Percutaneous retrieval of a broken Lunderquist guidewire from the pelvicalyceal system.

The stiff Lunderquist guidewire may occasionally be needed during percutaneous insertion of a nephrostomy catheter, especially in patients with a large amount of subcutaneous fat or with a hard renal capsule. This wire may fracture at the junction of its stiff portion with the flexible tip. We have reported such an occurrence, in which an operative procedure was avoided by successful percutaneous retrieval of the broken wire tip, using the loop-snare technique.

Transcatheter embolization of an arteriovenous malformation of the scrotum.

There are several vascular abnormalities that could affect the scrotum. The commonest is a varicocele, and differentiation between this and other lesions is possible using Doppler ultrasound and pelvic angiography. A patient with a scrotal arteriovenous malformation (AVM) is presented in whom transcatheter embolization was possible.

Transcatheter embolotherapy of massive bleeding after surgery for benign gynecologic disorders.

Transcatheter embolotherapy is a well-established technique for control of bleeding in patients with pelvic trauma and pelvic malignancies, but it has been rarely used in massive vaginal bleeding after surgery for benign gynecologic disorders. We report five patients with massive post-operative vaginal hemorrhage following total abdominal hysterectomy (n = 3), repeated dilatation and curettage (n = 1) and cesarean section (n = 1), all successfully controlled with transcatheter embolization after many operative procedures had failed to stop the hemorrhage. The age of the patients ranged from 21 to 36 years.

Cervical aortic arch: case report with a 12-year follow-up.

We report a patient with a cervical aortic arch diagnosed by thoracic aortography and restudied 12 years later. We also briefly discuss the clinical significance of this rare anomaly of development of the aortic arch.

Retrograde venous bullet embolization: a rare occurrence.

We report a patient who sustained a single gunshot wound in the left supraclavicular fossa followed by retrograde venous bullet embolization from the left subclavian or innominate veins to a tributary of the right popliteal vein. We briefly discuss the clinical importance of this occurrence and emphasize the value of venography in the diagnosis of this rare form of missile migration.

Ventilation-perfusion imaging and pulmonary angiography: changing pattern of use.

The hospitals and departmental records of the University of Virginia Medical Center from 1976 to 1980 show an increasing frequency of ventilation studies relative to perfusion studies and a decrease in frequency of ventilation-perfusion diagnosis of pulmonary embolus. Pulmonary angiograms have increased from one per 68 nuclear studies to one per 14. A review of 70 patients with correlating angiography or autopsy shows that 89% of nuclear studies were accurate.

Cardiac pacemaker failure: a complication of trauma.

Trauma to the patient with an implanted cardiac pacemaker can result in serious damage to the device. We have described a case in which the lead was fractured after accidental electric shock. Recognition that trauma is a possible cause of pacemaker malfunction is critical to proper evaluation and prompt treatment of this potentially lethal complication.

Intrarenal pheochromocytoma and renal artery stenosis.

A rare case of intrarenal pheochromocytoma associated with a renal artery stenosis is reported. The association between pheochromocytoma and renal artery stenosis is discussed.

Transcatheter embolic control of iatrogenic hematobilia.

For the patient with hematobilia, a serious complication of liver injury, angiography is the definitive diagnostic procedure. In addition to localizing precisely the source of the hemorrhage, angiography also provides an effective alternative to surgery for the control of hemorrhage. In two cases of iatrogenic hematobilia discussed, the bleeding sites were identified by angiography, and the bleeding was controlled by transcatheter embolization.