The Path to Primary Specialty Recognition of Interventional Radiology and the IR/DR Certificate.

Primary specialty recognition of interventional radiology (IR) by the American Board of Medical Specialties (ABMS) was the result of over a decade of work by many individuals. The transformation from a subspecialty of diagnostic radiology (DR) to the 37th ABMS primary specialty and the 4th primary certificate of the American Board of Radiology was a challenging and complex process of change management. The IR/DR certificate codified unique combination of competencies that defines and distinguishes IR procedural, imaging, and periprocedural patient care.

Occupational health hazards in the interventional laboratory: Time for a safer environment.

Over the past 30 years, the advent of fluoroscopically guided interventional procedures has resulted in dramatic increments in both X-ray exposure and physical demands that predispose interventionists to distinct occupational health hazards. The hazards of accumulated radiation exposure have been known for years, but until recently the other potential risks have been ill-defined and under-appreciated. The physical stresses inherent in this career choice appear to be associated with a predilection to orthopedic injuries, attributable in great part to the cumulative adverse effects of bearing the weight and design of personal protective apparel worn to reduce radiation risk and to the poor ergonomic design of interventional suites.

Acalculous Cholecystitis in Burn Patients: Is There a Role for Percutaneous Cholecystostomy?

Although acute acalculous cholecystitis is uncommon in burn patients, this condition can be rapidly fatal due to delays in diagnosis and treatment and should always be considered in the differential diagnosis when burn patients become septic, develop abdominal pain, or have hemodynamic instability. This article reviews the use of percutaneous cholecystostomy in burn patients as both a diagnostic and therapeutic intervention.

Temporary balloon tamponade for managing subclavian arterial injury by inadvertent central venous catheter placement.

Purpose: To evaluate the feasibility, efficacy, and safety of a temporary balloon tamponade technique for managing subclavian arterial injury secondary to inadvertent central venous catheter placement.

Materials And Methods: Patients with subclavian arterial injury caused by inadvertent placement of a central venous catheter (size range 7-F to 7.5-F) who were treated only with temporary balloon tamponade between February 2002 and October 2009 were included.

Use of yttrium-90 microspheres in patients with advanced hepatocellular carcinoma and portal vein thrombosis.

Purpose: Patients with portal vein thrombosis (PVT) and hepatocellular carcinoma (HCC) have limited treatment options because of increased disease burden and diminished hepatic perfusion. Yttrium-90 ((90)Y) microspheres may be better tolerated than chemoembolization in these patients. The present study reviews the safety and efficacy of (90)Y microspheres in HCC with major PVT.

Direct puncture of the recanalized paraumbilical vein for portal vein targeting during transjugular intrahepatic portosystemic shunt procedures: assessment of technical success and safety.

Purpose: To assess the success of direct percutaneous puncture of the recanalized paraumbilical vein (RPUV) for access and visualization of the portal vein (PV) to guide transhepatic puncture during transjugular intrahepatic portosystemic shunt (TIPS) creation. The predictive value of successful catheterization based on preprocedural vein diameter was analyzed.

Materials And Methods: A retrospective review of all TIPS procedures from 2002 to 2008 performed at a single institution was conducted, and a subset of procedures in which portal venography was attempted via the paraumbilical vein were identified.