A Comparative Study of a Small Series of Patients (50 Patients) with Pelvic Varicose Veins Treated with Plugs Alone or Plugs and Polidocanol.

LEVEL OF EVIDENCE: Level 2. PURPOSE: To compare the safety and efficacy of vascular plug (VP) and vascular plug and polidocanol foam (VPPF) treatments for embolization in pelvic congestion syndrome (PCS). MATERIALS AND METHODS: A comparative, prospective, two-center study enrolled 50 women with PCS from January 2019 to January 2020. The patients were divided into two groups, and embolization was performed with VP (n = 25) and VPPF (n = 25) treatments. The mean age of the patients was 45.6 years ± 6.9. Three clinical parameters were assessed: abdominal pain, dyspareunia, and lower limb pain. The primary outcome (clinical success at 1 yr using a VAS), number of devices, procedure and fluoroscopy times, radiation doses, costs, and complications were compared. The participants were followed-up at 1, 3, 6, and 12 months. RESULTS: At the 1-year follow-up, clinical success did not significantly differ between the two groups (VP vs. VPPF) regarding the improvement of the symptoms analyzed (pelvic pain, dyspareunia, lower extremity pain, and other symptoms (p < 0.05)). The mean number of devices per case was 4 ± 1.1 for the VP group and 2 ± 0.31 for the VPPF group (p < 0.001). No major complications were recorded in either group. The VPPF group had a significantly longer fluoroscopy time (42.8 min ± 14.2 vs. 25.4 min ± 7) and longer radiation dose (VPPF air kerma 839.4 ± 513 vs. VP air kerma 658.4 mGy ± 355 (all p < 0.001)). CONCLUSIONS: Embolization for PCS resulted in pain relief in 90% of patients; the use of polidocanol did not demonstrate changes in the clinical outcome. The use of a VP alone was associated with decreased fluoroscopy time and radiation dose.

Future scenarios and opportunities for interventional radiology in the post COVID-19 era.

Pandemic outbreak has led health systems worldwide into a rapid reorganization in response to coronavirus infections, forcing interventional radiology units to adapt. Interventional procedures have evolved in number, type and setting and have arguably been optimized as a direct consequence of this pandemic; a result that will undoubtedly lead to radical change within the specialty. This paper explores the future of interventional radiology from various perspectives, and forecasts the new opportunities that will be presented, from the adaptation of the interventional radiology staff and angiography suite, to the immunological environment, and through to digital medical education. We analyze the economic impact and the future relationship we can expect with the rest of the medical industry.

Rotura vesicular secundaria a traumatismo abdominal cerrado / Secondary gallbladder rupture to close abdominal traumatism

Varón de 45 años de edad que ingresa por urgencias con un traumatismo abdominal cerrado, tras sufrir un accidente de tráfico. Se le realiza una TC abdominal sin y con contraste, visualizándose la vesícula biliar contraida y con contenido intraluminal hiperdenso sugerente de hemobilia. Existe además líquido libre intraperitoneal. No se encontraron otras lesiones abdominales. Con el diagnóstico de rotura vesicular por imagen, se realizó CPRE y colecistectomía que localizaron la rotura y confirmaron el diagnóstico (AU)

Enfisema subcutáneo y neumomediastino secundarios a extracción dental / Subcutaneous emphysema and pneumomediastinum secondary to tooth extraction

La tumefacción facial es un hallazgo frecuente tras la extracción de una pieza dental. Entre las causas más frecuentes que la producen se encuentran las reacciones anafilácticas, las infecciones o los hematomas. Otra causa poco frecuente, pero que hay que incluir en el diagnóstico diferencial es el enfisema subcutáneo.A continuación describimos un caso de enfisema subcutáneo y neumomediastino tras la extracción de un cordal (AU)