CardioVascular and Interventional Radiology最新文献

{"title":"Transarterial Embolization Versus Manipulation Under Anesthesia and Arthroscopic Capsular Release for Refractory Adhesive Capsulitis-A Cost-Effectiveness Analysis.","authors":"Kameel Khabaz, Rashed Alananzeh, Layth Alkhani, Sammy Allaw, Xiao Wu, Qian Yu, Mikin Patel, Osman Ahmed","doi":"10.1007/s00270-026-04563-8","DOIUrl":"10.1007/s00270-026-04563-8","url":null,"abstract":"<p><p>This study compared the cost-effectiveness of transarterial embolization (TAE), manipulation under anesthesia (MUA), and arthroscopic capsular release (ACR) for refractory primary adhesive capsulitis. A systematic review with single-arm meta-analyses informed a three-state Markov model over a 36-month horizon. Clinical success, defined as mild pain at 3 months, was highest for TAE (73.3%), followed by ACR (61.4%) and MUA (55.5%). At a $100,000 per quality-adjusted life-year (QALY) threshold, TAE was the optimal strategy (incremental cost-effectiveness ratio vs. ACR: $77,807/QALY). When success was defined by range-of-motion recovery, MUA and ACR yielded more QALYs at lower cost. Based on indirect comparisons, these findings suggest TAE may be a cost-effective option for pain-predominant adhesive capsulitis, while MUA and ACR may be preferred when mechanical restriction is the primary target.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"1977-1988"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663455","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 Embolization Alone Versus Drug-Eluting Microspheres Chemoembolization for Hepatocellular Carcinoma (RAD-18-TAcE): A Multicenter Randomized Clinical Trial.","authors":"Cristina Mosconi, Makoto Taninokuchi Tomassoni, Sara Zanella, Alexandro Paccapelo, Giovanni Marasco, Simone Gusmini, Francesca Ratti, Diego Palumbo, Sandro Sironi, Riccardo Muglia, Marco Mario Edgardo Fronda, Marco Calandri, Paolo Fonio, Paolo Marra, Andrea Doriguzzi Breatta, Alessandro Cucchetti, Francesco De Cobelli, Matteo Renzulli","doi":"10.1007/s00270-026-04487-3","DOIUrl":"10.1007/s00270-026-04487-3","url":null,"abstract":"<p><strong>Purpose: </strong>To compare transarterial embolization (TAE) and drug-eluting microspheres transarterial chemoembolization (DEM-TACE) in the treatment of hepatocellular carcinoma (HCC) through a non-inferiority randomized clinical trial.</p><p><strong>Materials and methods: </strong>Patients diagnosed with unresectable HCC were randomly assigned to either the TAE or DEM-TACE group. The primary endpoint was time to progression (TTP), and secondary endpoints included overall survival, hospitalization stay, tumor response rates, and severe adverse events (SAE).</p><p><strong>Results: </strong>At the end of the trial, a total of 111 patients (56 TAE and 55 DEM-TACE) were enrolled between 2019 and 2022. The median TTP was similar between TAE and DEM-TACE (7.56 vs. 7.98 months, p = 0.432). In patients with confirmed disease progression, the mean TTP was 6.68 vs. 8.43 months for TAE and DEM-TACE, respectively, with a mean difference of 1.75 months (95% CI - 1.47-4.97), falling within the predefined equivalence range; two one side test (TOST) analysis confirmed equivalence (p < 0.001 and p = 0.022 for lower and upper bounds. Overall survival, tumor response rates, and adverse events were also not statistically different between groups (p > 0.05 for each outcome). Finally, Days of hospitalization were not statistically different (median 4 days for both arms, p = 0.638).</p><p><strong>Conclusion: </strong>TAE and DEM-TACE had comparable results in the treatment of early and intermediate stage unresectable HCC.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"2052-2061"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210129","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":"Stereotactic Microwave Ablation of Early-Stage Hepatocellular Carcinoma in Patients with Transjugular Intrahepatic Portosystemic Shunts: A Matched Case-Control Study.","authors":"Liang Zhang, Quirin D Strotzer, Laura S Kupke, Vinzenz Mayr, Georg H Hiernickel, Moritz Brandenstein, Lukas Luerken, Simon Jage, Gregor Scharf, Christian Stroszczynski, Ingo Einspieler","doi":"10.1007/s00270-026-04522-3","DOIUrl":"10.1007/s00270-026-04522-3","url":null,"abstract":"<p><strong>Purpose: </strong>To assess safety and outcomes of stereotactic CT-guided microwave ablation (MWA) for hepatocellular carcinoma (HCC) in patients with transjugular intrahepatic portosystemic shunts (TIPS) versus a matched control group without TIPS.</p><p><strong>Materials and methods: </strong>Retrospective matched case-control study of cirrhotic patients with HCC treated with stereotactic CT-guided MWA. TIPS patients were matched 1:1 to controls using hierarchical matching based on Child-Pugh class, number of treated tumors, MELD score, tumor diameter, and ablation date. Primary endpoints were primary technique efficacy (PTE), local tumor progression (LTP), 30-day complications, and 30-day all-cause mortality. Secondary endpoints were 12-month Kaplan-Meier estimates for progression-free survival (PFS), hepatic decompensation-free survival (HDFS), and overall survival (OS), compared using log-rank tests.</p><p><strong>Results: </strong>46 patients (23 TIPS, 23 controls) with 62 index lesions were analyzed. PTE was achieved in 30/31 lesions (96.8%) in both groups. Among lesions with PTE, LTP occurred in 1/30 lesions (3.3%) in the TIPS group and 0/30 lesions (0%) in controls. Within 30 days, two major complications occurred in the TIPS group and one in the control group; no 30-day deaths occurred. Observed 12-month estimates did not differ significantly between groups for PFS (52.4% vs. 46.0%, p = 0.876), HDFS (71.8% vs. 76.9%, p = 0.519), or OS (91.1% vs. 90.0%, p = 0.903). Child-Pugh A was associated with higher HDFS than Child-Pugh B (95.8% vs. 50.2%, p = 0.001).</p><p><strong>Conclusion: </strong>Stereotactic CT-guided MWA of early-stage HCC appears feasible in carefully selected patients with TIPS, warranting further evaluation in larger cohorts.</p><p><strong>Level of evidence: </strong>3b.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"2029-2041"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374539","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":"Personalizing Bone Tumor Ablation: Decision Models from the University Hospital of Strasbourg.","authors":"Roberto Luigi Cazzato, Francois Severac, Dominik A Steffen, Matilde Mandolini, Sinan Orkut, Afshin Gangi","doi":"10.1007/s00270-026-04568-3","DOIUrl":"10.1007/s00270-026-04568-3","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the clinical decision-making underlying the selection of the percutaneous ablation modality for bone tumors.</p><p><strong>Materials and methods: </strong>Two experienced interventional radiologists designed in consensus a model for ablation modality selection. Consecutive patients with primary and metastatic bone tumors were retrospectively identified. Demographic, clinical, and imaging data were collected for each tumor. The dataset was randomly divided into a training set (618/926 tumors; 66.7%) and a test set (308/926 tumors; 33.3%). A decision-tree model derived from the training set and the model proposed by the experts were both verified on the test set. Models' performance was assessed.</p><p><strong>Results: </strong>The decision-tree and the experts-based models achieved comparable accuracy (81.8% vs. 80.5%; p = 0.493). For cryoablation, the experts-based model demonstrated significantly higher sensitivity (94.0% vs. 87.5%, p = 0.008), whereas the decision-tree model showed significantly higher specificity (79.3% vs. 69.3%, p = 0.001). For radiofrequency ablation, the decision-tree model exhibited substantially higher sensitivity (35.8% vs. 7.5%, p < 0.001), while the experts-based model had higher specificity (98.4% vs. 93.7%, p = 0.004). Performance for interstitial laser ablation was comparable between the two models, with no significant differences in sensitivity (98.8% vs. 98.9%, p = 1) and specificity (94.1% vs. 95.0%, p = 0.500).</p><p><strong>Conclusion: </strong>The experts-derived and the decision-tree models demonstrated comparable overall accuracy despite relying on the different decision-making. Prospective multicenter studies are required to determine which of these two approaches is more suited for implementation in clinical practice.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":"2042-2051"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705511","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":"Cone-Beam Computed Tomography Angiography Protocol Optimization in Peripheral and Visceral Interventions.","authors":"Motaz Daraghma, Junaid Raja","doi":"10.1007/s00270-026-04628-8","DOIUrl":"https://doi.org/10.1007/s00270-026-04628-8","url":null,"abstract":"<p><p>Established cone-beam CT angiography protocols exist for neurointerventional, hepatic, and prostatic artery applications, but no widely accepted acquisition framework addresses renal embolization, gastrointestinal hemorrhage, pulmonary vascular intervention, or below-the-knee peripheral disease. This narrative review searched PubMed/MEDLINE, EMBASE, and the Cochrane Library through May 2025 for acquisition parameters and contrast protocols in these territories. Six interdependent variables (injection rate, contrast concentration, volume, scan delay, catheter position, and hemodynamics) govern image quality and must be optimized jointly. Territory-specific parameters are synthesized, and radiation considerations are addressed, with emphasis on total procedural exposure and on whether cone-beam acquisitions replace, rather than simply add to, other angiographic acquisitions.Level of Evidence Level 5. Narrative review of published literature without formal quality assessment or meta-analysis.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079736","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":"Endovascular Iliac Vein Revascularization Versus Conservative Management for Chronic, Symptomatic Iliac Vein Obstruction: A Systematic Review and Meta-Analysis.","authors":"Hassaan Qazi, Muhammad Yasir, Muhammad Usman, Adnan Shah, F N U Sawaira, Muhammad Amir Talha Khan, Muhammad Zeeshan, Muhammad Arsalan","doi":"10.1007/s00270-026-04629-7","DOIUrl":"https://doi.org/10.1007/s00270-026-04629-7","url":null,"abstract":"<p><strong>Purpose: </strong>To synthesize the existing evidence comparing endovascular iliac vein revascularization versus conservative management for chronic, symptomatic venous obstruction.</p><p><strong>Materials and methods: </strong>We searched PubMed, Embase, Scopus, Cochrane CENTRAL, and ClinicalTrials.gov for comparator-controlled studies of endovascular iliac vein revascularization versus conservative management. The primary outcome was the Venous Clinical Severity Score (VCSS); secondary outcomes were the Villalta score, Venous Insufficiency Epidemiological and Economic Study Quality of Life (VEINES-QOL), and Visual Analogue Scale (VAS) pain. Continuous outcomes were pooled as mean differences (MD) using random-effects models with the Hartung-Knapp-Sidik-Jonkman adjustment. Certainty was assessed with GRADE (PROSPERO CRD420261446246).</p><p><strong>Results: </strong>Four studies (three randomized trials, one cohort; 554 patients; n per outcome: VCSS 317, Villalta 479, VAS 267, VEINES-QOL 274) met eligibility. Revascularization reduced VCSS (MD - 2.24, 95% confidence interval [CI] - 3.86 to -0.63) and the Villalta score (MD - 3.48, 95% CI - 4.75 to - 2.21; both I² = 0%). VAS pain and VEINES-QOL were inconclusive under the primary model. Technical success was 96.6%, stent thrombosis 1.9%. The largest trial showed threefold more bleeding (major and non-major, 11.6% vs. 3.6%), mainly non-major. Certainty was low for VCSS and Villalta and very low for VEINES-QOL and VAS pain.</p><p><strong>Conclusion: </strong>Revascularization reduced venous symptom severity under the primary model, though neither estimate was robust to omitting individual studies, and the VCSS prediction interval crossed the null. Bleeding risk was increased in the largest trial; quality-of-life and pain effects were inconclusive. The evidence offers modest support for revascularization in patients failing conservative therapy, with short follow-up.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079764","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":"CIRSE Standards of Practice for the Endovascular Management of Acute Lower Limb Ischaemia.","authors":"Mohamad Hamady, Florian Wolf, Ahmad Al-Rekabi, Konstantinos Katsanos, Dražen Perkov, Maria Antonella Ruffino","doi":"10.1007/s00270-026-04622-0","DOIUrl":"https://doi.org/10.1007/s00270-026-04622-0","url":null,"abstract":"<p><strong>Background: </strong>Acute lower limb ischaemia is a medical emergency that requires immediate diagnosis and management to avoid catastrophic consequences. As an alternative to open surgical procedures, endovascular intervention is a minimally invasive approach that can be effective in appropriately selected patients, with outcomes comparable to open surgery in contemporary series. The ongoing improvement and expansion of techniques and tools continue to refine clinical outcomes.</p><p><strong>Purpose: </strong>CIRSE Standards of Practice documents recommend a reasonable approach to, and best practices for, performing procedures, in this case, endovascular procedures to restore flow in acute lower limb ischaemia.</p><p><strong>Methods: </strong>The writing group, established by the CIRSE Standards of Practice Committee on the recommendation of the Endovascular Subcommittee of CIRSE, consisted of five clinicians with internationally recognised expertise in acute lower limb ischaemia and one research assistant. The writing group reviewed the existing literature and conducted a pragmatic evidence search utilising PubMed to identify publications in English pertaining to human subjects from 2013 to 2025. The final recommendations were developed through consensus, incorporating relevant and valid older primary sources, including the 2011 CIRSE Standards of Practice document.</p><p><strong>Results: </strong>Endovascular techniques are established in the treatment of acute lower limb ischaemia and are associated with high technical success rates, which correlate with improved clinical outcomes. Regular follow-up surveillance is recommended to achieve good long-term results.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079741","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":"Efficacy and Safety of Adrenal Artery Embolization for Idiopathic Hyperaldosteronism: A Systematic Review & Meta-Analysis.","authors":"Eduardo Germano Teixeira, Rafael Duran, Filipe Barra, Iago Maia Hezel, Viviane Pinheiro de Oliveira Germano, Marco Rivera, Bernard Campos Araruna Giancristoforo","doi":"10.1007/s00270-026-04641-x","DOIUrl":"https://doi.org/10.1007/s00270-026-04641-x","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of adrenal artery embolization for idiopathic hyperaldosteronism.</p><p><strong>Materials and methods: </strong>PubMed, Embase, and Cochrane databases were searched through June 2026. Studies reporting clinical outcomes after adrenal artery embolization for idiopathic hyperaldosteronism were included. Outcomes comprised 24-h ambulatory and home blood pressure, plasma aldosterone and renin, aldosterone-to-renin ratio, serum potassium and cortisol, and safety. Random-effects models and leave-one-out analyses were used.</p><p><strong>Results: </strong>Four studies including 284 patients allocated to or undergoing adrenal artery embolization were included: outcome-specific sample sizes varied according to data availability. Adrenal artery embolization reduced 24-h systolic blood pressure by 15.31 mmHg and diastolic blood pressure by 10.49 mmHg. Plasma aldosterone decreased by 68.18 pg/mL, the aldosterone-to-renin ratio by 49.03, and serum potassium increased by 0.60 mmol/L. Serum cortisol did not significantly change. Pain and fever occurred in 82.41% (178/216) and 18.98% (41/216) of patients across three studies. Major adverse events occurred in 4.58% (13/284): four strokes (one fatal hemorrhagic, adjudicated unrelated), five hypertensive or severe-hypertension events, one myocardial infarction, one new-onset heart failure, one ventricular tachycardia, and one hypotensive event requiring vasopressors-only three within 1 month.</p><p><strong>Conclusion: </strong>Adrenal artery embolization showed preliminary associations with improved blood pressure and biochemical outcomes without a significant change in serum cortisol. Evidence was predominantly uncontrolled, serious adverse events occurred, and superiority over optimized medical therapy was not established. Randomized trials with standardized techniques and long-term clinical outcomes are required.</p><p><strong>Level of evidence: </strong>Level IV, Systematic Review/Meta-Analysis of predominantly single-arm studies.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079785","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 Imaging Response: Have We Chosen the Right Endpoint After Transarterial Chemoembolization?","authors":"Hamidreza Rouientan, Mohadese Ahmadzade, Mohammad Ghasemi-Rad, Shahram Akhlaghpoor","doi":"10.1007/s00270-026-04631-z","DOIUrl":"https://doi.org/10.1007/s00270-026-04631-z","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073667","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":"Transoral Biopsy Approach for a Right-Sided Petrous Apex Lesion.","authors":"Manraj Ks Heran, Antonio Carlos Hernández Villegas, Hugh M McHugh","doi":"10.1007/s00270-026-04627-9","DOIUrl":"https://doi.org/10.1007/s00270-026-04627-9","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058554","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}