Scholars@Duke
Waleska Michelle Pabon-Ramos

Waleska Michelle Pabon-Ramos

Associate Professor of Radiology
Radiology, Interventional Radiology

Selected Publications

Lymphatic Drainage in Patients with Heart Failure: A Feasibility Study.

Journal Article J Cardiovasc Transl Res · February 3, 2025 Lymphatic dysfunction contributes to congestion and end-organ damage in heart failure (HF), yet current therapies do not directly target lymphatic congestion. Thoracic duct (TD) drainage offers a novel approach to address this gap. This multicenter feasibi ... Full text Link to item Cite

The Role of Interventional Radiology in Managing Placenta Accreta Spectrum Disorder.

Journal Article Clin Obstet Gynecol · January 22, 2025 Interventional Radiology (IR) can be a crucial player in managing placenta accrete spectrum disorder (PAS), offering minimally invasive angiographic techniques that can prevent or control hemorrhage and preserve fertility. These include prophylactic balloo ... Full text Link to item Cite

Long term impact of transjugular intrahepatic portosystemic shunt (TIPS) creation on hepatic morphology.

Journal Article Clin Imaging · June 2024 PURPOSE: The purpose of this study was to evaluate long-term morphologic changes occurring in the liver after TIPS creation with correlation with hepatic function to gain insight on the physiologic impact of TIPS on the liver. METHODS: This retrospective s ... Full text Link to item Cite

Successful coil embolization of a ruptured pseudoaneurysm of the superior gluteal artery after a percutaneous awake robot-assisted sacroiliac joint fusion: illustrative case.

Journal Article J Neurosurg Case Lessons · April 8, 2024 BACKGROUND: Robot-assisted sacroiliac joint (SIJ) fusion has gained popularity, but it carries the risk of complications such as injury to the superior gluteal artery (SGA). The authors present the case of an awake percutaneous robot-assisted SIJ fusion le ... Full text Link to item Cite

Comparing magnetic resonance imaging and ultrasound in the clinical evaluation of fibroids prior to uterine artery embolization.

Journal Article Curr Probl Diagn Radiol · 2024 PURPOSE: Uterine artery embolization has become established as a frontline treatment for uterine leiomyomata. In planning embolization, preprocedural imaging can further characterize pathology and anatomy, but it may also reveal coexisting diagnoses that h ... Full text Link to item Cite

Intravenous Midazolam for Anxiolysis in MRI

Journal Article Journal of Radiology Nursing · September 1, 2023 Objective: The purpose of this project was to understand the effect of administration of intravenous (IV) midazolam on duration of procedure times and anxiety levels experienced by adult outpatients having magnetic resonance imaging (MRI). Secondarily, thi ... Full text Cite

Transfusion Requirements with Hybrid Management of Placenta Accreta Spectrum Incorporating Targeted Embolization and a Selective Use of Delayed Hysterectomy.

Journal Article Am J Perinatol · October 2022 OBJECTIVE: This study compares the number of units of red blood cells (RBCs) transfused in patients with placenta accreta spectrum (PAS) treated with or without a multidisciplinary algorithm that includes placental uterine arterial embolization (P-UAE) and ... Full text Link to item Cite

How we approach localized vascular anomalies.

Journal Article Pediatr Blood Cancer · August 2022 Vascular anomalies are a group of disorders divided into two distinct subtypes: vascular tumors and vascular malformations. Vascular tumors are proliferative in nature, while malformations are nonproliferative. Simple, localized vascular malformations refe ... Full text Link to item Cite

Learning from errors: Implementation of a resident-oriented radiology morbidity and mortality conference as an educational tool.

Journal Article Clin Imaging · April 2022 PURPOSE: Our diagnostic radiology (DR) program lacked a formalized, structured process for residents to learn from errors. Prior DR residency Accreditation Council for Graduate Medical Education (ACGME) survey results additionally demonstrated opportunity ... Full text Link to item Cite

Safety Profile of Particle Embolization for Treatment of Acute Lower Gastrointestinal Bleeding.

Journal Article J Vasc Interv Radiol · March 2022 PURPOSE: To assess ischemic adverse events following particle embolization when used as a second-line embolic to coil embolization for the treatment of acute lower gastrointestinal bleeding (LGIB). MATERIALS AND METHODS: The single-institution retrospectiv ... Full text Link to item Cite

Quantifying the Financial Impact of Delayed Adoption of CPT Code Changes in Radiology.

Journal Article Curr Probl Diagn Radiol · 2022 PURPOSE: To quantify the financial effect of delayed reporting of new moderate sedation (MS) Current Procedural Terminology (CPT) codes at an academic radiology practice, and to identify barriers to timely reporting. MATERIALS AND METHODS: Billing and reim ... Full text Link to item Cite

The Prevalence of Uterine Fibroids in African American Women with Hemoglobin SS Sickle Cell Disease as Determined by Pelvic Magnetic Resonance Imaging.

Journal Article Acad Radiol · December 2021 RATIONALE AND OBJECTIVES: This study explores the relationship between the development of uterine fibroids and hemoglobin SS sickle cell disease (SCD) by examining the prevalence of uterine fibroids as detected by pelvic magnetic resonance imaging (MRI) in ... Full text Link to item Cite

Proton pump inhibitor use is associated with increased rates of post-TIPS hepatic encephalopathy: Replication in an independent patient cohort.

Journal Article Clin Imaging · September 2021 PURPOSE: Proton pump inhibitor (PPI) use is a potential risk factor for hepatic encephalopathy (HE), but few studies have examined the effect on post-TIPS HE. The purpose of this study was to determine whether PPIs are associated with increased rates of po ... Full text Link to item Cite

Intravascular Ultrasound-Guided Transvenous Biopsy of Abdominal and Pelvic Targets Difficult to Access by Percutaneous Needle Biopsy: Technique and Initial Clinical Experience.

Journal Article J Vasc Interv Radiol · September 2021 PURPOSE: To report initial clinical experience with intravascular ultrasound (US)-guided transvenous biopsy (TVB) for perivascular target lesions in the abdomen and pelvis using side-viewing phased-array intracardiac echocardiography catheters. MATERIALS A ... Full text Link to item Cite

Placental uterine artery embolization followed by delayed hysterectomy for placenta percreta: A case series.

Journal Article Gynecol Oncol Rep · August 2021 We describe outcomes of patients with suspected placenta percreta treated with placental uterine artery embolization (P-UAE) followed by delayed hysterectomy. This is a prospective case series of subjects from 2005 to 2018 with suspected placenta percreta ... Full text Link to item Cite

Lymphatic Dysregulation in Patients With Heart Failure: JACC Review Topic of the Week.

Journal Article J Am Coll Cardiol · July 6, 2021 The lymphatic system is an integral part of the circulatory system and plays an important role in the volume homeostasis of the human body. The complex anatomy and physiology paired with a lack of simple diagnostic tools to study the lymphatic system have ... Full text Link to item Cite

The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: A report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders.

Journal Article Phlebology · June 2021 [Box: see text]With the support of the American College of Obstetricians and Gynecologists, the American Vein & Lymphatic Society, the American Venous Forum, the Canadian Society of Phlebology, the Cardiovascular and Interventional Radiology Society of Eur ... Full text Link to item Cite

Sharp Recanalization of Chronic Central Venous Occlusions of the Thorax Using a Steerable Coaxial Needle Technique from a Supraclavicular Approach.

Journal Article Cardiovasc Intervent Radiol · May 2021 PURPOSE: To evaluate the technical success and safety of a steerable coaxial sharp recanalization technique that utilizes routine needles in patients with refractory thoracic central venous occlusions. MATERIALS AND METHODS: This retrospective study was pe ... Full text Link to item Cite

The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: A report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders.

Journal Article J Vasc Surg Venous Lymphat Disord · May 2021 As the importance of pelvic venous disorders (PeVD) has been increasingly recognized, progress in the field has been limited by the lack of a valid and reliable classification instrument. Misleading historical nomenclature, such as the May-Thurner, pelvic ... Full text Link to item Cite

Research Priorities in Lymphatic Interventions: Recommendations from a Multidisciplinary Research Consensus Panel.

Journal Article J Vasc Interv Radiol · May 2021 Recognizing the increasing importance of lymphatic interventions, the Society of Interventional Radiology Foundation brought together a multidisciplinary group of key opinion leaders in lymphatic medicine to define the priorities in lymphatic research. On ... Full text Link to item Cite

Magnetic Resonance Lymphangiography of the Central Lymphatic System: Technique and Clinical Applications.

Journal Article J Magn Reson Imaging · February 2021 Magnetic resonance lymphangiography (MRL) is a noninvasive imaging technique that can be used in the management of lymphatic disorders to delineate the central lymphatic system for treatment planning. This article reviews the MRL technique, its advantages, ... Full text Link to item Cite

Percutaneous gastrojejunostomy tubes: Identification of predictors of retrograde jejunal limb migration into the stomach.

Journal Article Clin Imaging · February 2021 PURPOSE: To identify whether technically modifiable factors during gastrojejunostomy (GJ) tube insertion are predictive of retrograde jejunal limb migration into the stomach. MATERIALS AND METHODS: Retrospective review of our procedural database over a 5-y ... Full text Link to item Cite

Percutaneous Gastrojejunostomy Tube Insertion in Patients with Surgical Gastrojejunal Anastomoses: Analysis of Success Rates and Durability.

Journal Article J Vasc Interv Radiol · February 2021 Patients with a gastrojejunal anastomosis pose challenging anatomy for percutaneous gastrojejunostomy (GJ)-tube placement. A retrospective review of 24 patients (mean age 67.8 years, 13 males) with GJ anastomoses who underwent attempted GJ tube placement r ... Full text Link to item Cite

Financial Effect of Unbundling Moderate Sedation from Procedural Codes in Radiology.

Journal Article J Vasc Interv Radiol · August 2020 PURPOSE: To assess and quantify the financial effect of unbundling newly unbundled moderate sedation codes across major payors at an academic radiology practice. MATERIALS AND METHODS: Billing and reimbursement data for 23 months of unbundled moderate seda ... Full text Link to item Cite

Lymphatic Imaging: Current Noninvasive and Invasive Techniques.

Journal Article Semin Intervent Radiol · August 2020 After nearly disappearing, invasive lymphangiography not only has resurged, but new approaches have been developed to guide lymphatic interventions. At the same time, noninvasive lymphatic imaging is playing a larger role in the evaluation of lymphatic pat ... Full text Link to item Cite

Complications during Lymphangiography and Lymphatic Interventions.

Journal Article Semin Intervent Radiol · August 2020 Lymphangiography as a diagnostic procedure dates back to the 1950s and was widely performed for several decades until being supplanted by other advanced imaging techniques. With the advent of thoracic duct embolization to treat chylothorax, Constantin Cope ... Full text Link to item Cite

Length of Stay Predicts Risk of Early Infection for Hospitalized Patients Undergoing Central Venous Port Placement.

Journal Article J Vasc Interv Radiol · March 2020 PURPOSE: To compare early totally implantable central venous port catheter-related infection rates after inpatient vs outpatient placement and to determine whether the risk associated with inpatient placement is influenced by length of hospital stay. MATER ... Full text Link to item Cite

Treatment of Arm Swelling in Hemodialysis Patients with Ipsilateral Arteriovenous Access and Central Vein Stenosis: Conversion to the Hemodialysis Reliable Outflow Graft versus Stent Deployment.

Journal Article J Vasc Interv Radiol · February 2020 PURPOSE: To compare outcomes after conversion of arteriovenous (AV) access to Hemodialysis Reliable Outflow (HeRO) graft vs stent deployment in patients with arm swelling owing to ipsilateral central vein stenosis. MATERIALS AND METHODS: This single-center ... Full text Link to item Cite

Recognition and management of dermatologic complications from interventional radiology procedures.

Journal Article Diagn Interv Imaging · November 2019 A variety of dermatologic complications can occur after interventional radiology procedures, including fluoroscopy-induced radiation dermatitis, thermal skin injury from tumor ablation, non-target embolization to the skin, allergic reactions related to int ... Full text Link to item Cite

Management of Port Occlusions in Adults: Different-Site Replacement versus Same-Site Salvage.

Journal Article J Vasc Interv Radiol · July 2019 PURPOSE: To compare the safety and effectiveness of different-site port placement versus same-site port salvage in adult patients with occluded ports. MATERIALS AND METHODS: Ninety-five occluded subcutaneous infusion ports (ports) in 95 patients presenting ... Full text Link to item Cite

Research Priorities in Pelvic Venous Disorders in Women: Recommendations from a Multidisciplinary Research Consensus Panel.

Journal Article J Vasc Interv Radiol · June 2019 Pelvic venous disorders (PeVDs) in women can present with chronic pelvic pain, lower-extremity and vulvar varicosities, lower-extremity swelling and pain, and left-flank pain and hematuria. Multiple evidence gaps exist related to PeVDs with the consequence ... Full text Link to item Cite

No Increased Mortality After TIPS Compared with Serial Large Volume Paracenteses in Patients with Higher Model for End-Stage Liver Disease Score and Refractory Ascites.

Journal Article Cardiovasc Intervent Radiol · May 2019 PURPOSE: To compare survival after transjugular intrahepatic portosystemic shunt (TIPS) creation versus serial large volume paracenteses (LVP) in patients with refractory ascites and higher Model for End-Stage Liver Disease (MELD) scores. MATERIALS AND MET ... Full text Link to item Cite

Proton Pump Inhibitor Use Is Associated with an Increased Frequency of New or Worsening Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt Creation.

Journal Article J Vasc Interv Radiol · February 2019 PURPOSE: To determine whether proton pump inhibitor (PPI) use increases the rate of new or worsening hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) creation. MATERIALS AND METHODS: In this retrospective study, 284 of ... Full text Link to item Cite

Identification and Management of Abdominal Wall Varices in Pregnancy.

Journal Article Obstet Gynecol · October 2018 BACKGROUND: Portal hypertension in pregnancy is associated with elevated risk of variceal hemorrhage. Ectopic varices, those located outside the esophagus or stomach, are rare but have a high risk of associated maternal morbidity or mortality. CASE: A 31-y ... Full text Link to item Cite

Pilot Evaluation of Angiogenesis Signaling Factor Response after Transcatheter Arterial Embolization for Hepatocellular Carcinoma.

Journal Article Radiology · October 2017 Purpose To identify changes in a broad panel of circulating angiogenesis factors after bland transcatheter arterial embolization (TAE), a purely ischemic treatment for hepatocellular carcinoma (HCC). Materials and Methods This prospective HIPAA-compliant s ... Full text Link to item Cite

MRI of the Central Lymphatic System: Indications, Imaging Technique, and Pre-Procedural Planning.

Journal Article Top Magn Reson Imaging · August 2017 Magnetic resonance imaging is increasingly being used to evaluate the lymphatic system. Advances in magnetic resonance (MR) software and hardware allow improved visualization of lymph nodes and lymphatic vessels. We describe how MR lymphangiography can be ... Full text Link to item Cite

Treatment of central venous in-stent restenosis with repeat stent deployment in hemodialysis patients.

Journal Article J Vasc Access · May 15, 2017 PURPOSE: To report patency rates for stent deployment for treatment of in-stent stenosis of the central veins of the chest in hemodialysis patients. MATERIALS AND METHODS: A retrospective analysis was performed on 29 patients who underwent 35 secondary per ... Full text Link to item Cite

Morbidity and healthcare costs of vascular anomalies: a national study.

Journal Article Pediatr Surg Int · February 2017 PURPOSE: This study aimed to define morbidities and costs related to modern-day medical care for children with vascular anomalies. METHODS: We reviewed the 2003-2009 Kids' Inpatient Database for pediatric patients (age < 21 years) hospitalized with hemangi ... Full text Link to item Cite

Randomized Controlled Trial of Octyl Cyanoacrylate Skin Adhesive versus Subcuticular Suture for Skin Closure after Implantable Venous Port Placement.

Journal Article J Vasc Interv Radiol · January 2017 PURPOSE: To compare early outcomes of skin closure with octyl cyanoacrylate skin adhesive versus subcuticular suture closure. MATERIALS AND METHODS: Over a 7-month period, 109 subjects (28 men and 81 women; mean age, 58.6 y) scheduled to undergo single-lum ... Full text Link to item Cite

Effectiveness of Transarterial Embolization of Hepatocellular Carcinoma as a Bridge to Transplantation.

Journal Article J Vasc Interv Radiol · January 2016 PURPOSE: To assess the effectiveness of bland transarterial embolization of hepatocellular carcinoma (HCC) as a "bridge" to transplantation. MATERIALS AND METHODS: In this retrospective study, 117 patients with HCC that met Milan criteria underwent bland e ... Full text Link to item Cite

Postintervention Patency Rates and Predictors of Patency after Percutaneous Interventions on Intragraft Stenoses within Failing Prosthetic Arteriovenous Grafts.

Journal Article J Vasc Interv Radiol · November 2015 PURPOSE: To determine postintervention patency rates after endovascular interventions on intragraft stenosis within failing prosthetic arteriovenous (AV) grafts, as well as predictors of patency. MATERIALS AND METHODS: Retrospective review of percutaneous ... Full text Link to item Cite

Assessing medical students' knowledge of IR at two American medical schools.

Journal Article J Vasc Interv Radiol · November 2014 PURPOSE: To determine if there was a difference in the level of knowledge about interventional radiology (IR) between medical students in preclinical years of training compared with medical students in clinical years of training at two medical schools and ... Full text Link to item Cite

Alternative treatment for bleeding peristomal varices: percutaneous parastomal embolization.

Journal Article Cardiovasc Intervent Radiol · October 2013 PURPOSE: To describe how peristomal varices can be successfully embolized via a percutaneous parastomal approach. METHODS: The medical records of patients who underwent this procedure between December 1, 2000, and May 31, 2008, were retrospectively reviewe ... Full text Link to item Cite

Percutaneous interventions on the hemodialysis reliable outflow vascular access device.

Journal Article J Vasc Interv Radiol · April 2013 PURPOSE: To determine the outcomes of percutaneous interventions for prolonging the patency of the Hemodialysis Reliable Outflow (HeRO) device. MATERIALS AND METHODS: Between January 2007 and August 2011, 73 percutaneous interventions were performed on 26 ... Full text Link to item Cite

Early outcomes of empiric embolization of tumor-related gastrointestinal hemorrhage in patients with advanced malignancy.

Journal Article J Vasc Interv Radiol · November 2012 PURPOSE: To report short-term results of empiric transcatheter embolization for patients with advanced malignancy and gastrointestinal (GI) hemorrhage directly from a tumor invading the GI tract wall. MATERIALS AND METHODS: Between 2005 and 2011, 37 mesent ... Full text Link to item Cite

Excretory urography: trends in clinical use and diagnostic yield.

Journal Article Abdom Imaging · October 2010 OBJECTIVE: To assess for changes in clinical usage and diagnostic yield of excretory urography (EU) following the introduction of CT urography (CTU). MATERIALS AND METHODS: We retrospectively reviewed reports from 6313 EUs performed between July 1995 and F ... Full text Link to item Cite

Radiologic evaluation of blunt thoracic aortic injury in pediatric patients.

Journal Article AJR Am J Roentgenol · May 2010 OBJECTIVE: The objective of our study was to assess the mechanism of injury, associated injuries, and radiographic findings of pediatric patients presenting with blunt thoracic aortic injury. MATERIALS AND METHODS: The medical records and imaging studies o ... Full text Link to item Cite