Basivertebral nerve ablation technique.

Chronic low back pain represents a leading cause of global disability, but can often be complex in etiology, with multiple pain generators contributing to patient discomfort. Anterior column low back pain involves the vertebral bodies and discs, with the vertebral body endplates now known to be a significant pain generator. Vertebrogenic low back pain secondary to irritation of the basivertebral nerve presents as axial discomfort, worse with forward flexion, and with concomitant Type I or II Modic changes on MRI.

Minimally Invasive Therapies for Knee Osteoarthritis.

Knee osteoarthritis (KOA) is a musculoskeletal disorder characterized by articular cartilage degeneration and chronic inflammation, affecting one in five people over 40 years old. The purpose of this study was to provide an overview of traditional and novel minimally invasive treatment options and role of artificial intelligence (AI) to streamline the diagnostic process of KOA. This literature review provides insights into the mechanisms of action, efficacy, complications, technical approaches, and recommendations to intra-articular injections (corticosteroids, hyaluronic acid, and plate rich plasma), genicular artery embolization (GAE), and genicular nerve ablation (GNA).

Safety and Effectiveness of Large-Bore Percutaneous Cholangioscopy-Assisted Gallstone Retrieval for Inoperable Calculous Cholecystitis: A Multi-Institutional Retrospective Study.

Purpose: To evaluate the safety and effectiveness of large-bore percutaneous biliary access techniques for cholangioscopy-assisted gallstone extraction in patients with a history of acute calculous cholecystitis who are poor surgical candidates.

Materials And Methods: A retrospective analysis was conducted on patients who underwent percutaneous cholangioscopy for gallstone extraction using large-bore access (24 or 30 F) at 2 large academic centers from September 2020 and August 2022. Technical success, procedure duration, fluoroscopy time, immediate postprocedural symptom reduction, 3-month symptom-free outcomes, and adverse events (AEs) were assessed.

Multi-institutional Retrospective Study of Percutaneous Cholangioscopy-Assisted Lithotripsy for Inoperable Calculous Cholecystitis.

Purpose: This study aimed to assess the safety and efficacy of percutaneous lithotripsy for gallstone eradication in patients with calculous cholecystitis with stones >1 cm.

Materials And Methods: Multi-institutional institutional review board approved retrospective review of patients who presented with calculous cholecystitis and were not determined to be surgical candidates. All patients underwent percutaneous cholecystostomy tube placement for acute infection, which was later exchanged for a large sheath for ShockPulse (Olympus, Tokyo, Japan) lithotripsy and stone destruction.

Temporal and geospatial variations among the interventional radiology physician workforce in the United States.

Objective: To analyze the temporal trends and state-wide geospatial variations in Vascular and Interventional Radiology (VIR) workforce in the United States.

Methods: The State Physician Workforce Data from the AAMC website was accessed for years 2015, 2017, and 2019. The variables collected for each state included total number of active physicians, total number of physicians per specialty and total number of female physicians in VIR.

Interventional Oncology: Keeping Out of Trouble in Ablation Techniques.

Interventional radiologists provide an essential role in the therapy and management of cancer patients. Computed-tomography (CT) guided percutaneous procedures have enabled interventionalists to treat multiple solid organ malignancies with minimal risk, however, certain lesions may present challenges to physicians due to a difficult approach, or their close proximity to other vital structures. The following presents a brief summary of tips and tricks the interventionalist may use to provide their patients with safe and effective therapy.

Cost Analysis of Prostate Artery Embolization (PAE) and Transurethral Resection of the Prostate (TURP) in the Treatment of Benign Prostatic Hyperplasia.

Purpose: Prostatic arterial embolization (PAE) has emerged as a minimally invasive alternative to TURP; however, there are limited cost comparisons reported. The purpose of this study was to compare in-hospital direct costs of elective PAE and TURP in a hospital setting.

Materials And Methods: Institutional Review Board-approved retrospective review was performed on patients undergoing PAE and TURP from January to December 2014.

Unexplained gastrointestinal bleed due to arteriobiliary fistula after percutaneous liver biopsy.

We represent a case of a 54-year-old male who presented to the emergency department with right upper quadrant abdominal pain and melena three weeks after percutaneous liver biopsy. He was found to have anemia secondary to an upper gastrointestinal hemorrhage, unresponsive to multiple blood transfusions. Angiography later revealed an arteriobiliary fistula with contrast extravasation entering the duodenum.

Robotic-Assisted Versus Manual Prostatic Arterial Embolization for Benign Prostatic Hyperplasia: A Comparative Analysis.

Purpose: Prostatic artery embolization (PAE) is a safe and efficacious procedure for benign prostatic hyperplasia (BPH), though is technically challenging. We present our experience of technical and clinical outcomes of robotic and manual PAE in patients with BPH.

Materials And Methods: IRB-approved retrospective study of 40 consecutive patients 49-81 years old with moderate or severe grade BPH from May 2014 to July 2015: 20 robotic-assisted PAE (group 1), 20 manual PAE (group 2).

Multicenter Prospective Clinical Series Evaluating Radiofrequency Ablation in the Treatment of Painful Spine Metastases.

Background: Radiofrequency ablation (RFA) of vertebral body metastases (VBM) has been reported as safe and effective in retrospective studies. This single-arm prospective multicenter clinical study evaluates RFA in the treatment of painful VBM.

Methods: Fifty patients with VBM were prospectively enrolled during a 13-month period at eight US centers under an IRB-approved study.

Comparative Analysis of Prostate Volume as a Predictor of Outcome in Prostate Artery Embolization.

Purpose: To determine the role of prostate volume as a predictor of outcome after prostatic artery embolization (PAE).

Materials And Methods: From January 2012 to September 2014, 78 consecutive patients undergoing PAE were evaluated at baseline and 1, 3, and 6 months. Analysis was performed comparing prostate volume groups (group 1, < 50 cm3; group 2, 50-80 cm(3); group 3, > 80 cm3) at baseline and follow-up to assess for differences in outcomes of American Urological Association (AUA) symptom index, quality of life (QOL)-related symptoms, and International Index of Erectile Function (IIEF).

Recurrent Hemarthrosis Following Knee Arthroplasty Treated with Arterial Embolization.

Recurrent hemarthrosis is an uncommon but troublesome complication following knee arthroplasty. This study reports the results for 13 patients with spontaneous recurrent hemarthrosis after knee arthroplasty treated with arterial embolization. The average interval between arthroplasty and embolization was 47 months (range, 2-103 months), and the average time from onset of hemarthrosis to embolization was 4.

The Effect of Hepatocellular Carcinoma Surveillance in an Urban Population With Liver Cirrhosis.

Background: Hepatocellular carcinoma (HCC) surveillance in patients with cirrhosis is aimed at early detection so that effective therapeutic options may be offered. We undertook this study to assess the patterns of surveillance that had been offered to HCC patients evaluated at our center, and the effect of these strategies on outcome.

Methods: Consecutive patients, age 18 years and older, diagnosed with HCC between December 2007 and December 2012 were identified.

Ultrasound-accelerated catheter-directed thrombolysis for acute submassive pulmonary embolism.

Purpose: To evaluate the safety and efficacy of ultrasound-accelerated catheter-directed thrombolysis (USAT) in patients with submassive pulmonary embolism (PE).

Materials And Methods: This retrospective study comprised 45 consecutive patients (15 prospective, 30 retrospective) who underwent USAT for submassive PE from June 2012-May 2014. Inclusion criteria were right ventricular dysfunction (RVD) as indicated by right ventricle-to-left ventricle (RV:LV) ratio > 0.

Laparoscopic-assisted versus open pancreaticoduodenectomy: early favorable physical quality-of-life measures.

Background: We compared outcomes and postpancreatectomy quality of life (QOL) in paired cohorts of patients undergoing conventional open pancreaticoduodenectomy (OPD) or laparoscopic-assisted pancreaticoduodenectomy (LAPD).

Methods: Comparative analysis of QOL was performed in a matched cohort of 53 patients after OPD or LAPD between 2010 and 2013. The Medical Outcomes Study Short Form-36 Health Survey and the Karnofsky score were used.

Early results from a United States trial of prostatic artery embolization in the treatment of benign prostatic hyperplasia.

Purpose: To report early findings from a prospective United States clinical trial to evaluate the efficacy and safety of prostatic artery embolization (PAE) for benign prostatic hyperplasia (BPH).

Materials And Methods: From January 2012 to March 2013, 72 patients were screened and 20 patients underwent treatment. Patients were evaluated at baseline and selected intervals (1, 3, and 6 mo) for the following efficacy variables: American Urological Association (AUA) symptom score, quality of life (QOL)-related symptoms, International Index of Erectile Function score, peak urine flow rate, and prostate volume (on magnetic resonance imaging at 6 mo).

Transesophageal echocardiographic screening before atrial flutter ablation: is it necessary for patient safety?

Background: Transesophageal echocardiography (TEE) is commonly used before atrial flutter (AFl) ablation to detect atrial thrombus (AT) and thereby identify a heightened risk for systemic embolism both in patients with their initial episodes of AFl and in those with prior episodes whose anticoagulation has been inadequate. This treatment strategy has been extrapolated from guidelines for atrial fibrillation. In fact, limited data exist regarding the prevalence or clinical associations of AT and spontaneous echocardiographic contrast (SEC) in patients with AFl.

How does laparoscopic-assisted hepatic resection compare with the conventional open surgical approach?

Background: Laparoscopic-assisted hepatic resection (LAHR) has been described as a safe and reliable means of liver resection for tumors or live-donor hepatectomy. Here we compare the outcomes in paired cohorts between patients undergoing open hepatic resection (OHR) and LAHR.

Study Design: Two hundred and twelve patients who underwent either OHR or LAHR from March 2004 to July 2011 were analyzed to assess outcomes.