Predicting Unilateral Aldosterone Secretion in Primary Aldosteronism.

Introduction: Primary aldosteronism affects 20% of patients with resistant hypertension and may be due to unilateral or bilateral causes. Patients with a unilateral source of aldosterone secretion are potentially curable with adrenalectomy. Adrenal vein sampling (AVS) is the definitive test for subtype differentiation but may not be accessible outside tertiary centers.

Acalculous cholecystitis- an imaging and therapeutic update.

In this review, we highlight current understanding of the pathogenesis of acalculous cholecystitis, as well as its key imaging and clinical features. We also review what happens after a diagnosis and outline current interventional methods.

Chemoembolization Beyond Hepatocellular Carcinoma: What Tumors Can We Treat and When?

Liver metastases are the most common malignancy found in the liver and are 20 to 40 times more common than primary hepatic tumors, including hepatocellular carcinoma. Patients with liver metastases often present with advanced disease and are not eligible for curative-intent surgery or ablative techniques. The unique hepatic arterial blood supply of liver metastases allows interventional radiologists to target these tumors with transarterial therapies.

A 5-Year Update on the IR Residency Match: 2022 National Survey Results of Program Directors and Matched Applicants Compared with 2017.

Purpose: To characterize the experiences of matched applicants (MAs) and program directors (PDs) in the 2022 interventional radiology (IR) residency Match and compare with 2017 data.

Methods: Surveys were distributed to IR PDs and MAs from the 2022 Match. Findings were compared with those of 2017 using the 2-sample t test and Fisher exact test.

Choosing the right treatment for the right lesion, Part II: a narrative review of drug-coated balloon angioplasty and its evolving role in dialysis access maintenance.

Background And Objective: Drug-coated balloons (DCBs) seek to inhibit restenosis in treated hemodialysis access lesions by delivering an anti-proliferative agent (paclitaxel) into the vessel wall. While DCBs have proven effective in the coronary and peripheral arterial vasculature, the evidence for their use in arteriovenous (AV) access has been less robust. In part two of this review, a comprehensive overview of DCB mechanisms, implementation, and design is provided, followed by an examination of the evidence basis for their use in AV access stenosis.

Choosing the right treatment for the right lesion, part I: a narrative review of the role of plain balloon angioplasty in dialysis access maintenance.

Background And Objective: The majority of patients with end-stage renal disease (ESRD) requiring hemodialysis (HD) do so via an arteriovenous fistula (AVF) or graft. Both of these accesses are complicated by dysfunction related to neointimal hyperplasia (NIH) and subsequent stenosis. Percutaneous balloon angioplasty using plain balloons is the first line treatment for clinically-significant stenosis, with excellent initial response rates, however, with poor long-term patency and need for frequent reintervention.

Techniques in adrenal vein sampling: Multipurpose catheter shape facilitates sampling of cranially oriented right adrenal veins.

Adrenal vein sampling (AVS) failure is often attributed to difficulty sampling the right adrenal vein (RAV). Normally, the RAV is caudally oriented, however, cranial orientation of the RAV is not uncommon. In such cases, use of a multipurpose (MPA) catheter shape may facilitate sampling.

"Double-Down" Adrenal Vein Sampling Results in Patients with Apparent Bilateral Aldosterone Suppression: Utility of Repeat Sampling including Super-Selective Sampling.

Purpose: To report outcomes of patients undergoing adrenal vein sampling (AVS) for primary aldosteronism with results indicating apparent bilateral adrenal suppression (ABAS), in which the adrenal aldosterone-to-cortisol ratios are decreased bilaterally ("double-down") compared to the non-adrenal sample, and evaluate repeat AVS results.

Materials And Methods: Between 2003 and 2020, 762 patients underwent AVS. Twenty patients (2.

Infectious Recidivism in Tunneled Dialysis Catheters Removed for Bloodstream Infection in the Intensive Care Unit.

Purpose: To determine the rate of recurrent infection of ICU patients who underwent tunneled dialysis catheter (TDC) exchange or removal for bloodstream infection.

Materials And Methods: Forty seven patients, with a total of 61 TDCs removed for bloodstream infection while admitted in an ICU from 2017-2020, were identified. TDCs were exchanged over a wire or removed and replaced.

Medical Student Education During the COVID-19 Pandemic: Initial Experiences Implementing a Virtual Interventional Radiology Elective Course.

Rationale And Objectives: In response to the COVID-19 pandemic reducing medical student presence on clinical services and in classrooms, academic institutions are utilizing a virtual format to continue medical student education. We describe a successful initial experience implementing a virtual elective in interventional radiology (IR) and provide the course framework, student feedback, and potential improvements.

Materials And Methods: A 2-week virtual IR elective curriculum was created utilizing a combination of synchronous and asynchronous learning and the "flipped" classroom educational model.

Endovascular Treatment of an Anatomically Complex Iliac Lesion and a Review of Variant Iliac Venous Anatomy.

The diagnosis and treatment of pelvic venous disease is complicated by a number of potential venous anatomic variants. Stent-assisted recanalization of a chronically occluded left external iliac vein draining directly into the inferior vena cava, with absence of the left common iliac vein, is described here. Variant iliac venous anatomy is reviewed in 3 categories: additional iliac vessels, absence/shortening of iliac vessels, and deviations in the drainage pattern of iliac vessels.

Postembolotherapy Pulmonary Arteriovenous Malformation Follow-Up: A Role for Graded Transthoracic Contrast Echocardiography Prior to High-Resolution Chest CT Scan.

Background: High-resolution chest CT (HRCT) scan is recommended after pulmonary arteriovenous malformation (PAVM) embolotherapy to assess for PAVM persistence and untreated PAVM growth. Graded transthoracic contrast echocardiography (TTCE) predicts the need for embolotherapy in PAVM screening. This study sought to determine whether postembolotherapy graded TTCE can similarly predict the need for repeat embolotherapy.

The 2017 Integrated IR Residency Match: Results of a National Survey of Applicants and Program Directors.

Purpose: To characterize and compare the experiences of matched applicants and program directors (PDs) participating in the first large-scale integrated interventional radiology (IR) residency match.

Materials And Methods: Survey questionnaires were distributed nationally to integrated IR applicants who matched in the 2017 Match cycle and PDs. Both groups were questioned regarding their experiences with the application, interview, rank, and match processes as well as applicant-specific and PD-specific information.

Long-term outcomes of a benign biliary stricture protocol.

Purpose: To evaluate long-term outcomes of a structured protocol for percutaneous treatment of benign biliary stricture.

Materials And Methods: Seventy-one patients (37 men, 34 women; mean age, 54 y; age range, 23-84 y) entered the protocol, which consisted of staged upsizing of internal/external biliary catheters, balloon dilation (nominally 8 mm), and prolonged stent treatment (6 mo) at maximal catheter size (nominally 18 F). It concluded with a capping trial and catheter removal if the stricture remained patent.