Paola Devis

Interests

Research

Interventional OncologyBody Imaging

Teaching

Interventional OncologyVascular and Interventional RadiologyBody Imaging

Courses

No activities entered.

Scholarly Contributions

Books

• Devis, P., & Arif, H. (2020). The Ultimate guide to point of care ultrasound guided procedures. chapter title- Ultrasound-guided Percutaneous Drainage Procedures: Springer.

Chapters

• Devis, P., & Arif, H. (2017). The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures. In The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures.
• Situ-lacasse, E., Situ-lacasse, E., Javedani, P., Devis, P., Devis, P., Arif Tiwari, H., & Arif-tiwari, H. (2020). Ultrasound-Guided Percutaneous Drainage Procedures. In The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures. Springer, Cham. doi:10.1007/978-3-030-28267-7_11
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  Ultrasound-guided procedures, especially those that are for needle guidance, are all based on the learned skill of being able to track the needle tip the entire time, while it is in the patient under ultrasound imaging. By learning this critical skill, the physician should feel confident in the successful completion of both simple and more complicated, invasive procedures. Ultrasound-guided percutaneous drainage or aspiration of abnormal fluid collections is becoming standard of care in current clinical practice. Ultrasound guidance has led to reduced morbidity and mortality and decrease in length of stay and healthcare costs. Ultrasound-guided percutaneous drainage is minimally invasive and relatively inexpensive and has several advantages over CT including real-time guidance and lack of radiation.
• Situ-LaCasse, E., Javedani, P., Devis, P., & Arif-Tiwari, H. (2019). Ultrasound-Guided Percutaneous Drainage Procedures. In The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures. Springer Nature.

Journals/Publications

• Devis, P. (2021).               Covid-19 and Renal Infarct: To be or not to be on anticoagulation. Clinical Nephrology Case Studies, 9, 117-122.
• Sherman, N. C., Williams, K. N., Hennemeyer, C. T., Devis, P., Chehab, M., Joseph, B., & Tang, A. L. (2022). Authors' response to "The diameter of the gelatin sponge affects the outcome of pelvic internal iliac artery embolization". The journal of trauma and acute care surgery.
• Devis, P. (2015). 2015 SIR Abstract : Systematic MRI Characterization of Tissue Outcomes Following IRE of Hepatic Tumors. Journal of Vasular and Interventional Radiology, 26(2):S60-61.
• Devis, P. (2016). Hepatic Cirrhosis - Letter to the Editor. New England Journal of Medicine.
• Devis, P. (2017). Man lured with alcohol, takes bait and gets caught- A cautionary fish tale. The American Surgeon.
• Sherman, N. C., Williams, K. N., Hennemeyer, C. T., Devis, P., Chehab, M., Joseph, B., & Tang, A. L. (2021). Effects of nonselective internal iliac artery angioembolization on pelvic venous flow in the swine model. The journal of trauma and acute care surgery, 91(2), 318-324.
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  Pelvic angioembolization (AE) is a mainstay in the treatment algorithm for pelvic hemorrhage from pelvic fractures. Nonselective AE refers to embolization of the bilateral internal iliac arteries (IIAs) proximally rather than embolization of their tributaries distally. The aim of this study was to quantify the effect of nonselective pelvic AE on pelvic venous flow in a swine model. We hypothesized that internal iliac vein (IIV) flow following IIA AE is reduced by half.
• Takamatsu, C., Devis, P., & Tolouian, R. (2021). COVID-19 and renal infarct: To be or not to be on anticoagulation. Clinical nephrology. Case studies, 9, 117-122.
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  We present a unique case of a male veteran with a history of Castleman disease, presenting with multiple arterial and venous vascular thromboses in the setting of recent Coronavirus (COVID-19)-disease diagnosis. We explore this patient's morbidity related to thrombotic complications of his COVID-19 diagnosis that were potentially avoidable with a comprehensive outpatient evaluation of his risk for thrombosis, as well as the initiation of anticoagulation and/or antiplatelet therapy given his high risk. Our case highlights the need for a standardized clinical workup of patients in the outpatient setting for risk assessment of vascular thrombosis associated with COVID-19 infection to direct medical management, in order to minimize adverse outcomes, complications requiring inpatient admission, and the need for additional yet limited medical resources and interventions. We propose a minimum of low-dose aspirin 81 mg daily as a reasonable approach for outpatient clinicians to consider, based on their best clinical judgement, when managing mild COVID-19, while other options, such as novel oral anticoagulants, are undergoing further investigation.
• Vercruysse, G. A., Bauman, Z. M., Devis, P., & Hennemeyer, C. T. (2018). Man lured with alcohol, takes bait and gets caught - A cautionary fish tale.. The American Surgeon, 84.
• Vercruysse, G. A., Bauman, Z. M., Hennemeyer, C. T., Devis, P., & Rhee, P. M. (2018). Man Lured with Alcohol, Takes Bait, and Gets Caught: A Cautionary Fish Tale. The American surgeon, 84(2), e85-e86.
• Black, S. M., Black, S., Devis, P., Hennemeyer, C., Ho, P., Janicek, A., Markus, H., Mushtaq, R., & Woodhead, G. (2017). Course of platelet count in chronic liver disease after correction of portal hypertension through TIPS: A retrospective analysis. Journal of Vascular and Interventional Radiology, 28(2), S232. doi:10.1016/j.jvir.2016.12.1171
• Devis, P. (2017). Coccidioidomycosis Mimicking Peritoneal Carcinomatosis: Case report Applied Radiology. Applied Radiology: 2017;46(4):28-29. April 03, 2017, 46(4): 28-29.
• Devis, P., & Knuttinen, G. (2017). Deep venous thrombosis in pregnancy: incidence, pathogenesis and endovascular management.. Cardiovasc Diagn Ther, 7(Suppl 3), S309-S319. doi:10.21037
• Devis, P., & Knuttinen, M. G. (2017). Deep venous thrombosis in pregnancy: incidence, pathogenesis and endovascular management. Cardiovascular diagnosis and therapy, 7(Suppl 3), S309-S319.
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  Deep venous thrombosis (DVT) during pregnancy is associated with high mortality, morbidity, and costs. Pulmonary embolism (PE), its most feared complication, is the leading cause of maternal death in the developed world. DVT can also result in long-term complications that include postthrombotic syndrome (PTS) adding to its morbidity. Women are up to 5 times more likely to develop DVT when pregnant. The current standard of care for this condition is anticoagulation. This review discusses the epidemiology, pathogenesis, prophylaxis and diagnosis of DVT during pregnancy, and then focuses on endovascular treatment modalities. Inferior vena cava (IVC) filter placement and pharmacomechanical catheter directed thrombolysis (PCDT) in the pregnant patient are discussed, as well as patient selection criteria, and complications.
• Devis, P., Jindala, R., Hur, S. H., & Eldersveld, J. M. (2017). Coccidioidomycosis mimicking peritoneal carcinomatosis. Applied Radiology, 46(4), 28-29. doi:10.37549/ar2370
• Devis, P. (2016). Segmental arterial mediolysis and fibromuscular dysplasia: What comes first, the chicken or the egg?. Cardiovascular Pathology, 25(2):113-5.
• Hall, E. T., Gibson, B. A., Hennemeyer, C. T., Devis, P., Black, S., & Larsen, B. T. (2016). Segmental arterial mediolysis and fibromuscular dysplasia: what comes first, the chicken or the egg?. Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology, 25(2), 113-5.
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  Segmental arterial mediolysis (SAM) is a rare vasculopathy characterized by lysis of the outer media in splanchnic arteries and formation of dissecting pseudoaneurysms that may spontaneously rupture, leading to massive and often fatal intraabdominal hemorrhage. The pathogenesis of SAM is poorly understood. Healed SAM lesions closely resemble fibromuscular dysplasia (FMD), leading some authors to postulate that SAM represents a precursor to FMD despite distinct clinical differences between these two disorders. Herein, we present a 61-year-old woman with fatal SAM who showed histologic features in her aorta suggesting the opposite pathogenetic relationship, with an unclassified "FMD-like" arteriopathy preceding development of SAM.
• Devis, P., Woodhead, G. J., Kalb, B., Black, S., & Krupinski, E. (2015). Systematic MRI Characterization of Tissue Outcomes Following IRE of Hepatic Tumors. JVIR - Journal of Vascular and Interventional Radiology.
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  February 2015Volume 26, Issue 2, Supplement, Pages S60–S61
• Woodhead, G., Devis, P., Black, S., Krupiński, E. A., Jindal, R., Kalb, B., & Hennemeyer, C. (2015). Systematic MRI characterization of tissue outcomes following irreversible electroporation of hepatic tumors. Journal of Vascular and Interventional Radiology, 26(Issue 2- supplement), s60-s61. doi:10.1016/j.jvir.2014.12.166
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  PurposeIRE is an evolving technique for the percutaneous ablation of hepatic tumors. Recent advances in body MRI, including proprietary software and sequences developed at our institution, facilitate analysis of post-ablation tissue characteristics. We propose that early MRI findings post-IRE predict treatment response with high accuracy. Early detection of incompletely treated hepatic tumors will improve clinical decision-making.Materials and MethodsOver an 18-month period (10/2012-04/2014) 34 hepatic tumors underwent IRE using the NanoKnife Ablation System (AngioDynamics). 5 patients were lost to follow-up and 1 lesion was not treated due to a targeting error, leaving 28 tumors for analysis (15 HCC and 13 metastases). MRI: Patients underwent a baseline MRI, with subsequent imaging at 1 and 6 months post-IRE. MRIs were performed on a 1.5T system (Magnetom Aera, Siemens) using a standardized protocol of dynamic pre- and post-contrast T1-weighted 3D gradient echo, single shot T2 with and without fat saturation, and diffusion weighted sequences. Image Review: All MRIs were reviewed by two blinded experts in body MRI with 7 and 15 years of experience. Imaging features catalogued pre- and post-IRE: a) precontrast T1 signal, b) perfusion pattern, c) T2 signal, and d) apparent diffusion coefficient. Findings were recorded on pre-prepared worksheets. Statistical analysis was performed in conjunction with clinical and procedural data.ResultsTwo distinct MRI outcomes are seen after IRE of hepatic tumors: (1) complete devascularization, and (2) residual enhancement. Lesions devoid of internal enhancement post-IRE were deemed devascularized, with additional findings variably present (e.g., intrinsic high T1 signal and progressive lesion retraction). Overall, MRI findings at 1-month post-IRE reliably predicted 6-month imaging outcomes (23/28 cases). Any residual nodular enhancement at 1 month post-IRE was predictive of disease progression (6/6 cases). Only 5 cases initially categorized as devascularized developed recurrence at 6 months.ConclusionEarly MRI findings following IRE predict treatment response with high accuracy. This ongoing study will yield insight into the long-term success of IRE-treated hepatic tumors. PurposeIRE is an evolving technique for the percutaneous ablation of hepatic tumors. Recent advances in body MRI, including proprietary software and sequences developed at our institution, facilitate analysis of post-ablation tissue characteristics. We propose that early MRI findings post-IRE predict treatment response with high accuracy. Early detection of incompletely treated hepatic tumors will improve clinical decision-making. IRE is an evolving technique for the percutaneous ablation of hepatic tumors. Recent advances in body MRI, including proprietary software and sequences developed at our institution, facilitate analysis of post-ablation tissue characteristics. We propose that early MRI findings post-IRE predict treatment response with high accuracy. Early detection of incompletely treated hepatic tumors will improve clinical decision-making. Materials and MethodsOver an 18-month period (10/2012-04/2014) 34 hepatic tumors underwent IRE using the NanoKnife Ablation System (AngioDynamics). 5 patients were lost to follow-up and 1 lesion was not treated due to a targeting error, leaving 28 tumors for analysis (15 HCC and 13 metastases). MRI: Patients underwent a baseline MRI, with subsequent imaging at 1 and 6 months post-IRE. MRIs were performed on a 1.5T system (Magnetom Aera, Siemens) using a standardized protocol of dynamic pre- and post-contrast T1-weighted 3D gradient echo, single shot T2 with and without fat saturation, and diffusion weighted sequences. Image Review: All MRIs were reviewed by two blinded experts in body MRI with 7 and 15 years of experience. Imaging features catalogued pre- and post-IRE: a) precontrast T1 signal, b) perfusion pattern, c) T2 signal, and d) apparent diffusion coefficient. Findings were recorded on pre-prepared worksheets. Statistical analysis was performed in conjunction with clinical and procedural data. Over an 18-month period (10/2012-04/2014) 34 hepatic tumors underwent IRE using the NanoKnife Ablation System (AngioDynamics). 5 patients were lost to follow-up and 1 lesion was not treated due to a targeting error, leaving 28 tumors for analysis (15 HCC and 13 metastases). MRI: Patients underwent a baseline MRI, with subsequent imaging at 1 and 6 months post-IRE. MRIs were performed on a 1.5T system (Magnetom Aera, Siemens) using a standardized protocol of dynamic pre- and post-contrast T1-weighted 3D gradient echo, single shot T2 with and without fat saturation, and diffusion weighted sequences. Image Review: All MRIs were reviewed by two blinded experts in body MRI with 7 and 15 years of experience. Imaging features catalogued pre- and post-IRE: a) precontrast T1 signal, b) perfusion pattern, c) T2 signal, and d) apparent diffusion coefficient. Findings were recorded on pre-prepared worksheets. Statistical analysis was performed in conjunction with clinical and procedural data. ResultsTwo distinct MRI outcomes are seen after IRE of hepatic tumors: (1) complete devascularization, and (2) residual enhancement. Lesions devoid of internal enhancement post-IRE were deemed devascularized, with additional findings variably present (e.g., intrinsic high T1 signal and progressive lesion retraction). Overall, MRI findings at 1-month post-IRE reliably predicted 6-month imaging outcomes (23/28 cases). Any residual nodular enhancement at 1 month post-IRE was predictive of disease progression (6/6 cases). Only 5 cases initially categorized as devascularized developed recurrence at 6 months. Two distinct MRI outcomes are seen after IRE of hepatic tumors: (1) complete devascularization, and (2) residual enhancement. Lesions devoid of internal enhancement post-IRE were deemed devascularized, with additional findings variably present (e.g., intrinsic high T1 signal and progressive lesion retraction). Overall, MRI findings at 1-month post-IRE reliably predicted 6-month imaging outcomes (23/28 cases). Any residual nodular enhancement at 1 month post-IRE was predictive of disease progression (6/6 cases). Only 5 cases initially categorized as devascularized developed recurrence at 6 months. ConclusionEarly MRI findings following IRE predict treatment response with high accuracy. This ongoing study will yield insight into the long-term success of IRE-treated hepatic tumors. Early MRI findings following IRE predict treatment response with high accuracy. This ongoing study will yield insight into the long-term success of IRE-treated hepatic tumors.
• Devis, P., Devis, P., Hennemeyer, C., Jindal, R., Kalb, B., & Woodhead, G. J. (2014). Systematic MRI characterization of tissue imaging outcomes following percutaneous irreversible electroporation of hepatic tumors. Journal of Vascular and Interventional Radiology, 25(3), S190-S191. doi:10.1016/j.jvir.2013.12.514
• Devis, P., & John, S. G. (2013). Case Report: Migration of Fractured PICC Line, Southwest Journal of Pulmonary Critical Care. 2013; 7 (5). Southwest Journal of Pulmonary and Critical Care., 2013;7(5)304-304 DOI 10.13175/swjpcc151-13.
• John, S., & Devis, P. (2013). Medical image of the week: migration of fractured PICC line. Southwest Journal of Pulmonary, Critical Care and Sleep, 25(4), 625-6. doi:10.13175/swjpcc151-13
• Devis, P., Iwanik, D., & Aikens, C. (2005). Metastatic Adenocarcinoma Presenting as Monoarticular Arthritis of the Knee. AJR. American journal of roentgenology, 184(3 Suppl), S107-9.

Proceedings Publications

• Chavarro, D., Melo, O. L., D'aleman, P., Devis, P., Gonzales, S. G., Rojas, D., & Reynales, H. (1995, July-September). Efectos de la diabetes en el embarazo sobre el recién nacido. In Revista Colombiana de Obstertricia, 46.

Presentations

• Devis, P. (2017, February). Endovascular management of Visceral Arterial Aneurysms and Pseudo-aneurysms. The University of Arizona Medical Imaging Grand Rounds.
• Devis, P. (2017, February). “Endovascular management of Visceral Arterial Aneurysms and Pseudoaneurysms”. Vascular Surgery Teaching Conference, The University of Arizona College of Medicine Tucson, Sarver Heart Center.

Poster Presentations

• Devis, P. (2016, Fall). Winner - Best Poster Award - "Denever peritoneo-venous shunt: as essential tool in the managment of malignant ascites". SIR 41st Annual Scientific Meeting.

Reviews

• Devis, P., & Knuttien, G. (2017. DVT in pregnancy: Incidence, Treatment and Outcomes; Review article Journal: Thrombosis.

Case Studies

• Devis, P. (2016. Gastro Intestinal Basidiobolomycosis: A case report and review of the literature.(p. 000).
• Devis, P. (2017. Gastrointestinal Basidiobolomycosis(pp ID # s4024).
• Devis, P., Lee, J., & Kramer, J. (2017. Management of Portal Vein stenosis following liver transplant.(pp TBD).

Others

• Devis, P., Tang, A., Williams, K., & Sherman, N. (2017, May). IRB approved Animal study, May 2017: aims to quantify the degree of pelvic venous flow reduction following unilateral and bilateral internal iliac artery embolization in Swine. Study in collaboration between IR and the division of Trauma Surgery: Data was collected and is currently being analyzed..