CVIR Endovascular最新文献

{"title":"Physician-modified endografts using an endoskeleton ePTFE platform for complex aortic aneurysms requiring a single fenestration: a proof-of-concept study.","authors":"Kenjiro Kaneko, Takao Ohki, Eisaku Ito","doi":"10.1186/s42155-026-00753-0","DOIUrl":"10.1186/s42155-026-00753-0","url":null,"abstract":"<p><strong>Background: </strong>Endovascular interventions for complex aortic aneurysms-including juxtarenal abdominal aortic (JAAA), pararenal abdominal aortic (PRAAA), and thoracoabdominal aortic (TAAA) aneurysms-face inherent limitations, such as manufacturing delays and anatomical restrictions. In Japan, where commercial off-the-shelf branched or fenestrated devices remain limited, physician-modified endografts (PMEGs) represent a crucial practical alternative. Conventional polyester-based PMEGs, however, pose challenges regarding manual resheathing and fenestration site fragility. This study evaluated the safety and early- to mid-term clinical outcomes of PMEGs constructed using the endoskeleton-based, expanded polytetrafluoroethylene (ePTFE)-covered AFX VELA platform.</p><p><strong>Methods: </strong>This retrospective study included four high-risk patients with complex aortic aneurysms requiring a single fenestration. All were unsuitable for open surgical repair (OSR), standard endovascular aneurysm repair (EVAR), or chimney endovascular aneurysm repair (ChEVAR) due to an infrarenal neck length (IRL) < 2 mm. Fenestrations were created via sharp ePTFE incision and reinforced with an expansile hydrogel coil. Following manual resheathing without dedicated crimping tools, target vessel cannulation and bridging stent reconstruction were performed. Endpoints included technical success, 30-day major adverse events (MAEs), target vessel patency, endoleaks, sac diameter changes, and reinterventions.</p><p><strong>Results: </strong>The cohort (two men, two women; mean age, 73.0 years) presented with saccular aneurysms (one JAAA, two PRAAAs, and one Crawford type V TAAA). The mean maximum diameter was 54.3 mm, and all had an IRL of 0 mm. Technical success was 100%, with zero 30-day mortalities or MAEs. Over a 31.5-month mean follow-up, primary target vessel patency remained 100%, without endoleaks or required reinterventions. Aneurysm sac diameter regressed by 5 mm in two patients and remained stable in two. No aortic-related mortalities occurred.</p><p><strong>Conclusions: </strong>This proof-of-concept study is the first to describe AFX VELA-based PMEGs and shows that the technique is feasible in carefully selected patients with complex aortic aneurysms. The procedure does not require dedicated crimping tools or complex resheathing maneuvers, whereas its mid- to long-term durability requires continued evaluation. Establishing a definitive clinical role will require larger prospective studies with extended follow-up.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921734","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":"Onyx-only superior rectal artery embolisation for bleeding internal haemorrhoids: initial single-centre experience.","authors":"Luis Loureiro, Paulo Almeida, Samuel Cardoso, Romaric Loffroy, Rui Machado","doi":"10.1186/s42155-026-00767-8","DOIUrl":"10.1186/s42155-026-00767-8","url":null,"abstract":"<p><strong>Purpose: </strong>To report an initial single-centre experience with Onyx-18-only superior rectal artery embolisation for bleeding internal haemorrhoids, focusing on technical feasibility, treatment laterality, and updated clinical outcomes.</p><p><strong>Materials and methods: </strong>Consecutive Onyx-only procedures performed between October 2023 and April 2026 in patients with bleeding-predominant internal haemorrhoids were retrospectively reviewed. Patients with portal hypertension/cirrhosis were excluded because of the distinct pathophysiology of anorectal bleeding. Patient-level clinical outcomes and procedure-level technical variables were analysed separately. Updated telephone follow-up was obtained on 12 August 2026.</p><p><strong>Results: </strong>Six patients underwent 9 procedures. Technical success was achieved in all procedures. Three patients were treated bilaterally at the initial session and 3 initially unilaterally; 2 of the latter required staged contralateral embolisation. At updated follow-up, all 6 patients reported absence of rectal bleeding after completion of treatment. Median follow-up was 19.5 months (range, 4-34), and 5 of 6 patients had at least 12 months of follow-up. One transient episode of rectal pain occurred; no major or clinically evident ischaemic complication was observed.</p><p><strong>Conclusion: </strong>Onyx-only haemorrhoidal artery embolisation was technically feasible with encouraging updated bleeding control. The observed association between bilateral treatment and fewer staged procedures is hypothesis-generating and may partly reflect an operator learning curve.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908091","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":"Through-and-through access for mechanical aspiration thrombectomy of a catheter-associated internal jugular vein thrombosis mimicking lemierre syndrome.","authors":"Francois H Cornelis, Bruno Solis, Stephen B Solomon","doi":"10.1186/s42155-026-00772-x","DOIUrl":"10.1186/s42155-026-00772-x","url":null,"abstract":"","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908149","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":"When \"right\" goes wrong: poor accuracy of calculated right adrenal vein aldosterone levels in subtyping primary aldosteronism.","authors":"Saachi Datta, Robin Wang, Vivek Bhalla, Jehan Z Bahrainwala, Susan Seav, Andrew C Picel, David Wang, Matthew L Hung","doi":"10.1186/s42155-026-00769-6","DOIUrl":"10.1186/s42155-026-00769-6","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to externally validate a published ratio of left adrenal aldosterone to calculated-right adrenal aldosterone (Aldosterone_LAV:cAldosterone_RAV) proposed to determine disease subtype when right-sided adrenal vein sampling is unsuccessful.</p><p><strong>Materials and methods: </strong>This single-center retrospective study included 199 post-adrenocorticotropic hormone stimulation adrenal vein sampling cases (2016-2025). A selectivity index ≥ 5 was considered diagnostic and lateralization index ≥ 4 indicated unilateral disease. The cAldosterone_RAV was calculated as cAldosterone_RAV = [2 × Aldosterone_IVC × (Cortisol_LAV/Cortisol_IVC)]-Aldosterone_LAV. The ratio of Aldosterone_LAV:cAldosterone_RAV determined disease subtype; published thresholds were ≥ 3 for left-sided and ≤ 0.33 for right-sided disease. Intermediate values were deemed bilateral disease. Sensitivities and specificities of this metric were calculated using standard AVS interpretation as the gold standard reference. Receiver operating characteristic curve analysis performed on the Aldosterone_LAV:cAldosterone_RAV ratio derived institution-optimized thresholds by maximizing the Youden's J statistic.</p><p><strong>Results: </strong>Adrenal vein sampling was technically successful with determinate lateralization indices in 164 patients (41 left, 35 right, 88 bilateral). Using the published thresholds of 3 and 0.33, the Aldosterone_LAV:cAldosterone_RAV ratio had an overall accuracy of 43.3% (95% CI 35.9-50.9%). Institution-optimized thresholds of ≥ 32.43 (left-sided) and ≤ 0.56 (right-sided) improved the accuracy to 65.9% (95% CI 58.3-72.7%). Using institution-optimized thresholds, the sensitivities/specificities for the calculated right-sided, left-sided, and bilateral disease were 88.6%/95.3%, 92.7%/63.4%, and 44.3%/93.4%, respectively.</p><p><strong>Conclusions: </strong>The Aldosterone_LAV:cAldosterone_RAV ratio can help to rule in right-sided disease with high specificity, but otherwise has poor overall accuracy in disease subtyping, underscoring the importance of meticulous technique to achieve diagnostic samples during adrenal vein sampling.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892977","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":"Long-term outcomes of the \"pave-and-crack\" technique for severely calcified femoropopliteal chronic total occlusions.","authors":"Birte Winther, Andrej Schmidt, Lena Rummler, Axel Fischer, Sandra Düsing, Sabine Steiner, Xiao Di, Tobias Hirsch, Dierk Scheinert, Tim Wittig","doi":"10.1186/s42155-026-00766-9","DOIUrl":"10.1186/s42155-026-00766-9","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the long-term safety and efficacy of the pave-and-crack technique, combining aggressive balloon dilatation and covered stent implantation, for endovascular therapy (EVT) of highly calcified femoropopliteal chronic total occlusions (CTOs) in poor surgical candidates unsuitable for open revascularization or conventional EVT.</p><p><strong>Design: </strong>Single-center retrospective cohort study based on a prospectively maintained peripheral artery disease database.</p><p><strong>Methods: </strong>Patients with symptomatic femoropopliteal CTOs treated using the pave-and-crack technique between September 2014 and April 2025 were included. Lesion and procedural characteristics, technical success, defined as residual stenosis ≤ 30%, complications, major target limb amputation, and symptom status were assessed. Kaplan-Meier analysis was used to estimate freedom from target lesion revascularization (TLR) and all-cause mortality through 5 years.</p><p><strong>Results: </strong>A total of 122 patients with 136 femoropopliteal CTOs were treated. Mean lesion length was 253.0 ± 90.1 mm, and 93.4% (127/136) of lesions were severely calcified. Retrograde access was required in 72.8% (99/136) of procedures. Technical success was achieved in 93.4% (127/136). Freedom from target lesion revascularization was 91.4% ± 2.6% at 1 year, 77.9% ± 4.6% at 3 years, and 66.7% ± 7.2% at 5 years. Major target limb amputation occurred in four cases presenting with CLTI (8.5%; 4/47) and none with claudication (0%; 0/89). Five-year freedom from all-cause mortality was 71.4 ± 6.9% for claudicants and 41.4 ± 11.2% for patients with CLTI (p < 0.01).</p><p><strong>Conclusion: </strong>The pave-and-crack technique is feasible for highly calcified femoropopliteal CTOs, achieving high technical success, encouraging long-term freedom from TLR, and high limb salvage.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892940","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":"Endovascular adhesive repair using N-butyl cyanoacrylate for spontaneous dissecting aneurysms of the celiac and hepatic arteries: technique and long-term outcomes.","authors":"Hideki Ishimaru, Satomi Yoshimi, Tomoki Nakano, Shuto Miyamura, Taiga Oka, Chika Somagawa, Maki Hirao, Takahiro Kagimoto, Tomoki Minami, Ryo Toya","doi":"10.1186/s42155-026-00768-7","DOIUrl":"10.1186/s42155-026-00768-7","url":null,"abstract":"<p><strong>Purpose: </strong>To describe false lumen embolization with an endovascular adhesive repair concept, in which N-butyl cyanoacrylate is injected with the intention of promoting reapposition of the dissected layers while preserving the parent-artery.</p><p><strong>Materials and methods: </strong>Three men aged 50, 55, and 68 years with spontaneous dissecting aneurysms of the celiac axis (two patients) or the right hepatic artery (one patient, with dissection extending from the common hepatic artery) were treated; one patient had segmental arterial mediolysis; in another, the gastroduodenal collateral pathway had been surgically interrupted by prior pancreaticoduodenectomy. Indications were aneurysm enlargement with persistent pain, progressive aneurysm enlargement, and concern for rupture during planned endoscopic treatment. A microcatheter was navigated into the false lumen under digital subtraction angiography, and a 33% N-butyl cyanoacrylate-iodized oil mixture was injected to embolize the false lumen and appose the intimal flap. In two patients, a silicone balloon catheter was used to limit N-butyl cyanoacrylate overflow into the true lumen; it was introduced through a separate femoral access in Case 1 and through the same guiding sheath as the microcatheter in Case 2. Technical and clinical success, parent-artery patency, complications, and recurrence were assessed.</p><p><strong>Results: </strong>Evident inflow into the false lumen disappeared in all cases, with all parent-arteries preserved. There was no rupture, unintended non-target embolization, or catheter adhesion. Follow-up showed no recurrence, and patency was verified during clinically indicated vascular studies at 10.5, 6, and 4 years; in two patients the repaired segment again served as a catheterization route.</p><p><strong>Conclusion: </strong>False lumen embolization with an endovascular adhesive repair concept was technically successful with parent-artery preservation in three highly selected patients, and patency was confirmed at 10.5, 6, and 4 years after treatment. Further investigation is required to determine the safety, reproducibility, and appropriate indications of this technique.</p><p><strong>Level of evidence: </strong>Level 4, Case Series.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892943","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":"Beyond vein diameter: pain phenotyping complements updated diagnostic criteria for female pelvic venous disorders.","authors":"Vinicius Adami Vayego Fornazari, Renato Abu Hana, Grit Armstrong Adler, Sara Lojo-Lendoiro, Nucelio Lemos, Gregory Kirk Lewis, Jean-Pierre Pelage, Gloria Maria Salazar","doi":"10.1186/s42155-026-00764-x","DOIUrl":"10.1186/s42155-026-00764-x","url":null,"abstract":"","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882685","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":"Use of the Wrapsody™ Cell-Impermeable Endoprosthesis for the treatment of pelvic congestion syndrome due to nutcracker syndrome.","authors":"Elene Tkabladze, Karl Julius Büchner","doi":"10.1186/s42155-026-00748-x","DOIUrl":"10.1186/s42155-026-00748-x","url":null,"abstract":"<p><p>Endovascular stenting is a preferred treatment approach for the management of pelvic congestion syndrome (PCS) secondary to nutcracker syndrome. However, there is no consensus on which stenting device is advantageous for patients. In this report, we summarize off-label use of the Wrapsody™ Cell-Impermeable Endoprosthesis (CIE) for this condition. A 30-year-old woman presented with chronic left flank and lower abdominal pain, progressively worsening since childbirth. Imaging demonstrated compression of the left renal vein between the aorta and superior mesenteric artery with reflux into the ovarian vein. Endovascular treatment was performed using a 14 × 40 mm CIE. The procedure was technically successful and symptomatic resolution was achieved without complications. Follow-up over 2 years confirmed persistent device patency and absence of venous congestion. This case highlights that the CIE, a device originally designed for restoration of hemodialysis access, is an effective endovascular option for managing PCS due to nutcracker syndrome.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851908","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":"Identifying research areas in peripheral artery disease treatment-a Delphi consensus approach.","authors":"Stefan Müller-Hülsbeck, Franziska Reiter, Andreas H Mahnken, Nathalie Kaufmann, Robert A Morgan","doi":"10.1186/s42155-026-00762-z","DOIUrl":"10.1186/s42155-026-00762-z","url":null,"abstract":"<p><strong>Background: </strong>The multitude of existing techniques for the endovascular treatment of peripheral artery disease (PAD), as well as newly emerging technologies combined with the diversity of patient profiles highlight the need for further research in this area. We conducted a Delphi consensus study, an established method utilising an iterative approach to reach consensus within a group of experts over several rounds, to identify gaps and new areas of research in the field of PAD.</p><p><strong>Results: </strong>Using a four-round Delphi process, we started with 17 statements proposed by an expert panel to be rated on a 5-point Likert scale by EBIR-ES holders. We defined two consensus metrics to measure the agreement within the group: as > 75% concordance or > 60% certainty. Six statements that did not meet this threshold after round 1 underwent further rounds of expert feedback, discussion, and reassessment. Fifty-two EBIR-ES holders evaluated the initial statements and 36 contributed to the final consensus. While certainty was stable across all rounds, an increase in concordance was seen in 4 (67%) statements. As a supplement to the traditional Delphi method, we interpreted the decrease in concordance for 2 (33%) statements as areas in need of further research.</p><p><strong>Conclusions: </strong>The Delphi consensus method is an effective method for discovering potential research topics. Through iterative feedback, it encourages experts to refine their views and promotes a productive exchange of ideas. We identified the use of filter wires for atherectomy, as well as the comparison between atherectomy devices as key areas needing further research. Moreover, these findings underscore the value of developing formalised, multidisciplinary consensus guidelines to guide clinical practice.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841428","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":"Superior hypogastric nerve block versus spinal anesthesia for early pain control after uterine fibroid embolization: a prospective quasi-randomized comparative study.","authors":"Priscila Henriques da Silva, Gustavo Borges Teixeira Mendes, Thiago Franchi Nunes, Vinicius Adami Vayego Fornazari, Gloria Maria Martinez Salazar, Andrea Puchnick, Suzan Menasce Goldman, Denis Szejnfeld","doi":"10.1186/s42155-026-00749-w","DOIUrl":"10.1186/s42155-026-00749-w","url":null,"abstract":"<p><strong>Purpose: </strong>To compare early postprocedural pain and rescue opioid use after uterine fibroid embolization (UFE) in patients treated with superior hypogastric nerve block (SHNB) versus spinal anesthesia.</p><p><strong>Materials and methods: </strong>This single-center prospective quasi-randomized comparative study included consecutive women with symptomatic intramural uterine fibroids treated between March 2022 and October 2023. Patients were allocated according to a predefined alternating sequence to SHNB or spinal anesthesia. Allocation concealment was not used, and patients, treating teams, and outcome assessors were not blinded. Pain was assessed at 1, 6, and 18 h after embolization using a 0-10 visual numeric scale. Rescue analgesia consisted of 3 mg intravenous morphine for moderate or severe pain according to a standardized institutional protocol. The primary endpoint was any rescue morphine use during the 18-h postprocedural observation period. Secondary endpoints were total rescue morphine dose and pain scores over time. Pain trajectory was analyzed using linear mixed-effects models, and rescue morphine outcomes were analyzed using modified Poisson and Poisson regression models.</p><p><strong>Results: </strong>Forty-two patients were included, with 21 in each group. Baseline characteristics were reasonably balanced, with all absolute standardized mean differences below 0.40. Rescue morphine use occurred in 13 of 21 patients (61.9%) in each group (risk ratio, 1.00; 95% confidence interval (CI), 0.62-1.61). No significant treatment-by-time interaction was observed for pain trajectory (P = .650), and time-specific between-group differences in pain scores were not significant at 1, 6, or 18 h. In adjusted analyses, treatment group was not associated with pain trajectory, any rescue morphine use, or total rescue morphine dose. Larger fibroid diameter was associated with higher pain burden and greater morphine requirement. SHNB was technically successful in all patients and was not associated with block-related complications during the assessed follow-up window.</p><p><strong>Conclusion: </strong>In this small prospective quasi-randomized comparative study, no detectable between-group differences were observed in rescue morphine use or early postprocedural pain scores between SHNB and spinal anesthesia after UFE. These exploratory findings support the feasibility of SHNB as a procedural analgesic strategy but should not be interpreted as evidence of equivalence or noninferiority.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"9 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834624","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}