Pub Date : 2024-09-23DOI: 10.1016/j.jvir.2024.08.028
Lucas R. Cusumano MD, MPH, Hiro D. Sparks MD, Kara E. Masterson MSN, NP, Scott J. Genshaft MD, Adam N. Plotnik MD, Siddharth A. Padia MD
Purpose
To report the 24-month outcomes and subgroup analysis evaluating the safety and effectiveness of the genicular artery embolization (GAE) for the treatment of symptomatic knee osteoarthritis (OA).
Materials and Methods
Forty participants with symptomatic moderate-to-severe knee OA from a single-center, single-arm, prospective investigational device exemption trial of GAE were included in this study. Abnormal genicular artery neovascularity was identified at the subject’s focal knee pain with digital subtraction angiography and cone-beam computed tomography (CT). Embolization was performed with 100-μm microspheres. The primary end point was treatment effectiveness as measured by sustained improvement in OA symptoms at 24 months, quantified using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Treatment success was defined as ≥50% decrease in WOMAC relative to baseline. Clinical outcomes were assessed with mean age of 66.0 years (SD ± 8.1) and body mass index of 30.1 kg/m2 (SD ± 6.2).
Results
Of the 40 patients, 2 (5.0%) were lost to follow-up. Overall, 18 of 38 (47.4%) patients demonstrated ≥50% reduction in WOMAC at 24 months. In the subset of patients with initial clinical success at 12 months, 18 of 25 (72.0%) reported sustained clinical success at 24 months. Seven of 25 (28.0%) patients had symptom recurrence between 12 and 24 months and were determined to be clinical failures. All treatment-related adverse events occurred within 12 months after GAE, without additional events after 12 months.
Conclusions
GAE is effective in achieving sustained symptom relief related to moderate-to-severe knee OA for up to 24 months with an acceptable safety profile.
{"title":"Genicular Artery Embolization for Treatment of Symptomatic Knee Osteoarthritis: 2-Year Outcomes from a Prospective IDE Trial","authors":"Lucas R. Cusumano MD, MPH, Hiro D. Sparks MD, Kara E. Masterson MSN, NP, Scott J. Genshaft MD, Adam N. Plotnik MD, Siddharth A. Padia MD","doi":"10.1016/j.jvir.2024.08.028","DOIUrl":"10.1016/j.jvir.2024.08.028","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the 24-month outcomes and subgroup analysis evaluating the safety and effectiveness of the genicular artery embolization (GAE) for the treatment of symptomatic knee osteoarthritis (OA).</div></div><div><h3>Materials and Methods</h3><div>Forty participants with symptomatic moderate-to-severe knee OA from a single-center, single-arm, prospective investigational device exemption trial of GAE were included in this study. Abnormal genicular artery neovascularity was identified at the subject’s focal knee pain with digital subtraction angiography and cone-beam computed tomography (CT). Embolization was performed with 100-μm microspheres. The primary end point was treatment effectiveness as measured by sustained improvement in OA symptoms at 24 months, quantified using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Treatment success was defined as ≥50% decrease in WOMAC relative to baseline. Clinical outcomes were assessed with mean age of 66.0 years (SD ± 8.1) and body mass index of 30.1 kg/m<sup>2</sup> (SD ± 6.2).</div></div><div><h3>Results</h3><div>Of the 40 patients, 2 (5.0%) were lost to follow-up. Overall, 18 of 38 (47.4%) patients demonstrated ≥50% reduction in WOMAC at 24 months. In the subset of patients with initial clinical success at 12 months, 18 of 25 (72.0%) reported sustained clinical success at 24 months. Seven of 25 (28.0%) patients had symptom recurrence between 12 and 24 months and were determined to be clinical failures. All treatment-related adverse events occurred within 12 months after GAE, without additional events after 12 months.</div></div><div><h3>Conclusions</h3><div>GAE is effective in achieving sustained symptom relief related to moderate-to-severe knee OA for up to 24 months with an acceptable safety profile.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"35 12","pages":"Pages 1768-1775"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1016/S1051-0443(24)00532-3
{"title":"Subscription Information Page","authors":"","doi":"10.1016/S1051-0443(24)00532-3","DOIUrl":"10.1016/S1051-0443(24)00532-3","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"35 10","pages":"Page A2"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312956","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 : 2024-09-23DOI: 10.1016/S1051-0443(24)00533-5
{"title":"Contents in Brief","authors":"","doi":"10.1016/S1051-0443(24)00533-5","DOIUrl":"10.1016/S1051-0443(24)00533-5","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"35 10","pages":"Page A4"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312957","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 : 2024-09-23DOI: 10.1016/j.jvir.2024.08.010
{"title":"CME Test Questions: October 2024","authors":"","doi":"10.1016/j.jvir.2024.08.010","DOIUrl":"10.1016/j.jvir.2024.08.010","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"35 10","pages":"Page 1491"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142313073","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 : 2024-09-23DOI: 10.1016/j.jvir.2024.07.004
{"title":"Crossword Puzzle","authors":"","doi":"10.1016/j.jvir.2024.07.004","DOIUrl":"10.1016/j.jvir.2024.07.004","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"35 10","pages":"Page 1577"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142313023","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 : 2024-09-23DOI: 10.1016/j.jvir.2024.09.006
Yan Epelboym MD, MPH
{"title":"Long-Term Outcomes of Genicular Artery Embolization for Knee Osteoarthritis","authors":"Yan Epelboym MD, MPH","doi":"10.1016/j.jvir.2024.09.006","DOIUrl":"10.1016/j.jvir.2024.09.006","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"35 12","pages":"Pages 1776-1777"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331308","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 : 2024-09-23DOI: 10.1016/j.jvir.2024.09.008
Jason Chiang, Steven S Raman, Abinaya Ramakrishnan, Pedram Keshavarz, James W Sayre, Justin P McWilliams, Richard S Finn, Vatche G Agopian, Gina Choi, David S K Lu
Purpose: To correlate preablation needle biopsy-acquired histopathologic grade of Liver Imaging Reporting and Data System (LI-RADS) 5 hepatocellular carcinoma (HCC) with postablation local tumor control rate, intrahepatic distant tumor progression-free survival, and overall survival.
Materials and methods: This single-center, retrospective cohort study included adult patients with LI-RADS 5 HCC who underwent a preablation core needle biopsy within 3 months prior to thermal ablation from January 2015 to December 2022. Histopathologic grade from the needle biopsy was evaluated as predictor of local tumor control rate, intrahepatic distant tumor progression-free survival, and overall survival. Kaplan-Meier survival curves were compared using the Gehan generalized Wilcoxon test.
Results: The study group comprised 133 patients (mean age, 67 years [SD ± 10]; 107 men) with LI-RADS 5 confirmed HCC, stratified into 18 poorly differentiated tumors (median follow-up, 27.7 months; interquartile range [IQR], 15.5-55.4 months) and 115 well-differentiated/moderately differentiated tumors (median follow-up, 29.2 months; IQR, 15.4-59.9 months). No difference in local tumor control rate was noted between the 2 cohorts (hazard ratio [HR], 1.16; 95% CI, 0.32-4.23; P = .898). There was significantly lower intrahepatic distant tumor progression-free survival after thermal ablation in the poorly differentiated cohort (HR, 2.54; 95% CI, 0.92-7.05; P < .001). The overall survival in the poorly differentiated cohort was also lower, although this did not reach statistical significance (HR, 1.77; 95% CI, 0.60-5.26; P = .202).
Conclusions: Patients with needle biopsy-proven poorly differentiated LI-RADS 5 HCC had significantly lower intrahepatic distant tumor progression-free survival after thermal ablation compared with those with well-differentiated/moderately differentiated HCC.
{"title":"Correlation of Needle Biopsy-Acquired Histopathologic Grade of Hepatocellular Carcinoma with Outcomes after Thermal Ablation.","authors":"Jason Chiang, Steven S Raman, Abinaya Ramakrishnan, Pedram Keshavarz, James W Sayre, Justin P McWilliams, Richard S Finn, Vatche G Agopian, Gina Choi, David S K Lu","doi":"10.1016/j.jvir.2024.09.008","DOIUrl":"10.1016/j.jvir.2024.09.008","url":null,"abstract":"<p><strong>Purpose: </strong>To correlate preablation needle biopsy-acquired histopathologic grade of Liver Imaging Reporting and Data System (LI-RADS) 5 hepatocellular carcinoma (HCC) with postablation local tumor control rate, intrahepatic distant tumor progression-free survival, and overall survival.</p><p><strong>Materials and methods: </strong>This single-center, retrospective cohort study included adult patients with LI-RADS 5 HCC who underwent a preablation core needle biopsy within 3 months prior to thermal ablation from January 2015 to December 2022. Histopathologic grade from the needle biopsy was evaluated as predictor of local tumor control rate, intrahepatic distant tumor progression-free survival, and overall survival. Kaplan-Meier survival curves were compared using the Gehan generalized Wilcoxon test.</p><p><strong>Results: </strong>The study group comprised 133 patients (mean age, 67 years [SD ± 10]; 107 men) with LI-RADS 5 confirmed HCC, stratified into 18 poorly differentiated tumors (median follow-up, 27.7 months; interquartile range [IQR], 15.5-55.4 months) and 115 well-differentiated/moderately differentiated tumors (median follow-up, 29.2 months; IQR, 15.4-59.9 months). No difference in local tumor control rate was noted between the 2 cohorts (hazard ratio [HR], 1.16; 95% CI, 0.32-4.23; P = .898). There was significantly lower intrahepatic distant tumor progression-free survival after thermal ablation in the poorly differentiated cohort (HR, 2.54; 95% CI, 0.92-7.05; P < .001). The overall survival in the poorly differentiated cohort was also lower, although this did not reach statistical significance (HR, 1.77; 95% CI, 0.60-5.26; P = .202).</p><p><strong>Conclusions: </strong>Patients with needle biopsy-proven poorly differentiated LI-RADS 5 HCC had significantly lower intrahepatic distant tumor progression-free survival after thermal ablation compared with those with well-differentiated/moderately differentiated HCC.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331306","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 : 2024-09-23DOI: 10.1016/j.jvir.2024.06.035
Andrei Jipa MD, Mina S. Makary MD
{"title":"Hepatic Capsular Rupture during Wedged Portography","authors":"Andrei Jipa MD, Mina S. Makary MD","doi":"10.1016/j.jvir.2024.06.035","DOIUrl":"10.1016/j.jvir.2024.06.035","url":null,"abstract":"","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"35 10","pages":"Pages 1578-1579"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1051044324004482/pdfft?md5=9180d0d59f1b8e0077f0a33bbf2a4ae6&pid=1-s2.0-S1051044324004482-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142310728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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