Chang Ho Jeon

윤종혁, et al. J Korean Soc Radiol. 2026 ;87:e69. https://doi.org/10.3348/jksr.2026.0051

이동희, et al. J Korean Soc Radiol. 2026 ;87:e27. https://doi.org/10.3348/jksr.2026.0006

Urologic trauma encompasses a spectrum of injuries involving the kidney, ureter, bladder, and urethra, with management strategies increasingly emphasizing organ preservation through minimally invasive, image-guided approaches. The updated American Association for the Surgery of Trauma 2025 grading system provides the most recent guideline for renal trauma classification, reflecting evolving imaging standards and management principles. In parallel, interventional radiology (IR) has assumed an increasingly important role in contemporary trauma care, offering effective, organ-preserving solutions through endovascular and percutaneous techniques. Renal trauma, the most frequent form of genitourinary injury, is now primarily managed non-operatively in hemodynamically stable patients, with transcatheter arterial embolization and stent-based repair serving as cornerstones of hemorrhage control and renal salvage in high-grade lesions. Clinical evidence demonstrates that selective or superselective embolization achieves high technical success and renal preservation, consolidating IR as a key component of multidisciplinary trauma management. Injuries to the lower urinary tract remain complex, but minimally invasive, image-guided interventions are increasingly recognized as integral to modern care, particularly in controlling hemorrhage and preserving function. Superselective embolization, percutaneous urine diversion, and fluoroscopic urethral realignment exemplify how IR provides life-saving, organ-preserving options for ureteral, bladder, and urethral trauma. Collectively, these developments underscore the expanding impact of IR across the full spectrum of urologic trauma management.

Background and Objectives: Transarterial embolization (TAE) serves as a valuable alternative for gastrointestinal bleeding when endoscopy fails or is inaccessible. Quick-soluble gelatin sponge particles (QS-GSPs) dissolve rapidly and may reduce ischemic complications compared to permanent embolic agents. This study evaluated the safety and effectiveness of TAE using QS-GSPs for acute lower gastrointestinal bleeding. Materials and Methods: This retrospective multicenter study analyzed patients who underwent TAE with QS-GSPs for acute nonvariceal lower GI bleeding between 2021 and 2024. Technical success (occlusion or stasis of blood flow in the target artery), clinical success (cessation of bleeding symptoms with hemodynamic stability during the week following TAE without major complications), and procedure-related complications were assessed. Results: A total of 29 patients (mean age 64.9 years) were included. Active bleeding was detected in 6 patients (20.7%) on angiography. Embolized arteries included jejunal (n = 7), ileal (n = 7), ileocolic anastomotic (n = 1), cecal (n = 2), colic (n = 7), and rectosigmoid (n = 5) arteries. QS-GSPs (150–350 μm (n = 10) or 350–560 μm (n = 19)), which dissolve completely within several hours, were used as the sole embolic agents. Technical and clinical success rates were 100% and 75.9% (22/29), respectively. Clinical failure occurred in seven patients (24.1%) due to persistent (n = 4) or recurrent (n = 3) bleeding within one week. Transient bowel ischemia occurred in two patients (6.9%) but resolved spontaneously. The clinical success rate did not differ significantly between patients with active bleeding (66.7%) versus those without (73.9%). Conclusions: TAE with QS-GSPs for acute lower GI bleeding demonstrated a favorable safety profile with clinical success exceeding 75%. Transient bowel ischemia occurred in 6.9% of patients with spontaneous resolution, and no bowel infarction was observed.

Background and Objectives: Transcatheter arterial embolization (TAE) serves as a valuable alternative for gastrointestinal bleeding when endoscopy fails or is inaccessible. Quick-soluble gelatin sponge particles (QS-GSP) dissolve rapidly and may reduce ischemic complications compared to permanent embolic agents. This study evaluated the safety and effectiveness of TAE using QS-GSP for acute lower gastrointestinal bleeding. Materials and Methods: This retrospective multicenter study analyzed patients who underwent TAE with QS-GSP for acute nonvariceal lower GI bleeding between 2021 and 2024. Technical success (occlusion or stasis of blood flow in target artery), clinical success (cessation of bleeding symptoms with hemodynamic stability during the week following TAE without major complications), and procedure-related complications were assessed. Results: A total of 29 patients (mean age 64.9 years) were included. Active bleeding was detected in 6 patients (20.7%) on angiography. Embolized arteries included jejunal (n=7), ileal (n=7), ileocolic anastomotic (n=1), cecal (n=2), colic (n=7), and rectosigmoid (n=5) arteries. QS-GSPs (150–350 μm [n=10] or 350–560 μm [n=19]), which dissolve completely within 4 hours, were used as the sole embolic agents. Technical and clinical success rates were 100% and 75.9% (22/29), respectively. Clinical failure occurred in 7 patients (24.1%) due to persistent (n=4) or recurrent (n=3) bleeding within one week. Transient bowel ischemia occurred in 2 patients (6.9%) but resolved spontaneously. The clinical success rate did not differ significantly between patients with active bleeding (66.7%) versus those without (73.9%). Conclusions: TAE with QS-GSP for acute lower GI bleeding demonstrated a favorable safety profile with clinical success exceeding 75%. Transient bowel ischemia occurred in 6.9% of patients with spontaneous resolution, and no bowel infarction was observed.

PURPOSE To evaluate the efficacy of staged full-length balloon-assisted maturation (BAM) for the maturation of arteriovenous fistulas (AVFs) on entire segmental veins, including stenosis, causing primary AVF failure. METHODS This study included patients who underwent AVF surgery using an autogenous vein between February 2020 and June 2021 and received staged angioplasty with a full-length balloon catheter. To minimize balloon overlap and the risk of barotrauma to the immature vein, serial-staged upsizing balloon angioplasty with a long balloon catheter covering the entire vein segment was employed approximately 2 weeks apart. RESULTS Twenty-three patients (mean age, 69.50 years; mean follow-up, 620.62 days) with average diameters of the radial artery and cephalic vein at 2.14 +/- 0.5 mm and 2.43 +/- 0.5 mm, respectively, were enrolled. In the first procedure, the average AVF diameter and flow were 4.03 +/- 0.57 mm and 438.08 +/- 220.95 mL/min, respectively, with juxta-anastomotic stenosis (JAS) present in 61.5% of cases. After staged full-length BAM, the average fistula diameter and flow improved to 5.95 +/- 0.86 mm and 717.52 +/- 305.95 mL/min, respectively. Maturation was achieved in 87% of the cases. No hematomas or ruptures occurred around the arterialized veins. Despite successful maturation and cannulation, 65.2% of the patients required additional percutaneous transluminal angioplasty (PTA) during the follow-up period. The necessity for PTA was determined by the presence of JAS prior to the first staged full-length BAM, with an odds ratio of 11.74 (95% confidence interval: 1.31-104.96, P = 0.03). CONCLUSION Staged full-length BAM can be safely used in patients with small veins requiring further maturation. Most patients achieved successful cannulation following maturation without post-procedural complications. CLINICAL SIGNIFICANCE Staged full-length BAM is a safe and effective method for enhancing maturation in patients with underdeveloped small veins.

This study aimed to compare the prognosis and characteristics of patients with advanced hepatocellular carcinoma treated with first-line atezolizumab plus bevacizumab (AB) combination therapy and hepatic artery infusion chemotherapy (HAIC). We retrospectively assessed 193 and 114 patients treated with HAIC and AB combination therapy, respectively, between January 2018 and May 2023. The progression-free survival (PFS) of patients treated with AB combination therapy was significantly superior to that of patients treated with HAIC (p < 0.05), but there was no significant difference in overall survival (OS). After propensity score matching, our data revealed no significant differences in OS and PFS between patients who received AB combination therapy and those who received HAIC therapy (p = 0.5617 and 0.3522, respectively). In conclusion, our propensity score study reveals no significant differences in OS and PFS between patients treated with AB combination therapy and those treated with HAIC.

This study aimed to compare the prognosis and characteristics of patients with advanced hepatocellular carcinoma treated with first-line atezolizumab plus bevacizumab (AB) combination therapy and hepatic artery infusion chemotherapy (HAIC). We retrospectively assessed 179 and 72 patients treated with HAIC and AB combination therapy, respectively, between January 2018 and January 2023. The progression-free survival of patients treated with HAIC was significantly superior than that of patients treated with AB (P<0.05), but there was no significant difference in overall survival and objective response rate (ORR) between the two groups (P=0.1056 and P=0.137, respectively). After propensity score matching (PSM), our data revealed that there was no significant difference in PFS between patients who received AB combination therapy and HAIC therapy (P=0.8888). However, patients who received AB combination therapy had significantly better overall survival than those who received HAIC therapy (P=0.0133). In addition, after PSM, significant differences in ORR and disease control rate were not observed. In conclusion, our propensity score study reveals that patients treated with AB therapy have a significantly longer OS than those treated with HAIC.

정현석, et al. J Korean Soc Radiol. 2023 Jul;84(4):824-834. https://doi.org/10.3348/jksr.2023.0046