Hepatic Transcatheter Arterial Chemoembolization Complicated by Postembolization Syndrome

Postembolization syndrome (PES) is a common complication after embolic procedures, and it is a frequent cause of extended inpatient hospital admissions. PES is a self-limited constellation of symptoms consisting of fevers, unremitting nausea, general malaise, loss of appetite, and variable abdominal pain following the procedure. Although a definite cause is unknown, this syndrome is thought to be a result of therapeutic cytotoxicity, tumor ischemia, and resulting intrahepatic and extrahepatic inflammation. The authors report a case of PES precipitated by transcatheter intrarterial chemoembolization of hepatic metastases

Similar Outcomes of Endovascular Ischemic Stroke Treatment Performed by Interventional Radiologists and Neuro Interventional Fellowship Trained Physicians

Endovascular stroke treatment (EVT) may be provided by physicians with varying specialty training. It is possible that physicians without dedicated neurointerventional training will have outcomes inferior to physicians with such dedicated training

Outcomes of Stroke Thrombectomy Performed by Interventional Radiologists versus Neurointerventional Physicians.

PURPOSE: To test the hypothesis that interventional radiologists (IRs) and neurointerventional (NI) physicians have similar outcomes of endovascular stroke thrombectomy (EVT), which could be used to improve the availability of thrombectomy. MATERIALS AND METHODS: Eight hospitals providing EVT performed by IRs and NI physicians at the same institution submitted sequential retrospective data limited to the era of modern devices. Good clinical outcomes (a 90-day modified Rankin score [mRS] of 0-2) and technically successful revascularization (a modified thrombolysis in cerebral infarction score of ≥2b) were compared between the specialties after adjusting for treating hospital, patient age, stroke severity, Alberta stroke program early computed tomography score, time from symptom onset to door, and clot location. Propensity score matching was used to compare the outcomes. A total of 1,009 patients were evaluated (622 treated by IRs and 387 treated by NI physicians). RESULTS: The median time from stroke onset to puncture was 245 versus 253 minutes (P = .49), the technically successful revascularization rate was 81.8% versus 82.4% (P = .81), and the good clinical outcome rate was 45.5% versus 50.1% (P = .16). After adjusting, the physician specialty was not a significant predictor of good clinical outcomes (odds ratio, 1.028; 95% confidence interval, 0.760-1.390; P = .86). After matching, an mRS of 0-2 was present in 47.7% of IR treated patients and 51.1% of NI treated patients (P = .366). CONCLUSIONS: There were no significant differences in the successful revascularization rate and good clinical outcomes between IRs and NI physicians. The outcomes of EVT performed by IRs were similar to those of EVT performed by NI physicians, as determined using previously published trials and registries. This may be useful for addressing coverage and access to stroke interventions

Outcomes of Stroke Thrombectomy Performed by Interventional Radiologists versus Neurointerventional Physicians

PURPOSE: To test the hypothesis that interventional radiologists (IRs) and neurointerventional (NI) physicians have similar outcomes of endovascular stroke thrombectomy (EVT), which could be used to improve the availability of thrombectomy. MATERIALS AND METHODS: Eight hospitals providing EVT performed by IRs and NI physicians at the same institution submitted sequential retrospective data limited to the era of modern devices. Good clinical outcomes (a 90-day modified Rankin score [mRS] of 0-2) and technically successful revascularization (a modified thrombolysis in cerebral infarction score of ≥2b) were compared between the specialties after adjusting for treating hospital, patient age, stroke severity, Alberta stroke program early computed tomography score, time from symptom onset to door, and clot location. Propensity score matching was used to compare the outcomes. A total of 1,009 patients were evaluated (622 treated by IRs and 387 treated by NI physicians). RESULTS: The median time from stroke onset to puncture was 245 versus 253 minutes (P = .49), the technically successful revascularization rate was 81.8% versus 82.4% (P = .81), and the good clinical outcome rate was 45.5% versus 50.1% (P = .16). After adjusting, the physician specialty was not a significant predictor of good clinical outcomes (odds ratio, 1.028; 95% confidence interval, 0.760-1.390; P = .86). After matching, an mRS of 0-2 was present in 47.7% of IR treated patients and 51.1% of NI treated patients (P = .366). CONCLUSIONS: There were no significant differences in the successful revascularization rate and good clinical outcomes between IRs and NI physicians. The outcomes of EVT performed by IRs were similar to those of EVT performed by NI physicians, as determined using previously published trials and registries. This may be useful for addressing coverage and access to stroke interventions

Outcomes of Stroke Thrombectomy Performed by Interventional Radiologists vs Neurointerventional Physicians.

PURPOSE: To test the hypothesis that interventional radiologists (IR) have outcomes for endovascular stroke thrombectomy (EVT) similar to Neurointerventional (NI) physicians and could be used to improve availability of thrombectomy. MATERIALS AND METHODS: Eight hospitals providing EVT performed by IR and NI in the same institution submitted sequential retrospective data limited to the era of modern devices. Good clinical outcome (90 day modified Rankin score 0-2) and successful revascularization (modified Thrombolysis in Cerebral Infarction score \u3e 2b) were compared between specialties, adjusted for treating hospital, patient age, stroke severity, Alberta Stroke Program Early CT Score (ASPECTS), time from symptom onset to door, and clot location. Propensity score matching was used to compare outcomes. A total of 1009 patients were entered (622 treated by IR and 387 treated by NI). RESULTS: Median stroke onset to puncture was 245 vs 253 minutes (p=.49), technically successful revascularization was 81.8% vs 82.4% (p=.81), and good clinical outcome was 45.5% vs 50.1% (p=.16), respectively. After adjusting, physician specialty was not a significant predictor of good clinical outcome (odds ratio 1.028 [95% CI 0.760-1.390]; p=.86). After matching, mRS 0-2 was 47.7% for IR and 51.1% for NI (p=0.366). CONCLUSION: There was no significant difference in successful revascularization and good clinical outcomes between IR and NI physicians. Outcomes by IR were similar to NI outcomes from previously published trials and registries. This may be useful to address coverage and access to stroke interventions

#TwittIR: Understanding and Establishing a Twitter Ecosystem for Interventional Radiologists and Their Practices.

The use of social media among interventional radiologists is increasing, with Twitter receiving the most attention. Twitter is an ideal forum for open exchange of ideas from around the world. However, it is important for Twitter users to gain a rudimentary understanding of the many potential communication pathways to connect with other users. An intentional approach to Twitter is vital to efficient and successful use. This article describes several common communication pathways that can be utilized by physicians in their interventional radiology practice

#TwittIR: Understanding and Establishing a Twitter Ecosystem for Interventional Radiologists and Their Practices

The use of social media among interventional radiologists is increasing, with Twitter receiving the most attention. Twitter is an ideal forum for open exchange of ideas from around the world. However, it is important for Twitter users to gain a rudimentary understanding of the many potential communication pathways to connect with other users. An intentional approach to Twitter is vital to efficient and successful use. This article describes several common communication pathways that can be utilized by physicians in their interventional radiology practice