Shockwave Intravascular Lithotripsy Use in the Femoro-Popliteal Segment: Considerations From an Expert Pan-European Panel Regarding Best-Care Practice.

Purpose: Produce expert recommendations regarding the optimal use of Shockwave intravascular lithotripsy (IVL) when treating femoro-popliteal steno-occlusive peripheral artery disease (PAD), guiding operators to use Shockwave IVL.

Materials And Methods: A modified 3-step Delphi process was used to gain consensus surrounding preoperative/intraoperative/postoperative considerations when using Shockwave IVL for femoro-popliteal PAD. This included a structured survey, focus-group (with qualitative thematic analysis of views expressed), and final confirmatory round; participants were recruited across Europe including the United Kingdom/Switzerland.

Acute and Chronic Ilio-Femoral Venous Reconstruction.

Ilio-femoral venous reconstruction has progressed from being only performed by a limited number of pioneers (often using equipment repurposed from other areas of interventional radiology) to a discrete subspecialty of endovascular practice with a dedicated range of tools and increasingly evolved techniques to secure optimal results. This review is intended to reflect the modern practice of ilio-femoral stenting in the acute and chronic settings, from initial patient assessment to completion of procedure and follow-up care.

Single-session mechanical thrombectomy for iliofemoral deep vein thrombosis using a dual mechanism of action device combining basket and rotational thrombectomy.

Objective: Interventional treatments for acute iliofemoral deep vein thrombosis (DVT) remain controversial after publication of the Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) study. Interventions have been shown to reduce post-thrombotic syndrome severity and improve quality of life in DVT patients, but have been accompanied by risk of major bleeding from thrombolytics. We describe thrombus removal using a novel combined basket-rotational thrombectomy device that minimizes the need for thrombolytics or repeat procedures.

A meta-analysis of the medium- to long-term outcomes in patients with chronic deep venous disease treated with dedicated venous stents.

Objective: This review summarizes the safety profile, stent patency, and clinical effectiveness of dedicated venous stents for the treatment of chronic deep venous disease. The approaches to stenting and post-procedural management of different vascular units are also explored.

Methods: The MEDLINE and Embase databases were searched for pertinent literature published from January 2010 to January 2023.

Interventional therapies in acute pulmonary embolus-current trends and future directions.

Venous thromboembolic disease presenting with acute pulmonary embolus (PE) can be treated in a variety of ways from anticoagulation as an outpatient to surgical embolectomy with many new interventional therapies being developed. Mortality in these patients can be as high as 50% and many of these treatments are also considered to be high risk. Early involvement of a multidisciplinary team and patient risk stratification can aid management decisions in these complex patients who can suddenly deteriorate.

Leg Ulcer Pathway Acceleration (LUPA) study.

Background: Leg ulcers are common, costly, and significantly impair quality of life, but their management is variable and associated with considerable delays in healing. The aim of this study was to design an accelerated leg ulcer care pathway in a community and hospital setting to improve patient outcomes.

Methods: A new referral pathway was developed using a series of healthcare professional and patient interviews, focus groups, and stakeholder workshops.

Target Balloon-Assisted Antegrade and Retrograde Use of Re-Entry Catheters in Complex Chronic Total Occlusions.

Unlabelled: Purpose, Retrograde recanalizations have gained increasing recognition in complex arterial occlusive disease. Re-entry devices are a well described adjunct for antegrade recanalizations. We present our experience with target balloon-assisted antegrade and retrograde recanalizations using re-entry devices in challenging chronic total occlusions.

Endovascular salvage of thrombosed haemodialysis vascular access.

Haemodialysis access thrombosis is associated with significant morbidity and access abandonment rates, for which endovascular salvage is a well described treatment option. This study aimed to evaluate the outcomes of endovascular salvage procedures of thrombosed vascular access circuits and identify factors influencing outcomes. Retrospective review of 328 consecutive procedures performed over 10 years at our institution between January 2010 and December 2019.

Risk factors and classification of reintervention following deep venous stenting for acute iliofemoral deep vein thrombosis.

Background: Acute iliofemoral deep vein thrombosis (DVT) is associated with the development of post-thrombotic syndrome (PTS). Thrombolysis and deep venous stenting can restore vessel outflow and can reduce the incidence of PTS. However, for a proportion of patients, subsequent stenosis or reocclusion will necessitate further intervention.

Intraluminal catheter plasty. An alternative technique to remove tethered abdominal surgical drains.

Objective: Retained surgical drains can lead to significant complications including gastrointestinal fistulae, abscess formation and intestinal obstruction. Today, there is little in the literature describing the role of Interventional Radiology (IR) in assisting the removal of surgical drains. We describe the use of the well-established intraluminal catheter plasty technique, previously used for the removal of adhered central venous catheters, in order to remove a tethered abdominal drain.

Performance of Open and Closed Cell Laser Cut Nitinol Stents for the Treatment of Chronic Iliofemoral Venous Outflow Obstruction in Patients Treated at a Single Centre.

Objective: A number of dedicated self expanding nitinol stents have been developed for use in the venous system, with both open cell (OC) and closed cell (CC) designs available. Data comparing these different designs are lacking. The objective of this study was to evaluate outcomes in patients treated with open and closed cells for unilateral chronic iliac vein obstruction.

Safety and efficacy of the Mynx Control vascular closure device in peripheral arterial procedures: A prospective study.

Objectives: This article aims to present a prospective study investigating the safety and efficacy of the Mynx Control extravascular closure device (Cordis Corporation, FL, USA), for femoral arterial closure in patients undergoing peripheral arterial procedures.

Methods: Between January 2020 and February 2021, 100 Mynx Control devices were deployed in 91 consecutive patients (mean age: 67.5 ± 16.

The Impact of the COVID-19 Pandemic on the Workload, Case Mix and hospital Resources at a Tertiary Vascular Unit.

Background: The aim of this study was to examine the COVID-19 pandemic and its associated impact on the provision of vascular services, and the pattern of presentation and practice in a tertiary referral vascular unit.

Methods: This is a retrospective observational study from a prospectively maintained data-base comparing two time frames, Period 1(15th March-30th May 2019-P1) and Period 2(15th March-30th May 2020-P2)All the patients who presented for a vascular review in the 2 timeframes were included. Metrics of service and patient care episodes were collected and compared including, the number of emergency referrals, patient encounters, consultations, emergency admissions and interventions.

Optimising access and provision of interventional radiology service to patients by utilising a new referral system.

Objective: Implementing a streamlined interventional radiology (IR) service in the UK has been a challenge. This study aims to review a set of changes introduced in IR at a tertiary centre, including a new referral process and the designation of IR clinical nurse specialists.

Methods: A new process of referring patients to IR using a single generic referral pathway was implemented, replacing an order dropdown-based system.

Medium-term outcomes after inferior vena cava reconstruction for acute and chronic deep vein thrombosis and retroperitoneal fibrosis.

Objective: In the present study, we evaluated the technical and clinical outcomes after endovascular inferior vena cava (IVC) reconstruction in patients with nonmalignant obstruction.

Methods: The preoperative, procedural, and follow-up medical records and imaging studies were retrospectively reviewed for 59 consecutive patients who had undergone endovascular IVC reconstruction for nonmalignant obstruction from February 2014 to January 2019. The patients were classified into three groups according to the quality of their infrainguinal inflow vessels.

Utilisation of Image Guidance to Enhance Safety of Deployment of the Mynx Control Vascular Closure Device.

The Mynx Control device (Cardinal Healthcare, Dublin, Ohio, USA) was recently licensed and allows for entirely extravascular arteriotomy closure. It uses a polyethylene glycol sealant plug which is absorbed fully within 30 days, alleviating concerns around difficulties with regaining access in future. The Mynx device uses a balloon, inflated within the artery and retracted against the arteriotomy to achieve haemostasis, with the extravascular sealant plug then deployed outside the vessel wall.

Impact of COVID-19 Pandemic on the Outcomes in Patients With Critical Limb Threatening Ischaemia and Diabetic Foot Infection.

Objective: Examine the impact of COVID-19 pandemic on the outcomes in patients with CLTI or DFI.

Background: Patients with CLTI and/or DFI are at risk of amputations if not treated in a timely manner.

Methods: We compared the outcomes in patients with CLTI or DFI during 2 periods; Period 1[P1] (15/03/2019-31/05/2019) and period 2[P2] (15/03/ 2020-31/05/2020- corresponding to COVID-19 pandemic).

The Outback Re-Entry Device. A Pictorial Review.

The Outback™ Elite re-entry catheter (CORDIS, Cardinal Health, USA) is designed to facilitate placement and positioning of guidewires within the peripheral vasculature and allows for re-entry of a guidewire back into the true lumen of a vessel following a subintimal crossing of an arterial occlusion. The device was first introduced in 2005 and has become widely utilized in a variety of situations involving both arterial and venous interventions. This article aims to share our experiences with the Outback™ device and inform interventionalists of its utility and versatility.

Initial Canadian Experience of Prostate Artery Embolization for Symptomatic Benign Prostatic Hyperplasia: Midterm Outcomes.

Introduction: This study aimed to assess the midterm outcomes and safety of prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH).

Methods: A single-center, retrospective review of PAE performed for BPH was performed. Validated International Prostate Symptom Score (IPSS), quality of life (QoL) index, and International Index for Erectile Function (IIEF-5) questionnaires were completed at baseline and at least 12 months post-procedure.

Patient radiation exposure for endovascular deep venous interventions.

Objective: The study aimed to assess the cumulative radiation exposure from preoperative, periprocedural, and follow-up imaging to patients who underwent common endovascular deep venous interventions for acute and chronic central venous outflow obstructive diseases; namely, deep vein thrombosis (DVT) thrombolysis, unilateral chronic iliofemoral venous stenting, and inferior vena cava (IVC) reconstruction in a single center.

Methods: Patients who had DVT thrombolysis of upper extremity (UE) DVT and lower extremity (LE) DVT, unilateral chronic iliofemoral venous stenting, and endovascular IVC reconstruction between May 1, 2012, and July 31, 2017, in a single unit were retrospectively reviewed. Demographic data, anatomic DVT, imaging, technical details of the index procedure, follow-up, and radiation exposure measured in dose-length product, dose-area product (DAP), and fluoroscopy time (FT) from related computed tomography scans and interventions were analyzed.

Are interventional radiology and allied specialities neglected in undergraduate medical education? A systematic review.

Objectives: Minimally invasive interventional approaches are gaining wider acceptance with several specialities incorporating such principles. Awareness and understanding of interventional principles require efficacious education and training methodologies. We performed a systematic review to identify all available interventional speciality learning modules or training opportunities available for undergraduate medical students.