This study proposed an AE classification system that outperformed the existing SIR classification in the studied domains.

No abstract

Objective: To assess the short-and long-term outcomes of vena cava filter (VCF) placement for prophylaxis against pulmonary embolism in patients at high risk due to trauma.Design and Setting: Case series at a level I trauma center.Patients: Patients were considered for prophylactic VCF placement if they met 1 of the injury criteria-spinal cord injuries with neurologic deficit, severe fractures of the pelvis or long bone (or both), and severe head injuryand had a contraindication to anticoagulation.Intervention: Vena cava filters were placed percutaneously by the interventional radiologists when the acute trauma condition was stabilized following admission. Main Outcome Measures:Filter tilt of 14°or more, strut malposition, insertion-related deep vein thrombosis, pulmonary embolism, or inferior vena cava patency.Results: There were 132 prophylactic VCFs placed. A 3.1% rate of insertion-related deep vein thrombosis occurred, all of which were asymptomatic. Filter tilt occurred in 5.5% of patients and strut malposition in 38%. Three cases of pulmonary embolism (1 fatal) occurred in a prophylactic VCF, and all patients had either filter tilt or strut malposition. The risk of pulmonary embolism developing was higher in those patients with filter tilt or strut malposition than in those who did not have these complications (6.3% vs 0%; P=.05; Fisher exact test). The 1-, 2-, and 3-year inferior vena cava patency rates (±SD) were 97%±3%.Conclusions: Prophylactic VCF can be placed safely with an acceptable rate of insertion-related deep vein thrombosis and long-term inferior vena cava patency. Patients with prophylactic VCF remain at risk for pulmonary embolism if the filter is tilted 14°or more or has strut malposition. In such patients, consideration should be given to placing a second filter.

No abstract

Immediate exclusion of a cervical internal carotid pseudoaneurysm was performed using an autologous vein-covered stent. One-month follow-up confirmed continued exclusion of the pseudoaneurysm and carotid patency without stenosis.

The membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee represents experts in a broad spectrum of interventional procedures from the private and academic sectors of medicine. Generally, Standards of Practice Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid broad expert constituency of the subject matter under consideration for standards production.Technical documents specifying the exact consensus and literature review methodologies as well as the institutional affiliations and professional credentials of the authors of this document are available upon request from SIR, 3975 Fair Ridge Dr., Suite 400 N., Fairfax, VA 22033. METHODOLOGYSIR produces its Standards of Practice documents using the following process. Standards documents of relevance and timeliness are conceptualized by the Standards of Practice Committee members. A recognized expert is identified to serve as the principal author for the standard. Additional authors may be assigned dependent upon the magnitude of the project.An in-depth literature search is performed using electronic medical literature databases. Then, a critical review of peer-reviewed articles is performed with regard to the study methodology, results, and conclusions. The qualitative weight of these articles is assembled into an evidence table, which is used to write the document such that it contains evidence-based data with respect to content, rates, and thresholds (Fig E1 and Table E1, available online at www.jvir.org).When the evidence of literature is weak, conflicting, or contradictory, consensus for the parameter is reached by a minimum of 12 Standards of Practice Committee members using a modified Delphi consensus method (Appendix A). For purposes of these documents, consensus is defined as 80% Delphi participant agreement on a value or parameter.The draft document is critically reviewed by the Standards of Practice Committee members by telephone conference calling or face-to-face meeting. The finalized draft from the Committee is sent to the SIR membership for further input/criticism during a 30-day comment period. These comments are discussed by the Standards of Practice Committee, and appropriate revisions are made to create the finished standards document. Prior to its publication, the document is endorsed by the SIR Executive Council.

The Günther Tulip filter is commonly used at this Level I trauma center as an optional filter that can be left in place as a permanent filter or removed up to 41 days after placement. Without an intervening repositioning procedure, the manufacturer suggests that the Günther Tulip filter can be safely removed within 14 days of implantation, or it can remain in place as a permanent filter.

Acute experimental osteomyelitis and abscesses were induced in the proximal tibia and surrounding soft tissues, respectively, in 67 New Zealand white rabbits. Fifty-three rabbits were injected with a Staphylococcus aureus solution and 26, with sterile saline in tibial medullae and/or surrounding soft tissues. Contrast material-enhanced computed tomography (CT) and magnetic resonance (MR) imaging were performed 7 days after inoculation. Immediately after imaging, the animals were killed and necropsy was performed. MR imaging was more sensitive than CT in the detection of osteomyelitis (94% vs 66%, P less than .025) and abscesses (97% vs 52%, P less than .001). MR imaging was equally specific as CT in the exclusion of osteomyelitis (93% vs 97%, chi 2 = 0) but less specific than CT in the exclusion of abscesses (77% vs 100%, P less than .025). The overall accuracy of MR imaging was somewhat, although not significantly, greater than that of CT in the detection of both osteomyelitis (93% vs 80%) and abscesses (87% vs 75%).