Interventional News’ top 10 most popular stories of 2021
The top 10 stories of 2021 feature advances in ablation precision, as well as a multicentre, first-in-human prospective study exploring the safety and efficacy of combined renal and common hepatic artery denervation in patients with type 2 diabetes and hypertension. The CAVA trial, which delivered evidence supporting the use of totally implanted ports to supply systemic chemotherapy, also attracted many readers.
1) Ablation 2.0: Improved precision as interventionalists approach A0
Ablation is entering a new era of increased precision and quantification, the interventional radiology community argues. Several clinical trials—including the ACCLAIM, COLLISION, and COVER-ALL trials—are currently underway, and aim to bolster the evidence-base demonstrating favourable patient outcomes from thermal ablation.
2)Multi-organ denervation to combat cardiometabolic disease: A novel concept put to the test
Following a successful proof-of-concept study, researchers have embarked upon a first-in-human study to explore the safety and efficacy of combined renal and common hepatic artery denervation in patients with type 2 diabetes and hypertension. Co-principal investigators Gerard S Goh and Markus P Schlaich explain the rationale behind this single-blinded, multicentre, prospective feasibility study—named the MODUS trial—and explore the “pandemic” of cardiometabolic disease.
3) GAE with Embosphere microspheres has comparable long-term results to imipenem cilastatin in knee osteoarthritis treatment, study finds
Trisacryl gelatin microspheres 100–300μm in size can be considered for genicular artery embolization (GAE), a study presented at the 2021 meeting of the Society of Interventional Radiology (SIR; 20–26 March, online) reported. The presentation covered two-year outcomes of a study comparing Embosphere microspheres (Merit Medical), with imipenem cilastatin for GAE in patients with moderate-to-severe knee osteoarthritis. The particles are comparable in terms of pain reduction and there is a sustained effect out to two-years of follow-up, Shivank Bhatia (University of Miami Miller School of Medicine, Miami, USA) informed delegates.
4) Interventional radiology community calls for postpartum haemorrhage response team due to “underutilisation” of UAE) in review of 10 million births in the USA
Despite lower mortality and shorter hospital stays, uterine artery embolization (UAE) is used far less commonly than hysterectomy in the management of clinically significant postpartum haemorrhage. This conclusion, presented at the Society of Interventional Radiology (SIR) annual meeting (20–26 March, online) by Janice Newsome (Emory University Hospital, Atlanta, USA), has led investigators to call for a postpartum haemorrhage response team, akin to a trauma response team. MD candidate Linzi Ardnt, also at Emory University Hospital, is the lead researcher for this work.
5) Parag Patel
From an early understanding in medical school that interventional radiology was “the future”, Parag Patel has dedicated his career to the discipline, notably as a primary investigator of the BEST-CLI and ATTRACT trials, and now as the incoming president-elect of the Society of Interventional Radiology (SIR). He has also been integral to the design and implementation of a universal interventional radiology education curriculum in the USA. In so doing, he has played a large part in shaping that future he once envisioned.
6) Coding changes will impact reimbursement for US interventional radiologists in 2021
Revisions to current procedural terminology codes in the USA for 2021 overhaul the evaluation and management section, reducing documentation requirements and introducing new rules determining the level of coding. These changes will affect interventional radiologists and radiation oncologists more than they will impact the day-to-day work of diagnostic radiologists, according to Erin Stephens, a senior client manager in education at Healthcare Administrative Partners.
7) Siemens Healthineers launches new CT scanner for fast diagnosis and precise interventions in demanding clinical areas
Siemens Healthineers has launched the Somatom X.ceed, a new high-resolution, high-speed computed tomography (CT) scanner. The fastest single-source CT scanner from Siemens Healthineers can assist healthcare providers with their clinical decisions in areas like emergency imaging, cardiac CT, and CT-guided interventions.
8) Imaging, precise tools, in-procedure ablation zone visibility, and confirmation of success with adequate margins could propel thermal ablation to achieve outcomes on par with surgery
Constantinos Sofocleous (Memorial Sloan-Kettering Cancer Center, New York, USA) sat down with Interventional News to discuss how image-guided thermal ablation, when it is deployed with an intent to cure small colorectal liver metastases, can be fine-tuned so that its outcomes match those achieved by open surgery.
9) Ablation-confirmation software must become the new normal for IRs to be competitive with surgeons
“If interventional radiologists wish to become competitive with surgeons, the availability of software enabling the accurate comparison of pre- and post-interventional computed tomography or magnetic resonance imaging scans must become mandatory and routinely employed,” Luigi Solbiati (professor of Radiology at Humanitas University, Milan, Italy) argues.
10) CAVA randomised controlled trial delivers powerful evidence supporting the use of totally implanted ports (PORTs) to supply systemic chemotherapy
For most patients receiving systemic anticancer treatment, totally implanted ports (PORTs) are more effective and safer than both Hickman-type tunnelled catheters (Hickman) and peripherally inserted central catheters (PICCs). The CAVA trial’s results, published online in The Lancet, recommended reshaping current guidelines and practice, so that most patients requiring chemotherapy for solid tumours receive a PORT within the UK National Health Service, foreshadowing a pivot in practice that might be “slow to start with”.