Vena cava syndrome from stenosis of the superior vena cava or inferior vena cava caused by compression from a malignant tumor is a typical clinical condition in patients with advanced-stage malignant disease. Vena cava syndrome is difficult to manage, reducing patients’ quality of life. Vena cava stent placement can improve the symptoms caused by vena cava compression. The Spiral Z stent has high axial force and is suitable for vena cava stenting. However, since it is also a stent that is prone to recoil (so-called jumping), it is necessary to be aware of the characteristics of the stent.

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Deep vein thrombosis is a condition that can lead to acute pulmonary embolism, posing a particularly life-threatening risk. The incidence of deep vein thrombosis is increasing in Japan, attributed to lifestyle changes, and it has become a noteworthy concern, especially during periods of environmental changes, including evacuations during disasters such as mega-earthquakes. To prevent pulmonary embolism arising from acute deep vein thrombosis, inferior vena cava (IVC) filters are often placed.
Though IVC filter placement is a straightforward procedure in interventional radiology, recent advancements in anticoagulant therapy and insights gained from past cases have led to the evolution of more stringent indications. In addition, concerns have been raised about the recurrence of deep vein thrombosis and complications associated with long-term IVC filter placement. It is now recommended that IVC filters be promptly retrieved once their role is deemed fulfilled.
In this context, this discussion will provide insights into the current status of IVC filter indications, and the practical aspects of IVC filter placement and retrieval, taking into account these evolving considerations and the need for swift retrieval after the completion of their intended role.

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Transjugular liver biopsy (TJLB) is performed in patients who have difficulty undergoing percutaneous liver biopsy due to ascites or coagulopathy. It has become a standard procedure in the USA and Europe since its development by Dotter et al. in 1964. TJLB is a useful procedure that can be safely performed in patients with coagulopathy with very few complications such as bleeding. However, TJLB is a complicated procedure, and the biopsy specimens tend to be fragmented, so it is not widely performed in Japan. This manuscript outlines the indications, complications, biopsy procedures, and technical points of TJLB.

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Tunneled cuffed dialysis catheters, the focus of this study, are an important type of vascular access for patients undergoing chronic hemodialysis, particularly in those for whom it is difficult to create other types of vascular access, such as an arteriovenous fistula or arteriovenous graft. Tunneled cuffed dialysis catheters serve as long-term indwelling devices. Although image-guided placement is recommended and crucial to ensure safety and reduce complications, some interventional radiologists’ familiarity with the image-guided placement of these catheters does not appear to be as well established as with conventional central venous catheters or central venous ports. This article provides a comprehensive review of the types of dialysis catheters, their indications, maintenance, and strategies for the prevention and management of associated complications such as catheter-related bloodstream infections and catheter dysfunction, along with recommendations from guidelines and consensus statements. Furthermore, this article details the procedural and technical aspects of tunneled cuffed dialysis catheter placement at our institution, including preparation, preprocedural checks, and techniques to avoid complications.

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Traditionally, surgical treatments such as stripping or high ligation were the mainstay for treating saphenous vein varicosities. However, with the emergence of endovenous laser ablation (EVLA) and radiofrequency ablation (RFA), treatments have become less invasive. In recent years, endovenous treatments using n-butyl-2-cyanoacrylate (NBCA), known as cyanoacrylate closure (CAC), have also appeared. Endovenous thermal ablation (ETA) and CAC are performed in the majority of cases for varicose veins, and they have become familiar to interventional radiologists. This article provides an overview of the diagnosis of lower limb varicose veins, basic treatments using ETA and CAC, and practical considerations regarding adverse events and troubleshooting.

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The case of a woman in her 30s who was incidentally diagnosed as having a renal arteriovenous malformation (AVM) is described. The AVM was of the aneurysmal type and consisted of an aneurysm and a venous sac. We decided to perform coil embolization of the venous sac via a venous approach due to the complicated anatomy. It was possible to approach the venous sac from both the venous and arterial sides, allowing for complete occlusion through isolation and packing. Considering the patientʼs age, risk of postoperative recurrence, and complications, we consider that achievement of complete occlusion through transcatheter isolation and packing was significant.

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We report two cases of delayed leukoencephalopathy after cerebral endovascular treatment. Case 1 was a man in his 50s who underwent thrombectomy and stent placement for acute occlusion of the left middle cerebral artery (MCA) M1 segment. Three weeks later, he presented with headache and aphasia, and diffusion-weighted imaging (DWI) revealed extensive vasogenic edema in the left MCA territory. Contrast-enhanced magnetic resonance imaging (MRI) showed granular and nodular enhancement within the edema. Case 2 was a man in his 70s who underwent carotid artery stent placement (CAS) for left internal carotid artery (ICA) occlusion. One week later, he developed altered consciousness, and DWI revealed patchy vasogenic edema in the distal perfusion area of the catheter-induced vessel. Unfortunately, since the patient had chronic renal disease, contrast-enhanced MRI was not performed. In both cases, significant improvements in symptoms and imaging findings were observed with steroid treatment. Although definitive diagnosis was not established through biopsy, based on the findings and clinical course, we considered these cases to be delayed leukoencephalopathy due to type IV allergy associated with foreign material embolism.

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