Successful Radiofrequency Ablation of an Intrathyroidal Parathyroid Adenoma After Failed Parathyroidectomy.

Background/objective: Radiofrequency ablation (RFA) has been increasingly used as an alternative to surgery in patients with primary hyperparathyroidism who are unable or unwilling to have surgery.

Case Report: We present a case of a 64-year-old woman who had surgery for primary hyperparathyroidism complicated by osteoporosis. Preoperative imaging with 4-dimensional computed tomography scan suggested multigland disease; however, she had persistent hyperparathyroidism after parathyroid exploration.

Thirty-Day Healthcare Encounters after Elective Uterine Artery Embolization for Fibroids with and without Superior Hypogastric Nerve Block.

Purpose: To evaluate how the implementation of superior hypogastric nerve block (SHNB) during uterine artery embolization (UAE) for uterine fibroids impacts same-day discharge and healthcare encounters (HCEs) within 30 days.

Materials And Methods: A total of 240 patients who underwent successful UAE for fibroids between January 2018 and December 2022 were retrospectively reviewed. HCEs within 30 days, including emergency department and urgent care visits, admissions, and readmissions, were categorized as early (0-7 days of discharge) and late (8-30 days of discharge) and related or unrelated to interventional radiology (IR) care.

Ultrasound-guided percutaneous thrombin injection for the management of upper extremity pseudoaneurysms: 20 years of tertiary care center experience.

Purpose: To evaluate the safety and efficacy of ultrasound-guided percutaneous thrombin injection for the treatment of upper extremity pseudoaneurysms.

Methods: An institutional database containing 8,316,467 radiology reports was searched for suitable cases over a 241-month period. Fourteen female and 10 male patients, average age of 69.

A Safety and Feasibility Single-Arm Study of a Novel Catheter Thrombectomy Device for the Treatment of Pulmonary Embolism (ENGULF).

Background: Despite advances in therapy options, pulmonary embolism (PE) continues to carry a high risk of mortality and morbidity. Currently, therapeutic options are limited with only 2 US Food and Drug Administration-cleared catheter-based embolectomy devices approved for the treatment of intermediate-risk PE. The novel Hēlo PE thrombectomy catheter (Endovascular Engineering, Inc) has a flexible and collapsible funnel with an internal agitator for a dual mechanism of treatment for acute PE.

Patient and Provider Perspectives of Telehealth and In-Person Interventional Radiology Clinic Visits.

Purpose: To assess patient and provider satisfaction with interventional radiology (IR) outpatient telehealth and in-person clinic.

Materials And Methods: This institutional review board-approved study analyzed patient satisfaction with clinic via survey after an IR outpatient telehealth or in-person visit. A physician telehealth experience survey was completed by 8 IR physicians.

Neoadjuvant Yttrium-90 Transarterial Radioembolization with Resin Microspheres Prescribed Using the Medical Internal Radiation Dose Model for Intrahepatic Cholangiocarcinoma.

Purpose: To evaluate outcomes of patients with intrahepatic cholangiocarcinoma (iCCA) undergoing neoadjuvant yttrium-90 (Y) transarterial radioembolization (TARE) with resin microspheres prescribed using the Medical Internal Radiation Dose (MIRD) model.

Materials And Methods: This retrospective institutional review board-approved study included 37 patients with iCCA treated with Y-TARE from October 2015 to September 2020. The primary outcome was overall survival (OS) from Y-TARE.

Society of Interventional Radiology Multidisciplinary Position Statement on Percutaneous Ablation of Non-small Cell Lung Cancer and Metastatic Disease to the Lungs: Endorsed by the Canadian Association for Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, and the Society of Interventional Oncology.

Purpose: To state the Society of Interventional Radiology's position on the use of image-guided thermal ablation for the treatment of early stage non-small cell lung cancer, recurrent lung cancer, and metastatic disease to the lung.

Materials And Methods: A multidisciplinary writing group, with expertise in treating lung cancer, conducted a comprehensive literature search to identify studies on the topic of interest. Recommendations were drafted and graded according to the updated SIR evidence grading system.

Priming of Sorafenib Prior to Radiofrequency Ablation Does Not Increase Treatment Effect in Hepatocellular Carcinoma.

Background: Preclinical studies have shown that modulation of the tumor microvasculature with anti-angiogenic agents decreases tumor perfusion and may increase the efficacy of radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC). Retrospective studies suggest that sorafenib given prior to RFA promotes an increase in the ablation zone, but prospective randomized data are lacking.

Aims: We conducted a randomized, double-blind, placebo-controlled phase II trial to evaluate the efficacy of a short-course of sorafenib prior to RFA for HCC tumors sized 3.

Image-guided Microinvasive Percutaneous Treatment of Breast Lesions: Where Do We Stand?

Treatment of breast lesions has evolved toward the use of less-invasive or minimally invasive techniques. Minimally invasive treatments destroy focal groups of cells without surgery; hence, less anesthesia is required, better cosmetic outcomes are achieved because of minimal (if any) scarring, and recovery times are shorter. These techniques include cryoablation, radiofrequency ablation, microwave ablation, high-intensity focused US, laser therapy, vacuum-assisted excision, and irreversible electroporation.

Analysis of Kinematic Differences in Hand Motion between Novice and Experienced Operators in IR: A Pilot Study.

Purpose: To prospectively validate electromagnetic hand motion tracking in interventional radiology to detect differences in operator experience using simulation.

Methods: Sheath task: Six attending interventional radiologists (experts) and 6 radiology trainees (trainees) placed a wire through a sheath and performed a "pin-pull" maneuver, while an electromagnetic motion detection system recorded the hand motion. Radial task: Eight experts and 12 trainees performed palpatory radial artery access task on a radial access simulator.

Yttrium-90 radioembolization using MIRD dosimetry with resin microspheres.

Objective: To review the technical feasibility of resin microsphere (SIR-Spheres®) yttrium-90 radioembolization prescribed using the medical internal radiation dose (MIRD) model.

Methods: All radioembolization procedures for hepatic malignancies using resin microspheres with MIRD model between November 2015 and February 2019 were included in this IRB-approved study (n = 60). Student's T test was used to compare prescribed activity based on MIRD and BSA models.

Transitioning the IR Clinic to Telehealth: A Single-Center Experience during the COVID-19 Pandemic.

Telehealth has not previously been widely implemented as a result of regulatory and reimbursement concerns; however, in the current national emergency of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services has relaxed many of its rules, allowing increased adoption of telehealth services, improving the safety and access of outpatient health care. A complete understanding of the regulatory requirements, technologic options, and billing processes of telehealth is required to initiate a successful clinic. A model is presented here based on a single institution's experience with implementing telehealth in the outpatient interventional radiology clinic.

Treating short bowel syndrome with pharmacotherapy.

Introduction: Short bowel syndrome (SBS) has traditionally been regarded as a rapidly fatal medical catastrophe. The advent of pharmacological options directly targeting disease pathophysiology justified this review.

Areas Covered: Since the 1970s, home parenteral nutrition has reduced mortality, converting SBS into a chronic and disabling compensated and occasionally curable illness.

Impact of evaluation in interventional radiology clinic prior to uterine artery embolization: changes in management.

Purpose: To assess the impact of pre-procedural evaluation of patients with symptomatic uterine fibroids and adenomyosis in interventional radiology (IR) clinic.

Method: In this IRB-approved, HIPAA-compliant retrospective study, consecutive patients evaluated in the IR clinic in a tertiary academic hospital between 1/1/2015 and 9/30/2018 by a single board-certified interventional radiologist were included. Medical records were reviewed to obtain medical history, imaging and endometrial biopsies results.

Transradial and Transfemoral Uterine Fibroid Embolization Comparative Study: Technical and Clinical Outcomes.

Purpose: To compare clinical and technical outcomes of transradial (TRA) uterine artery embolization (UAE) with those of the transfemoral (TFA) approach.

Materials And Methods: Consecutive patients who underwent UAE with TRA and TFA in an academic hospital between May 2014 and June 2018 were included in this study. The ability to perform the procedure as planned, complication rates, and reduction in uterine volume, fibroid enhancement, and symptomatic improvement were compared using descriptive statistics, Student t-test, and chi-square test.

Uterine Artery Embolization with Gelfoam for Acquired Symptomatic Uterine Arteriovenous Shunting.

Purpose: To evaluate the technical and clinical success rates and safety of bilateral gelfoam uterine artery embolization (UAE) for symptomatic acquired uterine arteriovenous shunting due to prior obstetric or gynecologic event.

Materials And Methods: This was a retrospective study of consecutive patients of reproductive age who presented with abnormal uterine bleeding after recent gynecologic procedures or obstetric events between January 2013 and February 2018. Bilateral UAE was performed in all patients using gelfoam slurry.

Electronic IR Group Peer Review and Learning Performed during Daily Clinical Rounds.

Purpose: To describe the implementation and efficacy of electronic capture of interventional radiology (IR) group peer review performed during morning rounds in an academic institution.

Materials And Methods: Peer-review submissions 24 months before (July 2012 through June 2014) and 24 months after (July 2014 through June 2016) implementation of an electronic group IR peer review were evaluated. Electronic IR peer review assessed clinical decision-making, patient care, and technique appropriateness by using the following responses: agree, acceptable alternative, or inappropriate.

Primary Stent Placement for Hepatic Artery Stenosis After Liver Transplantation: Improving Primary Patency and Reintervention Rates.

Recent studies have reported high rates of reintervention after primary stenting for hepatic artery stenosis (HAS) due to the loss of primary patency. The aims of this study were to evaluate the outcomes of primary stenting after HAS in a large cohort with longterm follow-up. After institutional review board approval, all patients undergoing liver transplantation between 2003 and 2017 at a single institution were evaluated for occurrence of hepatic artery complications.

Impact of Performing Nonurgent Interventional Radiology Procedures on Weekends.

Most clinical services limit weekend care to urgent or emergent situations. However, providing access to nonemergent procedures on weekends may reduce length of hospital stay and unnecessary admissions. No data are available on the impact of providing nonemergent interventional radiology (IR) procedural services on weekends.