 (⁹⁰Y) transarterial radioembolization (TARE).</p><p><strong>Materials and methods: </strong>Between August 2016 and August 2024, patients with BCLM who underwent ⁹⁰Y TARE with glass microspheres were retrospectively included. Primary outcomes were overall survival (OS) and hepatic progression-free survival (hPFS). The secondary outcome was the objective response rate. Response to treatment was assessed using Positron Emission Tomography (PET) Response Criteria in Solid Tumors. Patients were divided into 2 groups as responders and nonresponders.</p><p><strong>Results: </strong>Twenty-six women with a mean age of 57.9 years (SD ± 13.8) met the inclusion criteria. The median OS and hPFS for all patients were 6.1 months (interquartile range [IQR], 4.3-9.0 months) and 4.2 months (IQR, 2.5-5.6 months), respectively. The median TAD for responders and nonresponders were 157 Gy and 150 Gy, respectively (P = .768). The median OS and hPFS for responders versus nonresponders were 8.3 months (IQR, 5.5-14.8 months) and 4.1 months (IQR, 3.1-6.3 months) versus 4.0 months (IQR, 2.5-4.5 months) and 2.1 months (IQR, 1.3-2.7 months), respectively (P = .025 and P = .210, respectively). TAD showed a significant OS benefit above 145 Gy but did not change hepatic hPFS (P = .024 and P = .397, respectively).</p><p><strong>Conclusions: </strong>Imaging response was modestly correlated with OS, and TAD was not correlated with response in this series.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descending Genicular Artery Access for Retrograde Recanalization of a Long-Segment Occlusion of the Superficial Femoral Artery.","authors":"Madan Mohan Balaguruswamy, Sampathkumar Palanisamy, Hariharaprakash Radhakrishnan, Karthik Murugesan Rajamallika, Devi Gayathri Palanivel, Ramraj Guruswami","doi":"10.1016/j.jvir.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.jvir.2025.09.007","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling Clinical Relevance and Risk in Yttrium-90 Radioembolization of the Liver: Lung Shunt Fraction Variability According to Imaging Modality, Cancer Type, and Tumor Size.","authors":"M Allan Thomas, Tharun Alamuri, Ryan C Lee, Dan Giardina, John Karageorgiou, Naganathan Mani, Daniel A Braga, Christopher D Malone","doi":"10.1016/j.jvir.2025.09.006","DOIUrl":"10.1016/j.jvir.2025.09.006","url":null,"abstract":"<p><strong>Purpose: </strong>To test the hypothesis that lung shunt fraction (LSF) in yttrium-90 (⁹⁰Y) radioembolization (RE) of the liver can be modeled for clinical relevance and risk on the basis of cancer type, tumor size, and imaging modality.</p><p><strong>Materials and methods: </strong>This was a retrospective analysis of 354 consecutive cases from a 34-month period at a single institution. Cancer type (hepatocellular carcinoma [HCC] vs non-HCC) and maximum tumor size were tracked. LSF was computed from planar imaging (LSF_planar) and 3 macroaggregated albumin-single photon emission computed tomography (SPECT)/computed tomography (CT) methods with different corrections at the lung/liver boundary (LSF_Full, LSF_2cm, and LSF_Left). Five tumor categories were analyzed: (a) HCC measuring <3 cm, (b) HCC measuring 3-8 cm, (c) HCC measuring >8 cm, (d) cases with transjugular intrahepatic portosystemic shunt (TIPS)/vascular invasion, and (e) non-HCC.</p><p><strong>Results: </strong>Median LSF was significantly different (all P < .001) among LSF_planar, LSF_Full, LSF_2cm, and LSF_Left methods, with values of 6.9%, 3.9%, 1.4%, and 0.8%, respectively. There were 72% and 19% of cases with LSF_planar of >5% and >10%, respectively, but only 7% and 2% using LSF_2cm. LSF was lower for HCC measuring <3 cm relative to HCC measuring 3-8 cm and >8 cm (P ≤ .003). In the <3-cm HCC group, there were no cases with LSF_planar > 20% or LSF_2cm > 5%. Cases with TIPS/vascular invasion maintained the highest median LSF (LSF_planar, 9.0%; LSF_2cm, 2.8%) and the highest percentages of cases with LSF values of >10% and >20% across all methods.</p><p><strong>Conclusions: </strong>Despite significant variations with imaging modality and correction methods, consistent trends in LSF magnitude with cancer type and tumor size were still uncovered. The relative risk of observing clinically relevant LSF can be modeled for different liver tumor categories in ⁹⁰Y-RE.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Society of Interventional Radiology Practice Guidance Document on Percutaneous Arteriovenous Fistulae for Dialysis Access.","authors":"Bart L Dolmatch, Andrew J Gunn, Bulent Arslan, Vincent Gallo, Mustafa Haddad, Robert J Kennedy, Mary E Meek, Keith B Quencer, Dheeraj K Rajan, Rishi N Razdan, Brandon M Repko, Gabriel Werder, Andre Uflacker, Luke R Wilkins","doi":"10.1016/j.jvir.2025.08.019","DOIUrl":"10.1016/j.jvir.2025.08.019","url":null,"abstract":"<p><p>The Renal and Genitourinary Clinical Specialty Council of the Society of Interventional Radiology (SIR) formed a workgroup in collaboration with the SIR Guidelines and Statements Division to create up-to-date society-based consensus recommendations for the creation and maturation of percutaneous arteriovenous fistulae (pAVFs) for hemodialysis access. This practice guidance document serves as a summary of what is required to develop a pAVF program, including patient preparation, performance of the procedure, adverse event management, and follow-up care.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abernethy Malformation Shunt Closure to Treat Hepatic Encephalopathy Mimicking Parkinson Disease.","authors":"Rasmiranjan Padhi, Arun Prasannan, Virag Shethna, Jagadeesan Dhanasekaran, Shanmuga Sundaram Radhakrishnan","doi":"10.1016/j.jvir.2025.08.043","DOIUrl":"10.1016/j.jvir.2025.08.043","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Effectiveness of Yttrium-90 Radioembolization in Normal Lung Parenchyma: A Preclinical Study in Rabbits with Pathological Correlation to Absorbed Dose.","authors":"Ioannis Spyridonidis, Marios Platon Dimopoulos, Pinelopi Bosgana, Trifon Spyridonidis, Theodoros Skouras, Michalis Theofanis, Christos Papageorgiou, Nikolaos Giannikas, Panagiotis M Kitrou, Konstantinos Katsanos, Dimitrios Karnabatidis","doi":"10.1016/j.jvir.2025.08.044","DOIUrl":"10.1016/j.jvir.2025.08.044","url":null,"abstract":"<p><p>This study investigated the effects of yttrium-90 (⁹⁰Y) radioembolization in 8 rabbits, focusing on delivery accuracy, dosimetry, and pathological outcomes. ⁹⁰Y was successfully delivered angiographically targeted via the pulmonary lower basal segmental arteries to all rabbits, with confirmation via positron emission tomography (PET)/computed tomography (CT) imaging and a lung target median of the mean dose of 132.1 Gy (range, 11.2-262.3 Gy). Pathological analysis in all surviving subjects revealed complete necrosis of the irradiated segments, with associated inflammation in adjacent nonirradiated tissue. Radiological follow-up with CT scan showed triangular fibrosis in 6 rabbits at 1 month, progressing to fibrosis at 3 months. Dosimetry analysis confirmed dose distribution to the targeted lung regions. Of 8 rabbits, 1 died intraprocedurally, and another died 1.5 weeks after the procedure for unknown reasons. The remaining rabbits had no severe adverse events, with 1 case of pleural effusion resolving with no intervention at 3 months. The study demonstrated the feasibility of ⁹⁰Y delivery to the lungs.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Tumors Marked Percutaneously with Indocyanine Green Dye-Soaked Embolization Coils: A Visual Beacon for Accurate Intraoperative Localization during Lung-Sparing Surgery.","authors":"Edward J Walsh, Hasnain Bawaadam, Joseph G Mammarappallil, Jason R Snider, William C Allsopp, Frederick J Brodeur, Aaron R Green, Ganesh Krishna, Brandon M Wojcik","doi":"10.1016/j.jvir.2025.08.042","DOIUrl":"10.1016/j.jvir.2025.08.042","url":null,"abstract":"<p><p>Thoracic surgeons using minimally invasive techniques for lung nodule resection often rely on localization markers to determine precise nodule location intraoperatively. Transbronchial or transthoracic injection of indocyanine green (ICG) dye has become a popular technique. However, surgery must be performed immediately before dye dissipates into surrounding tissue. This multicenter retrospective study evaluated the effectiveness of computed tomography (CT)-guided transthoracic placement of ICG dye-soaked coils (ICG-Cs) for preoperative lung nodule localization. Nineteen adult patients with 21 nodules underwent CT ICG-C placement from March 01, 2023, until February 28, 2025, at 2 medical centers. There were no adverse events. Median time from localization to surgery was 1 day (interquartile range, 0-4 days), with 57.1% undergoing surgery >24 hours later. Localization success rate was 100%. CT-guided transthoracic placement of ICG-C is a novel technique that allows for accurate nodule localization, delayed surgical resection, and the preservation of healthy lung tissue.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' Response: \"Comparison of Outcomes after TARE and TAE in HCC >7 cm; Selection Bias Raises Questions\".","authors":"Ken Zhao, Vlasios Sotirchos, Brett Marinelli, Hooman Yarmohammadi","doi":"10.1016/j.jvir.2025.08.041","DOIUrl":"10.1016/j.jvir.2025.08.041","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy and Clinical Impact of Ultrasound-Guided Percutaneous Lung Biopsy in Pediatric Patients: A Retrospective Observational Study.","authors":"Jiaojiao Ding, Xin Ni, Xiao Zhang, Jiabin Wan, Wenyuan Shi","doi":"10.1016/j.jvir.2025.08.040","DOIUrl":"https://doi.org/10.1016/j.jvir.2025.08.040","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic accuracy, safety, and clinical impact of ultrasound-guided percutaneous lung biopsy (US-PLB) in pediatric peripheral lung lesions.</p><p><strong>Materials and methods: </strong>A retrospective cohort analysis included 34 pediatric patients (24 male, 10 female; mean age 7.9 ± 4.4 years) undergoing US-PLB from March 2019 to February 2024. Diagnostic metrics (sensitivity, specificity, positive and negative predictive values) and adverse events were analyzed. The influence of biopsy results on clinical management was assessed.</p><p><strong>Results: </strong>Among 33 diagnostic procedures, US-PLB demonstrated an accuracy of 97.0% (32/33), with sensitivity of 80.0% (4/5 malignant lesions) and specificity of 100% (28/28 benign lesions). Minor complications occurred in 17.6% (6/34) of patients, including pneumothorax (2.9%) and transient hemoptysis (2.9%). Biopsy findings directly altered therapeutic strategies in 44.1% (15/34) of cases, including initiation of chemotherapy or targeted antimicrobial therapy.</p><p><strong>Conclusion: </strong>US-PLB is a safe and accurate radiation-free diagnostic technique for pediatric peripheral lung lesions, offering critical histopathologic and microbiologic guidance for clinical decision-making.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}