CardioVascular and Interventional Radiology最新文献

{"title":"Setting Realistic Expectations in Pulmonary Embolism Therapy with Aspiration Thrombectomy: Insights from Real-World Data.","authors":"Blair E Warren, Alanna Supersad, Sebastian Mafeld","doi":"10.1007/s00270-024-03927-2","DOIUrl":"10.1007/s00270-024-03927-2","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"280-281"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846104","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":"Beyond MELD Score: Association of Machine Learning-derived CT Body Composition with 90-Day Mortality Post Transjugular Intrahepatic Portosystemic Shunt Placement.","authors":"Tarig Elhakim, Arian Mansur, Jordan Kondo, Omar Moustafa Fathy Omar, Khalid Ahmed, Azadeh Tabari, Allison Brea, Gabriel Ndakwah, Shams Iqbal, Andrew S Allegretti, Florian J Fintelmann, Eric Wehrenberg-Klee, Christopher Bridge, Dania Daye","doi":"10.1007/s00270-024-03886-8","DOIUrl":"10.1007/s00270-024-03886-8","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the association of machine learning-derived CT body composition and 90-day mortality after transjugular intrahepatic portosystemic shunt (TIPS) and to assess its predictive performance as a complement to Model for End-Stage Liver Disease (MELD) score for mortality risk prediction.</p><p><strong>Materials and methods: </strong>This retrospective multi-center cohort study included patients who underwent TIPS from 1995 to 2018 and had a contrast-enhanced CT abdomen within 9 months prior to TIPS and at least 90 days of post-procedural clinical follow-up. A machine learning algorithm extracted CT body composition metrics at L3 vertebral level including skeletal muscle area (SMA), skeletal muscle index (SMI), skeletal muscle density (SMD), subcutaneous fat area (SFA), subcutaneous fat index (SFI), visceral fat area (VFA), visceral fat index (VFI), and visceral-to-subcutaneous fat ratio (VSR). Independent t-tests, logistic regression models, and ROC curve analysis were utilized to assess the association of those metrics in predicting 90-day mortality.</p><p><strong>Results: </strong>A total of 122 patients (58 ± 11.8, 68% male) were included. Patients who died within 90 days of TIPS had significantly higher MELD (18.9 vs. 11.9, p < 0.001) and lower SMA (123 vs. 144.5, p = 0.002), SMI (43.7 vs. 50.5, p = 0.03), SFA (122.4 vs. 190.8, p = 0.009), SFI (44.2 vs. 66.7, p = 0.04), VFA (105.5 vs. 171.2, p = 0.003), and VFI (35.7 vs. 57.5, p = 0.02) compared to those who survived past 90 days. There were no significant associations between 90-day mortality and BMI (26 vs. 27.1, p = 0.63), SMD (30.1 vs. 31.7, p = 0.44), or VSR (0.97 vs. 1.03, p = 0.66). Multivariable logistic regression showed that SMA (OR = 0.97, p < 0.01), SMI (OR = 0.94, p = 0.03), SFA (OR = 0.99, p = 0.01), and VFA (OR = 0.99, p = 0.02) remained significant predictors of 90-day mortality when adjusted for MELD score. ROC curve analysis demonstrated that including SMA, SFA, and VFA improves the predictive power of MELD score in predicting 90-day mortality after TIPS (AUC, 0.84; 95% CI: 0.77, 0.91; p = 0.02).</p><p><strong>Conclusion: </strong>CT body composition is positively predictive of 90-day mortality after TIPS and improves the predictive performance of MELD score.</p><p><strong>Level of evidence: </strong>Level 3, Retrospective multi-center cohort study.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"221-230"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543917","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":"Venous Leak Embolization Results in Clinical Improvement of Patients with Mixed Arterio-Venous Erectile Dysfunction Not Responding to Arterial Revascularization Alone.","authors":"Nicolas Diehm, Dominique Hirschle, Christoph Kalka, Hak Hong Keo, Vignes Mohan, Martin Christian Schumacher, Andreas Gutwein, Dai-Do Do, Hanno Hoppe","doi":"10.1007/s00270-024-03910-x","DOIUrl":"10.1007/s00270-024-03910-x","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the safety and efficacy of additional venous leak embolization after an initial arterial revascularization to treat patients with combined arteriogenic and venogenic erectile dysfunction (ED).</p><p><strong>Materials and methods: </strong>Single-center observational study from October 1, 2019, to September 30, 2022, including 26 patients with ED resistant to phosphodiesterase-5-inhibitors (PDE5i) and without significant clinical benefit after arterial revascularization of erection-related arteries. Additional treatment with venous leak embolization was performed 458 ± 424 days after arterial revascularization. Arterial obstruction and venous leak were verified based on color Doppler flow analysis, computed tomography angiography, and computed tomography cavernosography. The primary safety endpoint was any major adverse event 6 weeks after the procedure. The primary feasibility endpoint was defined as an IIEF-6 (International Index of Erectile Function-6) score improvement of ≥ 4 points at 6-week follow-up post intervention.</p><p><strong>Results: </strong>Procedural success was achieved in all patients with no major adverse events on follow-up. The primary feasibility endpoint at 6-week follow-up was reached with 3/26 (11.5%) of patients following arterial revascularization only. Six weeks after additional venous embolization, the primary feasibility endpoint was reached in 17/26 (65.4%) of patients.</p><p><strong>Conclusion: </strong>Venous leak embolization yields additional clinical improvement and treatment potential in patients with vasculogenic ED not responding to PDE5i due to mixed arterio-venous disease and insufficient clinical improvement after arterial revascularization alone.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"184-193"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784130","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":"A Meta-Analysis and Meta-Regression of Embolisation Outcomes of Pulmonary Arteriovenous Malformations.","authors":"Yousef Shahin, Cyrilkumaar Vijayakumar, Amarit Gill, Andrzej Lejawka, Steve Bennett, Rebecca Willis, Mustafa Abbas, Daniel Kusumawidjaja","doi":"10.1007/s00270-024-03907-6","DOIUrl":"10.1007/s00270-024-03907-6","url":null,"abstract":"<p><strong>Purpose: </strong>Embolisation is a widely utilised therapeutic intervention for pulmonary arteriovenous malformation (PAVM). We conducted a meta-analysis to evaluate outcomes of PAVM embolisation and factors associated with embolisation outcomes.</p><p><strong>Methods: </strong>MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 2000 to July 2022 on studies that assessed embolisation outcomes of PAVM. Immediate technical success rate defined as the complete occlusion of the PAVM at the time of embolisation and treatment success rate defined as ≥ 70% venous sac reduction on follow-up imaging were pooled from included studies with use of random effects proportion meta-analysis. Heterogeneity across studies was assessed with the I² statistic.</p><p><strong>Results: </strong>Forty-four studies including 1865 patients (604 (32%) males, mean age (range) 45 (24-59) years, 1125 (60%) had hereditary haemorrhagic telangiectasia (HHT)) were included in the meta-analysis. Studies included a total of 4314 PAVMs of which 4047 (94%) were treated. Studies reported morphology of 3074 PAVMs (2519 (58%) simple and 555 (13%) complex). The pooled overall immediate technical success rate for PAVM embolisation was 99%, 95% CI (98-100%) and the treatment success rate was 86%, 95% CI (84-89%). Younger age (p = 0.041), simple PAVM (0.020), and embolisation using plugs (p = 0.001) were associated with higher treatment success. Feeding artery and sac embolisation (p = 0.021) and using coils (p = 0.001) were associated with lower treatment success. There was no significant difference in recanalisation rate between different embolisation agents (OR 0.64, 95% CI -0.09- 1.38).</p><p><strong>Conclusion: </strong>This meta-analysis shows that PAVM embolisation is safe and effective. Higher treatment success rates for PAVM embolisation can be achieved using plugs as the primary embolisation agent. Embolisation agent used had no effect on recanalisation rates.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"167-179"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667069","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":"Commentary on: Venous Leak Embolization Results in Clinical Improvement of Patients with Mixed Arterio-Venous Erectile Dysfunction Not Responding to Arterial Revascularization Alone.","authors":"Heather K Moriarty","doi":"10.1007/s00270-025-03965-4","DOIUrl":"10.1007/s00270-025-03965-4","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"194-195"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000581","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":"Liver Regeneration Following Thermal Ablation Using Nanocarrier Mediated Targeted Mesenchymal Stem Cell Therapy.","authors":"Prasoon P Mohan, Sapna Deo, Zhao-Jun Liu, Emre Dikici, Hugo Kaneku, Doyoung Chang, Monica Garcia-Buitrago, Hamed Jalaeian, Elnaz Zeynaloo, Yulexi Y Ortiz, Yan Li, Shivank Bhatia, Omaida Velazquez, Sylvia Daunert","doi":"10.1007/s00270-024-03862-2","DOIUrl":"10.1007/s00270-024-03862-2","url":null,"abstract":"<p><strong>Purpose: </strong>To test the efficacy of nanocarrier (NC) mediated mesenchymal stem cell (MSC) therapy for liver regeneration following thermal ablation of porcine livers.</p><p><strong>Materials and methods: </strong>Liver radiofrequency ablation was performed in 18 swines divided into MSC, MSC + NC and control groups. The test groups received infusion of MSC or MSC + NC labeled with enhanced green fluorescent protein (eGFP) via hepatic artery. MSC + NC group had MSCs coated with dendrimer nanocarrier complexed with I-Domain of lymphocyte function-associated antigen-1 (LFA-1). Nanocarriers direct homing of MSCs by binding to its counterpart protein, intercellular adhesion molecule-1 (ICAM-1), which is overexpressed at the periablation margins from inflammation. Ablation cavity reduction by CT volumetry was used as surrogate marker for liver regeneration. Cell proliferation was assessed with Ki67 and HepPar-1 stains. GFP identified MSC derived cells.</p><p><strong>Results: </strong>Total number of ablations in control animals were 13 across 4 animals. In the MSC group, there were 23 ablations across 6 animals, and in MSC + NC group there were 21 ablations across 6 animals. Ablation cavity volume reduction from day 0 to 30 were 64.4 ± 15.0%, 61.5 ± 12.9% and 80.3 ± 9.4% for control, MSC and MSC + NC groups, respectively (MSC + NC vs MSC: p < 0.001, MSC + NC vs. control: p = 0.001). GFP⁺ cell count at margins was 426.8 ± 193.2 for MSC group and 498.6 ± 235.2 for MSC + NC group (p = 0.01). The mean Ki67 and HepPar-1 staining at margins were 9.81 ± 4.5% and 6.12 ± 4.2% for MSC + NC group versus 7.59 ± 3.7% and 5.09 ± 3.7% for MSC group, respectively (P < 0.001 and P = 0.09, respectively).</p><p><strong>Conclusion: </strong>Nanocarrier-mediated MSC therapy promotes liver regeneration by engrafting MSCs at ablation margins, potentially making liver-directed therapy viable for patients with severe liver dysfunction. This technology may also benefit other solid organs.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"233-243"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589593","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":"Impact of Antithrombotic Therapy on Thrombotic and Bleeding Complications after Elective Endovascular Repair of Abdominal Aortic Aneurysms.","authors":"Josephine Kranendonk, Ad A Vermulst, Daphne van der Veen, Cornelis Kramers, Michiel C Warlé, Michel M P J Reijnen","doi":"10.1007/s00270-024-03946-z","DOIUrl":"10.1007/s00270-024-03946-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the influence of antithrombotic therapy on occurrence of thrombotic and bleeding complications after endovascular aneurysm repair (EVAR).</p><p><strong>Methods: </strong>In this retrospective single-center cohort study, patients who underwent elective endovascular aneurysm repair for abdominal aortic aneurysm were categorized into three antithrombotic groups: single antiplatelet therapy (SAPT), anticoagulants, or dual antiplatelet therapy (DAPT). Outcome measures were the incidence of major adverse cardiovascular events (MACE), prosthetic limb occlusions, and bleeding complications during follow-up.</p><p><strong>Results: </strong>Among 616 patients (SAPT: n = 450, anticoagulants: n = 84, and DAPT: n = 82), Kaplan-Meier analysis showed no significant difference (log-rank p = 0.37) in incidence of MACE between patients receiving SAPT (20.9%), anticoagulants (25.0%), and DAPT (14.6%) during a median follow-up of almost 4 years. In multivariable Cox regression analysis, only age (HR = 1.03; 95% CI 1.01-1.06, p = 0.01) and American Society of Anesthesiologists (ASA) classification (HR = 1.46; 95% CI 1.12-1.91; p = 0.01) were significant predictors for MACE. Prosthetic limb occlusion was observed in 38 patients during a median follow-up of 4 years; incidence between patients receiving SAPT (5.8%), anticoagulants (10.7%), and DAPT (3.7%) was not significantly different (log-rank p = 0.08). Age (HR = 0.96; 95% CI 0.92-1.00; p = 0.03) and use of anticoagulants (HR = 3.79, 95% CI 1.46-9.83; p < 0.01) were significant predictors for prosthetic limb occlusion. Bleeding complications occurred in 73 patients during median follow-up of almost 4 years, without significant difference (log rank p = 0.06) in incidence between patients receiving SAPT (10.7%), anticoagulants (19.0%), and DAPT (11.0%). ASA classification (HR = 1.74; 95% CI 1.23-2.46; p < 0.01) was a significant predictor for bleeding complications.</p><p><strong>Conclusion: </strong>Use of anticoagulants after EVAR appears to be associated with a higher risk of prosthetic limb occlusion compared to the use of single or dual antiplatelet therapy.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"157-166"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000582","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":"Transarterial Radioembolization with Yttrium-90 Resin Microspheres for Huge Focal Nodular Hyperplasia.","authors":"Lin Zhang, Xiaobin Feng, Xin Huang, Ziwei Liang, Yong Liao, Bin Liang, Chunhui Ren, Jingjing Li, Shizhong Yang, Zuoxiang He, Qian Lu, Lai Wei, Jiahong Dong","doi":"10.1007/s00270-024-03913-8","DOIUrl":"10.1007/s00270-024-03913-8","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"270-273"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876242","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":"Augmenting the MELD Score with Machine Learning-Derived Body Composition Metrics on Abdominal CT to Predict 90-Day Mortality Post-TIPSS.","authors":"Iranna Mallappa Hittalamani","doi":"10.1007/s00270-024-03936-1","DOIUrl":"10.1007/s00270-024-03936-1","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"231-232"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833919","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":"Percutaneous Deep Venous Arterialization by Balloon Angioplasty without Stent Implantation for Patients with Chronic Limb-Threatening Ischemia Undergoing Hemodialysis: A Retrospective Cohort, Single-Center, Single-Arm Study.","authors":"Tomonari Takagi, Akira Miyamoto, Norihiko Ohura, Yasutaka Yamauchi","doi":"10.1007/s00270-024-03871-1","DOIUrl":"10.1007/s00270-024-03871-1","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective, single-center study aimed to determine the efficacy of percutaneous deep venous arterialization in patients on hemodialysis with chronic limb-threatening ischemia.</p><p><strong>Materials and methods: </strong>Twenty-one consecutive limbs on hemodialysis with chronic limb-threatening ischemia were treated with percutaneous deep venous arterialization using balloon angioplasty following a failed pedal arterial reconstruction between May 2021 and June 2022. An arteriovenous fistula near the ankle joint was created to ensure sufficient venous flow reversal to the pedal veins. In case of occlusion of the tibial artery, a guidewire was advanced (subintimal) to the ankle joint vicinity was technically important. The primary outcome measures were the 6-month complete wound healing and freedom from major amputation rates; the secondary outcome measure was the 6-month amputation-free survival.</p><p><strong>Results: </strong>Occlusion of all pedal arteries was observed in 17 limbs (81.0%). Arteriovenous fistulas were predominantly created at the distal portions of the posterior tibial artery and vein in 18 limbs (85.7%). No extravasation at the fistulas was observed. Re-intervention was required in 16 limbs (76.2%) due to tibial artery or deep vein occlusion. The 6-month complete wound healing rate was 42.9% (nine limbs), with a median healing time of 85 days (interquartile range: 58-151 days). The 6-month freedom from major amputation and amputation-free survival rates were 90.5% (19 limbs) and 61.9% (13 limbs), respectively.</p><p><strong>Conclusion: </strong>Balloon angioplasty without stent implantation for percutaneous deep venous arterialization is promising for improving the complete wound healing and amputation-free survival rates after pedal artery reconstruction failure.</p><p><strong>Level of evidence: </strong>Level 3b, retrospective cohort study.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"244-250"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388271","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}