TAME for Chronic Toe Pain

 Transarterial Microembolization Therapy for Chronic First Metatarsophalangeal Joint Pain

🔍 **Clinical Question:**  

To evaluate the feasibility, safety, and preliminary effectiveness of transarterial microembolization (TAME) for refractory first metatarsophalangeal joint (MTPJ) pain in patients with inflammatory arthritis, gout, or osteoarthritis.

💡 **Key Insight:**  

Transarterial microembolization (TAME) targets hypervascularity and pathological nerve ingrowth, key contributors to chronic pain, by selectively embolizing feeder arteries, thereby disrupting pain pathways and reducing inflammatory mediators.

TAME demonstrated significant reduction in pain and weekly analgesic use, establishing it as a safe and effective minimally invasive alternative for managing chronic metatarsophalangeal joint pain refractory to conventional treatments.

👉 **Why it matters:**  

The favorable safety profile and effectiveness of TAME suggest potential applications in other small joint pathologies.

➡️ **Full Article:** 

https://doi.org/10.1016/j.jvir.2025.08.047

#InterventionalRadiology #MSKIR #Pain #OA #MedEd

Percutaneous Cystis Duct Stent

Outcomes of Percutaneous Cystic Duct Stent Placement for Acute Cholecystitis

🔍 **Clinical Question:**

To evaluate whether PCDS placement is safe and effective for nonsurgical patients with acute cholecystitis and cystic duct (CD) anatomy predicts technical success.

 

💡 **Key Insight:**

Percutaneous cystic duct stent (PCDS) placement was attempted in patients with acute cholecystitis who were nonsurgical candidates.

PCDS placement is technically feasible, with 95.3% success in patients with open cystic duct and normal course.

 

👉 **Why it matters:**

Patients who are diagnosed with acute cholecystitis who are nonsurgical candidates should be offered the option of PCDS placement to avoid the long-term presence of a percutaneous cholecystostomy tube. This can often be achieved in a single procedure after initial percutaneous cholecystostomy tube placement.

 

➡️ **Full Article:** 

https://doi.org/10.1016/j.jvir.2025.10.023

#InterventionalRadiology #Biliary #Gallbladder #CholeTube #MedEd

SIR Guidelines on Percutaneous Dialysis AVF

A Society of Interventional Radiology Practice Guidance Document on Percutaneous Arteriovenous Fistulae for Dialysis Access

🔍 **Clinical Question:**  

What are the up-to-date society-based consensus recommendations for the creation and maturation of percutaneous arteriovenous fistulae (pAVFs) for hemodialysis access?

💡 **Key Insight:**  

Vessel mapping is essential for successful pAVF creation, evaluating inflow arteries, perforator vein(s), and superficial outflow veins.

Although technical success of pAVF creation is >95%, patients should be aware that many of the fistulae will require additional procedures to ensure fistula maturation. Successful cannulation rates are approximately 80%.

The interventionalist is responsible for postprocedural pAVF management, which usually includes a follow-up visit 1–2 weeks after creating a pAVF. 

Use the appropriate Current Procedural Terminology (CPT) code (36836 or 36837) for percutaneous creation of upper extremity AVFs (these codes refer to procedures performed via single or dual access sites.)

👉 **Why it matters:**  

Percutaneous AVF creation offers many benefits over surgical AVFs with ongoing evidence of its safety and effectiveness. This practice guidance document serves as a summary of what is required to develop a pAVF program, including patient preparation, performance of the procedure, adverse event management, and follow-up care.

➡️ **Full Article:** 

https://doi.org/10.1016/j.jvir.2025.08.019

#InterventionalRadiology #VascularIR #AVF #Hemodialysis #PercutaneousAVF #PracticeGuideline #PracticeBuilding #MedEd