Sasan Partovi

• MD
• Medical Doctor at Cleveland Clinic

This systematic review explores the role of cross-sectional imaging modalities—computed tomography angiography (CTA) and magnetic resonance angiography (MRA)—in the preoperative planning of dialysis vascular access for patients with end-stage renal disease (ESRD). A systematic search was conducted using PubMed and Cochrane databases, yielding 45 st...

Ultrasound of the urinary bladder detects diverse and complex pathology. This manuscript deals with various bladder diseases imaged with multiparametric ultrasound, including contrast enhanced ultrasound.

Carotid artery stiffness is associated with aging and atherosclerotic disease, leading to cerebrovascular events. Shear Wave Elastography (SWE) is a novel ultrasound technique offering a direct, quantitative assessment of the arterial wall elasticity. The aim of this study is to validate the technical feasibility of SWE in measuring carotid stiffne...

The term acute aortic syndrome (AAS) refers to a range of different entities, including dissection, intramural haematoma and penetrating atherosclerotic ulcer. Patients with chronic renal disease and particularly those with dominant polycystic kidney disease are susceptible to this pathology, given the underlying renal arteriopathy and hypertension...

For end-stage renal disease (ESRD) patients requiring hemodialysis, reliable vascular access is crucial, especially when conventional supradiaphragmatic options are exhausted. This study reviews the technical aspects, clinical outcomes, and complications of translumbar and transhepatic tunneled dialysis catheter (TDC) placements. These alternative...

Orthotopic liver transplantation (OLT) is the treatment of choice for end-stage liver disease. However, OLT may be associated with certain postoperative management challenges. Though refractory ascites (RA) is not a common complication post-OLT, it can have a significant impact on patient outcomes and quality of life. RA post-OLT can be caused by p...

Background/Objectives: To evaluate radiation exposure in standard interventional radiology procedures using a twin robotic X-ray system compared to a state-of-the-art conventional angiography system. Methods: Standard interventional radiology procedures (port implantation, SIRT, and pelvic angiography) were simulated using an anthropomorphic Alders...

Percutaneous biliary endoscopy (PBE), also known as cholangioscopy, represents a significant advancement in the field of interventional radiology. This technique offers a minimally invasive alternative to traditional surgery or peroral approaches for a range of biliary diseases, including stone clearance, biliary stricture/mass evaluation, and biop...

Background ⁹⁰Y radioembolization is an established treatment modality for hepatic malignancies. Successful radioembolization requires optimal dose delivery to tumors while minimizing dosages to parenchyma. Post-treatment positron emission tomography (PET)/computed tomography (CT) dosimetry is the established benchmark, whereas PET/magnetic resonanc...

The spectrum of venous thromboembolic (VTE) disease encompasses both acute deep venous thrombosis (DVT) and chronic postthrombotic changes (CPC). A large percentage of acute DVT patients experience recurrent VTE despite adequate anticoagulation, and may progress to CPC. Further, the role of iliocaval venous obstruction (ICVO) in lower-extremity VTE...

Background: Reperfusion therapy is challenging in the elderly. Catheter-directed therapies are an alternative for higher-risk pulmonary embolism (PE) patients if systemic thrombolysis (ST) is contraindicated or has failed. Their safety has not been evaluated in specific vulnerable populations. Aims: We aimed to assess the safety of reperfusion t...

Purpose To evaluate efficacy, safety, and outcomes of endovascular treatment of hepatic vein stenosis post major liver resection. Methods A retrospective data analysis was performed including all interventional treatments of hepatic vein stenosis post major liver resection since 2010. Post procedural course and clinical parameters including amount...

The evolution of ultrasound (US) techniques has greatly improved the evaluation of many parameters in dialysis vascular access, which is typically achieved through an arteriovenous fistula (AVF) or graft (AVG). These techniques include grayscale B-mode, color Doppler, power Doppler, spectral Doppler, non-Doppler US flow imaging techniques, contrast...

To evaluate Quiescent Interval Slice Selective (QISS) balanced steady-state free precession (bSSFP) and QISS fast low-angle shot (FLASH) sequences for non-contrast Magnetic Resonance Angiography (MRA) of iliac arteries regarding image quality and diagnostic confidence in order to establish these sequences in daily clinical practice. A prospective s...

Purpose: Proximal splenic artery embolization (pSAE) has been advocated as a valuable tool to ameliorate portal hyper-perfusion (PHP). The purpose of this study was to determine the safety and efficacy of pSAE to treat refractory ascites (RA) and/or refractory hydrothorax (RH) in the setting of PHP post-liver transplant. Material and methods: A...

Emergency imaging of the scrotum is part of routine medical practice. Indications include epididymitis/epididymo-orchitis, testicular torsion, trauma, tumors and infarction. Prompt diagnosis and management are needed to ensure optimal patient outcome. Ultrasound (US) is the initial, and often the only, imaging modality for testicular pathologies. U...

Carotid atherosclerosis is a major cause for stroke, with significant associated disease burden morbidity and mortality in Western societies. Diagnosis, grading and follow-up of carotid atherosclerotic disease relies on imaging, specifically ultrasound (US) as the initial modality of choice. Traditionally, the degree of carotid lumen stenosis was c...

Purpose: To describe the imaging findings of hepatic infarction after transjugular intrahepatic portosystemic shunt (TIPS) placement and identify risk factors, clinical manifestations, and outcomes of infarction after TIPS. Materials and methods: In this retrospective analysis of a TIPS registry (1995-2021), cirrhotic patients with hepatic infar...

Portal hypertension defined as pressure within the portal venous system is an important event in the evolution of cirrhosis. With the development of clinically significant portal hypertension, there is increased risk of developing gastroesophageal varices and hepatic decompensation. Endoscopic evaluation of esophageal and gastric varices and hepati...

Central venous occlusion is a common condition in certain patient populations, with significant associated morbidity. Symptoms range from mild arm swelling to respiratory distress and can be particularly troublesome in the end stage renal disease population when related to dialysis access and function. Crossing completely occluded vessels is often...

Objectives To assess diagnostic accuracy of automated 3D volumetry of cardiac chambers based on computed tomography pulmonary angiography (CTPA) for the differentiation of pulmonary hypertension due to left heart disease (group 2 PH) from non-group 2 PH compared to manual diameter measurements. Methods Patients with confirmed PH undergoing right h...

The purpose of this study was to prospectively analyse image quality and radiation dose of body mass index (BMI)-adapted low-radiation and low-iodine dose CTA of the thoracoabdominal aorta in obese and non-obese patients. This prospective, single-centre study included patients scheduled for aortic CTA between November 2017 and August 2020 without s...

Objective Transjugular intrahepatic portosystemic shunt (TIPS) placement is used to treat the sequelae of portal hypertension, including refractory variceal bleeding, ascites and hepatic hydrothorax. However, hernia-related complications such as incarceration and small bowel obstruction can occur after TIPS placement in patients with pre-existing h...

Ultrasound (US) remains a valuable modality for the assessment of vascular diseases, with conventional sonographic techniques such as grayscale and Doppler US used extensively to assess carotid atherosclerosis and abdominal aortic aneurysms. However, conventional US techniques are inherently limited by factors such as operator dependency and limite...

The concept of tumor field effect implies that cancer is a systemic disease with its impact way beyond the visible tumor confines. For instance, in Glioblastoma (GBM), an aggressive brain tumor, the increase in intracranial pressure due to tumor burden often leads to brain herniation and poor outcomes. Our work is based on the rationale that highly...

Hepatic encephalopathy (HE) is a challenging complication after transjugular intrahepatic portosystemic shunt (TIPS) placement. Despite recent advances, much is still uncertain regarding risk factors, preventative measures, and the management of HE after TIPS placement. Appropriate patient selection and pre-procedural risk stratification remain are...

Introduction Transjugular intrahepatic portosystemic shunt (TIPS) placement is a well-established but technically challenging procedure for the management of sequelae of end-stage liver disease. Performed essentially blindly, traditional fluoroscopically guided TIPS placement requires multiple needle passes and prolonged radiation exposure to achie...

Background Portal vein thrombosis (PVT) is a rare but severe entity that can cause clinically significant sequela such as worsening portal hypertension or mesenteric ischemia. Those cases refractory to medical management may be referred for endovascular intervention. Several technical considerations have been described in the literature, but a cohe...

With the advent of multidetector computed tomography (CT), CT angiography (CTA) has gained widespread popularity for noninvasive imaging of the arterial vasculature. Peripheral extremity CTA can nowadays be performed rapidly with high spatial resolution and a decreased amount of both intravenous contrast and radiation exposure. In patients with per...

Purpose: To evaluate the value of dual-phase parenchymal blood volume (PBV) C-arm mounted cone-beam-CT (CBCT) to enable assessment of radiopaque, doxorubicin-loaded drug-eluting embolics (rDEE) based on the visual degree of embolization, embolic density and residual tumor perfusion as early predictors for tumor recurrence after transarterial chemo...

The concept of tumor field effect implies that cancer is a systemic disease with its impact way beyond the visible tumor confines. For instance, in Glioblastoma (GBM), an aggressive brain tumor, the increase in intracranial pressure due to tumor burden often leads to brain herniation and poor outcomes. Our work is based on the rationale that highly...

Objective The purpose of this study was to investigate the value of cone beam computed tomography (CBCT) scanners versus plain radiography for detection and classification of fractures of the wrist and hand after acute trauma. Methods Images of 56 patients that received both plain radiography and CBCT after presenting to our emergency department w...

The manuscript discusses the application of CT pulmonary angiography, ventilation–perfusion scan, and magnetic resonance angiography to detect acute pulmonary embolism and to plan endovascular therapy. CT pulmonary angiography offers high accuracy, speed of acquisition, and widespread availability when applied to acute pulmonary embolism detection....

Objective: This paper examines the incidence, clinical presentation, and pathophysiology of portal vein thrombosis (PVT) in cirrhosis. Additionally, we have reviewed the literature regarding the current status of medical and interventional radiology management of PVT and have proposed a novel algorithm for the management given different clinical s...

Background and objective: The incidence of patients with end-stage renal disease (ESRD) and subsequent need for dialysis is continuously rising. The detailed preoperative planning and careful creation of a functioning access for hemodialysis as a bridge to transplant or as a long-term solution, has a crucial role to reduce vascular access associat...

Intravascular ultrasound (IVUS) has been used extensively in coronary applications. Its use in venous applications has increased as endovascular therapy has increasingly become the mainstay therapy for central venous diseases. IVUS has been used for both diagnostic and therapeutic purposes in managing venous stenotic disease, venous occlusive disea...

Late vena cava/hepatic outflow obstruction after orthotopic liver transplantation (OLT), while rare, is among the most challenging complications. The cause may be an organized thrombus, reactive edema, fibrosis/scarring with calcification, or neointimal hyperplasia. Moreover, the obstruction can involve different anatomical parts of the vena cava....

Gastrointestinal malignancy encompasses a wide range of disease processes. Its incidence and mortality rate rank among the highest of all cancers. Venous thromboembolic disease is a common complication of gastrointestinal malignancy. Anticoagulation remains the first-line therapy. However, for patients who cannot tolerate or have failed anticoagula...

Not only the degree of luminal narrowing but also the plaque morphology and composition play an important role in risk stratification of carotid atherosclerotic lesions. During the last few years, carotid contrast-enhanced ultrasound (CEUS) has emerged as a valuable imaging tool to assess such vulnerable carotid plaques. This review article discuss...

Inferior vena cava (IVC) filter has been used to manage patients with pulmonary embolism and deep venous thrombosis. Its ease of use and the expansion of relative indications have led to a dramatic increase in IVC filter placement. However, IVC filters have been associated with a platitude of complications. Therefore, there exists a need to examine...

Background Small bowel transplant (SBT) is a surgical procedure that may be used in patients with pathology resulting in severe intestinal failure resistant to conventional forms of surgical and nonsurgical treatment. Intestinal failure is defined as the failure of enterocytes to absorb sufficient macronutrients, water, and/or electrolytes to susta...

Gastrostomy tube is an effective and safe long-term feeding access that is well-tolerated by patients. The typical placement routes include surgical, endoscopic and interventional radiologic placement. In particular, percutaneous interventional radiologic gastrostomy (PIRG) has increasingly become the preferred method of choice in many practices. A...

Objective: The manuscript discusses landmark studies using abbreviated MRI for breast cancer screening. This includes abbreviated dynamic contrast enhanced MRI and diffusion weighted imaging. Our institutional experience with abbreviated MR protocol for breast cancer screening is also described. Conclusion: Abbreviated MRI protocols were found t...

Multi-energy computed tomography (MECT) refers to acquisition of CT data at multiple energy levels (typically two levels) using different technologies such as dual-source, dual-layer and rapid tube voltage switching. In addition to conventional/routine diagnostic images, MECT provides additional image sets including iodine maps, virtual non-contras...

Heart failure is a clinical condition that is associated with significant morbidity and mortality. With the advent of left ventricular assist device (LVAD), an increasing number of patients have received an artificial heart both as a bridge-to-therapy and as a destination therapy. Clinical trials have shown clear survival benefits of LVAD implantat...

Background Acute thrombotic pulmonary embolism (PE) is a common and potentially fatal event with imaging playing a pivotal role in the diagnosis and management of these patients. Method This review discusses imaging techniques, diagnostic algorithms, imaging findings and endovascular treatment of acute thrombotic PE, and illustrates important diffe...

Objectives To assess the diagnostic accuracy of automated 3D volumetry of central pulmonary arteries using computed tomography pulmonary angiography (CTPA) for suspected pulmonary hypertension alone and in combination with echocardiography. Methods This retrospective diagnostic accuracy study included 70 patients (mean age 66.7, 48 female) assesse...

Background Bronchial artery embolization (BAE) can be a challenging intervention due to variations of the vascular anatomy. Purpose To evaluate the utility of C-arm cone-beam computed tomography (CBCT) for BAE in patients with hemoptysis and indefinite bronchial artery (BA) anatomy on pre-interventional CT imaging. Material and Methods From Novem...

Purpose To compare different imaging techniques (volume perfusion CT, cone-beam CT, and dynamic gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid–enhanced dynamic contrast–enhanced MR imaging with golden-angle radial sparse parallel MR imaging) in evaluation of transarterial chemoembolization of hepatocellular carcinoma (HCC) using radiop...

Subtle tissue deformations caused by mass-effect in Glioblastoma (GBM) are often not visually evident, and may cause neurological deficits, impacting survival. Radiomic features provide sub-visual quantitative measures to uncover disease characteristics. We present a new radiomic feature to capture mass effect-induced deformations in the brain on G...

Since its introduction, contrast‐enhanced ultrasound (CEUS) has gained an important role in the diagnosis and management of abdominal and pelvic diseases. Contrast‐enhanced ultrasound can improve lesion detection rates as well as success rates of interventional procedures when compared to conventional ultrasound alone. Additionally, CEUS enables th...

Introduction: The term "carotidynia" has been used to describe a symptom or a nosologic entity characterized by pain in the lateral neck region and over the carotid bifurcation. Recent advances in diagnostic imaging and the introduction of diagnostic criteria have led to the adoption of term "Transient perivascular inflammation of the carotid arte...

Background: To evaluate the benefits of arterial phase imaging and parenchymal blood volume (PBV) maps acquired by C-arm computed tomography during TACE procedure in comparison to cross-sectional imaging (CSI) using CT or MRI. Methods: From January 2014 to December 2016, a total of 29 patients with HCC stage A or B (mean age 65 years; range 47 t...

Nonvariceal upper gastrointestinal bleeding (UGIB) is associated with significant morbidity and mortality among hospitalized patients and thus presents a treatment challenge for the interventional radiologist. Common causes of nonvariceal UGIB include peptic ulcer disease, Mallory–Weiss tear, erosive inflammatory changes, ulcer disease, malignancy,...

Ultrasound has been established as an important diagnostic tool in assessing vascular abnormalities. Standard B-mode and Doppler techniques have inherent limitations with regards to detection of slow flow and small vasculature. Contrast-enhanced ultrasound (CEUS) is a complementary tool and is useful in assessing both the macro- and microvascular a...

Purpose To assess quantitative stenosis grading by color-coded fluoroscopy using an in vitro pulsatile flow phantom. Methods Three different stenotic tubes (80%, 60%, and 40% diameter restriction) and a nonstenotic reference tube were compared regarding their different flow behavior by using contrast-enhanced fluoroscopy with a flat-detector syste...

Pulmonary arteriovenous malformation (PAVM) is a rare disease disproportionally affecting patients with hereditary hemorrhagic telangiectasia and may be associated with other pulmonary or infectious etiologies. Respiratory symptoms are the most common, including dyspnea, hypoxemia, and hemoptysis. Due to the impairment of normal pulmonary filtratio...

This is a rare case of an isolated pectoralis minor partial-thickness tendon tear in a 24-year-old man who was involved in a major trauma. The purpose of this paper is to report the clinical signs, symptoms, cross-sectional imaging findings, and management of an isolated pectoralis minor tendon tear. Furthermore, this case represents a novel trauma...

Objective: The purpose of this preliminary retrospective study was to analyse if cone beam computed tomography (CBCT) is able to identify more bleeding sites and corresponding feeding arteriesin patients with haemorrhage of uncertain origin. Methods: In eighteen vascular territories (sixteen patients) pre-interventional computed tomography angio...

The pulmonary arteries are affected by a variety of congenital and acquired abnormalities. Multiple state-of-the art imaging modalities are available to evaluate these pulmonary arterial abnormalities, including computed tomography (CT), magnetic resonance imaging (MRI), echocardiography, nuclear medicine imaging and catheter pulmonary angiography....

Although pulmonary embolism is the most common abnormality of the pulmonary artery, there is a broad spectrum of other congenital and acquired pulmonary arterial abnormalities. Multiple imaging modalities are now available to evaluate these abnormalities of the pulmonary arteries. CT and MRI are the most commonly used cross-sectional imaging modali...

The recently published PRESERVE trial is presently the largest and most comprehensive clinical trial comparing commonly applied strategies for prevention of iodinated contrast-induced acute kidney injury in high-risk patients. The fundamental conclusion of the PRESERVE trial is that oral acetylcysteine and intravenous sodium bicarbonate are not sup...

Purpose: To evaluate indications, technical success rate and complications of CT-guided translumbar catheter placement in the inferior vena cava for long-term central venous access (Port and Hickman catheters) as a bail-out approach in patients with no alternative options for permanent central venous access. Materials and methods: This retrospec...

Endoleaks are a common complication of endovascular aortic repair (EVAR). As a result, patients require lifelong imaging surveillance following EVAR. In current clinical practice evaluation for endoleaks is predominantly performed with computed tomography angiography (CTA). Due to the significant cumulative radiation burden associated with repetiti...

Aorto-enteric fistula (AEF) is a rare life-threatening condition. Early recognition and diagnosis are of paramount importance to improve outcome. In this article four cases of AEF with relevant pre- and post-procedural images are presented to demonstrate the utility of cross-sectional imaging in the work-up of AEF. The literature is reviewed to des...

Ultrasound (US) represents the initial modality in the workup of abdominal aortic pathology based on the plethora of advantages including widespread availability, low cost, safety profile and repeatability. However, US has inherent limitations including limited spatial information of pathologic processes to neighboring structures, lower sensitivity...

Partial circulatory support is a promising concept for the treatment of heart failure patients. A better understanding of induced hemodynamic changes is essential for optimizing treatment efficacy. Computational fluid dynamics (CFD) is an alternative method to gain insight into flow phenomena difficult to obtain in vivo. In 10 patients implanted wi...

Objective: To retrospectively compare the diagnostic performance of isotropic 3D steady-state free precession (3D-SSFP) sequences with 2D turbo spin-echo proton density-weighted fat-saturated (2D-TSE-PD fs) images in hip magnetic resonance arthrography; arthroscopy was a standard of reference. Methods: Eighty-one patients with suspected labral t...