CVIR Endovascular最新文献

{"title":"Who should be considered for prostate artery embolization: revisiting the urologic guidelines based on results from over 300 patients with benign prostatic hyperplasia.","authors":"Gabriel M Knight, Ajay Varadhan, Elana Benishay, Delmarie M Rivera-Rodríguez, Kimberly Jenkins, Elias Hohlastos, Riad Salem, Samdeep Mouli","doi":"10.1186/s42155-026-00703-w","DOIUrl":"https://doi.org/10.1186/s42155-026-00703-w","url":null,"abstract":"<p><strong>Background: </strong>Prostate artery embolization (PAE) has emerged as a minimally invasive therapy which affords improvement in benign prostatic hyperplasia (BPH) symptoms and objective urinary parameters with a favorable adverse event (AE) profile. While PAE was recently included in the American Urological Association (AUA) Guidelines, guidance on its specific use-cases is limited. This study sought to answer remaining questions surrounding the safety and efficacy of PAE across different patient subpopulations where formal guidance for PAE is limited.</p><p><strong>Methods: </strong>Three hundred two patients with BPH underwent PAE. Key baseline characteristics were gathered. Patients were compared from baseline to follow-ups with regards to (1) objective parameters, including maximum urinary flow rate (Q<sub>max</sub>), post-void residual (PVR), and prostate specific antigen (PSA); (2) prostate volume; (3) BPH symptoms, including International Prostate Symptom Score (IPSS), IPSS Quality-of-Life (IPSS-QoL), and BPH Impact Index (BPH-II); (4) sexual symptoms, including the International Index of Erectile function (IIEF) and Male Sexual Health Questionnaire for Ejaculatory Function Short Form (MSHQ-EjD-SF); and (5) AEs. Additional sub-analyses were performed comparing the safety/efficacy of PAE across key sub-groups.</p><p><strong>Results: </strong>PAE afforded significant improvement (p < 0.05) in each subjective/objective BPH parameter and sexual function score at nearly all follow-up points. Specifically, IPSS improved by 12.3-13.8 points (52.8-59.2%); IPSS-QoL by 2.3-2.8 points (47.9-58.3%); IIEF by 3.2-5.7 points (15.6-27.8%); PSA by 1.5-2.0 ng/mL (15.6-28.5%); and prostate volume by 16.9%. Twelve (4.0%) AEs were reported; no sexual/severe AEs were observed. PAE was safe and afforded significant improvement in subjective/objective BPH parameters in patients with: prostate volumes ≥ 80 mL; prior BPH surgery/intervention; higher medical comorbidity; pre-procedural catheter-dependent urinary retention; pre-procedural renal insufficiency; and pre-procedural hematuria.</p><p><strong>Conclusions: </strong>PAE improved subjective/objective BPH parameters and sexual function. Further, it safely afforded significant improvement in subjective/objective BPH parameters in specific contexts/scenarios where current guidance for PAE is limited, including patients with larger prostates, prior BPH intervention, higher medical comorbidity, urinary retention, renal insufficiency, and hematuria. Altogether, PAE can be performed safely and effectively in several real-world contexts in which formal guidance for PAE is limited, and where it may offer unique advantages compared to surgical therapies.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov, NCT03052049. Registered 6 September 2017, https://clinicaltrials.gov/study/NCT03052049 ; Clinicaltrials.gov, NCT02026908. Registered 10 June 2019, https://cdn.</p><p><strong>Clinicaltrials: </str","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149247494","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":"Preoperative bladder artery embolization before transurethral resection of large bladder tumors: a propensity score-matched retrospective cohort study.","authors":"Chengtao Gu, Jun Li, Hao Zheng, Zilong Zhang, Hao Xu, Zhe Zhang, Gang Shen, Long Cheng","doi":"10.1186/s42155-026-00779-4","DOIUrl":"10.1186/s42155-026-00779-4","url":null,"abstract":"<p><strong>Background: </strong>Transurethral resection of bladder tumor (TURBT) can be technically challenging in patients with large bladder tumors because intraoperative bleeding may obscure the surgical field, prolong the procedure, and hinder complete tumor resection. Preoperative bladder artery embolization may reduce tumor vascularity and facilitate subsequent TURBT; however, comparative evidence regarding its perioperative benefits and safety remains limited. This study evaluated the perioperative outcomes of preoperative bladder artery embolization followed by TURBT within 24 h in patients with bladder tumors measuring ≥ 3 cm.</p><p><strong>Results: </strong>Among 75 eligible patients, 27 underwent preoperative bladder artery embolization followed by TURBT and 48 underwent TURBT alone. Propensity score matching generated 17 matched pairs. Compared with the TURBT-alone group, the embolization group had significantly lower intraoperative blood loss (68.03 [56.68, 75.50] mL vs. 101.96 [93.62, 116.67] mL, P = 0.005) and shorter operation time (60.00 [49.00, 67.00] min vs. 80.00 [75.00, 87.00] min, P = 0.009). Postoperative hospital stay (7 [7, 8] days vs. 8 [8, 10] days, P = 0.035) and catheterization time (6 [6, 7] days vs. 8 [7, 8] days, P = 0.009) were also shorter in the embolization plus sequential TURBT group.</p><p><strong>Conclusions: </strong>For bladder tumors measuring ≥ 3 cm, bladder artery embolization followed by sequential TURBT within 24 h may reduce intraoperative blood loss, shorten operation time, and promote early postoperative recovery.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brachial artery access for endovascular procedures: how safe is it?","authors":"Lucy Rose Howroyd, Arjan Singh Khattar, Hoi-Ying Claudia Tam, Robert Morgan, Joo-Young Chun","doi":"10.1186/s42155-026-00741-4","DOIUrl":"10.1186/s42155-026-00741-4","url":null,"abstract":"<p><strong>Purpose: </strong>While femoral and radial artery access are routine for endovascular procedures, brachial artery access remains an important alternative in selected cases. This study aimed to evaluate the complication rate of percutaneous brachial artery access at a tertiary centre and identify potential risk factors for access-site complications.</p><p><strong>Materials and methods: </strong>A retrospective review was performed of all procedures utilising percutaneous brachial artery access over a 12.5-year period. Patient demographics, sheath size, closure technique and complications were recorded. Complications were classified according to the CIRSE classification system.</p><p><strong>Results: </strong>One hundred percutaneous brachial artery punctures were identified. Sheath sizes ranged from 3 to 9 Fr; the majority (57%) using 6 Fr. Most procedures (84%) were performed for aortic, mesenteric/renal, or peripheral arterial interventions. Overall, 23 complications occurred (23%), including 9 (9%) grade 3 complications requiring additional treatment. No convincing association was identified between complication rate and patient age, gender, or sheath size. Vascular closure devices were used in seven cases, five of which resulted in complications, including three grade 3 events.</p><p><strong>Conclusions: </strong>The complication rate associated with brachial artery access in this series was higher than that reported in much of the published literature. These findings suggest that brachial artery access may be less safe than commonly perceived and that vascular closure devices should be used with caution, particularly given their off-label status for this access site. Standardised procedural protocols and post-procedural care pathways may help reduce complication rates. Broader auditing and reporting across centres are encouraged to better define best practice.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde access revascularization in chronic limb threatening ischaemia.","authors":"Yujia Gao, Lorenzo Patrone, Neil Davies, Anthie Papadopoulou, Nick Woodward, Janice Tsui, Mark Portou, Shanka Benaragama, Conrad von Stempel","doi":"10.1186/s42155-026-00786-5","DOIUrl":"10.1186/s42155-026-00786-5","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic limb-threatening ischaemia (CLTI) is associated with high rates of major amputation, mortality and comorbidity that can make conventional femoral access challenging or contraindicated; in particular in patients with recent groin surgery, infection, previous aorto-bifemoral stent reconstruction, hostile groins, or unfavourable body habitus. Tibio-pedal arterial minimally invasive retrograde revascularisation (TAMI) provides an alternative access strategy.</p><p><strong>Materials and methods: </strong>This retrospective single-centre cohort study included 84 TAMI procedures in 81 limbs from 77 patients with CLTI (median age 72 years; 64% male; Rutherford IV 22%; Rutherford V-VI 78%). TAMI was performed because of recent groin surgery/infection in 35% of procedures and patient-related factors in 65%. The primary clinical endpoint was freedom from major adverse limb events (MALE), defined as major amputation or clinically driven target-vessel reintervention (CDTVR). Secondary endpoints included technical success, defined as restoration of continuous inline flow through at least one infrapopliteal artery to the foot with < 50% residual stenosis on completion angiography, and access vessel safety.</p><p><strong>Results: </strong>Retrograde access was obtained predominantly via the dorsalis pedis (71%) and distal posterior tibial arteries (16%). Technical success was achieved in 66/84 procedures (78%); in 10/84 (12%), TAMI access and lesion crossing were successful but the predefined angiographic endpoint was not met, while eight procedures (10%) were abandoned. Asymptomatic access vessel spasm was documented in 35/84 procedures (42%) that had resolved by 24 h. Among 68 patients (71 limbs) with longitudinal follow-up, median follow-up was 150 days (IQR 76-322). CDTVR occurred in 22/71 limbs (30%) and major amputation in 14/71 (20%); 25/68 patients (37%) died. Kaplan-Meier estimated freedom from MALE was 57.9% (95% CI 43.9-69.6%) at 6 months and 51.2% (95% CI 36.0-64.5%) at 12 months. In multivariable Cox regression analysis, none of the evaluated covariates was significantly associated with MALE.</p><p><strong>Conclusion: </strong>In this selected, anatomically complex CLTI cohort, TAMI was a feasible alternative access strategy when conventional femoral access was challenging or not feasible, with a low observed rate of clinically significant pedal access complications.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ischemic paralysis caused by internal iliac artery embolism after endovascular recanalization for lower extremity arteriosclerosis obliterans: a case report.","authors":"Jing Wang, Jing Li, Xuemin Zhang, Xiaoming Zhang, Tao Zhang","doi":"10.1186/s42155-026-00783-8","DOIUrl":"10.1186/s42155-026-00783-8","url":null,"abstract":"<p><strong>Background: </strong>Lower extremity paralysis is a devastating complication after endovascular therapy for lower extremity arteriosclerosis obliterans (LEAOD). Common mechanisms include ischemia-reperfusion injury, acute arterial embolism, and thrombosis. Paralysis caused by internal iliac artery embolism is exceptionally rare and may be overlooked when postoperative neurologic deficits are initially attributed to spinal or cerebral causes.</p><p><strong>Case presentation: </strong>An 86-year-old man developed recurrent bilateral intermittent claudication 3 years after endovascular treatment for LEAOD, followed by right toe ulceration. Preoperative computed tomographic angiography showed severe multilevel stenosis and in-stent reocclusion in both lower limbs. He underwent bilateral thrombus aspiration, balloon angioplasty, and catheter-directed thrombolysis. One hour after the procedure, acute left lower limb weakness (muscle strength grade 0-1) and hypoesthesia below the mid-calf occurred. Emergency abdominal-pelvic non-contrast CT, lumbar spine MRI, brain imaging, and lower limb CTA excluded lumbar canal disease and stroke, while suggesting new internal iliac artery occlusion. Emergency thrombus aspiration and balloon angioplasty of the left internal iliac artery restored substantial patency and improved muscle strength to grade III-IV in the thigh and grade III in the leg. Because pain persisted and distal perfusion remained insufficient, femoral endarterectomy and infrapopliteal balloon angioplasty were subsequently performed. After 1 month of rehabilitation, muscle strength remained grade III, with persistent sensory impairment and assisted ambulation.</p><p><strong>Conclusions: </strong>Internal iliac artery embolism is a rare but clinically important cause of ischemic paralysis after peripheral endovascular intervention. In patients with extensive multilevel occlusive disease, preoperative assessment of internal iliac collateral perfusion and cautious staged procedural planning may reduce risk. Sudden postoperative limb paralysis should prompt urgent spinal and vascular imaging, followed by timely revascularization when ischemia is suspected.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fallopian tube recanalization: is technical patency enough?","authors":"Vinicius Adami Vayego Fornazari, Renato Abu Hana, Grit Armstrong Adler, Sara Lojo-Lendoiro, Gregory Kirk Lewis, Gloria Maria Salazar","doi":"10.1186/s42155-026-00781-w","DOIUrl":"https://doi.org/10.1186/s42155-026-00781-w","url":null,"abstract":"","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticoagulation practices in venous occlusive disease after stent placement.","authors":"Omar Ayman, Olivia Antonescu, Warren A Campbell, Hyeonjeong Lim, Eunjee Lee, Jeffrey F B Chick, David Shin, Mina S Makary","doi":"10.1186/s42155-026-00763-y","DOIUrl":"10.1186/s42155-026-00763-y","url":null,"abstract":"<p><strong>Purpose: </strong>Characterize physician anticoagulation practices after stent placement in patients with venous occlusive disease.</p><p><strong>Materials and methods: </strong>Survey-based analysis was conducted between January 2023 and April 2023 (for 109 days) evaluating practices of post venous stent placement anticoagulation regimens. A survey investigated provider demographics, agent selection, dosing, duration, and patient factors taken in agent choice. The survey was distributed through email lists and promoted on social media and limited users to one response. Questions stratified for both superior vena cava (SVC) and upper extremity and inferior vena cava (IVC) and lower extremity interventions. Descriptive statistics determined the significance of the regimen utilization.</p><p><strong>Results: </strong>One hundred twenty-nine respondents participated in the study, with interventional radiologists constituting 94%. The preferred regimen for SVC interventions was direct oral anticoagulants (DOAC) and single antiplatelet therapy, accounting for 39/117 of respondents. For IVC interventions, low molecular weight heparin (LMWH) and single antiplatelet therapy was the regimen of choice representing 12/38 of preferences. SVC intervention therapy duration was most common to be lifetime for aspirin (10; 43%), 3 months for non-ASA antiplatelet agents (23; 52%), and 6 months for anticoagulants (32; 44%). For IVC therapies, the trend of drug duration for aspirin was most common to be lifetime (6;40%), for non-ASA antiplatelets was 3 months (10; 53%), and for anticoagulants tied for 6 and 12 months (7; 30% each). Eight risk factors affected post-intervention anticoagulation selection.</p><p><strong>Conclusion: </strong>This work highlights the most common post-venous stenting anticoagulation regimens currently in clinical practice.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective evaluation of uterine artery embolization using diluted NBCA-lipiodol mixture for uterine fibroids: preliminary treatment outcomes.","authors":"Nguyen Thi Bich Van, Nguyen Thanh Khiem, Nguyen Ngoc Cuong, Phan Hoang Giang, Nguyen Quang Trung, Thieu Thi Tra My, Bui Thi Phuong Thao, Tran Quoc Hoa","doi":"10.1186/s42155-026-00782-9","DOIUrl":"10.1186/s42155-026-00782-9","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the safety and effectiveness of uterine artery embolization using NBCA - lipiodol mixture via radial artery access for the treatment of uterine fibroids.</p><p><strong>Methods: </strong>Forty patients underwent uterine artery embolization with NBCA mixed with lipiodol (1:10). The uterine fibroid volumes were determined on magnetic resonance imaging before and 3-6 months after the procedure. We analyzed the following parameters: dominant fibroid volume, hemoglobin levels, symptoms before treatment, after embolization, and complications.</p><p><strong>Results: </strong>The mean age was 41 ± 6.5 years and mean uterine volume prior to treatment, 137.7 ± 104.3 ml. After 3-6 months embolization, the mean fibroid volume decreased from 137.7 ± 104.3 cm³ to 51 ± 54.3 cm³ (p < 0.001), corresponding to a mean volume reduction of 64.7 ± 22.7%. Hemoglobin levels also significantly increased (p < 0.001). No major intraprocedural adverse events were observed. Major complications occurred in 2.5% (fibroid expulsion). The minor complications rate was 20%, related to post-embolization syndrome (pain). The late adverse events occurred in 10%: alopecia (7.5%), vaginal dryness (2.5%). The length of hospital stay was 1.9 ± 0.8 days. Clinical symptomatic improvement was observed in 100% and symptoms were resolved in 87.5%.</p><p><strong>Conclusion: </strong>This prospective single-arm study suggests that UAE using a diluted NBCA-lipiodol mixture is feasible and appears to be safe, with encouraging early clinical and MRI outcomes. However, the short follow-up period, absence of a comparative control group, and lack of direct assessment of fibroid infarction preclude definitive conclusions regarding its efficacy or its role relative to established particulate embolic agents.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transarterial embolization in musculoskeletal care: an indication-stratified narrative review.","authors":"Jean-Pierre Pelage, Thunayan Aldalmani, Ruben Geevarghese, Norbert Zhang, Marc-Antoine Jegonday, Gregory Berry, Anthony Dohan, Audrey Fohlen, Sylvain Grange","doi":"10.1186/s42155-026-00776-7","DOIUrl":"https://doi.org/10.1186/s42155-026-00776-7","url":null,"abstract":"<p><strong>Background: </strong>Transarterial embolization (TAE) is increasingly used across a broad spectrum of musculoskeletal conditions, ranging from established hemostatic and tumor-related indications to emerging pain-directed procedures for degenerative joint disease and chronic inflammatory tendinopathies. Because these applications differ substantially in clinical maturity, methodological quality, durability of outcomes, and comparative evidence, an indication-stratified synthesis is needed.</p><p><strong>Main body: </strong>This narrative review summarizes technical principles, vascular anatomy considerations, embolic agent selection, clinical indications, and evidence maturity in musculoskeletal TAE. Hemostatic and selected tumor-related applications are established components of multidisciplinary care, whereas pain-directed embolization, including Genicular artery embolization for knee osteoarthritis and embolization for tendinopathies, is generally performed as a stand-alone minimally invasive procedure targeting pathological neovascularity. Current evidence remains heterogeneous, with variable study designs, follow-up, endpoints, and definitions of technical and clinical success.</p><p><strong>Conclusions: </strong>Musculoskeletal TAE is an expanding field with established, intermediate, and exploratory indications. Its evidence base is strongest for hemostatic and selected tumor-related applications, whereas stand-alone pain-directed embolization requires careful patient selection, standardized outcome assessment, and further comparative trials to define durability and clinical value.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful management of refractory lymphoma-associated chylothorax with CT-guided direct embolization and pleurodesis.","authors":"Yosuke Yamamoto, Jitsuro Tsukada, Masashi Tamura, Hiroki Yoshikawa, Yuji Furukawa, Ryo Ogawa, Mizuki So, Mamina Miyabayashi, Junya Tsuzaki, Seishi Nakatsuka, Yu Okubo, Akihisa Sakurada, Keisuke Asakura, Masahiro Jinzaki, Masanori Inoue","doi":"10.1186/s42155-026-00780-x","DOIUrl":"https://doi.org/10.1186/s42155-026-00780-x","url":null,"abstract":"<p><strong>Background: </strong>Lymphoma-associated chylothorax is a challenging condition in which thoracic duct embolization (TDE) has limited efficacy because lymphatic leakage is often multifocal and difficult to localize. Furthermore, TDE performed without confirmed localization of the leakage site may increase upstream intralymphatic pressure and paradoxically worsen chylous leakage. Accurate localization of the leakage site before intervention is therefore essential.</p><p><strong>Case presentation: </strong>A 53-year-old man with low-grade B-cell lymphoma developed refractory bilateral chylothorax during chemotherapy. Conventional intranodal lymphangiography (INL) performed on two occasions failed to identify the leakage site, yet TDE was performed at the referring institution and was followed by marked clinical deterioration. Dynamic contrast-enhanced MR lymphangiography (DCE-MRL) subsequently demonstrated active lymphatic leakage from the residual lymphoma lesion. CT-guided direct embolization with n-butyl-2-cyanoacrylate (NBCA) was performed in four sessions, followed by surgical pleurodesis for persistent right-sided chylothorax, resulting in durable resolution without recurrence during 29 months of follow-up.</p><p><strong>Conclusion: </strong>This case highlights the importance of avoiding TDE without confirmed localization of the leakage site in refractory lymphoma-associated chylothorax. When conventional lymphangiography fails to identify the leakage site, DCE-MRL may facilitate targeted intervention and improve treatment planning. CT-guided direct embolization may represent a useful therapeutic option in carefully selected patients.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}