Pulmonary embolism (PE) is a feared complication of deep venous thrombosis (DVT) that can lead to respiratory distress and even death. The mainstay of preventing PE is anticoagulation, but other strategies exist. Inferior vena cava (IVC) filters are an alternative strategy for PE prophylaxis in individuals who may have contraindications to receiving anticoagulation. Although the placement of an IVC filter is a minimally invasive and typically uncomplicated procedure, all procedures have their risks. We present a case of a 35-year-old woman who experienced a rare complication of IVC filter placement and suffered a retroperitoneal hemorrhage. The patient underwent placement of an IVC filter for PE prophylaxis before a scheduled sleeve gastrectomy. Hours after placement, she returned with new symptoms and signs of blood loss. She was found to have a retroperitoneal hematoma due to bleeding from a lumbar artery that was penetrated by a strut of the filter. Arterial hemorrhage from a lumbar artery is a rare complication of IVC filter placement, and it can result in poor outcomes for the patient. We aim to increase awareness of this rare but dangerous complication to improve recognition and patient outcomes in cases of delayed arterial hemorrhage following IVC filter placement.

Uterine fibroid, widely known as leiomyoma, is one of the most common benign tumours of the female reproductive system. It is not uncommon for pregnancies to be complicated by uterine fibroids. Most commonly, the first line of large uterine fibroids management in pregnancy is conservative, with myomectomy counselling after delivery if necessary. In this paper, we present a case of a very high-risk pregnancy, that was managed by delivery via caesarean section at 34 weeks of gestation, which was performed for a patient, with an 18 centimetres (cm) fibroid, first diagnosed during pregnancy. Interventional radiology involvement was critical in this case for minimizing the final blood loss and surgical complications. Bilateral internal iliac artery balloons were used. Maternal and foetal risks, the timing of delivery, and the options for the management of fibroids in pregnancy will be discussed.

Splenic abscess is an uncommon medical condition that presents many diagnostic difficulties. Although rare, this clinical disease can be potentially life-threatening, with a fatality rate exceeding 70% in immunocompromised patients. Clinical manifestations of splenic abscess include fever, tenderness in the upper left region of the abdomen, and leukocytosis with left shift. Performing abdominal ultrasonography (USG) and CT in patients presenting with clinical manifestations enables a prompt and accurate diagnosis. The treatment for splenic abscess includes medical therapy, imaging-guided drainage, and splenectomy. We discuss the case of a 60-year-old female patient who presented to our emergency department with a large splenic abscess; she was managed with an ultrasound-guided drainage catheter, which led to the successful resolution of the condition. She did not experience any recurrence during six years of follow-up. This case report aims to highlight the role of interventional radiology in managing splenic abscesses.

Craniofacial pain syndromes exhibit a high prevalence in the general population, with a subset of patients developing chronic pain that significantly impacts their quality of life and results in substantial disabilities. Anatomical and functional assessments of the greater occipital nerve (GON) have unveiled its implication in numerous craniofacial pain syndromes, notably through the trigeminal-cervical convergence complex. The pathophysiological involvement of the greater occipital nerve in craniofacial pain syndromes, coupled with its accessibility, designates it as the primary target for various interventional procedures in managing craniofacial pain syndromes. This educational review aims to describe multiple craniofacial pain syndromes, elucidate the role of GON in their pathophysiology, detail the relevant anatomy of the greater occipital nerve (including specific intervention sites), highlight the role of imaging in diagnosing craniofacial pain syndromes, and discuss various interventional procedures such as nerve infiltration, ablation, neuromodulation techniques, and surgeries. Imaging is essential in managing these patients, whether for diagnostic or therapeutic purposes. The utilization of image guidance has demonstrated an enhancement in reproducibility, as well as technical and clinical outcomes of interventional procedures. Studies have shown that interventional management of craniofacial pain is effective in treating occipital neuralgia, cervicogenic headaches, cluster headaches, trigeminal neuralgia, and chronic migraines, with a reported efficacy of 60-90% over a duration of 1-9 months. Repeated infiltrations, neuromodulation, or ablation may prove effective in selected cases. Therefore, reassessment of treatment response and efficacy during follow-up is imperative to guide further management and explore alternative treatment options. Optimal utilization of imaging, interventional techniques, and a multidisciplinary team, including radiologists, will ensure maximum benefit for these patients.

UNASSIGNED: Streptococcus constellatus rarely causes pyopneumothorax, which is a serious state and requires a surgery. However, not every patient can tolerate surgery and individualized solutions are needed. Furthermore, many known situations are risk factors of S. constellatus infection, but S. constellatus pyopneumothorax associated with Hashimoto\'s thyroiditis has not been reported.
UNASSIGNED: We present the case of a 74-year-old male with multiple encapsulated pyopneumothorax caused by S. constellatus. Given his respiratory failure, we provided two-stage percutaneous right empyema radiography for catheter drainage in the radiology interventional department instead of surgery. Moreover, an occult Hashimoto\'s thyroiditis was discovered in the patient, which was possibly associated with S. constellatus pyopneumothorax. Levothyroxine was administered to improve his situation.
UNASSIGNED: To our knowledge, it is the first case described in this context. We provided an alternative treatment for S. constellatus encapsulated pyopneumothorax in patient who might not tolerate surgery. We also revealed the possible relationship between S. constellatus pyopneumothorax and Hashimoto\'s thyroiditis.

A novel telescopic access sheath technique has been described to maintain access to the ureter in cases of stent encrustation, placing a suture on the externalised distal end of the stent followed by advancing a sheath over to peel off encrustations and maintain access in the ureter, as well as application of this technique in a child. Herein we present a modification of the telescopic sheath technique that allows exchange of luminally encrusted stents without requiring passage of the sheath into the ureter or ureteroscopy alongside the stent.

Pre-surgical lymph node marking is an established medical procedure of vital importance in the treatment of cancer patients.
A 60-year-old man with a history of prostatic adenocarcinoma in a plan for resection of hypogastric adenopathy. Image guided pre-surgical marking was indicated.
Preoperative marking was performed with local anesthesia under computed tomography with transosseous access and hydrodissection.
We present a technique that has been little studied and rarely reported in the international literature for the surgical identification of deep pelvic adenopathy.
La marcación pre quirúrgica de ganglios es un procedimiento médico establecido y de vital importancia en el tratamiento de pacientes oncológicos.
Hombre de 60 años con antecedentes de adenocarcinoma prostático en plan de resección de adenopatía hipogástrica. Se indicó marcación prequirúrgica mediante guía imagenológica.
Se realizó marcación prequirúrgica con anestesia local bajo tomografía computada con acceso transóseo e hidrodisección.
presentamos una técnica poco estudiada y escasamente reportada en la bibliografía internacional para la identificación quirúrgica de una adenopatía pélvica profunda.

Middle meningeal arteriovenous fistula (MMAVF) is a shunt between the middle meningeal artery and the vein surrounding the artery. We report an extremely rare case of spontaneous MMAVF; then, we evaluated the effectiveness of trans-arterial embolization for spontaneous MMAVF and the possible cause of spontaneous MMAVF. A 42-year-old man with tinnitus, a left temporal headache, and pain surrounding the left mandibular joint was diagnosed with MMAVF on digital subtraction angiography. Trans-arterial embolization with detachable coils was conducted, which resulted in a fistula closure and symptoms\' diminishment. The cause of MMAVF was thought to be the rupture of the middle meningeal artery aneurysm. A middle meningeal artery aneurysm can be a cause of spontaneous MMAVF, and trans-arterial embolization might be an optimal treatment.

UNASSIGNED: Acute pancreatitis is one of the most common gastrointestinal diseases. Approximately 20% of the patients develop peripancreatic collections. Step-up management it\'s now the best approach with less rate of morbidity and mortality compared with open or minimally invasive surgery. Percutaneous management could reach a success rate between 50 and 76%. Our study shows the outcomes of trans-gastric versus transabdominal percutaneous drainage in cases of acute peripancreatic fluid infected collections in the absence of interventionist endoscopy.
UNASSIGNED: A retrospective review of a prospectively collected database was conducted. All the patients older than 18 years old that underwent percutaneous drainage between January 2010-December 2021 were included. Analysis and description of outcomes such as mortality, complications, and avoidance of surgical procedures was performed.
UNASSIGNED: 18 patients underwent percutaneous drainage. 66.67% of patients were male. Mean age was 52.55 ± 22.06 years. Mean weight was 74.43 ± 15.25 kg. Mean size of peripancreatic collections 118.4 ± 49.12 mm. Wall-off necrosis was present in 33.33%. Trans-gastric approach was performed in 50% of the cases, the rest was trans-abdominal. No mortality was evidenced after 30 days of follow up. After trans-gastric percutaneous drainage, all patients avoided surgical open or laparoscopic procedure.
UNASSIGNED: Standardized step-up approach shows increased rates of success in percutaneous drainage of peripancreatic collections. Our case series shows a high rate of success in terms of avoidance any surgical procedure with no mortality after trans-abdominal and trans-gastric percutaneous drainage. Nevertheless, further prospective studies with higher sample size are needed.

OBJECTIVE: To investigate clinical outcomes of percutaneous transhepatic treatment for biliary stricture after duct-to-duct biliary anastomosis in living donor liver transplantation (LDLT).
METHODS: This retrospective study examined baseline characteristics, procedural details, clinical outcomes, drainage catheter removal rate within 8 months, and recurrence after catheter removal using patients\' medical records and images. Risk factors for failure of drainage catheter removal within 8 months and recurrence of biliary stricture after drainage catheter removal were assessed via univariable and multivariable analyses.
RESULTS: A total of 112 patients (53.4 ± 8.79 years, 91 men) were evaluated. Multiple drainage catheters were placed in 75 patients (70.0%). Drainage catheters were successfully removed in 107 patients (95.5%). Failure of drainage catheter removal within 8 months was associated with hepatic artery complications (p = 0.034) and strictures requiring alternative passage techniques (p = 0.034). The cumulative primary patency rates after drainage catheter removal at 1, 2, 3, and 5 years were 85.4%, 79.8%, 75.8%, and 68.4%, respectively. Recurrence of biliary stricture was associated with the presence of an untreated isolated sectoral duct (aHR, 3.632; 95% CI, 1.086-12.150, p = 0.037) and with concurrent bile leaks (aHR, 2.475; 95% CI, 1.090-5.621, p = 0.031).
CONCLUSIONS: Percutaneous transhepatic treatment was effective for the treatment of biliary strictures after duct-to-duct biliary anastomosis in LDLT. Multiple drainage catheter maintenance was needed because multiple strictures often occurred in these patients.
CONCLUSIONS: • Percutaneous transhepatic treatments are useful and effective for the treatment of biliary stricture after duct-to-duct biliary anastomosis in living donor liver transplantation (LDLT), although an endoscopic approach is available for this type of reconstruction. • Multiple drainage catheters were frequently placed in these patients because of multiple complex strictures. • We found that recurrence after drainage catheter removal was associated with isolation of the sectoral duct and with concurrent bile leaks.