Optimizing the Interventional Approach for Embolization of Pulmonary Arteriovenous Malformations in Patients With Osler-Weber-Rendu Syndrome.

Techniques in vascular and interventional radiology are adapted to the ever-evolving clinical challenges that interventional operators face. In the case of rare diseases, supporting literature that guides an operator's plan for intervention is limited. As a result, published case reports and series can be utilized to direct future intervention and potentially help others tasked with similar clinical scenarios. The proceeding case offers an interventional solution to a clinical manifestation of an otherwise rare disease, Osler-Weber-Rendu (OWR) syndrome. The supporting literature for techniques in embolization of pulmonary arteriovenous malformations (AVMs) in OWR syndrome is limited due to disease rarity. Therefore, the objective of the following case is to offer clinical insights on how to perform this procedure successfully and critique methods previously utilized.

Characterizing the Online Presence of Interventional Radiologists: A Potential Marketing Opportunity.

Purpose Patients increasingly utilize online resources to access healthcare information. Over the years, there has been an increasing trend of websites that allow patients to review their physicians. In many instances, the information found on these websites can be inaccurate or obsolete. This can affect patients' ability to make informed decisions about their provider choices. The need for interventional radiologists (IRs) is expected to rise due to an increasing demand for minimally invasive procedures. However, there is a lack of research regarding their online presence. Therefore, this study aims to characterize the online presence of IRs in the United States. Materials The Physicians Compare National Downloadable File (PCNDF) from the Center for Medicare Services was used to identify a sample of IRs in the United States. Then, a Google Custom Search Engine was created to parse the first ten search results for each physician using a set of search parameters. A coded script analyzed the URL contents of each link and placed the search results into one of the following categories: health or hospital system, third-party, social media, academic journal, or other. Results A total of 1,666 IRs were included for analysis. The results are as follows: 26.94% were from hospital or health systems, 66.93% were from third-party websites, 5.48% were from social media sites, 0.02% were from academic journals, and 0.64% were from other. Conclusion The online presence of IRs is primarily controlled by third-party websites, many of which do not allow physicians to manage their content. As the field of interventional radiology continues to grow; a great opportunity exists for physicians to expand their digital presence to more accurately reflect their practice.

Vascular Complications of Splenectomy in a Patient with Gastric Dieulafoy-like Lesions in Left-sided Portal Hypertension Secondary to Splenic Vein and Artery Thrombosis.

Due to lower clinical significance, the management of Dieulafoy and Dieulafoy-like lesions is less commonly reported than the management of their impending venous equivalent, variceal bleeding. Though Dieulafoy and Dieulafoy-like lesions are often benign, they can become life-threatening in certain clinical scenarios, especially with substantial changes in hemodynamic blood flow, which results in hemorrhage. Post-procedural hemodynamic blood flow should be carefully monitored in patients who receive procedures that drastically alter hemodynamic flow pressures. Factoring in the presence of Dieulafoy and Dieulafoy-like lesions might deepen the complexity of an intuitive surgical or interventional procedure for an experienced operator, and should, therefore, involve the cooperative effort between surgical, interventional, and diagnostic services to appropriately manage the patients. The case we present demonstrates the dire consequences of a routine splenectomy when a considerable change in hemodynamic pressure across benign Dieulafoy-like lesions occurs in a patient with both splenic artery and venous thrombosis.

Becoming the Standard: Expanding the Conventional Use of Interventional Embolization for Ruptured Pulmonary Artery Aneurysms.

Behcet's disease is inflammatory vasculitis that has a high incidence of mortality in patients with pulmonary artery aneurysm (PAA) formation. Traditionally, patients with Behcet's disease and PAA rupture undergo invasive surgical management. Surgical intervention; however, has been shown to have high complication, failure, and mortality rates. It has become a more contemporary practice to utilize the interventional embolization of pulmonary artery aneurysms (PAAs) in patients with Behcet's disease and other various etiologies because of its inherent minimally invasive nature and decreased risk for complications. The management paradigm for treating PAAs has shifted toward endovascular embolization even in severe or emergent cases where surgical management was once thought to be the standard. The following case is a testimony to the practicality of interventional embolization in the setting of a symptomatic patient presenting with PAAs.

Combined surgical and endovascular treatment of complex high-flow conus medullaris arteriovenous fistula associated with Parkes Weber syndrome: case report.

Parkes Weber syndrome (PWS) is a congenital overgrowth disorder characterized by unilateral limb and axial hypertrophy, capillary malformations of the skin, and high-flow arteriovenous fistulas (AVFs). Spinal AVFs in the setting of PWS are challenging vascular lesions that often contain multiple arteriovenous (AV) shunts. The present case report highlights an adolescent girl with PWS who presented with a ruptured complex high-flow conus medullaris AVF. She was successfully treated with endovascular embolization and microsurgery. At the 2-year follow-up, the patient remained free of neurological symptoms and had no recurrence of the vascular malformation.