Vascular and Interventional Radiology The Requisites This page intentionally left blank T H E R E Q U I S I T E S Vascular and I nterventional R adiology Second Edition John A. Kaufman, MD, MS, FSIR, FCIRSE Director, Dotter Interventional Institute Frederick S. Keller Professor of Interventional Radiology Oregon Health & Science University Hospital Portland, Oregon Michael J. Lee, MSc, FRCPI, FRCR, FFR(RCSI), FSIR, EBIR Consultant Interventional Radiologist, Beaumont Hospital Professor of Radiology, Royal College of Surgeons in Ireland Department of Radiology, Beaumont Hospital Dublin, Ireland 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 VASCULAR AND INTERVENTIONAL RADIOLOGY: ISBN: 978-0-323-04584-1 THE REQUISITES Copyright © 2014 by Saunders, an imprint of Elsevier Inc. Copyright © 2004 by Mosby, Inc., an affliate of Elsevier Inc. 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Practitioners and researchers must always rely on their own experience and knowledge in evaluat- ing and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identifed, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administra- tion, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negli- gence or otherwise, or from any use or operation of any methods, products, instructions, or ideas con- tained in the material herein. Library of Congress Cataloging-in-Publication Data Kaufman, John A., author. Vascular and interventional radiology: the requisites / John A. Kaufman, Prof Michael J. Lee.—Second edition. p. ; cm.—(Requisites) (Requisites in radiology series) Includes bibliographical references and index. ISBN 978-0-323-04584-1 (hardcover) I. Lee, Michael J., author. II. Title. III. Series: Requisites series. IV. Series: Requisites in radiology. [DNLM: 1. Vascular Diseases—radiography. 2. Radiography, Interventional—methods. WG 500] RD598.67 617.4’13059--dc23 2013009169 Senior Content Strategist: Don Scholz Content Development Specialist: Margaret Nelson Publishing Services Manager: Deborah Vogel Project Manager: Brandilyn Flagg Designer: Steve Stave Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 For our children, Nick, Claire, and Alex. You are everything to us. John and Cathy Kaufman For Eileen, Aoife, Ronan, Daire, and Sarah, and my parents Joe and Rose. Michael J. Lee This page intentionally left blank Contributors Michael D. Beland, MD Niamh Hambly, MBBChBAO, MRCPI, FFR(RCSI) Assistant Professor Consultant Radiologist Department of Diagnostic Imaging Beaumont Hospital Alpert Medical School of Brown University; Dublin, Ireland Director of Ultrasound Chapter 23: Image-Guided Breast Intervention Department of Diagnostic Imaging Rhode Island Hospital Farah G. Irani, MD Providence, Rhode Island Department of Interventional Radiology Chapter 25: Image-Guided Tumor Ablation: Basic Principles University Hospital of Strasbourg Strasbourg, France Peter J. Bromley, MD, FRCPC Chapter 24: Musculoskeletal Intervention Consultant Radiologist Departments of Radiology and Surgery Alice M. Kim, MD Peter Lougheed Centre Clinical Instructor of Radiology Calgary, Alberta, Canada Department of Radiology Chapter 14: Portal and Hepatic Veins New York Hospital Queens—New York Presbyterian – Weill Cornell Medical College; Xavier Buy, MD Radiologist Department of Interventional Radiology Department of Radiology University Hospital of Strasbourg New York Hospital Queens Strasbourg, France Flushing, New York Chapter 24: Musculoskeletal Intervention Chapter 27: Image-Guided Ablation as a Treatment Option for Thoracic Malignancies Colin P. Cantwell, FRCR, FFR Consultant Interventional Radiologist William W. Mayo-Smith, MD, FACR Radiology Department Professor of Radiology St. Vincent’s University Hospital Alpert Medical School of Brown University; Dublin, Ireland Director of CT and Body Imaging & Intervention Chapter 26: Image-Guided Ablation of Renal Tumors Department of Radiology Chapter 28: Image-Guided Ablation of Liver Tumors Rhode Island Hospital Providence, Rhode Island Damian E. Dupuy, MD, FACR Chapter 25: Image-Guided Tumor Ablation: Basic Principles Professor of Diagnostic Imaging Department of Diagnostic Imaging Gary M. Nesbit, MD Alpert Medical School of Brown University; Professor Director of Tumor Ablation Dotter Interventional Institute, Radiology, Neurosurgery, and Department of Diagnostic Imaging Neurology Rhode Island Hospital Oregon Health & Science University Providence, Rhode Island Portland, Oregon; Chapter 27: Image-Guided Ablation as a Treatment Option for Adjunct Associate Professor Thoracic Malignancies Department of Radiology University of Utah Afshin Gangi, MD, PhD Salt Lake City, Utah Professor Chapter 5: Carotid and Vertebral Arteries University of Strasbourg; Department of Interventional Radiology Constantino S. Pena, MD Nouvel Hopital Civil (NHC) Affliate Assistant Professor Strasbourg, France Department of Radiology Chapter 24: Musculoskeletal Intervention University of South Florida College of Medicine Tampa, Florida; Debra A. Gervais, MD Medical Director of Vascular Imaging Division Chief, Abdominal Imaging and Intervention Department of Interventional Radiology Division Chief, Pediatric Imaging Baptist Cardiac and Vascular Institute Assistant Program Director, MGH Radiology Residency Miami, Florida Massachusetts General Hospital and Harvard Medical School Chapter 3: Noninvasive Vascular Imaging Boston, Massachusetts Chapter 26: Image-Guided Ablation of Renal Tumors Chapter 28: Image-Guided Ablation of Liver Tumors vii This page intentionally left blank Foreword The frst edition of Vascular and Interventional Radiology: percutaneous access to treat disease, interventional radi- THE REQUISITES was the tenth book in the series and ology simply offers a better option than traditional open shared the overall series goal of providing core material in surgery for many conditions. major subspecialty areas of radiology for use by residents One of the major strengths of THE REQUISITES and fellows during their training and by practicing radiolo- series has been the continuity of authorship from one edi- gists seeking to review or expand their knowledge. The tion to the next, allowing authors to build on their work original book achieved its goals in outstanding fashion and while updating it appropriately. The current book is as now it is time for the second edition, which refects the fresh and relevant to today’s contemporary practice of vas- rather remarkable strides that have been made in vascular cular and interventional radiology as its predecessor. The and interventional radiology over the past several years. book also continues to be comprehensive enough to serve As noted previously, each book in THE REQUISITES as both an introductory text to the subject material covered series has offered a different set of challenges. In the case and an effcient source for review prior to examinations. of vascular and interventional radiology, a major challenge While the length and format of each volume in THE for the second edition was the need to cover many new pro- REQUISITES series are dictated by the material being cedures and provide outcomes information for procedures covered, the principal goal of the series is to equip the that have begun to mature. Examples from the two ends reader with a text that provides the basic factual, concep- of the spectrum include the transformative development tual, and interpretive material required for clinical practice. of regional delivery of targeted therapies and the growing I believe residents in radiology will fnd that the second body of knowledge about outcomes in the use of percu- edition of Vascular and Interventional Radiology: THE REQ- taneously implanted devices and stents. Drs. Kaufman UISITES is an excellent tool in these respects for learning and Lee have again done an outstanding job of distilling the subject. Drs. Kaufman and Lee have again captured this important material and the basic concepts of vascular the most important material in a very user-friendly text. and interventional radiology into a text that achieves high In addition to residents, physicians in practice and those marks for readability and accessibility. undertaking fellowship programs in vascular and interven- There is no subspecialty area of radiology more vulner- tional radiology will also fnd this book extremely useful. able to turf battles than vascular and interventional radiol- For seasoned practitioners and fellows alike, Vascular and ogy. It is imperative that radiologists continue to acquire Interventional Radiology: THE REQUISITES provides the skills in this area if the specialty is going to remain a strong material they need for contemporary clinical practice. provider of these services. One of the great advantages I congratulate John Kaufman and Michael Lee for that radiologists have is their superior knowledge of imag- another outstanding contribution to THE REQUISITES ing, which is of course the guiding hand of both diagnos- in Radiology. tic and therapeutic interventions. Drs. Kaufman and Lee have richly illustrated their book to refect the fexibility James H. Thrall, MD of multi-modality imaging that is now associated with per- Radiologist-in-Chief forming interventions. Department of Radiology In surgery morbidity is often linked to the amount Massachusetts General Hospital; of normal tissue that must be compromised in order to Juan M. Taveras Professor of Radiology reach—visualize—diseased tissues. By using noninvasive Harvard Medical School imaging to achieve visualization and minimally invasive Boston, Massachusetts ix