The pandemic and changes in early career researchers' career prospects, research and publishing practices.

Introduction: As part of the Harbnger-2 project, this study aimed to discover the impact of the COVID-19 pandemic on junior researchers' work-life, career prospects, research and publishing practices and networking.

Methods: An online international survey of 800 early career researchers (ECRs) was conducted in 2022. A questionnaire was developed based on three rounds of interviews and distributed using multiple channels including publishers, social media, and direct email to ECRs.

Massive pulmonary embolism in patients with extreme bleeding risk: a case series on the successful use of ultrasound-assisted, catheter directed thrombolysis in a district general hospital.

Massive pulmonary embolism (PE), characterised by profound arterial hypotension, is a life-threatening emergency with a 90-day mortality of over 50%. Systemic thrombolysis can significantly reduce the risk of death or cardiovascular collapse in these patients, by around 50%, but these benefits are offset by a fivefold increased risk of intracranial haemorrhage and major bleeding, which may limit its use in patients at high risk of catastrophic haemorrhage. We describe a case series of 3 patients presenting with massive PE, each with extreme risk of bleeding and contra-indication to systemic thrombolysis, treated successfully with ultrasound-assisted, catheter directed thrombolysis (U-ACDT).

Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised, sham-controlled, proof-of-concept trial.

Background: Previous randomised renal denervation studies did not show consistent efficacy in reducing blood pressure. The objective of our study was to evaluate the effect of renal denervation on blood pressure in the absence of antihypertensive medications.

Methods: SPYRAL HTN-OFF MED was a multicentre, international, single-blind, randomised, sham-controlled, proof-of-concept trial.

Sorafenib in combination with transarterial chemoembolisation in patients with unresectable hepatocellular carcinoma (TACE 2): a randomised placebo-controlled, double-blind, phase 3 trial.

Background: Transarterial chemoembolisation (TACE) is the standard of care for patients with intermediate stage hepatocellular carcinoma, while the multikinase inhibitor sorafenib improves survival in patients with advanced disease. We aimed to determine whether TACE with sorafenib improves progression-free survival versus TACE with placebo.

Methods: We did a multicentre, randomised, placebo-controlled, phase 3 trial (TACE 2) in 20 hospitals in the UK for patients with unresectable, liver-confined hepatocellular carcinoma.

Amplatzer Vascular Plug 4 Insertion for the Treatment of a Left Subclavian Artery Pseudoaneurysm.

We report the case of a 74-year-old male with an incidental finding of a pseudoaneurysm at the base of his neck arising from the left subclavian artery. Initial treatment with ultrasound-guided thrombin injection was unfortunately unsuccessful with early recanalization. An Amplatzer Vascular Plug 4 device was introduced into the neck of the pseudoaneurysm endovascularly with successful thrombosis and occlusion of the pseudoaneurysm.

Lone Stent-Graft Treatment of Symptomatic Gluteal Artery Aneurysm.

We report the case of a large superior gluteal artery aneurysm treated with covered stent-graft insertion. Exclusion of the aneurysm was achieved, with resolution of symptoms and shrinkage of the sac, without the need for embolization.

Transcatheter treatment of hepatocellular carcinoma with Doxorubicin-loaded DC Bead (DEBDOX): technical recommendations.

Tranarterial chemoembolization (TACE) has been established by a meta-analysis of randomized controlled trials as the standard of care for nonsurgical patients with large or multinodular noninvasive hepatocellular carcinoma (HCC) isolated to the liver and with preserved liver function. Although conventional TACE with administration of an anticancer-in-oil emulsion followed by embolic agents has been the most popular technique, the introduction of embolic drug-eluting beads has provided an alternative to lipiodol-based regimens. Experimental studies have shown that TACE with drug-eluting beads has a safe pharmacokinetic profile and results in effective tumor killing in animal models.

Liver, gastrointestinal, and cardiac toxicity in intermediate hepatocellular carcinoma treated with PRECISION TACE with drug-eluting beads: results from the PRECISION V randomized trial.

Objective: The purpose of our study was to evaluate hepatic, gastrointestinal, and cardiac toxicity after PRECISION transarterial chemoembolization (TACE) with drug-eluting beads (DEB) versus conventional TACE with doxorubicin in the treatment of intermediate-stage hepatocellular carcinoma (HCC).

Subjects And Methods: Two hundred twelve patients (185 men and 27 women; mean age, 67 years) were randomized to TACE with DEB or conventional TACE. The majority of patients (67% in both groups) presented in a more advanced stage.

Pre-uterine artery embolization MRI: beyond fibroids.

Uterine leiomyomata, or fibroids, although benign, cause debilitating symptoms in many women. Symptoms are often nonspecific and may be the presenting complaint in a number of other conditions. Furthermore, because the presence of fibroids may be coincident with other symptomatic conditions that result in similar complaints, there may be diagnostic difficulty and consequent difficulty in planning therapeutic strategy.

Transhepatic assisted transoral placement of a duodenal stent in malignant gastric outlet obstruction.

Gastric outlet obstruction is a well- recognized complication of locally advanced carcinoma of the head of the pancreas. The authors report a transoral placement of a duodenal stent over a percutaneous guide wire, inserted retrogradely through a transhepatic approach via the ampulla of Vater, in a patient in whom traditional stent placement was technically not possible. This technique allows safe duodenal stent placement for different malignant gastric outlet obstruction such as pancreatic, gastric, duodenal, and metastases to the peripancreatic region.

Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study.

Transcatheter arterial chemoembolization (TACE) offers a survival benefit to patients with intermediate hepatocellular carcinoma (HCC). A widely accepted TACE regimen includes administration of doxorubicin-oil emulsion followed by gelatine sponge-conventional TACE. Recently, a drug-eluting bead (DC Bead) has been developed to enhance tumor drug delivery and reduce systemic availability.

Endovascular stenting to treat obstruction of the superior vena cava.

This article discusses the use of image guided endovascular stenting to treat obstruction of the superior vena cava

Radiofrequency ablation of renal tumors.

Development of cross-sectional imaging has led to a significant increase in diagnosis of small renal tumors. Nephron-sparing surgery has proven to be effective in the management of these small tumors. Could radiofrequency ablation be as effective in the management of these patients, after showing promising results in a selected group of patients? In this article we discuss the principles of radiofrequency ablation and present results in a selected group of patients.

Diagnostic imaging of carcinoid metastases to the abdomen and pelvis.

Background: Functional and anatomical imaging methods are currently the standard approach to the evaluation of carcinoid tumor extent. Due to the nature of carcinoid tumors ,there is not a single imaging procedure that is sufficient to detect the malignancy. The aim of the study was to compare the value of CT, MR and functional imaging study with(111) In-Octreotide (SRS) in carcinoid detection and evaluation of its extent as well as to work out the imaging studies diagnostic algorithm that could enhance diagnostic efficacy.

Percutaneous transhepatic use of a cutting balloon in the treatment of a benign common bile duct stricture.

Benign biliary strictures (BBS) are difficult to treat. The majority of them are treated either endoscopically or using percutaneous techniques either with stents or conventional angioplasty balloons. To our knowledge we present the first case of use of a cutting balloon in the treatment of BBS through a percutaneous approach.

Large-volume liver metastases from neuroendocrine tumors: hepatic intraarterial 90Y-DOTA-lanreotide as effective palliative therapy.

Purpose: To prospectively evaluate the safety and effectiveness of hepatic intraarterial injection of yttrium 90 ((90)Y) tetraazacyclododecane tetraacetic acid (DOTA) lanreotide as a treatment for patients with progressive large-volume somatostatin receptor-positive liver metastases from neuroendocrine tumors.

Materials And Methods: The study was local ethics committee approved, and all patients gave informed consent. Twenty-three patients (13 men, 10 women; age range, 21-69 years; median age, 57 years) with histologically proved large-volume liver metastases from neuroendocrine cancers were treated.

Bleeding ectopic varices--treatment with transjugular intrahepatic porto-systemic shunt (TIPS) and embolisation.

Background/aims: Bleeding ectopic varices due to cirrhosis can be difficult to manage. We report our experience of uncontrolled bleeding from ectopic varices treated with transjugular intrahepatic porto-systemic shunt (TIPS).

Methods: We selected the 21 cirrhotics who underwent TIPS for bleeding ectopic varices from our database: Child-Pugh grade A (2), B (11) and C (8).

Liver transplantation in cirrhotic patients with small hepatocellular carcinoma: an analysis of pre-operative imaging, explant histology and prognostic histologic indicators.

Background: In recent years, liver transplantation in patients with hepatocellular cancers and cirrhosis has been restricted to those with small cancers (<5 cm for solitary and <3 cm for multifocal HCC with <3 nodules). The selection of patients for liver transplantation is based on pre-operative imaging. The accuracy of imaging correlated with explant histology and the effect of tumour stage has not been evaluated in this selected population.

Transjugular kidney biopsy.

Background: Most previous studies demonstrating the feasibility of transjugular kidney biopsy have used a modified Colapinto aspiration biopsy needle. We present 25 high-risk patients, with contraindications to percutaneous renal biopsy, who underwent transjugular kidney biopsy using a transvenous side-cut needle. This technique is easier to learn and can be performed by an interventional radiologist with transjugular liver biopsy experience and equipment.

TIPS for acute and chronic Budd-Chiari syndrome: a single-centre experience.

Background/aims: Transjugular intrahepatic portosystemic shunt (TIPS) is a technically challenging but feasible treatment for Budd-Chiari syndrome (BCS). However, information about the outcome, particularly in patients with liver failure, is scarce. We report our experience of TIPS for BCS.