Journal of Vascular and Interventional Radiology最新文献

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IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-22 DOI: 10.1016/j.jvir.2025.10.002

引用次数: 0

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 : 2026-01-21 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

Safety and Efficacy of Radiation Lobectomy for Primary Liver Cancers using Resin Microspheres. 树脂微球治疗原发性肝癌的安全性和有效性。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-21 DOI: 10.1016/j.jvir.2026.108543

Diana J Murcia, M Saad Malik, Razan Salman Ali, Anuradha Shenoy-Bhangle, Andrea Bullock, Michael Curry, Andreea M Catana, Devin Eckhoff, Diana Dinh, Jeffrey L Weinstein, Muneeb Ahmed, Ammar Sarwar

Purpose: Evaluate safety, hypertrophy, and kinetic growth rate (KGR) of future liver remnant following Y-90 radiation lobectomy in liver cancer using resin microspheres.

Methods: Retrospective, single center study. Patients with primary liver cancer undergoing RL-⁹⁰Y TARE from 11/2015 to 12/2022 included. Single-compartment dosimetry model was used. Total liver parenchymal volume (TLPV), treated parenchymal volume (TPV), future liver remnant volume (FLRV) were recorded at baseline (T₀), and post-treatment at 0-4 months (T₁), and > 4 months (T₂). Hypertrophy, FLRV/TLPV ratio, KGR were calculated. Treatment response was categorized by mRECIST for HCC and RECIST for iCCA. Primary outcomes included safety profile, hypertrophy, KGR. Secondary outcomes included disease response and proportion of patients bridged to surgery.

Results: 28 patients (68% HCC, 36% iCCA) were included. Right lobe treated in 18/28 (64%). The hypertrophy and KGR at T₁ were 16% (IQR:4-28) and 1.5%/week (IQR:0.6-2.3) with increase in FLRV (P <.001) and FLRV/TLPV ratio (P <.001). KGR was higher at T₁ vs T₂ (1.3% vs. 0.6%, P =.034). Treatment response (n=27) was complete, partial, stable, progressive in 53%, 24%, 6%, 18% for HCC and 0%, 20%, 50%, 30% for iCCA. Seven (25%) patients were bridged to resection at 2.5 months (IQR:1.9-4.7). No differences noted in atrophy, hypertrophy, KGR at both timepoints (T₁ and T₂) when stratified on type of cancer, cirrhosis, portal vein thrombosis, or prescribed tumor dose.

Conclusion: RL-⁹⁰Y TARE using single compartment dosimetry with resin microspheres can safely be performed in patients with primary liver cancer with KGR of 1.5%/week.

目的：用树脂微球评价Y-90放疗肝癌术后肝残体的安全性、肥厚和动态生长率（KGR）。方法：回顾性、单中心研究。纳入2015年11月至2022年12月期间接受RL-90Y TARE治疗的原发性肝癌患者。采用单室剂量学模型。在基线（T0）、治疗后0-4个月（T1）和治疗后4个月（T2）分别记录总肝实质体积（TLPV）、治疗后肝实质体积（TPV）和未来肝残余体积（FLRV）。计算肥厚、FLRV/TLPV比值、KGR。治疗效果按HCC的mRECIST和iCCA的RECIST进行分类。主要结局包括安全性、肥厚、KGR。次要结局包括疾病反应和接受手术的患者比例。结果：纳入28例患者（68% HCC, 36% iCCA）。右肺叶治疗18/28（64%）。T1时肥大和KGR分别为16% （IQR:4-28）和1.5%/周（IQR:0.6-2.3）， FLRV升高(p1 vs T2 （1.3% vs 0.6%, P = 0.034）。治疗反应（n=27）为完全、部分、稳定、进展，HCC为53%、24%、6%、18%，iCCA为0%、20%、50%、30%。7例（25%）患者在2.5个月时桥接切除（IQR:1.9-4.7）。在肿瘤类型、肝硬化、门静脉血栓形成或肿瘤处方剂量分层时，两个时间点（T1和T2）的萎缩、肥大、KGR均无差异。结论：RL-90Y TARE采用树脂微球单室剂量法治疗KGR为1.5%/周的原发性肝癌患者是安全的。

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引用次数: 0

Percutaneous Retrieval of an Embolized Mitral Clip from the Inferior Vena Cava. 经皮从下腔静脉取出栓塞的二尖瓣夹。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-19 DOI: 10.1016/j.jvir.2026.108003

Parnavi Singh, Ibrahim Thein, Aaron Abrishami, Joshua M Baker, Chikamuche Thaddeus Anyanwu, Brian J Schiro

引用次数: 0

Authors’ Response to Letter to “Safety and Effectiveness of Transarterial Chemoembolization for Caudate Lobe Hepatocellular Carcinoma: Long-Term Clinical Outcomes” 作者对“经动脉化疗栓塞治疗尾状叶肝细胞癌的安全性和有效性：长期临床结果”的回复。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-16 DOI: 10.1016/j.jvir.2026.108000

Eunbyeol Ko BS, Jin Hyoung Kim MD

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 : 2026-01-16 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

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 : 2026-01-13 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。

{"title":"Effect of Transarterial Embolization Combined with Chemotherapy on Regulatory T Cells and Vascular Endothelial Growth Factor in the Tumor Immune Microenvironment of Intrahepatic Cholangiocarcinoma","authors":"Jingxi Wu MD , Ye Liang MD , Yigong Ren MD , Bing Yuan MD , Haoyang Hu MD , Zeyi Zhang MD , Feng Duan MD","doi":"10.1016/j.jvir.2026.107994","DOIUrl":"10.1016/j.jvir.2026.107994","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate whether transarterial embolization (TAE) and systemic gemcitabine + cisplatin (GC) modulates CD4<sup>+</sup>CD25<sup>+</sup>Foxp3<sup>+</sup> 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.</div></div><div><h3>Materials and Methods</h3><div>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<sup>+</sup> 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.</div></div><div><h3>Results</h3><div>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]; <em>P</em> = .0140). All treatment groups showed reduced intratumoral Treg density compared with the control.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 4","pages":"Article 107994"},"PeriodicalIF":2.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991751","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

Contralateral Suppression Index as a Surrogate Marker for Aldosterone Lateralization in Simulated Incomplete Adrenal Vein Sampling 模拟不完全肾上腺静脉取样中对侧抑制指数作为醛固酮侧化的替代标志物。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-13 DOI: 10.1016/j.jvir.2026.107995

Derik J. Basson MD , Alfredo Páez-Carpio MD, PhD, EDIR, EBIR , Amos Kalu MD , Rawan Abu Mughli MD , Jacques Du Plessis MBChB, DA, DipPEC, MMED, FCRAD , Elizabeth David MD, FRCPC , Robyn Pugash MD, FRCPC , Gilbert Maroun MD

Purpose

To evaluate the contralateral suppression index (CSI) as a diagnostic tool for predicting aldosterone lateralization under simulated incomplete adrenal vein sampling (AVS) and to assess the impact of adrenal nodules and age on its performance.

Materials and Methods

This study retrospectively reviewed consecutive patients who underwent AVS for primary aldosteronism between January 1, 2016, and June 30, 2024. A total of 362 patients were analyzed. Bilaterally selective studies were reanalyzed by masking 1 adrenal side to simulate incomplete sampling. CSI was calculated from the available adrenal vein and inferior vena cava samples and tested across 3 thresholds (≥1.0, ≥0.5, and ≥0.2) using lateralization index (LI) ≥4.0 as the reference. Performance metrics included positive predictive value (PPV), sensitivity, and specificity, overall and stratified by adrenal nodules and age (<35 vs ≥35 years).

Results

Mean CSI was 0.33 in lateralized cases (LI ≥ 4.0) and 3.16 in nonlateralized cases (P < .001). Without a concordant nodule, CSI ≤1 supported lateralization (PPV, 70%; sensitivity, 88%; specificity, 94%); stricter thresholds increased certainty, with CSI ≤0.5 yielding a PPV of 98% and specificity of 99% (sensitivity, 61%) and CSI ≤0.2 achieving a PPV and specificity of 100% (sensitivity, 28%). With a concordant nodule, PPVs were 94%, 99%, and 100% at CSIs ≤1, ≤0.5, and ≤0.2, respectively, with sensitivity of 98%–64% . Results were consistent across age groups.

Conclusions

CSI reliably predicted aldosterone lateralization under simulated incomplete AVS. Thresholds of ≤0.5 and ≤0.2 provided confirmatory accuracy, particularly when combined with concordant imaging.

目的：评价模拟不完全肾上腺静脉取样（AVS）下对侧抑制指数（CSI）作为预测醛固酮偏侧化的诊断工具，并评估肾上腺结节和年龄对其性能的影响。材料和方法：我们回顾性分析了2016年1月1日至2024年6月30日期间接受AVS治疗原发性醛固酮增多症的连续患者。共分析362例患者。双侧选择性研究通过掩盖一个肾上腺侧来模拟不完全采样来重新分析。CSI从可用的肾上腺静脉和下腔静脉样本计算，并以侧化指数(LI)≥4.0为参考，在三个阈值（>1.0,>0.5和>0.2）下进行测试。性能指标包括阳性预测值（PPV）、敏感性和特异性、总体和肾上腺结节和年龄分层（结果：偏侧病例的平均CSI为0.33 (LI≥4.0)，非偏侧病例的平均CSI为3.16）(结论：CSI可靠地预测了模拟不完全AVS下醛固酮偏侧化。阈值≤0.5和≤0.2提供了确定的准确性，特别是当与一致性成像相结合时。

{"title":"Contralateral Suppression Index as a Surrogate Marker for Aldosterone Lateralization in Simulated Incomplete Adrenal Vein Sampling","authors":"Derik J. Basson MD , Alfredo Páez-Carpio MD, PhD, EDIR, EBIR , Amos Kalu MD , Rawan Abu Mughli MD , Jacques Du Plessis MBChB, DA, DipPEC, MMED, FCRAD , Elizabeth David MD, FRCPC , Robyn Pugash MD, FRCPC , Gilbert Maroun MD","doi":"10.1016/j.jvir.2026.107995","DOIUrl":"10.1016/j.jvir.2026.107995","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the contralateral suppression index (CSI) as a diagnostic tool for predicting aldosterone lateralization under simulated incomplete adrenal vein sampling (AVS) and to assess the impact of adrenal nodules and age on its performance.</div></div><div><h3>Materials and Methods</h3><div>This study retrospectively reviewed consecutive patients who underwent AVS for primary aldosteronism between January 1, 2016, and June 30, 2024. A total of 362 patients were analyzed. Bilaterally selective studies were reanalyzed by masking 1 adrenal side to simulate incomplete sampling. CSI was calculated from the available adrenal vein and inferior vena cava samples and tested across 3 thresholds (≥1.0, ≥0.5, and ≥0.2) using lateralization index (LI) ≥4.0 as the reference. Performance metrics included positive predictive value (PPV), sensitivity, and specificity, overall and stratified by adrenal nodules and age (<35 vs ≥35 years).</div></div><div><h3>Results</h3><div>Mean CSI was 0.33 in lateralized cases (LI ≥ 4.0) and 3.16 in nonlateralized cases (<em>P</em> < .001). Without a concordant nodule, CSI ≤1 supported lateralization (PPV, 70%; sensitivity, 88%; specificity, 94%); stricter thresholds increased certainty, with CSI ≤0.5 yielding a PPV of 98% and specificity of 99% (sensitivity, 61%) and CSI ≤0.2 achieving a PPV and specificity of 100% (sensitivity, 28%). With a concordant nodule, PPVs were 94%, 99%, and 100% at CSIs ≤1, ≤0.5, and ≤0.2, respectively, with sensitivity of 98%–64% . Results were consistent across age groups.</div></div><div><h3>Conclusions</h3><div>CSI reliably predicted aldosterone lateralization under simulated incomplete AVS. Thresholds of ≤0.5 and ≤0.2 provided confirmatory accuracy, particularly when combined with concordant imaging.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 4","pages":"Article 107995"},"PeriodicalIF":2.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991808","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

Caval-Iliac Vein Angle and Risk of Pulmonary Embolism in Patients with Right-Sided Deep Vein Thrombosis 右深静脉血栓患者腔髂静脉角与肺栓塞的风险。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-12 DOI: 10.1016/j.jvir.2025.09.026

Maofeng Gong MD, Rui Jiang MD, Xu He MD, Jianping Gu MD

Purpose

To investigate the risk factors for pulmonary embolism (PE) and evaluate the hypothesis that an increased caval-iliac vein angle (CVA) is associated with a decreased risk of PE in patients with right-sided deep venous thrombosis (DVT).

Materials and Methods

This retrospective study analyzed 163 patients with right-sided DVT who underwent computed tomography (CT) venography between 2017 and 2024. Demographic, clinical, and radiographic data were collected. Univariate analysis followed by multivariate analysis determined the odds ratio (OR) with a 95% confidence interval (CI). Correlations between CVA and PE on a continuous scale were evaluated using restricted cubic splines.

Results

In total, 76 patients (46.6%) were diagnosed with PE, while 87 (53.4%) were not. Patients with PE were found to have a higher prevalence of heart failure (adjusted OR, 4.16; 95% CI, 1.40–12.39; P = .011), autoimmune diseases (adjusted OR, 3.86; 95% CI, 1.06–14.05; P = .040), and a smaller CVA (adjusted OR, 0.89; 95% CI, 0.85–0.94; P < .001). Following propensity score matching, the inverse relationship between CVA (adjusted OR, 0.91; 95% CI, 0.86–0.95; P < .001) and PE persisted. Restricted cubic spline analysis revealed a greater CVA consistently correlated with a lower risk of PE (nonlinear P = .038). Moreover, CVA was a protective factor against symptomatic PE when the CVA was >15.75°.

Conclusions

Heart failure and autoimmune diseases were associated with an increased risk of PE, whereas an increased CVA was consistently linked with a decreased risk. A CVA greater than 15.75° serves potentially as a protective factor against symptomatic PE.

目的：探讨右侧深静脉血栓形成（DVT）患者发生肺栓塞（PE）的危险因素，并评估腔髂静脉角（CVA）增加与PE风险降低相关的假设。材料和方法：本回顾性研究分析了2017年至2024年间接受CT静脉造影的163例右侧DVT患者。收集了人口统计学、临床和放射学数据。单因素分析和多因素分析确定优势比（OR）， 95%可信区间（CI）。CVA和PE在连续尺度上的相关性使用受限三次样条进行评估。结果：76例（46.6%）诊断为PE， 87例（53.4%）未诊断为PE。发现PE患者有较高的心力衰竭患病率（校正OR， 4.16; 95% CI, 1.40-12.39; P = 0.011）、自身免疫性疾病患病率（校正OR， 3.86; 95% CI, 1.06-14.05; P = 0.040）和较小的CVA患病率（校正OR， 0.89; 95% CI, 0.85-0.94; P < 0.001）。在倾向评分匹配后，CVA（调整OR为0.91；95% CI为0.86-0.95;P < 0.001）与PE之间的负相关关系持续存在。限制性三次样条分析显示，较大的CVA与较低的PE风险一致相关（非线性P = 0.038）。此外，当CVA为bb0 15.75°时，CVA是预防症状性PE的保护因素。结论：心力衰竭和自身免疫性疾病与PE风险增加相关，而CVA增加则与PE风险降低相关。CVA大于15.75°可能是预防症状性PE的保护因素。

{"title":"Caval-Iliac Vein Angle and Risk of Pulmonary Embolism in Patients with Right-Sided Deep Vein Thrombosis","authors":"Maofeng Gong MD, Rui Jiang MD, Xu He MD, Jianping Gu MD","doi":"10.1016/j.jvir.2025.09.026","DOIUrl":"10.1016/j.jvir.2025.09.026","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the risk factors for pulmonary embolism (PE) and evaluate the hypothesis that an increased caval-iliac vein angle (CVA) is associated with a decreased risk of PE in patients with right-sided deep venous thrombosis (DVT).</div></div><div><h3>Materials and Methods</h3><div>This retrospective study analyzed 163 patients with right-sided DVT who underwent computed tomography (CT) venography between 2017 and 2024. Demographic, clinical, and radiographic data were collected. Univariate analysis followed by multivariate analysis determined the odds ratio (OR) with a 95% confidence interval (CI). Correlations between CVA and PE on a continuous scale were evaluated using restricted cubic splines.</div></div><div><h3>Results</h3><div>In total, 76 patients (46.6%) were diagnosed with PE, while 87 (53.4%) were not. Patients with PE were found to have a higher prevalence of heart failure (adjusted OR, 4.16; 95% CI, 1.40–12.39; <em>P</em> = .011), autoimmune diseases (adjusted OR, 3.86; 95% CI, 1.06–14.05; <em>P</em> = .040), and a smaller CVA (adjusted OR, 0.89; 95% CI, 0.85–0.94; <em>P</em> < .001). Following propensity score matching, the inverse relationship between CVA (adjusted OR, 0.91; 95% CI, 0.86–0.95; <em>P</em> < .001) and PE persisted. Restricted cubic spline analysis revealed a greater CVA consistently correlated with a lower risk of PE (nonlinear <em>P</em> = .038). Moreover, CVA was a protective factor against symptomatic PE when the CVA was >15.75°.</div></div><div><h3>Conclusions</h3><div>Heart failure and autoimmune diseases were associated with an increased risk of PE, whereas an increased CVA was consistently linked with a decreased risk. A CVA greater than 15.75° serves potentially as a protective factor against symptomatic PE.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 3","pages":"Article 107855"},"PeriodicalIF":2.6,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953468","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

Fracture and Retrieval of a Suture-Mediated Closure Device Catheter 一种缝线介导的闭合装置导管的骨折和恢复。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-12 DOI: 10.1016/j.jvir.2025.09.027

Elaine Liang BA , Sean W. Chen BS , Zaeem M. Billah MD , George G. Vatakencherry MD , Alok Bhatt MD

引用次数: 0

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