Journal of Vascular and Interventional Radiology最新文献

{"title":"Limb Anatomic Capital Across the Claudication-to-Chronic Limb-Threatening Ischemia Trajectory: A Scoping Review and Framework for Longitudinal Revascularization Stewardship.","authors":"Jeffrey H Shuhaiber","doi":"10.1016/j.jvir.2026.109092","DOIUrl":"https://doi.org/10.1016/j.jvir.2026.109092","url":null,"abstract":"<p><strong>Purpose: </strong>To explore whether claudication-stage management may affect native arterial substrate available for later revascularization options and propose a longitudinal stewardship framework.</p><p><strong>Materials and methods: </strong>A PRISMA-ScR review searched PubMed/MEDLINE across four domains: prior intervention and bypass outcomes, tibial runoff, procedural burden and conservative management, and no-option chronic limb-threatening ischemia (CLTI).</p><p><strong>Results: </strong>Twenty-eight studies and guidelines were included. Prior ipsilateral endovascular intervention was associated in one study with higher 1-year major amputation (31% vs 20%) and graft occlusion (28% vs 18%). Three-year primary patency was 35.8% with absent tibial outflow versus 60.9% with intact runoff. Complete optimal medical therapy was documented in 38.1% at intervention; supervised exercise completion ranged from 5% to 55%. Approximately 20% of patients with CLTI were reported to lack a conventional revascularization option.</p><p><strong>Conclusions: </strong>Evidence supports prospective measurement of limb anatomic capital but does not separate natural disease progression from intervention-associated change. Proposed stewardship tools require prospective clinical validation.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":"109092"},"PeriodicalIF":3.1,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009259","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":"Interventional Radiology as the Most Utilized Treatment Specialty for Hepatocellular Carcinoma: A 25-Year Multidisciplinary Analysis at a High-Volume Academic Transplant Center.","authors":"Arsalan Nadeem, Laura M Kulik, Aparna Kalyan, Daniel Borja-Cacho, Fatima Z Islam, Beau B Toskich, Kent Sato, Zachary Dietch, Karen Grace, Melissa J Williams, Ramona Gupta, Andrew C Gordon, Robert J Lewandowski","doi":"10.1016/j.jvir.2026.109089","DOIUrl":"https://doi.org/10.1016/j.jvir.2026.109089","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the longitudinal role of interventional radiology (IR) in multidisciplinary hepatocellular carcinoma (HCC) care over 25 years at a high-volume liver transplant center, and to evaluate changes in IR utilization and procedural composition following FDA approval of atezolizumab plus bevacizumab (Atezo/Bev) as first-line systemic therapy.</p><p><strong>Materials and methods: </strong>This retrospective single-center cohort included patients 3,473 patients with HCC (ICD-9: 155.0; ICD-10: C22.0) treated between 2000 and 2025. The cohort was 71.7% male, with a median age of 64 years. Data were obtained from institutional procedure records and CPT codes. Outcomes included patients and procedures by specialty, IR procedural mix by era, treatment sequencing, and peri-transplant patterns. Analyses included descriptive statistics and chi-square tests.</p><p><strong>Results: </strong>IR treated 2,520 (72.6%) and performed 4,313 procedures, including TARE (72.6%), TACE (18.7%), and ablation (7.9%). Surgery treated 1,350 (38.9%), medical oncology 746 (21.5%), and radiation oncology 96 (2.8%). Of 939 liver transplant patients, 510 (54.3%) received IR pre-transplant at a median of 201 days, primarily TARE (67.0%). After Atezo/Bev approval, IR patient proportion declined from 75.7% to 64.6% (p<0.001), while annual procedural volume remained stable (151 vs 192, p=0.366). TARE increased from 67.4% to 86.8% of procedures, while TACE decreased from 24.7% to 2.3%.</p><p><strong>Conclusion: </strong>Over 25 years, IR was the most utilized specialty in HCC care. TARE became the dominant locoregional and bridging therapy. After Atezo/Bev approval, IR utilization proportion declined, but procedural volume remained stable with a marked shift toward TARE and away from TACE.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":"109089"},"PeriodicalIF":3.1,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009284","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":"Ultrasound-Derived Hemodynamic Parameters for Predicting Presence and Site of Arteriovenous Fistula Stenosis.","authors":"Maofeng Gong, Keith Quencer, Takeshi Suzuki, Khashayar Farsad, Kentaro Yamada","doi":"10.1016/j.jvir.2026.109085","DOIUrl":"10.1016/j.jvir.2026.109085","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate predictive performance of ultrasound (US)-derived hemodynamic parameters in detecting ≥50% stenosis in patients with hemodialysis arteriovenous fistula (AVF) and determine predictors of juxta-anastomotic stenosis (JAS).</p><p><strong>Materials and methods: </strong>This single-center retrospective study reviewed patients with AVFs who underwent both US and fistulography. Basic demographics, comorbidities, AVF configuration, stenosis type, image time interval, US hemodynamic parameters, and angiographic information were compared.</p><p><strong>Results: </strong>A total of 87 patients were included. Both the stenotic peak systolic velocity (PSV) and Δstenotic-to-juxtastenotic PSV (adjusted odds ratio [aOR], 1.282; 95% CI, 1.103-1.491; P = .001) are associated with ≥50% stenosis, with the latter demonstrating superior predictive value (area under the curve, 0.659 vs 0.799; P = .004). Restricted cubic spline analysis showed that a larger Δstenotic-to-juxtastenotic PSV had an increased risk of ≥50% stenosis (P = .012). Furthermore, anastomotic PSV (aOR, 1.003; 95% CI, 1.001-1.006; P = .002) distinguished JAS from stenosis in draining or outflow vein. Among patients with JAS, the Δstenotic-to-juxtastenotic PSV was slightly superior to Δanastomotic PSV in detecting ≥50% stenosis.</p><p><strong>Conclusions: </strong>US-derived hemodynamic parameters based on PSV may serve as useful predictors in detecting the presence and site of AVF stenosis. ΔStenotic-to-juxtastenotic PSV demonstrated superior diagnostic performance for detecting overall AVF stenosis and JAS. A larger Δstenotic-to-juxtastenotic PSV was associated with an increased risk of ≥50% stenosis. Anastomotic PSV may help distinguish JAS from stenosis located in draining or outflow vein.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":"109085"},"PeriodicalIF":3.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992182","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":"Opioid-Sparing Sedation for Gastrostomy Tube Placement: A Retrospective Cohort Study Comparing Ketamine/Midazolam and Fentanyl/Midazolam.","authors":"Dylan Goodman, Ashraf Ahmad, Adam Belcher, Amy R Deipolyi","doi":"10.1016/j.jvir.2026.109081","DOIUrl":"https://doi.org/10.1016/j.jvir.2026.109081","url":null,"abstract":"<p><p>Percutaneous gastrostomy tube placement is associated with substantial procedural and postprocedural pain. This retrospective single-center sequential before-and-after cohort study compared fentanyl/midazolam versus ketamine/midazolam sedation for percutaneous gastrostomy placement between October 2022 and April 2026. Of 129 consecutive procedures screened, 30 were excluded, yielding 99 procedures performed with fentanyl/midazolam (n = 54) or ketamine/midazolam (n = 45). The primary outcome was a composite sedation/analgesia-related clinical outcome, including serious sedation-related events, oxygen desaturation <90%, postoperative analgesic use, or antiemetic administration. Ketamine/midazolam was associated with a lower rate of the composite clinical outcome compared with fentanyl/midazolam (40.0% vs 63.0%, p = .027), primarily driven by lower postoperative analgesic requirements. Trends favored ketamine for desaturation and serious sedation-related events, while antiemetic use, nadir systolic blood pressure, and Aldrete recovery scores were similar between groups. These findings suggest ketamine/midazolam was associated with reduced postoperative analgesic requirements and comparable observed safety for gastrostomy tube placement.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":"109081"},"PeriodicalIF":3.1,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957220","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":"Intravascular Ultrasound-Guided Transcaval Cisterna Chyli Access for Lymphatic Intervention: A Proof-of-Concept Study in a Porcine Model.","authors":"Nicholas Perkons, James Ronald, Waleska Pabon-Ramos, Charles Kim, Brendan Cline","doi":"10.1016/j.jvir.2026.109077","DOIUrl":"https://doi.org/10.1016/j.jvir.2026.109077","url":null,"abstract":"<p><strong>Purpose: </strong>Central lymphatic interventions are an emerging frontier for Interventional Radiology. Conventional lymphatic access relies on transabdominal puncture of the cisterna chyli following secondary opacification from groin or pedal contrast injection. These techniques are time-consuming and risk injury to multiple structures. This study evaluated the feasibility of direct transcaval cisterna chyli access using intravascular ultrasound with an intracardiac echocardiography probe (IVUS-ICE), motivated by the close proximity of the IVC and cisterna chyli in the retroperitoneum.</p><p><strong>Materials and methods: </strong>IVUS-ICE guidance was used to attempt cisterna chyli cannulation from the IVC in six swine. In the first cohort (n = 2), nodal lymphangiography was performed to co-localize the cisterna chyli prior to ultrasound guided cannulation. In the second cohort (n = 4), de novo access of the cisterna was attempted; rescue nodal lymphangiography was only performed if the cisterna could not be definitively identified sonographically. After central lymphatic cannulation, thoracic duct embolization was performed with coils and/or glue.</p><p><strong>Results: </strong>Transcaval cisterna chyli cannulation and subsequent thoracic duct embolization was successful in all animals (n=6). In the second cohort where primary IVUS-ICE access was attempted, de novo cannulation without preceding lymphangiography was successful in 75% of subjects. Success depended on the sonographic visibility and proximity of lymphatics to the IVC.</p><p><strong>Conclusion: </strong>This study demonstrates that IVUS-ICE-guided transcaval access is technically feasible. This approach may improve procedural safety and efficiency by eliminating transgression of abdominal structures inherent to transabdominal access and the often-time-consuming process for central lymphatic opacification for a subset of patients.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":"109077"},"PeriodicalIF":3.1,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957225","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":"Unusual Medial Course of Profunda Femoris Artery Complicating Femoral Venous Access.","authors":"Adil Basha, Pooja Atkuri, Sanjeeva P Kalva","doi":"10.1016/j.jvir.2026.109034","DOIUrl":"https://doi.org/10.1016/j.jvir.2026.109034","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":"109034"},"PeriodicalIF":3.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185710","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":"Safety and Effectiveness of Liquid Embolics for Prostate Artery Embolization: A Systematic Review and Meta-Analysis.","authors":"Ahmet Gunkan, Victor Arthur Ohannesian, Salvatore Tumolo, Sean Lee, Micheal T Lee, Derek Smetanick, Christian Fang, Mason K Whitaker, Nicholas McGhee, Sarah Placek, Jack Hannallah, Gregory Woodhead, Shamar Young","doi":"10.1016/j.jvir.2026.109025","DOIUrl":"https://doi.org/10.1016/j.jvir.2026.109025","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the literature on the use of liquid embolics (LEs) in prostate artery embolization (PAE) and to evaluate their safety and efficacy outcomes.</p><p><strong>Materials and methods: </strong>A comprehensive search of PubMed, Scopus, Cochrane, and Google Scholar was performed. Studies including ≥5 patients undergoing PAE with a LEs were eligible. The outcomes included adverse events (AEs), changes in prostate volume, International Prostate Symptom Score (IPSS), and quality-of-life (QoL) at follow-up. Subgroup analyses by liquid embolic type were performed when feasible. Outcomes were pooled using a random-effects meta-analysis.</p><p><strong>Results: </strong>Eleven studies (913 patients; mean/median age range, 67.5-79 years) were included. The systematic review identified that only two LEs, Ethylene-vinyl alcohol copolymer (EVOH) (n = 3 studies) and Glue (n = 8 studies), were explored in PAE. The three EVOH studies included a total of 95 cases, indicating that the current evidence base for LEs in PAE is predominantly derived from Glue experience. Of the 11 included studies, 9 were noncomparative and 2 compared LEs with particles. Pooled safety outcomes demonstrated no severe AEs. At last follow-up (range, 2-36 months), pooled mean changes from baseline were -2.73 in QoL (95% CI, -3.00 to -2.47; I² = 76%), -31.04 mL in prostate volume (95% CI, --39.04 to -23.04; I² = 94%), and -10.7 in IPSS (95% CI, -11.46 to -9.95; I² = 56%).</p><p><strong>Conclusion: </strong>LEs, particularly glue, which constitutes the majority of the available literature appear to demonstrate promising safety and efficacy in PAE. Further prospective studies are needed to better explore the role of LEs in PAE.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":"109025"},"PeriodicalIF":3.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765411","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":"Prediction Models for Infection Severity after Thermal Ablation of Liver Malignant Tumors.","authors":"Lin Jiang, Xiaoju Li, Xiaoli Wang, Xiaoer Zhang, Huanling Guo, Jiaqian Yao, Xiaoyan Xie, Ming Xu","doi":"10.1016/j.jvir.2026.108997","DOIUrl":"10.1016/j.jvir.2026.108997","url":null,"abstract":"<p><strong>Purpose: </strong>To identify predictors and develop models for predicting infection severity following percutaneous thermal ablation for liver malignancies.</p><p><strong>Materials and methods: </strong>A total of 8655 ultrasound (US)-guided percutaneous thermal ablations at a single center (January 2010-November 2023) were retrospectively reviewed. The study included 172 patients (mean age, 58.5 years [SD ± 11.4]; 145 men), with 86 infected (18 severe and 68 nonsevere) and 86 noninfected patients. Patients developing infection within 30 days were classified as severe (septic shock or infection-related death) or nonsevere. A noninfected control group was matched by the treatment date. A scoring system was developed to identify infection in patients with postablative fever. Two multivariate logistic regression models were constructed: 1 using preablative variables and another combining preablative and postablative characteristics.</p><p><strong>Results: </strong>Among 8655 ablations, 86 (0.99%) developed postablative infections. All infected patients developed postprocedural fever, compared with 29.1% (25/86) in controls. An infection screening score (cutoff ≥ 3) achieved a diagnostic accuracy of 0.910. For predicting infection severity, the preablation model identified metastatic tumor (odds ratio [OR], 4.98; P = .009) and subcapsular location (OR, 7.68; P = .002) as independent predictors, with area under the receiver-operating characteristic curve of 0.774, sensitivity of 0.889, and specificity of 0.500. The combined model included preprocedural monocyte ratio (monocyte count divided by white blood cell count: OR, 0.71; P < .001), subcapsular location (OR, 624.86; P < .001), and postfever procalcitonin (OR, 1.78; P < .001), outperformed the preablation model (area under the receiver-operating characteristic curve, 0.966; sensitivity, 0.889; specificity, 0.912).</p><p><strong>Conclusions: </strong>Infection severity after liver tumor ablation was effectively predicted. The combined model demonstrated excellent performance and could facilitate early risk stratification for timely intervention.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":"108997"},"PeriodicalIF":3.1,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702384","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":"Cover","authors":"","doi":"10.1016/j.jvir.2026.108929","DOIUrl":"10.1016/j.jvir.2026.108929","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 8","pages":"Article 108929"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148651136","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":"Subscription Information","authors":"","doi":"10.1016/j.jvir.2026.108934","DOIUrl":"10.1016/j.jvir.2026.108934","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 8","pages":"Article 108934"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148651135","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}