To assess the feasibility, technical performance, and safety of a novel endovascular electroencephalogram (eEEG) electrode, EP-01, designed for minimally invasive seizure localization in patients with drug-resistant epilepsy. This single-center, prospective, exploratory trial enrolled five patients with drug-resistant epilepsy undergoing the Wada test. The EP-01 electrode, featuring a platinum monopolar tip, was inserted into the venous sinuses using a microcatheter, and simultaneous recording of eEEG and scalp electroencephalography (EEG) signals was conducted. The primary outcome was the feasibility of eEEG signal acquisition, whereas the secondary outcomes included a signal sensitivity comparison between scalp and eEEG recordings, technical success assessment, and safety evaluation. Successful eEEG recording was achieved in all five patients (mean age 34.2 years, 2 women) experiencing focal impaired awareness seizures. The EP-01 electrode successfully captured EEG signals, detecting 158 interictal epileptiform discharges (IEDs). eEEG demonstrated significantly higher amplitudes (median: 130.4 μV) compared with scalp EEG (median: 0 μV), with 57.0% of IEDs undetectable by scalp EEG (p < 0.001). EEG changes during eye opening/closing were consistently recorded by eEEG. The technical success rate was 100%, with an average of 4.5 eEEG electrodes placed per patient. The median displacement of electrode tips during neck rotation was 3.45 mm; hemorrhagic or thrombotic complications were absent; and all devices were safely removed. In this short-term study, the EP-01 eEEG device demonstrated high feasibility and safety for minimally invasive EEG acquisition in patients with epilepsy. To the best of our knowledge, this study provides the first evidence of IED detection in multiple patients using an eEEG system tailored for epilepsy monitoring, underscoring EP-01's potential for localizing seizure foci. Moreover, the capability to place multiple electrodes improves its utility in comprehensive epileptogenic mapping. Given the limited recording duration, long-term studies are necessary to validate EP-01's clinical efficacy and safety. This study tested EP-01, a new device that records brain activity from inside the blood vessels, unlike traditional scalp EEG. In five people with epilepsy, the device safely captured stronger seizure-related signals than the traditional EEG. Moreover, the device could be placed and removed without complications. This less invasive method may help doctors more accurately find where seizures begin in the brain.

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is an emerging alternative to percutaneous transhepatic biliary drainage (PTBD) in patients with a malignant biliary obstruction, in case of technical failure of endoscopic retrograde cholangiopancreatography (ERCP). However, this procedure is technically challenging, and dedicated stents have only recently become available. This study prospectively evaluated the safety and feasibility of EUS-HGS with a dedicated stent. This prospective single-center study included patients with inoperable malignant biliary obstruction that underwent an EUS-HGS. The primary outcome was safety. Technical and clinical success were evaluated as secondary endpoints. We used a partially covered self-expandable metal stent (pcSEMS) (30% uncovered and 70% covered) with anti-migration features. EUS-HGS was attempted in 28 patients, achieving technical and clinical success rates of 89% (25/28) and 96% (22/23), respectively. Three patients (11%) experienced grade IIIA adverse events (AEs) (all cholangitis) within 30days: two with undrained right-sided bile ducts requiring percutaneous drainage, and one patient due to blockage of a side branch at the level of the covered part of the stent for which an endoscopic stent exchange was successfully performed. Five patients died < 30days due to disease progression, none of these patients experienced procedure-related AEs. Six out of the 22 patients with clinical success developed recurrent biliary obstruction after a median of 78days (IQR 45-108). Obstruction was caused by hyperplasia at the uncovered portion of the stent (n = 3) and due to sludge obstructing the stent (n = 3). Successful re-intervention was performed in all patients. This prospective study shows that EUS-HGS with a dedicated pcSEMS is feasible and safe. Tissue hyperplasia in the uncovered part of the stent and sludge obstruction may compromise long-term stent patency. Larger, comparative prospective studies are needed to assess optimal stent design and timing of EUS-HGS within the therapeutic algorithm.

Feasibility of the Protrieve Sheath for Embolic Protection During Venous Thrombectomy in Twenty-two Patients.

Salvage of Failing Abdominal Aortic Aneurysm Repairs with Fenestrated Endovascular Aortic Repair.

Standalone short-coil embolization of the middle meningeal artery for subdural hematomas: Efficient, safe, and radiation-sparing.

Single-Stage Endovascular Treatment of Combined Iliac and Infrainguinal Peripheral Arterial Disease Through Brachial Access.

Safety and Efficacy of Spontaneous Carotid Artery Dissection Management with Transfemoral Carotid Artery Stenting and Transcarotid Artery Revascularization: A Multi-Institutional Study.

Comparison of Long-Term Results According to Localization of Stenosis and Occlusion in Patients Undergoing Atherectomy for Infrainguinal Peripheral Arterial Disease.

Perioperative and Mid-term Outcome of Prefabricated Bovine Pericardial Grafts in the Context of Infected Aortic/Iliac Pathologies.

Perioperative and Midterm Outcomes of Branched or Fenestrated Endovascular Aneurysm Repair for Type 1A Endoleak after Endovascular Aneurysm Repair.

Predictors of Hemostasis Failure with Angio-Seal Device in a Real-World Setting for Infrainguinal Revascularization Procedures.

Budd-Chiari syndrome (BCS) results from the obstruction of hepatic venous outflow and can occur anywhere from the level of the small hepatic veins (HVs) to the junction of the inferior vena cava (IVC) and the right atrium. The obstruction of the HVs can be global or segmental. This results in sinusoidal congestion, which leads to portal hypertension and subsequent centrilobular fibrosis, nodular regenerative hyperplasia, and ultimately cirrhosis. Treatment is aimed at restoring HV or IVC outflow by angioplasty, stent placement, or creating a portosystemic shunt, which in turn drastically reduces hepatic sinusoidal pressure. Thus, treatment strategies should be based on detailed knowledge of the underlying causal factors, lesion classification, clinical presentation, and baseline liver function. The BCS classification system is divided into types and subtypes that can guide interventional therapy, with the aim of standardizing the imaging diagnosis and interventional therapy of BCS. Intravascular US (IVUS) aids in BCS lesion characterization as described by the BCS classification system. It can help determine the need for stent placement following angioplasty and is helpful in portosystemic shunt creation. Additionally, IVUS can reduce radiation dose, contrast agent volume, and procedure time and increase the technical success rate of procedures. It is essential for the radiologist to understand the BCS classification system as a useful tool to guide interventional therapy. ©RSNA, 2025 Supplemental material is available for this article.

Transvenous targeted embolization of cavernous sinus dural arteriovenous fistula: A single center experience.

Safety and efficacy of transcatheter aortic valve replacement using Sapien 3 balloon-expandable valve in type 0 bicuspid aortic valve stenosis patients.

Application of three ablative margin assessment techniques for hepatocellular carcinoma in clinical Ppractice: a comparative study.

Objective: To evaluate the clinical as well as technical success of endovascular management in patients of gastrointestinal bleeding. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi, Pakistan, from Feb 2023 to Aug 2023. Methodology: A total of 40 patients were enrolled with gastrointestinal bleeding treated with unsuccessful endoscopic management or in which endoscopic management was not possible. Study data was recorded on a predesigned proforma. This procedure involved the injection of small particles or coils into the blood vessels to block blood flow to the tumor, a minimally invasive alternative to surgery to control bleeding or shrink tumors. Results: Duration between angiography and clinical manifestations was 5.92±1.22 days. The pathological angiography was found in 72.5% of patients and embolization in 92.5% of patients. Total technical success was found in 90.0% and clinical success was found in 87.5%. Further, the re-bleeding was noted among 22.5% of patients. Re-bleeding was higher in those having two or more co morbidities.The overall mortality was 27.5%, higher in re-bleeding patients. Conclusion: Endovascular management is a highly safe and effective treatment option for gastrointestinal bleeding that cannot be treated endoscopically. This method has a high technical success rate and a low level of complications, making it suitable for high-risk patients.

Increased aortic angulation (AA) is anatomically challenging during transcatheter aortic valve implantation (TAVI) and may affect procedural outcomes. This study evaluates the clinical and procedural impact of aortic angulation in contemporary TAVI procedures. This retrospective single-center observational study included 509 consecutive patients undergoing transfemoral TAVI between January 2021 and December 2024. Primary end-point was device success according to VARC-3 criteria. Secondary end-points included technical success, early safety at 30 days, procedural time, fluoroscopy time, contrast volume, paravalvular regurgitation (PVR) and permanent pacemaker implantation (PPI). Multivariable logistic and linear regression models were used to assess the association between aortic angulation (in degrees) and clinical outcomes. ROC and spline regression analyses were used to evaluate potential threshold effects. Device success at discharge was achieved in 89.4% (455/509) of patients, technical success in 96.3% (490/509), and early safety at 30 days in 75.6% (385/509). Aortic angulation did not significantly influence device success (aOR: 0.974, 95% CI: 0.938-1.012, p = 0.175), technical success (aOR 1.034; 95% CI 0.980-1.091; P = 0.22), or early safety (aOR: 0.994, 95% CI: 0.968-1.020, p = 0.633). Similarly, no association was observed between aortic angulation and PPI (aOR 1.016; 95% CI 0.984-1.050; P = 0.34) and PVR. However, aortic angulation significantly correlated with increased fluoroscopy times (coefficient: 0.073, SE: 0.026; P = 0.006) and greater contrast usage (coefficient: 0.406, SE: 0.194; P = 0.037). While higher aortic angulation increased procedural imaging demand, it did not adversely affect device performance or clinical safety outcomes after TAVI. Importantly, outcomes remained consistent across prosthesis types.

Despite technical advancements, various conditions such as bleeding diathesis and altered anatomy challenge the creation of a durable conduit for biliary stone removal in endoscopic retrograde Cholangiopancreatography (ERCP). A fully covered self-expandable metal stent (SEMS) has been used as a robust conduit for drainage in a wide spectrum of pancreatobiliary diseases. However, its primary use for stone removal has not been fully evaluated. This study aimed to evaluate the efficacy and safety of a novel fully covered SEMS that is 3 cm in length and has a wide distal flare as a durable conduit for stone extraction through the papilla. Twenty patients with common bile duct stones were enrolled prospectively and underwent ERCP with the novel SEMS. Primary outcomes were technical and therapeutic success rates. Secondary outcomes were the device removal success rate and any adverse events. The technical and therapeutic success rates were 95% (19/20) and 90% (18/20), respectively. The novel SEMS was removed successfully in all patients (100%). Mild post-ERCP pancreatitis developed in 15% of the patients (3/20), and post-ERCP cholangitis occurred in 5% (1/20). There were no cases of moderate to severe pancreatitis, perforation, bleeding, or procedure-related mortality. The novel SEMS offers a durable conduit for safe and effective biliary stone extraction without major adverse events. Further studies in larger cohorts are warranted to confirm these findings (CRiS identifier KCT0006185).

Complex and thoracoabdominal aortic aneurysms are one of the most difficult clinical problems of vascular surgery due to high perioperative mortality in open surgeries and limited possibilities of standard endovascular aortic repair. The development of fenestrated and branched endografts has allowed to significantly expand the indications for endovascular treatment by preserving the visceral brunch perfusion under anatomically adverse conditions. To evaluate the efficacy and safety of endovascular repair of complex and thoracoabdominal aortic aneurysms using fenestrated and branched endografts. A retrospective single-center cohort study included 95 patients who underwent endovascular repair of the abdominal or thoracoabdominal aortic aneurysms using fenestrated and/or branched endografts between January 2022 and June 2025. Individually manufactured devices (custom-made), universal factory branched components and «on the table» endograft modification were used; the number of fenestrations varied from 1 to 4. Technical success (patency of all target vessels, absence of type I/III endoleaks, no conversion) was the main intraoperative endpoint. Clinical success (absence of contrast-induced nephropathy, mesenteric and spinal ischemia, myocardial infarction and stroke) was evaluated in the hospital period. Survival (aortic-related and overall), secondary interventions and endoleaks were analyzed in the long-term period. Control multispiral computed tomography was performed after 30 days and 12 months. Technical success was achieved in 92 (96.8%) patients. Conversion to open surgery was required in one (1.1%) case. Mean duration of intervention was 165 [120; 205] minutes, volume of contrast media - 240 [160; 300] ml. Clinical success amounted to 95.8%; complications included contrast-induced nephropathy in 3 (3.2%) patients and myocardial infarction in one (1.1%). In-hospital deaths were not recorded. In the long-term period, type IA and type IB endoleaks were revealed in 2 (2.1%) patients, type II endoleaks - in 6 (6.3%); 3 (3.2%) secondary interventions were performed. One long-term fatal outcome (1.1%) not related to aortic pathology was recorded. Endovascular repair of complex and thoracoabdominal aortic aneurysms using fenestrated and branched endografts has demonstrated a high frequency of technical and clinical success with low levels of in-hospital and long-term mortality. Precise preoperative planning, individualization of device selection and use of combined techniques ensure the safety and efficacy of the indicated tactics in patients with adverse anatomy and high comorbidity.

Venous stenosis or occlusion often hinders transvenous cardiac device lead implantation, especially in patients with prior devices or long-term venous access. Surgical alternatives and femoral routes carry higher risk. We retrospectively evaluated percutaneous transluminal angioplasty (PTA) in 11 patients with significant venous obstruction. Recanalization was successful in 10/11 cases (91%). Eight leads were implanted immediately, two delayed, with one re-occlusion linked to delay. No peri-procedural complications occurred. Technical success was defined as successful lead implantation through the recanalized vein; clinical success was defined as absence of subclavian venous syndrome (no arm pain or swelling) during follow-up. During follow-up, no symptomatic re-occlusion was observed. PTA appears safe and effective, with same-session lead implantation minimizing re-occlusion risk, offering a valuable alternative when conventional venous access is not feasible.