The Amplatzer vascular plug for large vessel occlusion in the endovascular management of aneurysms.

The Amplatzer vascular plug (AVP) is derived from the Amplatzer device used in correction of cardiac septal defects. We present a large series of the use of the AVP in the endovascular management of aneurysms. Three patients with a combination of aortic and peripheral aneurysms underwent embolisation with the AVP.

A diagnostic approach to mediastinal abnormalities.

A number of mediastinal reflections are visible at conventional radiography that represent points of contact between the mediastinum and adjacent lung. The presence or distortion of these reflections is the key to the detection and interpretation of mediastinal abnormalities. Anterior mediastinal masses can be identified when the hilum overlay sign is present and the posterior mediastinal lines are preserved.

Prospective nonrandomized trial of manual compression and Angio-Seal and Starclose arterial closure devices in common femoral punctures.

We compared the use of manual compression and Angio-Seal and Starclose arterial closure devices to achieve hemostasis following common femoral artery (CFA) punctures in order to evaluate safety and efficacy. A prospective nonrandomized, single-center study was carried out on all patients undergoing CFA punctures over 1 year. Hemostasis was achieved using manual compression in 108 cases, Angio-Seal in 167 cases, and Starclose in 151 cases.

Aneurysm of an aberrant right subclavian artery successfully excluded by a thoracic aortic stent graft with supra-aortic bypass of three arch vessels.

An aberrant right subclavian artery (ARSA) arising from a left-sided aortic arch is the fourth most common aortic arch anomaly. Aneurysmal dilatation of the ARSA requires treatment because of the associated risk of rupture. We present a case where supra-aortic bypass of the arch vessels was performed to facilitate exclusion of the aneurysm by a thoracic aortic stent graft.

Cutting balloon angioplasty for resistant renal artery in-stent restenosis.

A 76-year-old woman presented with recurrent arterial hypertension 6 months after uncomplicated primary renal artery stent placement. Diagnostic arteriography revealed severe renal artery in-stent restenosis. On repeat intervention, the lesion was resistant to attempted conventional percutaneous transluminal angioplasty (PTA) with unchanged systolic pressure gradients across the stent.