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.
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.
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.
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.