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Comparison of radial and femoral artery access for interventional oncology
S250
Posters and Exhibits
following LT, this contradicts the findings of recent publications². Further evaluation with prospective multicenter studies would be a reasonable next step to determine if the concordance rate of mRECIST is sufficient to allow for its use as a clinical tool and if response to LRT using mRECIST can help predict survival post-LT. References 1. Bargellini I et al. Modified RECIST to Assess Tumor Response after Transarterial Chemoembolization of Hepatocellular Carcinoma: CTPathologic Correlation in 178 Liver Explants. European Journal of Radiology 2013; 82(5):e212–e218. 2. Kim DJ, et al. Recurrence of Hepatocellular Carcinoma: Importance of mRECIST Response to Chemoembolization and Tumor Size. American Journal of Transplanation 2014; 14:1383–1390. 3. Lencioni R, Llovet J. Modified RECIST (mRECIST) for Hepatocellular Carcinoma. Seminars in Liver Disease 2010; 30(1):052–060. 4. Memon K, et al. Radiographic Response to Locoregional Therapy in Hepatocellular Carcinoma Predicts Patient Survival Times. Gastroenterology. 2011; 141(2):526–35, 535.
Abstract No. 566 Comparison of radial and femoral artery access for interventional oncology
Posters and Exhibits
Z. Cizman1, T. Ciszak1, J. Camacho2, C. Gilliland3, D. Kies1; 1Emory University, Atlanta, GA; 2Atlanta, GA; 3 Emory University School of Medicine, Atlanta, GA Purpose: The purpose of this study is to compare the technical success rate, time to discharge, mean fluoroscopy time, and complication rate of transfemoral artery access (TFA) to transradial artery access (TRA) for hepatic oncologic interventions. Materials: We performed a retrospective review of 20 patients who underwent TRA for hepatic oncologic interventions with a single user at an academic institution from August 2015 through September 2015. Electronic medical records and PACS were reviewed to find eligible patients and record fluoroscopy times, technical success, time to discharge, and complication rates. These results were compared to a similar number of patients who underwent TFA for hepatic oncologic interventions prior to the transition to TRA. Statistical analysis comparing the mean fluoroscopy and discharge times, and the technical success and complications, were performed. Exclusion criteria included planned admissions and admissions unrelated to an access site complication. Results: The technical success rate for TRA was 100%. The mean fluoroscopy time was 18.35 minutes with a time to discharge of 2 hours and 46 minutes. In contrast the TFA group had a mean fluoroscopy time of 15.36 minutes and time to discharge was 3 hours 3 minutes. Hemostasis during TRA was performed with a TR Band (Terumo). A mechanical closure device was used in all TFA cases. There were no minor or major complications within the TRA group. Two minor complications (hematoma) were noted in the TRF group. A major complication (sepsis following embolization) in the TRF group was not related to the access site. Conclusions: Initial data from a single user at an academic center suggest there is no significant increase in fluoroscopy time nor decrease in time to discharge for radial artery access in the setting of hepatic oncologic intervention.
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JVIR
Abstract No. 567 WITHDRAWN
Educational Exhibit
Abstract No. 568
Utility of hepatobiliary MR contrast agents for HCC diagnosis: a review for the interventional radiologist S. Osei-Bonsu1, M. Bergen1, A. Kesselman2, R. Seit2, W. Kwon2; 1SUNY Downstate Medical Center, Brooklyn, NY; 2SUNY Downstate, Brooklyn, NY Learning Objecties: Discuss the mechanism of action of hepatobiliary contrast agents and extracellular contrast agents in hepatic imaging. Describe the characteristics of HCC on hepatobiliary contrast agent enhanced MR. Describe the utility of hepatobiliary contrast agents in detection and characterization of HCC, and differentiating HCC from other focal hepatic lesions. Background: HCC is the most common primary malignancy of the liver. Interventional radiology plays a fundamental role in the treatment of this disease, performing palliative and curative locoregional therapies in non-surgical/non-transplant patients. Because the interventionalist is a central decision maker in the multidisciplinary treatment, it is important for the interventionalist to be proficient in MR imaging of the liver. Contrast enhanced MRI is an established modality in the diagnosis and evaluation of HCC. Traditionally, conventional extracellular gadolinium based agents have been used to diagnose lesions based on vascularity. However, this quality can be non-specific, and in certain cases may not reliably distinguish HCC from other benign hepatic lesions. Hepatobiliary agents, such as gadoxetate acid, have been developed to improve detection and characterization of hepatic lesions. They behave similarly to the extracellular contrast agents in the early dynamic phases, but are taken up by the hepatocytes and biliary system in the delayed hepatobiliary phase. This characteristic allows for further differentiation between HCC and other similar appearing focal lesions. Clinical Findings/Procedure Details: This exhibit will demonstrate the various uses of hepatobiliary agents in the diagnosis and differentiation of HCC from other liver lesions such as regenerating nodules, shunts, focal nodular hyperplasia and hepatic adenoma. Various examples using gadoxetate acid enhanced MR images will be provided. Conclusions: Utilization of hepatobiliary MR contrast agents provide certain advantages in the diagnosis of HCC. With the increased utilization of these agents, the interventional radiologist will encounter them in their practice.
Educational Exhibit
Abstract No. 569
Post-procedural care in vascular and interventional radiology: what every resident and interventional radiologist should know D. Sridhar, B. Taslakian, N. Bagadiya; NYU Langone Medical Center, New York, NY
Posters and Exhibits
following LT, this contradicts the findings of recent publications². Further evaluation with prospective multicenter studies would be a reasonable next step to determine if the concordance rate of mRECIST is sufficient to allow for its use as a clinical tool and if response to LRT using mRECIST can help predict survival post-LT. References 1. Bargellini I et al. Modified RECIST to Assess Tumor Response after Transarterial Chemoembolization of Hepatocellular Carcinoma: CTPathologic Correlation in 178 Liver Explants. European Journal of Radiology 2013; 82(5):e212–e218. 2. Kim DJ, et al. Recurrence of Hepatocellular Carcinoma: Importance of mRECIST Response to Chemoembolization and Tumor Size. American Journal of Transplanation 2014; 14:1383–1390. 3. Lencioni R, Llovet J. Modified RECIST (mRECIST) for Hepatocellular Carcinoma. Seminars in Liver Disease 2010; 30(1):052–060. 4. Memon K, et al. Radiographic Response to Locoregional Therapy in Hepatocellular Carcinoma Predicts Patient Survival Times. Gastroenterology. 2011; 141(2):526–35, 535.
Abstract No. 566 Comparison of radial and femoral artery access for interventional oncology
Posters and Exhibits
Z. Cizman1, T. Ciszak1, J. Camacho2, C. Gilliland3, D. Kies1; 1Emory University, Atlanta, GA; 2Atlanta, GA; 3 Emory University School of Medicine, Atlanta, GA Purpose: The purpose of this study is to compare the technical success rate, time to discharge, mean fluoroscopy time, and complication rate of transfemoral artery access (TFA) to transradial artery access (TRA) for hepatic oncologic interventions. Materials: We performed a retrospective review of 20 patients who underwent TRA for hepatic oncologic interventions with a single user at an academic institution from August 2015 through September 2015. Electronic medical records and PACS were reviewed to find eligible patients and record fluoroscopy times, technical success, time to discharge, and complication rates. These results were compared to a similar number of patients who underwent TFA for hepatic oncologic interventions prior to the transition to TRA. Statistical analysis comparing the mean fluoroscopy and discharge times, and the technical success and complications, were performed. Exclusion criteria included planned admissions and admissions unrelated to an access site complication. Results: The technical success rate for TRA was 100%. The mean fluoroscopy time was 18.35 minutes with a time to discharge of 2 hours and 46 minutes. In contrast the TFA group had a mean fluoroscopy time of 15.36 minutes and time to discharge was 3 hours 3 minutes. Hemostasis during TRA was performed with a TR Band (Terumo). A mechanical closure device was used in all TFA cases. There were no minor or major complications within the TRA group. Two minor complications (hematoma) were noted in the TRF group. A major complication (sepsis following embolization) in the TRF group was not related to the access site. Conclusions: Initial data from a single user at an academic center suggest there is no significant increase in fluoroscopy time nor decrease in time to discharge for radial artery access in the setting of hepatic oncologic intervention.
’
JVIR
Abstract No. 567 WITHDRAWN
Educational Exhibit
Abstract No. 568
Utility of hepatobiliary MR contrast agents for HCC diagnosis: a review for the interventional radiologist S. Osei-Bonsu1, M. Bergen1, A. Kesselman2, R. Seit2, W. Kwon2; 1SUNY Downstate Medical Center, Brooklyn, NY; 2SUNY Downstate, Brooklyn, NY Learning Objecties: Discuss the mechanism of action of hepatobiliary contrast agents and extracellular contrast agents in hepatic imaging. Describe the characteristics of HCC on hepatobiliary contrast agent enhanced MR. Describe the utility of hepatobiliary contrast agents in detection and characterization of HCC, and differentiating HCC from other focal hepatic lesions. Background: HCC is the most common primary malignancy of the liver. Interventional radiology plays a fundamental role in the treatment of this disease, performing palliative and curative locoregional therapies in non-surgical/non-transplant patients. Because the interventionalist is a central decision maker in the multidisciplinary treatment, it is important for the interventionalist to be proficient in MR imaging of the liver. Contrast enhanced MRI is an established modality in the diagnosis and evaluation of HCC. Traditionally, conventional extracellular gadolinium based agents have been used to diagnose lesions based on vascularity. However, this quality can be non-specific, and in certain cases may not reliably distinguish HCC from other benign hepatic lesions. Hepatobiliary agents, such as gadoxetate acid, have been developed to improve detection and characterization of hepatic lesions. They behave similarly to the extracellular contrast agents in the early dynamic phases, but are taken up by the hepatocytes and biliary system in the delayed hepatobiliary phase. This characteristic allows for further differentiation between HCC and other similar appearing focal lesions. Clinical Findings/Procedure Details: This exhibit will demonstrate the various uses of hepatobiliary agents in the diagnosis and differentiation of HCC from other liver lesions such as regenerating nodules, shunts, focal nodular hyperplasia and hepatic adenoma. Various examples using gadoxetate acid enhanced MR images will be provided. Conclusions: Utilization of hepatobiliary MR contrast agents provide certain advantages in the diagnosis of HCC. With the increased utilization of these agents, the interventional radiologist will encounter them in their practice.
Educational Exhibit
Abstract No. 569
Post-procedural care in vascular and interventional radiology: what every resident and interventional radiologist should know D. Sridhar, B. Taslakian, N. Bagadiya; NYU Langone Medical Center, New York, NY