Journal of Vascular and Interventional Radiology最新文献

英文中文

Incidence and Clinical Course of Lower-Limb Lymphedema after Intranodal n-Butyl-2-Cyanoacrylate Embolization for Postoperative Lymphorrhea 结内n -丁基-2-氰基丙烯酸酯栓塞治疗术后淋巴漏后下肢淋巴水肿的发生率和临床病程。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-04-01 Epub Date: 2026-01-21 DOI: 10.1016/j.jvir.2026.108541

Jitsuro Tsukada MD, PhD , Masanori Inoue MD, PhD , Masashi Tamura MD, PhD , Hideyuki Torikai MD , Hiroki Yoshikawa MD , Mamina Miyabayashi MD , Junya Tsuzaki MD , Togo Kogo MD , Yuji Furukawa MD , Ryo Ogawa MD , Yosuke Yamamoto MD , Yushi Suzuki MD, PhD , Nobutake Ito MD, PhD , Seishi Nakatsuka MD, PhD , Masahiro Jinzaki MD, PhD

Purpose

To evaluate the incidence and clinical course of lower-limb lymphedema following intranodal n-butyl-2-cyanoacrylate (nBCA) embolization of the inguinal lymph nodes for postoperative lymphorrhea.

Materials and Methods

This retrospective study included 26 patients (24 men and 2 women; age, 69.5 years) who underwent intranodal nBCA embolization for postoperative lymphorrhea between 2017 and 2023. Under ultrasound (US) guidance, inguinal lymph nodes were punctured, and embolization was performed with nBCA and ethiodized oil at a 2:1 ratio (ethiodized oil:nBCA). The primary approach was to embolize through the initially accessed lymph node when the efferent channel and leakage site were visualized. Clinical success was defined as improvement of lymphorrhea-related symptoms with catheter removal or ≥80% drainage reduction within 21 days. Lower-limb lymphedema was defined as new-onset or worsening of existing edema in 60 days after embolization and categorized as reversible or persistent.

Results

Clinical success was achieved in 24 of 26 patients (92.3%), with a median time to resolution of 6 days (range, 2–21 days). Lower-limb lymphedema worsened in 6 patients (23.1%), including 4 reversible and 2 persistent cases. No new-onset lymphedema occurred; all represented exacerbation of pre-existing edema. Both persistent cases involved patients with prior pelvic lymph node dissection. No procedure-related deaths or major complications occurred.

Conclusion

Inguinal intranodal nBCA embolization effectively controls postoperative lymphorrhea but may worsen pre-existing lower-limb lymphedema, particularly in patients with prior pelvic lymph node dissection. To minimize nontarget embolization of lower-extremity drainage pathways, lymphatic embolization should be performed as selectively and as close to the leakage site as possible.

目的探讨腹股沟淋巴结结内正丁基-2-氰基丙烯酸酯（nBCA）栓塞治疗术后淋巴漏术后下肢淋巴水肿的发生率及临床病程。材料和方法本回顾性研究纳入了26例患者（男性24例，女性2例，年龄69.5岁），这些患者在2017年至2023年期间接受了结内nBCA栓塞治疗术后淋巴漏。超声引导下穿刺腹股沟淋巴结，用nBCA和乙硫化油按2:1的比例栓塞（乙硫化油：nBCA）。当传出通道和渗漏部位可见时，主要的入路是通过最初进入的淋巴结进行栓塞。临床成功的定义是在21天内清除导管或引流量减少≥80%，淋巴相关症状得到改善。下肢淋巴水肿定义为栓塞后60天内新发或现有水肿加重，分为可逆性或持续性。结果26例患者中有24例（92.3%）获得临床成功，中位缓解时间为6天（范围2-21天）。下肢淋巴水肿加重6例（23.1%），可逆4例，持续性2例。无新发淋巴水肿；所有患者均表现为原有水肿加重。两例持续性病例均涉及先前盆腔淋巴结清扫的患者。无手术相关死亡或重大并发症发生。结论腹股沟结内nBCA栓塞可有效控制术后淋巴漏，但可能加重已存在的下肢淋巴水肿，特别是先前有盆腔淋巴结清扫的患者。为了尽量减少下肢引流通路的非靶栓塞，应选择性地进行淋巴栓塞，并尽可能靠近渗漏部位。

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引用次数: 0

SHAM-PAIN Trial: Genicular Artery Embolization for Reducing Pain in Medically Refractory Symptomatic Knee Osteoarthritis—A Randomized Sham-Controlled Pilot Study 假疼痛试验：膝动脉栓塞减轻医学上难治性症状膝骨关节炎的疼痛-一项随机假对照试验研究。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-04-01 Epub Date: 2026-01-09 DOI: 10.1016/j.jvir.2026.107990

Osman Ahmed MD , Faisal F. Al-Qawasmi MD , Magdalena Anitescu MD, PhD , Sara Wallace MD , Tessa Balach MD , Brendon Ross DO , Gregory Scott Stacy MD , Timothy Carroll PhD , Theodore Karrison PhD , Hollis Potter MD , Akhilesh Sista MD , Joel A. Block MD

引用次数: 0

Crossword Puzzle: Answer Key 填字游戏：回答关键

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-04-01 Epub Date: 2026-01-22 DOI: 10.1016/j.jvir.2026.107992

引用次数: 0

Bronchial Arterial Chemoembolization Combined with Tislelizumab for Non–Small Cell Lung Cancer: An Exploratory, Prospective, Single-Arm, Phase II Trial 支气管动脉化疗栓塞联合Tislelizumab治疗非小细胞肺癌：一项探索性、前瞻性、单组、II期试验

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-04-01 Epub Date: 2026-01-16 DOI: 10.1016/j.jvir.2026.108001

Chao Liang MM , Daqian Han MM , Hao Li MM , Manzhou Wang MM , Donglin Kuang MM , Huan Chen BM , Haolin Miao BM , Pengfei Chen MM , Huibin Lu MD , Pengfei Jiao MD , Jianzhuang Ren MD , Xinwei Han MD , Fang Li MD , Xuhua Duan MD

Purpose

To assess the effectiveness and safety of bronchial arterial chemoembolization (BACE) combined with tislelizumab for advanced non–small cell lung cancer (NSCLC).

Materials and Methods

In a prospective single-arm, Phase II study, patients with Stage IIIA–IIIC NSCLC who refused or were ineligible for standard treatments were enrolled. Patients received BACE followed by 200-mg tislelizumab every 3 weeks until disease progression, intolerable toxicities, or discontinuation determined by the investigators. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), objective response rate (ORR), disease control rate (DCR), safety, and quality of life (QoL).

Results

Thirty patients (median age, 67 years, 24 men) were enrolled between December 2021 and August 2022. The median follow-up was 23 months (95% CI, 21.5–24.5). At data cutoff (March 1, 2024), median PFS was 10.5 months (95% CI, 7.8–13.2), and median OS was 15.0 months (95% CI, 8.2–21.8). ORR was 60.0% (18 of 30 patients), and DCR was 80.0% (24 of 30 patients). PD-L1 expression, tumor feeding arteries, and previous treatment history were prognostic factors for PFS and OS. Throughout the treatment and follow-up period, no Grade ≥3 treatment-related adverse events (TRAEs) were observed, as assessed by the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Common Grade 1–2 TRAEs were nausea, chest pain, and anemia. QoL (global, physical, and emotional functioning) improved significantly after 1 treatment cycle versus baseline.

Conclusions

The prospective study suggests that BACE plus tislelizumab offer promising effectiveness and acceptable safety in advanced NSCLC, supporting further randomized trials.

目的：本研究的目的是评估BACE联合tislelizumab治疗晚期非小细胞肺癌（NSCLC）的疗效和安全性。材料和方法：在一项前瞻性单臂II期研究中，纳入了拒绝或不符合标准治疗条件的IIIA-IIIC期NSCLC患者。患者接受BACE治疗，随后每3周服用200mg tislelizumab，直到研究人员确定疾病进展、无法忍受的毒性或停药。主要终点是无进展生存期（PFS）；次要终点为总生存期（OS）、客观缓解率（ORR）、疾病控制率（DCR）、安全性和生活质量（QoL）。结果：在2021年12月至2022年8月期间入组了30例患者（中位年龄67岁，男性24例）。中位随访为23个月（95%可信区间[CI]， 21.5-24.5）。在数据截止日期（2024年3月1日），中位PFS为10.5 （95%CI, 7.8-13.2）个月，中位OS为15.0 （95%CI, 8.2-21.8）个月。ORR为60.0% (18 / 30)，DCR为80.0%（24 / 30）。PD-L1表达、肿瘤供血动脉和既往治疗史是PFS和OS的预后因素。在整个治疗和随访期间，根据不良事件通用术语标准（CTCAE） 4.0版评估，未观察到3级或更高级别的治疗相关不良事件（TRAEs）。常见的1-2级trae为恶心、胸痛和贫血。与基线相比，1个治疗周期后QoL（整体、身体、情绪功能）显著改善。结论：这项前瞻性研究表明，BACE联合tislelizumab在晚期NSCLC中具有良好的疗效和可接受的安全性，支持进一步的随机试验。

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引用次数: 0

Drain Irrigation with Vacuum Assistance Necrosectomy in Necrotizing Pancreatitis 真空辅助引流灌洗术治疗坏死性胰腺炎。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-04-01 Epub Date: 2026-01-22 DOI: 10.1016/j.jvir.2026.108547

Stella Chen MD, PhD , Ian W. Sullivan DO , Nathan E. Frenk MD , Perry Hampilos MD , Kei Yamada MD

Purpose

To compare traditional minimally invasive treatments for necrotizing pancreatitis with a novel percutaneous approach, drain irrigation with vacuum assistance (DIVA) necrosectomy.

Materials and Methods

In this retrospective, single-center study, 20 patients with necrotizing pancreatitis treated with minimally invasive necrosectomy between June 2022 and June 2024 at a tertiary care center were reviewed: 6 received DIVA, and 14 received video-assisted retroperitoneal debridement (VARD) or endoscopic transgastric necrosectomy (ETN). In the DIVA procedure, a suction device is inserted in a mature drain tract in tandem with an irrigation catheter, and vacuum debridement is performed with negative pressure reaching 98.9 kPa. Demographic data and preprocedural severity were recorded. The number of procedures each patient underwent, time to imaging resolution, and the number and nature of adverse events experienced were compared between the DIVA and VARD/ETN groups.

Results

Patients who underwent DIVA had higher disease severity at presentation (Acute Physiology and Chronic Health Evaluation II score, 15.0 vs 6.5; P = .012) and reached resolution of abdominal fluid collections more quickly (48.8 days vs 110.1 days, P = .017). DIVA patients all reached resolution, whereas only 12 (86%) of 14 VARD/ETN reached resolution. Additionally, DIVA trended toward fewer adverse events, although this difference was not statistically significant (risk ratio, 0.20; 95% CI, 0.03–1.5; P = .161).

Conclusions

Despite higher disease severity at presentation, patients undergoing image-guided DIVA necrosectomy experienced a faster resolution than VARD/ETN patients. These preliminary results warrant further research into DIVA’s role in treatment of necrotizing pancreatitis.

目的：本研究比较了传统微创治疗坏死性胰腺炎与一种新的经皮方法，真空辅助引流术（DIVA）坏死性切除术。材料和方法：在这项回顾性单中心研究中，回顾了2022年6月至2024年6月在三级保健中心接受微创坏死切除术治疗的20例坏死性胰腺炎患者：6例接受DIVA， 14例接受视频辅助腹膜后清创（VARD）或内镜下经胃坏死切除术（ETN）。DIVA手术是在成熟的引流道内插入吸引装置，配合冲洗导管，负压达到98.9kPa进行真空清创。记录人口统计数据和术前严重程度。比较DIVA组和VARD/ETN组之间每位患者接受手术的次数、成像分辨率的时间以及所经历的不良事件的数量和性质。结果：接受DIVA的患者在就诊时疾病严重程度更高（急性生理和慢性健康评估（APACHE） II评分15.0比6.5,p = 0.012），并且更快地达到腹腔积液的溶解（48.8天比110.1天，p = 0.017）。DIVA患者均达到缓解，而14例VARD/ETN患者中只有12例（86%）达到缓解。此外，DIVA倾向于较少的不良事件，尽管这种差异无统计学意义（RR 0.20, 95% CI 0.03-1.5, p = 0.161）。结论：尽管首发时疾病严重程度较高，但与VARD/ETN患者相比，接受图像引导的DIVA坏死切除术的患者缓解速度更快。这些初步结果为进一步研究DIVA在治疗坏死性胰腺炎中的作用提供了依据。

{"title":"Drain Irrigation with Vacuum Assistance Necrosectomy in Necrotizing Pancreatitis","authors":"Stella Chen MD, PhD , Ian W. Sullivan DO , Nathan E. Frenk MD , Perry Hampilos MD , Kei Yamada MD","doi":"10.1016/j.jvir.2026.108547","DOIUrl":"10.1016/j.jvir.2026.108547","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare traditional minimally invasive treatments for necrotizing pancreatitis with a novel percutaneous approach, drain irrigation with vacuum assistance (DIVA) necrosectomy.</div></div><div><h3>Materials and Methods</h3><div>In this retrospective, single-center study, 20 patients with necrotizing pancreatitis treated with minimally invasive necrosectomy between June 2022 and June 2024 at a tertiary care center were reviewed: 6 received DIVA, and 14 received video-assisted retroperitoneal debridement (VARD) or endoscopic transgastric necrosectomy (ETN). In the DIVA procedure, a suction device is inserted in a mature drain tract in tandem with an irrigation catheter, and vacuum debridement is performed with negative pressure reaching 98.9 kPa. Demographic data and preprocedural severity were recorded. The number of procedures each patient underwent, time to imaging resolution, and the number and nature of adverse events experienced were compared between the DIVA and VARD/ETN groups.</div></div><div><h3>Results</h3><div>Patients who underwent DIVA had higher disease severity at presentation (Acute Physiology and Chronic Health Evaluation II score, 15.0 vs 6.5; <em>P</em> = .012) and reached resolution of abdominal fluid collections more quickly (48.8 days vs 110.1 days, <em>P</em> = .017). DIVA patients all reached resolution, whereas only 12 (86%) of 14 VARD/ETN reached resolution. Additionally, DIVA trended toward fewer adverse events, although this difference was not statistically significant (risk ratio, 0.20; 95% CI, 0.03–1.5; <em>P</em> = .161).</div></div><div><h3>Conclusions</h3><div>Despite higher disease severity at presentation, patients undergoing image-guided DIVA necrosectomy experienced a faster resolution than VARD/ETN patients. These preliminary results warrant further research into DIVA’s role in treatment of necrotizing pancreatitis.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 4","pages":"Article 108547"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to “Safety and Effectiveness of Transarterial Chemoembolization for Caudate Lobe Hepatocellular Carcinoma: Long-Term Clinical Outcomes” 致“经动脉化疗栓塞治疗尾状叶肝癌的安全性和有效性：长期临床结果”的信。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-04-01 Epub Date: 2026-01-10 DOI: 10.1016/j.jvir.2025.107960

Hiroyuki Tokue MD, Yoshito Tsushima MD

引用次数: 0

Aliya as High-Frequency Irreversible Electroporation: A Call for Consistent Pulsed Electric Field Terminology in IR Literature Aliya作为高频IRE：介入放射学文献中一致的PEF术语的呼吁。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-04-01 Epub Date: 2026-01-01 DOI: 10.1016/j.jvir.2025.107988

Hamidreza Rouientan MD , Mohammad Ghasemi-Rad MD , Shahram Akhlaghpoor MD

引用次数: 0

Effectiveness of Nitinol-Constrained Balloon Angioplasty for Treating Postangioplasty Dissections in Chronic Total Occlusions of the Femoropopliteal Segment 镍钛醇约束球囊血管成形术治疗股腘段慢性完全性闭塞血管成形术后夹层的疗效。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-04-01 Epub Date: 2025-11-07 DOI: 10.1016/j.jvir.2025.107912

Domenico Mirabella MD , Salvatore Bruno MD , Manfredi La Marca MD , Ettore Dinoto MD , Carlo Setacci MD , Felice Pecoraro MD

Purpose

To assess the effectiveness of nitinol-constrained balloon (NCB; Chocolate; Medtronic, Dublin, Ireland) percutaneous transluminal angioplasty (PTA) for treating Diameter reduction, Spiral shape, Flow impairment, or adverse Morphology (DISFORM) III postangioplasty dissections in chronic total occlusions (CTOs) of the femoropopliteal segment.

Materials and Methods

The CHOCOlate-STABilization (CHOCO-STAB) study was conducted from February 2019 to February 2022. It included patients with peripheral arterial disease affected by chronic limb-threatening ischemia. This study specifically included patients with DISFORM III postangioplasty dissections who were treated using NCB angioplasty after initial PTA. The main outcomes assessed in this study were technical success and the occurrence of major adverse events.

Results

This study included 68 patients with a mean age of 72 years (SD ± 10), of whom 39% had diabetes. The initially treated CTOs had a mean length of 10.32 mm (SD ± 5; interquartile range, 5–15 mm), with moderate or severe calcification in 28%. Forty-seven (69%) patients received initial treatment with drug-coated balloons (DCBs). NCB angioplasty was feasible in all patients, achieving technical success in 62 (91%). Stent placement was required in the remaining 6 (9%) cases. Three-year estimated overall survival was 98.5%, primary patency was 88.2%, freedom from major amputation was 94.1%, and freedom from clinical target lesion revascularization was 94.1%.

Conclusions

Postangioplasty dissections represent a relevant adverse event that necessitates scaffolding in moderate and severe grades. The CHOCO-STAB study demonstrated the safety and potential of NCB angioplasty to reduce stent placement in patients treated with DCB and plain old balloon angioplasty who present with postangioplasty dissections.

目的：本研究旨在评估镍钛醇约束球囊（NCB; Chocolate, Medtronic）经皮腔内血管成形术（PTA）治疗慢性全闭塞（CTO）股腘段血管成形术后夹层畸形III的有效性。材料与方法：cho - stab研究于2019年2月至2022年2月进行。包括外周动脉疾病（PAD）伴慢性肢体威胁缺血（CLTI）的患者。本研究特别纳入了在初始PTA后使用NCB血管成形术治疗的DISFORM III型血管成形术后夹层患者。本研究评估的主要结果是技术成功和主要不良事件（MAE）的发生。结果：本研究纳入68例患者，平均年龄72岁（SD: 10），其中39%为糖尿病。最初治疗的cto平均长度为10.32 mm (IQR: 5-15; SD: 5)， 28%出现中度或重度钙化。47例（69%）患者接受了药物包被球囊（DCB）的初始治疗。NCB血管成形术在所有患者中都是可行的，62例（91%）获得了技术成功。其余6例（9%）需要植入支架。3年估计总生存率为98.5%，原发通畅率为88.2%，主要截肢解除率为94.1%，临床TLR解除率为94.1%。结论：血管成形术后夹层是一种相关的不良事件，在中度和重度时需要支架。CHOCO-STAB研究证明了NCB血管成形术的安全性和潜力，可以减少血管成形术后出现夹层的DCB和POBA患者的支架置入术。

{"title":"Effectiveness of Nitinol-Constrained Balloon Angioplasty for Treating Postangioplasty Dissections in Chronic Total Occlusions of the Femoropopliteal Segment","authors":"Domenico Mirabella MD , Salvatore Bruno MD , Manfredi La Marca MD , Ettore Dinoto MD , Carlo Setacci MD , Felice Pecoraro MD","doi":"10.1016/j.jvir.2025.107912","DOIUrl":"10.1016/j.jvir.2025.107912","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the effectiveness of nitinol-constrained balloon (NCB; Chocolate; Medtronic, Dublin, Ireland) percutaneous transluminal angioplasty (PTA) for treating Diameter reduction, Spiral shape, Flow impairment, or adverse Morphology (DISFORM) III postangioplasty dissections in chronic total occlusions (CTOs) of the femoropopliteal segment.</div></div><div><h3>Materials and Methods</h3><div>The CHOCOlate-STABilization (CHOCO-STAB) study was conducted from February 2019 to February 2022. It included patients with peripheral arterial disease affected by chronic limb-threatening ischemia. This study specifically included patients with DISFORM III postangioplasty dissections who were treated using NCB angioplasty after initial PTA. The main outcomes assessed in this study were technical success and the occurrence of major adverse events.</div></div><div><h3>Results</h3><div>This study included 68 patients with a mean age of 72 years (SD ± 10), of whom 39% had diabetes. The initially treated CTOs had a mean length of 10.32 mm (SD ± 5; interquartile range, 5–15 mm), with moderate or severe calcification in 28%. Forty-seven (69%) patients received initial treatment with drug-coated balloons (DCBs). NCB angioplasty was feasible in all patients, achieving technical success in 62 (91%). Stent placement was required in the remaining 6 (9%) cases. Three-year estimated overall survival was 98.5%, primary patency was 88.2%, freedom from major amputation was 94.1%, and freedom from clinical target lesion revascularization was 94.1%.</div></div><div><h3>Conclusions</h3><div>Postangioplasty dissections represent a relevant adverse event that necessitates scaffolding in moderate and severe grades. The CHOCO-STAB study demonstrated the safety and potential of NCB angioplasty to reduce stent placement in patients treated with DCB and plain old balloon angioplasty who present with postangioplasty dissections.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 4","pages":"Article 107912"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Consensus-Driven Vessel Preparation and Definitive Endovascular Treatment Strategies for Femoropopliteal Arterial Lesions Based on Plaque Morphology 基于斑块形态的股腘动脉病变的共识驱动血管准备和明确的血管内治疗策略。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-04-01 Epub Date: 2026-01-09 DOI: 10.1016/j.jvir.2026.107993

Steven Kum MD , Sven Bräunlich MD , Ehrin J. Armstrong MD , Koen Deloose MD , Mark J. Portou MD , Marianne Brodmann MD , Edwaldo Edner Joviliano MD, PhD , Gabriel Fernando Mejia-Villate MD , Jinoo Kim MD, PhD , Chung-Ho Hsu MD , Thatchawit Urasuk MD , Prem Chand Gupta MD , Varinder Singh Bedi MS , Tim Shiraev MD, MBBS , Shannon Thomas (FRACS, PhD) , Osamu Iida MD , Masahiko Fujihara MD , Zhenyu Shi MD, PhD , Dheeraj K. Rajan MD , Fabrizio Fanelli MD

Purpose

To provide recommendations for the most appropriate endovascular intervention of femoropopliteal (FP) arterial disease based on plaque characterization.

Materials and Methods

A panel of 22 physicians from multiple disciplines participated in a modified Delphi consensus, leveraging the RAND/UCLA Appropriateness Method. Panelists engaged in 2 rounds of voting, following a literature review, with an in-person discussion prior to the second round of voting. A rigorous statistical approach was used to analyze the points of agreement and disagreement. Consensus-based recommendations on the most appropriate endovascular approaches for treating patients with FP lesions, stratified by lesion morphology, were generated.

Results

Overall, 490 individual items were included in the voting, 458 (93%) of which achieved consensus and 32 (7%) were nonconsensus items, based on a priori criteria under the following categories: (a) recommendations on method for determining plaque morphology, (b) preferred endovascular devices for vessel preparation and definitive treatment stratified by (i) plaque morphology and (ii) Tosaka classification of in-stent restenosis, and (c) vessel preparation device safety-related considerations.

Conclusions

This international, multidisciplinary consensus provides evidence- and expert-informed recommendations for vessel preparation and definitive treatment of FP arterial disease, tailored to plaque morphology. These consensus recommendations aim to support clinical decision making and promote best interventional practices by serving as an expert opinion supplement to existing guideline-based care pathways.

目的：根据斑块特征为股腘动脉疾病的最合适的血管内介入治疗提供建议。材料和方法：一个由来自多个学科的22名医生组成的小组，利用兰德/加州大学洛杉矶分校的适当性方法，参与了修改后的德尔菲共识。小组成员在进行文献综述后进行了两轮投票，并在第二轮投票之前进行了面对面的讨论。采用了严格的统计方法来分析同意和不同意的观点。基于共识的建议，最合适的血管内入路治疗患者的FP病变，按病变形态分层，产生。结果：总的来说，490个单独的项目被纳入投票，其中458个（93%）达成共识，32个（7%）是非共识项目，基于以下类别的先验标准：(1)关于确定斑块形态方法的建议；(2)根据(a)斑块形态和(b)支架内再狭窄的to坂分类对血管准备和最终治疗的首选血管内装置进行分层；(3)容器制备装置安全相关注意事项。结论：这一国际性、多学科的共识为根据斑块形态量身定制的FP动脉疾病的血管准备和最终治疗提供了证据和专家知情的建议。这些共识建议旨在支持临床决策和促进最佳干预实践，作为现有的基于指南的护理途径的专家意见补充。

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引用次数: 0

Effect of Transarterial Embolization Combined with Chemotherapy on Regulatory T Cells and Vascular Endothelial Growth Factor in the Tumor Immune Microenvironment of Intrahepatic Cholangiocarcinoma 经动脉栓塞联合化疗对肝内胆管癌肿瘤免疫微环境中调节性T细胞和血管内皮生长因子的影响

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-04-01 Epub Date: 2026-01-13 DOI: 10.1016/j.jvir.2026.107994

Jingxi Wu MD , Ye Liang MD , Yigong Ren MD , Bing Yuan MD , Haoyang Hu MD , Zeyi Zhang MD , Feng Duan MD

Purpose

To investigate whether transarterial embolization (TAE) and systemic gemcitabine + cisplatin (GC) modulates CD4⁺CD25⁺Foxp3⁺ regulatory T cells (Tregs) infiltration, a major immunosuppressive subset, and expression of vascular endothelial growth factor (VEGF), a critical proangiogenic molecule, in a thioacetamide-induced orthotopic intrahepatic cholangiocarcinoma (ICC) model using male Sprague-Dawley (SD) rats.

Materials and Methods

Twenty-four ICC-bearing SD rats were randomized into 4 groups (n = 6 per group). The control group received no treatment, whereas the GC group was given intraperitoneal injections of gemcitabine (200 mg/kg) plus cisplatin (8 mg/kg) on Days 0, 4, 8, and 12. The TAE group underwent hepatic artery embolization on Day 0, and the combination group received TAE on Day 0 followed by GC administration. Tumor volume was measured via computed tomography (CT) on Days −1, 7, and 14. Flow cytometry determined the proportion of Tregs among CD4⁺ T cells. Intratumoral Treg density is quantified by immunofluorescence. Immunohistochemistry detected VEGF expression. Statistical analysis used 1-way analysis of variance with appropriate post hoc tests.

Results

There were no significant tumor volume differences within 14 days. TAE increased peripheral Treg proportion, whereas GC and combination therapy reduced it. The combination group had the lowest intratumoral Treg proportion (5.25% [SEM ± 0.76]). VEGF expression was elevated in the TAE group but suppressed in the combination group (8.68% [SEM ± 1.36] vs control, 18.37% [SEM ± 3.24]; P = .0140). All treatment groups showed reduced intratumoral Treg density compared with the control.

Conclusions

In a thioacetamide-induced orthotopic ICC rat model, TAE combined with systemic GC reduces intratumoral Treg infiltration and VEGF expression. These findings indicate that the combination therapy exerts superior immunomodulatory effects compared with TAE or GC monotherapy in rats.

目的：研究经动脉栓塞（TAE）和全身吉西他滨+顺铂（GC）是否能调节硫代乙酰胺诱导的原位肝内胆管癌（ICC）模型中CD4+CD25+Foxp3+调节性T细胞（Tregs）浸润和促血管生成的关键分子血管内皮生长因子（VEGF）的表达。材料与方法：将24只含icc的SD大鼠随机分为4组，每组6只。对照组不治疗，G+C组分别于第0、4、8、12天腹腔注射吉西他滨(200 mg/kg) +顺铂（8 mg/kg）。TAE组于第0天行肝动脉栓塞术，联合用药组于第0天行TAE后加GC给药。于第1、7、14天CT测量肿瘤体积。流式细胞术检测Tregs在CD4+ T细胞中的比例。免疫荧光法定量瘤内Treg密度。免疫组化检测VEGF表达。统计分析采用单因素方差分析和适当的事后检验。结果：14天内肿瘤体积无明显差异。TAE增加了外周Treg比例，GC和联合治疗降低了外周Treg比例。联合用药组肿瘤内Treg比例最低（5.25%±0.76%）。血管内皮生长因子（VEGF）表达在TAE组升高，联合治疗组降低（8.68%±1.36% vs.对照组18.37%±3.24%,P = 0.0140）。与对照组相比，所有治疗组均显示肿瘤内Treg密度降低。结论：在硫乙酰胺诱导的原位ICC大鼠模型中，TAE联合系统性GC可降低肿瘤内Treg浸润和VEGF表达。这些结果表明，与TAE或GC单药治疗相比，联合治疗对大鼠具有更好的免疫调节作用。

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