Journal of Vascular and Interventional Radiology最新文献

英文中文

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。

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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

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 : 2026-01-10 DOI: 10.1016/j.jvir.2025.107960

Hiroyuki Tokue MD, Yoshito Tsushima MD

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 : 2026-01-09 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

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 : 2026-01-09 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

In Memoriam: Plinio Rossi, 1929–2025 纪念普林尼·罗西，1929 - 2025年

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-08 DOI: 10.1016/j.jvir.2025.107963

Barry T. Katzen MD , Michael D. Dake MD , Fabrizio Fanelli MD

引用次数: 0

Crossword Puzzle 纵横字谜游戏

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-05 DOI: 10.1016/j.jvir.2025.107956

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 : 2026-01-05 DOI: 10.1016/j.jvir.2025.107955

引用次数: 0

Percutaneous Adrenal Biopsies in Patients with Cancer: The Utility of Preprocedural Endocrine Workup 经皮肾上腺活检在癌症患者：术前内分泌检查的效用。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2026-01-03 DOI: 10.1016/j.jvir.2025.107989

Erez Klein MD , Marcell Gyano MD, PhD , Vaiva Gustainyte DO , Junsung Choi MD , Bela Kis MD, PhD

Purpose

To assess the safety of adrenal biopsies in patients with known or suspected malignancies without preprocedural endocrine evaluations.

Materials and Methods

This was a single-center retrospective study that included 426 patients (249 men and 177 women; mean age, 66.1 years [SD ± 11.0]) with known or suspected malignancy who underwent 487 computed tomography (CT)–guided adrenal biopsies between October 2011 and December 2023. The authors analyzed medical records and cross-sectional imaging, evaluating technical and diagnostic success rates as well as complications.

Results

Of the 487 biopsies, 442 (91%) were performed in patients with confirmed malignancies, whereas 45 cases (9%) were patients presenting with new abdominal or lung mass and adrenal mass. The most common primary malignancy was lung cancer (272 of 487, 56%). Technical success rate was 99.8% (486 of 487), with a diagnostic success rate of 97.1% (473 of 487). Histopathological findings differed from known primary malignancy in 2.9% (14 of 487) of cases. Endocrine assessments were performed before 40 biopsies (8.2%). Three (3 of 487, 0.61%) new histological diagnoses of pheochromocytoma emerged, with 2 (66%) occurring in patients with known malignancies. A total of 45 adverse events (9.2%) were observed, primarily Grades 1–2, with only 6 classified as Grade 3 (4 hemorrhages and 2 cases of hypertension). Only 1 case of Grade 3 hypertension linked to pheochromocytoma.

Conclusions

Incidence of pheochromocytoma in patients with known or suspected extra-adrenal malignancies without endocrine workup was less than 1%. Therefore, endocrine workup prior to adrenal biopsies in patients with known and suspected malignancies may not be indicated despite recommendations of international guidelines.

目的：本研究旨在评估没有术前内分泌评估的已知或疑似恶性肿瘤患者肾上腺活检的安全性。方法：这是一项单中心回顾性研究，纳入了426例已知或疑似恶性肿瘤患者（249例男性，177例女性，平均年龄：66.1±11.0岁），这些患者在2011年10月至2023年12月期间接受了487次ct引导下的肾上腺活检。我们分析了医疗记录和横断面成像，评估了技术和诊断的成功率以及并发症。结果：在487例活检中，442例（91%）为确诊恶性肿瘤患者，而45例（9%）为出现新的腹部或肺部肿块和肾上腺肿块的患者。最常见的原发恶性肿瘤是肺癌（272/487,56%）。技术成功率为99.8%(486/487)，诊断成功率为97.1%（473/487）。在2.9%的病例（14/487）中，组织病理学结果与已知的原发性恶性肿瘤不同。40例（8.2%）活检前进行内分泌评估。出现3例（3/487,0.61%）嗜铬细胞瘤的组织学新诊断，其中2例（66%）发生在已知恶性肿瘤患者中。共观察到45例不良事件（9.2%），主要为1-2级，仅6例为3级（4例出血和2例高血压）。只有1例3级高血压与嗜铬细胞瘤有关。结论：已知或疑似肾上腺外恶性肿瘤而未进行内分泌检查的患者嗜铬细胞瘤的发生率低于1%。因此，尽管有国际指南的建议，已知和疑似恶性肿瘤的患者在肾上腺活检前可能不需要进行内分泌检查。

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