搜索结果：Journal of vascular and interventional radiology : JVIR

To report the results of the randomized (2:1) pivotal study evaluating the safety and effectiveness of the Instylla Embrace Hydrogel Embolic System (HES), consisting of 2 low-viscosity, liquid precursors that form a biocompatible crosslinked polyethylene glycol hydrogel, compared with standard of care (SOC) in the embolization of hypervascular tumors (HVTs). This prospective, multicenter, randomized, noninferiority study of adults with malignant and benign HVT had dual primary endpoints of safety and effectiveness. Safety was freedom of major adverse events (MAEs) through 30 days including death, nontarget embolization, unintended tissue ischemia, pulmonary embolism, vascular injury requiring intervention, renal or hepatic failure, abscess in target organ, or toxic/allergic reaction to HES. Effectiveness (technical success) was delivery of the embolic agent to the tumor feeding vessel(s), with stasis of flow assessed by an independent blinded imaging core laboratory. Additional endpoints were assessed through 180 days. Adverse events and imaging were independently adjudicated. There were 150 subjects (56% men and 44% women), with mean age of 65.4 years (SD &#xb1; 12.9) and tumors of &#x2264; 8 cm, recruited from 22 international centers. HES-treated subjects (102) had 118 tumors and 148 vessels treated, and SOC-treated subjects (48) had 56 tumors and 72 vessels treated. Both primary endpoints were successfully achieved. Freedom from MAE was 99% (P < .001), and technical success was achieved in 88.6% of HES and 77.9% of SOC (P = .001). This randomized study of a peripheral liquid embolic demonstrated that the Instylla Embrace HES met its primary endpoints in the treatment of HVTs.

This systematic review, meta-analysis and meta-regression evaluated whether the narrow aortic bifurcation (NAB) is associated with equal outcomes compared to regular aortic bifurcation (RAB) after endovascular aortic repair (EVAR). A systematic literature search of MEDLINE, Embase, and Scopus was performed through August 2025. A random-effect-meta-analysis of proportion was conducted to calculate the pooled odds ratios (OR) with 95% confidence intervals (CIs) for outcomes of interest. The primary endpoint was limb patency, secondary endpoints included reintervention and overall mortality. Random-effects meta-regression models evaluated the impact of follow-up duration and bifurcation diameter cut-off on treatment effects. Twelve studies met the inclusion criteria (&#x2248;2,300 patients), of which eight were eligible for quantitative synthesis. The meta-analysis revealed no significant differences between NAB and RAB groups regarding primary limb patency, reintervention, or overall mortality with pooled ORs of 0.96 (95% CI, 0.51-1.82), 1.12 (95% CI, 0.58-2.14) and 0.89 (95% CI, 0.43-1.87), respectively. Heterogeneity was moderate across all outcomes (I2 = 25-48%, p>0.10). Meta-regression demonstrated no significant association between treatment effect and either follow-up duration or bifurcation diameter cut-off. The mean Newcastle-Ottawa Scale score was 6.6/9, indicating low-to-moderate risk of bias. In this systematic review and meta-analysis of contemporary studies with pooled quantitative and qualitative evidence, NAB was not associated with worse limb patency, reinterventions rates or mortality following EVAR. Overall, these findings may suggest that modern bifurcated endografts can be used safely and effectively in patients with narrow distal aortic anatomy when appropriate planning and technique are applied.

Prioritization of emergency cases with risk-stratification tools can improve patient care and decrease morbidity. No triage system yet exists for Interventional Radiology (IR). In this study, IR attendings were anonymously surveyed using the Delphi method with the goal of establishing consensus about triaging IR cases. Common procedures were scored as high, medium, or low priority, or designated "do not include," with suggested appropriate intervention timing for each tier. Three rounds of surveys were conducted, garnering 63, 36, and 34 responses each. Across all rounds, 55% of responses came from academic IRs, 29% from private practice, and 16% from community hospitals, with 77% of respondents having 5 or more years of attending experience. Of 34 procedures, 21 achieved >75% agreement, with an additional two procedures reaching agreement if only considering respondents with 5 or more years of experience. Implementing this consensus-based IR triage system could improve treatment times and patient outcomes.

To characterize emergency interventional radiology (IR) practice at a tertiary care center in a rural Japanese prefecture, focusing on spatial transfer patterns, temporal workload distribution, and the clinical and procedural spectrum. This retrospective single-center study included patients who underwent emergency IR between February 2023 and April 2025. Patient demographics, referral status, medical region, procedure timing, indications, procedural categories, and 7-day and 30-day outcomes were analyzed. Inter-regional transfer patterns were evaluated using both former eight and current three secondary medical service areas, with transfer rates standardized per 100,000 population. A total of 150 emergency IR procedures were analyzed. Most procedures involved interhospital transfers (64.0%), while 36.0% were in-hospital emergencies. Among transferred patients, the median transfer distance was 40 km, the median time to procedure was 339 min, and no significant association was observed between transfer distance and time to procedure. Population-adjusted transfer rates differed from absolute case counts. After-hours procedures accounted for 65.3% of all cases. Non-neoplastic conditions were the most frequent indication. Embolization constituted 89% of procedures. The 7-day and 30-day mortality rate was 6% and 10.7%, consistent with previously reported outcomes. Emergency IR in this rural prefecture was characterized by substantial inter-regional patient transfers, a high after-hours workload, and a predominance of embolization procedures for hemorrhagic conditions. Given the low case volume per region and limited workforce, a centralized hub-based model with structured regional transfer systems may represent a practical and sustainable approach for delivering emergency IR services in rural settings.

Health care professionals in fluoroscopic laboratories face significant occupational hazards, including cancer, cataracts, and reproductive concerns due to prolonged exposure to iodizing radiation, and orthopedic injuries stemming from long-term use of heavy aprons as protection from radiation. Despite substantial advancements in radiation protection technology, adoption of these advancements has been slow, hindered by the high upfront costs of implementation and the lag in revising institutional and regulatory radiation exposure thresholds to reflect the capabilities of contemporary enhanced radiation protection devices (ERPDs). This multisociety statement, endorsed by the Society for Cardiovascular Angiography & Interventions, American College of Cardiology, the American Society of Echocardiography, the Heart Rhythm Society, the Society of Interventional Radiology, and the Society for Vascular Surgery, calls for mandatory implementation of ERPDs to meet as low as reasonably achievable standards. This expert consensus statement outlines the ethical and legal responsibilities of government, fluoroscopy laboratory manufacturers, and health care institutions to protect all health care professionals from avoidable workplace hazards and the urgent need to implement ERPDs. The document does not promote or recommend any single ERPD system, and the choice of protection technology is left to department preference. It also addresses the importance of training, monitoring, and continuous research to optimize radiation safety practices. The document advocates for updated regulations and standardized practices across states to ensure comprehensive protection for all fluoroscopy laboratory personnel.

To evaluate the feasibility, usability, and perceived impact of augmented and virtual reality (AR/VR) for preprocedural planning in transarterial interventional oncology procedures, as assessed through structured operator surveys. This IRB-approved, single-center pilot study was conducted over 1 year (September 2024-September 2025). Interventional radiologists used an AR/VR headset (Apple Vision Pro; Apple Inc., Cupertino, CA) with Visage Ease VP software (Visage Imaging, San Diego, CA) to review patient-specific volume renderings of cone-beam CT and cross-sectional imaging before complex oncologic procedures. Cases included hepatic angiography prior to Y90 radioembolization (n=42), percutaneous hepatic perfusion (n=7), and transarterial chemoembolization (n=1). Operators completed structured surveys assessing workflow integration, anatomic visualization, confidence, usability, and comfort using 5-point Likert scales (1=worst, 5=best). Fifty cases were analyzed, with a median case time of 81.0 minutes (IQR, 62.0-102.0). The median AR/VR planning time was 5 min [IQR 3.0-6.0], corresponding to a median of 6% of total case duration. AR/VR planning changed the procedural approach in 23 of 50 cases (46%). Likert score for procedural change had an overall mean of 3.3&#xb1;1.3, with mean scores of 2.4&#xb1;0.7 in cases where AR/VR did not influence the operator's intraprocedural approach and 4.4&#xb1;0.8 in cases where AR/VR did influence the approach. Anatomic visualization scored 4.7&#xb1;0.8, anatomic understanding 4.7&#xb1;0.9, and procedural confidence 4.6&#xb1;1.0. Workflow integration scored 4.8&#xb1;0.5, system usability 4.5&#xb1;0.9, and headset comfort 1.9&#xb1;1.1. Specific use cases are described. AR/VR-based preprocedural planning was feasible, efficient, and enhanced perceived anatomic understanding, procedural confidence, and planning in transarterial interventional oncology cases. Headset comfort remains a limitation.

To evaluate outcomes after endovascular embolization for left-sided varicocele, with attention to venographic anatomy and embolic agent selection. This retrospective single-center cohort included 46 men treated by endovascular embolization for symptomatic isolated left-sided varicocele between May 2018 and September 2025. The median age was 27 years (interquartile range [IQR], 22-32 years), and the median follow-up was 35 months (IQR, 22.5-70.0 months). Color Doppler ultrasound (US) confirmed pathologic reflux (>2 seconds during Valsalva). Venographic anatomy was classified using a 5-category scheme (Types 1-5) adapted from Jargie&#x142;&#x142;o et al (Acta Radiol 2014; 56:63). Two embolic strategies were applied at operator discretion within a uniform distal-to-proximal protocol: distal coils plus proximal n-butyl cyanoacrylate glue vs distal coils plus proximal polidocanol foam. The primary outcome was recurrence (clinical and/or color Doppler ultrasound [US] defined); secondary outcomes were technical success, clinical success, and adverse events (Society of Interventional Radiology [SIR]/Baerlocher classification). Technical success was 100% and clinical success was 97.8% (45/46). One recurrence (2.2%) required reintervention. Minor adverse events occurred in 2 of 46 patients (4.3%); no major adverse events occurred. Complex anatomy (Types 3-5) was present in 56.5%. In exploratory comparisons, clinical success was 94.7% with coil + glue vs 100% with coil + polidocanol (P = .41); recurrence and adverse event rates did not differ significantly by embolic strategy or anatomic complexity. The very low event rate precluded meaningful assessment of equivalence. Endovascular embolization for left-sided varicocele achieved high technical and clinical success with low recurrence, including in patients with complex anatomy and prior surgical varicocelectomy. The absence of detectable between-group differences should not be interpreted as equivalence.

Vascular anomalies comprise a heterogeneous group of vascular tumors and vascular malformations, which often require longitudinal multidisciplinary care. Interventional radiology (IR) plays a central role in the diagnosis and management of these lesions through imaging, image-guided intervention, and biopsy. Although embolization and related procedures remain fundamental, many vascular anomalies are diffuse, recurrent, syndromic, and procedural therapy alone may provide incomplete or temporary control. In this setting, medical therapy has become an important component of comprehensive care, with the potential to reduce pain, bleeding, coagulopathy, lesion activity, and the need for repeated procedures. This narrative review summarizes current medical therapies for common vascular anomalies from an IR perspective. The review addresses treatment indications, available outcome data, dosing and monitoring considerations, and treatment duration when known. As vascular anomaly care shifts toward genotype-informed and pathway-directed treatment, familiarity with systemic therapies may help interventional radiologists optimize patient selection, procedural timing, and multidisciplinary management.

To establish a controlled small-animal model of venous stent placement enabling longitudinal evaluation of thrombosis, vessel wall remodeling, and in-stent restenosis (ISR). Antithrombotic treatment arms were included to assess the model's responsiveness to biologic differences. Forty-four adult Sprague Dawley rats were randomized into saline (control), rivaroxaban, or clopidogrel groups. Self-expanding nitinol stents were deployed in the inferior vena cava (IVC). Stent patency and blood flow were assessed via high-frequency ultrasound (HFUS) at 1, 4, and 8 weeks. Histology was performed to evaluate neointimal hyperplasia and ISR. Procedural success was 100%, with a 77.2% survival rate at 24 hours (34/44). Rivaroxaban-treated rats showed the highest stent patency and preserved flow velocities at 1 week (169 &#xb1; 54 mm/s vs. 98 &#xb1; 53 mm/s, p < 0.001). Clopidogrel-treated animals exhibited intermediate outcomes. At 8 weeks, control animals had the highest incidence of ISR and thrombosis. No significant difference in peak systolic velocities was noted in controls between 1 week (98 &#xb1; 53 mm/s) and 1 month (83 &#xb1; 24 mm/s; p = 0.327). At 4 weeks, 67% of controls, 80% of clopidogrel, and 100% of rivaroxaban-treated stents remained patent. This study establishes a small-animal venous stent platform that integrates longitudinal imaging with structural validation of thrombosis and remodeling. The model demonstrates sensitivity to pharmacologic modulation and provides a foundation for mechanistic investigation and preclinical evaluation of venous stent therapies.

To determine the clinical utility of automated 3-dimensional (3D) computed tomography (CT)-based quantification of intratumoral artery-like volume (IAV) for the preprocedural assessment of transarterial radioembolization (TARE) eligibility by ruling out high lung shunt fraction (LSF) in patients with large hepatocellular carcinoma (HCC). This single-center retrospective study included patients with a single-nodular HCC (&#x2265;5 cm) who underwent both multiphasic CT and LSF measurement (2009-2024). LSF values were derived from technetium-99m macroaggregated albumin (MAA) scintigraphy. Automated 3D segmentation on arterial-phase CT defined tumor and aorta; IAVs were quantified using 5 thresholds (65%-85% at 5% intervals) relative to mean aortic Hounsfield unit. IAV metrics were compared across LSF groups (&#x2264;10%, 10%-20%, and >20%). Receiver-operating characteristic (ROC) analysis evaluated performance for LSF of >10% and >20% and determined cutoffs at fixed 80% and 90% sensitivities. Of 169 patients, 123, 26, and 20 had LSF of &#x2264;10%, 10%-20%, and >20%. IAV metrics at all thresholds showed a significant stepwise increase across these groups (P < .001). For predicting LSF of >10% and >20%, the area under the ROCs of IAV metrics ranged from 0.732 to 0.741 and 0.790 to 0.806, respectively. Using IAV75% as a representative metric, fixed 80% and 90% sensitivities yielded specificities of 50.4% (62/123) and 39.0% (48/123) for LSF of >10% (cutoffs, 0.06 and 0.02 cm3) and 74.5% (111/149) and 57.7% (86/149) for LSF of >20% (cutoffs, 0.50 and 0.16 cm3), respectively. Automated CT-based IAV enables objective LSF risk stratification in large HCC and can identify low-risk patients preprocedurally, supporting a more streamlined TARE workflow.

This retrospective analysis evaluated the safety and technical feasibility of a novel percutaneous biopsy tract electrocautery device. 120 consecutive patients undergoing tract closure with SinglePass Kronos electrocautery following percutaneous solid organ and/or mass coaxial core needle biopsy (CCNB) were included. Outcomes included procedure time, observation time, adverse events, required treatments, and mortality. Pre- and post-procedure hematologic parameters were compared in a 65-patient subset. Patients were 62.0 &#xb1; 17.9 years old, 49.2% male and 50.8% female with target organs including liver (74; 61.7%), kidney (28; 23.3%), abdomen/mesentery (10; 8.3%), lung (5; 4.2%) and other (3; 2.5%). The most common indications included liver mass (38; 31.7%), medical liver disease (33; 27.5%), and medical renal disease (25; 20.8%). Antithrombotic medications (21; 17.5%) were held per Society of Interventional Radiology guidelines. Ultrasound- (52.5%) or CT-guided (47.5%) procedures were completed in 17 &#xb1; 8 minutes with outpatients discharged 2.8 + 1.2 hours post-procedure. There were no serious adverse events and four small intraprocedural hematomas did not progress following electrocautery. Through 30-days of follow-up, there were no instances of bleeding, transfusions, interventions, surgeries, or need for bleeding-related readmission or clinical encounter. There were no instances of significant hemoglobin drop (>1.5 g/dL) in the 65-patient subgroup and no immediate or delayed procedure-related deaths; five patients expired in hospice. Use of the SinglePass device demonstrated the technical feasibility of CCNB tract closure via electrocautery with no major safety signals observed, including no major bleeding, significant adverse events, or procedure-related deaths.

To evaluate the safety and effectiveness of the Concerto detachable coil system for peripheral embolization in the Product Surveillance Registry (PSR; NCT01524276). A prospective, multicenter, global observational registry enrolled patients treated with the fibered detachable coil system for arterial or venous embolization. Patients were grouped by disease state and followed up to 12 months. Primary safety and performance objectives included technical and clinical success at index procedure, non-target tissue ischemia or embolization, occlusion of the target lesion, recanalization rate, coil compaction, and device fractures. Secondary objectives were a subanalysis of pain scores based on the Visual Analog Scale (VAS) and Patient Global Impressions Scale for Change (PGI-C) among patients with pelvic venous disorder (PeVD). A total of 130 patients were enrolled in this registry across 13 sites. Technical and clinical success of embolization using the fibered detachable coil system was achieved in 97.8% [95% CI: 96.28, 98.77] and 97.0% [95% CI: 93.11, 99.01] of procedures, respectively. Vessel occlusion rate was 100% at 12-months post intervention. No cases of non-target tissue ischemia, non-target embolization, target vessel recanalization, or device fracture were observed. A subanalysis of the PeVD cohort demonstrated a reduction in VAS pain scores. PGI-C was improved overall from the 30-day to the 12-month follow-up. The fibered detachable coil system demonstrated safe and effective performance across multiple peripheral vascular embolization disease states in real-world clinical practice.

To evaluate the effectiveness of transcatheter arterial chemoembolization (TACE) for locally advanced cervical cancer (LACC). Retrospective single-center data on patients with LACC were collected between 2011 and 2019. Patients with stage IB3 or IIA2 disease were grouped into those who underwent radical surgery alone (RS), TACE+RS, and TACE+concurrent chemoradiotherapy (CCRT). Patients with stages IIB or IIIA disease were grouped into those who underwent TACE+CCRT and CCRT alone. The 3- and 5-year overall survival rates, surgery-related indices, and incidence of surgical complications were analyzed in each group. One hundred eighty-seven patients were included. Among 107 patients with stage IB3 or IIA2 disease, 68 patients were treated with TACE. Of those, 53 patients (77.9%) achieved satisfactory tumor shrinkage to proceed to surgery (TACE+RS, n=53). The 3- and 5-year survival rates of the TACE+RS group were significantly greater than those of the RS alone group (n=39) (92.5% and 69.7% vs 76.9% and 41.0%, respectively, P<0.05). TACE significantly shortened operative time and reduced intraoperative bleeding and average length of stay (P<0.05). For stage IIB and IIIA patients, who were treated with CCRT, there were no significant differences in 3- and 5-year survival rates between the TACE+CCRT (n=30) and CCRT alone (n=50) groups (83.3% and 66.7% vs 84.0% and 66.0%, respectively, P>0.05). TACE can improve the suitability of patients with stage IB3 or IIA2 disease for surgery and increase survival rates. For patients with stage IIB or IIIA disease, receiving TACE before CCRT did not provide any additional benefit.

To compare the 2-year outcomes of drug-eluting stents (DES) versus drug-coated balloons (DCB) plus bare-metal stents (BMS) in patients with femoropopliteal artery disease. Data were analyzed from The Impact of Tibial Runoff on Clinical Outcome of Endovascular Therapy in Femoropopliteal Lesions (TALENT) Study, a multicenter, prospective study. Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics. The primary outcomes were freedom of all-cause mortality (f-ACM), freedom of major adverse events (f-MAE), clinically driven target lesion revascularization (CD-TLR), major adverse limb events (MALEs) and the secondary outcomes were the improvement in Rutherford classification and changes in quality of life assessed by the VascuQOL-25 questionnaire. A total of 429 patients were included (81 in DES group, 348 in DCB plus BMS group). During a median (Q1-Q3) follow-up of 20.2 months (11.6-27.1 months), no significant differences were observed between the two groups in 2-year f-ACM (91.4% vs 85.1%, p=0.096), f-MAE (79.6% vs 73.9%, p=0.330), CD-TLR (9.6% vs 12.6%, p=0.737) and MALEs (10.1% vs 12.3%, p=0.612). Both treatment modalities significantly improved in VascuQol score and Rutherford classification, with improvement rates of 76.1% and 71.3% at 24 months, respectively. An interaction effect (p=0.014 and 0.005, respectively) was observed for patients with intermittent claudication (R2-R3), suggesting that DES may be associated with lower risks of CD-TLR and MALEs. Over 2-year follow-up, DES and DCB plus BMS demonstrated favorable and comparable overall effectiveness in real-world patients with complex femoropopliteal lesions.

To introduce a 7-Degrees of Freedom (DOFDOF) robotic prostate biopsy system utilizing a "3-point volumetric fusion" algorithm and evaluate its clinical feasibility and comparative diagnostic yield against standard systematic biopsy. A prospective analysis was conducted on 48 biopsy-na&#xef;ve patients with mpMRI lesions (Prostate Imaging Reporting and Data System &#x2265;3) biopsied using a proprietary 7-DOF robotic system. The software integrates pre-operative MRI with real-time transrectal ultrasound (TRUS) using three internal anatomical landmarks to compensate for organ deformation. Patients underwent Robotic Targeted Biopsy (TB) followed by a 12-core Systematic Biopsy (SB) performed via the robot's joystick control. Primary outcomes were Overall Cancer Detection Rate (CDR) and quantitative tumor burden. Prostate cancer was detected in 23 (47.9%) of 48 patients (mean age 64.5 years, PSA 7.2 ng/mL). The cancer detection rate was 47.9% for TB and 43.8% for SB, with a P-value of .48, indicating no statistically significant difference. In cancer-positive cases, the mean tumor involvement in Robotic TB cores was 68.5%, which was significantly greater than the 31.4% observed in Systematic SB cores (P < .01). Cancer was detected exclusively by Robotic TB in two biopsy-naive patients (8.7%) harboring anterior lesions. The 7-DOF robotic system demonstrated high safety and clinical feasibility. Consistent with the established advantages of image guidance, the targeted approach yielded substantially higher tumor volume samples than systematic biopsy.

To test the hypothesis that S1 and S2 intrasacral corridor height shows substantial interindividual variability but is not associated with operative time or radiation exposure in patients undergoing cone-beam computed tomography (CT)-guided percutaneous pelvic osteosynthesis. This retrospective single-center study included 115 consecutive patients treated between March 2023 and November 2025 with cone-beam CT-guided percutaneous pelvic screw fixation for traumatic or fragility fractures. Patients who received at least 1 screw in an S1 and/or S2 intrasacral corridor were included. Corridor height was measured on follow-up CT using standardized multiplanar true outlet reconstructions. The primary end point was to explore the variability of corridor height. Secondary end points were to assess operative time, radiation exposure, and adverse events. A total of 169 screws were inserted in 115 patients (median age, 67 years). Median intrasacral corridor height was 23 mm (interquartile range, 21-26 mm), with a minimum of 10 mm and a maximum of 32 mm. Median operative time was 47 minutes, and median dose-area product was 78.8 Gy&#xb7;cm2. No significant correlation was observed between corridor height and operative time (Spearman &#x3c1; = 0.043; P = .65) or radiation exposure (Spearman &#x3c1; = -.057; P = .55). One adverse event (0.6%) was reported, not associated with smaller corridor height. S1 and S2 intrasacral corridors exhibit substantial anatomical variability. In this cohort of cone-beam CT-guided percutaneous pelvic osteosyntheses, corridor height did not influence operative time or radiation exposure. One adverse event was observed. These findings suggest that 3-dimensional cone-beam CT planning may facilitate safe and efficient screw placement despite sacral anatomical variations.

To determine the impact of endophytic vs exophytic tumor location on renal function following cryoablation. A retrospective review of 450 procedures in 392 patients who underwent percutaneous cryoablation of renal tumors over a 10-year period was performed. Two propensity score-matched cohorts of patients with endophytic and exophytic tumors were identified. Primary outcomes were change in estimated glomerular filtration rate (eGFR) at 3 months, 6 months, 1 year, and 3 years, and progression of chronic kidney disease (CKD) to or beyond Stage 3. After propensity score matching, each cohort consisted of 89 patients who underwent technically successful procedures. At 3 months, eGFR declined by 7.1 mL/min/1.73 m2 from baseline in the endophytic group (P = .003), compared with 2.4 mL/min/1.73 m2 (P = .68) in the exophytic group. By 3 years, patients with endophytic and exophytic tumors demonstrated a comparable decline (7.7 and 5.9 mL/min/1.73 m2, respectively; P = .49). A greater proportion of patients with endophytic tumors progressed to CKD Stage 3b or higher at 1 year compared with those with exophytic tumors (10/76 vs 1/71; P = .01). At 3 years, there was no significant difference in proportion of patients who progressed to CKD Stage 3b or higher (7/65 vs 6/68, endophytic vs exophytic, respectively; P = .78). Percutaneous cryoablation of endophytic tumors is associated with early eGFR CKD stage progression, although the long-term impact on renal function is comparable with that of exophytic tumors.

To test the hypothesis that gallstone organ-sparing cholangioscopy and percutaneous extraction (GO-SCOPE) achieves high single-session technical success, durable symptom improvement, and an acceptable safety profile in patients with symptomatic calculous biliary colic who elect nonsurgical management despite eligibility for cholecystectomy. This retrospective study evaluated consecutive patients who underwent GO-SCOPE between April 2024 and July 2025 at a single tertiary academic center. The procedure consisted of same-day percutaneous gallbladder access, cholangioscopy-assisted gallstone extraction with lithotripsy as needed, and placement of a percutaneous cholecystostomy or transcystic biliary drain for tract maturation. Sixty-six patients (mean age, 46.0 years; range, 25-72 years) underwent GO-SCOPE. Primary outcomes included technical success (removal of all visualized gallstones in a single session), clinical success (improvement or resolution of biliary colic symptoms), and 30-day adverse events classified according to the Society of Interventional Radiology (SIR) adverse event classification system. Secondary outcomes included residual or recurrent gallstones on follow-up imaging. Single-session technical success was achieved in 60 (90.9%) of 66 patients; 6 required repeat cholangioscopy for residual stones. Mean time to tube removal was 21.3 days. Among 60 patients with 3-month follow-up imaging, 2 (3.3%) demonstrated asymptomatic subcentimeter gallstones. Clinical success was achieved in 59 (98.3%) of 60 patients at 3-month follow-up and 30 (96.8%) of 31 patients at 12-month follow-up. Four adverse events occurred, including 1 moderate and 3 severe. GO-SCOPE demonstrated high technical and clinical success with an acceptable safety profile as an organ-sparing alternative to cholecystectomy in patients with symptomatic gallstone disease.

To determine whether procedural efficiency, catheter stability, and safety differ between specially designed double-loop (DPC) and single-loop (SPC) 10.2-F multihole pigtail catheters for pleural effusion and to assess the independent association between catheter type and instability. This single-center retrospective study (January 2024 to August 2025) analyzed 577 procedures (DPC, n = 299; SPC, n = 278). Inclusion required 10.2-F multihole catheters under combined ultrasound (US)-fluoroscopic guidance. Minimal effusions or incomplete records were excluded. Sample size included all eligible procedures without an a priori power calculation. Primary outcomes were catheter retraction and dislodgment. Secondary outcomes included procedure/fluoroscopy time, radiation exposure, success rates, and adverse events. Multivariable logistic regression evaluated the association between catheter type and retraction. DPC showed significantly lower retraction (0.7% [95% confidence interval (CI), 0.1%-2.4%] vs 16.9% [95% CI, 12.7%-21.8%]; P < .001) and dislodgment (0.3% [95% CI, 0.0%-1.8%] vs 2.9% [95% CI, 1.3%-5.6%]; P = .02). On multivariable analysis, DPC was independently associated with lower retraction odds (adjusted odds ratio, 0.034; 95% CI, 0.008-0.141; P < .001). DPC significantly reduced procedure time (11.9 vs 16.3 minutes), fluoroscopy time (20.4 vs 43.7 seconds), and radiation exposure (4.6 vs 10.0 mGy; all P < .001). Technical and clinical success rates were 100% in both groups. Overall adverse event rates were low and similar (2.0% vs 1.8%; P > .05). DPC demonstrated lower retraction and dislodgment rates than SPC. Its intrinsic anchoring mechanism not only simplifies the procedure and obviates the need for skin fixation but also reduces overall procedure time and radiation exposure.