Feasibility and safety of ADAPT in acute distal posterior cerebral artery occlusions.

Purpose: The direct aspiration first pass technique (ADAPT) is an effective and safe endovascular treatment for distal medium vessel occlusions (DMVO) of the anterior circulation. Clinical experience with ADAPT in the distal posterior circulation, however, is still limited and published data is scarce. In this original work, feasibility, safety and efficacy of ADAPT with distal access catheters (DAC) for treatment of acute distal posterior cerebral artery occlusions (DPCAOs) is evaluated.

Single-energy versus dual-energy imaging during CT-guided biopsy using dedicated metal artifact reduction algorithm in an in vivo pig model.

Purpose: To evaluate dual-energy CT (DE) and dedicated metal artifact reduction algorithms (iMAR) during CT-guided biopsy in comparison to single-energy CT (SE).

Methods: A trocar was placed in the liver of six pigs. CT acquisitions were performed with SE and dose equivalent DE at four dose levels(1.

Back to the Future: Lipiodol in Lymphography-From Diagnostics to Theranostics.

Lipiodol is an iodinated poppy seed oil first synthesized in 1901. Originally developed for therapeutic purposes, it has mainly become a diagnostic contrast medium since the 1920s. At the end of the 20th century, Lipiodol underwent a transition back to a therapeutic agent, as exemplified by its increasing use in lymphangiography and lymphatic interventions.

Semi-automated computed tomography Volumetry can predict hemihepatectomy specimens' volumes in patients with hepatic malignancy.

Background: One of the major causes of perioperative mortality of patients undergoing major hepatic resections is post-hepatectomy liver failure (PHLF). For preoperative appraisal of the risk of PHLF it is important to accurately predict resectate volume and future liver remnant volume (FLRV). The objective of our study is to prospectively evaluate the accuracy of hemihepatectomy resectate volumes that are determined by computed tomography volumetry (CTV) when compared with intraoperatively measured volumes and weights as gold standard in patients undergoing hemihepatectomy.

Radiation Exposure During Uterine Fibroid Embolization (UFE): A Confounder-Controlled Comparison Between a State-of-the-Art Angiography Unit and a Conventional Angiography unit.

Purpose: To compare radiation exposure of a state-of-the-art and a conventional angiography unit in patients undergoing uterine fibroid embolization (UFE).

Materials And Methods: Between January 2009 and December 2016, 286 patients underwent UFE in our Interdisciplinary Fibroid Center. The inclusion criteria for this retrospective analysis were first-time transarterial embolization for symptomatic fibroids, bilateral embolization, procedures applying a state-of-the-art (Group 1) or a conventional angiography unit (Group 2), and bilateral technical success with an adequate embolization endpoint after the injection of microspheres.

Treatment Failure After Image-Guided Percutaneous Radiofrequency Ablation (RFA) of Renal Tumors - A Systematic Review with Description of Type, Frequency, Risk Factors and Management.

 Radiofrequency ablation (RFA) is an established treatment for small renal tumors. The objective of this review is to systematically assess the type, frequency, risk factors and management of treatment failure after image-guided percutaneous RFA of renal tumors.  10 studies (967 patients, 1033 tumors) with a mean/median follow-up of ≥ 30 months were systematically identified and analyzed.

Evaluation of the plasmatic and parenchymal elution kinetics of two different irinotecan-loaded drug-eluting embolics in a pig model.

Purpose: To evaluate and compare irinotecan elution kinetics of two drug-eluting embolic agents in a porcine model.

Materials And Methods: Embolization of the left liver lobe was performed in 16 domestic pigs, with groups of two receiving 1 mL of DC Bead M1 (70-150 µm) or Embozene TANDEM (75 µm) loaded with 50 mg irinotecan. Irinotecan plasma levels were measured at 0, 10, 20, 30, 60, 120, 180, and 240 minutes after completed embolization and at the time of euthanasia (24 h, 48 h, 72 h, or 7 d).

Accuracy of estimation of graft size for living-related liver transplantation: first results of a semi-automated interactive software for CT-volumetry.

Objectives: To evaluate accuracy of estimated graft size for living-related liver transplantation using a semi-automated interactive software for CT-volumetry.

Materials And Methods: Sixteen donors for living-related liver transplantation (11 male; mean age: 38.2±9.

Hepatic artery stent-grafts for the emergency treatment of acute bleeding.

Purpose: We evaluated the technical success and clinical efficacy of stent-graft implantation for the emergency management of acute hepatic artery bleeding.

Methods: Between January 2010 and July 2013, 24 patients with hemorrhage from the hepatic artery were scheduled for emergency implantation of balloon expandable stent-grafts. The primary study endpoints were technical and clinical success, which were defined as successful stent-graft implantation with sealing of the bleeding site at the end of the procedure, and cessation of clinical signs of hemorrhage.

Emergency embolization for the treatment of acute hemorrhage from intercostal arteries.

To evaluate embolotherapy for the emergency management of acute bleeding from intercostal arteries. Between October 2003 and August 2012, 19 consecutive patients with hemorrhage from intercostal arteries were scheduled for emergency embolization. The primary study endpoints were technical and clinical success, which were defined as angiographic cessation of bleeding, and cessation of clinical signs of hemorrhage.

Therapeutic lymphangiography and CT-guided sclerotherapy for the treatment of refractory lymphatic leakage.

Purpose: To evaluate therapeutic lymphangiography and computed tomography (CT)-guided sclerotherapy for the treatment of refractory inguinal, pelvic, abdominal, and thoracic lymphatic leakage.

Materials And Methods: Between January 2008 and April 2011, 18 patients with refractory lymphatic leakage were treated with therapeutic lymphangiography. Additionally, 10 of these 18 patients underwent CT-guided sclerotherapy with injection of ethanol at the site of the leakage.

Efficacy and safety of percutaneous microwave coagulation therapy followed by I seed brachytherapy for VX2 hepatic tumors in a rabbit model.

The aim of this study was to evaluate the efficacy and safety of percutaneous microwave coagulation therapy (PMCT) followed by I seed brachytherapy for VX2 liver cancer in rabbits. Eighty New Zealand rabbits were injected with suspensions of VX2 tumor cells to create an animal model. The rabbits were randomly divided into 4 groups (n=20); the control, PMCT, I seed brachytherapy and combination groups.

Microwave ablation in porcine livers applying 5-minute protocols: influence of deployed energy on extent and shape of coagulation.

Purpose: To evaluate the influence of deployed energy on extent and shape of microwave (MW)-induced coagulation in porcine livers applying 5-minute protocols.

Materials And Methods: MW ablations (n = 25) were performed in ex vivo porcine livers (n = 8). Ablation time was 5 minutes.

Multimodal visibility of a modified polyzene-F-coated spherical embolic agent for liver embolization: feasibility study in a porcine model.

Purpose: To evaluate multimodal visibility of modified currently available microspheres on radiography, magnetic resonance (MR) imaging, and computed tomography (CT) in a porcine liver model.

Materials And Methods: Livers of four pigs were embolized with two sizes (100 μm ± 25 and 700 μm ± 50) of modified Embozene Microspheres embedded with different densities of barium sulfate and iodine as radiopaque materials (intensity groups A-C, with increasing intensity from A to C for 100 μm and intensities A and C for 700 μm) and iron oxide as magnetic substance for MR imaging visibility. Pigs embolized with currently available Embozene Microspheres served as control groups.

Superselective embolization for the management of postpancreatectomy hemorrhage: a single-center experience in 25 patients.

Purpose: To evaluate the efficacy of superselective embolization in patients with late postpancreatectomy hemorrhage (PPH).

Materials And Methods: Between January 2002 and July 2010, 25 patients (19 men) with suspected late PPH (> 24 hours after the operation) were evaluated. The primary study endpoint was technical success, defined as complete angiographic occlusion of the site of hemorrhage.

The use of balloon-expandable stent grafts for the management of acute arterial bleeding.

Purpose: To evaluate the efficacy and safety of balloon-expandable stent grafts in the emergency treatment of acute arterial hemorrhage.

Materials And Methods: Between July 2008 and December 2009, 15 patients with acute arterial hemorrhage from inflammatory vessel erosion or pseudoaneurysms (n = 9), noninflammatory pseudoaneurysms (n = 3), or iatrogenic vessel injury (n = 3) were treated with emergency stent graft implants. The primary study endpoints to determine treatment efficacy and safety were survival, complication rates, and freedom from recurrent hemorrhaging or reintervention.

Risk factors and clinical management of haemorrhage after open nephron-sparing surgery.

Objective: To identify risk factors for relevant haemorrhage after open nephron-sparing surgery (NSS) for renal cell carcinoma, and to evaluate its clinical management.

Patients And Methods: We evaluated bleeding complications after open NSS in 196 consecutive cases (193 patients) at our institution. The median (range) age of the patients was 64 (3-91) years and the tumour diameter was 2.

Immunohistochemical characterization of specific inflammatory tissue reactions following embolization with four different spherical agents in the minipig kidney model.

Purpose: To evaluate the immunohistochemical inflammatory reaction after porcine renal embolization with the new spherical embolic agent Embozene and to compare it with other spherical embolic agents.

Materials And Methods: After superselective porcine renal embolization (40 pigs) with different sizes of embolic agents (Embozene, Embosphere, Bead Block, Contour SE), tissue arrays were obtained (size ranges, 40-120 microm, 100-300 microm, 500-700 microm, 700-900 microm). After immunostaining for CD subtyping (CD45 and CD68) and cytokines (C-reactive protein [CRP] and interleukin-1 beta), a semiquantitative immunoreactivity score was calculated for each marker: intensity of staining was scored between 0 (negative) and 3 (intensive) and extent of staining between 0 and 4 (>80%), indicating the percentage of positive staining.

Experimental liver embolization with four different spherical embolic materials: impact on inflammatory tissue and foreign body reaction.

We sought to describe and compare material specific inflammatory and foreign body reactions after porcine liver embolization with spherical embolic agents. In 40 animals, superselective liver embolization was performed with four different spherical embolic agents of various sizes: 40-120 microm (Embozene, Embosphere), and 100-300 microm, 500-700 microm, and 700-900 microm (Embozene, Embosphere, Bead Block, and Contour SE, respectively). After 4 or 12 weeks, inflammatory reactions were evaluated microscopically according to the Banff 97 classification.

Acute increase in hepatic arterial flow during TIPS identified by intravascular flow measurements.

The purpose of this study was to investigate alterations of hepatic arterial flow during transjugular intrahepatic portosystemic stent shunt (TIPS) applying intravascular Doppler sonography. This prospective monocenter study included 25 patients with liver cirrhosis (alcohol induced [n = 19], chronic hepatitis associated [n = 3], primary biliary cirrhosis associated [n = 1], and cryptogenic [n = 2]) successfully treated with TIPS. All patients underwent intravascular hepatic arterial flow measurements during TIPS using an endoluminal flow sensor.

Reduction of late in-stent stenosis in a porcine coronary artery model by cobalt chromium stents with a nanocoat of polyphosphazene (Polyzene-F).

The purpose of this study was to investigate the potential of nanoscale coating with the highly biocompatible polymer Polyzene-F (PZF), in combination with cobalt chromium and stainless steel stents, to reduce in-stent stenosis, thrombogenicity, and vessel wall injury and inflammation. One bare cobalt chromium, PZF-nanocoated stainless steel or PZF-nanocoated cobalt chromium stent was implanted in right coronary artery of 30 mini-pigs (4- or 12-week follow-up). Primary study end points were in-stent stenosis and thrombogenicity.

Inflammation and recanalization of four different spherical embolization agents in the porcine kidney model.

Purpose: To evaluate the pattern of recanalization and specific inflammatory reaction after superselective embolization with four commercially available spherical embolic agents of different sizes in the mini pig kidney model.

Materials And Methods: In 40 mini pigs, the lower poles of both kidneys were superselectively embolized with Embozene, Embosphere, Bead Block, and Contour SE particles in sizes of 40-120 mircom (Embozene, Embosphere) and 100-300 microm, 500-700 microm, and 700-900 microm (Embozene, Embosphere, Bead Block, Contour SE). After a follow-up time of 4 or 12 weeks, recanalization was determined with angiography.

Acute liver failure after a late TIPSS revision.

We report a rare case of late transjugular intrahepatic portosystemic stent shunt (TIPSS) occlusion due to progressive stent protrusion into the periportal liver parenchyma, which was a result of delayed liver shrinkage 2 years after TIPSS. The initial TIPSS procedure had been carried out in a 52-year-old man as a bridge for liver transplantation because of post-alcoholic liver cirrhosis. We describe the applied TIPSS recanalization and revision technique.