Interventional radiology (Higashimatsuyama-shi (Japan)最新文献

{"title":"Transportal Embolization of the Dominant Outflow Vein for a Pancreatic Head Arteriovenous Malformation: A Case Report.","authors":"Hiroshi Baba, Hiromu Hidaka, Masayuki Hirata, Sho Kakinouchi, Kazuhiko Mikekado, Dai Shimamoto, Ryuichi Shimada, Yoshiki Asayama","doi":"10.22575/interventionalradiology.2025-0100","DOIUrl":"10.22575/interventionalradiology.2025-0100","url":null,"abstract":"<p><p>Pancreatic arteriovenous malformation is a rare vascular disorder for which no established treatment strategy exists. We report the case of an asymptomatic but progressively enlarging pancreatic head arteriovenous malformation in a 66-year-old man with alcoholic liver cirrhosis who had undergone multiple transarterial chemoembolization procedures for hepatocellular carcinoma. Angiography revealed multiple fine arterial feeders from the distal gastroduodenal artery and proximal anterior superior pancreaticoduodenal artery converging into a single dominant outflow vein draining into the superior mesenteric vein, consistent with a Cho type II / Yakes type IIIa arteriovenous malformation. Based on this classification, coil embolization of the dominant outflow vein was performed via a percutaneous transhepatic portal venous approach. The procedure was completed safely, and follow-up angiography confirmed complete and persistent shunt obliteration.</p>","PeriodicalId":73503,"journal":{"name":"Interventional radiology (Higashimatsuyama-shi (Japan)","volume":"11 ","pages":"e20250100"},"PeriodicalIF":0.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882848","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 Management of Aorto-iliac Bifurcation Rupture.","authors":"Sebastian Leal, Emery Perrin, Parnavi Singh, Joshua M Baker, Cameron Overfield, Raul E Herrera, Alex Powell","doi":"10.22575/interventionalradiology.2026-0018","DOIUrl":"10.22575/interventionalradiology.2026-0018","url":null,"abstract":"<p><p>Iatrogenic rupture at the aorto-iliac bifurcation is a rare but important life-threatening complication of endovascular intervention with limited guidance in the literature. This case report includes two cases of intra-procedural aorto-iliac bifurcation rupture managed emergently with temporary balloon occlusion and covered kissing stent placement. Both cases highlight the source of the complication and viable initial strategies for achieving temporary hemostasis while emphasizing the need for rapid recognition, appropriate equipment, and close collaboration with vascular surgery.</p>","PeriodicalId":73503,"journal":{"name":"Interventional radiology (Higashimatsuyama-shi (Japan)","volume":"11 ","pages":"e20260018"},"PeriodicalIF":0.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882850","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":"Lymphangiography and Glue Embolization of Postoperative Chylothorax Using Direct Mediastinal Lymph Node Puncture under CT Guidance: A Case Report.","authors":"Tadataka Hirai, Hiroyasu Fujiwara, Tomoki Yamatsuji, Susumu Kanazawa, Katsuya Kato","doi":"10.22575/interventionalradiology.2026-0047","DOIUrl":"10.22575/interventionalradiology.2026-0047","url":null,"abstract":"<p><p>We report the case of an 85-year-old woman with high-output chylothorax that developed after esophagectomy with thoracic duct ligation. Lymphangiography identified a leak site on the dorsal side of the left main bronchus, but failed to control the leak. Targeted sclerotherapy at the leak point temporarily reduced drainage but did not achieve closure. A mediastinal lymph node in the left retrocrural space that retained lipiodol from the previous lymphangiography was punctured under computed tomography guidance, followed by the injection of N-butyl cyanoacrylate glue, which occluded the leaking lymphatic channel. The drainage rapidly stopped, and the patient had no recurrence. Computed tomography-guided mediastinal lymph node puncture may be a minimally invasive alternative when conventional thoracic duct embolization is not feasible.</p>","PeriodicalId":73503,"journal":{"name":"Interventional radiology (Higashimatsuyama-shi (Japan)","volume":"11 ","pages":"e20260047"},"PeriodicalIF":0.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882801","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":"Initial Clinical Experience with Shape Memory Polymer Plugs for Various Venous Embolization.","authors":"Kaishu Tanaka, Yu Masuda, Hiroki Satomura, Kosuke Tomotake, Yuji Koretsune, Hiroki Yano, Shinya Kosai, Yasushi Kimura, Miho Yamakawa, Yusuke Ono, Hiroki Higashihara, Manabu Takamura, Naohiro Hosomi, Noriyuki Tomiyama","doi":"10.22575/interventionalradiology.2025-0116","DOIUrl":"10.22575/interventionalradiology.2025-0116","url":null,"abstract":"<p><strong>Purpose: </strong>Shape memory polymer plugs are novel, porous, self-expanding embolic devices that promote homogeneous thrombus formation with minimal imaging artifacts. Although increasingly used in arterial procedures, clinical data on venous applications remain limited. This technical note describes our initial experience with shape memory polymer plugs for multiple types of venous embolization and details the procedural techniques used to optimize outcomes.</p><p><strong>Material and methods: </strong>Five patients underwent venous embolization using shape memory polymer plugs. Indications included a pelvic arteriovenous malformation outflow vein, pelvic congestion syndrome, gastric varices treated with balloon-occluded retrograde transvenous obliteration, and a congenital portosystemic shunt. Delivery systems included 5-F or 6-F guiding sheaths or a 9-F balloon catheter. Technical modifications included partial deployment, a 5-minute dwell time, anchoring using Amplatzer vascular plugs, temporary balloon protection, and adjunctive sclerosant administration.</p><p><strong>Results: </strong>A total of 15 shape memory polymer plugs were deployed. Technical success was achieved in four of five cases. No plug migration occurred. One portosystemic shunt case showed persistent residual flow due to a size mismatch between the 12-mm shape memory polymer and the 10.5-mm vessel. Clinical improvement occurred in all patients. Follow-up (1-30 months) demonstrated durable occlusion in successful cases, confirmed by computed tomography with minimal artifact.</p><p><strong>Conclusions: </strong>Shape memory polymer plugs may be a feasible option in selected venous embolization cases. Their large occlusive volume, low radial force, and radiolucency offer procedural and imaging advantages. Device size limitations and anchoring requirements must be considered. Further studies and larger device options are needed.</p>","PeriodicalId":73503,"journal":{"name":"Interventional radiology (Higashimatsuyama-shi (Japan)","volume":"11 ","pages":"e20250116"},"PeriodicalIF":0.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882770","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":"Transabdominal Ultrasound-guided Transjugular Endovascular Mesocaval Shunt Creation in Extrahepatic Portal Vein Obstruction: A Single-center Experience.","authors":"Soumil Singhal, Malik Faizan, Sudhir Yadav, Vrishit Saraswat, Anurag Mehndiratta, Anubhav Khandelwal, Sanjay Saran Baijal","doi":"10.22575/interventionalradiology.2026-0031","DOIUrl":"10.22575/interventionalradiology.2026-0031","url":null,"abstract":"<p><strong>Purpose: </strong>Extrahepatic portal vein obstruction is a leading cause of upper gastrointestinal bleeding in India, with limited options once first- and second-line treatments fail. We describe a novel, fully endovascular technique for transjugular mesocaval shunt creation using transabdominal ultrasound guidance and report our single-center outcomes in patients with refractory variceal hemorrhage secondary to extrahepatic portal vein obstruction.</p><p><strong>Materials and methods: </strong>Five consecutive male patients (age range 17-54 years; mean 31.4 years) with confirmed extrahepatic portal vein obstruction in whom surgical shunting or who were unsuitable for portal vein recanalization with transjugular intrahepatic portosystemic shunt underwent transjugular mesocaval shunt creation between 2024 and 2025. Anticoagulation was initiated with intravenous heparin and transitioned to direct oral anticoagulants.</p><p><strong>Results: </strong>Technical success was achieved in all five patients (100%). Mean procedure time was 71 minutes (range 55-100 minutes), mean fluoroscopy time was 48 minutes (range 38.8-62.3 minutes), and mean postprocedural portosystemic pressure gradient was 5.6 mmHg (range 5-6 mmHg), confirming effective shunt decompression in all cases. Single-pass inferior vena cava-to-superior mesenteric vein puncture was achieved in four of five patients (80%). Four patients had previously undergone splenectomy with distal splenorenal shunt, and one had a prior failed surgical mesocaval shunt. One patient underwent combined portal vein recanalization with transjugular intrahepatic portosystemic shunt and mesocaval shunt creation as a bridge to transplantation, underwent liver transplantation after one month, and died of unrelated sepsis. In the remaining four patients, all shunts remained patent on Doppler follow-up (range 7-14 months), with no recurrent variceal bleeding and no procedure-related complications.</p><p><strong>Conclusions: </strong>Transjugular endovascular mesocaval shunt creation using transabdominal ultrasound guidance is feasible, safe, and reproducible in patients with extrahepatic portal vein obstruction who have undergone failed surgical shunting or are unsuitable for portal vein recanalization with transjugular intrahepatic portosystemic shunt. This approach eliminates the need for percutaneous abdominal wall access, computed tomography guidance, or intravascular ultrasound, making it accessible in resource-constrained settings.</p>","PeriodicalId":73503,"journal":{"name":"Interventional radiology (Higashimatsuyama-shi (Japan)","volume":"11 ","pages":"e20260031"},"PeriodicalIF":0.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882782","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 Case of Concomitant Inferior Epigastric Artery Injury and Superior Vesical Artery Pseudoaneurysm after Cesarean Section Treated with Transarterial and Transvaginal Embolization.","authors":"Atsunobu Hino, Shohei Chatani, Motoki Tanaka, Yugo Imai, Akitoshi Inoue, Yuki Tomozawa, Yoko Murakami, Akinaga Sonoda, Daisuke Katsura, Yoshiyuki Watanabe","doi":"10.22575/interventionalradiology.2025-0121","DOIUrl":"https://doi.org/10.22575/interventionalradiology.2025-0121","url":null,"abstract":"<p><p>Hemorrhagic complications following cesarean section, including rectus sheath hematoma and bladder flap hematoma, are uncommon but potentially life threatening. We describe a rare case of concurrent inferior epigastric artery injury and superior vesical artery pseudoaneurysm after cesarean delivery in a 27-year-old woman with a prior cesarean section. Despite laparotomy, hemostasis was not achieved, and she required massive transfusion. Transarterial embolization successfully controlled inferior epigastric artery bleeding, but tortuosity and collateral circulation limited embolization of the superior vesical artery pseudoaneurysm. Subsequent transvaginal ultrasound-guided direct puncture with injection of a mixture of n-butyl-2-cyanoacrylate and Lipiodol resulted in hemostasis. The patient recovered without rebleeding. This case underscores the importance of considering rare vascular complications after cesarean section and demonstrates transvaginal ultrasound-guided puncture as a valuable alternative when conventional methods fail.</p>","PeriodicalId":73503,"journal":{"name":"Interventional radiology (Higashimatsuyama-shi (Japan)","volume":"11 ","pages":"e20250121"},"PeriodicalIF":0.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802573","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":"Triple-coaxial Balloon-occluded n-butyl Cyanoacrylate Embolization for a Renal Arteriovenous Fistula: A Case Report.","authors":"Yohei Takeshita, Junji Moriya, Yo Matsui, Toshinori Seto","doi":"10.22575/interventionalradiology.2025-0124","DOIUrl":"https://doi.org/10.22575/interventionalradiology.2025-0124","url":null,"abstract":"<p><p>Renal arteriovenous fistula is a rare vascular lesion. We report a man in his 40s with a right renal arteriovenous fistula consisting of a single feeding artery, a single draining vein, and a venous aneurysmal component with outflow stenosis, corresponding to a type I lesion in the Cho/Yakes-based angio-architectural classification. To achieve occlusion extending from the shunt point toward the venous aneurysmal component while preserving the surrounding renal parenchyma, balloon-occluded embolization with warmed 33% n-butyl-2-cyanoacrylate using a triple-coaxial system was performed, followed by proximal coil reinforcement. The shunt disappeared completely without renal dysfunction or procedure-related complications. This case suggests that triple-coaxial balloon-occluded n-butyl-2-cyanoacrylate embolization may be a useful option for selected renal arteriovenous fistulas.</p>","PeriodicalId":73503,"journal":{"name":"Interventional radiology (Higashimatsuyama-shi (Japan)","volume":"11 ","pages":"e20250124"},"PeriodicalIF":0.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Recurrent Biliary Anastomotic Stricture with Drug-coated Balloon Dilation.","authors":"Malcolm Guan Hin Yeo, Hao Xiang","doi":"10.22575/interventionalradiology.2025-0076","DOIUrl":"https://doi.org/10.22575/interventionalradiology.2025-0076","url":null,"abstract":"<p><p>Biliary-enteric anastomotic strictures are a well-recognized post-surgical complication that can recur despite multiple interventions. In this case report, we describe the successful use of paclitaxel-coated balloon dilation in treatment of a biliary anastomotic stricture. A 72-year-old woman presented with a recurrent benign biliary stricture post-hepatico-jejunostomy for cholangiocarcinoma, despite endoscopic and percutaneous balloon dilation. Over 3 years, she had visited our hospital on 10 occasions for cholangitis secondary to her stricture. She was then treated with paclitaxel-coated balloon dilation, and her stricture has remained patent for the past 2 years without further hospital visitations.</p>","PeriodicalId":73503,"journal":{"name":"Interventional radiology (Higashimatsuyama-shi (Japan)","volume":"11 ","pages":"e20250076"},"PeriodicalIF":0.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802166","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":"Complication-related Removal of Central Venous Ports: Comparison of Subclavian and Upper Arm Approaches.","authors":"Tomokazu Takeuchi, Soma Kumasaka, Hiroyuki Tokue, Yuko Seki, Hayato Aoki, Ayako Taketomi-Takahashi, Yusuke Sato, Kei Shibuya, Masashi Ebara, Terutaka Yoshihara, Hiroyuki Yasui, Takayuki Yokota, Takayuki Suto, Yoshito Tsushima","doi":"10.22575/interventionalradiology.2026-0027","DOIUrl":"https://doi.org/10.22575/interventionalradiology.2026-0027","url":null,"abstract":"<p><strong>Purpose: </strong>To compare overall and cause-specific complication-related central venous port removal, particularly infection-related removal and catheter fracture, and time-to-event outcomes between the subclavian and upper arm approaches.</p><p><strong>Material and methods: </strong>This retrospective study included 1,195 patients who underwent ultrasound-guided central venous port implantation via the subclavian (n = 706) or upper arm (n = 489) approach between 2012 and 2021. Comparative analyses were restricted to a maximum of 5 years after implantation. A total of 621,902 catheter-days were analyzed. The evaluated outcomes were overall complication-related central venous port removal and cause-specific removals, including infection-related removal, catheter fracture, malposition, occlusion, leakage, and venous thrombosis. Crude incidence rate ratios were estimated using Poisson regression, adjusted incidence rate ratios using a negative binomial model, and removal-free survival using Kaplan-Meier analysis.</p><p><strong>Results: </strong>Within 5 years, complication-related removals occurred in 50 patients (7.1%) in the subclavian group and 41 (8.4%) in the upper arm group. Crude incidence rates were 0.131 and 0.171 per 1,000 catheter-days, respectively (crude incidence rate ratio, 0.77; 95% confidence interval, 0.51-1.16; <i>p</i> = 0.211). Adjusted analysis showed no significant difference between approaches (adjusted incidence rate ratio, 1.09; 95% confidence interval, 0.59-2.00; <i>p</i> = 0.786). Infection-related removal was more frequent in the upper arm group (crude incidence rate ratio, 0.55; 95% confidence interval, 0.34-0.91; <i>p</i> = 0.020). Catheter fractures occurred only in the subclavian group (12/706, 1.7%; 0.031 per 1,000 catheter-days). Overall, removal-free survival did not differ significantly (<i>p</i> = 0.234), whereas infection-free and fracture-free survival differed significantly.</p><p><strong>Conclusions: </strong>Overall complication-related removal rates were similar between the approaches, but complication profiles differed.</p>","PeriodicalId":73503,"journal":{"name":"Interventional radiology (Higashimatsuyama-shi (Japan)","volume":"11 ","pages":"e20260027"},"PeriodicalIF":0.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802565","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":"Two Lungs, One Pleural Space, Managing Buffalo Chest Syndrome with Bilateral Drainage Following Computed Tomography-guided Lung Biopsy, A Case Report.","authors":"Parth Gulati, Angus Chew, Kenneth K Lau","doi":"10.22575/interventionalradiology.2026-0042","DOIUrl":"10.22575/interventionalradiology.2026-0042","url":null,"abstract":"<p><p>Buffalo chest syndrome is a rare condition describing simultaneous bilateral pneumothoraces due to pleuropleural communication, with fewer than 50 reported cases. We describe a 70-year-old with prior esophagectomy/thoracotomy, who developed symptomatic bilateral pneumothoraces immediately after computed tomography-guided biopsy of a single lung lesion. This prompted insertion of bilateral 14-French pleural drains, achieving immediate clinical stability and full radiological resolution within 24 hours, compared with 2 to 5 days reported with single-drain management in existing literature. This single case highlights the potential role of early bilateral pleural drainage in buffalo chest syndrome, suggesting the potential of more rapid clinical and radiological resolution compared with previously reported single-drain approaches in symptomatic patients.</p>","PeriodicalId":73503,"journal":{"name":"Interventional radiology (Higashimatsuyama-shi (Japan)","volume":"11 ","pages":"e20260042"},"PeriodicalIF":0.8,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439274","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}