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To evaluate the local efficacy of image-guided thermal ablation of renal cell carcinoma (RCC) after ipsilateral partial nephrectomy. Pathology report revealed negative tumor margin in 3 patients, the fourth patient had surgery at another institution with no pathology report available. [Extracted from the article]

Purpose: Venous thromboembolism (VTE) is a harbinger of poor outcome for patients with cancer. The SIR guidelines for use of IVC filters state that patients with short life expectancies (≤ 6 months) should receive permanent filters. Our purpose was to develop a model for predicting 6 month survival in a cancer population referred for IVC filter placement. Materials and Methods: Clinical and laboratory parameters for patients, who received a permanent or optional IVC filter between January 2009 and December 2011, were reviewed. A Cox proportional hazards model was used to determine the significant predictors of 6 month survival. Results: 405 IVC filters (n=213 permanent filters, n=192 retrievable filters) were placed at a single institution and analyzed. Survival at 6 months was 209/405 (51.6%). The significant predictive factors of 6 month survival were: 1. Cancer stage (local vs metastatic; hazard ratio [HR] 0.184; p=0.0044). 2. Cancer stage (locally advanced vs metastatic; HR 0.435; p=0.0005). 3. Major surgery 30 days before IVC filter placement (HR 0.470; p=0.0021). 4. Planned surgery 30 days after IVC filter placement (HR 0.355; p<0.0001) 5. Albumin (HR 0.540; p<0.0001). These variables can be used to calculate a risk score for patients with VTE and cancer (VTEC) referred for IVC filters (VTEC-IVC) (see Table). Conclusion: Clinical and laboratory parameters can be used to predict 6 month survival in a population of cancer patients with solid malignancies referred for IVC filter placement. The model can be used to help physicians decide on which type of filter to implant (permanent versus optional) and, ultimately, impact IVC filter retrieval rates. [Copyright &y& Elsevier]

Learning Objectives: To review indications, technique, and outcomes from percutaneous transesophageal gastrostomy (PTEG) catheters. We review 12 successfully placed PTEG catheters at our institution over four years. Background: Patients unable to receive percutaneous fluoroscopic gastrostomy (PFG) catheters are at risk for developing long-term complications from indwelling nasogastric (NG) tubes. PTEG catheters are a feasible alternative offering palliative relief for patients needing either venting or feeding support. Clinical Findings/Procedure Details: Once adequate sedation is achieved, a guidewire is passed through an existing NG tube, which is subsequently removed. A 25 mm x 4 cm balloon catheter is then advanced into the stomach. The balloon is insufflated with contrast and withdrawn under fluoroscopy to just below the thoracic inlet. An appropriate access site is chosen on the lower left neck, and a 21-gauge needle is used to puncture the balloon under ultrasound guidance. A 0.018” microwire is passed through the needle and coiled in the balloon. The balloon and microwire are then passed, in tandem, into the gastric lumen and the balloon is disengaged from the microwire. The neck access is then sequentially dilated to accommodate a 14-French, 45-cm Mac Lock catheter (Cook, Bloomington, IN), which is passed into the stomach or jejunum and used for venting or feeding, as appropriate. In our experience, the most commonly encountered malignancy in need of an alternative gastrostomy approach has been metastatic gastric carcinoma (67%), ovarian carcinoma (17%), esophageal carcinoma (8%), and gallbladder carcinoma (8%). Patients survived 40.5 days (mean, range 28-85 days) following placement. Conclusion and/or Teaching Points: PTEG catheters are an essential tool for an interventional radiologist, providing patients an alternative for feeding or venting when direct percutaneous access into the stomach or jejunum is contraindicated. [Copyright &y& Elsevier]