Below-the-ankle Angioplasty: Current Evidence and Future Perspectives

Over 20 million adults in Europe suffer from peripheral arterial disease (PAD). The annual incidence of PAD is approximately 2.4%, while the annual incidence of critical limb ischaemia (CLI), the last and most severe stage of PAD, has been reported to be 0.4%. Endovascular angioplasty and/or stenting of infrapopliteal disease is, today, an established treatment for critical limb ischaemia. The main technical advantages of endovascular treatment over open bypass surgery include the possibility to revascularise more than one infrapopliteal vessels and, most importantly, to treat outflow pedal vessel disease or even reconstitute the pedal arch. Data of below-the-ankle angioplasty are beginning to sum up and the contribution of pedal arch angioplasty in limb salvage and wound healing are currently under investigation. In this review, currently available data and the future perspectives on below-the-ankle and pedal arch endovascular treatment will be presented

Interventional oncology procedures for breast cancer metastatic disease: current role and clinical applications

Worldwide, breast cancer constitutes the most common malignant neoplasm among females, impacting 2.1 million women annually. Interventional oncology techniques have been recently added as an additional therapeutic and palliative alternative in breast cancer metastatic disease, concerning mainly osseous, liver, and lung metastasis. In the current literature, there are reports of promising results and documented efficacy regarding the ablation of liver and lung metastasis from breast carcinoma, transarterial embolization or radioembolization, as well as the treatment of osseous metastatic disease. These literature studies are limited by the heterogeneity of breast cancer disease, the evaluation of variable different parameters, as well as the retrospective nature in most of the cases. Consequently, dedicated prospective series and randomized studies are required to identify the role of minimally invasive local therapies of interventional oncology armamentarium. The present review paper focuses upon the current role of interventional oncology techniques for the curative or palliative treatment of metastatic breast cancer disease. The purpose of this review paper is to present the current minimally invasive procedures in the treatment of metastatic breast disease, including local control rates and survival rates

Use of an amplatzer vascular plug in embolization of a pulmonary artery aneurysm in a case of hughes-stovin syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hughes-Stovin syndrome is a rare condition characterized by peripheral deep venous thrombosis accompanied by single or multiple pulmonary arterial aneurysms. The limited number of cases has precluded controlled studies of the management of pulmonary artery aneurysms, which usually cause massive hemoptysis leading to death. This is the first report of a new endovascular treatment of a single large pulmonary arterial aneurysm.</p> <p>Case presentation</p> <p>An 18-year-old Caucasian man was referred to our department with recurrent severe hemoptysis. His medical history included Hughes-Stovin syndrome diagnosed during a recent hospital admission. The patient was initially treated with corticosteroids. Because of his recurrent hemoptysis, we decided to embolize a 3.5 cm pulmonary arterial aneurysm using an Amplatzer Vascular Plug. The procedure was not complicated, and the patient's post-intervention course was uneventful. The patient has remained free from any complications of the embolization 36 months after the procedure.</p> <p>Conclusion</p> <p>Percutaneous embolization of a single large pulmonary artery aneurysm with an Amplatzer Vascular Plug in a patient with Hughes-Stovin syndrome is a less invasive procedure that represents the best multidisciplinary approach in treating these patients.</p

Consensus guidelines for the definition of time-to-event end points in image-guided tumor ablation: results of the SIO and DATECAN initiative

International audienceThere is currently no consensus regarding preferred clinical outcome measures following image-guided tumor ablation or clear definitions of oncologic end points. This consensus document proposes standardized definitions for a broad range of oncologic outcome measures with recommendations on how to uniformly document, analyze, and report outcomes. The initiative was coordinated by the Society of Interventional Oncology in collaboration with the Definition for the Assessment of Time-to-Event End Points in Cancer Trials, or DATECAN, group. According to predefined criteria, based on experience with clinical trials, an international panel of 62 experts convened. Recommendations were developed using the validated three-step modified Delphi consensus method. Consensus was reached on when to assess outcomes per patient, per session, or per tumor; on starting and ending time and survival time definitions; and on time-to-event end points. Although no consensus was reached on the preferred classification system to report complications, quality of life, and health economics issues, the panel did agree on using the most recent version of a validated patient-reported outcome questionnaire. This article provides a framework of key opinion leader recommendations with the intent to facilitate a clear interpretation of results and standardize worldwide communication. Widespread adoption will improve reproducibility, allow for accurate comparisons, and avoid misinterpretations in the field of interventional oncology research. Published under a CC BY 4.0 license. Online supplemental material is available for this article. See also the editorial by Liddell in this issue

MECHANISMS CONTROLLING MASCULINITY (EXPERIMENTAL STUDY IN TWO STRAINS OF MICE)

MECHANISMS RESPONSIBLE FOR THE DEFICIENT EXPRESSION OF MALE PHENOTYPE WERE STUDIED. AS EXPERIMENTAL MODEL WE USED THE C57BL/10J MALE MICE WHICH ARE DEFICIENT IN A NUMBER OF MALE CHARACTERISTICS AS COMPARED WITH THE DBA MALE MICE. AS FAR AS TESTOSTERONE IS THE CRUCIAL FACTOR FOR THE DEVELOPMENT OF THE MALE PHENOTYPE, WE STUDIED TESTOSTERONE UPTAKE BY ITS "TARGET-TISSUES", IN THESE TWO STRAINS. IN ADDITION WE STUDIED LOCAL METABOLISM OF TESTOSTERONE IN THE HYPOTHALAMUS PREOPTIC AREA OF THESE TWO STRAINS. TESTOSTERONE IS TAKEN UP BY ALL TISSUES STUDIED IN BOTH STRAINS OF MICE. MOREOVER, IT IS SHOWN THAT TESTOSTERONE IS TAKEN UP BY LIMITED CAPACITY UPTAKE SYSTEMS IN CYTOPLASM AND NUCLEUS, WHICH REPRESENT CYTOPLASMIC AND NUCLEAR RECEPTORS RESPECTIVELY. THE CAPACITY OF UPTAKE SYSTEMS IS THE SAME, WHILE THE EFFICIENCY IS GREATER IN C57 THAN IN DBA. INTHE HYPOTHALAMUS, TESTOSTERONE IS METABOLIZED IN BOTH STRAINS TO 5A REDUCED METABOLITES AND ESTROGENS. THE HYPOTHALAMUS-PREOPTIC AREA OF C57 MALE MICE HASDECREASED AROMATASE ACTIVITY, WHICH IS CONSISTENT WITH THEIR DEFICIENT MASCULINE BEHAVIORAL CHARACTERISTICS.ΜΕΛΕΤΗΘΗΚΑΝ ΟΙ ΜΗΧΑΝΙΣΜΟΙ ΠΟΥ ΕΥΘΥΝΟΝΤΑΙ ΓΙΑ ΤΗΝ ΕΛΛΕΙΜΜΑΤΙΚΗ ΑΝΑΠΤΥΞΗ ΤΟΥ ΑΡΣΕΝΙΚΟΥ ΦΑΙΝΟΤΥΠΟΥ. ΣΑΝ ΠΕΙΡΑΜΑΤΙΚΟ ΜΟΝΤΕΛΛΟ ΧΡΗΣΙΜΟΠΟΙΗΘΗΚΑΝ R ΑΡΣΕΝΙΚΑ ΠΟΝΤΙΚΙΑ C57BL/10J ΠΟΥ ΥΣΤΕΡΟΥΝ ΣΕ ΜΙΑ ΣΕΙΡΑ ΑΠΟ ΑΡΣΕΝΙΚΑ ΧΑΡΑΚΤΗΡΙΣΤΙΚΑ ΣΕ ΣΥΓΚΡΙΣΗΜΕ ΤΑ DBA/2J. ΕΠΕΙΔΗ Η ΤΕΣΤΟΣΤΕΡΟΝΗ ΕΙΝΑΙ Ο ΚΑΘΟΡΙΣΤΙΚΟΣ ΠΑΡΑΓΟΝΤΑΣ ΓΙΑ ΤΗΝ ΑΝΑΠΤΥΞΗ ΤΟΥ ΑΡΣΕΝΙΚΟΥ ΦΑΙΝΟΤΥΠΟΥ, ΜΕΛΕΤΗΘΗΚΕ Η ΠΡΟΣΛΗΨΗ ΤΗΣ ΑΠΟ ΤΟΥΣ ΙΣΤΟΥΣ ΣΤΟΧΟΥΣ ΤΗΣ ΣΤΑ ΔΥΟ ΣΤΕΛΕΧΗ ΠΟΝΤΙΚΙΩΝ. ΕΠΙΣΗΣ ΜΕΛΕΤΗΘΗΚΕ Ο ΤΟΠΙΚΟΣ ΜΕΤΑΒΟΛΙΣΜΟΣΤΗΣ ΣΤΟΝ ΥΠΟΘΑΛΑΜΟ-ΠΡΟΟΠΤΙΚΗ ΠΕΡΙΟΧΗ. Η ΤΕΣΤΟΣΤΕΡΟΝΗ ΠΡΟΣΛΑΜΒΑΝΕΤΑΙ ΑΠ'ΟΛΟΥΣ ΤΟΥΣ ΙΣΤΟΥΣ ΠΟΥ ΜΕΛΕΤΗΘΗΚΑΝ ΚΑΙ ΣΤΑ ΔΥΟ ΣΤΕΛΕΧΗ. ΔΕΧΤΗΚΕ ΟΤΙ Η ΠΡΟΣΛΗΨΗ ΓΙΝΕΤΑΙ ΣΕ ΠΕΠΕΡΑΣΜΕΝΗΣ ΧΩΡΗΤΙΚΟΤΗΤΑΣ ΣΥΣΤΗΜΑΤΑ ΠΡΟΣΛΗΨΗΣ ΣΤΟ ΚΥΤΤΑΡΟΠΛΑΣΜΑ ΚΑΙ ΤΟΝ ΠΥΡΗΝΑ ΠΟΥ ΑΝΤΙΣΤΟΙΧΟΥΝ ΣΤΟΥΣ ΚΥΤΤΑΡΟΠΛΑΣΜΑΤΙΚΟΥΣ ΚΑΙ ΠΥΡΗΝΙΚΟΥΣ ΥΠΟΔΟΧΕΙΣ. Η ΧΩΡΗΤΙΚΟΤΗΤΑ ΤΩΝ ΣΥΣΤΗΜΑΤΩΝ ΠΡΟΣΛΗΨΗΣ ΕΙΝΑΙ ΜΕΓΑΛΥΤΕΡΗ ΣΤΑ C57 ΚΑΙ ΣΤΑ DBA, ΕΝΩ Η ΑΠΟΔΟΤΙΚΟΤΗΤΑ ΕΙΝΑΙ ΜΕΓΑΛΥΤΕΡΗ ΣΤΑ C57 ΑΠ#ΤΙ ΣΤΑ DBA. ΣΤΟΝ ΥΠΟΘΑΛΑΜΟ Η ΤΕΣΤΟΣΤΕΡΟΝΗ ΜΕΤΑΒΟΛΙΖΕΤΑΙ ΚΑΙ ΣΤΑ ΔΥΟ ΣΤΕΛΕΧΗ ΠΡΟΣ 5Α-ΑΝΗΓΜΕΝΟΥΣ ΜΕΤΑΒΟΛΗΤΕΣ ΚΑΙ ΟΙΣΤΡΟΓΟΝΑ. Ο ΥΠΟΘΑΛΑΜΟΣ ΤΟΥ C57 ΕΧΕΙ ΕΛΑΤΤΩΜΕΝΗ ΔΡΑΣΤΙΚΟΤΗΤΑ ΑΡΩΜΑΤΑΣΗΣ, ΓΕΓΟΝΟΣ ΠΟΥ ΕΞΗΓΕΙ ΤΗΝ ΕΛΛΕΙΜΜΑΤΙΚΗ ΕΚΦΡΑΣΗ ΤΗΣ ΓΕΝΕΤΗΣΙΑΣ ΣΥΜΠΕΡΙΦΟΡΑΣ ΣΤΑ ΖΩΑ ΑΥΤΑ

Carotid Interventions Above and Below the Bulb

Atherosclerotic occlusive lesions of the common carotid artery (CCA), the internal carotid artery (ICA), and the intracranial branches are amenable to angioplasty and stenting. Non atheromatous occlusive lesions caused by fibromuscular dysplasia, arteritis, or trauma may also be treated by image guided intervention in selected patients. Aneurysmal lesions of the CCA, ICA and the intracranial branches of degenerative, mycotic or traumatic etiologies, as well as carotid cavernous fistulae are mostly best treated by embolization. Technological developments continuously expand the indications of interventional treatment in these vascular territories