Contemporary interventional management of pulmonary embolism.

Minimally invasive interventional techniques are being utilised more frequently in the management of acute and chronic pulmonary emboli; however, robust clinical evidence is only emerging for the utilisation of these techniques. Hence, there is a need for a robust mechanism of patient selection and careful consideration of the benefits and risks of the interventions. In this review, we discuss the risk stratification mechanisms; the role of the multidisciplinary pulmonary embolism response team to support decision-making; and describe the various commonly used interventional techniques and how these can be integrated into treatment strategies for the benefit of our patients.

Transarterial chemoembolization for hepatocellular carcinoma: a bibliometric analysis of the most cited articles.

PURPOSE: Bibliometric analysis is a quantitative assessment of the academic literature in a particular field. The aim of our study was to characterize the 100 top-cited articles regarding transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: The 'Web of Science' database was used to identify the leading articles regarding TACE for HCC. We determined the top 100 articles according to citations and performed an analysis on year of publication, authorship, department affiliation, publishing journal, institution and country of origin, subject matter and article type. RESULTS: The top-cited articles received between 92 and 2254 citations (median 283.4). The top 100 papers were published in 32 journals between 1983 and 2016. Cancer, Radiology and Hepatology published the most articles (n = 40). Internal medicine was the department affiliation of the first author in 49%. The country providing the most highly cited articles was Japan (n = 24). CONCLUSION: We performed an analysis of the 100 top-cited articles dealing with TACE for HCC, presenting a detailed list of the most influential and historically significant papers. Japan was the country that produced the most top-cited articles, highlighting its key contribution to this field of the literature.

Prostate artery embolisation: an all-comers, single-operator experience in 159 patients with lower urinary tract symptoms, urinary retention, or haematuria with medium-term follow-up.

AIM: To describe the authors' experience with prostate artery embolisation (PAE) to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) or refractory haematuria of prostatic origin (RHOPA). MATERIALS AND METHODS: PAE was attempted in 159 patients. Procedural details, pre/post-PAE symptom scores, and pre/post-PAE magnetic resonance imaging (MRI) data were recorded. Statistical analysis was performed to determine clinical outcomes and factors predicting clinical success. RESULTS: Technical success was achieved in 156 patients. In patients with LUTS, the International Prostate Symptom Score (IPSS) improved from a mean of 22 at baseline to 9.5 at 6-months post-PAE, then to 10.7, 10, 11.3, and 11 at 1, 2, 3, and 4 years. The quality of life (QoL) score improved from 4.6 at baseline to 2, 2.2, 2.4, 3.1, and 2.5 at the same time points. The International Index of Erectile Function (IIEF-5) scores remained stable. There was no significant difference in IPSS between bilateral or unilateral embolisation to 2 years, or between BPH alone or BPH with biopsy-proven prostate cancer to 3 years post-PAE. Percentage improvement in IPSS at 1 year correlated with percentage reduction in prostate volume on first post-PAE MRI. Percentage improvement in IPSS at 3 years correlated with initial IPSS. PAE facilitated urinary catheter removal in 13/24 patients in retention. PAE controlled bleeding in 12/12 patients with RHOPA. CONCLUSION: PAE is safe and effective in the management of symptomatic BPH. Patients with the highest baseline IPSS and reduction in prostate volume on first post-PAE MRI are likely to derive most benefit from embolisation.