The spleen is the most commonly injured organ in blunt abdominal trauma. Patients who are hemodynamically unstable due to splenic trauma undergo definitive operative management. Interventional radiology plays an important role in the multidisciplinary management of the hemodynamically stable trauma patient with splenic injury. Hemodynamically stable patients selected for nonoperative management have improved clinical outcomes when splenic artery embolization is utilized. The purpose of this article is to review the indications, technical aspects, and clinical outcomes of splenic artery embolization for patients with high-grade splenic injuries.

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gather survey data regarding initial certification from these members and: (1) determine the most used text resources and question banks, (2) determine the highest rated text resources and question banks, and (3) determine the trainee preparedness and overall experience for oral and computerized exams. Materials and Methods: A survey was sent to all members of the ECS. Over eighty responses were collected from group members. The questions included within the survey sought to gather information about exam preparation for initial certification and encompassed the most common study materials that residents use. The data was then collected, grouped, and analyzed. Results: Of the eighty-three responders from the ECS, 72.8% certified for interventional radiology through the interventional radiology (IR)/diagnostic radiology (DR) certifying exam (that began in 2017) whereas 21% certified through the certificate of added qualification in VIR. The text resources that were most commonly used and had the highest ratings were as follows: Vascular and Interventional Imaging: Case Review Series by Wael E. Saad, Minhaj Khaja, Suresh Vedantham (57 responses), Crack the Core by Prometheus Lionhart (41 responses), and Vascular and Interventional Radiology: The Requisites by John A. Kaufman and Michael J. Lee (39 responses). The question banks that were most commonly used and had the highest ratings were RadPrimer, BoardVitals, Qevlar, Face the Core, and Rock the Boards. The time spent studying for the computerized exam and their corresponding percentages were as follows: 3 to 6 months (16%), 1 to 3 months (52%), and < 1 month (29.3%). Conversely, the time spent studying for the oral exam and their corresponding percentages were as follows: 3 to 6 months (13%), 1 to 3 months (44.2%), and < 1 month (41.6%). Using these resources, 84.9% of responders felt prepared for the computerized exam and 87% for the oral exam. Conclusions: The survey data gathered from the members of the ECS can serve as potent recommendations for physicians-intraining who plan to take these examinations in the coming months. The aforementioned resources were consistently cited as being strong predictors of exam success. Due to the recent changes in residency and fellowship pathways for interventional radiology, consideration of past study methods for board exams is integral.

Approximately 5%–10% of common bile duct (CBD) stones cannot be removed by conventional methods because of altered anatomy. Percutaneous transhepatic cholangioscopic lithotomy has been cited as a viable alternative. A 69-year-old woman with a history of Roux-en-Y was found to have a lesion obstructing the CBD. A cholangioscope was advanced through a percutaneous transhepatic sheath and demonstrated an obstructing stone in the CBD that was removed with lithotripsy. The rate of successful stone removal with percutaneous transhepatic cholangioscopic lithotomy is 90%, with complication rates similar to endoscopic retrograde cholangiopancreatography and is an option in patients with altered surgical anatomy.

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Approximately 8% of patients with HCC are not suitable candidates for curative options. Caudate lobe HCC presents technical challenges for interventional radiologists. Caudate lobe HCC has higher local recurrence and poorer survival rate than other segments. Transarterial treatments of caudate HCC are difficult due to extreme variation of arterial supply. We present a case of a caudate lobe HCC with supply from the proper hepatic artery, which underwent successful conventional transcatheter arterial chemoembolization (cTACE) by utilizing a Fogarty catheter to direct the embolic material. The patient presented 5 days following the procedure with duodenitis and pancreatitis, which were managed conservatively. Follow-up imaging at 1 month showed significant improvement of the ischemic duodenitis/pancreatitis with successful cTACE.