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Fuentes-Perez A, Bush RL, Kalra M, Shortell C, Gloviczki P, Brigham TJ, Li Y, Erben Y. Systematic review of endovascular versus laparoscopic extravascular stenting for treatment of nutcracker syndrome. J Vasc Surg Venous Lymphat Disord 2023; 11:433-441. [PMID: 36404475 DOI: 10.1016/j.jvsv.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of the present study was to assess the current strategies of endovascular and laparoscopic extravascular stenting for symptomatic compression of the left renal vein (LRV), most frequently between the aorta and superior mesenteric artery (nutcracker syndrome [NCS]). METHODS We performed a systematic review of all studies of endovascular and laparoscopic extravascular LRV stenting for NCS using the PubMed/MEDLINE, Scopus, Embase, Cochrane, Science Citation Index Expanded, Emerging Sources Citation Index, and Epistemonikos databases. Data were collected in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analysis) guidelines. The English, Spanish, and German language literature was searched from January 1, 1946 to February 9, 2022. The outcomes assessed included symptom resolution, hematuria resolution, and reintervention at follow-up. RESULTS The search yielded 3498 reports. After removing the duplicates and those without the full text available, 1724 studies were screened. Of these, 11 studies were included in the present review. Of the 11 studies, 7 were on endovascular stenting and 4 on laparoscopic extravascular stenting; all 11 studies were retrospective, single-center case series. Of the 233 patients, 170 (80 women) had undergone endovascular stenting and 63 (9 women) had undergone extravascular stenting. The follow-up period varied from 1 to 60 months after endovascular stenting and 3 to 55 months after extravascular stenting. The symptoms had resolved in 76% (range, 50%-100%) after endovascular stenting and 83% (range, 71%-100%) after extravascular stenting. Hematuria had resolved in 86% (range, 60%-100%) after endovascular stenting and 89% (range, 77%-100%) after extravascular stenting. Of 185 patients, 9 had required reintervention after endovascular stenting and none after extravascular stenting. CONCLUSIONS Endovascular and laparoscopic extravascular stenting are less invasive and, thus, more attractive treatment options that have been more recently developed for the management of NCS. The results from the present study have shown that symptom and hematuria resolution must be provided before they can be considered preferred management options for patients affected by NCS. Given the limited number of patients involved, no definitive conclusion could be drawn regarding the superiority of one technique compared with the other.
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Affiliation(s)
- Ana Fuentes-Perez
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL
| | - Ruth L Bush
- John Sealy School of Medicine -UTMB, Galveston, TX
| | - Manju Kalra
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN
| | - Cynthia Shortell
- Department of Surgery, Duke University Medical Center, Durham, NC
| | - Peter Gloviczki
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN
| | | | - Yupeng Li
- Department of Political Science and Economics, Rowan University, Glassboro, NJ
| | - Young Erben
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL.
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Woods MA, Knavel Koepsel EM, Swietlik JF, Shin DS, Chick JFB, Weaver JJ, Watts MM, Laeseke P, Kleedehn MG, Monroe EJ. Intravascular US: Applications in Interventional Radiology. Radiographics 2022; 42:1742-1757. [PMID: 36190846 DOI: 10.1148/rg.220015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Interventional radiology applications of intravascular US (IVUS) continue to expand, complementing intraprocedural angiography and providing a unique vantage from which to guide endovascular interventions. Vascular pathologic conditions become sonographically visualized rather than inferred from the planar appearance of the opacified vascular lumen. Perivascular targets become sonographically visualized rather than approximated on the basis of fluoroscopic landmarks. The authors introduce broad categories of IVUS catheters, namely radial and side-firing varieties, as well as prevailing options for each and their technical specifications. Common applications within interventional radiology are covered in a systems approach, including deep venous thrombosis, May-Thurner syndrome, nutcracker syndrome, transjugular intrahepatic portosystemic shunts, aortic interventions, peripheral arterial disease, and endovascular or perivascular biopsy. Discussions are accompanied by technical pearls from the authors, and summarized evidence where IVUS has been shown to reduce procedural time, intravascular contrast agent dose, radiation exposure, and morbidity in each space is presented. Finally, emerging applications and future directions are discussed. ©RSNA, 2022.
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Affiliation(s)
- Michael A Woods
- From the Department of Radiology, Section of Vascular and Interventional Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792 (M.A.W., E.M.K.K., J.F.S., P.L., M.G.K., E.J.M.); Department of Radiology, Section of Vascular and Interventional Radiology (D.S.S., J.F.B.C., J.J.W.), and Deep Vein Institute (D.S.S., J.F.B.C.), University of Washington, Seattle, Wash; and Atlantic Medical Imaging Vascular Institute, Vineland, NJ (M.M.W.)
| | - Erica M Knavel Koepsel
- From the Department of Radiology, Section of Vascular and Interventional Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792 (M.A.W., E.M.K.K., J.F.S., P.L., M.G.K., E.J.M.); Department of Radiology, Section of Vascular and Interventional Radiology (D.S.S., J.F.B.C., J.J.W.), and Deep Vein Institute (D.S.S., J.F.B.C.), University of Washington, Seattle, Wash; and Atlantic Medical Imaging Vascular Institute, Vineland, NJ (M.M.W.)
| | - John F Swietlik
- From the Department of Radiology, Section of Vascular and Interventional Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792 (M.A.W., E.M.K.K., J.F.S., P.L., M.G.K., E.J.M.); Department of Radiology, Section of Vascular and Interventional Radiology (D.S.S., J.F.B.C., J.J.W.), and Deep Vein Institute (D.S.S., J.F.B.C.), University of Washington, Seattle, Wash; and Atlantic Medical Imaging Vascular Institute, Vineland, NJ (M.M.W.)
| | - David S Shin
- From the Department of Radiology, Section of Vascular and Interventional Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792 (M.A.W., E.M.K.K., J.F.S., P.L., M.G.K., E.J.M.); Department of Radiology, Section of Vascular and Interventional Radiology (D.S.S., J.F.B.C., J.J.W.), and Deep Vein Institute (D.S.S., J.F.B.C.), University of Washington, Seattle, Wash; and Atlantic Medical Imaging Vascular Institute, Vineland, NJ (M.M.W.)
| | - Jeffrey Forris Beecham Chick
- From the Department of Radiology, Section of Vascular and Interventional Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792 (M.A.W., E.M.K.K., J.F.S., P.L., M.G.K., E.J.M.); Department of Radiology, Section of Vascular and Interventional Radiology (D.S.S., J.F.B.C., J.J.W.), and Deep Vein Institute (D.S.S., J.F.B.C.), University of Washington, Seattle, Wash; and Atlantic Medical Imaging Vascular Institute, Vineland, NJ (M.M.W.)
| | - John J Weaver
- From the Department of Radiology, Section of Vascular and Interventional Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792 (M.A.W., E.M.K.K., J.F.S., P.L., M.G.K., E.J.M.); Department of Radiology, Section of Vascular and Interventional Radiology (D.S.S., J.F.B.C., J.J.W.), and Deep Vein Institute (D.S.S., J.F.B.C.), University of Washington, Seattle, Wash; and Atlantic Medical Imaging Vascular Institute, Vineland, NJ (M.M.W.)
| | - Micah M Watts
- From the Department of Radiology, Section of Vascular and Interventional Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792 (M.A.W., E.M.K.K., J.F.S., P.L., M.G.K., E.J.M.); Department of Radiology, Section of Vascular and Interventional Radiology (D.S.S., J.F.B.C., J.J.W.), and Deep Vein Institute (D.S.S., J.F.B.C.), University of Washington, Seattle, Wash; and Atlantic Medical Imaging Vascular Institute, Vineland, NJ (M.M.W.)
| | - Paul Laeseke
- From the Department of Radiology, Section of Vascular and Interventional Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792 (M.A.W., E.M.K.K., J.F.S., P.L., M.G.K., E.J.M.); Department of Radiology, Section of Vascular and Interventional Radiology (D.S.S., J.F.B.C., J.J.W.), and Deep Vein Institute (D.S.S., J.F.B.C.), University of Washington, Seattle, Wash; and Atlantic Medical Imaging Vascular Institute, Vineland, NJ (M.M.W.)
| | - Mark G Kleedehn
- From the Department of Radiology, Section of Vascular and Interventional Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792 (M.A.W., E.M.K.K., J.F.S., P.L., M.G.K., E.J.M.); Department of Radiology, Section of Vascular and Interventional Radiology (D.S.S., J.F.B.C., J.J.W.), and Deep Vein Institute (D.S.S., J.F.B.C.), University of Washington, Seattle, Wash; and Atlantic Medical Imaging Vascular Institute, Vineland, NJ (M.M.W.)
| | - Eric J Monroe
- From the Department of Radiology, Section of Vascular and Interventional Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792 (M.A.W., E.M.K.K., J.F.S., P.L., M.G.K., E.J.M.); Department of Radiology, Section of Vascular and Interventional Radiology (D.S.S., J.F.B.C., J.J.W.), and Deep Vein Institute (D.S.S., J.F.B.C.), University of Washington, Seattle, Wash; and Atlantic Medical Imaging Vascular Institute, Vineland, NJ (M.M.W.)
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Weaver JJ, Shin DS, Chick JFB, Monroe EJ. Intravascular ultrasound for endovascular precision in pediatrics. Pediatr Radiol 2022; 52:559-569. [PMID: 34716455 DOI: 10.1007/s00247-021-05220-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/30/2021] [Accepted: 10/05/2021] [Indexed: 11/25/2022]
Abstract
Intravascular ultrasound (IVUS) is used as a diagnostic adjunct to angiography and has become a valuable diagnostic and interventional tool with a well-documented safety profile. The American College of Cardiology and the European Society of Cardiology have published guidelines regarding the use of IVUS in the setting of percutaneous coronary intervention. IVUS has gained popularity in the interventional radiology (IR) community in recent years; however, there are no consensus guidelines for utilization. Furthermore, IVUS remains an infrequently used modality in pediatric IR, likely because of unfamiliarity with the equipment and techniques, as well as concerns over the compatibility of these instruments with pediatric anatomy. IVUS can be safely used as a helpful and sometimes necessary tool for pediatric interventions in appropriately selected patients. The utility of IVUS for reducing both fluoroscopy time and contrast agent volume makes it particularly valuable in pediatric practice. This article presents an overview of both the rotational and phased-array IVUS types and an in-depth discussion on the most common applications of these techniques in the pediatric setting across multiple procedure categories.
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Affiliation(s)
- John J Weaver
- Section of Vascular and Interventional Radiology, Department of Radiology, University of Washington, Seattle, WA, USA
| | - David S Shin
- Section of Vascular and Interventional Radiology, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Jeffrey Forris Beecham Chick
- Section of Vascular and Interventional Radiology, Department of Radiology, University of Washington, Seattle, WA, USA
- Section of Vascular and Interventional Radiology, Department of Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Eric J Monroe
- Section of Vascular and Interventional Radiology, Department of Radiology, American Family Children's Hospital, 1675 Highland Ave., Madison, WI, 53792, USA.
- Section of Vascular and Interventional Radiology, Department of Radiology, University of Wisconsin, Madison, WI, USA.
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