CVIR Endovascular最新文献

{"title":"Protrieve Sheath embolic protection during venous thrombectomy: early experience in seventeen patients.","authors":"Colvin Greenberg, David S Shin, Luke Verst, Eric J Monroe, Frederic J Bertino, Matthew Abad-Santos, Jeffrey Forris Beecham Chick","doi":"10.1186/s42155-024-00484-0","DOIUrl":"10.1186/s42155-024-00484-0","url":null,"abstract":"<p><strong>Purpose: </strong>The Protrieve Sheath (Inari Medical; Irvine, CA) is designed for embolic protection during venous thrombectomy. This report describes experience with its use.</p><p><strong>Materials and methods: </strong>Between November 2022 and December 2023 (13 months), seventeen patients, including nine (52.9%) females and eight (47.1%) males (mean age 58.8 ± 13.3 years, range 37-81 years), underwent deep venous thrombectomy following the Protrieve Sheath placement for embolic protection. Gender, age, presenting symptoms, procedural indications, obstructed venous segments, the Protrieve Sheath access and deployment sites, thrombectomy devices utilized, need for stent reconstruction, technical success, clinical success, adverse events (the Protrieve Sheath maldeployment or clinically significant embolic events), removed thrombi analyses, and mortality were recorded. Technical success was defined as successful deployment of the Protrieve Sheath funnel central to the thrombectomy site. Clinical success was defined as improvement in presenting venous occlusive symptoms without procedure-related venous thromboembolism.</p><p><strong>Results: </strong>The most common presenting symptom was extremity swelling (n = 15; 88.2%). Nine (52.9%) patients had malignant and eight (47.1%) had benign etiologies of venous obstruction. Obstructed venous segments included the inferior vena cava (IVC) and lower extremity (n = 9; 52.9%), isolated lower extremity (n = 4; 23.5%), isolated IVC (n = 2; 11.8%), thoracic central veins and superior vena cava (n = 1; 5.9%), and isolated thoracic central vein (n = 1; 5.9%). The Protrieve Sheath access sites included the right internal jugular vein (n = 15; 88.2%) for IVC and lower extremity obstructions and the right common femoral vein (n = 2; 11.8%) for thoracic central vein and superior vena cava obstructions. The Protrieve sheath funnel deployment locations included intrahepatic IVC in 13 patients (n = 13; 76.5%), suprarenal IVC in two (n = 2; 11.8%), and inferior cavoatrial junction in two (n = 2; 11.8%). Thrombectomy devices used included the ClotTriever System (Inari Medical) (n = 15; 88.2%), the InThrill Thrombectomy System (Inari Medical) (n = 4; 23.5%), the FlowTriever System (Inari Medical) (n = 2; 11.8%), the Lightning Flash 16 Aspiration System (Penumbra; Salt Lake City, UT) (n = 2; 11.8%), the Cleaner Rotational Thrombectomy System (Argon; Plano, TX) (n = 1; 5.9%), and the RevCore Thrombectomy System (Inari Medical) (n = 1; 5.9%). Ten (58.8%) patients required stent reconstruction following thrombectomy. Technical success was achieved in all patients. Clinical success was achieved in 16 (94.1%) patients. No immediate adverse events, including the Protrieve Sheath maldeployment or clinically significant embolic events, occurred.</p><p><strong>Conclusion: </strong>Use of the Protrieve Sheath during large-bore venous mechanical thrombectomy resulted in favorable technical and clinical outcomes withou","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"74"},"PeriodicalIF":1.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395203","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":"Outcome of tailored antiplatelet therapy in carotid stenting: a retrospective comparative study.","authors":"Pavol Vigláš, Vojtěch Smolka, Jan Raupach, Aleš Hejčl, David Černík, Filip Cihlář","doi":"10.1186/s42155-024-00482-2","DOIUrl":"10.1186/s42155-024-00482-2","url":null,"abstract":"<p><strong>Background: </strong>Carotid stenting requires dual antiplatelet therapy to effectively prevent thromboembolic complications. However, resistance to clopidogrel, a key component of this therapy, may lead to persistent risk of these complications. The aim of this study was to determine, if the implementation of routine platelet function testing and adjusting therapy was associated with lower incidence of thromboembolic complications and death.</p><p><strong>Methods: </strong>All consecutive patients treated with carotid artery stenting in a single institution over 8 years were enlisted in a retrospective study. Platelet function testing was performed, and efficient antiplatelet therapy was set before the procedure. Incidence of procedure-related stroke or death within periprocedural period (0-30 days) was assessed. The results were evaluated in relation to the findings of six prominent randomized control trials.</p><p><strong>Results: </strong>A total of 241 patients were treated for carotid stenosis, seven patients undergo CAS on both sides over time. There was 138 symptomatic (55,6%) and 110 asymptomatic stenoses (44,4%). Five thromboembolic complications (2,01%) occurred, four of them (1,61%) was procedure-related. Two patients died because of procedure-related stroke (0,82%). Incidence of procedure-related stroke or death was significant lower compared to the results of CREST study (2,01% vs. 4,81%, P = 0,0243) in the entire cohorts, and to the results of ICSS study in the symptomatic cohorts (2,86% vs. 7,37%, P = 0,0243), respectively.</p><p><strong>Conclusions: </strong>Tailored antiplatelet therapy in carotid stenting is safe and seems to be related with lower incidence of procedure-related death or stroke rate. Larger prospective studies to assess whether platelet function testing-guided antiplatelet therapy is superior to standard dual antiplatelet should be considered.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"73"},"PeriodicalIF":1.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395202","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":"A novel bailout technique using myocardial biopsy forceps to grasp a dislodged angio-seal collagen with footplate.","authors":"Hiromi Miwa, Naoki Hayakawa, Yasuyuki Tsuchida, Shinya Ichihara, Satoshi Hirano, Shunsuke Maruta, Kotaro Miyaji, Shunichi Kushida","doi":"10.1186/s42155-024-00487-x","DOIUrl":"10.1186/s42155-024-00487-x","url":null,"abstract":"<p><strong>Background: </strong>Hemostatic devices are now frequently used in femoral artery punctures, and the Angio-Seal (Terumo, Tokyo, Japan) is one of the most commonly used devices for closure of the femoral artery because it provides rapid hemostasis. Although device failure rarely occurs, if the collagen falls into the femoral artery, it may lead to severe limb ischemia. Herein, we describe a case of a novel endovascular technique for the treatment of Angio-Seal arterial closure device failure.</p><p><strong>Case presentation: </strong>The patient in Case 1 was a 75-year-old man with severe left limb claudication. We used a contralateral antegrade approach and used the Angio-Seal for hemostasis. However, the Angio-Seal collagen and footplate dropped and stopped at the bifurcation of the superficial femoral artery and deep femoral artery. The collagen with the footplate was caught with myocardial biotome forceps (MBF) and pulled into the external iliac artery (EIA). The distal common femoral artery (CFA) was punctured, and we delivered a 10.0- × 80-mm stent (SMART^®; Cordis, USA) to the EIA from the ipsilateral sheath. The stent was deployed at the EIA and crushed the collagen. The patient in Case 2 was an 88-year-old man with rest pain in the right limb. The right CFA was punctured using an ipsilateral approach and the Angio-Seal was used for hemostasis. The Angio-Seal collagen with the footplate dropped into the bifurcation of the deep femoral artery. The collagen and footplate were caught with MBF and pulled up to the EIA. The right CFA was punctured and a 10.0- × 60-mm stent (SMART^®; Cordis) was delivered from the ipsilateral sheath. The stent was deployed at the EIA and crushed the collagen with the footplate.</p><p><strong>Conclusions: </strong>MBF were used to grasp the dislodged collagen with the anchor and cover it with a stent at the iliac artery. This may be a useful bailout technique for Angio-Seal dislodgement.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"72"},"PeriodicalIF":1.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378608","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":"Damage Control Interventional Radiology: The bridge between non-operative management and damage control surgery.","authors":"Velio Ascenti, Anna Maria Ierardi, Maryam Alfa-Wali, Carolina Lanza, Elika Kashef","doi":"10.1186/s42155-024-00485-z","DOIUrl":"10.1186/s42155-024-00485-z","url":null,"abstract":"<p><p>Traumatic injuries continue to be on the rise globally and with it, the role interventional radiology (IR) has also expanded in managing this patient cohort. The role of damage control surgery (DCS) has been well established in the trauma management pathway, however it is only recently that Damage Control IR (DCIR) has become increasingly utilized in managing the extremis trauma and emergency patient.Visceral artery embolizations (both temporary and permanent), temporary balloon occlusions including Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in iliac arteries and aorta respectively are amongst the treatment options now available for the trauma (and non-traumatic bleeding) patient.We review the literature for the role of DCS and utilization of IR in trauma, outcomes and the paradigm shift towards minimally invasive techniques. The focus of this paper is to highlight the importance of multi-disciplinary working and having established pathways to ensure timely treatment of trauma patients as well as careful patient selection.We show that outcomes are best when both surgical and IR are involved in patient care from the outset and that DCIR should not be defined as Non-Operative Management (NOM) as it currently is categorized as.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"71"},"PeriodicalIF":1.2,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367417","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":"Kidney transplant artery and vein stenting: 15-year follow-up.","authors":"Jan H Peregrin, Daniel Vedlich, Ondřej Viklický","doi":"10.1186/s42155-024-00486-y","DOIUrl":"https://doi.org/10.1186/s42155-024-00486-y","url":null,"abstract":"<p><strong>Background: </strong>We would like to present an unusual case of simultaneous stenosis of renal graft artery and vein diagnosed four months after transplantation. both treated by stent placement. Our aim is to point at the fact that renal graft venous stenosis is very rarely reported in the literature and - as it is not easy to diagnose by routine US - it could be overlooked. If early detected it can be treated by stent placement.</p><p><strong>Case presentation: </strong>We present a case of 36-old-male with renal failure who received a kidney graft from deceased donor. The patient experienced delayed graft function. No rejection was found in the biopsy. Four months after transplantation the kidney function deteriorated to sCr 280 µmol/l. Graft artery stenosis together with graft vein stenosis was revealed. Both lesions were dilated with stent placement, the graft function returned to 230 µmol/l and became stable for 10 years. Ten years after stent placement graft function deteriorated to 300 µmol/l. An in stent restenosis of arterial stent was detected. It was successfully dilated by the balloon, the graft function returned to 230 µmol/l and stays stable for another 5 years.</p><p><strong>Conclusions: </strong>An unusual simultaneous transplanted kidney artery and vein stenosis treated by stent placement is presented. The patient had stable graft function for 15 years after the procedure with one re-intervention on arterial stent.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"70"},"PeriodicalIF":1.2,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332175","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":"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":"7 1","pages":"69"},"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":"11 1","pages":""},"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":"161 1","pages":""},"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":"161 1","pages":""},"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":"7 1","pages":"65"},"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}