Techniques in Vascular and Interventional Radiology最新文献

{"title":"The Outpatient Endovascular & Interventional Society (OEIS)—The Voice of Advocacy for the OBL: Origins, Principles, and Historical Perspective","authors":"","doi":"10.1016/j.tvir.2024.100946","DOIUrl":"10.1016/j.tvir.2024.100946","url":null,"abstract":"<div><p>The physician office offering imaging guided endovascular and minimally invasive interventional procedures is often referred to as an OBL (office based lab), OIS (office interventional suite), or OES (office endovascular suite). Initially, OBL's depended upon the national societies of interventional radiology (SIR), vascular surgery (SVS) and interventional cardiology (SCAI) to advocate for them. However, the OBL space needed a voice dedicated to advocating for the appropriate reimbursement of procedures in the OBL to allow the OBL to survive as a viable site of service and become integral to healthcare delivery in the US healthcare system. This need led to the formation of the Outpatient Endovascular &amp; Interventional Society (OEIS). The society is multispecialty and ensures safety in outpatient care in all sites of service while maintaining a focus on the OBL. The mission of the OEIS is to advocate for patients to have the ability to choose their provider and be able to receive safe and effective healthcare in a more friendly and far less costly site of service for them.</p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141047391","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":"Establishing a Critical Limb Ischemia Outpatient Center: Separating Facts from Myth","authors":"","doi":"10.1016/j.tvir.2024.100953","DOIUrl":"10.1016/j.tvir.2024.100953","url":null,"abstract":"<div><p>Critical Limb Ischemia or chronic limb-threatening ischemia represents the end stage of peripheral artery disease where arterial flow is compromised to the lower extremities and risk of limb loss may become imminent. Revascularization of lower extremities is one of the cornerstones of limb salvage and amputation prevention. Establishing centers of high quality CLI therapy requires creating different foundational pillars in order to be successful. This article discusses critical limb ischemia center creation from the perspective of critical limb ischemia therapists working in an outpatient setting.</p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140760885","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":"Interventional Radiology Approaches for Managing Postpancreatic Transplant Complications and Type 1 Diabetes Mellitus","authors":"Talal Mourad MD ,&nbsp;Wael Saad MD ,&nbsp;Osman Ahmed MD","doi":"10.1016/j.tvir.2023.100927","DOIUrl":"10.1016/j.tvir.2023.100927","url":null,"abstract":"<div><p><span><span>Type 1 diabetes mellitus<span><span><span> (T1DM) is a chronic autoimmune disorder characterized by the destruction of insulin-secreting beta cells in the pancreas, resulting in metabolic disturbances and long-term complications. While subcutaneous insulin remains the primary approach for achieving normoglycemia, pancreatic transplantation has emerged as an effective intervention for long-standing T1DM, providing insulin independence and normalized </span>glycosylated hemoglobin<span> levels. However, complications associated with pancreatic transplantation are frequent, necessitating thorough evaluation using diverse imaging modalities. This manuscript presents an overview of complications encountered with pancreatic transplantation, including vascular complications such as arterial and venous graft thrombosis, vessel stenosis, </span></span>pseudoaneurysm<span>, arterio-enteric fistula, and arteriovenous malformations<span>. Additionally, the manuscript discusses other associated complications such as pancreatitis, </span></span></span></span>pseudocyst<span><span> formation, fistulas, pseudo-thrombosis of the </span>iliac vein<span>, post-transplantation lymphoproliferative disorder, and fluid collections. The integration of various imaging modalities plays a crucial role in diagnosing and managing these complications, with interventional radiologists assuming a vital role in employing image-guided procedures. Moreover, the manuscript explores pancreatic </span></span></span>islet cell transplantation<span><span> as a promising cellular-based therapy for T1DM, offering stable long-term glycemic control and decreased reliance on exogenous insulin in a significant proportion of recipients. This </span>minimally invasive procedure involves the image-guided transcatheter infusion of islet cells obtained from deceased donors into the recipient's liver. The importance of interventional radiologists in managing complications related to pancreatic transplantation is underscored, with endovascular or image-guided approaches being utilized to address the diverse spectrum of encountered complications. Furthermore, the potential of islet cell transplantation as a minimally invasive alternative to traditional pancreatic transplantation is emphasized, as it offers the prospect of preventing many associated 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":"135454864","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 Treatment of Venous Outflow and Portal Venous Complications After Liver Transplantation","authors":"Michael T. Aaberg MD ,&nbsp;Carlos E. Marroquin MD ,&nbsp;Nima Kokabi MD ,&nbsp;Anant D. Bhave MD ,&nbsp;Joseph T. Shields MD ,&nbsp;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}

{"title":"Pediatric Transplant Interventions","authors":"Pareena Sharma ,&nbsp;Ritu Shah ,&nbsp;Vaz Zavaletta MD, PhD ,&nbsp;Frederic Bertino MD ,&nbsp;Tina Sankhla ,&nbsp;Jun Man Kim ,&nbsp;Michael Leshen ,&nbsp;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,&nbsp;Owosela Babajide BS,&nbsp;Judy Gichoya MD, MS,&nbsp;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,&nbsp;Shenise Gilyard,&nbsp;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}

{"title":"Interventional Radiological Treatment of Orthotopic Heart Transplant Complications","authors":"Jonathan Charles BS ,&nbsp;Monique Girgis BS ,&nbsp;Nariman Nezami MD ,&nbsp;Kamal Massis MD ,&nbsp;Cliff Davis MD ,&nbsp;Glenn Hoots MD ,&nbsp;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}

{"title":"Transplant Renal Interventions","authors":"Hamed Jalaeian MD, RPVI, MSc ,&nbsp;David H. Field MD, MS ,&nbsp;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 ,&nbsp;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}