CardioVascular and Interventional Radiology最新文献

{"title":"Hydrophilic Polymer Embolism: An Underappreciated Complication of Endovascular Procedures that Physicians Should be Aware Of.","authors":"Marco Parillo, Robert P Wawer Matos Reimer, Carlo A Mallio, Peter Reimer, Aart J van der Molen","doi":"10.1007/s00270-025-04098-4","DOIUrl":"10.1007/s00270-025-04098-4","url":null,"abstract":"<p><p>Hydrophilic polymer embolization (HPE) represents a complication of endovascular interventions, occurring when the hydrophilic coating detaches, eventually causing distal ischemia and/or inflammation. We conducted a scoping review using PubMed, providing a summary of the main clinical implications potentially related to HPE. The analysis primarily found case reports/series (n = 48/56), suggesting that this event is perceived as sporadic. However, the potentially subtle presentation of HPE and a limited understanding of this condition among medical professionals are likely to contribute to its underrepresentation in medical literature. To better understand HPE risks, a detailed device analysis considering material and coating variations is crucial. Collaboration among manufacturers, clinicians, and regulators is needed to improve safety, diagnostics, and patient outcomes, bridging knowledge gaps and addressing this complex issue effectively.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332521","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":"In Vitro Evaluation of Hydrogel Coils Combined with Liquid Embolic and Sclerosing Agents for Endovascular Embolization.","authors":"Akiko Narita, Hiroaki Okada, Yuki Maruchi, Kyohei Takahata, Takahiro Yamamoto, Nozomu Matsunaga, Shuji Ikeda, Masashi Shimohira, Kojiro Suzuki","doi":"10.1007/s00270-025-04096-6","DOIUrl":"https://doi.org/10.1007/s00270-025-04096-6","url":null,"abstract":"<p><strong>Purpose: </strong>Hydrogel coils have expandable hydrogels that enhance the embolization effect. Hydrogel coils are sometimes used in combination with liquid embolic or sclerosing agents. This study evaluated the effect of liquid embolic and sclerosing agents on hydrogel coils.</p><p><strong>Material and methods: </strong>This study consists of two experiments. (1) 0.035 inch-outward-expanding hydrogel coils were soaked in the following solutions: ethanol, 25% n-butyl-2-cyanoacrylate with lipiodol (NBCA), 5% ethanolamine oleate with iopamidol (EOI), and 3% polidocanol. Changes of the hydrogel coils were observed sequentially using a stereomicroscope. (2) Hydrogel coils were soaked in phosphate-buffered saline (pH 7.4, 37 °C) for > 30 min and then moved into the above solutions. Changes of the hydrogel coils were evaluated over time.</p><p><strong>Results: </strong>(1) The primary coil diameter soaked in ethanol and NBCA did not change. The primary coil diameter soaked in EOI and polidocanol increased to 2.7 times the original value and 3.1 times, respectively, but the hydrogels cracked. (2) The primary coil diameter of expanded coils soaked in phosphate-buffered saline was 2.0 times the original value. The primary coil diameter decreased 1.0-fold in ethanol. In NBCA, frayed structures gradually appeared at the surface of the hydrogels, increasing in primary coil diameter 4.3 times, and were exposed from NBCA. The primary coil diameter soaked in EOI and polidocanol increased 2.5 times and 2.8 times, respectively, and the hydrogels cracked.</p><p><strong>Conclusion: </strong>In vitro, sclerosing agents disabled or damaged hydrogel coils. The combination of sclerosing agents and hydrogel coils might clinically have adverse effects, including the insufficient and non-target embolization.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315931","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":"Comment on \"Impact of Sarcopenia on Outcomes Following Endovascular Treatment of Patients with Pelvic Venous Insufficiency\".","authors":"Deepak Kataria, Rachana Mehta, Ranjana Sah","doi":"10.1007/s00270-025-04097-5","DOIUrl":"https://doi.org/10.1007/s00270-025-04097-5","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309578","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":"Factors that Enhance the Stability of Polidocanol and Monoethanolamine Oleic Acid Foams, and Identification of the Optimal Foam-Creating Device.","authors":"Nobuyuki Higashino, Tetsuo Sonomura, Ryosuke Mimura, Kodai Fukuda, Hirotatsu Sato, Nobuyuki Kawai","doi":"10.1007/s00270-025-04072-0","DOIUrl":"https://doi.org/10.1007/s00270-025-04072-0","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effects of the air ratio and the addition of glucose solution (Gluc) on the stability of polidocanol-nonionic water-soluble contrast medium (Po/CM) and monoethanolamine oleate-nonionic water-soluble contrast medium (EO/CM) foams, and to identify the optimal device to prepare these foams.</p><p><strong>Materials and methods: </strong>Four sclerosants were used: Po/CM (Po:CM = 1:1), Po/CM-Gluc (Po:CM:70% Gluc = 2:1:1), EO/CM (EO:CM = 1:1), and EO/CM-Gluc (EO:CM:70% Gluc = 2:1:1). The four sclerosants were mixed with air at ratios of 1:4, 1:7, and 1:10 using the Micro Magic connector (MM), hydrophobic emulsifying connector (Hbic), and hydrophilic emulsifying connector (Hlic). The times taken to prepare the foams using each device and the foam half-lives were measured.</p><p><strong>Results: </strong>The Po/CM (1:10) and Po/CM-Gluc (1:10) foams could not be prepared using any device. The EO/CM-Gluc (1:10), Po/CM (1:7), and Po/CM-Gluc (1:7) foams could not be prepared using the MM. The times taken to prepare the foams were not significantly different between the Hbic and Hlic for EO/CM-Gluc (1:4) and Po/CM (1:4). The times taken to prepare the other foams decreased significantly in the order MM > Hbic > Hlic. The half-lives of the foams were significantly prolonged by increasing the air ratio. For foams with the same air ratio, the presence of Gluc significantly increased the half-lives of EO/CM and Po/CM compared with the foams without Gluc.</p><p><strong>Conclusion: </strong>The half-lives of foams were prolonged by increasing their air ratio and by adding Gluc. Of the tested mixture devices, Hlic created foams with longer half-lives in the shortest time.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246635","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 Feasibility of Endovascular Management of Pediatric Dialysis Access.","authors":"Jake DiFatta, Chase Mahler, Junjian Huang, A J Gunn, Junaid Raja","doi":"10.1007/s00270-025-04070-2","DOIUrl":"https://doi.org/10.1007/s00270-025-04070-2","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the safety and efficacy of pharmacomechanical intervention in the maintenance of pediatric dialysis access fistulas and grafts in the extremities.</p><p><strong>Materials and methods: </strong>A retrospective analysis of 67 interventions performed on 17 pediatric patients with dialysis access maintenance interventions was conducted. Use of angioplasty, stenting, thrombectomy devices, and thrombolytic agents such as tissue plasminogen activator (tPA) were recorded across interventions. Total number of interventions per patient and time between reinterventions were measured. Safety of these techniques was assessed according to the Cardiovascular and Interventional Radiology Society of Europe (CIRSE) complication guidelines. Technical success was defined as restoration of patency without a hemodynamically significant stenosis, and clinical success was defined as symptom resolution without reintervention of greater than 6 months.</p><p><strong>Results: </strong>The application of pharmacomechanical intervention demonstrated a favorable safety profile and high technical success rates across all categories. The median age at first intervention was 13 years (IQR 10.1-16.9, range 7-18), and median number of interventions was 2 with a range of 1-11. No major complications were observed during or after the procedures. Among the 67 interventions, angioplasty was the most frequently employed technique (n = 67, 100%), followed by thrombolysis and/or anticoagulation (n = 34, 50.7%), thrombectomy (n = 21, 31.3%), and stenting (n = 10, 14.9%). Technical success was 98.5% (66/67), and combined 6-month primary assisted and secondary patency from the index dialysis circuit intervention was 41.8% (28/67). For patients who received more than one treatment, median time to reintervention was 107 days.</p><p><strong>Conclusion: </strong>The high rate of technical success and absence of major or minor complications suggest that endovascular techniques for dialysis access maintenance including angioplasty, stenting, thrombolysis, and advances therapies can be safely and effectively performed in pediatric patients. Rates of primary and secondary patency are slightly lower compared to the adult population.</p><p><strong>Level of evidence: </strong>Level 4, Retrospective Cohort Study.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257394","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":"Outcomes After Thrombectomy for Acute Ischemic Stroke Related to Type of Stent Retriever; a MR CLEAN Registry Study.","authors":"Robrecht R M M Knapen, Robert-Jan B Goldhoorn, Jan Albert Vos, Bart J Emmer, Maarten Uyttenboogaart, Jeannette Hofmeijer, Wouter J Schonewille, Charles B Majoie, Yvo B W E M Roos, Aad van der Lugt, Diederik W J van Dippel, Hester F Lingsma, Christiaan van der Leij, Robert J van Oostenbrugge, Wim H van Zwam","doi":"10.1007/s00270-025-04048-0","DOIUrl":"https://doi.org/10.1007/s00270-025-04048-0","url":null,"abstract":"<p><strong>Purpose: </strong>Endovascular treatment (EVT) with a stent retriever is known to be effective and safe in patients with acute ischemic stroke due to large vessel occlusion. We aimed to compare the most used stent retrievers in a nationwide registry of EVT-treated stroke patients (MR CLEAN Registry).</p><p><strong>Methods: </strong>Patients with ischemic stroke due to large vessel occlusion, treated with stent retriever thrombectomy (each stent retriever with at least 100 EVTs) as first-line technique in the MR CLEAN Registry, were included. The primary outcome was the modified Rankin Scale (mRS) score at 90-day follow-up. Secondary outcomes included reperfusion (expanded Treatment In Cerebral Infarction [eTICI]), mortality at 90 days, symptomatic intracranial hemorrhage, National Institutes of Health Stroke Scale (NIHSS) score between 24 and 48 h post-EVT, and procedure time. With multivariable regression analyses, we calculated odds ratios (OR) and β-estimates to compare outcomes between the most frequently used stent retrievers, with adjustments for predefined variables. One subgroup analysis focused on the effect of the stent retriever on outcomes in M1 occlusions.</p><p><strong>Results: </strong>Trevo (Stryker) was the most frequently used stent retriever (n = 1541, 70%). Other types were Solitaire (n = 301, 14%) (Medtronic), Embotrap (n = 255, 11%) (Cerenovus; Johnson&Johnson), and Revive (n = 103, 5.2%) (Cerenovus; Johnson&Johnson). There was a slightly, but statistically significant, higher 90-day mRS score (adjusted common [ac]OR: 0.75, 95%CI: 0.57-0.99) and mortality rate (aOR: 1.77, 95%CI: 1.16-2.68) for the Solitaire and longer procedure times for the Revive stent (mean: 67.6 versus 58.9 min; adjusted β-estimate: 11.6, 95%CI: 2.69-20.6) compared to the Trevo retriever. There were no outcome differences in the M1 subgroup analyses.</p><p><strong>Conclusion: </strong>Differences in clinical, technical, and safety outcomes after EVT between the Trevo, Solitaire, Embotrap, and Revive stent retrievers were-although statistically significant-small. Treating physicians should use the stent retriever they are used to, and further studies with more strict patient selection should be conducted to validate these results.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257393","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":"CT-Guided Percutaneous Cryoablation of Small Renal Masses: General Anesthesia Versus Conscious Sedation with Dexmedetomidine.","authors":"Theresa Junker, Nina Stage, Mie Gaedt Thorlund, Benjamin Schnack Brandt Rasmussen, Bo Redder Mussmann, Tommy Kjærgaard Nielsen, Jakob Kjersgaard Johansen, Ole Graumann","doi":"10.1007/s00270-025-04079-7","DOIUrl":"https://doi.org/10.1007/s00270-025-04079-7","url":null,"abstract":"<p><strong>Purpose: </strong>General anesthesia (GA) is often used during CT-guided percutaneous cryoablation (PCA) of renal tumors. This retrospective study compared GA to conscious sedation (CS), with dexmedetomidine and remifentanil, regarding theater time and hospital stay during PCA of renal tumors.</p><p><strong>Materials and methods: </strong>This retrospective study reviewed 350 patients treated with PCA between January 1, 2015, and December 31, 2019. Associations were analyzed between the type of anesthesia and theater time, hospital stay, complications, and clinical outcomes.</p><p><strong>Results: </strong>The cohort consisted of 148 patients who received PCA in GA (mean age 64.7 ± 13.4 years; 99 men) and 202 patients who received PCA in CS (mean age 66.7 ± 10.7 years; 142 men). Patients in the GA group had significantly longer theater times (mean 2.6 h ± 0.48) compared to their CS counterparts (mean 2.1 h ± 0.46; p < 0.001). Furthermore, the median length of hospital stay was significantly longer in the GA group (8.5 vs. 5.5 h, p < 0.001). In addition, patients in the GA group had significantly lower levels of consciousness in the recovery room compared to the CS group (p = 0.047). There were no differences between the groups regarding complications, graded on the CIRSE classification system (p = 0.463), or rate of incomplete ablation at three-month follow-up (p = 0.229).</p><p><strong>Conclusion: </strong>Patients who undergo PCA of renal tumors under CS have significantly shorter theater time and length of hospital stay compared to patients who undergo PCA in GA, with no impact on complications or technical failure rate.</p><p><strong>Level of evidence: </strong>3, a retrospective cohort study.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246633","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 Cholangioscopy-Guided Crossing of Biliary-Enteric Anastomotic Strictures After Failure of Endoscopy and Conventional Percutaneous Techniques.","authors":"Jacopo Tintori, Pierpaolo Biondetti, Gaetano Valerio Davide Amato, Carolina Lanza, Anna Maria Ierardi, Gianpaolo Carrafiello","doi":"10.1007/s00270-025-04082-y","DOIUrl":"https://doi.org/10.1007/s00270-025-04082-y","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233298","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":"Increasing Popularity of Interventional Radiology Among Radiology Residents: Insights from a National Survey.","authors":"Nikolaos-Achilleas Arkoudis, Ornella Moschovaki-Zeiger, Dimitrios Filippiadis, Stavros Spiliopoulos","doi":"10.1007/s00270-025-04095-7","DOIUrl":"https://doi.org/10.1007/s00270-025-04095-7","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233297","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 Electrochemotherapy as a Bridge to Surgery in a Large Hepatocellular Carcinoma with Biliary Invasion and Liver Dysfunction: From Rescue to Cure.","authors":"Claudio Sallemi, Maria Parmigiani, Edoardo Vincenzo Andreani, Massimo Graffeo, Carlotta Ferretti, Marco Garatti","doi":"10.1007/s00270-025-04091-x","DOIUrl":"https://doi.org/10.1007/s00270-025-04091-x","url":null,"abstract":"","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233299","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}