Journal of Vascular and Interventional Radiology最新文献

Purpose: 
: To evaluate safety and effectiveness of microwave ablation (MWA) in the treatment of liver metastases (LM) secondary to non-small cell lung cancer (NSCLC).

Materials and methods: 
: This retrospective study included patients with NSCLC who underwent MWA of LM from 3/2015 to 7/ 2022. Local tumor progression-free survival (LTPFS) and overall survival (OS) were estimated using competing risk analysis and the Kaplan-Meier method. Post-procedural adverse events were recorded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0.

Results: 
: Twenty-three patients with 32 LM were treated in 27 MWA sessions. The dimension of the largest index tumor was 1.96 ± 0.75 cm (mean ± SD). Technical success was 100%. Technical efficacy was achieved in 26/32 tumors (81.3%). Median length of follow-up was 37.7 months (IQR: 20.5-54.5). Median LTPFS was 16.3 months (95% CI: 7.87-44.10). Median OS was 31.7 months (95% CI: 11.1 to 65.8 months). Ablation margin was a significant factor for LTPFS, with tumors ablated without a measurable margin being more likely to progress compared to those with measurable margins (Subdistribution hazard ratios [SHR] 0.008-0.024, p<0.001). Older age (HR:1.18, 95%CI:1.09-1.28, p< 0.001) and presence of synchronous lung metastases (HR:14.73, 95%CI: 1.86-116.95, p = 0.011) were significant predictors of OS. Serious adverse events (CTCAE grade ≥3) within 30 days occurred in 2/27 sessions (7.4%), including pulmonary embolus and severe abdominal pain.

Conclusion: 
: Percutaneous MWA is a safe treatment for NSCLC LM, with longer survival seen in younger patients and those without synchronous lung tumors.

Purpose: The aim of this study was to assess recent US medical school trends in compensation for academic interventional radiologists (IR) and compensation characteristics based on rank, sex and race/ethnicity.

Methods: Data for IR and diagnostic radiologist (DR) compensation were obtained from the Association of American Medical Colleges (AAMC), which annually surveys U.S. medical schools. IR compensation data was analyzed from 2017 to 2023 with regard to rank, gender and race/ethnicity and compared with DR compensation.

Results: AAMC Faculty Salary Survey data for 2023 included responses for 874 IR faculty members, including 21 instructors, 457 assistant professors, 208 associate professors, 130 full professors, 42 chiefs and 16 chairs. Median compensation increased by a rate of 5.0% per year for instructors and 3.0-3.6% per year for all other ranks. Surveyed median, 25^th and 75^th percentile compensation for IR faculty were consistently greater than that of DR faculty at all ranks except chairs. From 2020 to 2023, this difference in compensation trended downwards. Compensation for women was lower than men with a 2023 gender pay difference of $35K (8.4%), $33K (7.5%), $26K (5.1%), and $32K (6.2%) for instructors, assistant, associate, and full professors respectively. In 2023, compared to White assistant professors, Asians made 94 cents on the dollar, Black/African-Americans made 97 cents on the dollar, and Hispanic/Latinx/Spanish-origin physicians made 95 cents on the dollar, at the same rank.

Conclusion: IR faculty compensation has barely kept pace with inflation over recent years, overall increasing with rank, and overall higher than for DR counterparts.

Purpose: To identify predictors of clinical success in invasive treatment for femoropopliteal arterial disease aiding clinical decision-making.

Materials and methods: A retrospective analysis was performed on 676 consecutive patients who underwent a first episode of invasive treatment for femoropopliteal disease, either endovascular therapy (EVT) or femoropopliteal bypass (FPB), between 2004 and 2015. Primary end points were primary and secondary clinical patency and amputation rate. Kaplan-Meier curves were used to evaluate clinical patency. A Cox proportional hazard model explored predictors of primary end points.

Results: Most patients (58%) underwent EVT as primary intervention, while 42% underwent FPB. Median follow-up was 43 months. The only independent predictor for loss of primary clinical patency was critical limb-threatening ischemia (CLTI) (P = .008; hazard ratio [HR], 1.25; 95% CI, 1.07-1.47). Secondary clinical patency was positively associated with FPB surgery (P = .037; HR, 0.66; 95% CI, 0.44-0.97), a higher pre-interventional ankle-brachial index (P = .029; HR, 0.43; 95% CI, 0.20-0.92), more distal runoff vessels (P = .036; HR, 0.77; 95% CI, 0.60-0.98), and the absence of ischemic heart disease (P = .006; HR, 1.69; 95% CI, 1.16-2.47). In patients with CLTI, chronic renal failure predicted loss of primary and secondary clinical patency and increased amputation risk.

Conclusions: In this cohort, CLTI was independently associated with decreased primary clinical patency in invasive treatment for femoropopliteal disease. Secondary clinical patency was positively associated with FPB, higher ankle-brachial index, more runoff vessels, and the absence of ischemic heart disease.