Assuntos
Artérias , Ensaios Clínicos como Assunto/normas , Embolização Terapêutica/normas , Sintomas do Trato Urinário Inferior/terapia , Próstata/irrigação sanguínea , Hiperplasia Prostática/terapia , Radiografia Intervencionista/normas , Projetos de Pesquisa/normas , Terminologia como Assunto , Artérias/diagnóstico por imagem , Consenso , Embolização Terapêutica/efeitos adversos , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico por imagem , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Padrões de Prática Médica/normas , Hiperplasia Prostática/diagnóstico por imagem , Hiperplasia Prostática/fisiopatologia , Radiografia Intervencionista/efeitos adversos , Resultado do TratamentoAssuntos
Publicações Periódicas como Assunto , Radiologistas , Canadá , Humanos , Radiologia , Sociedades MédicasAssuntos
Políticas Editoriais , Publicações Periódicas como Assunto , Radiologia , Canadá , Humanos , Sociedades MédicasRESUMO
PURPOSE: Apparent diffusion coefficient (ADC) values, which are derived from diffusion-weighted imaging, have a potential role for predicting treatment response. A systematic review was conducted to examine the value of baseline ADC values for predicting leiomyoma size reduction after uterine arterial embolization (UAE). METHODS: Study selection, quality appraisal and data extraction were conducted independently by two authors. Statistical analyses included the calculation of weighted means and summary correlation coefficients (under the random effects model). RESULTS: Eleven studies consisting of a total of 258 patients (age, weighted mean±standard deviation [SD], 43.1±10.1 years) were included. The weighted mean±SD ADC value was 1.2±1.5 ×10-3 s/mm2 at baseline (ten studies) and 1.3±2.8 ×10-3 s/mm2 at approximately 6 months after embolization (six studies). The weighted mean percentage leiomyoma volume reduction (VR) at 6 months was 47.1%±35.6% (seven studies). Based on four studies, the weighted summary correlation coefficient for the correlation between baseline ADC and leiomyoma VR at approximately 6 months was not significant (r=0.40; 95% CI, -0.07 to 0.72; I2=69.7%). No associations were found in three of the four studies that examined changes in ADC values as a predictor. CONCLUSION: Due to high heterogeneity, it is unclear whether ADC may be useful for predicting treatment responses to UAE.
Assuntos
Leiomioma/patologia , Leiomioma/terapia , Embolização da Artéria Uterina/métodos , Útero/irrigação sanguínea , Adulto , Imagem de Difusão por Ressonância Magnética/métodos , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Resultado do Tratamento , Neoplasias Uterinas/patologia , Útero/patologia , Procedimentos Cirúrgicos Vasculares/métodos , Procedimentos Cirúrgicos Vasculares/estatística & dados numéricosRESUMO
PURPOSE: Percutaneous tissue biopsy is a mainstay of diagnostic and interventional radiology, providing a minimally invasive method for diagnosing malignant and benign disease. The purpose of this review was to collect and summarize the best available evidence regarding the risk factors associated with bleeding complications in image-guided liver biopsy. METHODS: A literature review was performed, searching Medline, EMBASE, CINAHL, the Cochrane Library, the National Institute for Health and Care Excellence (NICE) and Canadian Agency for Drugs and Technology in Health (CADTH) databases for any studies evaluating bleeding complications in image-guided liver biopsy. A total of 68 articles, published between January 1994 and April 2015, were reviewed in full, with 34 ultimately eligible for inclusion in the review. RESULTS: Bleeding of any kind occurred in up to 10.9% of image-guided liver biopsies, with major bleeding episodes ranging from 0.1% to 4.6% and minor bleeding events occurring in up to 10.9% of biopsies. The overall rate of bleeding was, however, found to be less than 2%. Several risk factors (patient, operator, and procedure-related) were identified as potentially indicative of an increased risk of post-biopsy bleeding. Patient-related risk factors included patient age (>50 years or <2 years), inpatient status (8/12 vs. 4/12, P < 0.001), comorbidities and/or concurrent diagnoses and coagulation status (rate of bleeding was 3.3% for international normalized ratio [INR] 1.2-1.5 vs. 7.1% for INR >1.5, P < 0.001). There was no consensus on impact of operator experience (>200 biopsies/year vs. <50/year) on post-biopsy bleeding rate. Procedure-related risk factors included needle size (cutting biopsy vs. fine needle aspiration, P < 0.001) and the presence of a patent track on post-biopsy ultrasound (P < 0.001). Lastly there was no difference found between targeted vs. nontargeted biopsies and number of needle passes. CONCLUSION: Reported rate of post-biopsy bleeding ranges between 0% and 10.9%, although the vast majority of studies reported bleeding rates under 2%. Several patient, operator, and procedure-related risk factors are associated with a higher risk of bleeding following liver biopsy.
Assuntos
Biópsia por Agulha Fina/efeitos adversos , Hemorragia/complicações , Biópsia Guiada por Imagem/métodos , Fígado/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha Fina/métodos , Criança , Pré-Escolar , Hemorragia/mortalidade , Humanos , Lactente , Recém-Nascido , Fígado/patologia , Pessoa de Meia-Idade , Agulhas/tendências , Radiologia Intervencionista/métodos , Radiologia Intervencionista/estatística & dados numéricos , Fatores de Risco , Ultrassonografia de Intervenção/métodos , Adulto JovemAssuntos
Radiografia Intervencionista/normas , Projetos de Pesquisa/normas , Terminologia como Assunto , Tórax/irrigação sanguínea , Doenças Vasculares/terapia , Veias , Consenso , Constrição Patológica , Registros Eletrônicos de Saúde/normas , Humanos , Flebografia/normas , Valor Preditivo dos Testes , Radiografia Intervencionista/métodos , Fatores de Risco , Resultado do Tratamento , Doenças Vasculares/diagnóstico por imagem , Doenças Vasculares/etiologia , Doenças Vasculares/fisiopatologia , Grau de Desobstrução Vascular , Veias/diagnóstico por imagem , Veias/fisiopatologiaAssuntos
Antibacterianos/administração & dosagem , Antibioticoprofilaxia/normas , Radiografia Intervencionista/normas , Infecção da Ferida Cirúrgica/prevenção & controle , Procedimentos Cirúrgicos Vasculares/normas , Fatores Etários , Antibacterianos/efeitos adversos , Antibioticoprofilaxia/efeitos adversos , Consenso , Esquema de Medicação , Farmacorresistência Bacteriana , Humanos , Radiografia Intervencionista/efeitos adversos , Fatores de Risco , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/microbiologia , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/efeitos adversosRESUMO
OBJECTIVE: We provide a brief review of the tumor microenvironment, the impact of six interventional radiology treatments on the tumor microenvironment, and potential methods to improve treatment efficacy. CONCLUSION: Interventional oncology plays a unique role in cancer therapy, contributing to both antitumorigenic and protumorigenic effects.
Assuntos
Oncologia , Neoplasias/terapia , Radiografia Intervencionista/métodos , Microambiente Tumoral , Animais , HumanosRESUMO
PURPOSE: To develop a new adverse event (AE) classification for the interventional radiology (IR) procedures and evaluate its clinical, research, and educational value compared with the existing Society of Interventional Radiology (SIR) classification via an SIR member survey. MATERIALS AND METHODS: A new AE classification was developed by members of the Standards of Practice Committee of the SIR. Subsequently, a survey was created by a group of 18 members from the SIR Standards of Practice Committee and Service Lines. Twelve clinical AE case scenarios were generated that encompassed a broad spectrum of IR procedures and potential AEs. Survey questions were designed to evaluate the following domains: educational and research values, accountability for intraprocedural challenges, consistency of AE reporting, unambiguity, and potential for incorporation into existing quality-assurance framework. For each AE scenario, the survey participants were instructed to answer questions about the proposed and existing SIR classifications. SIR members were invited via online survey links, and 68 members participated among 140 surveyed. Answers on new and existing classifications were evaluated and compared statistically. Overall comparison between the two surveys was performed by generalized linear modeling. RESULTS: The proposed AE classification received superior evaluations in terms of consistency of reporting (P < .05) and potential for incorporation into existing quality-assurance framework (P < .05). Respondents gave a higher overall rating to the educational and research value of the new compared with the existing classification (P < .05). CONCLUSIONS: This study proposed an AE classification system that outperformed the existing SIR classification in the studied domains.
Assuntos
Garantia da Qualidade dos Cuidados de Saúde/normas , Radiografia Intervencionista/efeitos adversos , Radiografia Intervencionista/normas , Radiologia Intervencionista/normas , Humanos , Sociedades MédicasAssuntos
Antineoplásicos/administração & dosagem , Carcinoma Hepatocelular/terapia , Embolização Terapêutica/normas , Neoplasias Hepáticas/terapia , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica/normas , Humanos , Neoplasias Hepáticas/patologia , Metástase Neoplásica , Seleção de Pacientes , Melhoria de Qualidade , Medição de RiscoAssuntos
Dor nas Costas/epidemiologia , Cervicalgia/epidemiologia , Doenças Profissionais/epidemiologia , Saúde Ocupacional , Radiografia Intervencionista/efeitos adversos , Radiologistas , Absenteísmo , Dor nas Costas/diagnóstico , Dor nas Costas/prevenção & controle , Avaliação da Deficiência , Ergonomia , Humanos , Incidência , Descrição de Cargo , Cervicalgia/diagnóstico , Cervicalgia/prevenção & controle , Doenças Profissionais/diagnóstico , Doenças Profissionais/prevenção & controle , Postura , Prevalência , Roupa de Proteção/efeitos adversos , Lesões por Radiação/diagnóstico , Lesões por Radiação/epidemiologia , Lesões por Radiação/prevenção & controle , Proteção Radiológica/instrumentação , Medição de Risco , Fatores de Risco , Licença Médica , Fatores de TempoAssuntos
Derivação Arteriovenosa Cirúrgica/normas , Implante de Prótese Vascular/normas , Diagnóstico por Imagem/normas , Procedimentos Endovasculares/normas , Oclusão de Enxerto Vascular/terapia , Melhoria de Qualidade/normas , Indicadores de Qualidade em Assistência à Saúde/normas , Diálise Renal/normas , Trombose/terapia , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Implante de Prótese Vascular/efeitos adversos , Consenso , Técnica Delphi , Procedimentos Endovasculares/efeitos adversos , Medicina Baseada em Evidências/normas , Oclusão de Enxerto Vascular/diagnóstico por imagem , Oclusão de Enxerto Vascular/etiologia , Oclusão de Enxerto Vascular/fisiopatologia , Humanos , Valor Preditivo dos Testes , Fluxo Sanguíneo Regional , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/fisiopatologia , Resultado do Tratamento , Grau de Desobstrução VascularRESUMO
OBJECTIVE: The aim of this article is to provide an overview of peripheral nerve blocks, the use of peripheral nerve block within and outside interventional radiology, and the complications of peripheral nerve block. CONCLUSION: Interventional radiologists are often responsible for sedation and pain management in the majority of interventional radiology procedures. Peripheral nerve block is increasingly being used in interventional radiology.
Assuntos
Artérias/diagnóstico por imagem , Diagnóstico por Imagem/normas , Doença Arterial Periférica/diagnóstico por imagem , Radiografia Intervencionista/normas , Radiologia Intervencionista/normas , Sociedades Médicas/normas , Artérias/fisiopatologia , Consenso , Diagnóstico por Imagem/métodos , Hemodinâmica , Humanos , Doença Arterial Periférica/fisiopatologia , Doença Arterial Periférica/terapia , Valor Preditivo dos Testes , Prognóstico , Radiografia Intervencionista/métodos , Radiologia Intervencionista/métodos , Fluxo Sanguíneo Regional , Reprodutibilidade dos Testes , Índice de Gravidade de DoençaRESUMO
PURPOSE: To report a single operator's experience using a modified single-puncture gastrostomy technique deploying up to three nonabsorbable gastropexy anchors. MATERIALS AND METHODS: A retrospective review of 69 consecutive patients undergoing gastrostomy, gastrojejunostomy, or jejunostomy tube insertion between March 2012 and January 2014 was performed. Technical success and 30-day local, major, and minor complication rates were assessed according to the Society of Interventional Radiology (SIR) Standards of Practice for Gastrointestinal Access. Procedure time was also recorded. RESULTS: Primary technical success of the procedure was 98.6% (68/69). In one patient, the procedure was aborted because the stomach could not be safely accessed. Major complications occurred in one of 69 (1.4%) patients, minor complications occurred in 10 of 69 (13%) patients, and local complications occurred in three of 69 (4.3%) patients. Local complications consisted of redness and mild tenderness at the enteric access site. Mean procedure time was 5 minutes (range, 3.1-36 min). CONCLUSIONS: Single-puncture, multianchor gastrostomy is a feasible technique for radiologically guided enteric access tube insertion with technical success and complication rates similar to conventional gastrostomy techniques. This technique could be considered when expeditious performance of a procedure is required.