Ralph Gnannt

The landscape & outlook of #paediatricIR (PIR) is evolving & expanding across Europe. As the call to make PIR more accessible to the wider body of IR practitioners becomes louder, CIRSE shines a spotlight on the discipline. ➡️t.ly/HGZ_7 #IRad #pediatricIR

@Radil0logist @UW_MSKrad @ABR_Radiology @ssr_rwg @UWRadRes @HandSociety These are not hemangiomas but Venous Malformations. Phleboliths are pathognomonic

@UW_MSKrad @ABR_Radiology @ssr_rwg @UWRadRes @HandSociety Maffucci, phleboliths from haemangiomas. Increased risk of chondrosarcoma.

#CaseOfTheWeek ‼️🥳‼️ ☢️🩻☠️Case#39☠️🩻☢️ In honor of the @ABR_Radiology Certifying Exam tomorrow, what syndrome does this patient have❓❔ What are they at increased risk of❔❓ #FOAMrad #RadEd #OrthoTwitter @ssr_rwg @UWRadRes #MedEd #OrthoEd @HandSociety

It remains unclear who delivers PIR across Europe, what procedures they do, and how they do them. With these challenges in mind, #CIRSE has launched a new task force – the #Paediatric IR Task Force. Read more via the #CIRSEinsider! ow.ly/wcLN50OCZGy @BarnacleAlex @gnannt

@Dtepl Nice case, thank you for sharing! I suggest a couple of cc of STS to occlude outflow. And then add some Bleomycin

#venousmalformation of the tongue in a 2 YO kid. MRI T2 shows an hyperintense lesion inside the tongue muscle. Sclerotherapy should be scheduled with an ICU bed on hold. The tongue can swell severely after the procedure and obstruct the airway. 24 ha of intubation is often needed

#ICCD is dedicated to raising awareness & advocacy for children w/ cancer. At #ECIO2023, experts will share the latest research & clinical experiences in IO. The paediatric IO session will focus on how to optimize tools & the best treatment techniques. bit.ly/3E8uyJZ

@Dtepl @No_cut_surgery Nice case of a diffuse infantile hemangioma of the liver. How old was the child when it became symptomatic?

@No_cut_surgery The patient was medicated with Sirolimus, Propranolol, and steroids, and quickly got stabilized. Then steroids were taken away. And now the patient is without a respirator and growing up .

Today's case: a neonatal multifocal hepatic hemangioma, associated with multiple skin lesions, coagulation disorders and mild congestive heart failure. Diffuse neonatal hemangiomatosis (DNH) is a rare and potentially deadly if left untreated.

Today's case: A difficult low-flow left orbital #vascularmalformation with exophthalmos, CT guided #sclerotherapy with bleomycin. The needle is inside the retro-orbital space, we control the correct position of the needle with the injection of water-soluble contrast first.

@Jaimealsn @Dtepl Yes, we started using it in adults and children. But follow-up is still short

@gnannt @Dtepl Have you tried? What are your thoughts? Thanks

Today's case: typical mycrocistic #lymphaticmalformation with skin involvement. These are lymphatic vesicles, that sometimes bleed and can be very problematic to the patient. CO2 laser if available can help vaporizing these small vesicles #vascularanomalies

@Dtepl I‘m referring to this procedure pubmed.ncbi.nlm.nih.gov/34608081/

@gnannt Yes, we don't always have a CO2 laser available at the hospital, so we inject bleomycin with small needles directly into the vesicles, with mixed results. It reduces the episodes of bleeding, but the vesicles typically won't disappear with bleo.

@JoseLuisdelCura @Dtepl @apaezcarpio For congenital LM Doxycycline is working very well and there are almost no side effects. You can treat this lesion in an ambulatory setting even in small babies. I use STS3% first to denaturate the cell lining and inject Doxy after. This makes Doxy more efficient.

@Dtepl @apaezcarpio My experience with doxy is not so good. I gave it up because of it. And it is more difficult to manage

Case of the day : a 1-year-old with lymphatic macro cystic malformation of the neck. Patient had hospital admission a few months ago because of local infection. Sclerotherapy with Sts will surely help reduce the infections events and reduce the lesion size. #vascularanomalies #ir

@Dtepl @KispiZuerich @JVIRmedia @socpedsir @ESPRSociety @GuerbetGroup No, I don’t think so. But it’s nice to visualize lymph outflow directly and proof the problem not only by laboratory tests

@gnannt @KispiZuerich @JVIRmedia @socpedsir @ESPRSociety @GuerbetGroup Beautiful images, we treat the same way our pediatric fountain patients, but we don't use endoscopy, just fluoro. Do you think that Endo is always necessary ?

Transhepatic lymphatic embolization with glue in a young fontan patient with PLE @KispiZuerich together with G.Maleux from UZ Leuven, Belgium @JVIRmedia @socpedsir @ESPRSociety very exciting to see those tiny lymph vessels filling up with contrast @GuerbetGroup

Two members of @socpedsir in the @cirsesociety committees helping to give a voice to pediatric interventional radiology, congratulations to @BarnacleAlex

Thanks for supporting this project and your amazing talk! @narayan_karu

First official Peds IR session @ESPRSociety organised by the Task Force has started @alexdabadie @socpedsir @simonpmcguirk

⭐️ Breaking news at #ECIO2022 ⭐️ The first #paediatricIR session EVER at #ECIO, today! The future is here. ⭐️ @cirsesociety @socpedsir @BSIR_News

Check out our latest #AuthorSpotlight video, ft. Dr. Anne Gill! She discusses her experience treating acute + chronic systemic venous occlusions in paediatric populations + offers valuable advice for all doctors youtu.be/9gmsip00Y2Q cvirendovasc.springeropen.com/articles/10.11…

Next SPIR Webinar Title : Vascular Anomalies: A Primer Date: Wednesday, 26 Jan 2022 1:00 PM, EST Speaker: Dr Alex Barnacle @BarnacleAlex Registration: sent to SPIR members via email. @SIRRFS @SIRspecialists @TraineesBSIR @BSIR_News @SIR_ECS @SIRmembers