CardioVascular and Interventional Radiology最新文献

{"title":"Preoperative CT-Guided Cryoneurolysis of the Genicular Nerves Before Total Knee Arthroplasty: Study Protocol for a Prospective Randomized Controlled Trial.","authors":"Vasileios Balomenos, Ornella Moschovaki-Zeiger, Panagiotis Koulouvaris, Olga Savvidou, Dimitrios Mastrokalos, Nikolaos Kelekis, Dimitrios Fillipiadis, Dimitrios Koulalis","doi":"10.1007/s00270-026-04588-z","DOIUrl":"https://doi.org/10.1007/s00270-026-04588-z","url":null,"abstract":"<p><strong>Purpose: </strong>Pain control and early mobility remain primary challenges after Total Knee Arthroplasty (TKA). This study will evaluate whether pre-TKA CT-guided cryoneurolysis of the genicular nerves improves postoperative pain, mobility, and quality of life in patients with knee osteoarthritis.</p><p><strong>Materials and methods: </strong>One hundred patients undergoing unilateral TKA will be randomized 1:1 in this prospective, open-label trial. Intervention patients will receive CT-guided cryoneurolysis of three genicular nerves (superior medial, superior lateral, and inferior medial) 24-72h before surgery; controls will undergo TKA alone. Chronic opioid users and patients unable to self-assess are excluded. Perioperative analgesia and rehabilitation will be standardized. Patients will be assessed preoperatively and at 1, 3, 6, and 12 months using the Brief Pain Inventory (BPI), Knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Quality of Life Index (QLI). The primary endpoint is the BPI Pain Interference Scale at 3 months; secondary endpoints include KOOS, WOMAC, and QLI scores, opioid consumption (morphine milligram equivalents), time to mobilization, and length of stay. Safety endpoints comprise adverse events of either procedure, graded by the modified CIRSE classification.</p><p><strong>Expected outcomes: </strong>One hundred patients provide >80% power to detect the minimal clinically important difference of 1.5 points on the BPI Pain Interference Scale. We hypothesize superior pain relief and function with cryoneurolysis.</p><p><strong>Conclusion: </strong>This protocol evaluates a long-acting, opioid-sparing analgesic approach using interventional radiology techniques. If superiority is demonstrated, preoperative cryoneurolysis could become a standard \"pre-habilitation\" (preoperative functional optimization) tool after TKA.</p><p><strong>Trial registration: </strong>This study protocol has been registered in ClinicalTrials.gov (Identifier: NCT07425457) and follows the SPIRIT guidelines for interventional trials and adheres to the Declaration of Helsinki. The study has been approved by the Ethics Committee and Institutional Review Board of the National and Kapodistrian University of Athens (Approval ID: A9, 10/09/2025). Informed consent will be obtained from every individual participant included in the study.</p><p><strong>Clinicaltrials: </strong>gov, CRYO-TKA Trial, NCT07425457. Registered on 20/02/2026 LEVEL OF EVIDENCE: Not applicable (study protocol).</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why Interventional Radiology Should Consider Robotics: A Step Toward Augmented Interventional Radiology.","authors":"Francois H Cornelis, Stephen B Solomon","doi":"10.1007/s00270-026-04600-6","DOIUrl":"https://doi.org/10.1007/s00270-026-04600-6","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Vascular Embolization with N-Butyl Cyanoacrylate-Lipiodol Mixture: A Systematic Literature Review and Meta-Analysis of 8996 Patients.","authors":"Romaric Loffroy, Mohamed Mostafa Fouad, Mouadh Ben Nasr, Francesco Giurazza, Federico Collettini, Geert Maleux, Jose Urbano, Aaron Fischman, Hiroshi Kondo, Clare Bent, Bora Peynircioglu, Gilles Soulez, Karim Abd El Tawab, José Hugo Mendes Luz, Anna-Maria Ierardi, Tiago Bilhim, Frédéric Clarençon, Pierre-Olivier Comby, Elisabeth Darmon-Kern, Olivier Chevallier","doi":"10.1007/s00270-026-04596-z","DOIUrl":"https://doi.org/10.1007/s00270-026-04596-z","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the literature and perform a meta-analysis assessing the efficacy and safety of N-butyl cyanoacrylate (NBCA) glue diluted with Lipiodol for vascular embolization.</p><p><strong>Methods: </strong>A systematic search of MEDLINE/PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) identified studies published between January 2004 and May 2024. Data were independently extracted and evaluated by two reviewers. Studies reporting efficacy and/or safety outcomes in ≥10 patients treated with NBCA-Lipiodol® Ultra Fluid alone were included. The primary outcome was the overall rate of technically successful embolization, defined as immediate haemostasis or complete occlusion; secondary outcomes included technical success by indication, recurrent bleeding, clinical success by indication, defined according to each indication, and procedure-related complications, including reported major complications.</p><p><strong>Results: </strong>A total of 150 studies involving 8996 patients were included: 132 peripheral (8301 patients) and 18 central (695 patients) embolization studies. Outcomes varied across indications. Technical success ranged from 94.1% (tumour) to 100% for peripheral indications and from 76.1% (dAVF) to 97.1% (CNS tumour) for central indications. Clinical success ranged from 73.9% (variceal bleeding) to 100% (varicoceles) for peripheral indications and from 57.9% (AVM) to 89.5% (dAVF) for central indications. Substantial between-study heterogeneity was observed, with indication and study design identified as moderators. The overall technical success rate under a random-effects model was 96.5% [95% CI 95.6-97.4], while the estimated clinical success rates were 86.2% [82.3-89.7] for peripheral and 78.7% [57.6-93.9] for central indications. The overall and major complication rates were 15.6% [12.4-19.1] and 3.2% [2.5-3.9], respectively.</p><p><strong>Conclusion: </strong>NBCA is a safe and effective embolic agent across a broad range of vascular indications. It provides high technical and clinical success rates with low reported major complication rates in both peripheral and central territories.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing a Trauma Hybrid Operating Room from an Interventional Radiology Perspective.","authors":"Alfredo Páez-Carpio, Aida Ahrari, Robyn Pugash, Michael Basedow, Michael Teutenberg, Christian Houbois, Avery B Nathens, Gilbert Maroun","doi":"10.1007/s00270-026-04546-9","DOIUrl":"10.1007/s00270-026-04546-9","url":null,"abstract":"<p><p>Hybrid operating rooms have been increasingly adopted in trauma centers to enable integrated surgical and endovascular care in hemorrhagic emergencies, but practical guidance on their operational implementation from the interventional radiology perspective remains limited. We describe our experience implementing a trauma hybrid operating room at an American College of Surgeons-verified Level I trauma center, addressing room design, zoning for rapid transitions between laparotomy and angioembolization, a mobile supply cart, and a pre-embolization checklist. We outline a training approach centered on radiation safety, sterility during procedural transitions, and simulation-based interdisciplinary coordination and discuss key implementation challenges, local activation criteria, and strategies to ensure timely access. This report focuses on operational design; institutional process metrics and clinical outcomes were not included. However, these operational lessons may be relevant to other centers seeking to develop or refine trauma hybrid operating room programs.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"1811-1824"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seeing Intracranial in-Stent Restenosis Before it Happens: What Baseline Vessel Wall Imaging Can-and Can't-Tell Us Yet.","authors":"Isabel Fragata","doi":"10.1007/s00270-026-04573-6","DOIUrl":"10.1007/s00270-026-04573-6","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"1873-1874"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paving the Way: a Systematic Review and Meta-Analysis of Randomized Controlled Trials of Atherectomy as Vessel Preparation Prior to Balloon Angioplasty in Peripheral Arterial Disease.","authors":"Joshua Qi Jing Ho, Sonal Udayasiri, Michael Stewart, Andy Owen, Numan Kutaiba, Jessie Low, Ali Khabaza, Dinesh Ranatunga, Julian Maingard, Mark Brooks, Ashu Jhamb, Lucy Corlette, Charles Handley, Christen Barras, Hong Kuan Kok, Hamed Asadi","doi":"10.1007/s00270-026-04527-y","DOIUrl":"10.1007/s00270-026-04527-y","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review and meta-analysis compares the safety and efficacy of atherectomy as a vessel preparation tool prior to balloon angioplasty (ATH + BA) versus balloon angioplasty alone (BA) for the treatment of peripheral arterial disease (PAD).</p><p><strong>Materials and methods: </strong>Medline, Embase, CENTRAL, and Clinicaltrials.gov databases were searched for randomized controlled trials (RCTs) comparing ATH + BA versus BA alone in treating PAD. The outcomes analysed included primary patency, technical success, bailout stenting, flow-limiting dissection, clinically driven target lesion revascularization (CD-TLR), distal embolization, arterial perforation, major amputation, and all-cause mortality. A subgroup analysis was done to compare femoropopliteal versus infrapopliteal and plain balloon angioplasty versus drug-coated balloon.</p><p><strong>Results: </strong>Seven RCTs met the inclusion criteria (489 patients). Atherectomy as vessel preparation was associated with reduced rates of bailout stenting (OR: 0.14, 95% CI 0.03-0.67, p = 0.01) and flow-limiting dissection (OR: 0.29, 95% CI 0.10-0.84, p = 0.02). Primary patency (OR: 2.13, 95% CI 1.00-4.50, p = 0.049) and CD-TLR at 6 months (OR: 0.24, 95% CI 0.06-0.96, p = 0.04) results favoured ATH + BA. No significant differences were found in technical success, 12-month primary patency, CD-TLR at 12 months, distal embolization, arterial perforation, major amputation, or all-cause mortality. Subgroup analysis demonstrated a reduction in bailout stenting in femoropopliteal studies (OR: 0.05, 95% CI 0.01-0.21) compared with infrapopliteal studies (OR: 0.86, 95% CI 0.31-2.40).</p><p><strong>Conclusions: </strong>This meta-analysis found that atherectomy as vessel preparation prior to BA reduced bailout stenting, flow-limiting dissections, and 6-month CD-TLR, with improved 6-month patency compared with BA alone. However, these benefits did not translate into improvements in clinical outcomes at 12 months. Larger RCTs are needed to establish the clinical benefit of atherectomy.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"1657-1666"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-Assisted Computed Tomography-Guided Percutaneous Bone Procedures: A Prospective Multicenter Pilot Study.","authors":"Baptiste Bonnet, Nicolas Stacoffe, Michael Dassa, Lambros Tselikas, Paul Beunon, Sean Tutton, Jean-Baptiste Pialat, Laurent Milot, Louis Thiery, Charles Mastier, Nassima Daidj, William Boulade, Thierry de Baère, Frédéric Deschamps, Gilles Piana","doi":"10.1007/s00270-026-04545-w","DOIUrl":"10.1007/s00270-026-04545-w","url":null,"abstract":"<p><strong>Purpose: </strong>To prospectively evaluate the feasibility, safety, and targeting accuracy of robotic-assisted CT-guided percutaneous bone procedures.</p><p><strong>Materials and methods: </strong>This prospective multicenter pilot study included adult patients undergoing CT-guided percutaneous bone consolidation or tumor ablation between September 2024 and January 2025 at three academic institutions. All procedures were planned and performed using the Epione® robotic platform. Targets included the thoracic and lumbar spine and the pelvis. The primary endpoint was feasibility of robotic-assisted needle insertion, defined as successful needle placement without conversion to manual technique. Secondary endpoints included safety, targeting accuracy, procedural time, and radiation dose. Targeting accuracy was measured as lateral tip deviation and angular deviation between planned and final needle positions.</p><p><strong>Results: </strong>Thirty-four patients underwent 90 needle insertions, including 66 in the spine (73.3%) and 24 in the pelvis (26.7%). Indications were bone consolidation in 87/90 insertions (97%) and tumor ablation in 3/90 (3%). Robotic insertion was feasible in 89/90 insertions (98.9%). Seven adverse events occurred in 6 patients (17.6%), including four serious events, none related to the device or procedure. Mean lateral tip deviation was 2.0 ± 1.4 mm, and mean angular deviation was 3.1° ± 2.7°. Mean dose-length product was 3224 ± 2215 mGy.cm. Mean total procedure time was 03 h 09 min ± 50 min.</p><p><strong>Conclusions: </strong>Robotic-assisted CT-guided bone procedures showed high feasibility and satisfactory targeting accuracy, with no device- or procedure-related adverse events. These findings support further evaluation in larger comparative studies.</p><p><strong>Clinical trial registration: </strong>NCT06376682.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"1875-1885"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review on Artificial Intelligence as a Solution to Burnout in Interventional Radiology.","authors":"Henry Zhang, Aria Torkpour, Boroumand Zeidaabadi, Nader Ashraf, Anousha Yazdabadi, Shams I Iqbal, Hamed Asadi, Roberto Luigi Cazzato, Robert Morgan, Behnam Shaygi","doi":"10.1007/s00270-026-04440-4","DOIUrl":"10.1007/s00270-026-04440-4","url":null,"abstract":"<p><strong>Purpose: </strong>We review burnout risk factors in interventional radiology (IR) and explore how artificial intelligence (AI) would address burnout from a workplace aspect.</p><p><strong>Materials and methods: </strong>We performed a literature search on PubMed on risk factors for burnout in interventional radiology and AI tools to address burnout challenges.</p><p><strong>Results: </strong>IR specialists face burnout risk at personal, workplace and system levels. AI could identify burnout using demographic data and free text, alleviate administrative workload, and manage workflow. AI could also enhance procedural efficiency via automated navigation systems, reducing stress from radiation exposure. Future directions include enhanced burnout identification and medical coding for access to longitudinal data.</p><p><strong>Conclusion: </strong>AI may be a solution to addressing specific burnout risk factors in interventional radiology.</p><p><strong>Level of evidence: </strong>No level of evidence. Review Article.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"1726-1736"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genicular Artery Embolization Using Imipenem/Cilastatin vs. Microsphere for Knee Osteoarthritis (GAUCHO). 12-Month Clinical Results of a Single-blind Randomized Controlled Trial.","authors":"Mateus Picada Correa, Alexandre Froes Michelin, Lyson Azevedo Aguiar, Ricardo Lugokenski, Rodrigo Ilha Algarve, Joaquim M Motta-Leal-Filho","doi":"10.1007/s00270-026-04504-5","DOIUrl":"10.1007/s00270-026-04504-5","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the safety and clinical outcomes of genicular artery embolization (GAE) performed with permanent microspheres (PM) and imipenem/cilastatin (I/C) in patients with mild-to-moderate knee osteoarthritis.</p><p><strong>Materials and methods: </strong>In this IRB-approved prospective, randomized, single-center, single-blind trial, 60 patients with mild-to-moderate knee osteoarthritis were allocated to GAE with I/C (n = 30) or microspheres (n = 30). Clinical outcomes were assessed at baseline, 30 days, 90 days, and 365 days using Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS).</p><p><strong>Results: </strong>Baseline characteristics were similar between groups, except for a higher rate of bilateral treatment in the microsphere group (56.6% vs. 30.0%, p = 0.037). Technical success was achieved in all procedures, with lower embolic volume in the microsphere group (p = 0.003). The mean volume of embolic was 1.5 ml in the microsphere group and 2.0 ml in the I/C group (p = 0.003). Between-group comparisons showed no significant differences in VAS at 30, 90, and 365 days (3.20 vs. 2.28, p = 0.102; 3.38 vs. 3.33, p = 0.931; and 3.95 vs. 3.88, p = 0.928), in WOMAC pain (6.25 vs. 4.83, p = 0.182; 8.11 vs. 6.00, p = 0.051; and 7.50 vs 6.27, p = 0.323), or in KOOS pain (63.59 vs. 72.12, p = 0.115; 56.58 vs. 67.14, p = 0.074; and 53.76 vs. 65.81, p = 0.081) for I/C versus microspheres, respectively.</p><p><strong>Conclusion: </strong>GAE using either I/C or microspheres is safe and effective, with significant clinical improvement over 12 months and no major differences in adverse events and pain outcomes between embolic agents.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"1825-1837"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional Radiology in the UK and Greece: Contrasting Pathways and Practice Models.","authors":"S Lechareas","doi":"10.1007/s00270-026-04424-4","DOIUrl":"10.1007/s00270-026-04424-4","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"1897-1898"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}