Korean Journal of Interventional Radiology

Review Article | Dec 31, 2025

Interventional Radiology in the Management of Urologic Trauma: A Contemporary Review: Chang Ho Jeon; Korean J Interv Radiol 2025;30(1):9-18.
Published online December 31, 2025; DOI: https://doi.org/10.64961/kjir.2025.00052

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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.

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Review Article | Mar 4, 2026

Interventional radiologist’s guide to the latest trends in pulmonary arteriovenous malformation management: Sang Yub Lee; Korean J Interv Radiol 2026;31(1):1-12.
Published online March 4, 2026; DOI: https://doi.org/10.64961/kjir.2026.00010

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Pulmonary arteriovenous malformations (PAVMs) are rare congenital vascular anomalies characterized by a direct connection between pulmonary arteries and veins, resulting in right-to-left shunting, arterial hypoxemia, and an increased risk of paradoxical embolic events. Endovascular embolization has become the standard of care for the treatment of PAVMs, significantly reducing the risk of neurologic and hemorrhagic complications. However, optimal patient selection, choice of embolic materials, procedural strategies, and post-treatment surveillance remain areas of active evolution. This review provides an interventional radiologist–focused overview of contemporary practice in PAVM management. Key topics include the clinical relevance of hereditary hemorrhagic telangiectasia, current indications for treatment in adult and pediatric populations, and periprocedural strategies to minimize complications such as air embolism and catheter-related thrombosis. Advances in embolic materials, including detachable coils, venous sac embolization techniques, and vascular plugs, are discussed with an emphasis on their relative efficacy and impact on recanalization and reperfusion rates. Procedure-related complications and their management are reviewed, highlighting both common self-limiting events and rare but serious adverse outcomes. Finally, current approaches to post-embolization surveillance are summarized, with a focus on the role of computed tomography, metal artifact reduction techniques, and emerging dynamic imaging modalities such as time-resolved magnetic resonance angiography for detecting treatment failure. By integrating recent evidence and practical procedural considerations, this review aims to support interventional radiologists in optimizing the safety, durability, and long-term outcomes of PAVM embolization.

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How I Do It | Mar 5, 2026

Catheter-directed sclerotherapy for ovarian endometriomas: Byung Soo Im, Ji Hoon Shin; Korean J Interv Radiol 2026;31(1):43-45.
Published online March 5, 2026; DOI: https://doi.org/10.64961/kjir.2026.00017

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Case Report | Sep 19, 2025

Embolization of Traumatic Ureteric Artery Bleeding: A Case Report: Suyoung Park; Korean J Interv Radiol 2025;30(1):2-4.
Published online September 19, 2025; DOI: https://doi.org/10.64961/kjir.2025.00024

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We present a rare case of traumatic ureteric artery bleeding successfully treated with transcatheter arterial embolization. A 65-year-old male with blunt abdominal trauma and hypotension was found to have a left retroperitoneal hematoma with active extravasation on CT. Initial angiography showed no visible bleeding; however, cone-beam CT revealed active hemorrhage from a ureteric artery displaced by the hematoma. Selective embolization using n-butyl cyanoacrylate and ethiodized oil was performed, resulting in hemodynamic stabilization. Follow-up imaging demonstrated resolution of bleeding and positional change of the ureteric artery as the hematoma resolved. This case highlights the diagnostic value of cone-beam CT and the importance of considering ureteric artery injury in cases of unexplained retroperitoneal hemorrhage.

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Case Report | Nov 18, 2025

Closure of a Misplaced Drainage Catheter Tract in the Stomach Using a Suture-Mediated Vascular Closure Device: A Case Report: Dong Jae Shim; Korean J Interv Radiol 2025;30(1):5-8.
Published online November 18, 2025; DOI: https://doi.org/10.64961/kjir.2025.00038

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Suture-mediated vascular closure devices (SMVCD) can be applied to close non-vascular structures, although this represents an off-label use. A 53-year-old woman who underwent hysterectomy and chemoradiation therapy due to endometrioid adenocarcinoma two years ago presented for generalized peritonitis due to anastomotic perforation following adhesiolysis and resection. CT revealed multifocal peritoneal abscesses. During perigastric fluid drainage, a pigtail drainage catheter was inadvertently placed into the stomach. To reduce the risk of gastroperitoneal fistula and peritonitis, the gastrostomy site was percutaneously closed using an SMVCD. Immediately after closure, gastrography using orally administered contrast medium and a 10-month follow-up CT demonstrated no leakage or procedure-related complications. This case suggests the potential for safe off-label use of vascular closure devices in the closure of gastrointestinal tract punctures.

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Review Article | Mar 6, 2026

Strategic integration of radioembolization and chemoembolization for the management of hepatocellular carcinoma in Korea: In Joon Lee; Korean J Interv Radiol 2026;31(1):13-23.
Published online March 6, 2026; DOI: https://doi.org/10.64961/kjir.2025.00066

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Transarterial chemoembolization (TACE) has long been the standard locoregional therapy for unresectable hepatocellular carcinoma, while transarterial radioembolization (TARE) using yttrium-90 microspheres has emerged as a promising alternative driven by advances in dosimetry and improved outcomes. TARE offers high complete response rates, durable local control, and minimal post-embolization syndrome, particularly in patients with localized or large tumors and preserved hepatic function. However, its broader use is limited by radiation-related toxicity, technical challenges, and socioeconomic factors, including high cost and limited repeatability. In contrast, TACE remains widely applicable, repeatable, and cost-effective, achieving excellent tumor control through refined superselective techniques, especially in Korea. Rather than competing modalities, TARE and TACE should be integrated within a tailored treatment strategy, with the choice determined by tumor characteristics, hepatic reserve, and institutional expertise.

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Original Article | Apr 16, 2026

Impact of Tumor Location on Radiofrequency Ablation Outcomes as First-Line Therapy for Hepatocellular Carcinoma: Gwang Hyeon Choi, Chang Jin Yoon, Chong-ho Lee, Kun Yung Kim, Eun Sun Jang, Jin-Wook Kim, Seung Jae Lee, Sook-Hyang Jeong, Minuk Kim, Jae Hwan Lee; Korean J Interv Radiol 2026;31(2):125-135.
Published online April 16, 2026; DOI: https://doi.org/10.64961/kjir.2025.00073

Purpose Tumor location influences the effectiveness and safety of RFA. This study evaluated RFA outcomes as first-line therapy for HCC <3 cm, focusing on tumor location impact. Materials and Methods In this retrospective cohort study, 281 patients with newly diagnosed HCC <3 cm in up to three lesions treated with RFA between 2003 and 2019 were analyzed. The tumor location was categorized as superficial (outer third), mid-portion (middle third), or deep (near vena cava), using an imaginary line from the liver surface to the vena cava. Perivascular tumors were defined as those abutting portal or hepatic veins. Recurrence-free survival (RFS) among location groups was compared with risk factors analyzed via Cox regression. Results Patients (mean age, 61.1 ± 11.1 years) were predominantly male (73.3%), hepatitis B virus surface antigen–positive (66.2%), and of Child-Pugh class A (97.5%). Deep tumors had shorter RFS than superficial/mid-portion tumors (HR, 1.87; 95% CI, 1.20 to 2.93; p = 0.005), as did perivascular versus non-perivascular tumors (HR, 1.87; 95% CI, 1.16 to 3.00; p = 0.008). Group C (deep + perivascular, n = 10) had shorter RFS than group A (no risk factors: HR, 3.12; 95% CI, 1.50 to 6.45; p = 0.002) and group B (one risk factor: HR, 1.59; 95% CI, 1.05 to 2.40; p = 0.028). Multivariable analysis identified tumor depth, perivascular location, size >2 cm, creatinine, and prothrombin time as independent predictors of shorter RFS. Conclusion Tumor depth and proximity to vasculature independently predict RFS in small HCCs treated with RFA, highlighting the role of tumor location in determining patient prognosis.

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Original Article | Mar 30, 2026

Impact of embolic agents on outcomes of renal angiomyolipoma embolization: a dual-center retrospective cohort study: Kun Yung Kim, Minuk Kim, Chang Jin Yoon, Chong-ho Lee, Sung-hwan Yoon, Young-Min Han, Jae Hwan Lee; Korean J Interv Radiol 2026;31(1):36-42.
Published online March 30, 2026; DOI: https://doi.org/10.64961/kjir.2025.00045

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Purpose Transcatheter arterial embolization (TAE) is widely used for managing renal angiomyolipoma (AML) to prevent hemorrhage and control symptoms while preserving renal function. However, the optimal embolic material remains undetermined due to limited comparative data. This study aimed to compare the effectiveness of ethanol-based embolization versus polyvinyl alcohol (PVA) and to evaluate additional benefits of microcoil use in ethanol-based treatments. Materials and Methods We retrospectively analyzed 119 patients with single renal AML who underwent TAE at two tertiary centers between 2005 and 2023. Patients were grouped into ethanol-based (ethanol alone or ethanol plus microcoil, n = 93) and PVA (n = 26) cohorts. Subgroup analysis compared ethanol alone (n = 24) versus ethanol plus microcoil (n = 69). Inverse probability treatment weighting and linear mixed-effects models were used to assess tumor volume reduction and treatment response (≥50% volume reduction). Results After adjustment, the ethanol group demonstrated significantly greater tumor volume reduction than the PVA group at 6 and 12 months (adjusted mean difference = –23.9%, p = 0.002; –23.1%, p = 0.001) and a higher response rate (92.1% vs. 78.4%, p = 0.043). In the subgroup analysis, ethanol plus microcoil achieved higher response (91.3% vs. 73.8%; OR, 3.73; p = 0.038) and lower recurrence (7.1% vs. 30.2%; OR, 0.18; p = 0.008) compared with ethanol alone. Conclusion Ethanol-based embolization provides superior tumor control compared to PVA in renal AML, and the addition of microcoils enhances early volume reduction and reduces recurrence, supporting its use as an effective treatment strategy.

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Ethanol-Based Embolization for Renal Angiomyolipoma: Is the Embolic Agent the Answer, or the Strategy?
Ho Jong Chun
Korean Journal of Interventional Radiology.2026; 31(2): 47. CrossRef

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Original Article | Jul 27, 2026

Securement of Central Venous Catheters: Suture Fixation vs. Stabilization Devices in a Multicenter Retrospective Study: Jung Ui Hong, Yohan Kwon, Dong Jae Shim, Jae Hwan Lee; Korean J Interv Radiol 2026;31(2):145-155.
Published online July 27, 2026; DOI: https://doi.org/10.64961/kjir.2026.00123

Purpose The use of adhesive-pad stabilization devices (SDs) instead of suture fixation (SF) may affect dislocation or infection rates. This study aimed to investigate the impact of SDs compared with SF for securing central venous catheters (CVCs). Materials and Methods This multicenter retrospective study was conducted in three tertiary institutions. Two institutions secured CVCs using sutures, whereas one used SDs, between February 2021 and July 2022. Rates of inadvertent dislocation and central line– associated bloodstream infection (CLABSI) were compared using incidence rate ratios (IRRs) from Poisson regression and Kaplan-Meier analysis after propensity-score matching. Factors associated with dislocation and CLABSI were evaluated using Cox proportional hazards analysis. Results A total of 2,110 patients (1,045 female; median age, 61 years [IQR, 50 to 72]) underwent CVC placement (SD, 854; SF, 1,256). After propensity-score matching (455 SD, 666 SF), dislocation occurred more frequently in the SD group (5.85 vs. 2.17 per 1,000 catheter-days; IRR, 2.64; 95% CI, 1.36 to 5.34). CLABSI occurred less frequently in the SD group (IRR, 0.19; 95% CI, 0.04 to 0.54). Kaplan-Meier analysis showed similar results. In multivariable analysis, SD was an independent risk factor for dislocation (adjusted HR [aHR], 2.23; 95% CI, 1.11 to 4.48). SD use showed a protective trend against CLABSI but did not reach statistical significance (aHR, 0.49; 95% CI, 0.13 to 1.82). When dislocation was modeled as a competing event, this protective association reached statistical significance (subdistribution HR, 0.19; 95% CI, 0.05 to 0.66). Conclusion Securement of CVCs with SDs was associated with a higher rate of catheter dislocation. Although SD use was associated with lower CLABSI rates, this finding requires further validation.

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Risk-Adapted Central Venous Catheter Securement: Which Strategy, for Which Catheter, in Which Patient?
Jeong Ho Kim
Korean Journal of Interventional Radiology.2026; 31(2): 164. CrossRef

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Case Report | May 26, 2026

Plug-Assisted Thrombectomy for Extensive SVC Thrombosis: A Case Report: Tae Wook Baek, Ji Hoon Kim, Dong Il Gwon, Ji Hoon Shin, Jin Hyoung Kim; Korean J Interv Radiol 2026;31(2):56-61.
Published online May 26, 2026; DOI: https://doi.org/10.64961/kjir.2026.00052

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Acute SVC syndrome caused by extensive thrombosis requires prompt endovascular intervention. We report a 48-year-old female with colon cancer presenting with massive chemoport-related thrombosis involving the SVC, right atrium (RA), and bilateral brachiocephalic veins. Due to the lack of an embolic protection filter landing zone, we performed a novel plug-assisted thrombectomy (PAT) technique. A 20-mm vascular plug was positioned at the SVC-RA junction as a temporary tethered filter without detachment. Following mechanical thrombectomy, plug retrieval, and adjunctive balloon dilatation, the patient recovered and was discharged on day 12. This case demonstrates the technical feasibility of PAT as a proof-of-concept approach for embolic protection in patients with extensive SVC thrombosis where conventional filter placement is anatomically precluded.

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Review Article | May 11, 2026

Drug-Coated Balloon Angioplasty for Dysfunctional Hemodialysis Access: An Update: Kichang Han; Korean J Interv Radiol 2026;31(2):92-102.
Published online May 11, 2026; DOI: https://doi.org/10.64961/kjir.2026.00045

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Hemodialysis vascular access dysfunction remains a major cause of morbidity and repeated interventions. Stenosis related to neointimal hyperplasia and altered hemodynamics leads to access flow limitation and thrombosis, particularly in AVFs. While percutaneous transluminal angioplasty is the standard first-line treatment, durability is often limited, resulting in frequent reinterventions. Drug-coated balloons, most commonly paclitaxel-based, have been introduced to inhibit restenosis and have demonstrated improved target lesion patency compared with conventional balloon angioplasty in several randomized trials, though outcomes vary by lesion location and study design. This narrative review summarizes the current evidence for drug-coated balloon angioplasty in dysfunctional arteriovenous access, discusses key trial endpoints, reviews safety and practical considerations, and highlights ongoing controversies and future directions.

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Review Article | Mar 23, 2026

Clinical challenges and transjugular intrahepatic portosystemic shunt strategies for pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome: an Asian perspective: Tan-Yang Zhou, Hong-Liang Wang, Zhi-Cheng Jin, Bin Xiong, Ji Hoon Shin; Korean J Interv Radiol 2026;31(1):24-35.
Published online March 23, 2026; DOI: https://doi.org/10.64961/kjir.2026.00031

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Pyrrolizidine alkaloid–induced hepatic sinusoidal obstruction syndrome (PA-HSOS) is highly prevalent in Asia, primarily due to the widespread use of traditional herbal medicines containing hepatotoxic pyrrolizidine alkaloids. This condition poses significant clinical challenges, including diagnostic difficulties and limited therapeutic options, frequently leading to severe liver damage and portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) treatment has emerged as a key intervention for managing complications associated with PA-HSOS, such as refractory ascites and variceal bleeding, by reducing portal pressure and supporting liver function recovery. However, TIPS has not been widely accepted as a salvage therapy for severe PA-HSOS unresponsive to anticoagulation therapy, mainly due to concerns about post-TIPS complications, particularly hepatic encephalopathy. Consequently, careful patient selection and risk stratification are critical. This review synthesizes the current evidence on PA-HSOS in Asia, evaluates the clinical utility of TIPS, and discusses strategies to optimize outcomes while minimizing adverse effects. Specifically, we review the epidemiology, pathophysiology, and diagnostic advancement of PA-HSOS, with a particular focus on the evolving role of TIPS in its management.

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Review Article | Jun 18, 2026

Endovascular Treatment of Below-the-Knee Arterial Disease in Chronic Limb-Threatening Ischemia: Tae Won Choi, Je Hwan Won, Jinoo Kim; Korean J Interv Radiol 2026;31(2):103-112.
Published online June 18, 2026; DOI: https://doi.org/10.64961/kjir.2026.00087

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Chronic limb-threatening ischemia represents the most severe form of peripheral artery disease and is associated with high risks of limb loss and mortality. It is closely associated with below-the-knee arterial disease, with substantial overlap between the two conditions, particularly in patients with diabetes. Endovascular treatment plays a central role in restoring distal tibial and pedal perfusion, which is critical for wound healing and limb salvage. However, it remains technically challenging due to small vessel size, diffuse disease, and heavy calcification, which limit luminal expansion and predispose to recoil, dissection, and restenosis. Procedural success requires a structured approach integrating access strategy, guidewire crossing, and subsequent treatment. Crossing strategies, including subintimal tracking, retrograde tibio-pedal access, and bidirectional techniques such as controlled antegrade and retrograde tracking, are often required in complex lesions. Plain balloon angioplasty remains the most broadly applicable treatment, whereas drug-coated balloons show inconsistent benefit. Drug-eluting stents provide favorable outcomes in selected short focal lesions, whereas other technologies have more limited evidence. Overall, treatment should be individualized based on lesion characteristics and clinical context.

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Original Article | May 26, 2026

Two-Session Catheter-Directed Ethanol Sclerotherapy for Symptomatic Peritoneal Inclusion Cysts: A Preliminary Case Series: Byung Soo Im, Ji-Hoon Kim, Gun Ha Kim, Shakir Ali H. Aljerdah, Ji Hoon Shin; Korean J Interv Radiol 2026;31(2):136-144.
Published online May 26, 2026; DOI: https://doi.org/10.64961/kjir.2026.00101

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Purpose This study aims to investigate the clinical outcomes and safety of a standardized two-session catheter-directed ethanol sclerotherapy protocol for peritoneal inclusion cysts. Materials and Methods Between November 2020 and July 2025, six women (median age, 32.5 years) with symptomatic peritoneal inclusion cysts underwent ethanol sclerotherapy. After complete drainage using an 8.5-Fr or 10.2-Fr pigtail catheter, two sessions of sclerotherapy were performed on consecutive days. In each session, 99.5% ethanol (50% of the aspirated volume, up to 150 mL) was instilled and retained for 20 minutes. Follow-up ultrasound was performed at 1, 3, and 6 months. Technical success was defined as successful completion of both sessions with a 20-minute ethanol retention time, and clinical success was defined as symptom improvement with a >50% decrease in cyst diameter at 3 months. Results Technical success was achieved in all cases (6/6, 100%). The median maximum cyst diameter significantly decreased from 14.0 cm (range, 6.0 to 20.0 cm) to 5.25 cm (range, 2.0 to 8.0 cm) at the follow-up within 1 month (p = 0.03). Clinical success was achieved in all cases at 3 months (6/6, 100%). No residual cysts were visualized on follow-up ultrasound at 6 months in all patients (6/6, 100%). Anti-Müllerian hormone levels measured in four patients showed heterogeneous changes, precluding definitive conclusions regarding the impact on ovarian reserve. No major complications occurred. Conclusion Two-session catheter-directed ethanol sclerotherapy appears to be a safe and effective minimally invasive alternative to surgery for peritoneal inclusion cysts, providing a high rate of complete resolution.

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Case Report | May 7, 2026

Transjugular Biliary Stenting: Case Report and Literature Review: Soumil Singhal, Heera Ram, Anubhav Khandelwal, Sanjay Saran Baijal; Korean J Interv Radiol 2026;31(2):50-55.
Published online May 7, 2026; DOI: https://doi.org/10.64961/kjir.2026.00059

We report a 54‑year‑old woman with chronic pancreatitis, duodenal obstruction, massive ascites, and refractory thrombocytopenia who developed septic obstructive cholangitis after occlusion of a plastic common bile duct (CBD) stent. Endoscopic exchange failed and PTBD was prohibitively risky. Transjugular intrahepatic biliary stenting (TIBS) provides an alternative route that avoids transperitoneal hepatic capsule puncture. Via right internal jugular access, the right hepatic vein was catheterized, a posterior sectoral bile duct punctured, and a guidewire crossed the distal CBD stricture. A 12 × 80 mm self‑expandable metallic stent was deployed and the transhepatic tract embolized with coils. The patient experienced rapid clinical and biochemical recovery (bilirubin, 13.3 to 1.37 mg/dL) over 9 days postprocedure without any hemorrhagic complications. TIBS is a decisive, life‑saving alternative when standard routes are not possible.

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Case Report | Aug 11, 2026

Recurrent Caudate Lobe HCC Supplied by a Variant Right Inferior Adrenal Artery: A Case Report: Donghyun Kim, Hyo-Cheol Kim; Korean J Interv Radiol 2026;31(2):74-78.
Published online August 11, 2026; DOI: https://doi.org/10.64961/kjir.2026.00143

Variant right inferior adrenal arterial supply to caudate lobe HCC is rare and may be overlooked. We report a 53-year-old man with recurrent caudate lobe HCC after 12 TACE sessions. During the 13th TACE, cone-beam CT of the common hepatic artery did not reveal tumor vascularity. At the 14th TACE, performed 3 days later, the right inferior phrenic artery, the most common extrahepatic collateral feeder to caudate lobe HCC, showed no tumor supply. Angiography and cone-beam CT from a small aortic common trunk giving rise to a variant right inferior adrenal artery and the right renal capsular artery revealed predominant supply from the variant right inferior adrenal artery. Embolization through these branches achieved compact iodized oil uptake without immediate complications.

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Editorial | May 7, 2026

Ethanol-Based Embolization for Renal Angiomyolipoma: Is the Embolic Agent the Answer, or the Strategy?: Ho Jong Chun; Korean J Interv Radiol 2026;31(2):47-49.
Published online May 7, 2026; DOI: https://doi.org/10.64961/kjir.2026.00094

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Review Article | Jul 14, 2026

Endovascular Management of Type 2 Endoleak after Endovascular Aneurysm Repair: An Interventional Radiologist's Perspective: Joon Ho Kwon; Korean J Interv Radiol 2026;31(2):113-124.
Published online July 14, 2026; DOI: https://doi.org/10.64961/kjir.2026.00122

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Type 2 endoleak (T2EL) is the most common complication after endovascular aneurysm repair (EVAR), occurring in 10%–25% of patients. Although many T2ELs follow a benign course, persistent T2EL is associated with sac expansion, secondary endoleaks, rupture, and aneurysm-related mortality. Endovascular treatment is indicated in cases of progressive sac growth and is broadly divided into the transarterial approach and the direct sac puncture approach—the latter encompassing transabdominal, translumbar, and transcaval routes. Each approach has distinct technical advantages and limitations, and selection should be tailored to the source vessel of the endoleak, sac location, surrounding anatomy, and patient-related factors. Coils, N-butyl cyanoacrylate, and ethylene vinyl alcohol copolymer (Onyx) constitute the principal embolic agents, with liquid embolics showing improved durability over coils alone in recent comparative studies. Prophylactic embolization of the inferior mesenteric artery, lumbar arteries, or the aneurysm sac during EVAR has recently emerged as a promising preventive strategy. This review summarizes the current approaches, embolic materials, prophylactic strategies, and clinical outcomes of T2EL management from the perspective of the interventional radiologist.

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Editorial | Sep 26, 2025

Inaugural Editorial: Jin Wook Chung; Korean J Interv Radiol 2025;30(1):1-1.
Published online September 26, 2025; DOI: https://doi.org/10.64961/kjir.2025.00031

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Case Report | Aug 20, 2026

Transarterial Radioembolization via Right Internal Thoracic Artery in a Patient with HCC: A Case Report: Hyo-Cheol Kim; Korean J Interv Radiol 2026;31(2):79-84.
Published online August 20, 2026; DOI: https://doi.org/10.64961/kjir.2026.00157

Extrahepatic collateral supply from the Sappey superior artery of the right internal thoracic artery (RITA) is an uncommon but important source of perfusion to HCC located in segment IV. Preprocedural CT demonstrated a large segment IV HCC supplied by the Sappey superior artery. Initial transfemoral angiography confirmed tumor vascularization but failed to achieve superselective catheterization because of marked tortuosity of the aortic arch. The procedure was converted to a right transradial approach, which provided stable access to the RITA and enabled successful superselection of the Sappey superior artery. Y-90 radioembolization via the Sappey superior artery and hepatic artery was completed without complications.

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Case Report | Aug 5, 2026

Sheath-Assisted Percutaneous Forceps Biopsy of the Cyst Wall under Ultrasound Guidance for the Histological Diagnosis of Complex Hepatic Cystic Lesions: Soumil Singhal, Vinamrita Patni, Sudhir Yadav, Anubhav Khandelwal, Sanjay Saran Baijal; Korean J Interv Radiol 2026;31(2):62-68.
Published online August 5, 2026; DOI: https://doi.org/10.64961/kjir.2026.00115

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Complex hepatic cystic lesions with inconclusive imaging pose a recurring diagnostic problem: cyst-fluid cytology and conventional core-needle biopsy seldom capture the epithelial lining needed for a histological diagnosis, and current guidelines advise against simple cyst aspiration. We describe a sheath-assisted percutaneous forceps biopsy technique for direct cyst-wall sampling under ultrasound guidance, illustrated in two male patients (76 and 48 years). After Seldinger placement of an 8-Fr sheath into the cyst, rat-tooth forceps obtained direct biopsies of the wall epithelium, and the tract was embolized with Gelfoam. Technical success was achieved in both cases; histology showed columnar biliary epithelium consistent with mucinous cystic neoplasm, whereas fluid cytology was non-diagnostic. No complications occurred. This technique offers a feasible means of obtaining a histological diagnosis in complex hepatic cystic lesions when conventional methods are inconclusive.

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Case Report | Aug 11, 2026

A Side-Hole Catheter Technique for Overcoming Hostile Vascular Anatomy during Chemoembolization: A Case Report: Min Gwan Kim, Hyo-Cheol Kim; Korean J Interv Radiol 2026;31(2):69-73.
Published online August 11, 2026; DOI: https://doi.org/10.64961/kjir.2026.00150

In a 58-year-old man with HCC undergoing TACE, a segment III tumor was supplied by an accessory left hepatic artery arising from the left gastric artery (LGA). The dominant technical challenge shifted from acute angulation at the LGA origin to inadequate back support in distal branches. To overcome repeated dislodgement, the catheter was exchanged for a 5-Fr catheter with a hand-cut side hole, positioned at the LGA orifice while the tip was anchored in the celiac trunk. This technique allowed a microcatheter to traverse in a single well-supported pass, enabling successful superselective TACE without immediate complications. This case emphasizes the importance of distinguishing ostial angulation from back-support failure and highlights the utility of proximal side-hole anchoring in complex multivessel selection.

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How I do It | Sep 21, 2026

Single-Incision Technique for Placement of Totally Implantable Venous Access Port via the Axillary Vein: Woo Jin Yang, Myung Gyu Song, Tae-Seok Seo; Korean J Interv Radiol 2026;31(2):167-170.
Published online September 21, 2026; DOI: https://doi.org/10.64961/kjir.2026.00136

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Letter-to-Editor | Sep 8, 2026

Risk-Adapted Central Venous Catheter Securement: Which Strategy, for Which Catheter, in Which Patient?: Jeong Ho Kim; Korean J Interv Radiol 2026;31(2):164-166.
Published online September 8, 2026; DOI: https://doi.org/10.64961/kjir.2026.00213

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Case Report | Sep 8, 2026

Comprehensive Interventional Management of Postoperative Duodenal Perforation: A Case Report: Jae Hwan Lee, Kun Yung Kim, Chang Jin Yoon; Korean J Interv Radiol 2026;31(2):85-91.
Published online September 8, 2026; DOI: https://doi.org/10.64961/kjir.2026.00178

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Duodenal perforation is an uncommon but potentially fatal complication of pancreatic surgery. We report a 73-year-old man who presented with hematochezia after laparoscopic distal pancreatectomy with splenectomy for pancreatic body cancer, complicated by a postoperative pancreatic fistula that led to gastroduodenal artery bleeding treated with a stent-graft. Contrast-enhanced CT showed active duodenal bleeding with a surrounding hematoma. The bleeding duodenal branch was embolized, and the hematoma was drained percutaneously; a fistulous communication between the periduodenal collection and the duodenal lumen was subsequently demonstrated. Through the drainage tract, an 8-Fr Foley catheter was advanced into the duodenal lumen and its balloon inflated to secure a controlled fistula, while a percutaneous gastrojejunostomy provided distal enteral feeding. The catheter was maintained for approximately 2 months, and the tract was embolized at the time of removal to minimize residual leakage. The patient recovered fully. This case demonstrates the feasibility of staged interventional management for postoperative duodenal perforation when reoperation is not feasible.

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Original Article | Aug 11, 2026

Clinical Efficacy and Patency of Stents for Malignant Iliocaval Venous Occlusion: Wonseon Shin, Gyoung Min Kim, Kichang Han, Man Deuk Kim, Joon Ho Kwon, Jong Yun Won, Juil Park; Korean J Interv Radiol 2026;31(2):156-163.
Published online August 11, 2026; DOI: https://doi.org/10.64961/kjir.2026.00024

Abstract
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Purpose This study aimed to evaluate the clinical efficacy and patency of stents placed for symptomatic iliac vein or IVC obstruction caused by malignant tumors. Materials and Methods A total of 34 consecutive patients with malignant iliac vein or IVC obstruction underwent stent placement. We reviewed their electronic medical records, pre- and post-procedural CT scans, and angiograms retrospectively, and evaluated technical success, clinical success, and patient-based and vessel-based reocclusion rates confirmed by follow-up cross-sectional images. The reocclusion rate difference between IVC and iliac stents was also assessed. Results All patients complained of leg and/or trunk edema. The stents were placed in the following locations: IVC (n = 9); iliac veins (n = 19); and both IVC and iliac veins (n = 6). Technical success rate was 100% and the clinical success rate was 87.5% during hospitalization. Cross-sectional area of the affected thigh was significantly decreased after stent placement (mean 11.7%, p = 0.003). The median follow-up period was 65 days (Q1–Q3, 28.5–227.3; IQR, 198.8). The patient-based reocclusion rate was 42.8%. The vessel- based reocclusion rates for IVC (12.5%) tended to be lower than those of iliac veins (45.0%), though the difference was not statistically significant (p = 0.194). Conclusion Stent insertion for iliac vein or IVC obstruction secondary to malignancy is technically feasible and can help to improve patients’ symptoms. IVC stents tend to achieve a higher rate of patency than iliac vein stents.