Michael T. Aaberg MD , Carlos E. Marroquin MD , Nima Kokabi MD , Anant D. Bhave MD , Joseph T. Shields MD , Bill S. Majdalany MD, FSIR
{"title":"Endovascular Treatment of Venous Outflow and Portal Venous Complications After Liver Transplantation","authors":"Michael T. Aaberg MD , Carlos E. Marroquin MD , Nima Kokabi MD , Anant D. Bhave MD , Joseph T. Shields MD , Bill S. Majdalany MD, FSIR","doi":"10.1016/j.tvir.2023.100924","DOIUrl":"10.1016/j.tvir.2023.100924","url":null,"abstract":"<div><p><span>Liver transplantation<span><span> continues to rapidly evolve, and in 2020, 8906 orthotopic liver transplants were performed in the United States. As a technically complex surgery with multiple </span>vascular anastomoses<span>, stenosis and thrombosis of the venous anastomoses<span> are among the recognized vascular complications. While rare, venous complications may be challenging to manage and can threaten the graft and the patient. In the last 20 years, endovascular approaches have been increasingly utilized to treat post-transplant venous complications. Herein, the evaluation and interventional treatment of post-transplant </span></span></span></span>venous outflow<span><span> complications, portal vein stenosis, </span>portal vein thrombosis<span><span>, and recurrent portal hypertension with </span>transjugular intrahepatic portosystemic shunt (TIPS) are reviewed.</span></span></p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136010254","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}
Pareena Sharma , Ritu Shah , Vaz Zavaletta MD, PhD , Frederic Bertino MD , Tina Sankhla , Jun Man Kim , Michael Leshen , Jay Shah
{"title":"Pediatric Transplant Interventions","authors":"Pareena Sharma , Ritu Shah , Vaz Zavaletta MD, PhD , Frederic Bertino MD , Tina Sankhla , Jun Man Kim , Michael Leshen , Jay Shah","doi":"10.1016/j.tvir.2023.100930","DOIUrl":"10.1016/j.tvir.2023.100930","url":null,"abstract":"<div><p><span><span><span>The field of pediatric<span><span> organ transplantation has grown significantly in recent decades, with </span>interventional radiology (IR) playing an essential role in managing pre and post-transplant complications. Pediatric transplant patients face unique challenges compared to adults, including donor-recipient size mismatch, and complications of a growing child with changing physiology. Interventional radiologists play a major role in pediatric renal and </span></span>liver transplant<span><span>. IR interventions begin early in the child's pretransplant journey, with diagnostic procedures such as biopsies, angiograms, and cholangiograms. These procedures are essential for understanding the etiology of organ failure and identifying potential transplant candidates. Minimally invasive </span>therapeutic procedures may serve as bridges to transplant and may include </span></span>vascular access<span><span> optimization for hemodialysis, </span>transjugular intrahepatic portosystemic shunts<span> (TIPS) creation, and tumor embolization or ablation. After transplant, image-guided biopsies for the surveillance of </span></span></span>graft rejection<span><span> and treatment of vascular or luminal stenoses, pseudoaneurysms<span>, and anastomotic leaks can maintain the function and longevity of the transplant organ. Careful consideration must be given to patient size and evolving </span></span>anatomy<span>, radiation exposure, and the need for deeper sedation for pediatric patients. Despite these challenges, the integration of IR in pediatric transplant care has proven beneficial, offering minimally invasive alternatives to surgery, faster recovery times, and improved outcomes.</span></span></p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135412267","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":"Disparities in Transplant Interventions","authors":"Kaesha Thomas MD, Owosela Babajide BS, Judy Gichoya MD, MS, Janice Newsome MD, FSIR","doi":"10.1016/j.tvir.2023.100921","DOIUrl":"10.1016/j.tvir.2023.100921","url":null,"abstract":"","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136009936","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":"Special Considerations and Techniques of Interventions in Lung Transplant Recipients","authors":"Daniel H. Kim, Shenise Gilyard, Robert Suh","doi":"10.1016/j.tvir.2023.100926","DOIUrl":"10.1016/j.tvir.2023.100926","url":null,"abstract":"<div><p><span><span><span>Lung transplant remains an important treatment option for patients with end-stage </span>lung diseases providing improvement in survival rates and </span>quality of life. Specialized considerations should be applied with interventions of lung transplant recipients as they host specific anatomic variations and high risk towards certain complications. In this article, we highlight the role of </span>interventional radiology<span> for lung transplant recipients along with discussion of interventional techniques. Specific emphasis is placed on describing and explaining the techniques pertained to the points of anastomosis<span>, diagnosis and treatment of malignancies, and management of complications in lung transplant recipients.</span></span></p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136010985","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}
Jonathan Charles BS , Monique Girgis BS , Nariman Nezami MD , Kamal Massis MD , Cliff Davis MD , Glenn Hoots MD , Jamil Shaikh MD
{"title":"Interventional Radiological Treatment of Orthotopic Heart Transplant Complications","authors":"Jonathan Charles BS , Monique Girgis BS , Nariman Nezami MD , Kamal Massis MD , Cliff Davis MD , Glenn Hoots MD , Jamil Shaikh MD","doi":"10.1016/j.tvir.2023.100928","DOIUrl":"10.1016/j.tvir.2023.100928","url":null,"abstract":"<div><p><span>Orthotopic heart transplantation is a life-saving procedure that has substantially improved the lives of countless patients since its inception. However, there are several procedure-related complications that require prompt management. </span>Interventional radiology<span><span>, with its ever expanding toolkit, is a cornerstone of the multidisciplinary team following post-cardiac transplant patients. Percutaneous, endovascular therapy provides minimally invasive, safe, and effective treatments for immediate and delayed </span>cardiac transplant complications and this paper serves to highlight the various management options interventional radiology can provide for orthotopic heart transplantation complications.</span></p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135326034","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}
Hamed Jalaeian MD, RPVI, MSc , David H. Field MD, MS , Emil I. Cohen MD, FSIR
{"title":"Transplant Renal Interventions","authors":"Hamed Jalaeian MD, RPVI, MSc , David H. Field MD, MS , Emil I. Cohen MD, FSIR","doi":"10.1016/j.tvir.2023.100925","DOIUrl":"10.1016/j.tvir.2023.100925","url":null,"abstract":"<div><p><span><span>Renal transplantation is the most commonly performed solid-organ </span>allograft<span><span> surgery; in 2021, 25487 kidneys were transplanted in the United States, and nearly 42,000 adult patients were listed for transplant. As the treatment of choice for patients with end-stage renal disease, transplantation is performed at more than 250 centers. Despite a high rate of success, renal transplantation is not without complication, and the interventional radiologist plays a crucial role in the management of the postoperative patient. Knowledge of postsurgical anatomy, imaging findings, and technical challenges unique to these patients is important for the safe and effective treatment of transplant-related conditions. We offer a guide to the most common interventions in the </span>renal transplant population, including biopsy, vascular interventions, and the management of </span></span>urinary obstruction.</p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136010079","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":"Surgical Versus Image-Guided Interventions in the Management of Complications After Liver Transplantation","authors":"Denise J. Lo MD , Joseph F. Magliocca MD","doi":"10.1016/j.tvir.2023.100922","DOIUrl":"10.1016/j.tvir.2023.100922","url":null,"abstract":"<div><p><span><span>Liver transplantation is a technically demanding surgical procedure with known complications, and the optimal approach to addressing vascular and biliary complications requires a coordinated effort between surgical and interventional radiology teams. Vascular complications involving the </span>hepatic artery, </span>portal vein<span>, or hepatic veins<span><span> can be characterized by their mechanism, chronicity, and timing of presentation. These factors help determine whether the optimal therapeutic approach is surgical or endovascular. Very early presentation in the </span>perioperative period favors surgical revision, while later presentation is best addressed endovascularly. Biliary complications can be categorized as leaks or strictures, and coordinated surgical, endoscopic, and percutaneous management is needed to address these types of complications. Through advances in technique and the management of complications, outcomes after liver transplantation continue to improve.</span></span></p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136010084","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":"Transplant Hepatic Artery Complications","authors":"Ziga Cizman MD, Wael Saad","doi":"10.1016/j.tvir.2023.100923","DOIUrl":"10.1016/j.tvir.2023.100923","url":null,"abstract":"<div><p>Hepatic artery<span><span> complications can be divided into 2 different categories, nonocclusive and steno-occlusive disease. Steno-occlusive disease is a collective term that encompasses hepatic artery thrombosis, hepatic artery stenosis, and hepatic arterial kinks, while nonocclusive </span>arterial disease<span><span> encompasses less than 5% of complications and is a collective term used to describe arteriovenous fistulae, </span>pseudoaneurysms<span>, arterial rupture<span> and nonocclusive hepatic artery hypoperfusion syndrome. This article details the angiographic techniques and definitions needed to accurately diagnose arterial transplant complications and describes the technical aspects and results of endoluminal management of these arterial complications. In addition, this article discusses the presentation, etiology and indications for treatment, including surgical management of these various complications.</span></span></span></span></p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135410388","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":"Perspectives of Cone-beam Computed Tomography in Interventional Radiology: Techniques for Planning, Guidance, and Monitoring","authors":"Matthias Barral MD, PhD , Olivier Chevallier MD, PhD , Francois H. Cornelis MD, PhD","doi":"10.1016/j.tvir.2023.100912","DOIUrl":"10.1016/j.tvir.2023.100912","url":null,"abstract":"<div><p>Cone-beam computed tomography (CBCT) has emerged as a prominent imaging modality in interventional radiology that offers real-time visualization and precise guidance in various procedures. This article aims to provide an overview of the techniques used to guide and monitor interventions that use CBCT. It discusses the advantages of CBCT, its current applications, and potential future CBCT-related developments in the field of interventional radiology.</p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136010013","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}
Anna M. Sorensen MD , Annie M. Zlevor BA , Meridith A. Kisting MA , Allison B. Couillard MD , Timothy J. Ziemlewicz MD , Giuseppe V. Toia MD, MS , J. Louis Hinshaw MD , Michael Woods MD , Lindsay M. Stratchko DO , Perry J. Pickhardt MD , Marcia L. Foltz RN , Walter W. Peppler PhD , Fred T. Lee Jr. MD , Erica M. Knavel Koepsel MD
{"title":"CT Navigation for Percutaneous Needle Placement: How I Do It","authors":"Anna M. Sorensen MD , Annie M. Zlevor BA , Meridith A. Kisting MA , Allison B. Couillard MD , Timothy J. Ziemlewicz MD , Giuseppe V. Toia MD, MS , J. Louis Hinshaw MD , Michael Woods MD , Lindsay M. Stratchko DO , Perry J. Pickhardt MD , Marcia L. Foltz RN , Walter W. Peppler PhD , Fred T. Lee Jr. MD , Erica M. Knavel Koepsel MD","doi":"10.1016/j.tvir.2023.100911","DOIUrl":"10.1016/j.tvir.2023.100911","url":null,"abstract":"<div><p>CT navigation (CTN) has recently been developed to combine many of the advantages of conventional CT and CT-fluoroscopic guidance for needle placement. CTN systems display real-time needle position superimposed on a CT dataset. This is accomplished by placing electromagnetic (EM) or optical transmitters/sensors on the patient and needle, combined with fiducials placed within the scan field to superimpose a known needle location onto a CT dataset. Advantages of CTN include real-time needle tracking using a contemporaneous CT dataset with the patient in the treatment position, reduced radiation to the physician, facilitation of procedures outside the gantry plane, fewer helical scans during needle placement, and needle guidance based on diagnostic-quality CT datasets. Limitations include the display of a virtual (vs actual) needle position, which can be inaccurate if the needle bends, the fiducial moves, or patient movement occurs between scans, and limitations in anatomical regions with a high degree of motion such as the lung bases. This review summarizes recently introduced CTN technologies in comparison to historical methods of CT needle guidance. A “How I do it” section follows, which describes how CT navigation has been integrated into the study center for both routine and challenging procedures, and includes step-by-step explanations, technical tips, and pitfalls.</p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135965847","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}