Ibero-American Society of Interventionism (SIDI) and the Spanish Society of Vascular and Interventional Radiology (SERVEI) Standard of Practice (SOP) for the Management of Inferior Vena Cava Filters in the Treatment of Acute Venous Thromboembolism.

OBJECTIVES: to present an interventional radiology standard of practice on the use of inferior vena cava filters (IVCFs) in patients with or at risk to develop venous thromboembolism (VTE) from the Iberoamerican Interventional Society (SIDI) and Spanish Vascular and Interventional Radiology Society (SERVEI). METHODS: a group of twenty-two interventional radiologist experts, from the SIDI and SERVEI societies, attended online meetings to develop a current clinical practice guideline on the proper indication for the placement and retrieval of IVCFs. A broad review was undertaken to determine the participation of interventional radiologists in the current guidelines and a consensus on inferior vena cava filters. Twenty-two experts from both societies worked on a common draft and received a questionnaire where they had to assess, for IVCF placement, the absolute, relative, and prophylactic indications. The experts voted on the different indications and reasoned their decision. RESULTS: a total of two-hundred-thirty-three articles were reviewed. Interventional radiologists participated in the development of just two of the eight guidelines. The threshold for inclusion was 100% agreement. Three absolute and four relative indications for the IVCF placement were identified. No indications for the prophylactic filter placement reached the threshold. CONCLUSION: interventional radiologists are highly involved in the management of IVCFs but have limited participation in the development of multidisciplinary clinical practice guidelines.

COVID-19 Outbreak: Infection Control and Management Protocol for Vascular and Interventional Radiology Departments-Consensus Document.

COVID-19 (SARS-CoV-2 virus) pandemic was recently declared by the WHO as a global health emergency. A group of interventional radiology senior experts developed a consensus document for infection control and management of patients with COVID-19 in interventional radiology (IR) departments. This consensus statement has been brought together at short notice with the help of different protocols developed by governmental entities and scientific societies to be adapted to the current reality and needs of IR Departments. Recommendations are the specific strategies to follow in IR departments, preventive measures and regulations, step by step for donning and doffing personal protective equipment, specific IR procedures which can not be delayed, and aerosol-generating procedures in IR with COVID-19 patients. It is advisable with this document to be adapted to local workplace policies.

Combined use of uterine artery embolization and local methotrexate injection in interstitial ectopic pregnancies with poor prognosis.

OBJECTIVE: To report three cases of interstitial pregnancies treated successfully by combining uterine artery embolization (UAE) and ultrasound-guided local administration of methotrexate (MTX); and to assess the effect of UAE on ovarian reserve by prospectively measuring serum antimüllerian hormone (AMH) levels. DESIGN: Case report. SETTING: Departments of obstetrics and gynecology and radiology of a university hospital. PATIENT(S): Three patients with interstitial pregnancy. Treatment with multiple IM injections of MTX had failed in cases 1 and 3. Case 2 presented high initial serum beta-hCG levels (93,563 mIU/mL), suggesting the presence of a substantial amount of trophoblastic tissue. INTERVENTION(S): All three patients underwent UAE and an ultrasound-guided local injection of MTX under spinal anesthesia. MAIN OUTCOME MEASURE(S): Evolution of serum beta-HCG and AMH levels. Resolution of pregnancies. RESULT(S): All three cases presented an appropriate decrease in serum beta-HCG levels, though this reduction was slower in case 2 because of the initial value. Resolution of pregnancy was achieved without complications in all three cases. Levels of AMH were not affected in any of the patients. CONCLUSION(S): Interstitial pregnancies with a poor prognosis can be treated successfully with a combination of UAE and local MTX. This approach seems to be safe and maintains the ovarian reserve.

Vesselplasty: a new technical approach to treat symptomatic vertebral compression fractures.

OBJECTIVE: The objective of our study was to evaluate the effectiveness and safety of vesselplasty to treat symptomatic vertebral compression fractures (VCFs). SUBJECTS AND METHODS: Twenty-nine patients undergoing vesselplasty at our institution between April 2006 and February 2008 were enrolled in the study. All patients had been undergoing medical therapy for one or more painful VCFs. Pain, mobility, and analgesic use scores were obtained, and restoration of vertebral body height was evaluated. A two-tailed paired Student's t test was used to compare differences in the mean scores for levels of pain, mobility, and analgesic use before and after the procedure and to evaluate changes in vertebral body height. We analyzed the influence of the age of the fracture and its cause in the variations in the pain, mobility, and analgesic use scores. RESULTS: Seven of the 29 patients had fractures in more than one level, for a total of 37 procedures. The cause of the vertebral collapse was osteoporosis in 27 (73%), high-impact trauma in five (13.5%), myeloma in three (8%), and metastatic fracture in two (5.4%). The average pain score before treatment was 8.72 +/- 1.25 (SD), whereas the average pain score after treatment was 3.38 +/- 2.35. The average mobility score before treatment was 2.31 +/- 1.94, whereas the average mobility score after treatment was 0.59 +/- 1.05 (p < 0.001). The average analgesic use score before treatment was 3.07 +/- 1.46, whereas it was 1.86 +/- 1.90 after treatment (p < 0.001). There was no evidence of clinical complications. CONCLUSION: Vesselplasty offers statistically significant benefits in improvements of pain, mobility, and the need for analgesia in patients with symptomatic VCFs, thus providing a safe alternative in the treatment of these fractures.

Vascular imaging and interventional procedures in hepatic cirrhosis.

Changes in the vascularization of the cirrhotic liver are related to the progression of the disease. Knowledge of normal hepatic vascular anatomy and anatomic is essential for understanding the altered hepatic circulation seen in cirrhosis. We analyze the changes in liver perfusion with special interest in the anatomic features that are important in interventional procedures. The indications, technical notes, and complications of transjugular liver biopsy, transiugular intrahepatic portosystemic shunt (TIPS), and embolization of hepatocellular carcinoma, are reviewed.