No abstract

Interventional radiology provides a wide variety of vascular, nonvascular, musculoskeletal, and oncologic minimally invasive techniques aimed at therapy or palliation of a broad spectrum of pathologic conditions. Outcome data for these techniques are globally evaluated by hospitals, insurance companies, and government agencies targeting in a high-quality health care policy, including reimbursement strategies. To analyze effectively the outcome of a technique, accurate reporting of complications is necessary. Throughout the literature, numerous classification systems for complications grading and classification have been reported. Until now, there has been no method for uniform reporting of complications both in terms of definition and grading. The purpose of this CIRSE guideline is to provide a classification system of complications based on combining outcome and severity of sequelae. The ultimate challenge will be the adoption of this system by practitioners in different countries and health economies within the European Union and beyond.

No abstract

Purpose To demonstrate that hepatic tumor volume and enhancement pattern measurements can be obtained in a time efficient and reproducible manner on a voxel-by-voxel basis to provide a true 3D volumetric assessment. Materials and Methods Retrospective evaluation of MRI data obtained from 20 patients recruited for a single-institution prospective study. All patients carried a diagnosis of hepatocellular carcinoma (HCC) and underwent drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE) for the first time. All patients had undergone contrast-enhanced MRI before and after DEB-TACE although poor image quality excluded 3 resulting in a final count of 17 patients. vRECIST and qEASL were measured and segmentation and processing times were recorded. Results Thirty-four scans were analyzed. The time for semi-automatic segmentation was 65±33 seconds with a range of 40–200 seconds. vRECIST and qEASL of each tumor were then computed less than one minute for each. Conclusion Semi-automatic quantitative tumor enhancement (qEASL) and volume (vRECIST) assessment is feasible in a workflow efficient time frame. Clinical correlation is necessary, but vRECIST and qEASL could become part of the assessment of intra-arterial therapy for interventional radiologists.

6.9% vs 8.4% and declined to 0.2 to 0.3 percentage points difference by three years after the trial ended. Over follow-up of 9.8 years, the intensive therapy group had a significantly lower risk of the primary outcome than did the standard therapy group (hazard ratio [HR], 0.83; 95% confidence interval [CI], 0.70-0.99; P ¼ .04). There was an absolute reduction in risk of 8.6 major cardiovascular events per 1000 person years but there was no reduced cardiovascular mortality benefit (HR, 0.88; 95% CI, 0.64-1.20; P ¼ .42). There was no reduction in total mortality in the intensive therapy group (HR, 1.05; 95% CI, 0.89-1.25; P ¼ .54) with the median follow-up of 11.8 years.Comment: With no reduction in total mortality, small to moderate reductions in rates of cardiovascular events need to be considered along with potential harms due to aggressive attempts to control glucose and side effects of treatment including weight gain and hypoglycemia. Patients and physicians need to decide together whether a reduction in cardiovascular events at the risk of complications of diabetes control and no improvement in mortality is a desired individual patient goal.

No abstract

Spontaneous muscle hematomas are a common and serious complication of anticoagulant treatment. The incidence of this event has increased along with the rise in the number of patients receiving anticoagulants. Radiological management is both diagnostic and interventional. Computed tomography angiography (CTA) is the main tool for the detection of hemorrhage to obtain a positive, topographic diagnosis and determine the severity. Detection of an active leak of contrast material during the arterial or venous phase is an indication for the use of arterial embolization. In addition, the interventional radiological procedure can be planned with CTA. Arterial embolization of the pedicles that are the source of the bleeding is an effective technique. The rate of technical and clinical success is 90% and 86%, respectively.

Distal coil embolization of the superior rectal arteries for disabling chronic bleeding due to haemorrhoidal disease is safe and effective in patients untreatable by surgery.