Complex Arterial Pathology of Angiomyolipomas of Tuberous Sclerosis.

Based on observations at angiography, it was hypothesized that angiomyolipomas (AMLs) associated with tuberous sclerosis complex (TSC) have a more robust parasitic blood supply and require more complex embolization involving lower order vessels compared with the non-TSC patients' AMLs. This was a retrospective review of 71 patients who underwent angiography and embolization for renal AML at multiple centers within a single health system. All of the patients with TSC (11/11) were found to have "complex" tumor vascular supply.

Evaluation of a Hydrogel Liquid Embolic Agent in a Porcine Mesenteric Hemorrhage Model.

Purpose: To evaluate the ability to achieve hemostasis of a new liquid embolic agent in a porcine mesenteric artery hemorrhage model.

Materials And Methods: An anticoagulated porcine mesenteric artery hemorrhage model was created using a transarterial approach. Arterial hemorrhage was the result of aspiration needle punctures and simultaneous radiofrequency current application.

The use of an upper extremity hemodialysis access site for stenting of the superior mesenteric artery for chronic mesenteric ischemia.

We report the use of an upper extremity hemodialysis access site to facilitate endovascular treatment of the superior mesenteric artery in the setting of chronic mesenteric ischemia. A 64-year-old woman with end-stage renal disease on hemodialysis presented with worsening symptoms associated with chronic mesenteric ischemia. Her left upper extremity interposition graft within the fistula access site was selected to avoid a hostile aortoiliac system and in consideration of the potential benefits it provided over transfemoral, transbrachial, and transradial sites.

Multicenter Trial of the VenaTech Convertible Vena Cava Filter.

Purpose: To demonstrate rates of successful filter conversion and 6-month major device-related adverse events in subjects with converted caval filters.

Materials And Methods: An investigational device exemption multicenter, prospective, single-arm study was performed at 11 sites enrolling 149 patients. The VenaTech Convertible Vena Cava Filter (B.

Intraoperative Angiography for Arteriovenous Malformation Resection in the Prone and Lateral Positions, Using Upper Extremity Arterial Access.

Background: Intraoperative angiography is routinely utilized for aneurysms and arteriovenous malformations (AVMs) to verify complete occlusion and resection. Surgery for spinal and posterior fossa neurovascular lesions is usually performed in prone position. Intraoperative angiography in the prone position is challenging and there is no standardized protocol for this procedure.

Pulmonary arteriovenous malformation embolization: how we do it.

We report our experience with an embolization technique that allows safe, controllable exclusion of pulmonary arteriovenous malformations using detachable coils, a single venous access site, coaxial catheter guidance, and 1 or 2 microcatheters. This technique is particularly useful when treating central lesions with a short feeding artery and when high flow increases the risk of coil migration and nontarget embolization. It affords precise placement and repositioning of coils prior to detachment.

Significance of elevated transplant renal artery velocities in the postoperative renal transplant patient.

Introduction: Non-invasive imaging studies can provide visualization of allograft perfusion in the postoperative evaluation of newly transplanted renal allografts.

Aim: The purpose of our study was to evaluate the significance of elevated renal artery velocities in the immediate postoperative period.

Methods: Peak systolic velocities (PSVs) were obtained in the transplanted renal artery of 128 patients immediately after transplantation.

Percutaneous insertion of peritoneal ports.

Objective: To describe a technique for image-guided percutaneous insertion of peritoneal ports in patients without ascites who have undergone surgical debulking for stage III ovarian cancer.

Materials And Methods: Between 2006 and 2010, 29 intraperitoneal ports were placed percutaneously in 29 patients who presented after debulking surgery for stage III ovarian cancer. Ultrasound and fluoroscopy guidance were used to assist in the port placement.

Double microcatheter single vascular access embolization technique for complex peripheral vascular pathology.

The authors describe an embolization technique that allows safe, controllable exclusion of complex vascular pathologies using a single vascular access and 2 microcatheters. This technique is particularly useful in situations where high flow increases the risk of coil migration and nontarget embolization and in large aneurysms. It affords precise placement and repositioning of coils.

The Gandras catheter for uterine artery embolization: the procedure-driven development of a novel medical device.

Uterine artery embolization (UAE) is a safe and effective therapy for women suffering from symptomatic fibroid tumors of the uterus. In order to complete the procedure, the interventionalist must be able to catheterize both uterine arteries from a single femoral puncture site. The uterine arteries are subsequently embolized, or occluded, to stasis by injecting small particles mixed with radio opaque contrast under fluoroscopic guidance.

Bronchobiliary fistula successfully treated with n-butyl cyanoacrylate via a bronchial approach.

A bronchobiliary fistula is an abnormal communication between the biliary tree and the airway that can result in debilitating amounts of bilioptysis, or bile-stained sputum. The authors present an approach for the conservative management of a bronchobiliary fistula in a patient who failed traditional conservative therapy and refused surgical intervention.

Embolization for treatment of gastrointestinal hemorrhage secondary to recurrent renal cell carcinoma.

Massive gastrointestinal hemorrhage secondary to metastatic renal cell carcinoma involving the jejunum is rare but has been previously described in the medical literature. Treatment options for metastatic renal cell carcinoma are limited, but transcatheter arterial embolization can be performed to control gastrointestinal hemorrhage either alone or prior to surgical resection. We describe a case of successful transcatheter arterial embolization for control of massive gastrointestinal hemorrhage secondary to locally recurrent renal cell carcinoma invading the jejunum and review the literature.

Placement of subcutaneous chest wall ports ipsilateral to axillary lymph node dissection.

Without scientific evidence, practice has been to avoid placing chest wall ports ipsilateral to axillary lymph node dissection. Because the lymphatic system in the chest wall drains via both the internal mammary and axillary nodes, it seems that this practice might unduly restrict venous access options. Our study was designed to evaluate outcome after placement of chest wall ports ipsilateral to axillary lymph node dissection in patients with breast cancer.