Traditional Educational Posters and 20 Educational e-Posters Chosen by SIR19 the Annual Scientific Meeting Committee In advance of the upcoming annual meeting of the Society of Interventional Radiology in Austin, Texas, the program committee wishes to highlight the traditional educational posters and educational exhibit e-posters that will be presented. The posters were chosen using blinded review. Authors are congratulated for their contributions. Nadine Abi-Jaoudeh, MD, FSIR Chair, 2019 Annual Meeting Scientific Program NOTE ON ABSTRACTS ORDER Please note that abstracts Nos. 645 and 669 have been relocated to the Educational e-Poster section because of a late change in their presentation format from traditional poster to e-poster. Traditional Educational Posters Abstract No. 623 year, are present in pre-menopausal or pregnant women, cirrhosis, liver transplantation, or if the patient is symptomatic. All pseudoan- Case-based review of splenic artery aneurysms and eurysms are treated regardless of size as they carry a higher risk of pseudoaneurysms rupture than true aneurysms. Endovascular management has largely A Mohla1, R Gattu1, O Awan2, Y Awan1 replaced surgical options. 1St Agnes Medical Center, Baltimore, MD, 2University of Maryland Treatment options include stenting, to preserve blood flow, or embo- Medical Center, Baltimore, MD lization. Embolization agents include coils, particles, and Gelfoam. Readers will gain a better understanding on the technical aspects of LEARNING OBJECTIVES: The purpose of this educational exhibit is the procedure, the choice of complete embolization or stenting, as well to review the etiology, pathophysiology, clinical presentation, and as proximal versus distal interventions. Complications and regular fol- treatment options available for splenic artery aneurysms (SAA) and low-up requirements will also be discussed. pseudoaneurysms (SAP). We use a case-based analysis of a patient presenting with a splenic artery pseudoaneurysm rupture to demon- CONCLUSIONS: Splenic artery aneurysms and pseudoaneurysms are strate the typical workup, radiographic findings, and endovascular rare but potentially life-threatening conditions that require prompt treatment options available. recognition and treatment. Interventional radiologists play a crucial role in the diagnosis, treatment, and clinical management of patients BACKGROUND: Splenic artery aneurysms and pseudoaneurysms are presenting with SAAs and SAPs. rare, yet potentially life-threatening entities that can carry a mortal- ity rate of 75% when ruptured. SAPs are particularly uncommon with less than 200 cases described in the literature. Their presentation can Abstract No. 624 range from asymptomatic incidental findings to severe hemodynamic instability. Most SAPs occur due to acute or chronic pancreatitis; how- Diagnosis and endovascular techniques used in the repair ever, they are also seen secondary to blunt abdominal trauma, peptic of type I, II, and III endoleaks ulcer disease, and iatrogenic causes. S Raza1, D Putterman1, C Greben1, E Gandras1, S Raza1 CLINICAL FINDINGS/PROCEDURE DETAILS: Incidental SAAs < 2cm in 1North Shore University Hospital, Northwell Health, Manhasset, NY size do not require treatment and may be followed yearly. Treatment is indicated if aneurysms measure > 2cm, increase more than 0.5cm/ LEARNING OBJECTIVES: 1. Pictorial, case-based discussion of Type I, II and III endoleaks that were treated by interventional radiologists at our 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, 2019. *An underline under an author’s name designates the abstract presenter. † N/A in the author affiliation area indicates that no affiliation was available at press time. In some abstracts, the authors’ names and affiliations are duplicated due to inconsistent affiliation listings by authors with the same affiliation. ©SIR, 2019 SIR 2019 Annual Scientific Meeting | 1 2 | Traditional Educational Posters SIR 2019 Annual Scientific Meeting institution. 2. Discuss the clinical presentation, criteria for intervention, or webs of pulmonary vessels leading to chronic pulmonary hyperten- key imaging findings and specific repair techniques of each type of sion and right-sided heart failure. endoleak. CLINICAL FINDINGS/PROCEDURE DETAILS: Catheter-based pulmo- BACKGROUND: Endoleak, or persistent blood flow in the aneurysm nary angiography remains the gold standard for defining the extent sac outside of the endograft, is a commonly encountered challenge of CTEPH and associated hemodynamic changes to right heart. Com- after aortic aneurysm repair. There are five types of endoleaks. Type I puted tomography pulmonary angiogram (CTPA), ventilation/per- endoleaks result from failure of the stent graft to achieve a circumfer- fusion pulmonary scintigraphy (V/Q scan), dual-energy computed ential seal at the proximal (IA) or distal (IB) attachment sites. Type II tomography (DECT) and cardiac magnetic resonance imaging (MRI) endoleaks are the most common type and result from retrograde fill- provide non-invasive assessment of location, extent, and functional ing of the aneurysm sac from feeding vessels. Type III endoleaks result effects of pulmonary arterial stenosis, webs, and occlusion and help from endograft device defect including junctional leak or separation determine who would benefit from surgical or endovascular inter- of graft components. Type IV endoleaks result from graft porosity and vention. Pulmonary endarterectomy is the definitive curative therapy. Type V endoleaks refer to an enlarging aneurysm sac in the absence Some patients are poor surgical candidates due to underlying comor- of an identifiable endoleak. Interventional radiology plays a vital role bidities or distal thrombus location. Balloon pulmonary angioplasty in treating Type I, II and III endoleaks, whereas Type IV endoleaks are (BPA) has been shown to lower pulmonary vascular resistance and usually self limited and Type V endoleaks are treated with open surgi- improve right ventricular dysfunction in patients with inoperable or cal repair. refractory disease. Readers will be shown examples of BPA cases fol- lowed by a discussion of technical considerations and post-procedure CLINICAL FINDINGS/PROCEDURE DETAILS: We present five cases of evaluation. Type IA/IB endoleak, eight cases of Type II endoleak showcasing both common and uncommon arterial feeding vessels, and two cases of CONCLUSIONS: Imaging plays a crucial role in the management of Type III endoleak. Type I and III endoleaks are uncommon and treated CTEPH, from initial work-up to treatment referral and monitoring. Bal- emergently due to a high risk of aneurysm sac rupture. Type I endoleaks loon pulmonary angioplasty is an emerging and promising treatment were treated in various ways including coil or n-butyl cyanoacrylate and should be considered part of the interventional radiology domain. (n-BCA) embolization and graft extension. Type III endoleaks were treated with deployment of a new stent graft over the defective area. Type II endoleaks were treated via direct embolization of the aneurys- Abstract No. 626 mal sac and feeding vessel with microcoils, n-BCA and Avitene. Percutaneous atherectomy in peripheral arterial disease: CONCLUSIONS: Endoleaks are a frequently encountered complication current devices, indications, outcomes, and tips and tricks after aortic aneurysm repair, with interventional radiology playing a for a successful outcome critical role in patient management and treatment. Understanding R Norby1, D Sheeran2 the imaging findings, complications and technical aspects of treating 1 2 endoleaks will help guide effective treatment and clinical success. University of Virginia, Charlottesville, VA, University of Virginia Health System, Charlottesville, VA Abstract No. 625 LEARNING OBJECTIVES: To review current types of atherectomy devices, their indications, outcomes, limitations, complications, and Interventional radiology in the management of chronic various techniques for optimal results. thromboembolic pulmonary hypertension BACKGROUND: Peripheral arterial disease (PAD) is associated with A Patel1, M Toliyat2, P Sutphin3, S Kalva2 significant morbidity and mortality, with increasing prevalence world- wide. Traditionally, endovascular revascularization in PAD has been 1University of Texas Southwestern, Dallas, TX, 2University of Texas performed with balloon angioplasty and/or stenting. Percutaneous Southwestern Medical Center, Dallas, TX, 3UT Southwestern Medical atherectomy offers interventionalists a minimally invasive option to Center, Dallas, TX remove atheroma and debulk both de novo and restenotic lesions. LEARNING OBJECTIVES: 1. Understand the critical role of various imag- CLINICAL FINDINGS/PROCEDURE DETAILS: