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Educational Exhibit Traditional Posters and E-Posters Chosen By Educational Exhibit Traditional Posters and e-Posters Chosen by the Annual Scientific Meeting Committee In advance of the upcoming annual meeting of the Society of Interventional Radiology in Seattle, the program committee wishes to highlight the scientific abstracts that will be presented. Abstracts were chosen using blinded review. Authors are congratulated for their contributions. Baljendra Kapoor, MD, FSIR Chair, 2020 Annual Meeting Scientific Program Traditional Posters Abstract No. 734 by interventional radiology (IR) with PTA, stent placement across the celiac axis, SMA and IMA. Recurrent stenosis necessitated use of Diagnosis and endovascular techniques used in the a drug-eluting balloon in one patient. We present 3 cases of brachial treatment of chronic mesenteric ischemia artery access, 1 of radial artery access, 3 with CFA access and 1 cases of S Raza1, E Gandras2, J Weinstein2, C Greben2, M Farooq2 AVG access. These cases highlight the different angiographic appear- ances of CMI, technical challenges and mesenteric vessel imaging 1Northwell Health, North Shore University Hospital, Manhasset, characteristics favoring upper versus lower extremity arterial access. NY, 2North Shore University Hospital-Manhasset, Manhasset, NY CONCLUSION AND/OR TEACHING POINTS: CMI is an important clinical LEARNING OBJECTIVES: 1. Pictorial, case-based discussion of chronic entity with IR playing a critical role in patient management and treat- mesenteric ischemia (CMI) including a review of the clinical presen- ment. Understanding the imaging findings, complications and tech- tation, criteria for intervention and key imaging findings. 2. Discuss nical aspects of treating CMI will help guide effective treatment and revascularization techniques and devices including stents, percuta- clinical success. neous angioplasty (PTA), drug-eluting balloons and how to measure and analyze endoluminal pressures. 3. Anatomical and patient con- siderations when determining if upper versus lower extremity arte- Abstract No. 735 rial access is appropriate. Arterial access sites reviewed include radial artery, brachial artery, common femoral artery and upper extremity “Putting the best foot forward”: utilization of dorsalis arteriovenous graft. pedis artery access for geniculate artery embolization 1 2 3 4 BACKGROUND: CMI most commonly results from occlusive atheroscle- J Meshekow , O Furusato Hunt , P Gerard , S McCabe , S rotic disease involving the proximal ostia of at least two of the three Maddineni5, G Rozenblit6 major mesenteric arteries: celiac axis, superior mesenteric artery 1Westchester Medical Center / New York Medical College, Beacon, (SMA), and inferior mesenteric artery (IMA). Other less common NY, 2Westchester Medical Center, Hartsdale, NY, 3New York Medical causes of CMI include compression by tumor, dissection and fibro- College- Westchester Medical Center, Valhalla, NY, 4Westchester muscular dysplasia. Typical clinical symptoms include postprandial Medical Center, Katonah, NY, 5Westchester Medical Center, abdominal pain, weight loss and aversion to food. Diagnosis can be Chappaqua, NY, 6Westchester Medical Center, Eastchester, NY made by CT angiography, conventional angiography, MRA or duplex LEARNING OBJECTIVES: 1. Provide a current overview of the therapeu- ultrasound. Endovascular treatment consists of revascularization with tic role of geniculate artery embolization in the treatment of osteo- angioplasty and stent placement with literature supporting high long- arthritic knee pain. 2. Demonstrate the utility of dorsalis pedis artery term patency rates and low morbidity. access for unfavorable geniculate artery anatomy encountered with CLINICAL FINDINGS/PROCEDURE DETAILS: We present 8 selected antegrade femoral artery access. cases of CMI secondary to multivessel atherosclerotic disease treated SIR assumes no legal liability or responsibility for the completeness, accuracy and correctness of the information presented in the abstracts. Abstracts are published in the Annual Meeting Supplement to the Journal of Vascular and Interventional Radiology as submitted by the authors, except for minor stylistic adjustments to ensure consistency of format and adherence to Supplement style. Dosages, indications and methods of use for products that are referred to in the supplement by the authors may reflect their clinical experience or may be derived from the professional literature or other clinical sources. Because of the differences between in vitro and in vivo systems and between laboratory animal models and clinical data in humans, in vitro and animal data may not necessarily correlate with clinical results. Content current as of January 12, 2020. *An underline under an author’s name designates the abstract presenter. ©SIR, 2020 SIR 2020 Annual Scientific Meeting | 1 2 | Traditional Posters SIR 2020 Annual Scientific Meeting BACKGROUND: Osteoarthritis is the most prevalent degenerative perspective, the procedure is not as widely performed as one would joint disease and causes chronic disability in older adults. The patho- imagine. Understanding urologic work up including questionnaires, physiology is thought to consist of chronic inflammatory synovitis urodynamic flow studies and PVRs can help an interventional radiolo- with associated upregulation of angiogenesis promoting cytokines, gist distinguish good candidates from bad. To evaluate for candidacy, which ultimately leads to cartilage and bone destruction. Additionally, an interventional radiologist must thoroughly understand lower uri- recruitment of unmyelinated sensory nerves in these areas may con- nary tract symptoms (LUTS) in the setting of BPH/O as these guide tribute to regional pain. It has been postulated that embolization of management from conservative treatment to surgery. Maintaining a these abnormal neovessels disrupts inflammatory and pain-mediating relationship with the urologists remains important; however, an inter- pathways, thereby relieving symptoms. Geniculate artery embolization ventional radiologist who is capable of producing and interpreting has been demonstrated to be an effective treatment for mild to moder- urologic tests allows greater opportunity to find appropriate candi- ate osteoarthritis refractory to conservative treatment. Improvement dates. This exhibit highlights the urologic workup required to evaluate in knee pain and function has been shown up to 4 years after treatment patients appropriately as well as elucidates the ease of interpreting without significant complications. Traditionally, access for geniculate studies to find suitable candidates for PAE. artery embolization is achieved in antegrade fashion by means of the CONCLUSION AND/OR TEACHING POINTS: 1. Lower urinary tract symp- ipsilateral or contralateral femoral artery. However, normal variations toms (LUTS) can occur in the setting of BPH/O and guide manage- in geniculate artery anatomy (hairpin orientation of geniculate artery ment. 2. Worsened LUTS after conservative management gives rise to branches arising from the popliteal) may prohibit cannulation of the the need for further work up. 3. Further work up includes the Interna- target vessel from above. We present such a case as well as our experi- tional Prostate Symptom Score (IPSS), International Index of Erectile ence in providing successful treatment by means of retrograde access Function (IIEF) Questionnaire and Sexual Health Inventory For Men via the dorsalis pedis artery. (SHIM). 4. Pending on the IPSS Score, patient may or may not be a can- CLINICAL FINDINGS/PROCEDURE DETAILS: A. General Overview of didate for PAE. 5. Other urologic testing includes Urinalysis, PSA level, Traditional Geniculate Artery Embolization Techniques B. Overview postvoid residual test (PVR), DRE and Urodynamic testing (Qmax). 6. of Transpedal Access: i. Patient Selection. ii. Preprocedure workup iii. Understanding/interpreting the urologic work up gives an interven- Equipment and Devices iv. Access and Technique v. Pre- and Postpro- tional radiologist appropriate tools to evaluate for PAE. cedural “Dorsalis Pedis Cocktail” vi. Arterial Closure vii. Postprocedural care and follow-up. Abstract No. 737 CONCLUSION AND/OR TEACHING POINTS: For geniculate artery embo- lization, retrograde accesses via the dorsalis pedis artery is an effec- Hemorrhoidal artery embolization: a new frontier in tive salvage technique for patients with unfavorable geniculate artery hemorrhoid disease management anatomy. T Garg1, L Cusumano2, L Stevens3, M Naveed4 1Seth GS Medical College & KEM Hospital, Mumbai, Abstract No. 736 Maharashtra, 2UCLA Medical Center, Los Angeles, CA, 3The University of Texas at Austin Dell Medical School, Austin, An overview of interpreting urologic testing for prostate TX, 4Einstein Medical Center, Philadelphia, PA artery embolization candidacy LEARNING OBJECTIVES: 1. To learn about the clinical features, diag- 1 1 1 1 1 S Patel , M Swikehardt , H Brent , D Cohen-Addad , S Fahrtash , I nostic evaluation and treatment modalities available for hemorrhoids. 1 1 Provancha , W Kwon 2. To review the arterial anatomy of the superior rectal artery and its 1SUNY Downstate Medical Center, Brooklyn, NY anatomical variants 3. To learn about the procedure of hemorrhoidal artery embolization. LEARNING OBJECTIVES: 1. Overview of urologic testing in the setting of BPH/O. 2. Interpreting urologic testing. 3. Implications of urologic BACKGROUND: Hemorrhoidal disease affects 5% to 40% of people testing for PAE candidacy. 4. Pearls and pitfalls for Prostate artery
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