Pub Date : 2026-03-01Epub Date: 2025-09-18DOI: 10.1016/j.jvir.2025.08.046
Sameer Bhatia MBBS, MS
{"title":"Histopathologic Response and Oncologic Outcomes after Transarterial Chemoembolization and Transarterial Radioembolization for Hepatocellular Carcinoma: Selection Bias and Suboptimal Technique Are Better Explanations","authors":"Sameer Bhatia MBBS, MS","doi":"10.1016/j.jvir.2025.08.046","DOIUrl":"10.1016/j.jvir.2025.08.046","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 3","pages":"Article 107851"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102844","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}
Pub Date : 2026-03-01Epub Date: 2025-12-09DOI: 10.1016/j.jvir.2025.107957
Emiliano Garza-Frias MD , Ashraf Thabet MD , Paul B. Shyn MD , Ronald S. Arellano MD
This retrospective study was conducted to describe the technique, effectiveness, and safety of percutaneous microwave ablation of metastatic lesions in the spleen. A total of 10 patients (female-to-male ratio, 7:3; mean age, 65 years) with 11 splenic metastases underwent microwave ablation between March 2018 and February 2025. The median lesion size was 2.2 cm (IQR, 1.2–4.0 cm). The mean ablation time per lesion was 13 minutes (range, 5–25 minutes). There were 2 mild adverse events (1 minimal hematoma and 1 trace stable pneumothorax), classified as Society of Interventional Radiology (SIR) Grade 1. At a median follow-up time of 18.5 months (IQR, 7–75 months), local control was reported in 90% of the lesions (n = 10). Percutaneous microwave ablation of splenic metastases appears to be an effective minimally invasive treatment modality to achieve local control and splenic preservation with mild, self-limiting adverse events.
本回顾性研究旨在描述经皮微波消融脾脏转移病灶的技术、有效性和安全性。2018年3月至2025年2月期间，共有10例11例脾转移患者（F:M, 7:3，平均年龄65岁）接受了微波消融治疗。中位病灶大小为2.6 cm （1.0 cm - 6.2 cm）。每个病灶平均消融时间为13分钟（5 - 25分钟）。有2例轻度不良事件（1例轻微血肿和1例轻度稳定气胸），分类为SIR 1。中位随访时间为18.5个月（7-75个月），90%的病灶得到局部控制（n=10）。经皮微波消融脾转移瘤似乎是一种有效的微创治疗方式，可以实现局部控制，脾脏保存，不良事件轻微，自限性。
{"title":"Effectiveness and Safety of Percutaneous Microwave Ablation of Metastatic Splenic Lesions","authors":"Emiliano Garza-Frias MD , Ashraf Thabet MD , Paul B. Shyn MD , Ronald S. Arellano MD","doi":"10.1016/j.jvir.2025.107957","DOIUrl":"10.1016/j.jvir.2025.107957","url":null,"abstract":"<div><div>This retrospective study was conducted to describe the technique, effectiveness, and safety of percutaneous microwave ablation of metastatic lesions in the spleen. A total of 10 patients (female-to-male ratio, 7:3; mean age, 65 years) with 11 splenic metastases underwent microwave ablation between March 2018 and February 2025. The median lesion size was 2.2 cm (IQR, 1.2–4.0 cm). The mean ablation time per lesion was 13 minutes (range, 5–25 minutes). There were 2 mild adverse events (1 minimal hematoma and 1 trace stable pneumothorax), classified as Society of Interventional Radiology (SIR) Grade 1. At a median follow-up time of 18.5 months (IQR, 7–75 months), local control was reported in 90% of the lesions (n = 10). Percutaneous microwave ablation of splenic metastases appears to be an effective minimally invasive treatment modality to achieve local control and splenic preservation with mild, self-limiting adverse events.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 3","pages":"Article 107957"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745500","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}
Pub Date : 2026-03-01Epub Date: 2025-12-19DOI: 10.1016/j.jvir.2025.107972
Qipeng Wang PhD , Hang Dong MD , Li Ma PhD , Jingqin Ma MD, PhD , Wen Zhang MD, PhD , Jiaze Yu MD, PhD , Minjie Yang MD, PhD , Yongjie Zhou MD, PhD , Yaozu Liu PhD , Rufeng Chen PhD , Jianjun Luo MD, PhD
Purpose
To explore the predictive performance of AMMON-OHE model in transjugular intrahepatic portosystemic shunt (TIPS) cohort and explore the prognostic relevance between overt hepatic encephalopathy (OHE) and all-cause mortality.
Materials and Methods
This single-center retrospective analysis included 278 cirrhotic patients receiving TIPS creation between 2018 and 2022. Pre-TIPS/before-discharge/1-month AMMON-OHE models were constructed using patients’ clinical and biochemical variables at different time points and assessed using integrated Brier scores (IBSs), C-index, and decision curves analysis.
Results
Within follow-up (median, 31.8 months), 91 (32.7%) patients developed OHE and 46 (16.5%) died. The AMMON-OHE models outperformed liver function scores in predicting OHE, with 1-month model performing the best (2-year: IBS, 0.1593; C-index, 0.7462). Age, diabetes, albumin, and ammonia were pre-TIPS independent predictors for OHE. Combining age of 65 years further improved the pre-TIPS AMMON-OHE model’s predictive performance (2-year C-index, 0.7124–0.7482) and risk stratification ability, with 2-year OHE-free incidence further stratified in high-risk patients (from 55.1% to 37.0% and 61.0% [age >65 and ≤65 years]; P < .001) and low-risk patients (from 86.0% to 63.0% and 94.7% [age > and ≤65]; P = .021).OHE occurrence was associated with reduced survival rate (hazards ratio, 4.49; 95% CI, 2.44–8.26; P < .001), especially early, nonprecipitated, severe, or recurrent/persistent OHE (P < .001 for all). Such risk stratification was applicable to differentiate death risk, whether combining age (P = .002) or not (P = .019).
Conclusion
For cirrhotic patients treated with TIPS, the AMMON-OHE model can be used to identify high OHE–risk patients before TIPS. Furthermore, the occurrence of post-TIPS OHE is associated with increased mortality.
{"title":"Validation of AMMON-OHE Model for Predicting Overt Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt","authors":"Qipeng Wang PhD , Hang Dong MD , Li Ma PhD , Jingqin Ma MD, PhD , Wen Zhang MD, PhD , Jiaze Yu MD, PhD , Minjie Yang MD, PhD , Yongjie Zhou MD, PhD , Yaozu Liu PhD , Rufeng Chen PhD , Jianjun Luo MD, PhD","doi":"10.1016/j.jvir.2025.107972","DOIUrl":"10.1016/j.jvir.2025.107972","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the predictive performance of AMMON-OHE model in transjugular intrahepatic portosystemic shunt (TIPS) cohort and explore the prognostic relevance between overt hepatic encephalopathy (OHE) and all-cause mortality.</div></div><div><h3>Materials and Methods</h3><div>This single-center retrospective analysis included 278 cirrhotic patients receiving TIPS creation between 2018 and 2022. Pre-TIPS/before-discharge/1-month AMMON-OHE models were constructed using patients’ clinical and biochemical variables at different time points and assessed using integrated Brier scores (IBSs), C-index, and decision curves analysis.</div></div><div><h3>Results</h3><div>Within follow-up (median, 31.8 months), 91 (32.7%) patients developed OHE and 46 (16.5%) died. The AMMON-OHE models outperformed liver function scores in predicting OHE, with 1-month model performing the best (2-year: IBS, 0.1593; C-index, 0.7462). Age, diabetes, albumin, and ammonia were pre-TIPS independent predictors for OHE. Combining age of 65 years further improved the pre-TIPS AMMON-OHE model’s predictive performance (2-year C-index, 0.7124–0.7482) and risk stratification ability, with 2-year OHE-free incidence further stratified in high-risk patients (from 55.1% to 37.0% and 61.0% [age >65 and ≤65 years]; <em>P</em> < .001) and low-risk patients (from 86.0% to 63.0% and 94.7% [age > and ≤65]; <em>P</em> = .021).OHE occurrence was associated with reduced survival rate (hazards ratio, 4.49; 95% CI, 2.44–8.26; <em>P</em> < .001), especially early, nonprecipitated, severe, or recurrent/persistent OHE (<em>P</em> < .001 for all). Such risk stratification was applicable to differentiate death risk, whether combining age (<em>P</em> = .002) or not (<em>P</em> = .019).</div></div><div><h3>Conclusion</h3><div>For cirrhotic patients treated with TIPS, the AMMON-OHE model can be used to identify high OHE–risk patients before TIPS. Furthermore, the occurrence of post-TIPS OHE is associated with increased mortality.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 3","pages":"Article 107972"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806001","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}
Pub Date : 2026-03-01Epub Date: 2025-10-17DOI: 10.1016/j.jvir.2025.10.012
Ronald S. Winokur MD , Gloria Salazar MD , Kathleen Gibson MD , Mark H. Meissner MD , Lindsay Machan MD , Neil M. Khilnani MD
{"title":"Randomized Controlled, Single-Blinded, Parallel-Group Trial of Ovarian Vein and Pelvic Vein Embolization in Women with Chronic Pelvic Pain and Pelvic Varices (EMBOLIZE Trial)","authors":"Ronald S. Winokur MD , Gloria Salazar MD , Kathleen Gibson MD , Mark H. Meissner MD , Lindsay Machan MD , Neil M. Khilnani MD","doi":"10.1016/j.jvir.2025.10.012","DOIUrl":"10.1016/j.jvir.2025.10.012","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 3","pages":"Article 107880"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330646","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}
Preventive transarterial embolization (TAE) for splenic artery aneurysm (SAA) is recommended in high-risk cases owing to the high mortality after rupture. This study evaluated the cost effectiveness of preventive TAE for SAAs smaller than guideline-recommended threshold of 30 mm.
Materials and Methods
A Markov model with 6 states (well without treatment, well after treatment, TAE for aneurysm growth, recanalization, rupture, and death) was developed to compare preventive TAE with the watch-and-wait strategy using 1-year cycles over a lifetime. Model parameters were derived from prior studies and a national administrative claims database in Japan. The base case was a 60-year-old female with SAA measuring 20 mm. The incremental cost-effectiveness ratio (ICER) was evaluated against Japan’s willingness-to-pay threshold of 5 million yen per quality-adjusted life year (QALY). Deterministic and probabilistic sensitivity analyses incorporated scenarios varying multiple parameters.
Results
Analysis of 2,870 patients undergoing preventive TAE for SAAs from the database revealed an ICER of 3,522,204 yen/QALY (22,724 USD/QALY) in the base case, below the threshold. The ICER exceeded the threshold at 71.4 years in females and 65.9 in males. Quality-of-life (QOL) improvement by treatment (12–24 months and longer), time to QOL difference resolution, age at discovery, and costs of preventive TAE were the key ICER influencers. Without QOL improvement, preventive TAE was not cost-effective.
Conclusions
Preventive TAE for SAA may be cost-effective but only when treatment leads to improvements in QOL. These findings highlight the importance of patient selection and can guide cost-conscious clinical decision-making and reimbursement policy.
{"title":"Cost-effectiveness of Preventive Transarterial Embolization for Splenic Artery Aneurysm Below the Guideline-Recommended Size Threshold: A Japanese Claims-Based Study","authors":"Go Shirota MD, PhD , So Sato MD , Hideo Yasunaga MD, PhD , Yuichiro Matsuo MD, MPH , Masaaki Akahane MD , Daisuke Itoh MD, PhD , Osamu Abe MD, PhD","doi":"10.1016/j.jvir.2025.09.021","DOIUrl":"10.1016/j.jvir.2025.09.021","url":null,"abstract":"<div><h3>Purpose</h3><div>Preventive transarterial embolization (TAE) for splenic artery aneurysm (SAA) is recommended in high-risk cases owing to the high mortality after rupture. This study evaluated the cost effectiveness of preventive TAE for SAAs smaller than guideline-recommended threshold of 30 mm.</div></div><div><h3>Materials and Methods</h3><div>A Markov model with 6 states (well without treatment, well after treatment, TAE for aneurysm growth, recanalization, rupture, and death) was developed to compare preventive TAE with the watch-and-wait strategy using 1-year cycles over a lifetime. Model parameters were derived from prior studies and a national administrative claims database in Japan. The base case was a 60-year-old female with SAA measuring 20 mm. The incremental cost-effectiveness ratio (ICER) was evaluated against Japan’s willingness-to-pay threshold of 5 million yen per quality-adjusted life year (QALY). Deterministic and probabilistic sensitivity analyses incorporated scenarios varying multiple parameters.</div></div><div><h3>Results</h3><div>Analysis of 2,870 patients undergoing preventive TAE for SAAs from the database revealed an ICER of 3,522,204 yen/QALY (22,724 USD/QALY) in the base case, below the threshold. The ICER exceeded the threshold at 71.4 years in females and 65.9 in males. Quality-of-life (QOL) improvement by treatment (12–24 months and longer), time to QOL difference resolution, age at discovery, and costs of preventive TAE were the key ICER influencers. Without QOL improvement, preventive TAE was not cost-effective.</div></div><div><h3>Conclusions</h3><div>Preventive TAE for SAA may be cost-effective but only when treatment leads to improvements in QOL. These findings highlight the importance of patient selection and can guide cost-conscious clinical decision-making and reimbursement policy.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 3","pages":"Article 107849"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102771","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}
Pub Date : 2026-03-01Epub Date: 2025-12-24DOI: 10.1016/j.jvir.2025.107974
Sameer Rehman MD, MBA , Shreyas Naidu BS , Raja Shehayar Mehdi MD , Syed Akbarullah MD , Dustin Boyer MD , Nauman Jahangir MD , Michael Schunk MD , Robert Suh MD
Purpose
To evaluate the effectiveness and safety outcomes of percutaneous cryoablation for Stage IA non–small cell lung cancer (NSCLC) in medically inoperable patients.
Materials and Methods
This retrospective study analyzed 176 consecutive patients who underwent percutaneous cryoablation for biopsy-proven Stage IA NSCLC at a single institution between July 2020 and July 2025. Inclusion criteria included tumor size ≤3 cm, medically inoperable disease or patient refusal of surgery, and an Eastern Cooperative Oncology Group (ECOG) performance status score of <2. Procedures were performed under computed tomography (CT) guidance with a standardized triple freeze-thaw protocol. Follow-up involved routine CT and positron emission tomography (PET) imaging at standardized intervals. Overall survival (OS) and local progression-free survival (LPFS) and adverse event rates were calculated using Kaplan-Meier and Cox proportional hazards models.
Results
Of the 170 patients with complete follow-up data, the 1-year and 3-year LPFS rates were 91.8% and 89.4%, respectively, whereas the overall local progression rate was 10.6%. OS rates were 100.0% at 1 year and 94.7% at 3 years. On multivariate analysis, only larger tumor size (Stage IA3 vs IA2) was a significant independent predictor of local progression (adjusted hazard ratio, 4.71; P = .001). Pneumothorax requiring intervention was the most common adverse event (17.6%), with no in-hospital deaths, air embolism, or massive pulmonary hemorrhage.
Conclusions
Percutaneous cryoablation provides effective local control with a favorable safety profile in patients with medically inoperable Stage IA NSCLC particularly with tumor smaller than 2.0 cm. These results support further exploration of cryoablation as a primary treatment modality for this patient population.
{"title":"Lung Ablation Outcomes for Inoperable Stage IA Non–Small Cell Lung Cancer","authors":"Sameer Rehman MD, MBA , Shreyas Naidu BS , Raja Shehayar Mehdi MD , Syed Akbarullah MD , Dustin Boyer MD , Nauman Jahangir MD , Michael Schunk MD , Robert Suh MD","doi":"10.1016/j.jvir.2025.107974","DOIUrl":"10.1016/j.jvir.2025.107974","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effectiveness and safety outcomes of percutaneous cryoablation for Stage IA non–small cell lung cancer (NSCLC) in medically inoperable patients.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study analyzed 176 consecutive patients who underwent percutaneous cryoablation for biopsy-proven Stage IA NSCLC at a single institution between July 2020 and July 2025. Inclusion criteria included tumor size ≤3 cm, medically inoperable disease or patient refusal of surgery, and an Eastern Cooperative Oncology Group (ECOG) performance status score of <2. Procedures were performed under computed tomography (CT) guidance with a standardized triple freeze-thaw protocol. Follow-up involved routine CT and positron emission tomography (PET) imaging at standardized intervals. Overall survival (OS) and local progression-free survival (LPFS) and adverse event rates were calculated using Kaplan-Meier and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Of the 170 patients with complete follow-up data, the 1-year and 3-year LPFS rates were 91.8% and 89.4%, respectively, whereas the overall local progression rate was 10.6%. OS rates were 100.0% at 1 year and 94.7% at 3 years. On multivariate analysis, only larger tumor size (Stage IA3 vs IA2) was a significant independent predictor of local progression (adjusted hazard ratio, 4.71; <em>P</em> = .001). Pneumothorax requiring intervention was the most common adverse event (17.6%), with no in-hospital deaths, air embolism, or massive pulmonary hemorrhage.</div></div><div><h3>Conclusions</h3><div>Percutaneous cryoablation provides effective local control with a favorable safety profile in patients with medically inoperable Stage IA NSCLC particularly with tumor smaller than 2.0 cm. These results support further exploration of cryoablation as a primary treatment modality for this patient population.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 3","pages":"Article 107974"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844483","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}
Pub Date : 2026-03-01Epub Date: 2025-12-06DOI: 10.1016/j.jvir.2025.107945
Gun Ha Kim MD, MS, Dong Il Gwon MD, PhD, Hee Ho Chu MD, MS, Eunbyeol Ko RN, BS, Jeongyeon Kim RN, BS, Gi-Young Ko MD, PhD, Hyun-Ki Yoon MD, PhD
Purpose
To evaluate the long-term outcomes of plug-assisted retrograde transvenous obliteration (PARTO) for the treatment of gastric varices (GVs).
Materials and Methods
This retrospective study included 220 patients treated with PARTO between February 2011 and December 2022. PARTO was performed for secondary prophylaxis (SP) in 81 patients with recent gastric variceal bleeding and for primary prophylaxis (PP) in 139 patients with large (≥2 cm), growing GVs or planned anticoagulation. The effectiveness of PARTO and potential trade-offs, such as worsening of esophageal varices (EVs) and ascites, were analyzed.
Results
The technical success rate of PARTO was 94.5% (208 of 220). Severe adverse events occurred in 2 patients (0.9%). The median procedure time was 22 minutes (range, 8–121 minutes). Long-term follow-up data were available for 177 patients (PP, n = 119, and SP, n = 58), with a median follow-up of 32.4 months (interquartile range, 18.7–58.3 months). All 177 showed thrombosed or obliterated GVs. Ten patients (5.6%) showed recurrence of GVs different to that treated with PARTO, occurring at a median time of 14.4 months. The presence of combined Type 1 and Type 2 gastroesophageal varices was an independent predictive factor for recurrence of GVs (P = .004). The cumulative 1-, 3-, 5-, and 10-year freedom from GV recurrence rates were 97.3%, 94.1%, 92.2%, and 85.1%, respectively. EV exacerbation was observed in 59 patients (33.3%).
Conclusions
PARTO is effective for GV treatment and may serve as a first-line option for both PP and SP in selected patients. However, due to potential EV worsening, close endoscopic monitoring is essential.
{"title":"Plug-Assisted Retrograde Transvenous Obliteration for Gastric Varices: Long-Term Outcomes of Primary and Secondary Prophylaxis","authors":"Gun Ha Kim MD, MS, Dong Il Gwon MD, PhD, Hee Ho Chu MD, MS, Eunbyeol Ko RN, BS, Jeongyeon Kim RN, BS, Gi-Young Ko MD, PhD, Hyun-Ki Yoon MD, PhD","doi":"10.1016/j.jvir.2025.107945","DOIUrl":"10.1016/j.jvir.2025.107945","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the long-term outcomes of plug-assisted retrograde transvenous obliteration (PARTO) for the treatment of gastric varices (GVs).</div></div><div><h3>Materials and Methods</h3><div>This retrospective study included 220 patients treated with PARTO between February 2011 and December 2022. PARTO was performed for secondary prophylaxis (SP) in 81 patients with recent gastric variceal bleeding and for primary prophylaxis (PP) in 139 patients with large (≥2 cm), growing GVs or planned anticoagulation. The effectiveness of PARTO and potential trade-offs, such as worsening of esophageal varices (EVs) and ascites, were analyzed.</div></div><div><h3>Results</h3><div>The technical success rate of PARTO was 94.5% (208 of 220). Severe adverse events occurred in 2 patients (0.9%). The median procedure time was 22 minutes (range, 8–121 minutes). Long-term follow-up data were available for 177 patients (PP, n = 119, and SP, n = 58), with a median follow-up of 32.4 months (interquartile range, 18.7–58.3 months). All 177 showed thrombosed or obliterated GVs. Ten patients (5.6%) showed recurrence of GVs different to that treated with PARTO, occurring at a median time of 14.4 months. The presence of combined Type 1 and Type 2 gastroesophageal varices was an independent predictive factor for recurrence of GVs (<em>P</em> = .004). The cumulative 1-, 3-, 5-, and 10-year freedom from GV recurrence rates were 97.3%, 94.1%, 92.2%, and 85.1%, respectively. EV exacerbation was observed in 59 patients (33.3%).</div></div><div><h3>Conclusions</h3><div>PARTO is effective for GV treatment and may serve as a first-line option for both PP and SP in selected patients. However, due to potential EV worsening, close endoscopic monitoring is essential.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 3","pages":"Article 107945"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710326","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}
Pub Date : 2026-03-01Epub Date: 2025-09-03DOI: 10.1016/j.jvir.2025.08.040
Jiaojiao Ding , Xin Ni PhD , Xiao Zhang MS , Jiabin Wan BS , Wenyuan Shi MD
Purpose
To evaluate the diagnostic accuracy, safety, and clinical impact of ultrasound-guided percutaneous lung biopsy (US-PLB) in pediatric peripheral lung lesions.
Materials and Methods
A retrospective cohort analysis included 34 pediatric patients (24 boys; 10 girls; mean age, 7.9 years [SD ± 4.4]) who underwent US-PLB from March 2019 to February 2024. Diagnostic metrics (sensitivity, specificity, and positive and negative predictive values) and adverse events were analyzed. The influence of biopsy results on clinical management was assessed.
Results
Among 33 diagnostic procedures, US-PLB demonstrated an accuracy of 97.0% (32/33), with a sensitivity of 80.0% (4/5 malignant lesions) and specificity of 100% (28/28 benign lesions). Minor complications occurred in 17.6% (6/34) of patients, including pneumothorax (2.9%) and transient hemoptysis (2.9%). Biopsy findings directly altered therapeutic strategies in 44.1% (15/34) of cases, including initiation of chemotherapy or targeted antimicrobial therapy.
Conclusions
US-PLB is a safe and accurate radiation-free diagnostic technique for pediatric peripheral lung lesions, offering critical histopathologic and microbiologic guidance for clinical decision making.
{"title":"Diagnostic Accuracy and Clinical Impact of Ultrasound-Guided Percutaneous Lung Biopsy in Pediatric Patients: A Retrospective Observational Study","authors":"Jiaojiao Ding , Xin Ni PhD , Xiao Zhang MS , Jiabin Wan BS , Wenyuan Shi MD","doi":"10.1016/j.jvir.2025.08.040","DOIUrl":"10.1016/j.jvir.2025.08.040","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the diagnostic accuracy, safety, and clinical impact of ultrasound-guided percutaneous lung biopsy (US-PLB) in pediatric peripheral lung lesions.</div></div><div><h3>Materials and Methods</h3><div>A retrospective cohort analysis included 34 pediatric patients (24 boys; 10 girls; mean age, 7.9 years [SD ± 4.4]) who underwent US-PLB from March 2019 to February 2024. Diagnostic metrics (sensitivity, specificity, and positive and negative predictive values) and adverse events were analyzed. The influence of biopsy results on clinical management was assessed.</div></div><div><h3>Results</h3><div>Among 33 diagnostic procedures, US-PLB demonstrated an accuracy of 97.0% (32/33), with a sensitivity of 80.0% (4/5 malignant lesions) and specificity of 100% (28/28 benign lesions). Minor complications occurred in 17.6% (6/34) of patients, including pneumothorax (2.9%) and transient hemoptysis (2.9%). Biopsy findings directly altered therapeutic strategies in 44.1% (15/34) of cases, including initiation of chemotherapy or targeted antimicrobial therapy.</div></div><div><h3>Conclusions</h3><div>US-PLB is a safe and accurate radiation-free diagnostic technique for pediatric peripheral lung lesions, offering critical histopathologic and microbiologic guidance for clinical decision making.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"37 3","pages":"Article 107823"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006794","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}
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