Technical and clinical success analysis of transarterial embolization therapy in type II endoleaks following endovascular aortic repair.

This single-center study investigated the safety and efficacy of transarterial embolization of type II endoleaks for expanding aneurysm sacs following endovascular aortic repair (EVAR).36 patients (33 men, 75.9±6.

Bridging Visual-Spatial Ability and Skill Performance: The Impact of Perceived Quality of a Practical Seminar in Interventional Radiology Education.

Background: Medical education integrates skills training and simulation to prepare students for clinical tasks. A seminar on interventional radiology was restructured to include specific practical training utilizing a 3D-catheter model. We aimed to investigate the complex interplay between student evaluations, their visual-spatial ability and practical performance.

Endovascular therapy in intermittent claudication: Impact of IVUS guidance on treatment decisions.

Conservative therapy is favored over revascularization for patients with peripheral arterial disease (PAD) and intermittent claudication (IC) owing to the better long-term results. The adjunctive use of intravascular ultrasound (IVUS) significantly improves endovascular therapy. However, data on IVUS and IC is scarce.

Ultra-high Versus Standard Resolution Photon-Counting Detector CT Angiography for Imaging of Femoral Stents in a Cadaveric Perfusion Model.

Background And Aims: The aim of this study was to investigate the imaging performance and quality differences of PCD-CT in standard resolution mode (SR) versus ultra-high resolution mode (UHR) in the lower extremity runoff of dose-matched CTAs in a human cadaveric model.

Methods: Extracorporeal perfusion of the upper leg was established in one fresh-frozen human cadaver via inguinal and popliteal accesses using a peristaltic pump. Seven peripheral stents were deployed in the SFA.

Photon-Counting Detector CT Angiography Versus Digital Subtraction Angiography in Patients with Peripheral Arterial Disease.

Rationale And Objectives: This study aims to compare the diagnostic confidence of photon-counting detector CT angiography (PCD-CTA) depending on the used vascular reformatting kernels with digital subtraction angiography (DSA) as diagnostic reference standard in peripheral arterial occlusive disease (PAOD).

Material And Methods: In 39 patients, 45 lower extremity PCD-CTA with subsequent DSA were analyzed. Advanced PAOD (Fontaine stage 4) was ascertained in 77.

Training for endovascular therapy of acute arterial disease and procedure-related complication: An extracorporeally-perfused human cadaver model study.

Purpose: The aim of this study was to evaluate the usability of a recently developed extracorporeally-perfused cadaver model for training the angiographic management of acute arterial diseases and periprocedural complications that may occur during endovascular therapy of the lower extremity arterial runoff.

Materials And Methods: Continuous extracorporeal perfusion was established in three fresh-frozen body donors via inguinal and infragenicular access. Using digital subtraction angiography for guidance, both arterial embolization (e.

An Intra-Individual Comparison of Low-keV Photon-Counting CT versus Energy-Integrating-Detector CT Angiography of the Aorta.

This retrospective study aims to provide an intra-individual comparison of aortic CT angiographies (CTAs) using first-generation photon-counting-detector CT (PCD-CT) and third-generation energy-integrating-detector CT (EID-CT). High-pitch CTAs were performed with both scanners and equal contrast-agent protocols. EID-CT employed automatic tube voltage selection (90/100 kVp) with reference tube current of 434/350 mAs, whereas multi-energy PCD-CT scans were generated with fixed tube voltage (120 kVp), image quality level of 64, and reconstructed as 55 keV monoenergetic images.

Comparison of ultrahigh and standard resolution photon-counting CT angiography of the femoral arteries in a continuously perfused in vitro model.

Background: With the emergence of photon-counting CT, ultrahigh-resolution (UHR) imaging can be performed without dose penalty. This study aims to directly compare the image quality of UHR and standard resolution (SR) scan mode in femoral artery angiographies.

Methods: After establishing continuous extracorporeal perfusion in four fresh-frozen cadaveric specimens, photon-counting CT angiographies were performed with a radiation dose of 5 mGy and tube voltage of 120 kV in both SR and UHR mode.

Pancreatic Ischemia-Reperfusion Injury Following Endovascular Treatment of Symptomatic Celiac and Superior Mesenteric Artery Stenosis.

With endovascular therapy becoming the first-line treatment for symptomatic chronic mesenteric ischemia, acute pancreatitis within the context of abdominal ischemia-reperfusion injury may be seen more often in cross-sectional imaging following this kind of interventions and should therefore be kept in mind by the reading physician.

Photon-Counting Detector CT for Femoral Stent Imaging in an Extracorporeally Perfused Human Cadaveric Model.

Background And Aims: This study aims to compare the performance of first-generation dual-source photon-counting detector computed tomography (PCD-CT) to third-generation dual-source energy-integrating detector (EID-CT) regarding stent imaging in the femoral arterial runoff.

Methods: Continuous extracorporeal perfusion was established in 1 human cadaver using an inguinal and infragenicular access and peristaltic pump. Seven peripheral stents were implanted into both superior femoral arteries by means of percutaneous angioplasty.

Standardized assessment of vascular reconstruction kernels in photon-counting CT angiographies of the leg using a continuous extracorporeal perfusion model.

This study evaluated the influence of different vascular reconstruction kernels on the image quality of CT angiographies of the lower extremity runoff using a 1st-generation photon-counting-detector CT (PCD-CT) compared with dose-matched examinations on a 3rd-generation energy-integrating-detector CT (EID-CT). Inducing continuous extracorporeal perfusion in a human cadaveric model, we performed CT angiographies of eight upper leg arterial runoffs with radiation dose-equivalent 120 kVp acquisition protocols (CTDI 5 mGy). Reconstructions were executed with different vascular kernels, matching the individual modulation transfer functions between scanners.

Bilateral inferior petrosal sinus sampling: Procedural data from a German single-center study.

Purpose: To assess radiation exposure and diagnostic performance of bilateral inferior petrosal sinus sampling for the distinction of pituitary and ectopic adrenocorticotropin-dependent Cushing's syndrome.

Materials And Methods: Procedural data of bilateral inferior petrosal sinus procedures were retrospectively evaluated. The analysis included the patients' clinical and demographic data, procedural radiation exposure, and complication rates, sampling results, clinical course of the patients, and calculation of diagnostic performance data.

Continuous extracorporeal femoral perfusion model for intravascular ultrasound, computed tomography and digital subtraction angiography.

Objectives: We developed a novel human cadaveric perfusion model with continuous extracorporeal femoral perfusion suitable for performing intra-individual comparison studies, training of interventional procedures and preclinical testing of endovascular devices. Objective of this study was to introduce the techniques and evaluate the feasibility for realistic computed tomography angiography (CTA), digital subtraction angiography (DSA) including vascular interventions, and intravascular ultrasound (IVUS).

Methods: The establishment of the extracorporeal perfusion was attempted using one formalin-fixed and five fresh-frozen human cadavers.

Malignant obstruction of the inferior vena cava: clinical experience with the self-expanding Sinus-XL stent system.

Purpose: To evaluate the technical and clinical outcome of Sinus-XL stent placement in patients with malignant obstruction syndrome of the inferior vena cava.

Methods: Between October 2010 and January 2021, 21 patients with different malignant primary disease causing inferior vena cava obstruction were treated with Sinus-XL stent implantation. Procedural data, technical and clinical outcome parameters were retrospectively analyzed.

2D-perfusion angiography for intra-procedural endovascular treatment response assessment in chronic mesenteric ischemia: a feasibility study.

Background: Endovascular revascularization has become the first-line treatment of chronic mesenteric ischemia (CMI). The qualitative visual analysis of digital subtraction angiography (DSA) is dependent on observer experience and prone to interpretation errors. We evaluate the feasibility of 2D-Perfusion Angiography (2D-PA) for objective, quantitative treatment response assessment in CMI.

Percutaneous implantation of peripherally inserted totally implantable venous access systems in the forearm in adolescent patients.

Background: Children with different underlying malignant diseases require long-term central venous access. As for port systems in a pectoral position, peripherally implanted port systems in the forearm revealed high levels of technical and clinical success in adult cohorts.

Objective: To investigate the technical and clinical outcomes of percutaneous central venous port implantation in the forearm in adolescents.

Color-coded summation images for the evaluation of blood flow in endovascular aortic dissection fenestration.

Background: To analyze the benefit of color-coded summation images in the assessment of target lumen perfusion in patients with aortic dissection and malperfusion syndrome before and after fluoroscopy-guided aortic fenestration.

Methods: Between December 2011 and April 2020 25 patients with Stanford type A (n = 13) or type B dissection (n = 12) and malperfusion syndromes were treated with fluoroscopy-guided fenestration of the dissection flap using a re-entry catheter. The procedure was technically successful in 100% of the cases and included additional iliofemoral stent implantation in four patients.

Percutaneous transrenal ureteral plug embolization: is there a need for tissue adhesives?

Purpose: We aimed to evaluate the feasibility, effectiveness and safety of ureteral embolization exclusively using Amplatzer Vascular Plugs (AVPs) in the management of ureteral leakages.

Methods: A retrospective analysis of 7 patients with ureteral leakages and fistulas having undergone transrenal ureteral embolization with AVPs was performed. In all cases, AVPs were deployed via a preexisting percutaneous transrenal nephrostomy tube.

Reduction of Radiation Exposure in Adrenal Vein Sampling: Impact of the Rapid Cortisol Assay.

Purpose:  To determine radiation exposure associated with adrenal vein sampling and its reduction by implementing the rapid cortisol assay and modification of the sampling protocol.

Materials And Methods:  A single-center retrospective study of adrenal vein sampling performed between August 2009 and March 2020 revealed data from 151 procedures. Three subgroups were determined.

A novel double clip-based vascular closure device in antegrade and retrograde femoral punctures: A single-center experience in peripheral non-cardiac procedures.

Background: This retrospective study investigates the efficacy and safety of the novel Celt ACD vascular closure device (VCD) following antegrade and retrograde common femoral artery (CFA) punctures for the treatment of peripheral artery disease in a challenging patient collective (e.g. calcifications, obesity, and anticoagulation).

Color-coded summation images in the evaluation of renal artery stenosis before and after percutaneous transluminal angioplasty.

Background: Endovascular therapy is the gold standard in patients with hemodynamic relevant renal artery stenosis (RAS) resistant to medical therapy. The severity grading of the stenosis as well as the result assessment after endovascular approach is predominantly based on visible estimations of the anatomic appearance. We aim to investigate the application of color-coded DSA parameters to gain hemodynamic information during endovascular renal artery interventions and for the assessment of the procedures´ technical success.

Endovascular therapy of arterioureteral fistulas.

: Arterioureteral fistulas (AUFs) are severe pathologies of different origin and with increasing incidence frequently appear in patients with underlying extensive malignancy and after pelvic surgery. AUF therapy is challenging since symptoms are frequently non-specific and patients are often unsuitable surgical candidates due to comorbidities. Since experiences with endovascular treatment strategies are limited, the feasibility, effectiveness, and safety were evaluated in a consecutive case series.