Randomized comparison of split tip versus step tip high-flow Approximately 210,000 patients curre... more Randomized comparison of split tip versus step tip high-flow Approximately 210,000 patients currently undergo hehemodialysis catheters. modialysis in the United States [1]. While the majority Background. Our purpose was to compare the function and of these patients have permanent forms of access such complications of two high-flow polyurethane hemodialysis as native fistulae or synthetic arteriovenous shunts, a catheters. large number of patients require temporary tunneled Methods. This prospective, randomized trial compared the Ash-Split (MedComp) and Opti-Flow (Bard Access Systems) hemodialysis catheter placement during maturation of catheters. All patients referred for tunneled hemodialysis cathshunts and fistulae, and a subset of patients use these eter placement were offered entry in the study, provided they catheters as their permanent form of access. In fact, the met inclusion criteria. Catheters were placed by interventional 2001 USRDS showed an increase in tunneled catheter radiologists using ultrasound and fluoroscopic guidance. Prouse of 71% from 1996 to 1999, paralleling an increase in cedure time and initial complications were recorded. Effective fistula use [1]. In addition, temporary tunneled catheters (QbEff) catheter flow rates and recirculation were studied at baseline, one month, three and six months using ultrasonic difor hemodialysis are used in the setting of renal translution (Transonic) at various pump speeds (Qb). Episodes of plantation as well as intermittently in patients with comcatheter malfunction and infection were recorded. Catheter plications of continuous ambulatory peritoneal dialysis removal or six months was the study endpoint. (CAPD). The total number of dialysis catheter place-Results. A total of 132 patients were enrolled in the trial. ments in the United States is difficult to determine but The groups did not differ as to age, sex distribution, height or weight (P Ͼ 0.05). Initial complications included kinking rewas estimated at 265,000 for the year 2000 (personal comsulting in catheter failure (Optiflow N ϭ 3), and tunnel bleeding munication; Tony Madison, MedComp, September 2001). (Optiflow N ϭ 1; Ash N ϭ 3). Adjusted mean flow rates While percutaneous imaging guided placement of these (QbEff) at Qb300 were 299 mL/min Ash and 305 mL/min catheters is associated with a very low short-term compli-Optiflow (P ϭ 0.06), at Qb400 were 365 mL/min Ash and cation rate [2-8], these catheters are prone to long-term 382 mL/min Optiflow (P ϭ 0.01), and at QbMax were 414 mL/ min Ash and 433 mL/min Optiflow (P ϭ 0.03). Recirculation complications that include infection and poor flow, often was significantly higher with the Optiflow catheter at most due to thrombosis and/or fibrin sheaths. A short-term measurement points. Total late complications were lower in study of a new high-flow catheter design [4] showed that the Ash group (P ϭ 0.04), and catheter survival was signifithe thin-walled polyurethane split-tip Ash Split hemocantly higher in the Ash group (P ϭ 0.02). dialysis catheter (MedComp, Harleysville, PA, USA) Conclusions. Both catheters can deliver flow rates well behad superior flow rates compared with a conventional siliyond those recommended by the Dialysis Outcomes Quality Initiative. While the Optiflow delivered higher flow rates at some cone step-tip catheter. Other comparative studies have measurement points, this was offset by higher recirculation. shown similar results [5, 8, 9]. A postulated but unproved The Ash catheter showed a long-term survival advantage and additional benefit of the split tip catheter is a reduction fewer late complications. in fibrin sheaths and hence late malfunction. The two lumens of the catheter are fused throughout the proximal shaft, which allows it to pass through a single tunnel, but
Conclusions: This study demonstrates that CAS fractures are not associated with an increased risk... more Conclusions: This study demonstrates that CAS fractures are not associated with an increased risk of restenosis. The true incidence of stent fracture may be underestimated by x-ray analysis due to limited resolution and frequent artifacts. Additional methods to evaluate for subtle CAS fractures may assist in defining a more precise incidence and might lead to insight into the potential etiologies. Further evaluation with a larger study population and a longer follow-up both for stent integrity and its association with restenosis or adverse clinical outcomes is needed.
We present a patient with a large spontaneous splenorenal shunt secondary to isolated splenic vei... more We present a patient with a large spontaneous splenorenal shunt secondary to isolated splenic vein thrombosis who developed severe bleeding from fundal gastric varices. The patient was managed emergently with splenic artery embolization and balloon occlusion retrograde embolization of the varices with alcohol. We discuss the clinical presentation, embolization techniques, and a potential complication of the use of alcohol for this purpose.
We describe a 44-year-old man with end-stage renal disease who underwent insertion of a stent gra... more We describe a 44-year-old man with end-stage renal disease who underwent insertion of a stent graft to repair a hemodialysis graft pseudoaneurysm. The indication for stent graft placement was an acute and rapidly enlarging intragraft pseudoaneurysm. The patient experienced no complications following the procedure, but he presented with two graft occlusions within the 2 months following the procedure.
The persistent sciatic artery (PSA) is a rare but clinically significant congenital vascular anom... more The persistent sciatic artery (PSA) is a rare but clinically significant congenital vascular anomaly. Clinical presentation varies and PSA can cause a number of complications, including limb loss. We describe the presenting features and treatments in two patients. The former was found to have thrombosis of a PSA with distal thromboemboli and was treated with a bypass graft. The latter was treated for an ischemic foot following successful ruptured aortic aneurysm repair and was found incidentally to have patent PSA with concomitant stenosis of the common iliac artery, which was successfully treated with stent grafting.
Journal of Vascular and Interventional Radiology, 2009
The membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee r... more The membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee represents experts in a broad spectrum of interventional procedures from the private and academic sectors of medicine. Generally, Standards of Practice Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid broad expert constituency of the subject matter under consideration for standards production. Technical documents specifying the exact consensus and literature review methodologies, as well as the institutional affiliations and professional credentials of the authors of this document, are available upon request from SIR, 3975 Fair Ridge Dr., Suite 400 N., Fairfax, VA 22033. METHODOLOGY SIR produces its Standards of Practice documents using the following process. Standards documents of relevance and timeliness are conceptualized by the Standards of Practice Committee members. A recognized expert is identified to serve as the principal author for the standard. Additional authors may be assigned depending on the magnitude of the project. An in-depth literature search is performed with use of electronic medical literature databases. Then, a critical review of peer-reviewed articles is performed with regard to the study methodology, results, and conclusions. The qualitative weight of these articles is assembled into an evidence table, which is used to write the document such that it contains evidence-based data with respect to content, rates, and thresholds. When the evidence of literature is weak, conflicting, or contradictory, consensus for the parameter is reached by a minimum of 12 Standards of Practice Committee members by using a modified Delphi Consensus Method (Appendix A). For the purposes of these documents, consensus is defined as 80% Delphi participant agreement on a value or parameter. The draft document is critically reviewed by the Standards of Practice Committee members by telephone conference calling or face-to-face meeting. The finalized draft from the Committee is sent to the SIR membership for further input/criticism during a 30-day comment period. These comments are discussed by the Standards of Practice Committee, and appropriate revisions made to create the finished standards document. Before its publication, the document is endorsed by the SIR Executive Council.
European Journal of Vascular and Endovascular Surgery, 2011
We present a case of an infected stent graft in the superficial femoral artery (SFA). A 67-year-o... more We present a case of an infected stent graft in the superficial femoral artery (SFA). A 67-year-old woman underwent excision of an infected Viabahn stent graft. At exploration there was no apparent artery around the majority of the stent graft, suggesting that the SFA had been autolysed. Infected stents and stent grafts are rare in the SFA position. The risk of infection is likely minimised with standard treatments including drainage of infection prior to stent graft placement and periprocedural antibiotic administration. Successful management will, in most cases, require excision of the stent graft and adjunctive arterial reconstruction, as necessary.
The educational objectives of this continuing medical education activity are for the reader to ex... more The educational objectives of this continuing medical education activity are for the reader to exercise, self-assess, and improve his or her skills in diagnostic radiology with regard to the complications of nonvascular interventions and their management. Conclusion The six scenarios in this article review how and why complications occur in nonvascular interventional procedures and how to manage them.
An ambulatory 37-year-old woman with end-stage renal disease, left lower extremity deep vein thro... more An ambulatory 37-year-old woman with end-stage renal disease, left lower extremity deep vein thrombosis (DVT), and renal and pancreatic transplants presents to the emergency department with chest pain. Radiologic Description Magnified view of lateral chest radiograph shows an inferior vena cava (IVC) filter in the right atrium (Fig. 1A). Unenhanced chest CT image shows the IVC filter in the right atrium and no pericardial fluid (Fig. 1B). Further history disclosed that a Günther Tulip retrievable vena cava filter (Cook, Inc.) was placed in the infrarenal vena cava 4 months prior because of acute gastrointestinal bleeding while the patient was receiving systemic anticoagulation for left lower extremity DVT.
A 35-year-old male weight lifter presents with swelling in the left arm. Radiologic Description L... more A 35-year-old male weight lifter presents with swelling in the left arm. Radiologic Description Left upper extremity venogram (Fig. 1A) obtained through a median cubital vein access shows extensive filling defects in the subclavian, axillary, and basilic veins. No antegrade flow into the brachiocephalic vein or superior vena cava is seen. Differential Diagnosis The diagnosis is deep vein thrombosis. Vascular tumor invasion is extremely rare. The cause of axillosubclavian vein thrombosis is either primary or secondary. Primary axillosubclavian vein thrombosis may be due to anatomic venous compression at the thoracic outlet (Paget-Schroetter syndrome) or upper limb immobility, whereas secondary axillosubclavian vein thrombosis may be due to venous catheterization (catheters, ports); hemodialysis conduits and fistulas; infusate-related (sclerosants, vesicants); pacemaker wires; IV drug abuse; radiation; fibrosis; cardiac failure; shoulder trauma; amyloidosis; sarcoidosis; oral contraceptive use; or local compression by tumor, metastatic disease, or lymphadenopathy.
Journal of Vascular and Interventional Radiology, 2001
PURPOSE: To compare, with use of intravascular ultrasound (IVUS) as an internal reference standar... more PURPOSE: To compare, with use of intravascular ultrasound (IVUS) as an internal reference standard in a porcine model, arterial diameters measured from arteriograms obtained with use of CO 2 to those obtained with use of iodinated contrast material (ICM). MATERIALS AND METHODS: In nine pigs, digital subtraction angiograms (DSAs) were obtained in the aorta and iliac arteries to compare vessel diameters measured with use of CO 2 to those measured with use of ICM. These measurements were divided by measurements made with use of intravascular ultrasound (IVUS) to yield a DSA/IVUS ratio. Differences between ICM and CO 2 were compared with analysis of variance to assess the effect of location (aorta vs iliac), contrast material used (ICM vs CO 2), and position (posteroanterior, right anterior oblique, or left anterior oblique). Secondary analysis compared measurements of dependent and nondependent iliac arteries and compared the use of hand-injected CO 2 to that of CO 2 injected by an injector. RESULTS: The DSA/IVUS ratio was 70.7% ؎ 4.4% with ICM use and 69.6% ؎ 6.3% with CO 2 use, which did not represent a significant difference (P ؍ .311). Animal position had no effect (P ؍ .477). Underestimation was worse in the iliac arteries than in the aorta (67.4% ؎ 1.5% vs 71.4% ؎ 1.7%; P ؍ .038). There was no difference in nondependent (P ؍ .163) arteries, but CO 2 underestimated dependent iliac artery size more than ICM did (66.3% ؎ 4.8% vs 70.3% ؎ 5.4%; P ؍ .051). Vessel diameter was underestimated more with the CO 2 injector than with hand-injected CO 2 (64.3% ؎ 2.3% vs 71.7% ؎ 1.7%; P < .0001). CONCLUSION: There is no difference in diameter underestimation between CO 2 and ICM in this animal model. Hand-injection of CO 2 causes less underestimation of vessel diameter than does the CO 2 injector. Index terms: Angiography • Carbon dioxide • Contrast media, comparative studies
Journal of vascular and interventional radiology : JVIR, Jan 27, 2017
To develop a new adverse event (AE) classification for the interventional radiology (IR) procedur... more To develop a new adverse event (AE) classification for the interventional radiology (IR) procedures and evaluate its clinical, research, and educational value compared with the existing Society of Interventional Radiology (SIR) classification via an SIR member survey. A new AE classification was developed by members of the Standards of Practice Committee of the SIR. Subsequently, a survey was created by a group of 18 members from the SIR Standards of Practice Committee and Service Lines. Twelve clinical AE case scenarios were generated that encompassed a broad spectrum of IR procedures and potential AEs. Survey questions were designed to evaluate the following domains: educational and research values, accountability for intraprocedural challenges, consistency of AE reporting, unambiguity, and potential for incorporation into existing quality-assurance framework. For each AE scenario, the survey participants were instructed to answer questions about the proposed and existing SIR clas...
Randomized comparison of split tip versus step tip high-flow Approximately 210,000 patients curre... more Randomized comparison of split tip versus step tip high-flow Approximately 210,000 patients currently undergo hehemodialysis catheters. modialysis in the United States [1]. While the majority Background. Our purpose was to compare the function and of these patients have permanent forms of access such complications of two high-flow polyurethane hemodialysis as native fistulae or synthetic arteriovenous shunts, a catheters. large number of patients require temporary tunneled Methods. This prospective, randomized trial compared the Ash-Split (MedComp) and Opti-Flow (Bard Access Systems) hemodialysis catheter placement during maturation of catheters. All patients referred for tunneled hemodialysis cathshunts and fistulae, and a subset of patients use these eter placement were offered entry in the study, provided they catheters as their permanent form of access. In fact, the met inclusion criteria. Catheters were placed by interventional 2001 USRDS showed an increase in tunneled catheter radiologists using ultrasound and fluoroscopic guidance. Prouse of 71% from 1996 to 1999, paralleling an increase in cedure time and initial complications were recorded. Effective fistula use [1]. In addition, temporary tunneled catheters (QbEff) catheter flow rates and recirculation were studied at baseline, one month, three and six months using ultrasonic difor hemodialysis are used in the setting of renal translution (Transonic) at various pump speeds (Qb). Episodes of plantation as well as intermittently in patients with comcatheter malfunction and infection were recorded. Catheter plications of continuous ambulatory peritoneal dialysis removal or six months was the study endpoint. (CAPD). The total number of dialysis catheter place-Results. A total of 132 patients were enrolled in the trial. ments in the United States is difficult to determine but The groups did not differ as to age, sex distribution, height or weight (P Ͼ 0.05). Initial complications included kinking rewas estimated at 265,000 for the year 2000 (personal comsulting in catheter failure (Optiflow N ϭ 3), and tunnel bleeding munication; Tony Madison, MedComp, September 2001). (Optiflow N ϭ 1; Ash N ϭ 3). Adjusted mean flow rates While percutaneous imaging guided placement of these (QbEff) at Qb300 were 299 mL/min Ash and 305 mL/min catheters is associated with a very low short-term compli-Optiflow (P ϭ 0.06), at Qb400 were 365 mL/min Ash and cation rate [2-8], these catheters are prone to long-term 382 mL/min Optiflow (P ϭ 0.01), and at QbMax were 414 mL/ min Ash and 433 mL/min Optiflow (P ϭ 0.03). Recirculation complications that include infection and poor flow, often was significantly higher with the Optiflow catheter at most due to thrombosis and/or fibrin sheaths. A short-term measurement points. Total late complications were lower in study of a new high-flow catheter design [4] showed that the Ash group (P ϭ 0.04), and catheter survival was signifithe thin-walled polyurethane split-tip Ash Split hemocantly higher in the Ash group (P ϭ 0.02). dialysis catheter (MedComp, Harleysville, PA, USA) Conclusions. Both catheters can deliver flow rates well behad superior flow rates compared with a conventional siliyond those recommended by the Dialysis Outcomes Quality Initiative. While the Optiflow delivered higher flow rates at some cone step-tip catheter. Other comparative studies have measurement points, this was offset by higher recirculation. shown similar results [5, 8, 9]. A postulated but unproved The Ash catheter showed a long-term survival advantage and additional benefit of the split tip catheter is a reduction fewer late complications. in fibrin sheaths and hence late malfunction. The two lumens of the catheter are fused throughout the proximal shaft, which allows it to pass through a single tunnel, but
Conclusions: This study demonstrates that CAS fractures are not associated with an increased risk... more Conclusions: This study demonstrates that CAS fractures are not associated with an increased risk of restenosis. The true incidence of stent fracture may be underestimated by x-ray analysis due to limited resolution and frequent artifacts. Additional methods to evaluate for subtle CAS fractures may assist in defining a more precise incidence and might lead to insight into the potential etiologies. Further evaluation with a larger study population and a longer follow-up both for stent integrity and its association with restenosis or adverse clinical outcomes is needed.
We present a patient with a large spontaneous splenorenal shunt secondary to isolated splenic vei... more We present a patient with a large spontaneous splenorenal shunt secondary to isolated splenic vein thrombosis who developed severe bleeding from fundal gastric varices. The patient was managed emergently with splenic artery embolization and balloon occlusion retrograde embolization of the varices with alcohol. We discuss the clinical presentation, embolization techniques, and a potential complication of the use of alcohol for this purpose.
We describe a 44-year-old man with end-stage renal disease who underwent insertion of a stent gra... more We describe a 44-year-old man with end-stage renal disease who underwent insertion of a stent graft to repair a hemodialysis graft pseudoaneurysm. The indication for stent graft placement was an acute and rapidly enlarging intragraft pseudoaneurysm. The patient experienced no complications following the procedure, but he presented with two graft occlusions within the 2 months following the procedure.
The persistent sciatic artery (PSA) is a rare but clinically significant congenital vascular anom... more The persistent sciatic artery (PSA) is a rare but clinically significant congenital vascular anomaly. Clinical presentation varies and PSA can cause a number of complications, including limb loss. We describe the presenting features and treatments in two patients. The former was found to have thrombosis of a PSA with distal thromboemboli and was treated with a bypass graft. The latter was treated for an ischemic foot following successful ruptured aortic aneurysm repair and was found incidentally to have patent PSA with concomitant stenosis of the common iliac artery, which was successfully treated with stent grafting.
Journal of Vascular and Interventional Radiology, 2009
The membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee r... more The membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee represents experts in a broad spectrum of interventional procedures from the private and academic sectors of medicine. Generally, Standards of Practice Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid broad expert constituency of the subject matter under consideration for standards production. Technical documents specifying the exact consensus and literature review methodologies, as well as the institutional affiliations and professional credentials of the authors of this document, are available upon request from SIR, 3975 Fair Ridge Dr., Suite 400 N., Fairfax, VA 22033. METHODOLOGY SIR produces its Standards of Practice documents using the following process. Standards documents of relevance and timeliness are conceptualized by the Standards of Practice Committee members. A recognized expert is identified to serve as the principal author for the standard. Additional authors may be assigned depending on the magnitude of the project. An in-depth literature search is performed with use of electronic medical literature databases. Then, a critical review of peer-reviewed articles is performed with regard to the study methodology, results, and conclusions. The qualitative weight of these articles is assembled into an evidence table, which is used to write the document such that it contains evidence-based data with respect to content, rates, and thresholds. When the evidence of literature is weak, conflicting, or contradictory, consensus for the parameter is reached by a minimum of 12 Standards of Practice Committee members by using a modified Delphi Consensus Method (Appendix A). For the purposes of these documents, consensus is defined as 80% Delphi participant agreement on a value or parameter. The draft document is critically reviewed by the Standards of Practice Committee members by telephone conference calling or face-to-face meeting. The finalized draft from the Committee is sent to the SIR membership for further input/criticism during a 30-day comment period. These comments are discussed by the Standards of Practice Committee, and appropriate revisions made to create the finished standards document. Before its publication, the document is endorsed by the SIR Executive Council.
European Journal of Vascular and Endovascular Surgery, 2011
We present a case of an infected stent graft in the superficial femoral artery (SFA). A 67-year-o... more We present a case of an infected stent graft in the superficial femoral artery (SFA). A 67-year-old woman underwent excision of an infected Viabahn stent graft. At exploration there was no apparent artery around the majority of the stent graft, suggesting that the SFA had been autolysed. Infected stents and stent grafts are rare in the SFA position. The risk of infection is likely minimised with standard treatments including drainage of infection prior to stent graft placement and periprocedural antibiotic administration. Successful management will, in most cases, require excision of the stent graft and adjunctive arterial reconstruction, as necessary.
The educational objectives of this continuing medical education activity are for the reader to ex... more The educational objectives of this continuing medical education activity are for the reader to exercise, self-assess, and improve his or her skills in diagnostic radiology with regard to the complications of nonvascular interventions and their management. Conclusion The six scenarios in this article review how and why complications occur in nonvascular interventional procedures and how to manage them.
An ambulatory 37-year-old woman with end-stage renal disease, left lower extremity deep vein thro... more An ambulatory 37-year-old woman with end-stage renal disease, left lower extremity deep vein thrombosis (DVT), and renal and pancreatic transplants presents to the emergency department with chest pain. Radiologic Description Magnified view of lateral chest radiograph shows an inferior vena cava (IVC) filter in the right atrium (Fig. 1A). Unenhanced chest CT image shows the IVC filter in the right atrium and no pericardial fluid (Fig. 1B). Further history disclosed that a Günther Tulip retrievable vena cava filter (Cook, Inc.) was placed in the infrarenal vena cava 4 months prior because of acute gastrointestinal bleeding while the patient was receiving systemic anticoagulation for left lower extremity DVT.
A 35-year-old male weight lifter presents with swelling in the left arm. Radiologic Description L... more A 35-year-old male weight lifter presents with swelling in the left arm. Radiologic Description Left upper extremity venogram (Fig. 1A) obtained through a median cubital vein access shows extensive filling defects in the subclavian, axillary, and basilic veins. No antegrade flow into the brachiocephalic vein or superior vena cava is seen. Differential Diagnosis The diagnosis is deep vein thrombosis. Vascular tumor invasion is extremely rare. The cause of axillosubclavian vein thrombosis is either primary or secondary. Primary axillosubclavian vein thrombosis may be due to anatomic venous compression at the thoracic outlet (Paget-Schroetter syndrome) or upper limb immobility, whereas secondary axillosubclavian vein thrombosis may be due to venous catheterization (catheters, ports); hemodialysis conduits and fistulas; infusate-related (sclerosants, vesicants); pacemaker wires; IV drug abuse; radiation; fibrosis; cardiac failure; shoulder trauma; amyloidosis; sarcoidosis; oral contraceptive use; or local compression by tumor, metastatic disease, or lymphadenopathy.
Journal of Vascular and Interventional Radiology, 2001
PURPOSE: To compare, with use of intravascular ultrasound (IVUS) as an internal reference standar... more PURPOSE: To compare, with use of intravascular ultrasound (IVUS) as an internal reference standard in a porcine model, arterial diameters measured from arteriograms obtained with use of CO 2 to those obtained with use of iodinated contrast material (ICM). MATERIALS AND METHODS: In nine pigs, digital subtraction angiograms (DSAs) were obtained in the aorta and iliac arteries to compare vessel diameters measured with use of CO 2 to those measured with use of ICM. These measurements were divided by measurements made with use of intravascular ultrasound (IVUS) to yield a DSA/IVUS ratio. Differences between ICM and CO 2 were compared with analysis of variance to assess the effect of location (aorta vs iliac), contrast material used (ICM vs CO 2), and position (posteroanterior, right anterior oblique, or left anterior oblique). Secondary analysis compared measurements of dependent and nondependent iliac arteries and compared the use of hand-injected CO 2 to that of CO 2 injected by an injector. RESULTS: The DSA/IVUS ratio was 70.7% ؎ 4.4% with ICM use and 69.6% ؎ 6.3% with CO 2 use, which did not represent a significant difference (P ؍ .311). Animal position had no effect (P ؍ .477). Underestimation was worse in the iliac arteries than in the aorta (67.4% ؎ 1.5% vs 71.4% ؎ 1.7%; P ؍ .038). There was no difference in nondependent (P ؍ .163) arteries, but CO 2 underestimated dependent iliac artery size more than ICM did (66.3% ؎ 4.8% vs 70.3% ؎ 5.4%; P ؍ .051). Vessel diameter was underestimated more with the CO 2 injector than with hand-injected CO 2 (64.3% ؎ 2.3% vs 71.7% ؎ 1.7%; P < .0001). CONCLUSION: There is no difference in diameter underestimation between CO 2 and ICM in this animal model. Hand-injection of CO 2 causes less underestimation of vessel diameter than does the CO 2 injector. Index terms: Angiography • Carbon dioxide • Contrast media, comparative studies
Journal of vascular and interventional radiology : JVIR, Jan 27, 2017
To develop a new adverse event (AE) classification for the interventional radiology (IR) procedur... more To develop a new adverse event (AE) classification for the interventional radiology (IR) procedures and evaluate its clinical, research, and educational value compared with the existing Society of Interventional Radiology (SIR) classification via an SIR member survey. A new AE classification was developed by members of the Standards of Practice Committee of the SIR. Subsequently, a survey was created by a group of 18 members from the SIR Standards of Practice Committee and Service Lines. Twelve clinical AE case scenarios were generated that encompassed a broad spectrum of IR procedures and potential AEs. Survey questions were designed to evaluate the following domains: educational and research values, accountability for intraprocedural challenges, consistency of AE reporting, unambiguity, and potential for incorporation into existing quality-assurance framework. For each AE scenario, the survey participants were instructed to answer questions about the proposed and existing SIR clas...
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