Abstract Interventional radiology (IR) is a subspecialty of radiology that utilizes imaging technology to perform minimally invasive procedures. These techniques often serve as alternatives to surgery, offering reduced risks, shorter recovery, and improved patient outcomes. This study aimed to assess medical students’ knowledge, awareness, and interest in IR worldwide. A systematic literature search was conducted using PubMed, Web of Science, Google Scholar, and Cochrane CENTRAL. Data on study design, inclusion criteria, and outcomes were extracted, and the risk of bias was evaluated using the Newcastle–Ottawa Scale. Twenty-five studies met the inclusion criteria: 24 cross-sectional and one cohort study, encompassing 8,855 participants. Among them, 2734 were preclinical, and 3552 were clinical students. Findings showed poor IR knowledge in preclinical years, with only 25% demonstrating adequate understanding. Awareness ranged from 22% to 81.9% among preclinical students and 32% to 81.2% among clinical students. Interest in pursuing IR as a career was higher in clinical years; however, limited exposure and gaps in sustained interest were consistent. Overall, medical students display limited IR knowledge despite considerable interest. Enhanced exposure, formal teaching, and integration of IR into curricula are necessary to bridge this gap and better prepare future physicians. Level of Evidence: Level 1, Systematic Review.
Abstract Background: Giant hepatic hemangiomas (GHHs) can cause significant symptoms and complications, yet the optimal minimally invasive therapy remains debated. This study aimed to evaluate the safety and long-term efficacy of percutaneous sclerotherapy using bleomycin combined with ethiodized oil for symptomatic GHHs. Patients and Methods: In this retrospective single-center study, 120 patients with symptomatic GHHs (>5 cm) underwent ultrasound-guided percutaneous sclerotherapy between September 2019 and October 2024. A standardized mixture of bleomycin and ethiodized oil was injected intralesionally. Technical success, symptom severity (Visual Analog Scale [VAS]), and lesion dimensions were recorded at baseline and at 6 months, 1, 2, 3, 4, and 5 years postprocedure. The complications were classified according to the Society of Interventional Radiology guidelines. Results: A total of 135 sessions were performed (mean bleomycin dose 43.4 IU per session). Technical success was 100%. Mean VAS score decreased from 6.9 ± 2.1 preprocedure to 2.7 ± 1.8 at the last follow-up ( P < 0.001). Both major and minor lesion dimensions decreased significantly at all the follow-up intervals. No major complications occurred; minor transient symptoms were managed conservatively. Conclusion: Percutaneous sclerotherapy with bleomycin and ethiodized oil is a safe and effective option for symptomatic GHHs, producing durable symptom relief and lesion shrinkage during the long-term follow-up.
Abstract Venous malformations are the most common congenital vascular anomaly. They are often symptomatic and are challenging to diagnose and treat. Bleomycin is an antineoplastic drug that has been used safely and effectively by intralesional administration in the treatment of vascular malformations. The use of reversible electroporation to increase cell membrane permeability to bleomycin has been utilized successfully in electrochemotherapy to significantly augment the cytotoxicity of bleomycin. We describe the use of bleomycin electroporation with sclerotherapy (bleomycin electrosclerotherapy) for treating a patient with a large low-flow lymphovascular malformation of the tongue causing intermittent airway obstruction. To the best of our knowledge, this is the first case report to describe the application of bleomycin electrosclerotherapy within the airway and to highlight the perioperative anesthetic challenges unique to this interventional approach.
Abstract Background: Internal jugular vein thrombosis (IJVthr) is a condition that is common in many high-risk patients. The standard treatment for IJVthr has been anticoagulation. For patients who require long-term intravenous access, vessel preservation is paramount. Mechanical thrombectomy may be a favorable treatment for maintaining vessel patency and improving patient outcomes in IJVthr. This study aims to evaluate the safety and feasibility of mechanical thrombectomy to treat IJVthr. Methods: This is a single-center retrospective study including all patients who were treated with mechanical thrombectomy for IJVthr between January 2022 and December 2025. Results: The study included 24 internal jugular vein thrombectomies performed over 3 years at the study institution. The mean age was 65.4 years, including 13 (54.1%) females and 11 (45.8%) males. The average time from symptom onset to presentation to the initial medical provider was 3 days. Technical success was defined as complete or near complete removal of thrombus with restored flow on venography in the jugular vein, which was 100%. 30-day follow-up imaging was performed in 22 cases (91.7%). On follow-up, 18 (81.8%) patients maintained complete patency (no residual thrombus with good color flow on ultrasound). Of patients who maintained complete patency, the average time from procedure to symptom resolution was 4 days. Symptom resolution defined clinical success. No cases involved 30-day device-related events or vessel perforation. No patient presented to the hospital during the follow-up period with a new diagnosis of pulmonary embolism. Conclusion: These early findings suggest that mechanical thrombectomy can safely and efficiently debulk IJVthr. Symptom improvement and vessel preservation were noted on follow-up.
Abstract Spontaneous pseudoaneurysms of the ovary in pregnancy are exceedingly rare. They are difficult to diagnose, and there is seldom a suspicion of such pathology during routine obstetric scans. Transvaginal sonography (TVS) is important in diagnosing rare ovarian pathologies like pseudoaneurysm and their characterization. Further, TVS-guided embolotherapy with thrombin in such pathology is safer and easily accessible. Thrombin as an embolic agent is more physiological, with fewer chances of adverse effects on fetoplacental circulation in case of retrograde reflux or inadvertent embolization. We hereby report a case of innovative use of TVS-guided thrombin injection in ovarian pseudoaneurysm and a successful cure with a 6-month follow-up. The ovarian pseudoaneurysm sac got completely thrombosed immediately, with significant pain relief in a follow-up of 6 months. TVS-guided thrombin injection can be safely used as a treatment modality in ovarian pseudoaneurysm in pregnancy with immediate symptomatic improvement.
