neurovascular-nuggets’ Post

🔬 Advancing Knee Pain Treatment Through Innovation and Research 🦵 At IR Centers, we are committed to pushing the boundaries of minimally invasive treatments through cutting-edge research and clinical trials. Recently, our team conducted a Pre-Clinical lab project to study novel embolic agents in the treatment of knee pain using genicular artery embolization (GAE). This preclinical research sets the stage for advancing patient care and outcomes. IR Centers’ physicians have been trailblazers in this field, having led the first clinical trial in the United States and the first randomized clinical trial for genicular artery embolization. These significant milestones highlight our dedication to bringing innovative, evidence-based treatments to patients. “Continued research, innovation, and development are at the core of IR Centers’ mission to improve patient care,” said Dr. Ari Isaacson, Chair of Research and Quality at IR Centers Ari Isaacson “By advancing novel embolic agents and refining techniques like genicular artery embolization, we aim to provide patients with more effective, less invasive options for managing chronic knee pain.” Why This Matters for Patients: When new, promising treatments are brought to market, it’s critical to work with leading providers who are pioneering the research and mastering these advanced techniques. The expertise gained through clinical trials and animal lab studies enables our physicians to deliver safer, more predictable outcomes for patients struggling with knee pain. As we continue to lead research efforts in genicular artery embolization, our mission remains clear: to provide innovative, minimally invasive solutions that enhance the quality of life for our patients. 📸 Stay tuned for continued advancements of the GAE procedure to see how we are invested in making a difference in the field of interventional radiology. #InnovationInHealthcare #ClinicalTrials #KneePain #Embolization #PatientCare #ResearchAndQuality #IRCenters #MinimallyInvasive #LeadingProviders #InterventionalRadiology Ari Isaacson Alex Pavidapha Prostate Centers USA Marco Mastrangelo Tiffany Ramos Lauren Richards Society of Interventional Radiology

Efficacy and safety of indocyanine green-fluorescence imaging guided liver resection: a single-arm prospective cohort study Purpose: This study aimed to evaluate the efficacy of indocyanine green (ICG)-fluorescence imaging for the identification of hepatic boundaries during liver resection and its advantages in surgical outcomes over conventional methods. Methods: This prospective, exploratory, single-arm clinical trial included 47 patients with liver tumors who underwent liver resection using ICG-fluorescence imaging (ICG-LR) between 2019 and 2020. The primary outcome measure was the successful identification of hepatic boundaries during liver resection, from the perspective of both the hepatic surface and intrahepatic boundary, using ICG-fluorescence imaging. The secondary outcomes comprised surgical outcomes. Using propensity score matching (PSM), the surgical outcomes were subsequently compared between the ICG-LR group and patients who underwent conventional liver resection (C-LR, n = 100) between 2017 and 2018. Results: Hepatic boundaries were successfully identified in 28 patients (60%; 95% confidence interval, 45-72%), including 21 and 7 who underwent anatomical and non-anatomical liver resection, respectively. After PSM, 40 patients were included in each of the ICG-LR and C-LR groups. The surgical outcomes were similar between the groups. Subsequently, surgical outcomes were compared between the groups focusing on anatomical liver resection. After PSM, 21 patients were included in each group. The ICG-LR group had a lower rate of Clavien-Dindo grade ≥ IIIa complications (0% vs. 24%; P = 0.017), including ascites and bile leak, and a shorter hospital stay (12 vs. 14 days, P = 0.041) than the C-LR group did. Conclusion: ICG-fluorescence imaging could be used to recognize hepatic boundaries during liver transection. Additionally, ICG-LR may be useful in preventing severe liver-associated complications. #fluorescenceguidedsurgery #fgs #liverresection #hepaticboundaries #icg #indocyaninegreen #verdye #diagnosticgreen https://lnkd.in/e4sS9bkw

A novel nomogram has been developed to predict the risk of postoperative Acute Kidney Injury (AKI) following robot-assisted partial nephrectomy. This innovative tool aims to enhance preoperative assessments and improve patient outcomes by providing a reliable prediction of AKI risk. For urology professionals, this development is crucial as it offers a valuable resource in surgical planning and patient counselling, potentially reducing complications associated with kidney surgeries. How might this predictive tool alter your approach to preoperative planning and patient management in robotic surgeries? Read more on this exciting advancement here: https://lnkd.in/ePWUqeJM

As any good scientist would know, the POWER of any study relies heavily on the number of patients included in it. By that measure, the publication below is a real heavyweight, including 7,833 patients - and with that by far the largest study to date looking at the performance of #photoncounting CT. The team from St. Francis Hospital & Heart Center investigated "Diagnostic Performance and Clinical Impact of Photon-Counting Detector Computed Tomography in Coronary Artery Disease", a topic that previous studies conducted by MUSC Cardiovascular Imaging, University Medical Center Mainz, Semmelweis University and Universitätsklinikum Freiburg have investigated, albeit on a smaller scale. The study - published in the JACC Journals - compared the diagnostic performance #photoncounting CT with that of two high-end conventional CT models and also how its results influenced the treatment decision in CAD patients. Its results confirm those of previous studies and also add insightful aspects that were not investigated before. First some of the "classical" measures of diagnostic performance: PPV (traditionally the achilles heel of Cardiac CT) increased from 63% (conventional CT) to 83.3% (PCCT). Diagnostic accuracy increased from 92.8% to 97.2%. But what about the clinical impact? ICA referral rate went from 13.1% for conventional CT to 9.9% for PCCT (reduction of 24%). Unnecessary referral for ICA went from 8.4% to 5.6% (reduction of 33%). Revascularization in case of referral went from 35.5% to 43.4% (increase of 22%). It should be noted that the scan modes used on the #photoncounting CT were largely not utilizing its ultra-high resolution capabilities, but "only" 0.4mm slice thickness. These numbers underline the potential of #photoncounting CT to increase the operational efficiency of the cardiac cathlab and its potential to identify those patients that require an intervention and avoid referring those that do not. An effect that is extremely important in the trend of establishing Cardiac CT as the first-line test in stable chest pain patients. Omar Khalique, MD, FACC, FSCCT, FSCMR, FASE, FSCAI Doosup Shin Mandeep Singh Roosha Parikh Richard Shlofmitz Allen Jeremias, MD, MSc Ziad Ali American College of Cardiology American Heart Association Society of Cardiovascular Computed Tomography #yescct Akos Varga-Szemes Tilman Emrich, MD, EBCR, FSCMR Pál Maurovich-Horvat Christopher Schlett Fabian Bamberg

HistoSonics, Inc. in Practical Patient Care: HistoSonics has announced the treatment of the first patients with pancreatic tumours in the GANNON trial using its Edison Histotripsy System. The trial evaluates the safety of #histotripsy, a non-invasive technology that uses focused ultrasound to target and destroy tumour tissue. The GANNON feasibility study will include up to 30 patients with inoperable pancreatic adenocarcinoma, either locally advanced (Stage 3) or with limited spread to other areas (Stage 4). Read the article: https://lnkd.in/e47ZiaMP

Irreversible Electroporation (IRE) as a Valid Treatment Option for Hepatic Epithelioid Hemangioendothelioma We are grateful to Dr. Raj Narayanan and his coauthors for this important retrospective study of IRE as a treatment option for hepatic EHE (HEHE). Patients and clinicians have been eager to learn more about the outcomes of this treatment and this research provides an excellent foundation for future investigation. What does this mean for patients? In this small cohort study of IRE for #HEHE, patients can better understand the benefits of IRE and its potential effectiveness. Advantages highlighted in this study such as post-treatment healing, the opportunity to have repeated procedures, and importantly, the ability to treat tumors near critical blood vessels give evidence supporting IRE as a viable treatment consideration for HEHE. We look forward to future prospective studies of IRE in HEHE that can expand on this research, hopefully adding a very effective ‘tool’ in the hepatic EHE treatment toolbox. Read the full article published earlier this month in CardioVascular and Interventional Radiology. https://lnkd.in/e88RPtq4 #EHE #epithelioidhemangioendothelioma #ultrararesarcoma #EHEFoundation #theEHEFoundation #EHEcancer #justlive #sarcoma #raredisease #EHEresearch #EHEawareness

📢 Just out in CardioVascular and Interventional Radiology (CVIR): New insights on the treatment of hepatic hemangiomas (HHs) using transcatheter arterial embolization (TAE) with bleomycin-Lipiodol & gelatin sponge particles! 🩺💉 Explore the impact on HH treatment. 🧠 Study Focus: • Retrospective analysis across 3 centers from 2014 to 2021 • 102 patients with 109 HHs examined • Assessment of TAE's effectiveness and safety • Analysis of CT changes post-TAE 🔬 Core Results: • Significant tumor reduction post-TAE (diameter: 8.5 cm to 5.9 cm, volume: 412.6 cm³ to 102.0 cm³, both P < 0.001) • 80.7% (88/109) tumors achieved 50% volume reduction • Sustained Lipiodol retention noted within shrinking tumors over time 🧩 Key Predictors of TAE Response: • Atypical enhancement (tiny dots on CT): P = 0.001 • Central arterioportal shunt (APS) within tumor: P = 0.002 • Both associated with lower success rates of TAE effectivity 🛡️ Safety Profile: • Postembolization syndrome and transient liver enzyme increase were common • No severe complications or death reported 📌 Conclusion: TAE proves to be a safe and effective method for reducing the size of HHs. Notably, the lesion enhancement pattern and APS are crucial in predicting TAE's efficacy. Dive into the full paper: https://lnkd.in/gBk9xdHv Shoutout to the researchers behind this study! 👏 What's your experience with TAE for HH? Could these findings change your protocol? Stay ahead in the latest vascular interventions. Join our community for updates: https://lnkd.in/gRwAjsEf #VIR #iRads #Radiology #InterventionalRadiology #HepaticHemangioma #PatientSafety #LiverHealth #Embolization #MedEd #Oncology #Healthcare

❤️🧲 The study evaluates mitral valve orifice area as a predictor of outcomes following biventricularrepair in patients with hypoplastic left ventricles (HLV). Conducted at Boston Children’sHospital, this single-center retrospective analysisinvolved 122 patients with HLV whounderwent biventricular repair between 2005 and 2022. The focus was on preoperativecardiovascular magnetic resonance (CMR) measurements of the mitral valve (MV) orifice areaduring diastole.Key findings include: 1.The study identified a low MV orifice area and pre-existing MV pathology as significant risk factors for adverse outcomes post-biventricular repair. 2. Primary composite outcomes were analyzed, including death, transplant, biventriculartakedown, heart failure admission, left atrial decompression, or unexpected reoperation. 3. The median follow-up was 0.7 years, with a primary outcome freedom rate of 53% foratrioventricular canal (AVC) patients and 69% for non-AVC at two years. 4. Secondary outcomes focused on ≥ moderatemitral stenosis or regurgitation, showing afreedom rate of 49% for AVC and 79% for non-AVC at two years. 5. Independent predictors of adverse primary outcomes included MV orifice area z-score <-2, transitional AVC for AVC patients, and abnormal MV anatomyand conal-septalventricular septal defect for non-AVC patients.This study highlights the critical role of MV orifice area in predicting outcomes in HLV patientsundergoing biventricular repair, suggesting that detailed preoperative CMR evaluation of theMVis essential for optimal surgical planning and risk assessment. Dr. Liddle explains below. Full text available here 👉 https://lnkd.in/g8ZDPA6K

📃Scientific paper: Aneurysm Treatment with Woven EndoBridge-17: Angiographic and Clinical Results at 12 Months from a Retrospective, 2-Center Series Abstract: BACKGROUND AND PURPOSE: This retrospective, 2-center study investigated the feasibility, safety, and efficacy at 12-month follow-up of the treatment of ruptured, unruptured, and recurrent intracranial aneurysms using the latest generation of the Woven EndoBridge (WEB) device, the WEB-17 system. MATERIALS AND METHODS: Aneurysms treated with WEB-17 were extracted from the databases of 2 neurovascular centers. Patients, aneurysm characteristics, complications, and clinical and anatomic results were analyzed. RESULTS: From February 2017 to May 2021, two hundred twelve patients with 233 aneurysms (181/233, 77.7%, unruptured-recurrent, and 52/233, 22.3%, ruptured) were included. High treatment feasibility (95.3%) was reported and was similar in ruptured aneurysms (94.2%) and unruptured-recurrent aneurysms (95.6%) (P = .71) and in typical (95.4%) and atypical (94.7%) locations (P = .70), but it was lower in aneurysms with an angle between the parent artery and main aneurysm axis of ≥45° (90.2%) compared with those with an angle of <45° (97.1%) (P = .03). Global mortality and morbidity were 1.9% and 3.8% at 1 month, respectively, and 4.4% and 1.9% at 12 months, respectively. One-month morbidity (P = .02) and mortality (P = .003) were higher in the ruptured group (10.0% and 8.0%, respectively) compared with unruptured-recurrent group (1.9% and 0.0%, respectively). Overall adequate occlusion (complete occlusion and neck remnant) was 86.3%. The percentage of adequate occlusion... Continued on ES/IODE ➡️ https://etcse.fr/ZMOGt ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

📃Scientific paper: Aneurysm Treatment with Woven EndoBridge-17: Angiographic and Clinical Results at 12 Months from a Retrospective, 2-Center Series Abstract: BACKGROUND AND PURPOSE: This retrospective, 2-center study investigated the feasibility, safety, and efficacy at 12-month follow-up of the treatment of ruptured, unruptured, and recurrent intracranial aneurysms using the latest generation of the Woven EndoBridge (WEB) device, the WEB-17 system. MATERIALS AND METHODS: Aneurysms treated with WEB-17 were extracted from the databases of 2 neurovascular centers. Patients, aneurysm characteristics, complications, and clinical and anatomic results were analyzed. RESULTS: From February 2017 to May 2021, two hundred twelve patients with 233 aneurysms (181/233, 77.7%, unruptured-recurrent, and 52/233, 22.3%, ruptured) were included. High treatment feasibility (95.3%) was reported and was similar in ruptured aneurysms (94.2%) and unruptured-recurrent aneurysms (95.6%) (P = .71) and in typical (95.4%) and atypical (94.7%) locations (P = .70), but it was lower in aneurysms with an angle between the parent artery and main aneurysm axis of ≥45° (90.2%) compared with those with an angle of <45° (97.1%) (P = .03). Global mortality and morbidity were 1.9% and 3.8% at 1 month, respectively, and 4.4% and 1.9% at 12 months, respectively. One-month morbidity (P = .02) and mortality (P = .003) were higher in the ruptured group (10.0% and 8.0%, respectively) compared with unruptured-recurrent group (1.9% and 0.0%, respectively). Overall adequate occlusion (complete occlusion and neck remnant) was 86.3%. The percentage of adequate occlusion... Continued on ES/IODE ➡️ https://etcse.fr/ZMOGt ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.