Percutaneous Pulmonary Embolism Thrombectomy and Thrombolysis: Technical Tips and Tricks
This article reviews currently available techniques and protocols for treating acute massive and submassive PE, with tips to safely and successfully perform percutaneous PE interventions. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - June 4, 2018 Category: Radiology Authors: Devcic, Zlatko Kuo, William T. Tags: Review Article Source Type: research

Catheter-Directed Thrombolysis for Submassive Pulmonary Embolism
Semin intervent Radiol 2018; 35: 122-128 DOI: 10.1055/s-0038-1642041Acute pulmonary embolism (PE) is a leading cause of morbidity and mortality in the United States. PE associated with right ventricular strain, termed submassive or intermediate-risk PE, is associated with an increased rate of clinical deterioration and short-term mortality. Trials have demonstrated systemic thrombolytics may improve patient outcomes, but they carry a risk of major hemorrhage. Catheter-directed thrombolysis (CDT) may offer similar efficacy to and a lower risk of catastrophic hemorrhage than systemic thrombolysis. Three prospective trials ha...
Source: Seminars in Interventional Radiology - June 4, 2018 Category: Radiology Authors: Chiarello, Matthew A. Sista, Akhilesh K. Tags: Review Article Source Type: research

Patient Assessment: Clinical Presentation, Imaging Diagnosis, Risk Stratification, and the Role of Pulmonary Embolism Response Team
Semin intervent Radiol 2018; 35: 116-121 DOI: 10.1055/s-0038-1642040Pulmonary embolism (PE) is currently the third leading cause of death and moreover is likely underdiagnosed. PE remains the most common preventable cause of hospital deaths in the United States, which may be attributable to its diagnostic challenges. Although difficult to diagnose, patient mortality rates are time-dependent, and thus, the suspicion and diagnosis of PE in a timely manner is imperative. Diagnosis based on several criteria which may dictate imaging workup as well as laboratory tests and clinical parameters are discussed. The evolution of trea...
Source: Seminars in Interventional Radiology - June 4, 2018 Category: Radiology Authors: Friedman, Tamir Winokur, Ronald S. Quencer, Keith B. Madoff, David C. Tags: Review Article Source Type: research

Intervention in Massive Pulmonary Embolus: Catheter Thrombectomy/Thromboaspiration versus Systemic Lysis versus Surgical Thrombectomy
This article will review the current medical management as well as catheter-directed therapies and surgical embolectomy in the treatment of patients with massive PE. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - June 4, 2018 Category: Radiology Authors: Moriarty, John M. Edwards, Martin Plotnik, Adam N. Tags: Review Article Source Type: research

Inferior Vena Cava Filters and Prevention of Recurrent Pulmonary Embolism
This article reviews the available data on the efficacy and risks associated with adjunctive IVC filter use to prevent recurrent PE. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - June 4, 2018 Category: Radiology Authors: Malhotra, Anuj Kishore, Sirish Trost, David Madoff, David C. Winokur, Ronald S. Tags: Review Article Source Type: research

Hypercoagulable States and Thrombophilias: Risks Relating to Recurrent Venous Thromboembolism
Semin intervent Radiol 2018; 35: 99-104 DOI: 10.1055/s-0038-1642037Inherited and acquired thrombophilias and hypercoagulable states, such as active cancer, estrogen-induced, autoimmune disorders, major surgery, hospitalization, and trauma, are well-known risk factors for venous thromboembolism (VTE). The effect of these on recurrent VTE is different for each specific risk factor. The major risk factors affecting VTE recurrence include the presence of active cancer and an unprovoked first VTE. In addition, the use of combined female hormones in a woman with a previous history of estrogen-related VTE is a major risk factor f...
Source: Seminars in Interventional Radiology - June 4, 2018 Category: Radiology Authors: Rybstein, Marissa D. DeSancho, Maria T. Tags: Review Article Source Type: research

Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism
Semin intervent Radiol 2018; 35: 92-98 DOI: 10.1055/s-0038-1642036Pulmonary embolism (PE) is a common and potentially deadly form of venous thromboembolic disease. It is the third most common cause of cardiovascular death and is associated with multiple inherited and acquired risk factors as well as advanced age. The prognosis from PE depends on the degree of obstruction and hemodynamic effects of PE and understanding the pathophysiology helps in risk-stratifying patients and determining treatment. Though the natural history of thrombus is resolution, a subset of patients have chronic residual thrombus, contributing to the...
Source: Seminars in Interventional Radiology - June 4, 2018 Category: Radiology Authors: Turetz, Meredith Sideris, Andrew T. Friedman, Oren A. Triphathi, Nidhi Horowitz, James M. Tags: Review Article Source Type: research

Novel Anticoagulant Treatment for Pulmonary Embolism with Direct Oral Anticoagulants Phase 3 Trials and Clinical Practice
Semin intervent Radiol 2018; 35: 83-91 DOI: 10.1055/s-0038-1642622Anticoagulant therapy is the cornerstone of therapeutic management in acute venous thromboembolism (VTE), consisting of pulmonary embolism and deep vein thrombosis. Direct oral anticoagulants (DOACs) have become the standard of care because of their good safety profile and ease of use in clinical practice. Indeed, phase 3 randomized trials (AMPLIFY, EINSTEIN, RECOVER, and HOKUSAI studies) showed that DOACs provided a similar efficacy and a better safety than conventional treatment with parenteral heparin with overlapping loading dose of vitamin K antagonists...
Source: Seminars in Interventional Radiology - June 4, 2018 Category: Radiology Authors: Tromeur, C écile van der Pol, Liselotte M. Mairuhu, Albert T.A. Leroyer, Christophe Couturaud, Francis Huisman, Menno V. Klok, Frederikus A. Tags: Review Article Source Type: research

As an Observer of Interventional Radiology
Semin intervent Radiol 2018; 35: 81-82 DOI: 10.1055/s-0038-1651498 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - June 4, 2018 Category: Radiology Authors: Ray, Charles E. Tags: Editorial Source Type: research

Intra- and Extrahepatic Collaterals: Pitfalls and Pathways for Locoregional Therapy
Semin intervent Radiol 2018; 35: 069-080 DOI: 10.1055/s-0038-1636523 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: Su, James Kapoor, Suraj Brown, Daniel B. Tags: How I Do It Source Type: research

Female Pelvic Vascular Malformations
Semin intervent Radiol 2018; 35: 062-068 DOI: 10.1055/s-0038-1636524Vascular malformations are classified primarily according to their flow characteristics, slow flow (lymphatic and venous) or fast flow (arteriovenous). They can occur anywhere in the body but have a unique presentation when affecting the female pelvis. With a detailed clinical history and the proper imaging studies, the correct diagnosis can be made and the best treatment can be initiated. Lymphatic and venous malformations are often treated with sclerotherapy while arteriovenous malformations usually require embolization. At times, surgical intervention o...
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: Annam, Aparna Tags: Review Article Source Type: research

Varicose Veins and Lower Extremity Venous Insufficiency
Semin intervent Radiol 2018; 35: 056-061 DOI: 10.1055/s-0038-1636522Lower extremity venous insufficiency and varicose veins are common conditions, affecting up to 25% of women. Herein, we review the pathophysiology of lower extremity venous insufficiency and varicose veins, the epidemiology of varicose veins, clinical diagnosis, and ultrasonographic diagnosis. We also discuss treatment rationale, algorithms, and techniques, with a focus on endovenous great saphenous vein ablation. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  | &nb...
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: DePopas, Eric Brown, Matthew Tags: Review Article Source Type: research

Updates on Uterine Artery Embolization
Semin intervent Radiol 2018; 35: 048-055 DOI: 10.1055/s-0038-1636521Uterine fibroids (leiomyomas) are the most common benign neoplasm of the female pelvis and have a lifetime prevalence exceeding 80% among African American women and approaching 70% among Caucasian women. Approximately 50% of women with fibroids experience symptoms which may include menorrhagia that may result in anemia, bulk symptoms with bladder and bowel dysfunction and abdominal protrusion, dysmenorrhea, and infertility. Hysterectomy remains the most common treatment option for fibroids and concerns have been raised about the overuse of this procedure. ...
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: Kohi, Maureen P. Spies, James B. Tags: Review Article Source Type: research

Pelvic Artery Embolization for Treatment of Postpartum Hemorrhage
Semin intervent Radiol 2018; 35: 041-047 DOI: 10.1055/s-0038-1636520Postpartum hemorrhage (PPH) is the leading cause of maternal perinatal morbidity and mortality worldwide. Defined as greater than 500 mL blood loss after vaginal delivery, and greater than 1,000 mL blood loss after cesarean delivery, PPH has many causes, including uterine atony, lower genital tract lacerations, coagulopathy, and placental anomalies. Correction of coagulopathy and identification of the cause of bleeding are mainstays of treatment. Medical therapies such as uterotonics, balloon tamponade, pelvic artery embolization, and uterine-sparing surgi...
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: Lindquist, Jonathan D. Vogelzang, Robert L. Tags: Review Article Source Type: research

Pelvic Congestion Syndrome: Systematic Review of Treatment Success
Semin intervent Radiol 2018; 35: 035-040 DOI: 10.1055/s-0038-1636519Pelvic venous insufficiency is now a well-characterized etiology of pelvic congestion syndrome (PCS). The prevalence of CPP is 15% in females aged 18 to 50 years in the United States and up to 43.4% worldwide. In addition to individual physical, emotional, and quality-of-life implications of CPP, there are profound healthcare and socioeconomic expenses with estimated annual direct and indirect costs in the United States in excess of 39 billion dollars. PCS consists of clinical symptoms with concomitant anatomic and physiologic abnormalities originating in ...
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: Brown, Candace L. Rizer, Magda Alexander, Ryan Sharpe, Emerson E. Rochon, Paul J. Tags: Review Article Source Type: research

Locoregional Therapies for the Treatment of Hepatic Metastases from Breast and Gynecologic Cancers
Semin intervent Radiol 2018; 35: 029-034 DOI: 10.1055/s-0038-1636518Breast cancer is the most common women's malignancy in the United States and is the second leading cause of cancer death. More than half of patients with breast cancer will develop hepatic metastases; this portends a poorer prognosis. In the appropriately selected patient, there does appear to be a role for curative (surgery, ablation) or palliative (intra-arterial treatments) locoregional therapy. Gynecologic malignancies are less common and metastases to the liver are most often seen in the setting of disseminated disease. The role of locoregional therap...
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: Mouli, Samdeep K. Gupta, Ramona Sheth, Neil Gordon, Andrew C. Lewandowski, Robert J. Tags: Review Article Source Type: research

Contraceptive Implant Migration and Removal by Interventional Radiology
Semin intervent Radiol 2018; 35: 023-028 DOI: 10.1055/s-0038-1636517As the reversible contraceptive arm implants grow more popular, there is an increasing need to recognize the complications resulting from implant migration and removal. This review summarizes the findings of imaging and removal methods. When an implant is lost, the axillary region should be investigated first. If the implant still cannot be found, visualization though different methods have been employed for non-radiopaque implants. Real-time fluoroscopic-guided localization and removal can be accomplished for radiopaque Nexplanon. Once the implant has bee...
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: Zhang, Salina Batur, Pelin Martin, Charles Rochon, Paul J. Tags: Review Article Source Type: research

Updates on MR-Guided Focused Ultrasound for Symptomatic Uterine Fibroids
Semin intervent Radiol 2018; 35: 017-022 DOI: 10.1055/s-0038-1636516Magnetic-resonance–guided focused ultrasound (MRgFUS), also called high-intensity focused ultrasound (HIFU) is an effective, noninvasive uterine-preserving treatment for symptomatic uterine fibroids. As the use of this therapeutic modality is not yet widespread, it may remain unfamiliar to many interventional radiologists. The purpose of this review is to discuss MRgFUS, including technology, patient selection, technique, outcomes, complications, and recent data on fertility and comparative effectiveness. [...] Thieme Medical Publishers 333 Seventh A...
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: Sridhar, Divya Kohi, Maureen P. Tags: Review Article Source Type: research

Gender Differences in Peripheral Vascular Disease
Semin intervent Radiol 2018; 35: 009-016 DOI: 10.1055/s-0038-1636515In the past 20 years, peripheral artery disease (PAD) has been increasingly recognized as a significant cause of morbidity and mortality in the United States. PAD has traditionally been identified as a male-dominant disease; however, recent population trends and studies in PAD suggest that women are affected at least as often as men. Women comprise a larger population of the elderly than men, as well as an increasing proportion of patients with PAD. Much of the existing research on PAD has focused on whole populations, and gender-specific data on PAD is sp...
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: Schramm, Kristofer Rochon, Paul J. Tags: Review Article Source Type: research

Management of Chronic Deep Vein Thrombosis in Women
Semin intervent Radiol 2018; 35: 003-008 DOI: 10.1055/s-0038-1636514Chronic deep vein thrombosis (DVT) affects hundreds of thousands of women in the United States. Chronic DVT can lead to pain, edema, venous ulcers, and varicosities. While there are limited data regarding the management of chronic DVT, several interventional radiology groups aggressively treat chronic DVT to aid patient symptom resolution. Recanalization of occluded veins and venous stenting re-establishes deep vein flow and decreases venous hypertension. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournal...
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: Hardman, Rulon L. Tags: Review Article Source Type: research

Confidence, in Relation to the Practice of Interventional Radiology
Semin intervent Radiol 2018; 35: 001-002 DOI: 10.1055/s-0038-1636525 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Authors: Ray, Charles E. Tags: Editorial Source Type: research

Post-Test Questions
Semin intervent Radiol 2018; 35: C1-C4 DOI: 10.1055/s-0038-1642064 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - April 5, 2018 Category: Radiology Tags: Post-Test Questions Source Type: research

Heparin-Induced Thrombocytopenia and Thrombosis: Preventing your Thrombolysis Practice from Taking a HITT
Semin intervent Radiol 2017; 34: 409-414 DOI: 10.1055/s-0037-1608864Heparin-induced thrombocytopenia and thrombosis (HITT) is an under-recognized cause of deep venous thrombosis treatment failure and of complications during catheter-directed thrombolysis. After a review of HITT pathophysiology, diagnosis, and management, three different cases are presented in this article. Each case highlights subtleties and challenges of HITT diagnosis and management. An example of a practical approach to the diagnosis of HITT is presented. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJour...
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Wannamaker, Eric Kondo, Kimi Johnson, D. Thor Tags: Clinical Corner Source Type: research

Malignant Venous Obstruction: Superior Vena Cava Syndrome and Beyond
Semin intervent Radiol 2017; 34: 398-408 DOI: 10.1055/s-0037-1608863Venous obstruction in the cancer population can result in substantial morbidity and, in extreme cases, mortality. While venous obstruction can be caused by both benign and malignant etiologies in this population, the management of malignant venous obstruction as a palliative measure can be somewhat nuanced with respect to nonprocedural and procedural management, both with respect to treatment of the underlying malignancy as well as treatment of venous hypertension, which may be associated with venous thrombosis. Symptom severity, primary malignancy, functi...
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Friedman, Tamir Quencer, Keith B. Kishore, Sirish A. Winokur, Ronald S. Madoff, David C. Tags: Review Article Source Type: research

Palliative Embolization for Refractory Bleeding
Semin intervent Radiol 2017; 34: 387-397 DOI: 10.1055/s-0037-1608862Bleeding is a common and often challenging complication of malignancy. Etiologies of hemorrhage in this patient population vary, and bleeding may present as an acute, life-threatening emergency or a chronic, low-volume blood loss. For patients with advanced malignancies, interventions to manage bleeding must be balanced by the patient's life expectancy and quality of life. As such, minimally invasive procedures such as transarterial embolization are useful therapeutic options in appropriately selected patients. There is a rich history of palliative transar...
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Niekamp, Andrew Sheth, Rahul A. Kuban, Joshua Avritscher, Rony Ganguli, Suvranu Tags: Review Article Source Type: research

Celiac Plexus Block and Neurolysis in the Management of Chronic Upper Abdominal Pain
Semin intervent Radiol 2017; 34: 376-386 DOI: 10.1055/s-0037-1608861Chronic upper abdominal pain occurs as a complication of various malignant and benign diseases including pancreatic cancer and chronic pancreatitis, and when present may contribute to lower quality of life and higher mortality. Though various pain management strategies are available as part of a multimodal approach, they are often incompletely effective and accompanied by side effects. Pain originating in upper abdominal viscera is transmitted through the celiac plexus, which is an autonomic plexus located in the retroperitoneum at the root of the celiac t...
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Cornman-Homonoff, Joshua Holzwanger, Daniel J. Lee, Kyungmouk S. Madoff, David C. Li, David Tags: Review Article Source Type: research

Biliary Obstruction: Endoscopic Approaches
Semin intervent Radiol 2017; 34: 369-375 DOI: 10.1055/s-0037-1608828Painless jaundice is a harbinger of malignant biliary obstruction, with the majority of cases due to pancreatic adenocarcinoma. Despite advances in treatment, including improved surgical techniques and neoadjuvant (preoperative) chemotherapy, long-term survival from pancreatic cancer is rare. This lack of significant improvement in outcomes is believed to be due to multiple reasons, including the advanced stage at diagnosis and lack of an adequate biomarker for screening and early detection, prior to the onset of jaundice or epigastric pain. Close attentio...
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Lee, Jeffrey H. DaVee, Tomas Tags: Review Article Source Type: research

Palliative Percutaneous Biliary Interventions in Malignant High Bile Duct Obstruction
This article reviews the rationale for this approach, periprocedural management, and techniques to optimize stent patency. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Deipolyi, Amy R. Covey, Anne M. Tags: Review Article Source Type: research

Bowel Obstruction: Decompressive Gastrostomies and Cecostomies
This article will review the history of decompressive gastrostomies and cecostomies as well as the indications, contraindications, technique, complications, and outcomes of these procedures. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Miller, Zoe A. Mohan, Prasoon Tartaglione, Robert Narayanan, Govindarajan Tags: Review Article Source Type: research

Symptomatic Fluid Drainage: Peritoneovenous Shunt Placement
Semin intervent Radiol 2017; 34: 343-348 DOI: 10.1055/s-0037-1608705Ascites causes significant discomfort and has negative impact on patient's quality of life. Medical therapies including dietary restriction and diuretics are successful in only 40 to 44% of patients with malignant ascites and repeated paracentesis only provides temporary symptomatic relief. Therefore, a more permanent solution is necessary. Indwelling catheters or peritoneovenous shunt placement can provide more permanent symptomatic relief and improve patients' quality of life. Unlike indwelling catheters, peritoneovenous shunts do not limit patients' lif...
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Yarmohammadi, Hooman Getrajdman, George I. Tags: Review Article Source Type: research

Symptomatic Fluid Drainage: Tunneled Peritoneal and Pleural Catheters
Semin intervent Radiol 2017; 34: 337-342 DOI: 10.1055/s-0037-1608704Malignant ascites and pleural effusion are significant contributors to patient symptoms such as shortness of breath, abdominal distension, and nausea in the setting of cancer. There are numerous methods employed to control such symptoms such as serial drainages, pleurodesis, and tunneled drainage catheters. Tunneled drainage catheters are a safe, effective, and a minimally invasive procedure to palliate the symptoms of malignant ascites and pleural effusion. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJour...
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Ha, Tony Madoff, David C. Li, David Tags: Review Article Source Type: research

Metastatic Osseous Pain Control: Bone Ablation and Cementoplasty
Semin intervent Radiol 2017; 34: 328-336 DOI: 10.1055/s-0037-1608747Nociceptive and/or neuropathic pain can be present in all phases of cancer (early and metastatic) and are not adequately treated in 56 to 82.3% of patients. In these patients, radiotherapy achieves overall pain responses (complete and partial responses combined) up to 60 and 61%. On the other hand, nowadays, ablation is included in clinical guidelines for bone metastases and the technique is governed by level I evidence. Depending on the location of the lesion in the peripheral skeleton, either the Mirels scoring or the Harrington (alternatively the Levy) ...
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Kelekis, Alexis Cornelis, Francois H. Tutton, Sean Filippiadis, Dimitrios Tags: Review Article Source Type: research

Metastatic Osseous Pain Control: Radiation Therapy
Semin intervent Radiol 2017; 34: 322-327 DOI: 10.1055/s-0037-1608703Metastatic disease to the bone is a common manifestation of advanced cancer, and can result in pain, pathologic fractures, hypercalcemia, and overall functional compromise. External beam radiation is a proven, highly efficacious, and noninvasive therapy that can provide symptomatic relief from painful osseous lesions. When deciding upon the best treatment regimen, it is important to consider patient factors such as overall life expectancy, performance status, disease burden, and site of osseous metastatic pain. Determination of best treatment ideally requi...
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Kang, Josephine Formenti, Silvia C. Tags: Review Article Source Type: research

Incorporating Quality of Life Metrics in Interventional Oncology Practice
Semin intervent Radiol 2017; 34: 313-321 DOI: 10.1055/s-0037-1608826Interventional radiologists care for a large number of cancer patients with the breadth of palliative intent minimally invasive procedures that we provide. Understanding our meaningful impact on patients' quality of life is essential toward validating our role in the palliation of cancer patients. As such, it is critically important for interventional radiologists to understand common instruments used for the reporting of patient's quality of life measures. Common instruments used to measure pain and quality of life for cancer patients include the numerica...
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Li, David Madoff, David C. Tags: Review Article Source Type: research

The Role of Palliative Care in Oncology
Semin intervent Radiol 2017; 34: 307-312 DOI: 10.1055/s-0037-1608702Palliative care is a powerful adjunct to oncology that adds distinct value to the physical, mental, and psychosocial well-being of patients living with cancer. Its expanding role and integration with standard oncologic care has proven clinical benefit, as the practice of palliative care can help alleviate symptom burden, enhance illness and prognostic understanding, and improve both the quality of life and overall survival for patients. The primary aim of this review article is to highlight the significant interplay between palliative care and oncology and...
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Agarwal, Rajiv Epstein, Andrew S. Tags: Review Article Source Type: research

Respect
Semin intervent Radiol 2017; 34: 305-306 DOI: 10.1055/s-0037-1608865 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Authors: Ray, Charles E. Tags: Editorial Source Type: research

Post-Test Questions
Semin intervent Radiol 2017; 34: C1-C6 DOI: 10.1055/s-0037-1617442 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - December 14, 2017 Category: Radiology Tags: Post-Test Questions Source Type: research

Hepatic Radioembolization Complicated by Abscess
Semin intervent Radiol 2017; 34: 303-304 DOI: 10.1055/s-0037-1606200 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Authors: Mascarenhas, Neil Ryu, Robert K. Salem, Riad Tags: Erratum Source Type: research

Importance of Multidisciplinary Approach to Vascular Malformation Management
Semin intervent Radiol 2017; 34: 301-302 DOI: 10.1055/s-0037-1604302 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Authors: Rochon, Paul J. Tags: How I Do It Source Type: research

Magnetic Resonance Lymphangiography and Lymphatic Embolization in the Treatment of Pulmonary Complication of Lymphatic Malformation
Semin intervent Radiol 2017; 34: 294-300 DOI: 10.1055/s-0037-1604301Lymphatic malformations (LMs; especially those involving the central conducting lymphatic channels) are characterized by dysplastic and incompetent lymphatic channels in multiple tissues and organs. The major cause of mortality and morbidity in patients with thoracic LM is deterioration of pulmonary function due to chronic chylous effusions and progressive interstitial lung disease. The etiology of these pulmonary processes is unknown, although lymphatic involvement is certain. Understanding of the changes in the lymphatic anatomy in patients with LM has b...
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Authors: Itkin, Maxim Tags: Review Article Source Type: research

Outcomes of Venous Malformation Sclerotherapy: A Review of Study Methodology and Long-Term Results
Semin intervent Radiol 2017; 34: 288-293 DOI: 10.1055/s-0037-1604300It is very important that patients seeking sclerotherapy for the treatment of venous malformations are aware of the expected course of the therapy. They should be thoroughly counseled about the complications, the need for multiple sessions of therapy, and also about the expected clinical outcome. The aim of this review is to discuss the long-term outcomes of sclerotherapy for the treatment of venous malformation. Many studies have discussed their individual center's experiences and short-midterm results, but there is a relative paucity of data on long-term...
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Authors: Ali, Sumera Mitchell, Sally E. Tags: Review Article Source Type: research

Percutaneous Image-Guided Cryoablation in Vascular Anomalies
Semin intervent Radiol 2017; 34: 280-287 DOI: 10.1055/s-0037-1604453Understanding and management of vascular anomalies has always been intriguing. These disorders exhibit an expected pattern of clinical presentation and progression, and characteristic imaging findings. Significant progress in understanding and treating patients with vascular anomalies has been made in the past quarter century. Newer multidisciplinary domains for treating these disorders with medical drugs and less invasive image-guided or surgical procedures are constantly evolving. Vascular anomalies can exhibit aggressive tumor-like behavior resulting in...
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Authors: Shaikh, Raja Tags: Review Article Source Type: research

Special Consideration for Intraosseous Arteriovenous Malformations
Semin intervent Radiol 2017; 34: 272-279 DOI: 10.1055/s-0037-1605368Intraosseous arteriovenous malformations (AVMs) have been associated with distortion, hypertrophy, osteolytic skeletal changes, bleeding, leg length discrepancy, and pathologic fracture. Computed tomography or magnetic resonance imaging is helpful in the evaluation of the extent and depth of intraosseous AVMs and associated soft-tissue AVMs. Treatment approaches can differ, depending on the angiographic classification. Embolotherapy with ethanol, coils, or n-butyl cyanoacrylate is the primary treatment for symptomatic intraosseous AVMs, and the goal of tre...
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Authors: Do, Young Soo Park, Kwang Bo Tags: Review Article Source Type: research

New Treatment Approaches to Arteriovenous Malformations
Semin intervent Radiol 2017; 34: 258-271 DOI: 10.1055/s-0037-1604299Arteriovenous malformations (AVMs) are high-flow vascular anomalies that have demonstrated a very high recurrence rate after endovascular treatment, surgical treatment, or a combination of both. Surgical treatments have shown good response when they are small and well localized but a poor response when diffuse. A better understanding of the nature of the lesion has led to a better response rate and a safer treatment for these patients. This has been accomplished through a detailed understanding of the angioarchitecture of the lesion, enabling a tailored ap...
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Authors: Gilbert, Patrick Dubois, Jos ée Giroux, Marie France Soulez, Gilles Tags: Review Article Source Type: research

Angioarchitecture of Hereditary Arteriovenous Malformations
This article describes three hereditary conditions known to be associated with arteriovenous malformation (AVM), along with their clinical and imaging features and angiographic angioarchitecture. Hereditary hemorrhagic telangiectasia, capillary malformation–AVM (CM–AVM), and PTEN tumor hamartoma syndrome are conditions with autosomal dominant inheritance, caused by mutations in different molecular pathways, which frequently present with symptomatic AVMs. Imaging biomarkers, including sites of predilection, angioarchitecture, and tissue overgrowth patterns, are helpful in identifying these patients and selecting...
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Authors: Burrows, Patricia E. Tags: Review Article Source Type: research

Advances in the Medical Management of Vascular Anomalies
Semin intervent Radiol 2017; 34: 239-249 DOI: 10.1055/s-0037-1604297Vascular anomalies comprise a spectrum of diseases that are broadly classified as tumors and malformations. Diagnosis is often challenging, given a wide range of clinical presentations with overlapping signs and symptoms. Accurate diagnosis is critical to determine prognosis and to generate a management plan, which frequently involves multiple subspecialists during different phases of treatment. An updated classification system provides structure and clear, consistent terminology, allowing for improved diagnosis, provider communication, and collaboration. ...
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Authors: Ricci, Kiersten W. Tags: Review Article Source Type: research

Vascular Anomalies Caused by Abnormal Signaling within Endothelial Cells: Targets for Novel Therapies
Semin intervent Radiol 2017; 34: 233-238 DOI: 10.1055/s-0037-1604296Vascular anomalies arise as a consequence of improper development and maintenance of the vasculature. Our knowledge on the pathophysiological bases of vascular anomalies has skyrocketed during the past 5 years. It is becoming clear that common intracellular signaling pathways are often activated by mutations, causing endothelial cell dysfunction. These mutations cause hyperactivation of two major intracellular signaling pathways that may be controlled by inhibitors developed for cancer treatment. Although we do not know yet all the downstream effects, it h...
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Authors: Nguyen, Ha-Long Boon, Laurence M. Vikkula, Miikka Tags: Review Article Source Type: research

Classification of Vascular Anomalies: An Update
Semin intervent Radiol 2017; 34: 225-232 DOI: 10.1055/s-0037-1604295Vascular anomalies present both a diagnostic and therapeutic challenge to physicians. Identification of these lesions is difficult due to their immense phenotypic variability, and naming conventions for vascular anomalies have historically been inconsistent. Terms such as “hemangioma” are informative when used correctly, but can cause confusion and miscommunication if applied indiscriminately to all vascular anomalies. Accuracy in classification is essential, as both disease course and therapeutic options differ greatly depending on the particu...
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Authors: Steiner, Jack E. Drolet, Beth A. Tags: Review Article Source Type: research

Post-Test Questions
Semin intervent Radiol 2017; 34: C1-C6 DOI: 10.1055/s-0037-1606191 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - September 11, 2017 Category: Radiology Tags: Post-Test Questions Source Type: research

Percutaneous Aortic Fenestration for Symptomatic Type B Aortic Dissection
Semin intervent Radiol 2017; 34: 220-224 DOI: 10.1055/s-0037-1602654 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Interventional Radiology)
Source: Seminars in Interventional Radiology - June 1, 2017 Category: Radiology Authors: Fergus, Johnathan Funaki, Brian Tags: Trainee Corner Source Type: research