High-Flow Arteriovenous Malformations: Treatment Using a Venous Approach.

High-flow arteriovenous malformations (AVMs) are among the rarest and most recalcitrant lesions in medicine. Patients with these anomalies are best managed longitudinally in tertiary referral centers by dedicated multidisciplinary teams that include surgeons, dermatologists, hematologists, geneticists, and interventional radiologists. A significant percentage of these lesions cannot be cured per se and intervention can worsen symptoms or preclude effective future embolization.

A novel conformable embolic for selective transarterial embolization of acute hemorrhages: a technical note.

Background: Obsidio conformable embolic (OCE, Boston Scientific, MA) is a novel, radiopaque and conformable embolic. The purpose of this report is to describe its use for treatment of acute intra-abdominal hemorrhages.

Methods And Results: Three patients presented with acute hemorrhage and were treated with OCE, including post-paracentesis hemorrhage, penetrating trauma to the liver, and blunt trauma in the spleen.

Survival Outcomes of Radiofrequency Ablation for Intrahepatic Cholangiocarcinoma from the SEER Database: Comparison with Radiotherapy and Resection.

Purpose: To determine effectiveness of radiofrequency ablation for treatment of intrahepatic cholangiocarcinoma (iCCA) using a population-based database.

Materials And Methods: Data was extracted from Surveillance, Epidemiology, and End Results database from 2000 to 2020 to include 194 patients who underwent ablation for iCCA. Patient demographics, overall survival (OS), and cancer-specific survival (CSS) were retrieved.

Recurrent thrombosis and patency of the arteriovenous access in patients receiving hemodialysis.

Background: Thrombosis of the vascular access in patients with end-stage renal disease requiring hemodialysis are common and require timely interventional procedures to restore patency. The aim of the current study was to identify factors having a significant effect on patency rates after access thrombosis. Our hypothesis was the length of time between the initial clotting of the access and the subsequent percutaneous declotting impacts the patency rates of the vascular access.

Vascular Plugs Improve Pulmonary Arteriovenous Malformation Occlusion over Coil Embolization Alone: A Proof-of-Concept Study Using Dual-Energy CT.

Purpose: To evaluate effectiveness of pulmonary arteriovenous malformation (PAVM) embolization using dual-energy computed tomography (CT) and spectral curve analysis by characterizing contrast enhancement and vascular perfusion as a surrogate of the degree of vascular occlusion after embolotherapy.

Materials And Methods: Nine consecutive adult patients underwent embolization for 21 PAVMs (size range, 0.4-2.

Early Infantile Diagnosis of Hereditary Hemorrhagic Telangiectasia Complicated by Child Abuse.

We report a rare case of hereditary hemorrhagic telangiectasia (HHT) in a 4-month-old female infant with findings of child abuse. She presented with poor feeding, vomiting, and irritability after a short fall from the bed. Initial evaluation found subdural hematomas, persistent hypoxia, failure to thrive, a frenulum tear, facial lacerations, and bruising.

Twenty years of embolization for acute lower gastrointestinal bleeding: a meta-analysis of rebleeding and ischaemia rates.

Background: Transarterial embolization (TAE) for acute lower gastrointestinal bleeding (LGIB) can be technically challenging due to the compromise between achieving haemostasis and causing tissue ischaemia. The goal of the present study is to determine its technical success, rebleeding, and post-embolization ischaemia rates through meta-analysis of published literature in the last twenty years.

Methods: PubMed, Embase, and Cochrane Library databases were queried.

Transarterial interventions in civilian gunshot wound injury: experience from a level-1 trauma center.

Purpose: To assess the effectiveness of trans-arterial vascular interventions in treatment of civilian gunshot wounds (GSW).

Materials And Methods: A retrospective review was performed at a level-1 trauma center to include 46 consecutive adults admitted due to GSW related hemorrhage and treated with endovascular interventions from July 2018 to July 2022. Patient demographics and procedural metrics were retrieved.

Preliminary Experience with a Low-Profile High-Density Braid Occluder for Transcatheter Embolization of Pulmonary Arteriovenous Malformations.

This brief report describes safety, technical feasibility, and early treatment effectiveness of the low-profile braided occluder (LOBO; Okami Medical, San Diego, Caliornia) for embolization of 9 pulmonary arteriovenous malformations (PAVMs) in 4 patients (3 female and 1 male; age range: 33 to 63 years; 3 patients showed positive results for hereditary hemorrhagic telangiectasia genes). A total of 10 occluders were deployed in 10 vessels (median treated vessel diameters, 3 and 4 mm for LOBO-3 and LOBO-5 groups, respectively). All devices were successfully deployed into the feeder pulmonary arteries, achieving complete cessation of flow.

A Review of Professional Liability in IR: Sweeping the Mines.

Medical professional liability (MPL) is becoming a substantial issue in interventional radiology (IR), with both impact on health care costs and negative psychological effects on physicians. MPL presents special challenges within IR because of the field's complex and innovative therapies that are provided to a diverse group of patients and complicated by the off-label use of devices and drugs that is pervasive in the field. This review discusses the principles and practices to avoid and manage MPLs that are specific to the field of IR.

Impact of Portal Hypertension on Adverse Events after Splenic Arterial Aneurysm Embolization.

Purpose: To evaluate the outcomes of splenic artery aneurysm (SAA) embolization and compare adverse event (AE) rates after embolization in patients with and without portal hypertension (PHTN).

Materials And Methods: A retrospective review of all patients who underwent embolization of SAAs at 2 institutions was performed (34 patients from institution 1 and 7 patients from institution 2). Baseline demographic characteristics, preprocedural imaging, procedural techniques, and postprocedural outcomes were evaluated.

Inferior Vena Cava Filter Litigation Review: An Analysis of Medicolegal Cases Pertaining to Inferior Vena Cava Filters.

Purpose: To identify and analyze all medical malpractice and product liability lawsuits pertaining to inferior vena cava (IVC) filters published within a well-recognized legal research database.

Materials And Methods: LexisNexis, a legal research database, was used to retrieve cases that mentioned harm from IVC filters, or lack thereof, as the cause for legal action. A total of 672 cases were analyzed for type of case (medical malpractice or product liability), filter model implanted, filter complications, court decisions, and settlement payments if any.

Outcomes of bellwether cases related to inferior vena cava filters in multidistrict litigations.

Objective: In the present study, we identified and reviewed the outcomes of bellwether cases related to inferior vena cava (IVC) filter multidistrict litigations (MDLs).

Methods: The legal research database, LexisNexis (New York, NY), was used to identify all cases related to IVC filters. Cases unrelated to the MDLs were excluded.

Real-time arteriography-directed percutaneous microwave ablation for small or poorly characterized hepatic lesions using hybrid Angio-CT.

Purpose: To report the utility of real-time arteriography-directed percutaneous MWA (rad-pMWA) in a hybrid angiography-computed tomography (Angio-CT) suite to treat small or inconspicuous hepatic tumors on non-contrast CT.

Method: This single-center retrospective cohort included 15 consecutive patients who underwent rad-pMWA (6 HCC, 4 mCRC, 4 NET, and 1 cholangiocarcinoma). The median longest axial diameter of treated tumors was 1.

Concomitant Lower-Extremity Deep Vein Thrombosis in Patients With Pulmonary Embolism Undergoing Catheter-Directed Therapy.

Deep vein thrombosis (DVT) is often seen in patients with acute pulmonary embolism (PE). Risk stratification of PE patients is useful in predicting mortality risk and hospital course. However, rates or predictors of DVT or proximal DVT (popliteal, femoral, common femoral, or iliac thrombosis) have not been studied in the highest-risk patients who receive catheter-directed therapy (CDT) for their PE.