Vascular and Interventional Radiology

BACKGROUND:  This study aimed to assess feasibility, logistical challenges, and clinical outcomes associated with the implementation of an Aortic Team model for the management of distal arch, descending thoracic and thoracoabdominal aortic disease. METHODS:  An Aortic Team care pathway was implemented in November 2019. Working as a unit, two cardiac surgeons, two vascular surgeons, an interventional radiologist, a cardiologist, and an anesthesiologist collectively determined care decisions via multispecialty presence at an Aortic Clinic...

INTRODUCTION: The purpose of this study is to evaluate the patient selection methods, treatment outcomes, complications, clinical and radiological follow-up after renal angiomyolipoma (AML) treatment with selective arterial embolization (SAE) in an Australian metropolitan tertiary centre. METHODS: This study presents a retrospective single-centre review of patients' medical records who underwent SAE for renal AML during the period of 1st January 2012 and 1st January 2023...

INTRODUCTION AND IMPORTANCE: Arteriovenous malformation (AVM) is a rare condition affecting less than 5/10,000 people, with high misdiagnosis due to its heterogeneity, inconsistent nomenclature, and diverse diagnostic criteria. Understanding its prevalence in this age group is crucial for effective treatment. Here we present a case report of a patient with AVM. IRB approval and patient consent were obtained. This study was done based on SCARE criteria. CASE PRESENTATION: A 53-year-old female patient was diagnosed with a right hip vascular mass suggestive of AVM...

PURPOSE: To evaluate the correlation between pulmonary hypertension (PH) and post-embolization pulmonary arteriovenous malformation (PAVM) recurrence. MATERIALS AND METHODS: With IRB approval the records of 377 patients with PAVMs evaluated at single HHT center of excellence between January 1, 2013, and September 10, 2023, were retrospectively reviewed. PAVMs embolized during this time-period were evaluated for recurrence. Patients and PAVMs not treated during this time-period were excluded...

Vascular anomalies broadly include vascular tumours and malformations. Arteriovenous malformations (AVM), though rare in the oral and maxillofacial regions, can present with swelling, facial asymmetry, ulceration, and bleeding tendencies, which can be life-threatening. Thus, to minimise the associated life-threatening consequences, prompt and appropriate diagnosis of the lesion is necessitated. The management of the AVM is a therapeutic challenge for maxillofacial surgeons; however, technological advances in interventional radiology have gained a foothold...

PURPOSE: To compare the risk of hemorrhagic complications of transthoracic needle biopsy such as pulmonary hemorrhage and hemoptysis between patients with pulmonary hypertension and patients without pulmonary hypertension. MATERIALS AND METHODS: Database search and citation review of search results were performed for studies reporting frequency of hemorrhagic complications of transthoracic needle biopsy in adult patients with evidence of pulmonary hypertension compared to patients undergoing the procedure without evidence of pulmonary hypertension...

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PURPOSE: To compare patency and reintervention outcomes following either POBA or DCBA for venous stenoses after percutaneous AV fistula creation. MATERIALS AND METHODS: One-hundred and ninety-five pAVFs were successfully created during the study period; 141 using Ellipsys® and 54 using WavelinQTM . Post pAVF creation, 95 patients (48.7%) required secondary PTA with either POBA (n=55, 58%) or DCBA (n=40, 42.1%). The most common site for PTA was the juxta-anastomotic segment (75...

PURPOSE: To conduct a systematic review to evaluate the safety and efficacy of endovascular treatment with stent grafts (SGs) for complications associated with persistent sciatic artery (PSA). MATERIALS AND METHODS: The MEDLINE, Web of Science, Scopus, and Ichushi Web databases were searched to identify articles focusing on endovascular treatment with SGs for complications associated with PSA published from inception to 15 September 2023. The review included 31 case reports, 2 case series, and 7 conference proceedings...

KEY CLINICAL MESSAGE: Giant cell tumor of bone (GCT) is a rare neoplasm which often presents as a lytic lesion in the epiphyseal region of long bones and which are usually accompanied by pain, swelling, and restricted movement. ABSTRACT: Giant cell tumor of bone (GCT) is a rare neoplasm that affects individuals in their third and fourth decades of life. Clinically, it often presents as a lytic lesion in the epiphyseal region of bones, notably the distal femur and proximal tibia...

Tibial exostosis, also known as osteochondroma, is a common benign bone tumor found predominantly in adolescents and young adults. Vascular complications associated with this tumor, such as arterial occlusion and pseudoaneurysm formation, are rare but can lead to significant morbidity if not promptly diagnosed and managed. We present a case of a 25-year-old patient who presented with thrombosis of the left popliteal vein and a painless swelling in the popliteal fossa. Radiographic and CT angiography revealed an exostosis on the proximal tibia causing arterial occlusion and venous compression...

Vein of Galen malformation (VGM) is a rare congenital, uncommon intracerebral vascular anomaly rarely complicated with the development of brain abscess as secondary to primary infection or after endovascular treatment. We report a very rare finding of a vein of Galen aneurysm associated with a large brain abscess at the time of diagnosis. A 12-year-old boy with a high-grade fever, severe headache, and recurrent episodes of convulsions came into the radiology department of Kassala Advanced Diagnostic Center...

INTRODUCTION: Arteriovenous grafts (AVGs) serve as an alternative to native arteriovenous fistulas (AVFs) in the context of hemodialysis patient life planning. AVGs are more susceptible to developing outflow stenosis (due to intimal hyperplasia), thrombosis, and infections. However, an often overlooked contributor to AVG failure is cannulation damage. The objective of this paper is to assess the impact of cannulations on AVGs. We aim to establish a classification of AVG damage by comparing clinical data and ultrasound images with microscopic morphological findings obtained from explanted grafts...

PURPOSE: To compare quantitative tortuosity descriptors of Internal Carotid Artery (ICA) on aneurysmal and non-aneurysmal side before and after embolization of aneurysm and to determine possible factors associated with its change. MATERIAL AND METHODS: An analysis of 52 patients with intracranial aneurysm, treated with endovascular procedure, was performed. Based on their Digital Subtraction Angiography images, obtained prior to the procedure and after first follow-up examination, tortuosity of ICA, both on the side of embolization and on the other side was analysed...

OBJECTIVES: This study aimed to compare the image quality and diagnostic performance of standard-resolution (SR) and ultra-high-resolution (UHR) coronary CT angiography (CCTA) based on photon-counting detector CT (PCD-CT) of coronary stents and explore the best reconstruction kernel for stent imaging. METHODS: From July 2023 to September 2023, patients were enrolled to undergo CCTA using a dual-source PCD-CT system after coronary angioplasty with stent placement...

Congenital heart disease in adult patients (ACHD) includes individuals with native anatomic deformities and those who have benefited from corrective, ameliorative, or interventional heart and vascular interventions. Congenital heart disease is the most common birth defect, although with interventions most survive into adulthood. Newborns and children with complex congenital heart diseases that feature cyanosis fail to thrive, and once this is identified, heart failure can promptly undergo diagnostic evaluations and treatment...

The liver is the second most common solid organ injured in blunt and penetrating abdominal trauma. Non-operative management (NOM) has become the standard of care for liver injuries in stable patients, where transarterial embolization (TAE) represents the main treatment, increasing success rates and avoiding invasive surgical procedures. In hemodynamically (HD) unstable patients, operative management (OM) is the standard of care. To date, there are no consensus guidelines about the endovascular treatment of patients with HD instability or in ones that responded to initial infusion therapy...

PURPOSE: To evaluate the histopathologic changes and potential correlations of tissue radiation absorbed dose (TAD) after 90 Y transarterial radioembolization (TARE) for colorectal liver metastases (CLM). MATERIALS AND METHODS: This prospective pilot study assessed 12 patients with 13 (CLM) through PET/CT--guided biopsies before, immediately (T0) and 3 weeks (T3) after TARE. Subsequent sampling from the same location was enabled by fiducial placement. Biopsy samples were evaluated with hematoxylin-eosin (H&E), TUNEL, Ki67, OxPhos, caspase-3 (CC3), and pH2AX antibodies...

PURPOSE: To evaluate the safety and efficacy of track cauterization for lung cryoablation through comparison of post-procedural adverse event (AE) rates. MATERIAL AND METHODS: Fifty-nine patients who underwent 164 percutaneous lung cryoablation between 2013 to 2018 were included in this retrospective study. The study cohort was subdivided into whether track cauterization was conducted at the end of the procedure. Also, the study cohort was subdivided into procedures conducted with 1 - 2 probes and 3 - 4 probes...

OBJECTIVES: Antiplatelet therapy is an essential element in the management of patients with arterial vascular disease. In peripheral arterial disease (PAD), dual antiplatelet therapy (DAPT), primarily clopidogrel and aspirin, is routinely prescribed following intervention. There is sparse data regarding the need for DAPT, the appropriate duration, or the heterogeneity of treatment effects for antiplatelet regimens across patients, leading to potential uncertainty and heterogeneity around treatment practices...