Interventional Radiology
Online ISSN : 2432-0935
Advance online publication
Displaying 1-8 of 8 articles from this issue
  • Tetsuya Hasegawa, Masanori Inoue, Masahiro Tsuboi, Kei Takase
    Article type: REVIEW
    Article ID: 2023-0042
    Published: 2024
    Advance online publication: October 04, 2024
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Postoperative hepatic lymphorrhea is a rare complication that can lead to refractory ascites. During surgery with lymph node dissection of the hepatoduodenal ligament, leakage of liver lymph into the abdominal cavity can occur. Due to the development of interventional radiology for various lymphatic leaks in recent years, the pathogenesis of hepatic lymphatic leakage has become more evident. Percutaneous transhepatic lymphangiography is important for the diagnosis of hepatic lymphorrhea. Although there have been case reports of percutaneous embolization and sclerotherapy treatments for hepatic lymphorrhea in recent years, there have been no case studies. However, the standard treatment for this condition remains unknown. This study discusses the anatomy of hepatic lymphatics and the pathogenesis, diagnosis, and treatment of hepatic lymphorrhea, including the latest literature on interventional radiology.

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  • Toshihiro Tanaka
    Article type: REVIEW
    Article ID: 2024-0016
    Published: 2024
    Advance online publication: October 04, 2024
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    In the current systemic therapy era, such as immunotherapy and molecular targeted therapy, treatment strategy of hepatocellular carcinoma is changing. Transarterial chemoembolization is more expected as a curative treatment option than before. Therefore, it is important to learn key techniques of transarterial chemoembolization procedures to achieve complete response. This article delineates the current indications for transarterial chemoembolization and several techniques used for its implementation.

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  • Takumi Sugiura, Nobuhiko Ogawa, Hiroshi Ikeno, Toru Yamamoto, Jun Yosh ...
    Article type: CASE REPORT
    Article ID: 2023-0036
    Published: 2024
    Advance online publication: August 07, 2024
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    A woman in her 40s was found to have a sewing needle within the right lumbar erector spinae muscle on imaging. The needle tip nearly reached the first lumbar vertebra and was close to the intervertebral foramen. An 8-gauge bone marrow biopsy needle was advanced under local anesthesia and biplane fluoroscopic guidance. The inner needle was withdrawn, while the outer needle was gently advanced to capture the proximal end of the sewing needle. The sewing needle was successfully grasped and removed using the endoscopic biopsy forceps. She was discharged without symptoms. Under biplane fluoroscopy guidance, percutaneous coaxial removal of the intramuscular sewing needle was successfully performed minimally invasively and at a low cost using an 8-gauge bone marrow biopsy needle and endoscopic forceps.

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  • Hiroaki Hagiwara, Yuka Takeuchi, Midori Komita, Naofumi Yasuda, Airi H ...
    Article type: CASE REPORT
    Article ID: 2024-0006
    Published: 2024
    Advance online publication: August 07, 2024
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    We report a case of lumbar spinal hematoma caused by balloon-occluded retrograde transvenous obliteration for gastric varices in a woman in her 60 s with liver cirrhosis due to non-alcoholic steatohepatitis. The patient presented to the emergency department with a chief complaint of sudden nausea and hematemesis. Endoscopic sclerotherapy was performed, followed by balloon-occluded retrograde transvenous obliteration for residual varices. During balloon-occluded retrograde transvenous obliteration, she complained of back pain and subsequently developed thigh pain. CT and MR scans revealed subdural hematoma and subarachnoid hemorrhage within the spinal canal at the thoracolumbar level. It is presumed that balloon-occluded retrograde transvenous obliteration altered blood flow in the paravertebral plexus, causing an intraspinal canal hemorrhage. To our knowledge, this study is the first to report a case of an iatrogenic spinal hematoma caused by balloon-occluded retrograde transvenous obliteration.

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  • Hiroshi Kawada, Shoma Nagata, Yoshifumi Noda, Nobuyuki Kawai, Tomohiro ...
    Article type: REVIEW
    Article ID: 2023-0026
    Published: 2024
    Advance online publication: March 27, 2024
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Nonocclusive mesenteric ischemia (NOMI) is a condition characterized by segmental or discontinuous mesenteric ischemia and intestinal necrosis without an organic obstruction in the mesenteric vessels. Diagnosis is challenging, and early intervention is crucial for improving patient outcomes. Various factors such as background factors, symptoms, biomarkers, and imaging techniques contribute to the diagnosis. Ensuring an early diagnosis and prompt treatment is of paramount importance. Although studies reported on the effectiveness of intra-arterial vasodilator infusion therapy as an endovascular treatment, its future role remains uncertain. Therefore, this review primarily aimed to provide a comprehensive summary of the advancements in the current state of NOMI management, with a specific emphasis on the implementation of endovascular therapy.

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  • Tatsuo Ueda, Hidemasa Saito, Sayaka Shirai, Fumie Sugihara, Ryutaro Fu ...
    Article type: REVIEW
    Article ID: 2023-0027
    Published: 2024
    Advance online publication: March 27, 2024
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Acute portal vein thrombosis is characterized by nonspecific abdominal pain, causing severe morbidity and mortality. Prompt diagnosis is crucial to avoid short-term complications such as intestinal infarction, sepsis, and death. The therapeutic goal is to prevent thrombus extension into the mesenteric veins and intestinal ischemia complications. Systemic anticoagulation is the standard treatment. However, endovascular treatments such as thrombolysis, thrombectomy, balloon angioplasty, stent placement, and transjugular intrahepatic portosystemic shunt placement have been performed in patients who are refractory to anticoagulation therapy or at a high risk of intestinal ischemia. This review discusses the clinical and diagnostic considerations in acute portal vein thrombosis, focusing on current endovascular treatments that are effective and safe. However, prospective data are required to compare endovascular treatment techniques and assess their outcomes.

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  • Hiroki Higashihara, Yasushi Kimura, Yusuke Ono, Kaishu Tanaka, Noriyuk ...
    Article type: REVIEW
    Article ID: 2023-0009
    Published: 2023
    Advance online publication: December 14, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Transarterial chemoembolization is still an effective treatment option for hepatocellular carcinoma worldwide and is categorized into conventional transarterial chemoembolization with ethiodized oil transarterial chemoembolization and transarterial chemoembolization with drug-eluting spherical material transarterial chemoembolization. Several randomized controlled trials conducted in Europe have shown the equivalent efficacy of ethiodized oil transarterial chemoembolization and drug-eluting spherical material transarterial chemoembolization. However, a recent randomized controlled trials in Japan established the superiority of ethiodized oil transarterial chemoembolization in terms of complete response rates although higher liver toxicity for ethiodized oil transarterial chemoembolization. Nevertheless, the survival advantage of ethiodized oil transarterial chemoembolization is yet to be substantiated. The adverse effects of drug-eluting spherical material transarterial chemoembolization are milder than those of ethiodized oil transarterial chemoembolization, rendering drug-eluting spherical material transarterial chemoembolization an advantageous option for patients with bilobar tumors and impaired liver function/performance status. This article aims to provide an overview of these embolization techniques and a review of recent literature.

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  • Koichiro Yamakado, Haruyuki Takaki
    Article type: REVIEW
    Article ID: 2022-0035
    Published: 2023
    Advance online publication: August 11, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Barcelona Clinic Liver Cancer staging system, which has been identified as the most commonly used staging system in patients with hepatocellular carcinoma, was initially published in 1999, and it was updated in 2022. This new Barcelona Clinic Liver Cancer staging shows more flexible strategies for the treatment of hepatocellular carcinoma based on each stage. Although the roles of trans-arterial chemoembolization were limited in intermediate stage (Barcelona Clinic Liver Cancer-B) patients in the previous version, its roles have been expanded in the new version of Barcelona Clinic Liver Cancer staging system. In this manuscript, we introduce how trans-arterial chemoembolization is incorporated in a new Barcelona Clinic Liver Cancer staging system and explore the new role of trans-arterial chemoembolization and what interventional radiologists seek for in a near future.

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