CVIR Endovascular最新文献

{"title":"Benefits and advances of Cone Beam CT use in prostatic artery embolization: review of the literature and pictorial essay.","authors":"Nassir Rostambeigi, Daniel Crawford, Jafar Golzarian","doi":"10.1186/s42155-024-00459-1","DOIUrl":"10.1186/s42155-024-00459-1","url":null,"abstract":"<p><p>Prostatic artery embolization (PAE) has proven to be an efficacious treatment for urinary symptoms of benign prostatic hyperplasia. PAE is performed in a complex and challenging anatomical field which may pose difficulties from procedural standpoint. Cone beam computed tomography (CBCT) has been proposed as an invaluable tool during the PAE procedure. A review of different techniques and advancements, as well as demonstration of CBCT benefits via a pictorial overview of the salient examples is lacking. The techniques of CBCT are discussed herein and the virtual injection technology as an advancement in CBCT is discussed. To show the merits of CBCT in PAE, a pictorial overview of various clinical scenarios is presented where CBCT can be crucial in decision making. These scenarios are aimed at showing different benefits including identification of the origin of the prostatic artery and avoiding non-target embolization. Other benefits may include ensuring complete embolization of entire prostate gland as angiographic appearance alone can be inconclusive if it mimics a severely thickened bladder wall or ensuring adequate embolization of the median lobe to provide relief from \"ball-valve\" effect. Further examples include verification of embolization of the entire prostate when rare variants or multiple (> 2) arterial feeders are present.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"46"},"PeriodicalIF":1.2,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11093965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923824","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":"Common design and data elements on rectal artery embolization for treatment of symptomatic internal hemorrhoidal disease: an interactive systematic review of clinical trials.","authors":"Samah Morsi, Marisabel Linares Bolsegui, Hassan Kobeissi, Sherief Ghozy, David F Kallmes, Scott R Kelley, Kellie L Mathis, Eric J Dozois, Conor G Loftus, Emily C Bendel, Vincent Vidal, Scott M Thompson","doi":"10.1186/s42155-024-00458-2","DOIUrl":"10.1186/s42155-024-00458-2","url":null,"abstract":"<p><strong>Background: </strong>Internal hemorrhoids (IH) is a common medical condition that can result in morbidity secondary to bleeding and discomfort. Treatment for IH has traditionally consisted of dietary and conservative medical management, focal treatments including banding and sclerotherapy or hemorrhoidectomy. Recently, rectal artery embolization (RAE) has been studied as a potential treatment for bleeding predominant IH. We performed a common design and data element analysis of studies that report on RAE.</p><p><strong>Materials and methods: </strong>We conducted a qualitative systematic literature review for rectal artery embolization (RAE) for symptomatic hemorrhoidal disease. The screening process involved five online databases (PubMed, Embase, Google Scholar, DOAJ, and Scopus). Additionally, ClinicalTrials.gov was examined for active, unpublished completed studies. The initial search yielded 2000 studies, with 15 studies meeting the inclusion criteria after screening and assessment. The included studies comprised one RCT, one case series, one pilot study and 12 cohort studies.</p><p><strong>Results: </strong>The population analysis revealed a male predominance across all studies, with varying cohort sizes. The baseline Goligher hemorrhoid grade was utilized in 80% of studies. The majority (73.3%) employed a transfemoral approach, and coils were the primary embolic material in 60% of studies, 26.6% were combination of coils and particles, and 6.6% were particles only. Patient selection criteria highlighted RAE's applicability for high surgical risk patients and those with anemia, chronic hematochezia, or treatment-refractory cases. Exclusion criteria emphasized factors such as previous surgeries, colorectal cancer, rectal prolapse, acute hemorrhoidal complications, and contrast allergy. Study designs varied, with cohort studies being the most common (12/15; 80%). Procedural details included the use of metallic coils and detachable micro-coils, with a high technical success rate reported in most studies ranging from 72 to 100%. The follow-up ranged from 1 to 18 months. The majority of studies reported no major immediate or post-procedural complications.</p><p><strong>Conclusion: </strong>While all studies focused on RAE as a treatment for IH, there was a great degree of heterogeneity among included studies, particularly regarding inclusion criteria, exclusion criteria, outcomes measures and timeframe. Future literature should attempt to standardize these design elements to help facilitate secondary analyses and increase understanding of RAE as a treatment option.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"45"},"PeriodicalIF":1.2,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11088570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908736","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":"In vitro comparison of the leakage of carbon dioxide and iodine contrast media in a bleeding model.","authors":"Ryoichi Kitamura, Kazuhiro Yoshida, Takaaki Maruhashi, Satoshi Tamura, Yutaro Kurihara, Koyo Suzuki, Yasushi Asari","doi":"10.1186/s42155-024-00457-3","DOIUrl":"10.1186/s42155-024-00457-3","url":null,"abstract":"<p><strong>Background: </strong>We aimed to compare the hydrodynamic values of carbon dioxide (CO₂) and iodine contrast media for bleeding detection using an in vitro model.</p><p><strong>Materials and methods: </strong>We created a bleeding model with large and small wounds in simulated blood vessels. We connected a syringe to the bleeding model and the blood pressure transducer, filling the circuit with CO₂ and iodine contrast media. The syringe's piston was pressed, and the flow rate and intravascular pressure of the CO₂ and iodine contrast media leaking from the bleeding model were measured. We compared each leaked contrast medium's volume, sphere-equivalent diameter, and sphere-equivalent area. These values were analyzed to compare the visibility of the leakage objectively.</p><p><strong>Results: </strong>At a constant flow rate, the intravascular pressure required for the model to leak was lower for the CO₂ than that for the iodine contrast medium. The CO₂ contrast medium leakage volume, equivalent circle diameter, and equivalent circle area were greater than those of the iodine one. These values indicate higher CO₂ visibility during fluoroscopy.</p><p><strong>Conclusions: </strong>In the bleeding model, a CO₂ contrast medium may be more prone to leakage than the iodine one in large and small wounds. Regarding visibility, a CO₂ contrast medium may be more likely to detect leakage than an iodine one.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"44"},"PeriodicalIF":1.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11087413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900059","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 and percutaneous embolization of a giant post traumatic arteriovenous fistula of inferior epigastric vessels.","authors":"Venkata Subbaih Arunachalam, Smily Sharma, Jineesh Valakkada, Anoop Ayyappan, Jayakrishnan Radhakrishnan, Santhosh Kumar Kannath","doi":"10.1186/s42155-024-00455-5","DOIUrl":"10.1186/s42155-024-00455-5","url":null,"abstract":"<p><strong>Background: </strong>Arteriovenous fistulas involving the anterior abdominal wall can result from trauma. Such fistulas may remain asymptomatic and undetected for a prolonged duration of time. They tend to recruit multiple arterial feeders with remodelling in the feeding arteries, making them challenging to treat.</p><p><strong>Case presentation: </strong>We discuss a rare case of a 60-year-old male who presented with complaints of a progressive painless swelling in right lower abdomen. There was a history of blunt injury to abdomen at the same site during alleged road traffic accident 3 years ago. On CT angiography, an arteriovenous fistula was localised to the anterior abdominal wall arising predominantly from the right inferior epigastric artery with a giant venous sac and terminating as a tortuous single venous channel into the right external iliac vein. Few other small feeders were also seen arising from branches of right superior epigastric artery along Winslow's pathway. The main challenge in endovascular management of this patient was embolization of a high flow shunt with a large venous sac and multiple arterial feeders. The dominant arterial feeder was embolized using vascular plug. The superficial location of the lesion offered an additional percutaneous window besides endovascular approach. The venous sac was percutaneously accessed and embolized using n-butyl cyanoacrylate after balloon occlusion of outflow vein. On follow up ultrasonographic evaluation at 3 months, near complete thrombosis of the venous sac was achieved.</p><p><strong>Conclusions: </strong>Traumatic arteriovenous fistulas involving the inferior epigastric vessels are rare clinical entities. CT angiogram and digital subtraction angiography help in the optimal diagnosis and treatment planning. The use of mechanical embolization devices to cause flow arrest offers an opportunity to use liquid embolic agents which offer better percolation within the lesion. Interventional radiology offers an ideal management of these complex high flow fistulas with a good technical success and acceptable safety profile.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"43"},"PeriodicalIF":1.2,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11074072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871313","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":"ELECT: prospective, randomized trial comparing microvascular plug versus platinum-fibered microcoils for embolization of aneurysm sac side branches before endovascular aortic aneurysm repair","authors":"Manuela Konert, Andrej Schmidt, Daniela Branzan, Tim Wittig, Dierk Scheinert, Sabine Steiner","doi":"10.1186/s42155-024-00454-6","DOIUrl":"https://doi.org/10.1186/s42155-024-00454-6","url":null,"abstract":"Preemptive selective embolization of aneurysm sac side branches (ASSBs) has been proposed to prevent type II endoleak after endovascular aortic aneurysm repair (EVAR). This study aimed to explore if an embolization strategy using microvascular plugs (MVP) reduces intervention time and radiation dose compared to platinum-fibered microcoils. Furthermore, the effectiveness of the devices in occluding the treated artery was assessed. Sixty patients scheduled for EVAR underwent percutaneous preemptive embolization of ASSBs using MVPs or coils after a 1:1 randomization. Follow-up imaging was performed during aortic stentgraft implantation. Overall, 170 ASSBs were successfully occluded (83 arteries by MVPs and 87 by coils) and no acute treatment failure occurred. The mean procedure time was significantly lower in the group treated with MVPs (55 ± 4 min) compared to coil occlusion (67 ± 3 min; p = 0.018), which was paralleled by a numerically lower radiation dose (119 Gy/cm2 vs. 140 Gy/cm2; p = 0.45). No difference was found for contrast agent use (34 ml MVP group vs 35 ml coil group; p = 0.87). At follow-up, reopening of lumbar arteries was seen in nine cases (four after coil embolization; five after MVPs). Both microvascular plugs and coils can be effectively used for preemptive embolization of aneurysm sac side branches before EVAR. Use of plugs offers a benefit in terms of intervention time. ClinicalTrials.gov Identifier: NCT03842930 Registered 15 February 2019. ","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"1 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140827036","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":"3-year clinical outcomes of A Singapore VenaSeal™ real world post-market evaluation Study (ASVS) for varicose vein ablation","authors":"Tjun Yip Tang, Charyl Jia Qi Yap, Sze Ling Chan, Shereen Xue Yun Soon, Vanessa Bao Xian Khoo, Edward Choke, Tze Tec Chong","doi":"10.1186/s42155-024-00452-8","DOIUrl":"https://doi.org/10.1186/s42155-024-00452-8","url":null,"abstract":"Medium-term clinical outcome data are lacking for cyanoacrylate glue (CAG) ablation for symptomatic varicose veins, especially from the Asian population. Aim was to determine the 3-year symptomatic relief gained from using the VenaSeal™ device to close refluxing truncal veins from the Singaporean ASVS prospective registry. The revised Venous Clinical Severity Score (rVCSS) and three quality of life (QoL) questionnaires were completed to assess clinical improvement in venous disease symptoms along with a dedicated patient satisfaction survey. 70 patients (107 limbs; 40 females; mean age of 60.9 ± 13.6 years) were included at 3 years. At 3 years, rVCSS showed sustained improvement from baseline (5.00 to 0.00; p < 0.001) and 51/70 (72.9%) had improvement by at least 2 or more CEAP categories. Freedom from reintervention was 90% and 85.7% patients were extremely satisfied with the treatment outcome. No further reports of further hypersensitivity reactions after one year. The 3-year follow-up results of the ASVS registry demonstrated continued and sustained clinical efficacy with few reinterventions following CAG embolization in Asian patients with chronic venous insufficiency. ClinicalTrials.gov Registration: NCT03893201.","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"16 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140798748","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":"Enhancing precision in vascular embolization: evaluating the effectiveness of the intentional early detachment technique with detachable coils in complex cases.","authors":"Shojiro Oka, Shigeshi Kohno, Shigeki Arizono, Yasuyuki Onishi, Masaya Fumimoto, Atsushi Yoshida, Reiichi Ishikura, Kumiko Ando","doi":"10.1186/s42155-024-00453-7","DOIUrl":"https://doi.org/10.1186/s42155-024-00453-7","url":null,"abstract":"","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"41 10","pages":"40"},"PeriodicalIF":1.2,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140657113","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":"Report of a semi-branched stent-graft to treat a type 1a endoleak after failed EVAR","authors":"Ozan Yazar, ChunYu Wong, Pieter Bartholomeus Salemans, Chrissy van Wely, Ruben Nouwens, Bart van Grinsven, Lee Hans Bouwman","doi":"10.1186/s42155-024-00448-4","DOIUrl":"https://doi.org/10.1186/s42155-024-00448-4","url":null,"abstract":"Endovascular techniques are advancing with the change of treatment paradigm for abdominal aortic aneurysms. Fenestrated EVAR (fEVAR) and branched EVAR (bEVAR) are used for complex aortic aneurysm repair. Both fEVAR and bEVAR have their own advantages and disadvantages. Semi-branches are a new feature that attempt to combine the advantages of both fEVAR and bEVAR. We describe the use of a 4-vessel semi-branched EVAR in a failed EVAR case with a type 1a endoleak. The novel feature of semi-branches in custom-made EVAR devices in endovascular aortic treatment following failed EVAR appear to be a feasible option.","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"15 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626228","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":"Hepatic artery stenosis following adult liver transplantation: evaluation of different endovascular treatment approaches","authors":"Sagar V. Desai, Balasubramani Natarajan, Vinit Khanna, Paul Brady","doi":"10.1186/s42155-024-00439-5","DOIUrl":"https://doi.org/10.1186/s42155-024-00439-5","url":null,"abstract":"To evaluate the efficacy and safety of hepatic artery interventions (HAI) versus extra-hepatic arterial interventions (EHAI) when managing clinically significant hepatic artery stenosis (HAS) after adult orthotopic liver transplantation. A single-center retrospective cohort analysis was conducted on liver transplant patients who underwent intervention for clinically significant HAS from September 2012 to September 2021. The HAI treatment arm included hepatic artery angioplasty and/or stent placement while the EHAI treatment arm comprised of non-hepatic visceral artery embolization. Primary outcomes included peri-procedural complications and 1-year liver-related deaths. Secondary outcomes included biliary ischemic events, longitudinal trends in liver enzymes and ultrasound parameters pre-and post-intervention. The HAI arm included 21 procedures in 18 patients and the EHAI arm included 27 procedures in 22 patients. There were increased 1-year liver-related deaths (10% [2/21] vs 0% [0/27], p = 0.10) and complications (29% [6/21] vs 4% [1/27], p = 0.015) in the HAI group compared to the EHAI group. Both HAI and EHAI groups exhibited similar improvements in transaminitis including changes of ALT (-72 U/L vs -112.5 U/L, p = 0.60) and AST (-58 U/L vs -48 U/L, p = 0.56) at 1-month post-procedure. Both treatment arms demonstrated increases in post-procedural peak systolic velocity of the hepatic artery distal to the stenosis, while the HAI group also showed significant improvement in resistive indices following the intervention. Direct hepatic artery interventions remain the definitive treatment for clinically significant hepatic artery stenosis; however, non-hepatic visceral artery embolization can be considered a safe alternative intervention in cases of unfavorable hepatic anatomy. ","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626121","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":"Embolisation of a high – flow renal arteriovenous fistula with the use of simultaneous transvenous and transarterial approach and balloon-assisted coil embolization","authors":"D. Markoutsas, D. Tzavoulis, G. Tsoukalos, I. Ioannidis","doi":"10.1186/s42155-024-00451-9","DOIUrl":"https://doi.org/10.1186/s42155-024-00451-9","url":null,"abstract":"Renal arteriovenous fistula (RAVF) is a rare vascular malformation, which can be asymptomatic or may cause hemorrhage, hypokalaemic hypertension, heart failure and hematuria. Endovascular embolization is a minimally invasive method which can preserve renal parenchyma. In our case, balloon assisted coil embolization with simultaneous transvenous and transarterial approach was used. A remodelling balloon, which is routinely used in neurovascular procedures, was chosen in order to eliminate the risk of coil migration and preserve feeding artery and renal parenchyma. We present a case of successful balloon – assisted coil embolization of a high flow renal arteriovenous fistula in a 25-year-old male patient via simultaneous transarterial and transvenous approach with preservation of the feeding artery. Endovascular embolisation is a safe and effective treatment of RAVFs with low risk of complications. Simultaneous transarterial and transvenous coil deployment with the use of a flow control balloon catheter can eliminate the risk of coil migration and coil protrusion into the parent artery with permanent RAVF occlusion and renal parenchyma preservation.","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"24 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626261","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}