Journal of Vascular and Interventional Radiology最新文献

Purpose: To evaluate differences in burnout, perceived stress, and job satisfaction among physicians, nurses, and technologists working in interventional radiology (IR) and cardiology (IC) teams within a high-volume, 24/7 tertiary care center.

Material and methods: This cross-sectional, questionnaire-based study was conducted at XXXXX's largest high-volume tertiary interventional center. Data were collected on-site using standardized instruments: the Maslach Burnout Inventory (MBI), the Perceived Stress Scale (PSS-14), and the Minnesota Satisfaction Questionnaire (MSQ). Group comparisons were performed using Mann-Whitney U and chi-square tests. Structural equation modeling (SEM) was used to explore direct and indirect effects among stress, burnout, and job satisfaction.

Results: IR physicians reported significantly higher emotional exhaustion (median: 26.0 vs. 20.0, p=0.025) and depersonalization (17.0 vs. 8.0, p<0.001) compared to IC physicians. Among staff, burnout levels were greater in IC personnel than in IR staff, with higher scores in emotional exhaustion (20.5 vs. 15.0, p=0.002) and depersonalization (9.5 vs. 5.0, p=0.010). IC staff also demonstrated significant lower job satisfaction across all subscales (all p<0.001). SEM revealed that perceived stress negatively impacted job satisfaction directly (β = -0.903, p<0.001) and indirectly via emotional exhaustion. The model explained for 34.4% of the variance in job satisfaction.

Conclusion: Burnout, perceived stress, and job satisfaction levels differed between interventional radiology and cardiology teams. IR physicians reported higher levels of burnout, while IC staff demonstrated lower job satisfaction. These findings highlight the need for targeted institutional strategies tailored to the specific needs of each group.

Objective: To evaluate the clinical application and outcomes of a percutaneously placed, retrievable, fully covered self-expandable metallic stent (FCSEMS) with retrieval string with an alternative retrieval string fixation technique for the management of benign biliary conditions.

Methods: This single-center, retrospective study included 87 patients who underwent percutaneous placement of retrievable FCSEMS with retrieval string between March 2020 and February 2025. Patients were categorized according to indication: anastomotic stricture (n = 30), bile leak (n = 41), and biliary stones (n = 16). The primary outcomes were technical and clinical success rates, with secondary outcomes including complication rates and long-term patency.

Results: Technical success was achieved in 98% of procedures. Clinical success rates were 97% for anastomotic strictures (6-month follow-up), 91% for bile leaks, and 94% for biliary stones. Mean stent indwelling times were 3.0 ± 0.8 months, 1.9 ± 0.7 months, and 0.7 ± 0.3 months, respectively. The estimated mean recurrence-free duration for anastomotic strictures was 41.7 months, with a 36-month patency rate of 67%. Stent migration occurred in 3.4% (3/87) of patients, while one retrieval string breakage and three cases of cholangitis were recorded.

Conclusion: In this single-center observational cohort, percutaneous implantation of a retrievable FCSEMS with retrieval string using an alternative fixation technique appears to be a safe and effective approach for the management of benign biliary conditions. In our cohort, this technique was associated with favorable long-term patency in anastomotic strictures, favorable outcomes in bile leaks and stones, and a low rate of stent migration.

Purpose: To assess the feasibility, safety and efficacy of superselective transarterial embolization (TAE) using imipenem/ cilastatin sodium for plantar fasciitis (PF) refractory to conservative management.

Materials and methods: This retrospective study included 12 patients (50% males, mean age: 36±9.07 years) with PF (pain on palpation along the proximal plantar fascia and thickened plantar fascia [>4 mm] on MRI) refractory to conservative management for ≥3 months. Superselective cannulation of branches from the posterior tibial artery (PTA) supplying the point of maximal pain at the plantar fascia origin was performed, and branches showing hypervascular staining (contrast blush) were embolized using a suspension of 500mg of imipenem/ cilastatin sodium in 5mL of iodinated contrast agent. Visual analogue scale (VAS) was used to assess pain at baseline, 1 day, 1 week, 1 month, 3 months, 6 months, 9 months, and 12 months post-procedure.

Results: PTA branches supplying area of hypervascular staining could be superselectively embolized in 11/12 patients (technical success: 91.7%; mean number of arteries embolized: 1.5±0.7; mean amount of embolizing agent used: 1.1±0.5 mL). A significant decrease in VAS score was noted on day 1 post-procedure (2.27±1.19 vs. 7.36±0.92; p<0.0001), which persisted through 12 months of follow-up. Clinical success, defined as ≥50% reduction in VAS score at 6 months, was achieved in 8/11 (72.73%) patients who underwent embolization and was sustained through 12 months of follow-up.

Conclusion: Superselective TAE using imipenem/ cilastatin sodium is feasible, safe, and effective in alleviating pain associated with PF refractory to conservative management, with a low risk of adverse events.

Purpose: To compare three left adrenal vein sampling sites-the left adrenal central vein (LCV), the peripheral common trunk (P-CMT), which is near the confluence of the inferior phrenic vein and LCV, and the middle common trunk (M-CMT)-and attempt to identify the reliable site for left adrenal vein sampling(AVS).

Materials and methods: Consecutive primary aldosteronism(PA) patients who underwent AVS at a general hospital (September 2019-October 2023) were enrolled. Procedure details and clinical data were collected to analyze the success rates of blood sampling (selectivity index[SI] ≥2) , aldosterone-to-cortisol (A/C) ratios, and bilateral suppression characteristics.

Results: Among the 155 enrolled patients (90 males), both LCV and P-CMT had higher cortisol levels, SI, and success rates than M-CMT (p<0.05). No meaningful differences were observed between LCV and P-CMT. In the 126 patients with successful sampling, LCV had higher cortisol levels than P-CMT, but no significant difference were observed in plasma aldosterone concentration (PAC), A/C ratios, and lateralization index (LI) . LI cutoffs (≥2 or ≥4) showed no difference in dominant side determination. Pearson analysis confirmed strong correlations in plasma cortisol, PAC, and LI between LCV and P-CMT. Apparent bilateral adrenal suppression (ABAS) rates did not differ significantly between P-CMT and LCV.

Conclusions: The peripheral common trunk is a valid and practical alternative to the left central adrenal vein for successful left adrenal vein sampling.

Purpose: This study reports the results of the adjunctive use of cutting balloon angioplasty (CBA) in the management of conventional balloon resistant renal artery stenosis (RAS). The primary outcome was to assess the clinical benefit of blood pressure control, and the secondary outcome was to assess renal growth.

Materials & methods: Patients under 21 years of age with renovascular hypertension who underwent angioplasty and CBA were reviewed. Thirty patients (70% male; median age 7.5 years [IQR: 5.7 - 12.5]) underwent 35 treatment episodes. 57% had fibromuscular dysplasia (FMD), 23% had FMD + mid aortic syndrome (MAS), and 20% had neurofibromatosis type-1 ± MAS. Clinical and follow-up data were reviewed. Renal artery sizing was calculated from the diameter of the normal portion of the involved artery or the contralateral normal renal artery. In patients with persistent stenosis despite optimal sized balloon angioplasty, CBA was performed.

Results: In total, 37 stenoses were targeted, 6 had prior balloon angioplasty in a separate treatment. Technical success (traversal of stenosis) rate was 89% (33/37). Angioplasty improvement (>30% stenosis improvement) rate was 94% (31/33). No significant relationship between technical failure, angiographic failure and stenosis location/length or syndrome. The AE rate was 16% (6/37), with two moderate (segmental and subsegmental thrombus) and two severe (pseudoaneurysm and arterial perforation). Clinical benefit rate at median follow-up of 59 months (IQR: 37 - 95) was 83% (25/30).

Conclusion: CBA offers a promising alternative for the management of resistant RAS, is technically feasible, and demonstrates clinical benefit. However, the observed AEs underscore the need for careful patient selection.

Purpose: Microwave ablation in the treatment of parathyroid adenomas is becoming increasingly popular because it does not require general anesthesia and short hospitalization times. Recurrent laryngeal nerve injury is the most expected complication and studies are ongoing to determine treatment efficacy and complication risks. This study aimed to investigate the effect of parathyroid adenoma location on treatment success and adverse event.

Materials and methods: A retrospective, observational case study included 285 patients with parathyroid adenoma treated at a single center. Pre- and post-procedure blood parameters, Ultrasound findings and parathyroid adenoma locations (Perrier Classification) were investigated in relation to procedural success and adverse event. Procedural success was defined as the patient's calcium and parathyroid hormone levels remaining within normal limits for at least 6 months of follow-up, the absence of blood flow in the parathyroid adenoma in the control Doppler, and its gradual reduction in size.

Results: Overall procedural success was 88.4% and the risk of transient hoarseness was 3.8% in all groups. In Group D, located near the recurrent laryngeal nerve, the procedure success rate was determined to be the lowest at 72.2%. However, no significant differences were found between location groups in terms of the risk of transient hoarseness or procedure success.

Conclusion: Microwave ablation therapy has a high success rate in all location groups of parathyroid adenomas and has a low risk of side effects. In location type D, the success rate is low, but no statistical difference has been detected.