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Although its exact origin is unknown, the familiar Latin axiom Primum non nocere (first, do no harm) has been spoken or thought by all physicians and healthcare providers at one time or another. For those of us who perform invasive procedures or surgery, this phrase lives deep within our psyche as we never want to have a complication ensue from any procedure causing injury to those we are trying to help. However, the only interventionalist who has never had a complication is the one who has never actually practiced his or her craft. All of us remember our complications much more than our successful cases and, because of this, we learn much more from procedures that go awry than from those that go smoothly. Fortunately, and much more often than not, clinical outcomes can be the same regardless of procedure-related complications provided we have the knowledge and tools to deal with complications and iatrogenic injuries when they occur. To remember another proverb written by the founder of America's first hospital—Benjamin Franklin—An ounce of prevention is worth a pound of cure.
In this issue, we explore iatrogenic complications of a variety of common interventional procedures as well as treatment options and, more importantly, strategies for prevention. This issue includes discussion of complications related to portal venous interventions both within the realm of interventional oncology and those related to the treatment of portal hypertension. With the incidence of nonalcoholic fatty liver disease exploding worldwide, advanced portal interventions have become more common in many radiology departments making many of us more likely to see or experience iatrogenic complications from these procedures in our practices. Gastrointestinal (GI) tract interventions are among the most frequent procedures performed in IR and strategies for avoiding iatrogenic injuries in enteral access and in the setting of GI bleeding are discussed. Finally, the potential for iatrogenic injuries in or around the liver is discussed within the contexts of biliary and locoregional therapies including transarterial chemoembolization and transarterial radioembolization to help ensure the best clinical outcomes for these very ill patients. We would like to thank Thieme and Dr. Baljendra Kapoor for inviting us to serve as guest editors for this issue of Digestive Disease Interventions. In addition, we would like to especially thank our superb colleagues from across the United States who generously gave of their time to create the excellent content included. We hope the information presented will help all our readers provide the highest quality care for their patients.
Article published online:
15 May 2023
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