Journal of Vascular and Interventional Radiology最新文献

英文中文

Peripheral Vasculature Embolization with the Onyx Liquid Embolic System in a Swine Model 玛瑙液体栓塞系统在猪模型中的外周血管栓塞。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.jvir.2025.08.032

Gary P. Siskin MD , Paul J. Rochon MD , Ripal Gandhi MD , Austin Cocciolone PhD , Andrew Winter PhD , Rahul S. Patel MD , Jafar Golzarian MD , Bulent Arslan MD

Purpose

To characterize the histologic and inflammatory changes that resulted from peripheral embolization using ethylene vinyl alcohol ([EVOH]; Onyx) in an animal model. This study also assessed the radiopacity of the Onyx after a 1-minute mixing time.

Materials and Methods

Embolization using EVOH alone or in combination with coils/plugs was performed on large-vessel, small-vessel, and very–small-vessel (3–5 mm, 1–3 mm, and <1 mm in diameter, respectively) targets in the peripheral vasculature of Yucatan miniature pigs. Multiple formulations of EVOH were used. Angiography at 1, 3, and 12 months was used to assess embolic migration and vessel occlusion. Pathological evaluations were performed to assess the biological response to Onyx-mediated embolization.

Results

Angiography demonstrated that the radiopacity of EVOH was sufficient for control during deployment in 98.2% of the procedures. Microcatheter removal was successful in all cases, and there was minimal migration of EVOH after delivery. Pathological findings indicated no significant tissue response or vessel trauma after embolization, and the occlusive material (consisting of EVOH, thrombus, and fibrotic tissue) evolved over time. The inflammatory response was minimal to mild, and vessel wall injury was observed in some cases. Complete to near-complete occlusion was achieved at every embolization site at the time of follow-up, although histologic evidence of recanalization was observed in 59.3% of the treated vessels.

Conclusions

The study demonstrated the effectiveness of EVOH as an embolic agent in the peripheral vascular system with adequate radiopacity, minimal adverse effects, and acceptable long-term histologic outcomes in a swine model.

目的：在动物模型中描述玛onyx （EVOH）外周栓塞引起的组织学和炎症变化。本研究还评估了混合时间1分钟后玛瑙的放射不透性。方法：分别对大血管、小血管和极小血管（3-5 mm、1-3 mm）进行EVOH单独或联合线圈/栓栓塞。结果：血管造影显示98.2%的手术中EVOH的放射不透性足以控制部署。所有病例均成功取出微导管，分娩后EVOH迁移最小。病理结果显示栓塞后没有明显的组织反应或血管损伤，并且闭塞物质（由EVOH、血栓和纤维化组织组成）随着时间的推移而演变。炎症反应轻微到轻微，在一些病例中观察到血管壁损伤。在随访时，每个栓塞部位都实现了完全或接近完全的闭塞，尽管在59.3%的治疗血管中观察到再通的组织学证据。结论：该研究在猪模型中证明了EVOH作为外周血管系统栓塞剂的有效性，具有足够的放射线透明度，最小的不良反应和可接受的长期组织学结果。

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引用次数: 0

Embolization of Roux-en-Y Limb Varices and Portal Vein/Rex Shunt Recanalization in Pediatric Liver Transplant Recipients with Gastrointestinal Bleeding 小儿肝移植术后消化道出血患者Roux-en-Y肢体静脉曲张栓塞及门静脉/Rex分流再通

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.jvir.2025.10.011

Claudia Moya Ochoa MD , Eduardo Bravo Rius MD , Gloria González García MD , María Paz Muñoz Fernández MD , Álvaro Vega González MD , Leonardo Álvarez Aros MD

引用次数: 0

Treatment of Liver Metastases from Uveal Melanoma with Percutaneous Hepatic Perfusion 经皮肝灌注治疗葡萄膜黑色素瘤肝转移。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.jvir.2025.10.018

Siddharth A. Padia MD , Sachin Modi BSc, MBBS, FRCR, MD , Eric Wehrenberg-Klee MD , Robert D. Adamo MD , Altan Ahmed MD, MSc , Marlana Orloff MD , Hendrik J.F. Helmerhorst MD, PhD , Bartosz Chmielowski MD, PhD , Orhan S. Ozkan MD , Mark C. Burgmans MD, PhD , Gerd Grözinger MD , Robert J. Lewandowski MD , Venkatesh P. Krishnasamy MD

Uveal melanoma frequently metastasizes to the liver, with over 90% of metastatic cases involving hepatic spread. Despite systemic therapy advances, prognosis remains poor in hepatic-dominant disease. Percutaneous hepatic perfusion (PHP) with melphalan, now U.S. Food and Drug Administration (FDA)–approved via the Hepzato Kit, delivers high-dose chemotherapy directly to the liver while reducing systemic toxicity through extracorporeal filtration. This review outlines PHP’s rationale, technique, patient selection, and institutional requirements. Ideal candidates have multifocal, bilobar liver metastases and limited extrahepatic disease. PHP requires coordinated care across interventional radiology, anesthesia, perfusion, and pharmacy. Clinical data show encouraging survival and disease control with manageable hematologic toxicity and rapid recovery. Research into improved filtration, optimized dosing, and immunotherapy integration may further improve outcomes.

葡萄膜黑色素瘤（UM）经常转移到肝脏，超过90%的转移病例涉及肝脏扩散。尽管全身治疗取得进展，但肝显性疾病的预后仍然很差。经皮肝灌注（PHP）使用melphalan，目前已通过Hepzato Kit获得fda批准，可直接向肝脏提供高剂量化疗，同时通过体外过滤降低全身毒性。这篇综述概述了PHP的基本原理、技术、患者选择和机构要求。理想的候选人有多灶性、双叶性肝转移和有限的肝外疾病。PHP需要介入放射学、麻醉、灌注和药学的协调护理。临床数据显示令人鼓舞的生存和疾病控制与可控的血液毒性和快速恢复。改进过滤、优化剂量和免疫治疗整合的研究可能会进一步改善结果。

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引用次数: 0

Self-Expanding Interwoven Nitinol Wire Stents for Treatment of Common Iliac Artery Stent Collapse 超级支架在髂总动脉支架塌陷中成功的再介入治疗。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.jvir.2025.10.024

Kensuke Uotani MD, Yutaka Koide MD, Yutaro Okamoto MD, Takuya Takahashi MD, Mai Takahashi MD, Ryota Kawasaki 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 : 2026-01-01 DOI: 10.1016/j.jvir.2025.107913

引用次数: 0

Feasibility and Effectiveness of Yttrium-90 Radioembolization in Normal Lung Parenchyma: A Preclinical Study in Rabbits with Pathological Correlation to Absorbed Dose 钇-90放射栓塞正常肺实质的可行性及疗效：与吸收剂量病理相关的兔临床前研究。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.jvir.2025.08.044

Ioannis Spyridonidis MD , Marios Platon Dimopoulos MD, MSc, PhD(c) , Pinelopi Bosgana MD , Trifon Spyridonidis MD , Theodoros Skouras MD , Michalis Theofanis MD , Christos Papageorgiou MD , Nikolaos Giannikas MD, MSc , Panagiotis M. Kitrou MD, MSc, PhD , Konstantinos Katsanos MD, MSc, PhD , Dimitrios Karnabatidis MD, PhD

This study investigated the effects of yttrium-90 (⁹⁰Y) radioembolization in 8 rabbits, focusing on delivery accuracy, dosimetry, and pathological outcomes. ⁹⁰Y was successfully delivered angiographically targeted via the pulmonary lower basal segmental arteries to all rabbits, with confirmation via positron emission tomography (PET)/computed tomography (CT) imaging and a lung target median of the mean dose of 132.1 Gy (range, 11.2–262.3 Gy). Pathological analysis in all surviving subjects revealed complete necrosis of the irradiated segments, with associated inflammation in adjacent nonirradiated tissue. Radiological follow-up with CT scan showed triangular fibrosis in 6 rabbits at 1 month, progressing to fibrosis at 3 months. Dosimetry analysis confirmed dose distribution to the targeted lung regions. Of 8 rabbits, 1 died intraprocedurally, and another died 1.5 weeks after the procedure for unknown reasons. The remaining rabbits had no severe adverse events, with 1 case of pleural effusion resolving with no intervention at 3 months. The study demonstrated the feasibility of ⁹⁰Y delivery to the lungs.

本研究在8只家兔中研究了钇-90 （Y90）放射栓塞的效果，重点研究了传递准确性、剂量学和病理结果。所有家兔均成功通过肺下基段动脉血管造影靶向给予Y90， PET/CT成像证实，肺靶中位平均剂量132.1Gy（范围11.2-262.3Gy）。所有存活受试者的病理分析显示辐照节段完全坏死，邻近未辐照组织伴有相关炎症。放射学随访和ct扫描显示6只兔在1个月时呈三角形纤维化，在3个月时进展为纤维化。剂量学分析证实剂量分布到靶肺区域。在8只兔子中，一只在手术中死亡，另一只在手术后1.5周死亡，原因不明。其余兔无并发症，1例胸腔积液在3个月时无干预解决。该研究证明了将Y90输送到肺部的可行性。

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引用次数: 0

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IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-01 DOI: 10.1016/S1051-0443(25)00789-4

引用次数: 0

Balloon-Guided Aspiration Thrombectomy of Internal Carotid Artery following Penetrating and Blunt Injury through the Skull Base 颅底穿透性钝性损伤后的颈内动脉球囊引导抽吸取栓术

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.jvir.2025.09.035

Sonam Santdasani APRN, FNP-BC , Jesse Liu MD , Scott Rewinkel MD , Marco Colasurdo MD

引用次数: 0

Atherectomy versus Stent Placement for Common Femoral Artery Atherosclerotic Disease: A Systematic Review 动脉粥样硬化切除术与支架置入术治疗普通股动脉粥样硬化疾病：一项系统综述。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.jvir.2025.08.015

Mathias Montveneur MD , Guillaume Daniel MD , Pierre-Jules Delannoy MD , Kinga Michalewska MD , Sonia Ramos-Pascual MEng, PhD , Mo Saffarini MEng, MBA , Nicolas Bouchareine MD

Purpose

To compare the outcomes of atherectomy versus stent placement for common femoral artery (CFA) symptomatic atherosclerosis.

Materials and Methods

This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in PROSPERO. MEDLINE and Embase databases were searched for records from 2000 to 2023. The following data were extracted and tabulated: (a) characteristics of studies, (b) patients, (c) lesions and interventions, and (d) clinical and technical outcomes. Risk of bias was assessed using Mixed Methods Appraisal Tool (MMAT).

Results

The search identified 2,088 references, of which 33 studies were included: 11 reported only on atherectomy, 20 reported only on stent placement, and 2 reported on both treatments. Atherectomy and stent placement studies were comparable in terms of age, sex, prevalence of comorbidities, chronic limb ischemia, preprocedural Rutherford score, and ankle-brachial index. Technical success ranged across the studies from 92% to 100% for atherectomy versus 94% to 100% for stent placement, periprocedural adverse event rates ranged from 0% to 24% versus 0% to 19%, rates of freedom from target lesion revascularization ranged from 83% to 100% versus 81% to 100%, and limb salvage rates ranged from 85% to 100% versus 94% to 100%. Stent fracture rates ranged from 0% to 8%. Only 5 of 13 studies on atherectomy and 5 of 22 studies on stent placement met all 7 MMAT criteria.

Conclusions

This systematic review demonstrates satisfactory outcomes with both methods, with no clear advantage of one technique over the other. However, available data on these 2 techniques are heterogeneous. Future studies are necessary to conclude if either technique is superior for the treatment of symptomatic CFA atherosclerosis.

目的：比较动脉粥样硬化切除术与支架置入术治疗股总动脉（CFA）症状性动脉粥样硬化的效果。方法：本综述遵循PRISMA指南，并在PROSPERO注册。检索MEDLINE和Embase数据库2000 - 2023年的记录。提取并制表以下数据：研究特征、患者、病变和干预措施，以及临床和技术结果。使用混合方法评估工具（MMAT）评估偏倚风险。结果：检索到2088篇文献，其中包括33篇研究：11篇仅报道动脉粥样硬化切除术，20篇仅报道支架置入术，2篇两种治疗均报道。动脉粥样硬化切除术和支架置入研究在年龄、性别、合并症患病率、慢性肢体缺血、术前卢瑟福和ABI方面似乎具有可比性。所有研究的技术成功率从动脉粥样硬化切除术的92% -100%到支架置入的94% -100%不等，围手术期并发症从0-24%到0-19%不等，TLR的自由度从83-100%到81-100%不等，肢体保留从85-100%到94-100%不等。支架骨折率从0-8%不等。13项动脉粥样硬化切除术研究中只有5项，22项支架植入研究中只有5项符合MMAT的全部7项标准。结论：动脉粥样硬化切除术和支架植入术似乎为有症状的CFA动脉粥样硬化提供了可比较且有利的结果。然而，没有前瞻性研究直接比较这两种技术，可用的数据是异构的。未来的研究需要得出结论，这两种技术中是否有一种更适合治疗有症状的CFA动脉粥样硬化。

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引用次数: 0

Clinical Outcomes following Mechanical Thrombectomy in Pulmonary Embolism Response Team–Consulted Patients: A Retrospective Analysis 肺栓塞反应小组咨询患者机械取栓后的临床结果：回顾性分析。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.jvir.2025.09.008

Ryan Nolan BS , Maanasi Samant MD , Suresh Vedantham MD , Westley Ohman MD , Nathan Droz MD , Kristen Sanfilippo MD, MPHS , Pavan Kavali MD

Purpose

To determine if use of mechanical thrombectomy (MT) impacts survival and additional outcomes in patients with acute intermediate-high–risk and high-risk pulmonary embolism (PE) who were evaluated by a Pulmonary Embolism Response Team (PERT).

Methods

This retrospective, single-center study included patients with intermediate-high–risk and high-risk PE who received PERT evaluation over 3.5 years and were treated with anticoagulation (AC) alone or MT + AC. The primary outcome was 30-day all-cause mortality, measured with inverse probability of treatment weighting. Exploratory outcomes included survival during the study period, PE-associated/caused mortality, hospital length of stay (LOS), supplemental oxygen at discharge, and MT-related metrics.

Results

Of 335 patients, 259 received AC alone and 76 received MT + AC. The use of MT was associated with reduced odds of 30-day all-cause mortality (odds ratio, 0.49; 95% CI, 0.27–0.76; P = .002). There were no significant differences in PE-associated/caused mortality. Hospital LOS was 2 days shorter in the MT + AC cohort (P < .001). Of patients receiving MT + AC, those with high-risk PE had a 4.5-day shorter stay (P < .001), whereas those with intermediate-high–risk PE had a 2-day shorter stay (P < .001). The proportion of patients receiving supplemental oxygen at discharge was lower in the MT + AC group (MT + AC vs AC, 4.1% vs 18.5%; P < .001), without significant differences in 30-day readmission rates (MT + AC vs AC, 9.5% vs 20.6%; P = .115). MT resulted in an 8.7-mm Hg reduction in mean pulmonary artery pressure, had a technical success rate of 100% (76 of 76), and an adverse event rate of 6.6% (5 of 76).

Conclusions

MT reduced 30-day all-cause mortality, hospital LOS, and supplemental oxygen at discharge in the intermediate-high–risk and high-risk PE population.

目的：该研究旨在确定机械取栓（MT）的使用是否会影响急性中、高、高风险肺栓塞（PE）患者的生存和其他结果，PE反应小组（PERT）对这些患者进行了评估。方法：这项回顾性、单中心研究纳入了接受PERT评估超过3.5年的中高、高危PE患者，这些患者接受抗凝治疗（AC）或MT+抗凝治疗（MT+AC）。主要终点是30天全因死亡率，用治疗加权的逆概率测量。探索性结果包括研究期间的生存率、pe相关/引起的死亡率、住院时间（LOS）、出院时补充氧气和mt相关指标。结果：335例患者中，259例单独接受AC治疗，76例接受MT+AC治疗。MT的使用与30天全因死亡率降低相关（OR=0.49, 95%CI=0.27-0.76, p=0.002）。pe相关/引起的死亡率没有显著差异。在MT+AC队列中，医院LOS缩短了2天（p结论：MT降低了30天的全因死亡率、医院LOS和中高风险PE人群出院时的补充氧）。

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