Table 1
The vortical and exciting way of development of the Interventional Radiology: an incredible succession of events, from the first rudimental angioplasty performed in 1964 by Charles Dotter at Oregon University in the USA, to all new therapeutic concepts, treatment modalities, devices, progressively introduced in the modern medical practice [3].
Figure 1
A 20-year-old woman (medical student) with history of Cloves syndrome (venous malformation at the pelvis and left leg), presenting with life threatening perineal hemorrhage from hemorrhoidal bundles: (a) Selective arteriography of the inferior mesenteric artery (IMA, arrow) showing vascularization of the rectum by the superior rectal arteries (SRA, asterisks). (b) Focal hypervascularization corresponding to the hemorrhoids. Superselective embolization of the left trunk is performed using a coaxial microcatheter (c, arrow) and microcoils placement (d) with good angiographic and clinical results. The different distal branches, respectively left, right and posterior trunk can be embolized according to the angiographic findings and anatomical classifications.
Figure 2
Selective arteriography of the celiac trunk (CT) in a patient addressed for massive upper bleeding from a gastric tumor. (a) Asterisk: left gastric artery (LGA); arrow: common hepatic artery (CHA); arrowhead: splenic artery (SA). (b) Superselective catheterization of the LGA showing a common anatomical variant with a left hepatic artery (LHA, arrow) originating from the LGA. On the left size, the branches supplying the lesser curvature of the stomach (arrowheads). (c) Embolization of the LGA is performed in this case in two steps: firstly, embolization of the LHA by coils (asterisk) to protect the liver; then, injection of a mixed oil Lipiodol-glue to obtain distal occlusion of the gastric bleeding (arrowheads). The LGA is the target in bariatric embolization for the treatment of the obesity; three ongoing trials are evaluating the outcomes of this new treatment modality, using coils and particles (see Table 1).
Figure 3
A 61-year-old man suffering from chronic osteoarthritis of the shoulder (so called “frozen shoulder”). (a) Arteriography of the left subclavian artery (LSA) showing the different collateral branches and a focal hypervascularization between the subacromial space and the humeral head (asterisk). Transarterial treatment by particle embolization: (b) selective catheterization of the thoraco-acromial artery and (c) control after superselective injection of 1.5 g of imipenem-cilastatin. Different articular branches (coracoid artery; anterior and posterior circumflex humeral; suprascapular) can be targeted to reduce te neo-angiogenesis related to the inflammation. In (d) and (e), embolization of the coracoid artery, respectively before and after the particle injection. Early results of this new therapeutic concept seem promising. Courtesy of Prof. M. Nakai and Prof. A. Ikoma from the Department of Radiology, Wakayama Medical University, Japan.
Figure 4
Interventional management of a renal mass in an inoperable patient, combined approach: transarterial preoperative embolization is performed through femoral access (b) using selective catheterization (c) and injection of glue (d), thus obtaining devascularization before percutaneous ablation. (e) CT-guided cryotherapy; combination of the percutaneous ablative therapies and the immune-modulating drugs in the so-called “Interventional Immunooncology” becomes an unexplored field of application with a tremendous potential to investigate in the next future.
Table 2
The large spectrum of the Extended Reality, involving different type of virtual experiences where the observer interacts with the surrounding environment. Merged (MeR) and Mixed Reality (MxR) are the most adapted concepts for medical applications as they allow interaction with digital objects while preserving contact with the real surrounding environment (patient and operatory theatre).