TARE is safe and can be effective in patients with an intermediate or advanced stage HCC who are refractory to TACE. This treatment strategy has the potential to downstage to liver transplantation.

Chylous ascites is a rare complication of acute pancreatitis. However, the incidence of intraperitoneal chyle leakage related to severe pancreatitis may be much higher. This is probably the result of direct damage to the cisterna chyli or its tributaries by pancreatic enzymes. In this case, conservative treatment failed to resolve the chyle leak. For the first time, to our knowledge, ultrasound guided therapeutic intranodal lymphangiography was shown to be a successful, minimally invasive treatment option in chylous ascites complicating acute necrotic pancreatitis.

Purpose: To evaluate safety and efficacy of balloon pulmonary angioplasty (BPA) for nonoperable chronic thromboembolic pulmonary hypertension (CTEPH) patients during initial experience of a single center.Methods: A total of 18 CTEPH patients (5 with residual pulmonary hypertension after pulmonary endarterectomy) were treated with BPA during the period 2014 -2018 and were retrospectively reviewed. Mean age was 61 ± 19yr, 55% female, mPAP 44 ± 12 mmHg, CO 4.3 ± 1.0 l/min, PVR 8.4 ± 3.6 WU. Subjects were evaluated by NYHA functional class, 6-min walk distance, NT-proBNP, echocardiography and right heart catheterization, before and after completions of BPA.Results: A total of 91 procedures were performed with a median number of 4 (2 -8) BPA sessions per patient. There were no death or major complications requiring extracorporeal support or (non)-invasive ventilation. The most common complication was self-limiting hemoptysis (3%). According to SIR classification, 4 mild, 4 moderate and 1 severe adverse events were noted. Invasive hemodynamics significantly improved with a cardiac index increase of 15% (p=0.0333), decrease of mean pulmonary artery pressure of 30% (p = 0.0013) and pulmonary vascular resistance of 45% (p = 0.0048), respectively. Stroke volume index (p = 0.0171) and pulmonary arterial compliance (p = 0.0004) were also significantly enhanced. Conclusion:BPA significantly improves cardiopulmonary hemodynamics with an acceptable safety profile. Further studies assessing the long-term efficacy of BPA are required.

Purpose: To evaluate the safety and efficacy of the microvascular plug (MVP) for selective renal artery embolization. Methods: Retrospective review was performed on a cohort of 6 patients undergoing renal artery embolization using the MVP between July 2015 and August 2018. Patients’ demographics, indication for embolization, technical details of the embolization procedure, and clinical events were gathered from the patients’ electronic medical records. Results: The patients underwent selective renal artery embolization with a MVP for iatrogenic vascular injuries (n = 3), traumatic vascular injuries (n = 2), and for elective embolization of an angiomyolipoma (n = 1), in native kidneys (n = 4) or in renal allografts (n = 2). Immediate occlusion of the feeding artery was achieved with 1 MVP device in 4 patients. In 1 patient, a second MVP was needed, and in another patient, additional 0.018-inch microcoils were used to completely occlude the injured artery. Technical success was achieved in all patients. The volume of the resulting renal infarction was estimated less than 5% of the renal volume. No other procedure-related complications occurred. Conclusion: The MVP is a safe and effective device allowing superselective renal artery embolization. Therefore, we recommend the MVP as a valuable embolic in superselective renal artery embolization. Additionally, a single device is sufficient in most cases, potentially reducing the cost, duration, and radiation exposure of the procedure.

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