Percutaneous transhepatic endoscopic holmium laser lithotripsy for intrahepatic and choledochal biliary stones.

Purpose: To report our approach for treating complicated biliary calculi by percutaneous transhepatic endoscopic biliary holmium laser lithotripsy (PTBL).

Patients And Methods: Twenty-two symptomatic patients (11 men and 11 women, age range 51 to 88 years) with intrahepatic or common bile duct calculi underwent PTBL. Nine patients had undergone previous gastrectomy and small-bowel anastomosis, thus precluding endoscopic retrograde cholangiopancreatography.

Endovascular management of mycotic aortic aneurysms.

Purpose: We report a single-center experience with the endovascular management of mycotic aortic aneurysms.

Case Reports: Four cases of mycotic aortic aneurysms are described; all treated with endovascular stent graft with variable configurations. All patients underwent successful placement of stent grafts for their aneurysms.

Optease vena cava filter optimal indwelling time and retrievability.

The purpose of this study was to assess the indwelling time and retrievability of the Optease IVC filter. Between 2002 and 2009, a total of 811 Optease filters were inserted: 382 for prophylaxis in multitrauma patients and 429 for patients with venous thromboembolic (VTE) disease. In 139 patients [97 men and 42 women; mean age, 36 (range, 17-82) years], filter retrieval was attempted.

Percutaneous transhepatic lithotripsy with the holmium: YAG laser for the treatment of refractory biliary lithiasis.

Fourteen patients who failed at least 1 endoscopic retrograde cholangiopancreatograpy attempt underwent Holmium laser biliary lithotripsy between 2003 and 2007. Ten had prior biliary surgeries, 7 harbored multiple stones, and 6 had common bile duct strictures. Mean age at surgery was 63.

Histology of tissue adherent to OptEase inferior vena cava filters regarding indwelling time.

The purpose of this paper is to report on the histology of tissues found on retrieved filters with regard to indwelling time. Between February 2006 and January 2007, 28 Optease inferior vena cava filters (Cordis Europa, Roden, The Netherlands) were retrieved from 27 patients. Twenty-two filters were inserted prophylactically for trauma patients and six for patients with venous thromboembolism.

Renal angiomyolipoma: long-term results following selective arterial embolization.

Background: The treatment for and long-term outcome of renal angiomyolipoma (AML) at high-risk for bleeding has not been determined.

Objective: To evaluate the complication rates and the long-term outcomes among patients treated by selective arterial embolization (SAE) for a large or symptomatic renal AML.

Design, Setting, And Participants: Forty-one patients with 48 kidneys containing AML were treated by SAE at a single tertiary academic center.

Retrievable vena cava filters in major trauma patients: prevalence of thrombus within the filter.

The purpose of this study was to report the prevalence of thrombus within a retrievable vena cava filter inserted prophylactically in major trauma patients referred for filter extraction. Between November 2002 and August 2005, 80 retrievable inferior vena cava filters (68 Optease and 12 Gunther-Tulip) were inserted into critically injured trauma patients (mean injury severity score 33.5).

Amplatzer Vascular Plug: expanding the applications spectrum.

The Amplatzer Vascular Plug is a new embolization device which has been used in different vascular anomalies, especially by cardiologists in the cardiac and pulmonary circulations. It is underused by interventional radiologists. We used this device in three different vascular conditions, which we present here.

Ethanol and polyvinyl alcohol mixture for transcatheter embolization of renal angiomyolipoma.

Objective: The purpose of this study was to assess the immediate and midterm effects of embolization of the angiogenic component of renal angiomyolipoma in which a mixture of ethanol and polyvinyl alcohol is used as a permanent obliterator.

Materials And Methods: Seventeen patients with 18 renal angiomyolipomas (size range, 5.5-20 cm; mean size, 10 cm) were treated with transcatheter embolization over an 8-year period.

Large renal angiomyolipomas: digital subtraction angiographic grading and presentation with bleeding.

Aim: To investigate whether a grading system of renal AMLs based on digital subtraction angiography (DSA) and computerized tomography (CT), could help to select patients for embolization.

Materials And Methods: Thirty patients with 35 renal angiomyolipomas (size range 4-20 cm, mean 9.9 cm) underwent both digital subtraction angiography (DSA) and computed tomography (CT).

Ethanol sclerotherapy of peripheral venous malformations.

Background: Venous malformations are congenital lesions that can cause pain, decreased range of movement, compression on adjacent structures, bleeding, consumptive coagulopathy and cosmetic deformity. Sclerotherapy alone or combined with surgical excision is the accepted treatment in symptomatic malformations after failed treatment attempts with tailored compression garments.

Objectives: To report our experience with percutaneous sclerotherapy of peripheral venous malformations with ethanol 96%.

Resolved abdominal aortic aneurysms following stent graft treatment: a report of five cases.

Complete aneurysm resolution is the hallmark of successful endoluminal stent-graft treatment. We describe 5 patients in whom an abdominal aortic aneurysm (AAA) disappeared completely at mid-term follow-up after endovascular stent-graft placement. We reviewed 45 patients (43 men and 2 women) who underwent AAA repair using an endovascular technique, from April 1997 to December 2001.

Endovascular closure of a large renal arteriovenous fistula.

A case is described of a large renal arteriovenous fistula causing long-term cardiovascular complications. Successful percutaneous embolization was achieved using temporary occlusion balloons, Guglielmi detachable coils, regular nondetachable spring coils, and cyanacrylate. The advanced therapeutic tools we used can improve the prognosis of patients with large and complicated arteriovenous fistulas and prevent surgery.

Perirectal urinoma from ureteral injury incurred during spinal surgery mimicking rectal perforation on computed tomography scan.

Study Design: A case of a perirectal urinoma from a ureteral injury incurred during spinal surgery is reported.

Objectives: To report ureteral injury as a rare complication of spinal surgery with misleading CT findings, and to emphasize the necessity of delayed scans in the diagnosis.

Summary Of Background Data: A ureteral injury is a rare complication of spinal surgery.

Transcutaneous detection of aortic arch atheromas by suprasternal harmonic imaging.

Objectives: The goal of the present study was to examine whether suprasternal harmonic imaging (SHI) (i.e., harmonic imaging from the suprasternal windows) can visualize protruding arch atheromas (PAAs) and reliably predict the presence or absence of significant lesions.

Urinomas caused by ureteral injuries: CT appearance.

Background: We report the computed tomographic (CT) features of urinomas caused by ureteral injuries which are often not clinically suspected, causing delay in diagnosis.

Methods: CT studies of 12 patients with ureteral injury were reviewed. Ureteral injuries were iatrogenic in 9 patients and traumatic in the remaining three.

Complications after laparoscopic gynecologic procedures: CT findings.

Laparoscopic gynecologic surgery has gained worldwide popularity in the past few years, but complications of this new technique do occur. We encountered three patients who developed major complications after laparoscopic gynecologic procedures including perforation of the sigmoid colon, urinary bladder, and ureter. We report the computed tomographic findings of these cases and the diagnostic dilemmas they posed.

Spiral computerized tomography (dual helical mode) as a detector of aortic atheromas in patients with stroke and systemic emboli: additional benefit of the contrast-enhanced technique.

Background: Protruding aortic atheromas are a potential source of stroke and systemic emboli. The single modality currently available for their detection has been transesophageal echocardiography. However, TEE does not allow full visualization of the upper part of the ascending aorta and proximal aortic arch.

Preoperative angiography and embolization of large pelvic tumors.

Background And Objectives: Pelvic tumors are often large and difficult to excise with appropriate surgical margins due to their size, proximity to neurovascular structures, and major intraoperative bleeding. The purpose of this study is to evaluate the yield of preoperative angiography and embolization so as to facilitate achievement of good surgical results.

Methods: Eighteen patients who suffered from large pelvic tumors (average size, 10.

CT angiography of superior mesenteric artery syndrome.

Objective: Our purpose was to describe the use of CT angiography and three-dimensional (3D) reconstruction in the diagnosis of superior mesenteric artery syndrome in three patients.

Conclusion: CT angiography combined with 3D reconstructions is a noninvasive technique that may have a complementary diagnostic role similar to that of angiography in patients with a classic clinical presentation suggestive of superior mesenteric artery syndrome. CT angiography combined with 3D reconstructions should be considered in patients who might otherwise require angiography.

Dual-helical CT for detecting aortic atheromas as a source of stroke: comparison with transesophageal echocardiography.

Purpose: To investigate whether unenhanced dual-helical computed tomography (CT) is useful in the rapid, noninvasive detection of protruding aortic atheromas.

Materials And Methods: Thirty-two consecutive patients at least 50 years of age who had recent ischemic stroke, systemic emboli, or both, underwent transesophageal echocardiography (TEE) and unenhanced dual-helical CT with thin sections (section thickness, 3.2 mm; reconstruction increment, 1.

Congenital aorto-caval fistula in the newborn: a case report.

The authors report a rare case of congenital fistula between the distal aspect of the descending aorta and the inferior vena cava. The clinical features of this aortocaval fistula is being described as well as the preoperative diagnostic workup, the intraoperative findings, and the complicated postoperative course and treatment.

[Multidisciplinary approach to the treatment of musculo-skeletal tumors].

Tumors of the musculoskeletal system are relatively rare. They occur mostly in the young, while in older age groups metastases and myeloma are more prevalent. Treatment has undergone major change in the past 20 years with the introduction of neoadjuvant treatment protocols.