Rachelle Durand

All Publications

• Trametinib Therapy for Hypertrophic Cardiomyopathy and Pulmonary Hypertension in a Child With RAF1-Related Noonan Syndrome (p.Ser257Leu): A Case Report. Clinical case reports Nilsson, C. N., Aljohani, O. A., Smith, M. A., Durand, R., Sheyanth, I. N., Nawaytou, H., Stieglitz, E., Valle, R., Datar, S. A. 2026; 14 (6): e72831

  Abstract

  This case describes a female infant with RAF1-related Noonan syndrome who developed severe hypertrophic obstructive cardiomyopathy, pulmonary hypertension, and cardiorespiratory failure that responded to trametinib treatment but ultimately progressed to death following dose tapering and discontinuation of therapy. To the best of our knowledge, this is the first case with detailed respiratory information in a trametinib-treated patient with RASopathy-related pulmonary disease.

  View details for DOI 10.1002/ccr3.72831

  View details for PubMedID 42256976

  View details for PubMedCentralID PMC13239823

• Alpelisib, a PI3Kα inhibitor, effectively treats vascular anomalies with diverse genotypes and phenotypes. Blood vessels, thrombosis & hemostasis Pithadia, D. J., Heskel, M. J., Shotayev, A., Davda, S., Durand, R., Cooke, D., Czechowicz, J., Lesh, M., Cornett, P., Shimano, K. A., Mathes, E. F., Frieden, I. J., Apsel Winger, B. 2026; 3 (1): 100133

  Abstract

  Vascular anomalies (VAs) are complex, highly morbid conditions that are increasingly managed by hematologists with targeted therapies. They are often driven by activating mutations in the phosphoinositide 3-kinase (PI3K)/AKT/mammalian target of rapamycin (mTOR) pathway. Alpelisib, a phosphoinositide 3-kinase-α (PI3Kα) inhibitor, is a key therapy for VAs; however, it is only approved for PIK3CA-related overgrowth spectrum (PROS), a VA diagnosis with multifaceted genotypic and phenotypic criteria, including a required PIK3CA mutation. Although there is a mechanistic rationale for alpelisib use in non-PROS VAs, published data supporting alpelisib use outside of PROS are limited. We conducted a single-center, retrospective study of 41 children and adults with VAs treated with alpelisib. Most patients failed prior therapies, including sirolimus. Alpelisib led to clinical improvement in 92% of the patients, 80% of whom did not meet PROS diagnostic criteria. There was no genetic testing in ∼50% of the responders, and ∼25% had mutations in non-PIK3CA genes in the PI3K/AKT/mTOR pathway (TEK, PIK3R1, and PTEN). Among patients with pre- and post-therapy imaging, 100% showed clinical improvement, but only 50% showed radiological improvement, highlighting discordance between imaging and clinical response. Our findings support expanding alpelisib use to VAs beyond PROS. In addition, they underscore the need for clinical trial end points based on clinical, not radiological, outcomes.

  View details for DOI 10.1016/j.bvth.2025.100133

  View details for PubMedID 41623364

  View details for PubMedCentralID PMC12859186

• 3D steady-state free precession in fetal body MR imaging: A useful adjunctive sequence. Acta radiologica open Leesmidt, K., Liu, A., Poder, L., Durand, R., Glenn, O., Li, Y., Courtier, J. 2026; 15 (1): 20584601261419037

  Abstract

  Fetal magnetic resonance imaging (MRI) has become a valuable noninvasive method for evaluating congenital anomalies of the fetus and can serve as an important adjunct to the prenatal ultrasound, particularly where the ultrasound is unable to exclude or detect fetal abnormalities. This pictorial review will describe the utilization of three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) in various clinical entities, specifically at 3T, and how to generate clinically valuable information.

  View details for DOI 10.1177/20584601261419037

  View details for PubMedID 41601917

  View details for PubMedCentralID PMC12833111

• Assessment of superior mesenteric vascular flow quantitation in children using four-dimensional flow magnetic resonance imaging: A feasibility study WORLD JOURNAL OF RADIOLOGY Leesmidt, K., Vakil, P., Verstraete, S., Liu, A. R., Durand, R., Courtier, J. 2025; 17 (2): 99333

  Abstract

  Four-dimensional (4D) flow magnetic resonance imaging (MRI) is used as a noninvasive modality for assessing hemodynamic information with neurovascular and body applications. The application of 4D flow MRI for assessment of bowel disease in children has not been previously described.To determine feasibility of superior mesenteric venous and arterial flow quantitation in pediatric patients using 4D flow MRI.Nine pediatric patients (7-14 years old, 5 male and 4 female) with history or suspicion of bowel pathology, who underwent magnetic resonance (MR) enterography with 4D flow MR protocol from November 2022 to October 2023. Field strength/sequence: 3T MRI using 4D flow MR protocol. Flow velocity and peak speed measurements were performed by two diagnostic radiologists placing the region of interest in perpendicular plane to blood flow on each cross section of superior mesenteric artery (SMA) and superior mesenteric vein (SMV) at three predetermined levels. Bland-Altman analysis, showed good agreement of flow velocity and peak speed measurements of SMV and SMA between two readers.Mean SMV flow velocity increased from proximal to mid to distal (0.14 L/minute, 0.17 L/minute, 0.22 L/minute respectively). Mean SMA flow velocity decreased from proximal to mid to distal (0.35 L/minute, 0.27 L/minute, 0.21 L/minute respectively). Observed agreement was good for flow velocity measurements of SMV (mean bias -0.01 L/minute and 95% limits of agreement, -0.09 to 0.08 L/minute) and SMA (mean bias -0.03 L/minute and 95% limits of agreement, -0.23 to 0.17 L/minute) between two readers. Good agreement for peak speed measurements of SMV (mean bias -1.2 cm/second and 95% limits of agreement, -9.4 to 7.0 cm/second) and SMA (mean bias -3.2 cm/second and 95% limits of agreement, -31.4 to 24.9 cm/second).Flow quantitation using 4D Flow is feasible to provide hemodynamic information for SMV and SMA in children.

  View details for DOI 10.4329/wjr.v17.i2.99333

  View details for Web of Science ID 001440468800004

  View details for PubMedID 40060952

  View details for PubMedCentralID PMC11885928

• The Sensitivity of Limited-Sequence MRI in Identifying Pediatric Cervical Spine Injury: A Western Pediatric Surgery Research Consortium Multicenter Retrospective Cohort Study. The journal of trauma and acute care surgery Melhado, C., Durand, R., Russell, K. W., Polukoff, N. E., Rampton, J., Iyer, R. R., Acker, S. N., Koehler, R., Prendergast, C., Stence, N., O'Neill, B., Padilla, B. E., Jamshidi, R., Vaughn, J. A., Ronecker, J. S., Selesner, L., Lofberg, K., Regner, M., Thiessen, J., Sayama, C., Spurrier, R. G., Ross, E. E., Liu, C. J., Chu, J., McNevin, K., Beni, C., Robinson, B. R., Linnau, K., Buckley, R. T., Chao, S. D., Sabapaty, A., Tong, E., Prolo, L. M., Ignacio, R., Floan Sachs, G., Kruk, P., Gonda, D., Ryan, M., Pandya, S., Koral, K., Braga, B. P., Auguste, K., Jensen, A. R. 2024

  Abstract

  Clinical clearance of a child's cervical spine after trauma is often challenging due to impaired mental status or an unreliable neurologic examination. Magnetic resonance imaging (MRI) is the gold standard for excluding ligamentous injury in children but is constrained by long image acquisition times and frequent need for anesthesia. Limited-sequence MRI (LSMRI) is used in evaluating the evolution of traumatic brain injury and may also be useful for cervical spine clearance while potentially avoiding the need for anesthesia. The purpose of this study was to assess the sensitivity and negative predictive value of LSMRI as compared to gold standard full-sequence MRI as a screening tool to rule out clinically significant ligamentous cervical spine injury.We conducted a ten-center, five-year retrospective cohort study (2017-2021) of all children (0-18y) with a cervical spine MRI after blunt trauma. MRI images were re-reviewed by a study pediatric radiologist at each site to determine if the presence of an injury could be identified on limited sequences alone. Unstable cervical spine injury was determined by study neurosurgeon review at each site.We identified 2,663 children less than 18 years of age who underwent an MRI of the cervical spine with 1,008 injuries detected on full-sequence studies. The sensitivity and negative predictive value of LSMRI were both >99% for detecting any injury and 100% for detecting any unstable injury. Young children (age < 5 years) were more likely to be electively intubated or sedated for cervical spine MRI.LSMRI is reliably detects clinically significant ligamentous injury in children after blunt trauma. To decrease anesthesia use and minimize MRI time, trauma centers should develop LSMRI screening protocols for children without a reliable neurologic exam.2 (Diagnostic Tests or Criteria).

  View details for DOI 10.1097/TA.0000000000004271

  View details for PubMedID 38523120

• Cervical Collar-Associated Pressure Injury in Pediatric Trauma Patients: A Western Pediatric Surgery Research Consortium Study. Journal of pediatric surgery Melhado, C., Russell, K. W., Acker, S. N., Padilla, B. E., Lofberg, K., Spurrier, R. G., Robinson, B., Chao, S., Ignacio, R. C., Ryan, M., Jensen, A. R. 2023

  Abstract

  Healthcare-associated pressure injuries (HAPI) are known to be associated with medical devices and are preventable. Cervical spine immobilization is commonly utilized in injured children prior to clinical clearance or for treatment of an unstable cervical spinal injury. The frequency of HAPI has been quantified in adults with cervical spine immobilization but has not been well-described in children. The aim of this study was to describe characteristics of children who developed HAPI associated with cervical immobilization.We analyzed a retrospective cohort of children (0-18 years) who developed a stage two or greater cervical HAPI. This cohort was drawn from an overall sample of 49,218 registry patients treated over a five-year period (2017-2021) at ten pediatric trauma centers. Patient demographics, injury characteristics, and cervical immobilization were tabulated to describe the population.The cohort included 32 children with stage two or greater cervical HAPI. The median age was 5 years (IQR 2-13) and 78% (n = 25) were admitted to the intensive care unit. The median (IQR) time to diagnosis of HAPI was 11 (7-21) days post-injury. The majority of cervical HAPI (78%, 25/32) occurred in children requiring immobilization for cervical injuries, with only four children developing HAPI after wearing a prophylactic cervical collar in the absence of a cervical spine injury.Advanced-stage HAPI associated with cervical collar use in pediatric trauma patients is rare and usually occurs in patients with cervical spine injuries requiring immobilization for treatment. More expedient cervical spine clearance with MRI is unlikely to substantially reduce cervical HAPI in injured children.Level III (Epidemiologic and Prognostic).

  View details for DOI 10.1016/j.jpedsurg.2023.10.021

  View details for PubMedID 38030530

• Central venous access in children: Placement trends over the last decade. Clinical imaging Gaballah, M., Durand, R., Srinivasan, A., Katcoff, H., Cahill, A. M., Otero, H. J. 2023; 97: 84-88

  Abstract

  To evaluate central venous access placement trends for radiology and non-radiology services over the last decade.Children who had central venous access procedures included in a large administrative database of 49 pediatric institutions in the United States between 2010 and 2020 were included. Patient demographics and patient specific factors were compared between groups. The percentage of procedures performed by interventional radiology (IR) and non-radiology services were compared over time and by region.A total of 483,181 vascular access encounters were recorded (45.3% female; median age 2 years (IQR 0-11 years)). Approximately one quarter of vascular access encounters were IR-led, with a slight increase of 3.8% between 2010 and 2020. Children who underwent IR-placed vascular access were older (median age of 4 years compared to 1 year in non-radiology encounters). Interventional radiology-placed access was greatest in the Midwest (33.5%) with a decrease of 5.9% over the study period; in the other three regions, IR-performed encounters increased. Patient comorbidities more prevalent in the IR encounters were technology dependence (42.4% of all radiology encounters), gastrointestinal (34.9%), respiratory (20.8%), and transplant (8.1%), while those which were more prevalent in the non-radiology encounters were nephrology/urology (21.4% of all non-radiology encounters), prematurity/neonatal (17.3%), and malignancy (17.3%).Interventional radiology-provided vascular access services have slightly increased over the last decade without significant service-line transfer to other specialties. Underlying comorbidities in IR-led vascular access encounters vary across institutions based on referral patterns, possibly reflecting the adoption of ultrasound guidance by other pediatric subspecialties.

  View details for DOI 10.1016/j.clinimag.2023.02.007

  View details for PubMedID 36921450

• Bowel perforation following percutaneous sclerotherapy of an intra-abdominal lymphatic malformation. Pediatric radiology Durand, R. E., Heye, P., Cahill, A. M., Laje, P., Srinivasan, A. S. 2022; 52 (8): 1592-1595

  Abstract

  Mesenteric lymphatic malformations result from abnormal proliferation of disorganized mesenteric lymphatic channels. Sclerotherapy is often preferred over surgery as it is less invasive and has lower post-procedure morbidity. Sclerotherapy has been described as durable and effective with a low complication rate. We describe a serious complication from sclerotherapy of a lymphatic malformation extending from the mesentery through the bowel wall, highlighting the spectrum of this pathology and the need for multidisciplinary management of complex cases.

  View details for DOI 10.1007/s00247-022-05347-1

  View details for PubMedID 35445817

• Torso vascular trauma. Seminars in pediatric surgery Evans, L. L., Aarabi, S., Durand, R., Upperman, J. S., Jensen, A. R. 2021; 30 (6): 151126

  Abstract

  Vascular injury within the chest or abdomen represents a unique challenge to the pediatric general surgeon, as these life- or limb-threatening injuries are rare and may require emergent treatment. Vascular injury may present as life-threatening hemorrhage, or with critical ischemia from intimal injury, dissection, or thrombosis. Maintaining the skillset and requisite knowledge to address these injuries is of utmost importance for pediatric surgeons that care for injured children, particularly for surgeons practicing in freestanding children's hospitals that frequently do not have adult vascular surgery coverage. The purpose of this review is to provide an overview of torso vascular trauma, with a specific emphasis in rapid recognition of torso vascular injury as well as both open and endovascular management options. Specific injuries addressed include blunt and penetrating mediastinal vascular injury, subclavian injury, abdominal aortic and visceral segment injury, inferior vena cava injury, and pelvic vascular injury. Operative exposure, vascular repair techniques, and damage control options including preperitoneal packing for pelvic hemorrhage are discussed. The role and limitations of endovascular treatment of each of these injuries is discussed, including endovascular stent graft placement, angioembolization for pelvic hemorrhage, and resuscitative endovascular balloon occlusion of the aorta (REBOA) in children.

  View details for DOI 10.1016/j.sempedsurg.2021.151126

  View details for PubMedID 34930597

• Validation of computed tomography angiography as a complementary test in the assessment of renal artery stenosis: a comparison with digital subtraction angiography. Pediatric radiology Fleury, A. S., Durand, R. E., Cahill, A. M., Zhu, X., Meyers, K. E., Otero, H. J. 2021; 51 (13): 2507-2520

  Abstract

  Renal artery stenosis is an important cause of hypertension in children, accounting for 5-10% of cases. When suspected, noninvasive imaging options include ultrasound (US), computed tomography (CT) angiography and magnetic resonance (MR) angiography. However, digital subtraction angiography (DSA) remains the gold standard.To investigate the accuracy and inter-reader reliability of CT angiography in children with suspected renal artery stenosis.This is a retrospective study of patients suspected of having renal artery stenosis evaluated by both CT angiography and DSA between 2008 and 2019 at a tertiary pediatric hospital. Only children who underwent CT angiography within 6 months before DSA were included. CT angiography studies were individually reviewed by two pediatric radiologists, blinded to clinical data, other studies and each other's evaluation, to determine the presence of stenosis at the main renal artery and 2nd- and 3rd-order branches. The sensitivity, specificity and accuracy were calculated using DSA as the reference. The effective radiation dose for CT angiography and DSA was also calculated. Kappa statistics were used to assess inter-reader agreement.Seventy-four renal units were evaluated (18 girls, 19 boys). The patients' median age was 8 years (range: 1-21 years). Overall, CT angiography was effective in detecting renal artery stenosis with a sensitivity of 85.7%, specificity of 91.5% and accuracy of 88.9%. There was moderate inter-reader agreement at the main renal artery level (k=0.73) and almost perfect inter-reader agreement at the 2nd/3rd order (k=0.98). However, the sensitivity at the 2nd- and 3rd-order level was lower (14.3%). CT angiography provided excellent negative predictive value for evaluating renal artery stenosis at the main renal artery level (90.1%) and at the 2nd- or 3rd-order branches (82.7%). The median effective dose of CT angiography studies was 2.2 mSv (range: 0.6-6.3) while the effective dose of DSA was 13.7 mSv.CT angiography has high sensitivity and specificity at the main renal artery level with a lower radiation dose than previously assumed. Therefore, it can be used as a diagnostic tool in patients with low to medium risk of renal artery stenosis, and as a screening and treatment planning tool in patients at high risk.

  View details for DOI 10.1007/s00247-021-05145-1

  View details for PubMedID 34374838

  View details for PubMedCentralID 17050355

• Contrast-enhanced ultrasound in pediatric interventional radiology. Pediatric radiology Acord, M. R., Cahill, A. M., Durand, R., Huang, D. Y., Shellikeri, S., Vatsky, S., Srinivasan, A. 2021; 51 (12): 2396-2407

  Abstract

  There is growing interest in the use of contrast-enhanced ultrasound (CEUS) in diagnostic and interventional radiology. CEUS applications in interventional radiology are performed with intravascular or intracavitary administration of microbubble-based US contrast agents to allow for real-time evaluation of their distribution within the vascular bed or in body cavities, respectively, providing additional information beyond gray-scale US alone. The most common interventional-radiology-related CEUS applications in children have been extrapolated from those in adults, and they include the use of CEUS to guide lesion biopsy and to confirm drain placement in pleural effusions and intra-abdominal fluid collections. Other applications are emerging in interventional radiology for use in adults and children, including CEUS to optimize sclerotherapy of vascular malformations, to guide arthrography, and for lymphatic interventions. In this review article we present a wide range of interventional-radiology-related CEUS applications, emphasizing the current and potential uses in children. We highlight the technical parameters of the CEUS examination and discuss the main imaging findings.

  View details for DOI 10.1007/s00247-020-04853-4

  View details for PubMedID 33978796

  View details for PubMedCentralID 5991005

• MRI for Response Assessment of Extensive Lymphatic Malformations in Children Treated With Sirolimus. AJR. American journal of roentgenology Durand, R., Reid, J. R., Belasco, J. B., Shellikeri, S., Calle-Toro, J. S., Cahill, A. M., Srinivasan, A. 2021; 217 (3): 741-752

  Abstract

  BACKGROUND. Extensive lymphatic malformations (LMs) may cause substantial morbidity. The mammalian target of rapamycin (mTOR) inhibitor sirolimus shows promise for treating vascular anomalies, although response assessment is not standardized. OBJECTIVE. The purpose of this study was to retrospectively characterize changes seen on MRI of children with extensive LMs treated with sirolimus. METHODS. Twenty-five children treated with sirolimus for extensive LMs were included. Baseline MRI was defined as the MRI examination performed closest to therapy initiation; follow-up MRI was defined as the most recent MRI examination performed while the patient was receiving therapy. Two pediatric radiologists independently determined MRI lesion volume by tracing lesion contours on all slices (normalized to patient body surface area expressed in square meters) and determined signal by placing an ROI on the dominant portion of the lesions (normalized to CSF signal) on baseline and follow-up T2-weighted MRI sequences. Interreader agreement was determined, and values were averaged for further analysis. Volume and signal changes were compared with patient, lesion, and treatment characteristics. RESULTS. The mean (± SD) interval between initiation of sirolimus treatment and follow-up MRI was 22.1 ± 13.8 months. The mean lesion volume index on baseline and follow-up MRI was 728 ± 970 and 345 ± 501 mL/m2, respectively (p < .001). Ninety-two percent of children showed a decrease in lesion volume index that was greater than 10% (mean volume change, -46.4% ± 28.2%). Volume change was inversely correlated with age (r = -0.466; p = .02). The mean volume change was -64.7% ± 25.4% in children younger than 2 years old versus -32.0% ± 21.6% in children 2 years old or older (p = .008). The mean volume change was -58.1% ± 24.0% for craniocervical lesions versus -35.5% ± 28.2% for lesions involving the trunk and/or extremities (p = .03). Mean lesion signal ratio on baseline and follow-up MRI was 0.81 ± 0.29 and 0.59 ± 0.26, respectively (p < .001). Mean signal ratio change was -23.8% ± 22.7%. Volume and signal changes were moderately correlated (r = 0.469; p = .02). Volume and signal changes were not associated with sex, lesion subtype, serum concentration of sirolimus, or the interval between sirolimus initiation and follow-up MRI (p > .05). Interreader agreement for volume index change was excellent (intraclass correlation coefficient, 0.983), and that for signal ratio change was moderate to good (intraclass correlation coefficient, 0.764). CONCLUSION. Sirolimus treatment of extensive LMs in children is associated with significant reductions in volume and signal on T2-weighted MRI. The decrease in volume is greater in younger children and craniocervical lesions. CLINICAL IMPACT. The results may facilitate development of standardized MRI-based criteria for assessing the response of vascular malformations to pharmacotherapy.

  View details for DOI 10.2214/AJR.20.24378

  View details for PubMedID 33405944

• Implantable venous access devices in children with severe hemophilia: a tertiary pediatric institutional experience. Pediatric radiology Bedoya, M. A., Raffini, L., Durand, R., Acord, M. R., Srinivasan, A., Krishnamurthy, G., Vatsky, S., Escobar, F., Cahill, A. M. 2020; 50 (8): 1148-1155

  Abstract

  Clotting factor replacement forms the pillar of treatment for children with hemophilia. Most children can be treated using peripheral venipuncture, but very young children and children with poor venous access might require a central venous catheter. Short-term and long-term complications of implantable venous access device placement (also known as port placement) can result in important morbidity and mortality in children with hemophilia.The purpose of this study is to describe our experience with port placement in children and adolescents with severe hemophilia (<1% of the Factors VIII or IX).We performed a retrospective review over a 10-year period to identify port placement in pediatric patients with severe hemophilia. We reviewed demographic and procedural information, access frequency, mechanical complications, and central-line-associated bloodstream infections (CLABSI). Eighteen males were included, with median age at insertion of 3.9 years (0.7-22.7 years). Fifteen of the 18 patients had hemophilia Type A and 3/18 had Type B. Thirteen had high neutralizing inhibitor titers.Technical success in port placement was achieved in 26/27 (96.3%) patients, with 1 port failure caused by venous occlusion from prior catheter placement. Port catheter size ranged from 5 French (Fr) to 7.5 Fr. All were single-lumen and placed via right (76.9%) or left (23.1%) internal jugular vein; 59.3% were placed during general anesthesia, and all had factor replacement prophylaxis. A peripherally inserted central catheter (PICC) was placed concurrently in 69.2% of the cases; per hospital policy, the port was only accessed 15 days post-placement to reduce the risk of site hematoma. Two patients were lost to follow-up. The total catheter days was 15,893. Ports were removed in 14/24 cases, most commonly because of CLABSI (7/24; 29.2%) and transition to peripheral infusion (3/24; 12.5%). Bleeding was the most common complication in the first 30 days after placement. There were nine CLABSI events (0.57 per 1,000 catheter days), all in patients with high neutralizing inhibitor titers. A higher frequency of port access (more or equal to daily vs. less than daily) correlated with higher infection rates (P=0.02). Median time from port insertion to first infection was 348 days (range 167-1,055 days). There were four fibrin-sheath-related catheter occlusions (0.25 per 1,000 catheter days): three catheters were salvaged with intra-catheter tissue plasminogen activator (tPA) instillation resulting in a salvage of an additional 1,214 catheter days, and one catheter was removed after tPA failure (0.06 per 1,000 catheter days).Port maintenance in boys with severe hemophilia is challenging given the need for long-term frequent device access that is associated with catheter-related infections. The rate of bleeding or infection did not differ in patients whether the device was accessed immediately or 15 days post placement. With appropriate pre- and post-procedural factor replacement, immediate and early term severe complications are not common.

  View details for DOI 10.1007/s00247-020-04668-3

  View details for PubMedID 32390060

• Postpyloric Balloon Occlusion to Increase Technical Success during Pediatric Percutaneous Gastrostomy/Gastrojejunostomy Tube Placement. Journal of vascular and interventional radiology : JVIR Durand, R., Cahill, A. M., Shellikeri, S., Acord, M. 2020; 31 (7): 1139-1142.e1

  Abstract

  Gastric distension through insufflation is a key step in creating a safe percutaneous window during gastrostomy/gastrojejunostomy (G/GJ) placement; however, poor or incomplete gastric distention can occur, despite the use of glucagon, and lead to rapid egress of air from the stomach into the duodenum. This report describes the adjunctive technique using postpyloric balloon occlusion in 29 patients to maximize gastric insufflation during G/GJ tube placement after failure of conventional methods. Balloon occlusion was successful in salvaging 23 of 29 (79.3%) of G/GJ tube placements without any complications.

  View details for DOI 10.1016/j.jvir.2020.03.004

  View details for PubMedID 32534976