Carotid endarterectomy versus carotid artery stenting: findings in regard to neuroclinical outcomes and diffusion-weighted imaging.

The purpose of our study was to evaluate prospectively the frequency and significance of brain lesions after elective carotid endarterectomy (CAE) and carotid artery stenting (CAS) by using diffusion-weighted magnetic resonance imaging (DW MRI) and then to correlate imaging findings with neuroclinical outcomes. From February 2003 through March 2005, 95 consecutive patients underwent surgical endarterectomy or CAS (with a cerebral protection device) at our institution. A total of 59 CAE procedures were performed in 46 consecutive patients (mean age, 65.

Endovascular stent graft placement in the treatment of ruptured tuberculous pseudoaneurysm of the descending thoracic aorta: case report and review of the literature.

We report a successful repair of a ruptured tuberculous pseudoaneurysm of the descending thoracic aorta by endovascular stent graft placement. This procedure is starting to be accepted as an alternative method to surgery, and we review similar cases in the literature.

Angiographic signs in specific vasculitides.

Vasculitis, defined by inflammation in the blood vessel wall and reactive mural damage, may present with various clinical signs, depending on the organs involved. Infection, collagen vascular disease, and granulomatous disease or idiopathic inflammation of the vessels may result in various degrees of stenosis, obstruction, aneurysmal dilatation, or rupture. The definitive pathologic diagnosis is established by biopsy; however, the biopsy may pose significant risk to the patient; and the biopsy sample may not be adequate.

"Extarterectomy" for tumors invading the carotid artery: an animal model.

Objective: Carotid artery (CA) invasion by head and neck tumors is a challenging problem for the cranial base surgeon. Proposed methods for management have the disadvantage of constant or temporary interruption of the arterial blood flow and, as a consequence, cerebral ischemic complications. The objective of the study was to investigate the long-term effects of a novel technique, "extarterectomy," on the vascular wall and the arterial blood flow in an ovine model.

An unusual vascular involvement in a patient with Behcet's disease: renal artery stenosis.

Behcet's disease (BD) is a rare multisystem inflammatory disorder characterized by recurrent ulcers affecting the mouth and genitals, various skin lesions, relapsing iritis, and vasculitis. Vascular events may dominate the clinical presentation in some patients with BD. Hitherto three forms of vascular disease such as venous occlusions, arterial aneurysms, and arterial occlusions have been reported in BD.

Endovascular treatment of AVF after hair transplantation.

Arteriovenous fistula (AVF) of the scalp is a very rare complication of hair transplantation. Only 9 cases have been reported in nearly half a century. The diagnosis is clinical but angiography is necessary for defining the angioarchitecture of the lesion.

Fibromuscular dysplasia-related renal artery stenosis associated with aneurysm: successive endovascular therapy.

Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vascular disease. FMD of the renal arteries is one of the leading causes of curable hypertension. The simultaneous occurrence of FMD and renal artery aneurysm has been described previously.

Interventional radiological management of vascular complications following renal transplantation.

In this pictorial essay, we describe the angiographic appearance of the most common vascular complications following renal transplantation, such as arterial stenoses, arteriovenous fistulas, pseudoaneurysms, and thromboses, and illustrate their interventional radiological management.

Percutaneous interventional therapy of persistent biliary fistulas.

Background: Persistent biliary leakage is a challenging problem when conservative treatment methods fail. We present our experience with alternative percutaneous radiologic interventions to seal refractory biliary leaks.

Methods: From April 1998 to December 2005, a retrospective analysis of 23 patients with biliary leakage revealed six patients who were unresponsive to drainage were treated with use of Histoacryl (n = 5), microcoils (n = 2), or covered stent (n = 2) alone or in various combinations.

Acute mesenteric ischemia: endovascular therapy.

Acute mesenteric ischemia (AMI) is an abdominal emergency with a high mortality. Prompt revascularization can prevent intestinal infarction and reduce mortality. We report three cases of acute occlusive mesenteric ischemia without signs of intestinal necrosis, which were successfully managed with endovascular interventions.

[Pulsatile tinnitus as the presenting symptom of dural arteriovenous fistula in two cases].

Pulsatile tinnitus associated with normal otoscopic findings may present as the only sign of a potentially life-threatening serious disease such as a dural arteriovenous fistula (dAVF) of the transverse or sigmoid sinus. If left untreated, dAVFs may lead to focal neurologic symptoms, intracranial hypertension, or hemorrhage, and finally to death. We report two cases of dAVF presenting with pulsatile tinnitus.

Experience with mesocaval shunt with autologous jugular vein interposition in patients with Budd-Chiari syndrome.

Background/aims: In the present era of interventional radiology and liver transplantation, the role of mesocaval shunt surgery for portal hypertension in Budd-Chiari syndrome is reviewed.

Methodology: This study analyzed the management of 35 patients with Budd-Chiari syndrome between June 1994 and June 2004 in our institution. During this 10-year interval, 31 of the 35 patients with Budd-Chiari syndrome underwent shunt procedures and four patients underwent liver transplantation.

Gene therapy: applications in interventional radiology.

Gene therapy is a new and rapidly developing area in medicine. Although it is a new therapy method, recent studies look promising. Since vascular wall is a good target for this treatment, interventional radiologists should become familiar with this new therapy and be involved in this multidisciplinary collaboration.

Adverse effects of anesthesia in interventional radiology.

Purpose: The aim of the study was to evaluate adverse events related to the use of anesthesia and anesthetic procedures associated with interventional radiology.

Materials And Methods: We retrospectively evaluated 124 interventional radiological procedures performed with anesthesia within a one-year period. Patients were separated into four groups according to the duration of procedure, the type of procedure performed, anesthetic agents used, and complications associated with anesthesia.

[The role of the interventional radiologist in central venous catheter dysfunction (pictorial essay)].

Failure to aspirate blood from the lumen of venous catheters, inadequate blood flow and/or high resistance pressures during hemodialysis were accepted as catheter dysfunction. Other correctable problems such as residual lumen thrombus, external fibrin catheter sheath or malpositioned catheter tip were identified by contrast injection. Catheter malpositions were corrected by snare-mediated catheter repositioning or by exchange of the catheter over a guidewire.

Retrieval of intravascular foreign bodies with goose neck snare.

Purpose: to evaluate the efficacy and advantages of the snare systems in the retrieval of foreign bodies from vascular system.

Materials And Methods: the snare technique has been used for intravascular foreign body retrieval. We performed percutaneous extraction of intravascular foreign bodies using combination multipurpose catheters and a nitinol snare loop.

[Stent originating pseudoaneurysm: endovascular treatment of a rare complication with hemobahn-covered stent (case report)].

Delayed rupture and aneurysm formation at the site of stent placement has rarely been described in the literature. However, these rare complications are usually fatal and the patients are taken to the operating theater for repeat endovascular treatment. In this case report, a rare complication that developed after percutaneous recanalization and stent angioplasty of chronic long-segment iliac artery occlusion, and the treatment of this complication are presented.

[Persistent fetal carotid-vertebrobasilar anastomoses].

The primitive trigeminal, otic (acoustic), hypoglossal, and proatiantal intersegmental arteries are persistent fetal anastomoses between the carotid and vertebrobasilar circulations. These fetal anastomoses regress at roughly the rate at which the posterior communicating and vertebral arteries develop. The purpose of this study is to review the persistent fetal carotid-vertebrobasilar anastomoses with MRI and DSA.

Reliability of intrarenal Doppler sonographic parameters of renal artery stenosis.

Purpose: The goal of this study was to retrospectively evaluate false-negative results of Doppler sonography in the diagnosis of renal artery stenosis (RAS) using intrarenal criteria.

Methods: We reviewed the clinical data and Doppler sonographic data for all patients in whom a diagnosis of RAS had been confirmed angiographically between November 1992 and January 2001. Mean intrarenal acceleration and acceleration time values-data obtained directly from color Doppler sonography-and findings of angiographic examination of the kidneys and stenotic renal arteries were evaluated.

Nitric oxide and oxidative stress in atherosclerotic renovascular hypertension: effect of endovascular treatment.

Purpose: Because activation of the renin-angiotensin system leads to an increase in oxidative stress, the authors investigated nitric oxide (NO; nitrite + nitrate), superoxide dismutase (SOD), catalase, and malondialdehyde (MDA) levels and the effect of endovascular treatment on these parameters in patients with atherosclerotic renovascular hypertension. The relationship of NO with blood pressure and renal functional indexes was also investigated.

Materials And Methods: In this prospective cohort study, serum creatinine, NO, SOD, catalase, plasma MDA, urinary microalbumin, and NO levels, and blood pressure were determined in 21 patients with hypertension and unilateral renal artery stenosis caused by atherosclerosis at entry and after 24 hours, 2 weeks, and 6 weeks of endovascular treatment.

Biliary reconstructions and complications encountered in 50 consecutive right-lobe living donor liver transplantations.

Biliary complications appear to be the leading cause of postoperative complications after living donor liver transplantation (LDLT). The aim of this study is to analyze the complications, treatment modalities, and outcomes of biliary anastomoses in a series of 50 consecutive right-lobe LDLTs. Median patient age was 45 years, and median right-lobe graft volume was 740 g.

Interventional radiological treatment in complications of pancreatitis.

Percutaneous interventional therapy plays an important role in treating complications of acute and chronic pancreatitis. With the development of cross-sectional imaging and advanced interventional techniques, percutaneous drainage has become the preferred treatment for pancreatic fluid collections such as acute collections, pseudocysts and abscesses. Abscess and pancreatic hemorrhage are the most life threatening complications of pancreatitis.