RESUMEN
Opportunities for interventional radiology (IR) education and exposure remain limited at medical institutions without a local IR presence, thereby excluding a medical student population with potential to pursue careers in IR or become referring providers to IR. The purpose of this study was to evaluate the efficacy of a Webinar-based IR elective as an educational tool for outreach to US medical schools lacking local preclinical IR exposure. Our early results indicate that a Webinar-based IR lecture series can serve as an effective method for educating future physicians about the field of IR and when to consult IR for patient management.
Asunto(s)
Selección de Profesión , Instrucción por Computador/métodos , Educación de Pregrado en Medicina/métodos , Internet , Radiólogos/educación , Radiología Intervencionista/educación , Especialización , Estudiantes de Medicina , Curriculum , Femenino , Humanos , MasculinoAsunto(s)
Aneurisma Falso/terapia , Aneurisma Roto/terapia , Embolización Terapéutica/efectos adversos , Embolización Terapéutica/instrumentación , Migración de Cuerpo Extraño/etiología , Enfermedad Iatrogénica , Arteria Pulmonar , Técnicas de Ablación/efectos adversos , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/etiología , Aneurisma Roto/diagnóstico por imagen , Aneurisma Roto/etiología , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/cirugía , Hemoptisis/etiología , Hemoptisis/terapia , Humanos , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Masculino , Microondas/efectos adversos , Persona de Mediana Edad , Neumonectomía , Arteria Pulmonar/diagnóstico por imagen , Factores de Tiempo , Resultado del TratamientoRESUMEN
Purpose: To determine whether chemoembolization using drug-eluting beads (DEB-TACE) is safe and effective for liver transplantation candidates with liver-limited hepatocellular carcinoma (HCC) without vascular invasion and baseline hepatic dysfunction. Materials and methods: Seventeen adult liver transplantation candidates (median age 66 years, range 58-73 years; 13 men) with HCC were treated with DEB-TACE as a part of Stage 1 of a prospective single-institution Phase II trial. All patients had marginal hepatic reserve based on at least one of the following criteria: ascites (n=14), bilirubin between 3 and 6 mg/dL (n=5), AST 5-10 times upper normal limit (n=1), INR between 1.6 and 2.5 (n=4), portal vein thrombosis (n=2), and/or portosystemic shunt (n=2). Primary study objectives were safety and best observed radiographic response. Results: Thirty-seven DEB-TACE procedures were performed. Objective response rate and disease control rate were 63% and 88%, respectively. HCC progression was observed in 12 patients. Median time to progression was 5.6 months (range 0.9-13.6 months). Within 1 month following DEB-TACE, 13 patients (76%) developed grade 3 or 4 AE attributable to the procedure. Four patients (all within Milan Criteria) were transplanted (2.7-6.9 months after DEB-TACE), and 12 patients died (1.8-32 months after DEB-TACE). All deaths were due to liver failure that was either unrelated to HCC (n=5), in the setting of metastatic HCC (n=5), or in the setting of locally advanced HCC (n=2). Mortality rate at 1 month was 0%. Conclusions: DEB-TACE achieves tumor responses but carries a high risk of hepatotoxicity for liver transplant candidates with HCC and marginal hepatic reserve.