British Society of Gastroenterology guidelines for the management of hepatocellular carcinoma in adults.

Deaths from the majority of cancers are falling globally, but the incidence and mortality from hepatocellular carcinoma (HCC) is increasing in the United Kingdom and in other Western countries. HCC is a highly fatal cancer, often diagnosed late, with an incidence to mortality ratio that approaches 1. Despite there being a number of treatment options, including those associated with good medium to long-term survival, 5-year survival from HCC in the UK remains below 20%.

The clinical value of the hepatic venous pressure gradient in patients undergoing hepatic resection for hepatocellular carcinoma with or without liver cirrhosis.

The role of hepatic venous pressure gradient (HVPG) measurement in risk stratification before liver resection is an ongoing area of debate. This study examines the impact of preoperative HVPG levels on overall survival (OS)/time to recurrence (TTR) and postoperative complications after hepatic resection of hepatocellular carcinoma (HCC). Thirty-eight HCC patients undergoing HVPG measurement before liver resection at Cambridge University Hospitals NHS Foundation Trust between January 2014 and April 2022 were retrospectively analysed.

Endovascular intervention to treat spontaneous carotid-cavernous fistula in a patient with Ehlers-Danlos Syndrome with an access site anatomical variant.

Vascular Ehlers-Danlos Syndrome (vEDS) is a rare and potentially life-threatening inherited connective tissue disorder. Patients with vEDS can present with spontaneous arterial dissections and ruptured aneurysms. There are previous reports of large artery dissections and vessel rupture following conventional catheter diagnostic angiography.

Common Healthcare Related Instruments Subjected To Magnetic Attraction Study (CHRISTMAS): prospective in situ experimental study.

Objective: To investigate the behaviour of common healthcare related objects in a 3 tesla (T) MRI (magnetic resonance imaging) scanner, examining their ability to self-propel towards the scanner bore and their potential for tissue penetration.

Design: Prospective in situ experimental study.

Setting: Clinical 3 T MRI scanner.

Corrigendum: Service evaluation of the impact of capnography on the safety of procedural sedation.

[This corrects the article DOI: 10.3389/fmed.2022.

Service Evaluation of the Impact of Capnography on the Safety of Procedural Sedation.

Background: Capnography has been associated with a reduced incidence of events related to respiratory compromise during procedural sedation.

Methods: A prospective service evaluation was conducted at a large United Kingdom (UK) teaching hospital to assess the impact of capnography on patient safety within four speciality services: bronchoscopy, endoscopy, interventional cardiology, and interventional radiology. Events were defined as provided by the World Society of Intravenous Anaesthesia.

Clinical Performance Status and Technical Factors Affecting Outcomes from Percutaneous Transhepatic Biliary Interventions; A Multicentre, Prospective, Observational Cohort Study.

Purpose: The purpose of this study was to evaluate the predictive value of a 'Modified Karnofsky Scoring System' on outcomes and provide real-world data regarding the UK practice of biliary interventions.

Materials And Methods: A prospective multi-centred cohort study was performed. The pre-procedure modified Karnofsky score, the incidence of sepsis, complications, biochemical improvement and mortality were recorded out to 30 days post procedure.

Cholangiocyte organoids can repair bile ducts after transplantation in the human liver.

Organoid technology holds great promise for regenerative medicine but has not yet been applied to humans. We address this challenge using cholangiocyte organoids in the context of cholangiopathies, which represent a key reason for liver transplantation. Using single-cell RNA sequencing, we show that primary human cholangiocytes display transcriptional diversity that is lost in organoid culture.

A stepwise thrombolysis regimen in the management of acute portal vein thrombosis in patients with evidence of intestinal ischaemia.

Background: Anticoagulation alone in acute, extensive portomesenteric vein thrombosis (PVT) does not always result in spontaneous clot lysis, and leaves the patient at risk of complications including intestinal infarction and portal hypertension.

Aim: To develop a new standard of care for patients with acute PVT and evidence of intestinal ischaemia.

Methods: We present a case series of patients with acute PVT and evidence of intestinal ischaemia plus ongoing symptoms despite initial systemic anticoagulation, who were treated with a thrombolysis protocol between 2014 and 2019.

Yttrium-90 Transarterial Radioembolization for Chemotherapy-Refractory Intrahepatic Cholangiocarcinoma: A Prospective, Observational Study.

Purpose: To evaluate the safety and efficacy of yttrium-90 transarterial radioembolization (TARE) for the treatment of unresectable, chemotherapy-refractory intrahepatic cholangiocarcinoma (ICC).

Methods: A prospective, observational study was carried out in 10 centers between 2013 and 2017. TARE plus standard care was delivered to patients with unresectable, chemotherapy-refractory or chemotherapy-intolerant ICC.

Ultrasound-assisted thrombolysis of an occluded transjugular portosystemic shunt.

Transjugular intrahepatic portosystemic shunt (TIPS) insertion is commonly performed for refractory ascites or variceal bleeding. However, TIPS dysfunction can be seen in both early and late settings, with shunt thrombosis a particular problem. Treatment of shunt dysfunction commonly involves angioplasty and re-lining, with or without embolectomy, mechanical thrombectomy, or thrombolysis.

Intraprocedural Distal Embolization After Femoropopliteal Angioplasty: Is There a Role for Below-the-Knee Stents?

Purpose: Intraprocedural distal embolization is an accepted complication of femoropopliteal angioplasty. The purpose of this study is to assess the use of below-the-knee stents in the "bail-out" of conventional methods.

Materials And Methods: We retrospectively reviewed 1485 of femoropopliteal angioplasties that were performed in our centre in a 4-year period and analysed 12 cases (<1%) where distal embolization that required further intervention occurred.

Renal transplant complications: diagnostic and therapeutic role of radiology.

Kidney was the first and is the most frequently transplanted organ. Despite improved surgical techniques and transplantation technology, complications do occur and, if left untreated, may lead to catastrophic consequences. Renal transplantation complications may be vascular (eg, renal artery and vein stenosis and thrombosis, arteriovenous fistula, and pseudoaneurysms); urologic (eg, urinary obstruction and leak, and peritransplantation fluid collections, including hematoma, seroma, lymphocele, and abscess formation); and nephrogenic, including acute tubular necrosis, graft rejection, chronic allograft nephropathy, and neoplasm.

Initial clinical evaluation of a non-contrast-enhanced MR angiography method in the distal lower extremities.

Purpose: To report the initial experience and diagnostic performance applying a novel flow-dependent non-contrast-enhanced MR angiography (NCE-MRA) method, in patients with suspected peripheral vascular disease, in comparison with established contrast-enhanced MRA (CE-MRA).

Methods: The lower legs of 34 patients were imaged at 1.5 T with both NCE-MRA and CE-MRA.

Extra-hepatic portal vein aneurysm: A case report, overview of the literature and suggested management algorithm.

Introduction: Portal venous aneurysms are a rare finding. The reported incidence is on the rise with increasing use of modern imaging techniques in clinical practice. However, there is still much to be elicited regarding their aetiology, natural history, and management.

Mycotic pseudoaneurysm of the superficial femoral artery in a patient with Cushing disease: case report and literature review.

Mycotic pseudoaneurysms of the peripheral arteries are rare and can occur as an extension of localized infection or from systemic sepsis. In some cases, no obvious source of infection may be identified. Both endovascular and open surgical management options are available for this important condition.

Modulation of blood pressure by central melanocortinergic pathways.

Background: Weight gain and weight loss are associated with changes in blood pressure through unknown mechanisms. Central melanocortinergic signaling is implicated in the control of energy balance and blood pressure in rodents, but there is no information regarding such an association with blood pressure in humans.

Methods: We assessed blood pressure, heart rate, and urinary catecholamines in overweight or obese subjects with a loss-of-function mutation in MC4R, the gene encoding the melanocortin 4 receptor, and in equally overweight control subjects.

Impact of calcification and intraluminal thrombus on the computed wall stresses of abdominal aortic aneurysm.

Background: Increased biomechanical stresses within the abdominal aortic aneurysm (AAA) wall contribute to its rupture. Calcification and intraluminal thrombus can be commonly found in AAAs, but the relationship between calcification/intraluminal thrombus and AAA wall stress is not completely described.

Methods: Patient-specific three-dimensional AAA geometries were reconstructed from computed tomographic images of 20 patients.

Transjugular renal biopsy: our experience and technical considerations.

The purpose of this study was to describe the indications for and technique of transjugular renal biopsy (TJRB) and evaluate the efficacy and complications of this method. We performed a retrospective review of 59 patients who underwent TJRB using the Quick-core needle biopsy system (Cook, Letchworth, UK) over a 4-year period. The indications for obtaining renal biopsy included acute renal failure, chronic renal failure, nephrotic syndrome, and proteinuria with or without other associated disease.

Targeting liver lesions for radiofrequency ablation: an experimental feasibility study using a CT-US fusion imaging system.

Purpose: To investigate the feasibility and validity of real-time guidance using a fusion imaging system that combines ultrasound (US) and computed tomography (CT) in the targeting and subsequent radiofrequency (RF) ablation of a liver target inconspicuous on US.

Methods And Materials: The study was designed as an experimental ex vivo study in calf livers with radiopaque internal targets, inconspicuous at US, simulating a focal liver lesion. The study included 2 phases.

Left gastric artery aneurysm: successful embolization with ethylene vinyl alcohol copolymer (Onyx).

Patients with left gastric artery aneurysms present with hemorrhagic shock due to rupture or occasionally it is an incidental finding on abdominal CT examinations. Due to the increased morbidity and mortality from this condition, adequate diagnosis and treatment are essential. In this article we present a patient with a left gastric artery aneurysm treated with a new embolization agent, ethylene vinyl alcohol copolymer (Onyx).