Yousof Al Zahrani

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Late-stage presentation, co-morbidities, and limited donor availability enable only a few patients to receive curative therapies. HCC is treated with liver resection and transplantation as the first line of treatment. Patients in advanced stages, on the other hand, are treated with a variety of locoregional treatments. Transarterial embolization (TAE), transarterial chemoembolization (TACE), and transarterial radioembolization (TARE) are different modalities of locoregional therapy for HCC with robust collateral circulation. One of the characteristics of HCC is that it is hypervascular, therefore, parasitic supply is not unusual. The left internal mammary artery (LIMA) is considered to be an uncommon parasitic supply in HCC. While TACE has been extensively reviewed in the literature, herein we report a successful case of TARE via the LIMA which was a safe and practical alternative for a patient with HCC.

Publication Date: 26 March 2021 (online) © 2019. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

Background: Fiducial markers are useful for stereotactic body radiotherapy for treatment of malignant tumors. Here, we report two cases of rare complications following percutaneous fiducial markers placement. Methods: First case, a 51-year-old male with high grade metastatic neuroendocrine tumour of the liver who underwent ultrasound guided placement of four fiducial markers in the right hepatic lobe tumour. Second case, a 41-year-old lady with rectal adenocarcinoma and pulmonary metastasis who underwent CT guidance fiducial markers placement in four metastatic lung lesions. Results: First case developed tumor cell seeding along the needle tract of the fiducial marker placement procedure. This was detected on follow up cross sectional imaging. Second case developed intracardiac migration of one of the fiducial markers into the left ventricle during the procedure. The patient continues to be totally asymptomtic on follow up after one and half month after the procedure. The migrated fiducial marker has not changed its location in the left ventricle as well. Conclusions: Although rare, tumour cell tract seeding and intracardiac migration following percutaneous fiducial markers placement are potential complications and should be taken in consideration. Publication Date: 26 April 2021 (online) © 2017. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

Objective: Vascular and interventional radiology (VIR) is one of the most rapidly growing fields of medicine. In this report, we evaluate the contribution of Arab countries to VIR publications and literature. Materials and Methods: Using PubMed database, we reviewed the total number of VIR publications from all Arab countries. In addition, we evaluated the total number of IR articles from each individual country, number of publications in VIR specialty journals and the type of manuscripts. Results: Seventy-four articles from different Arab countries were published in different journals from 1988 to 2016. Only 11 (14.9%) articles were published in interventional radiology journals. The majority of these publications were from Kingdom of Saudi Arabia 31 (41.9%) articles, followed by 20 (27.02%) articles from Egypt, 7 articles (9.5%) from Jordan, 6 articles (8.1) from Kuwait, and 4 articles (5.4%) from Morocco. There was one article (1.4%) from Lebanon, United Arab Emirates, Oman, Tunis, and Qatar. Nine (12.2%) articles from different Arab countries were published in the two highest impact specialty journals in VIR. Conclusion: This review demonstrated the limited number of publications and poor contribution of Arab countries to VIR literature. Collaborative efforts of researchers, governments, and funding bodies are needed to improve research output in this important field of medicine.

INTRODUCTION: Inadvertent placement of a nephrostomy tube into the inferior vena cava (IVC) is an extremely rare complication with few reported cases in the literature. CASE PRESENTATION: We present a lady with obstructive uropathy in a solitary kidney in whom an attempt by the community radiologist to place a nephrostomy tube was complicated by wrong insertion into the IVC. This report illustrates how a safe non- surgical removal of this tube using an intravenous balloon tamponade technique was successfully applied. DISCUSSION: Intravenous placement of nephrostomy catheters into the inferior vena cava is extremely rare complication. A few case reports have been published in the literature. The majority of these cases were removed in the operating room under general anesthesia. Using Intravenous balloon tamponade technique for removal has not been previously reported. CONCLUSION: Intravenous balloon tamponade technique is effective and is a good minimally invasive alternative to surgical removal of misplaced nephrostomy tube from IVC. Highlights: