Learning points taken so from #CIRSE2020
Biliary:
Transpapillary Vs suprapap biliary stenting. Suprapap stent placement is safer, avoids postop pancreatitis with similar clinical results, stent patency and patient survival . Clinical success was associated with survival increase
If you're going to do a percutaneous caecostomy, ensure there is a follow up definitive plan. Better to swing towards a colonic stent if you can.
Fibroid embolisation:
Hydronephrosis is not a CI to embolisation
PE risk is 1 in 400
10mg dexamethasone IV 1 hour pre UAE
Fibroid embolisation cont:
Wait 6 months post UAE and post procedure MRI before commencing pregnancy.
Any fibroid that touches the endometrium has a risk to pass. The larger the fibroid the higher the risk.
>50% of the fibroid in the cavity = high risk of passage 30-40%
Fibroid embolisation:
Consider hysteroscopic resection within a week post embolisation for high risk of passage fibroids (anyone doing this? @Irfan_I_Ahmed @keithppereira @thefibroidlady)
No sig diff in outcomes in the embolisation of ovarian collaterals at 1st UAE embo
Pulmonary AVM
Concern of aneurysmal dilatation and recanalisation using AVP plugs when treating pulmonary AVMs. Use a combination of AVP and coils to increase occlusive effect. The closer to the sac, the better.
Pulmonary AVM embolisation does not increase PAP.
Emborrhoid:
Use the symptom severity score in clinic
~70% clinic success with minimal complications
Identify all the vessels from IMA supplying the haemorrhoidal plexus and embolise at the level of the pubic bone. Use 2-3mm 0.018 coils. Look for the middle rectal supply.
GAE
Commonest complication is skin discolouration - use ice pack over the knee
Treat mild to moderate knee OA resistent to conservative treatment. Recurrence in severe group. Treat to prune not to stasis
Embosphere 100-300um dilute in 20ml contrast 100% (👍👏👏 @marklittle_IR)
Feel free to add learning points!!! I know I've missed a lot & I haven't completed all the posters! Although very different, it was a great conference & I thoroughly enjoyed it. @cirsesociety
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