CVIR Endovascular最新文献

{"title":"Feasibility of an antegrade-retrograde single-sheath inverse technique via vertical puncture in dysfunctional hemodialysis arteriovenous fistula angioplasty.","authors":"Tetsuya Hasegawa, Masahiro Tsuboi, Yuki Takahashi, Akira Endo, Yasuo Gotoh","doi":"10.1186/s42155-024-00480-4","DOIUrl":"https://doi.org/10.1186/s42155-024-00480-4","url":null,"abstract":"<p><strong>Background: </strong>Stenosis resulting in dysfunctional dialysis access may occur simultaneously on the anastomotic and central venous side. The purpose of this study was to retrospectively evaluate the feasibility of a single sheath inverse technique using the vertical puncture approach to perform bidirectional transvenous percutaneous transluminal angioplasty (PTA) from a single sheath for such dialysis access stenoses.</p><p><strong>Materials and methods: </strong>Twenty patients (26 cases; 13 males; median age, 74 [range: 50-89] years) who underwent PTA using the sheath inverse technique for dysfunctional arteriovenous fistula stenoses between April 2019 and June 2023 were included. All procedures were performed in an outpatient setting. A 4-cm sheath (4Fr, four cases; 5Fr, 19 cases; 6Fr, three cases) was inserted by vertical puncture through a cutaneous vein in the forearm (20 cases) or upper arm (six cases). After treating one side of the lesion, the sheath was reversed to treat the lesion on the opposite side. The vessel diameter at the sheath insertion site, the success rate of sheath inversion, the number of PTA balloon catheters used, the PTA success rate, adverse events, and primary and secondary patency rates up to one year after PTA were evaluated.</p><p><strong>Results: </strong>The median diameter at the sheath indwelling site was 5.2 (range: 3.6-9.5) mm, and sheath inversion was successful in all cases, eliminating the need to place an additional sheath at another site for contralateral stricture treatment. The number of balloon catheters used was one and two in 17 (65%) and eight cases (31%), respectively, and three in one case wherein a drug-coated balloon was used. PTA was successful in all cases and major complications were not observed. However, in one case wherein a sheath had to be placed at the arterial needle puncture site, the skin was hard, leading to difficulty in inversion, and transient venous spasm occurred post-inversion. The primary patency rates at 3, 6 and 12 months after the PTA were 87.5%, 41.7%, and 20.8%, respectively. The secondary patency rates at 6 and 12 months were 100% and 75%, respectively.</p><p><strong>Conclusion: </strong>The single-sheath inverse technique for arteriovenous fistulas was feasible without sheath withdrawal.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11415322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300574","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":"Correction: Interventional solutions for post‑surgical problems: a lymphatic leaks review","authors":"Fernando M. Gómez, Tarik R. Baetens, Ernestos Santos, Boris Leon Rocha, Benjamin Horwitz, Sara Lojo‑Lendoiro, Patricio Vargas, Premal Patel, Regina Beets‑Tan, Jose J. Martinez‑Rodrigo, Luis Marti Bonmati","doi":"10.1186/s42155-024-00483-1","DOIUrl":"https://doi.org/10.1186/s42155-024-00483-1","url":null,"abstract":"&lt;p&gt;&lt;b&gt;Correction: CVIR Endovasc 7&lt;/b&gt;,&lt;b&gt; 61 (2024)&lt;/b&gt;&lt;/p&gt;&lt;p&gt;&lt;b&gt;https://doi.org/10.1186/s42155-024-00473-3&lt;/b&gt;&lt;/p&gt;&lt;p&gt;Following publication of the original article [1], the author reported that the affiliations 3 and 4 have been interchanged. The original article has been corrected.&lt;/p&gt;&lt;p&gt;The affiliations 3 and 4 currently read:&lt;/p&gt;&lt;p&gt;3 Radiology, Division of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, USA.&lt;/p&gt;&lt;p&gt;4 Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam 1066 CX, The Netherlands.&lt;/p&gt;&lt;p&gt;The affiliations 3 and 4 should read:&lt;/p&gt;&lt;p&gt;3 Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam 1066 CX, The Netherlands.&lt;/p&gt;&lt;p&gt;4 Radiology, Division of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, USA.&lt;/p&gt;&lt;ol data-track-component=\"outbound reference\" data-track-context=\"references section\"&gt;&lt;li data-counter=\"1.\"&gt;&lt;p&gt;Gómez FM, Baetens TR, Santos E, et al. Interventional solutions for post-surgical problems: a lymphatic leaks review. CVIR Endovasc. 2024;7:61. https://doi.org/10.1186/s42155-024-00473-3.&lt;/p&gt;&lt;p&gt;Article PubMed PubMed Central Google Scholar &lt;/p&gt;&lt;/li&gt;&lt;/ol&gt;&lt;p&gt;Download references&lt;svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"&gt;&lt;use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"&gt;&lt;/use&gt;&lt;/svg&gt;&lt;/p&gt;&lt;h3&gt;Authors and Affiliations&lt;/h3&gt;&lt;ol&gt;&lt;li&gt;&lt;p&gt;Biomedical Imaging Research Group (GIBI2^30), La Fe Health Research Institute (IIS La Fe), Avenida Fernando Abril Martorell, València, 46026, Spain&lt;/p&gt;&lt;p&gt;Fernando M. Gómez, Jose J. Martinez‑Rodrigo &amp; Luis Marti Bonmati&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Radiology Department, La Fe University and Polytechnic Hospital, Avenida Fernando Abril Martorell, València, 46026, Spain&lt;/p&gt;&lt;p&gt;Fernando M. Gómez&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands&lt;/p&gt;&lt;p&gt;Fernando M. Gómez, Tarik R. Baetens &amp; Regina Beets‑Tan&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Radiology, Division of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, USA&lt;/p&gt;&lt;p&gt;Ernestos Santos&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Interventional Radiology, Hospital Clinico de la Universidad de Chile, Santos Dumont 999, Independencia, Región Metropolitana, Chile&lt;/p&gt;&lt;p&gt;Boris Leon Rocha&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Radiology Department, Facultad de Medicina Clinica Alemana- Universidad del Desarrollo, Santiago, 7650568, Chile&lt;/p&gt;&lt;p&gt;Benjamin Horwitz &amp; Patricio Vargas&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Department of Radiology, Hospital Álvaro Cunqueiro, Estrada de Clara Campoamor, 341, Vigo, 36312, Pontevedra, Spain&lt;/p&gt;&lt;p&gt;Sara Lojo‑Lendoiro&lt;/p&gt;&lt;/li&gt;&lt;li&gt;&lt;p&gt;Renal Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, Level 7, Southwood Building, Great Ormond Street, London, WC1N 3JH, UK&lt;/p&gt;&lt;p&gt;Premal Patel&lt;/p&gt;&lt;/li&gt;&lt;/ol&gt;&lt;span&gt;Authors&lt;/span&gt;&lt;ol&gt;&lt;li&gt;&lt;span&gt;Fernando M. Gómez&lt;/span&gt;View author publications&lt;p&gt;You can also search for this author in","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269728","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":"Carbon dioxide-enhanced angiography for detection of colonic diverticular bleeding and clinical outcomes","authors":"Ryoichi Kitamura, Takaaki Maruhashi, Reiko Woodhams, Koyo Suzuki, Yutaro Kurihara, Kaoru Fujii, Yasushi Asari","doi":"10.1186/s42155-024-00481-3","DOIUrl":"https://doi.org/10.1186/s42155-024-00481-3","url":null,"abstract":"To determine the ability of CO2-enhanced angiography to detect active diverticular bleeding that is not detected by iodinated contrast medium (ICM)-enhanced angiography and its impact on clinical outcomes when used to confirm embolization, particularly the risks of rebleeding and ischemic complications. We retrospectively identified a cohort of patients with colonic diverticular bleeding who underwent catheter angiography between August 2008 and May 2023 at our institution. We divided them according to whether they underwent CO2 angiography following a negative ICM angiography study or to confirm hemostasis post-embolization (the CO2 angiography group) or ICM angiography alone in the absence of active bleeding or for confirmation of hemostasis post-embolization (the ICM angiography group). The ability to detect active colonic diverticular bleeding and clinical outcomes were compared between the two groups. There were 31 patients in the ICM angiography group and 29 in the CO2 angiography group. The rate of detection of active bleeding by CO2 angiography that was not identified by ICM angiography was 48%. The rebleeding rate was 23% in the ICM angiography group and 6.9% in the CO2 angiography group. Among the patients who underwent TAE, the ischemic complications rate was 7.1% in the ICM angiography group and 4.5% in the CO2 angiography group. CO2 angiography may detect active diverticular bleeding that is not detectable by ICM angiography and appears to be associated with a lower rebleeding rate. IV. ","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215788","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":"Investigating the effects of percutaneous endovascular aneurysm repair for abdominal aortic aneurysm on the lumen size of the common femoral artery","authors":"Wilson Wei Xiang Ong, Hsien Ts’ung Tay, Tze Tec Chong","doi":"10.1186/s42155-024-00476-0","DOIUrl":"https://doi.org/10.1186/s42155-024-00476-0","url":null,"abstract":"Percutaneous endovascular aneurysm repair (PEVAR) is the definitive therapy of choice for abdominal aortic aneurysms worldwide. However, current literature regarding the anatomic changes in the common femoral artery (CFA) post-PEVAR is sparse and contradictory, and a significant proportion of these studies did not control for the potential confounding effects of ethnicity. Thus, this study aims to investigate the anatomical effects of PEVAR on the CFA using an Asian study cohort. Between January 2019 and September 2023, the records of 113 patients who received PEVAR were reviewed. Groins with previous surgical interventions were excluded. The most proximate pre- and postoperative CT angiography of patients receiving PEVAR via the Perclose ProGlide™ Suture-Mediated Closure System were retrospectively analysed for changes in both the CFA inner luminal diameter (ID) and outer diameter (OD), the latter also encompassing the arterial walls. Access site complications within 3 months post-PEVAR were also recorded per patient. One hundred seventeen groins from 60 patients were included in this study, with 1 report of pseudoaneurysm. The CFA ID exhibited a 0.167 mm decrease (p-value = 0.0403), while the OD decreased by 0.247 mm (p-value = 0.0107). This trend persisted when the data was separately analysed with the common cardiovascular risk factors of diabetes mellitus, hypertension and hyperlipidaemia. Our analysis demonstrated a statistically significant decrease in the CFA diameters post-PEVAR. However, the percentage changes were below established flow-limiting values, as reflected by the single access site complication reported. Hence, our findings give confidence in the safety profile of this procedure, even with the reported smaller baseline CFA lumen size in Asians. Moving forward, similar longer-term studies should be considered to characterise any late postoperative effects. ","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215778","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":"Transjugular antegrade transvenous obliteration, with and without portal decompression, for management of rectal variceal hemorrhage.","authors":"Gabriel E Li, Jeffrey Forris Beecham Chick, Eric J Monroe, Matthew Abad-Santos, Ethan W Hua, David S Shin","doi":"10.1186/s42155-024-00479-x","DOIUrl":"10.1186/s42155-024-00479-x","url":null,"abstract":"<p><strong>Purpose: </strong>To report antegrade transvenous obliteration, with or without concurrent portosystemic shunt creation, for the treatment of hemorrhagic rectal varices.</p><p><strong>Materials and methods: </strong>Eight patients, including five (62.5%) females and three (37.5%) males, with mean age of 55.8 ± 13.8 years (range: 30-70 years), underwent transjugular-approach antegrade transvenous obliteration of rectal varices, with or without portosystemic shunt creation. Demographic data, procedural details, technical success of variceal obliteration, clinical success, adverse events, and follow-up outcomes were retrospectively recorded. Clinical success was defined as resolution of rectal hemorrhage.</p><p><strong>Results: </strong>Portal venous access was achieved via a transjugular intrahepatic approach in all patients. The inferior mesenteric vein was selected, and foamy sclerosant (1:2:3 mixture by volume of ethiodized oil: sodium tetradecyl sulfate: air) was injected into the rectal varices with antegrade balloon occlusion in seven (87.5%) and without balloon occlusion in one (12.5%). Five of eight (62.5%) patients underwent concomitant transjugular intrahepatic portosystemic shunt (TIPS) creation (mean diameter 8.4 ± 0.9-mm) immediately following transvenous obliteration. Technical success of variceal obliteration was achieved in all patients. There were no immediate post-procedural adverse events. There were no reported occurrences of rectal ischemia, perforation, or stricture following obliteration. Two (40%) of the patients who underwent concomitant TIPS creation developed hepatic encephalopathy within 30 days of the procedure, which was medically managed. Clinical resolution of hemorrhage was achieved in all patients with no recurrent rectal variceal hemorrhage during mean follow-up of 666 ± 396 days (range: 14 - 1,224 days).</p><p><strong>Conclusion: </strong>Transvenous obliteration, with or without concurrent TIPS creation, is feasible with promising results for the management of rectal variceal hemorrhage.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127203","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":"Transfemoral hepatic vein access in double vein embolization - initial experience and feasibility.","authors":"Ulrik Carling, Sigurd Berger, Eyvind Gjønnæss, Bård Røsok, Sheraz Yaqub, Kristoffer Lassen, Åsmund Avdem Fretland, Eric Dorenberg","doi":"10.1186/s42155-024-00478-y","DOIUrl":"10.1186/s42155-024-00478-y","url":null,"abstract":"<p><strong>Background: </strong>Hepatic vein embolization in double vein embolization (DVE) can be performed with transhepatic, transjugular or transfemoral access. This study evaluates the feasibility and technical success of using a transfemoral access for the hepatic vein embolization in patients undergoing preoperative to induce hypertrophy of the future liver remnant (FLR).</p><p><strong>Material and methods: </strong>Retrospective analysis of single center cohort including 17 consecutive patients. The baseline standardized FLR was 18.2% (range 14.7-24.9). Portal vein embolization was performed with vascular plugs and glue through an ipsilateral transhepatic access. Hepatic vein embolization was performed using vascular plugs. Access for the hepatic vein was either transhepatic, transjugular or transfemoral. Technical success, number of hepatic veins embolized and complications were registered. In addition, volumetric data including degree of hypertrophy (DH) and kinetic growth rate (KGR), and resection data were registered. R: Seven of the 17 patients had transfemoral hepatic vein embolization, with 100% technical success. No severe complications were registered. In the whole cohort, the median number of hepatic veins embolized was 2 (1-6). DH was 8.6% (3.0-19.4) and KGR was 3.6%/week (1.4-7.4), without significant differences between the patients having transfemoral versus transhepatic /transjugular access (p = 0.48 and 0.54 respectively). Time from DVE to surgery was median 4.8 weeks (2.6-33.9) for the whole cohort, with one patient declining surgery, two having explorative laparotomy and one patient having change of surgical strategy due to insufficient growth.</p><p><strong>Conclusion: </strong>Transfemoral access is a feasible option with a high degree of technical success for hepatic vein embolization in patients with small future liver remnants needing DVE.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121147","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":"Anatomic locations of ureterovascular fistulae: a review of 532 patients in the literature and a new series of 8 patients.","authors":"Mohammed Shamseldin, Hendrik Heers, Thomas Steiner, Ralf Puls","doi":"10.1186/s42155-024-00475-1","DOIUrl":"10.1186/s42155-024-00475-1","url":null,"abstract":"<p><strong>Introduction: </strong>Ureterovascular fistula (UVF) is a rare but potentially life-threatening condition. Since its primary description by Moschkowitz in 1908, many case reports, studies and reviews have been written about this condition with the suggestive symptoms and risk factors repeatedly discussed. This study will be focusing on the different locations of 532 out of 605 fistulae published from 1908 up to 2022 besides eight new patients of our own.</p><p><strong>Material and methods: </strong>A systematic review of the literature started using PubMed database searching for \"ureteroarterial fistula\", \"arteriovascular fistula\" and \"uretero vascular fistula\" was performed yielding 122, 62 and 188 results respectively. Those studies and the cited literature in each study were examined to include studies, which did not appear in the primary search. A total of 605 patients in 315 publications were gathered. Only studies mentioning new patients, a clear indication of the location of the UVF, the presence/absence of urinary diversion (UD) as well as the type of UD if present were included. Ten duplicates as well as studies lacking information regarding the UVF and/or the UD (seven publications with 63 patients) were excluded, with 298 publications including 532 external patients remaining. Eight internal cases were included with a total of 540 cases.</p><p><strong>Results: </strong>From the 540 included cases, 384 patients (71.1%) had no UD compared to 156 patients (28.9%) with UD. Due to the anatomical ureteral course, the common iliac artery (CIA) was the most common vascular component of UVF, irrespective of the presence or absence of UD. Any dispute to whether the crossing point is the common or the external iliac artery (EIA) was settled for the CIA. Further common vascular components besides CIA include the aorta, EIA, internal iliac artery (IIA) including its branches and vascular bypasses including the anastomosis sites. Other unusual arterial localizations were stated under the \"others\" category.</p><p><strong>Conclusion: </strong>Identifying the location of the bleeding artery in UVF is critical and represents the most important step for successful management. We present the largest summary of described locations up to date including our own.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977166","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":"Selective embolisation of an idiopathic bronchial artery pseudoaneurysm presenting with recurrent laryngeal nerve palsy: a case report.","authors":"R Copping, N Ng, S Osman","doi":"10.1186/s42155-024-00474-2","DOIUrl":"10.1186/s42155-024-00474-2","url":null,"abstract":"<p><strong>Background: </strong>Bronchial artery pseudoaneurysms (BAP) or aneurysms (BAA) are rare, potentially life-threatening and remain poorly understood. They are most commonly idiopathic but may be associated with a number of other disease processes. Bronchial artery embolisation (BAE) is considered the first line treatment while surgical techniques are reserved for patients with a clear contraindication to embolisation or where anatomical factors preclude an endovascular approach.</p><p><strong>Case presentation: </strong>We present an interesting case of a 56 year-old male presenting with an idiopathic unruptured right BAP causing clinical and radiological signs of left recurrent laryngeal nerve (RLN) palsy. He was otherwise clinically well with no other reported symptoms and no significant past medical history. There were no significant findings on work-up and investigation. He was ultimately treated successfully with selective transarterial coil embolization of the right bronchial artery. This is an atypical presentation of a rare clinical entity and has not previously been published in the literature to our knowledge.</p><p><strong>Conclusions: </strong>BAPs and BAAs are highly variable in their presentation, ranging from incidental asymptomatic findings to catastrophic haemorrhage, depending on their location and if they are contained or ruptured. Timely diagnosis and referral to facilitate urgent embolisation is essential to prevent potentially serious clinical sequelae. Endovascular treatment in the form of BAE is considered first line.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977167","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":"Interventional solutions for post-surgical problems: a lymphatic leaks review.","authors":"Fernando M Gómez, Tarik R Baetens, Ernestos Santos, Boris León Rocha, Benjamín Horwitz, Sara Lojo-Lendoiro, Patricio Vargas, Premal Patel, Regina Beets-Tan, José J Martínez-Rodrigo, Luis Martí Bonmatí","doi":"10.1186/s42155-024-00473-3","DOIUrl":"10.1186/s42155-024-00473-3","url":null,"abstract":"<p><p>The lymphatic circulation plays a crucial role in maintaining fluid balance and supporting immune responses by returning serum proteins and lipids to the systemic circulation. Lymphatic leaks, though rare, pose significant challenges post-radical neck surgery, oesophagectomy, and thoracic or retroperitoneal oncological resections, leading to heightened morbidity and mortality. Managing lymphatic leaks necessitates consideration of aetiology, severity, and volume of leakage. Traditionally, treatment involved conservative measures such as dietary restrictions, drainage, and medical management, with surgical intervention reserved for severe cases, albeit with variable outcomes and extended recovery periods. Lymphography, introduced in the 1950s, initially served as a diagnostic tool for lymphoedema, lymphoma, tumour staging, and monitoring chemotherapy response. However, its widespread adoption was impeded by alternative techniques like Computed Tomography, learning curves, and its associated complications. Contemporary lymphatic interventions have evolved, favouring nodal lymphangiography over pedal lymphangiography for its technical simplicity and reduced complexity. Effective management of chylous leaks mandates a multimodal approach encompassing clinical evaluation and imaging techniques. In cases where conservative management proves ineffective, embolization through conventional lymphangiography by bipedal dissection or intranodal injection emerges as a viable option. This review underscores the importance of a comprehensive approach to diagnosing and treating lymphatic leaks, highlighting advancements in imaging and therapeutic interventions that enhance patient outcomes.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914550","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":"Association between statin intensity and femoropopliteal stent primary patency in peripheral arterial disease","authors":"Elisabeth R. Seyferth, Helen Song, Ansar Z. Vance, Timothy W. I. Clark","doi":"10.1186/s42155-024-00472-4","DOIUrl":"https://doi.org/10.1186/s42155-024-00472-4","url":null,"abstract":"Statins are widely used in coronary and peripheral arterial disease, but their impact on patency of stents placed for peripheral arterial disease is not well-studied. The purpose of this study was to evaluate femoropopliteal stent primary patency according to statin intensity at the time of stent placement and compare this effect to other covariates that may influence stent patency. A retrospective review identified 278 discrete femoropopliteal stent constructs placed in 216 patients over a 10-year period; Rutherford categories were 2 (3.6%), 3 (12.9%), 4 (21.2%), 5 (49.6%), and 6 (12.6%). Stent locations were common femoral (1.8%), common femoral/superficial femoral (0.7%), superficial femoral (50.7%), superficial femoral/popliteal (32.7%) and popliteal (14.0%) arteries; 63.3% of stents were paclitaxel-eluting. Primary patency of each stent construct was determined with duplex ultrasound, angiography, or computed tomographic angiography. Greater than 50% restenosis or stent occlusion was considered loss of patency. Cox proportional hazard and Kaplan–Meier modeling were used to assess the effect of statin use and additional covariates on stent patency. Patients on any statin at the time of stent placement were half as likely to undergo loss of primary unassisted patency as patients on no statin therapy (hazard ratio, 0.53; 95% confidence interval, 0.19–0.87; P = .004). Moderate/high intensity statin therapy conferred 17 additional months of median stent patency compared to the no statin group. Antiplatelet therapy, anticoagulant therapy, drug-eluting stents (versus bare metal or covered stents), and Rutherford class were not predictive of stent patency (P = 0.52, 0.85, 0.58, and 0.82, respectively). Use of statin therapy at the time of femoropopliteal stent placement was the most predictive examined variable influencing primary unassisted patency.","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141885012","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}