ACR-ABS-ACNM-ASTRO-SIR-SNMMI practice parameter for selective internal radiation therapy or radioembolization for treatment of liver malignancies.

Purpose: The American College of Radiology (ACR), American Brachytherapy Society (ABS), American College of Nuclear Medicine (ACNM), American Society for Radiation Oncology (ASTRO), Society of Interventional Radiology (SIR), and Society of Nuclear Medicine and Molecular Imaging (SNMMI) have jointly developed a practice parameter on selective internal radiation therapy (SIRT) or radioembolization for treatment of liver malignancies. Radioembolization is the embolization of the hepatic arterial supply of hepatic primary tumors or metastases with a microsphere yttrium-90 brachytherapy device.

Materials And Methods: The ACR -ABS -ACNM -ASTRO -SIR -SNMMI practice parameter for SIRT or radioembolization for treatment of liver malignancies was revised in accordance with the process described on the ACR website (https://www.

Management of life-threatening hemoperitoneum with minimally invasive percutaneous superselective arterial embolization.

The management of spontaneous hemoperitoneum centers on clinical suspicion, fluid resuscitation, appropriate early imaging, and therapeutic intervention. Traditionally, explorative laparotomy has been the treatment of choice for idiopathic spontaneous intraabdominal hemorrhage, but as less invasive percutaneous techniques have matured, superselective arterial embolization may play a critical role in emergent treatment. This case report describes a 65-year-old woman with large-volume hemoperitoneum.

Gastric bleeding in giant cell arteritis.

Giant cell arteritis (GCA) is a systemic vasculitis that classically affects large- and medium-sized vessels in the head and neck but can also manifest extracranially. We report the case of an elderly man who presented with sharp substernal pain, dizziness, and visual changes. He was initially hypotensive and anemic, and imaging showed hemoperitoneum with possible extravasation.

Acute lung injury secondary to e-cigarettes or vaping.

As of October 2019, 1299 cases of "e-cigarette, or vaping, product use associated lung injury" (EVALI) have been reported in the USA, with 26 deaths. Multiple patterns of lung injury have been reported, including lipoid pneumonia, organizing pneumonia, and acute eosinophilic pneumonia, with radiographic findings including diffuse pulmonary infiltrates. We report a case of lipoid pneumonia secondary to EVALI.

Renal Salvage with Renal Artery Stenting Improves Long-term Survival.

Background: The Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) Trial cast doubt on the benefits of renal artery stenting (RAS). However, the outcomes for patients with chronic kidney disease (CKD) were not analyzed separately in the CORAL Trial. We hypothesized that patients who experienced a significant improvement in renal function after RAS would have improved long-term survival, compared with patients whose renal function was not improved by stenting.

Irreversible electroporation of small renal masses: suboptimal oncologic efficacy in an early series.

Purpose: To report on the first short-term oncologic outcomes of percutaneous irreversible electroporation for small renal masses.

Methods: Patients with cT1a renal masses treated with irreversible electroporation from April 2013 through December 2016 were reviewed. Small, low complexity tumors were generally selected for irreversible electroporation using the NanoKnife System (Angiodynamics, Latham, NY, USA).

Safety and Effectiveness of the Denali Inferior Vena Cava Filter: Intermediate Follow-Up Results.

Purpose: The purpose of the study is to evaluate the clinical safety and effectiveness of the Denali (Bard, Tempe, Arizona) retrievable inferior vena cava (IVC) filter.

Materials And Methods: In this retrospective study, authors reviewed the data of Denali IVC filters placed at their institution between 2013 and 2015. The clinical presentation, indications, and procedure-related complications during placement and retrieval were evaluated.

Minimally Invasive Percutaneous Treatment of Small Renal Tumors with Irreversible Electroporation: A Single-Center Experience.

Purpose: To evaluate whether irreversible electroporation (IRE) can be used as an ablation technique for small renal tumors (T1a cancers or small benign tumors) and to describe features after ablation on computed tomography (CT) or magnetic resonance (MR) imaging.

Materials And Methods: In this retrospective study, 20 patients (mean age, 65 y ± 12.8 y) underwent CT-guided IRE of T1a renal carcinoma (n = 13) or small benign or indeterminate renal masses < 4 cm in size (n = 7).

Oncologic Efficacy of Radio Frequency Ablation for Small Renal Masses: Clear Cell vs Papillary Subtype.

Purpose: Current radio frequency ablation series do not distinguish renal cell carcinoma subtypes when reporting oncologic efficacy. Papillary neoplasms may be more amenable to radio frequency ablation than clear cell carcinoma because they are less vascular, which may limit heat energy loss. We report the long-term outcomes of patients treated with radio frequency ablation for small renal masses by renal cell carcinoma subtype.

Bleeding after laparoscopic supracervical hysterectomy managed with cervical artery embolization. A case report.

Background: Postoperative bleeding is a known complication after laparoscopic supracervical hysterectomy (LASH), and trachelectomy is the traditional management of significant bleeding.

Case: We present the case of a patient with significant postoperative bleeding 1 month after LASH, resulting in symptomatic anemia requiring blood transfusion. Gelfoam embolization of the bilateral cervical arteries was successful in stopping the bleeding.

The performance of a modified RENAL nephrometry score in predicting renal mass radiofrequency ablation success.

Objective: To assess the predictive performance of a modified RENAL nephrometry score for renal tumors undergoing radiofrequency ablation (RFA).

Methods: Patients who underwent RFA were identified from 2002 to 2011, and RENAL nephrometry scoring was performed for each. A modified RENAL (m-RENAL) nephrometry score was created to account for the small sizes of tumors ablated for which the size variable, R, was adjusted.

Establishment of a multidisciplinary hepatocellular carcinoma clinic is associated with improved clinical outcome.

Purpose: To evaluate differences in overall survival in patients with hepatocellular carcinoma (HCC) after the establishment of a multidisciplinary clinic (MDC) for HCC.

Methods: Patient demographic and tumor characteristics of 355 patients diagnosed with HCC were collected between October 2006 and September 2011. Patients diagnosed after the initiation of the HCC MDC on October 1, 2010, were compared to patients diagnosed in the 4 years before.

Renal function outcomes following selective angioembolization for iatrogenic vascular lesions after partial nephrectomy.

Purpose: To report one of the largest series of clinical and renal function outcomes of treated iatrogenic vascular lesions (IVL) after partial nephrectomy (PN). Angioembolization (AE) is the treatment of choice for patients with these lesions, but the additional renal injury conferred by this treatment has not been well described.

Patients And Methods: Patients who underwent open, laparoscopic, or robot-assisted PN from 2002 to 2012 were identified and those with AE were selected.

Salvage of angioplasty failures and complications in hemodialysis arteriovenous access using the FLUENCY Plus Stent Graft: technical and 180-day patency results.

Purpose: To review technical and 180-day clinical outcomes when stent grafts were used to treat dysfunctional arteriovenous (AV) hemodialysis access circuits.

Materials And Methods: The FLUENCY Plus Stent Graft (Bard Peripheral Vascular, Tempe, Arizona) was used to salvage percutaneous transluminal angioplasty (PTA) technical failures and complications in AV access circuits over 2 years. There were 106 patients treated with 138 stent grafts.

Long-term outcomes of renal tumor radio frequency ablation stratified by tumor diameter: size matters.

Purpose: Renal tumor size influences the efficacy of radio frequency ablation but identification of confident size cutoffs has been limited by small numbers and short followup. We evaluated tumor size related outcomes after radio frequency ablation for patients with adequate (greater than 3 years) followup.

Materials And Methods: We identified 159 tumors treated with radio frequency ablation as primary treatment.

Radiofrequency ablation of incidental benign small renal mass: outcomes and follow-up protocol.

Objective: To review our 10-year experience with radiofrequency ablation, focusing on the outcomes for the incidental benign renal tumor. Tumor ablation is an alternative minimally invasive approach for the treatment of small renal masses (SRMs), with published series appropriately emphasizing the outcomes for the renal cell carcinoma subset of treated tumors. However, just as with partial nephrectomy, approximately 20% of SRMs are benign.

Longitudinal changes in kidney parenchymal volume associated with renal artery stenting.

Objective: This study assessed the longitudinal changes in renal volume after renal artery stenting (RAS) to determine if renal mass is preserved by stenting.

Methods: The study cohort consisted of 38 patients with longitudinal imaging available for renal volume quantification before and after RAS. Renal volume was estimated as (kidney length) × (width) × (depth/2) based on preoperative renal imaging.

Radiofrequency ablation versus partial nephrectomy in patients with solitary clinical T1a renal cell carcinoma: comparable oncologic outcomes at a minimum of 5 years of follow-up.

Background: Long-term comparative outcomes for radiofrequency ablation (RFA) versus partial nephrectomy (PN) for the primary treatment of clinical T1a renal cell carcinoma (RCC) have not previously been reported.

Objective: Report comparative 5-yr oncologic outcomes for RFA versus PN in patients with clinical T1a RCC.

Design, Setting, And Participants: Observational single-institution cohort study, involving consecutive patients with a solitary histologically confirmed T1a RCC treated by RFA or PN and followed for a minimum of 5 yr.

Assessing outcomes to determine whether symptoms related to hypertension justify renal artery stenting.

Objective: The goal of the study was to determine the blood pressure (BP) response to renal artery stenting (RAS) for patients with hypertension urgency, hypertension emergency, and angina with congestive heart failure (angina/congestive heart failure [CHF]).

Methods: Patients who underwent RAS for hypertension emergencies (n = 13), hypertension urgencies (n = 25), and angina/CHF (n = 14) were included in the analysis. By convention, hypertension urgency was defined by a sustained systolic BP ≥ 180 mm Hg or diastolic BP ≥ 120 mm Hg, while the definition of hypertension emergency required the same BP parameters plus hypertension-related symptoms prompting hospitalization.

Common and rare collateral pathways in aortoiliac occlusive disease: a pictorial essay.

Objective: The development of collateral pathways for arterial blood flow is common in the presence of atherosclerotic occlusive disease of the abdominal aorta and iliac arteries. The collateral pathways are divided into systemic-systemic and systemic-visceral pathways. MDCT is commonly used to evaluate aortic stenosis and the resulting collateral pathways.

Predictors of outcome for renal artery stenting performed for salvage of renal function.

Objective: To identify preoperative clinical features that predict a durable improvement in renal function with renal artery stenting (RAS).

Methods: Sixty-one patients with renal insufficiency (serum creatinine ≥ 1.5 mg/dL) underwent RAS for renal salvage.

Is coronary computed tomography angiography a resource sparing strategy in the risk stratification and evaluation of acute chest pain? Results of a randomized controlled trial.

Objectives: Annually, almost 6 million U.S. citizens are evaluated for acute chest pain syndromes (ACPSs), and billions of dollars in resources are utilized.

Clinical and kidney morphologic predictors of outcome for renal artery stenting: data to inform patient selection.

Background: The purpose of the current study was to identify clinical and kidney morphologic features that predict a favorable blood pressure (BP) response to renal artery stenting (RAS).

Methods: The study cohort consisted of 149 patients who underwent primary RAS over 9 years. Patients were categorized as "responders" based on modified American Heart Association guidelines: BP <160/90 mm Hg on fewer antihypertensive medications or diastolic BP <90 mm Hg on the same medications.

Aortoiliac vascular injuries after misplacement of fixation screws.

Purpose: To report our experience with the diagnosis and treatment of aortoiliac vascular injuries caused by misplaced orthopedic fixation screws.

Materials: Six patients (age range, 35-60 years; mean, 52 years) were diagnosed with seven arterial injuries related to misplacement of fixation screws. The location of the injuries were thoracic aorta (n = 4) and common iliac arteries (n = 3).