Management of May Thurner Syndrome in Pregnant Patients.

May Thurner Syndrome contributes to thromboembolic disease and can cause significant morbidity in pregnant patients secondary to exaggerated anatomic relationships and physiologic changes in the hematologic system favoring thrombogenesis. Because this condition is both underrecognized and underreported, management in pregnant and postpartum patients is based on expert opinion without any formal evidence-based guidance. Herein, we review five pregnancies in four patients with May Thurner Syndrome and general management strategies.

Challenges in Pathology Specimen Processing in the New Era of Precision Medicine.

Context.—: Precision therapies for patients with driver mutations can offer deep and durable responses that correlate with diagnosis, metastasis prognosis, and improvement in survival. The use of such targeted therapies will continue to increase, pushing us to change our traditional approaches.

Safety and Efficacy of Acute Pulmonary Embolism Treated via Large-Bore Aspiration Mechanical Thrombectomy Using the Inari FlowTriever Device.

Purpose: To report initial experience with safety and efficacy in the treatment of pulmonary embolism (PE) using the FlowTriever device.

Materials And Methods: A single-center retrospective study was performed in all patients with acute central PE treated using the FlowTriever device between March 2018 and March 2019. A total of 46 patients were identified (massive = 8; submassive = 38), all with right ventricular (RV) strain and 26% with thrombolytic contraindications.

Multimodality Imaging of Focal and Diffuse Fibrosing Mediastinitis.

Fibrosing mediastinitis is a rare benign but potentially life-threatening process that occurs because of proliferation of fibrotic tissue in the mediastinum. The focal subtype is more common and typically is associated with an abnormal immunologic response to infection. Affected patients are typically young at presentation, but a wide age range has been reported, without a predilection for either sex.

Ethylene-vinyl alcohol copolymer endobiliary obliteration of hepatic segments in a patient with isolated bile leaks.

A 54-year-old woman with a symptomatic giant hepatic hemangioma underwent an extended left hepatic trisegmentectomy complicated by 250-350 mL/d postoperative bilious drainage. After 5 months of therapy, drainage was unabated, and the patient was no longer a surgical candidate. Sinography revealed three distinct isolated bile duct leaks involving segments 6, 7, and 8.

Modification of the HeRO graft allowing earlier cannulation and reduction in catheter dependent days in patients with end stage renal disease: a single center retrospective review.

After creation of an arteriovenous fistula or placement of an arteriovenous graft, several weeks are required for maturation prior to first cannulation. Patients need an alternative way to receive hemodialysis during this time, frequently a catheter. After multiple failed access attempts, patients can run out of options and become catheter dependent.

Efficacy of peripheral interventional radiologists performing endovascular stroke therapy guided by CT perfusion triage of patients.

Purpose: To assess safety and efficacy of intraarterial mechanical thrombectomy for treatment of ischemic stroke in a community hospital by peripheral interventional radiologists employing computed tomography (CT) perfusion imaging for patient selection.

Materials And Methods: Forty patients, 11 men (27.5%) and 29 women (72.

Thrombolysis of acute peripheral arterial and venous occlusions with tenecteplase and eptifibatide: a pilot study.

Purpose: To prospectively assess the feasibility, risk profile, and effect on fibrinogen levels of combination tenecteplase (TNK) and eptifibatide in transcatheter thrombolysis for peripheral arterial and venous thromboocclusive disease.

Materials And Methods: Sixteen consecutive patients (seven men, nine women) seen at our institution between March and August 2002 with arterial (n = 11) or venous (n = 5) thromboocclusive disease were treated with TNK (5-mg bolus and 0.25-mg/h infusion) and eptifibatide (180- micro g/kg bolus and 1- micro g/kg/min infusion).

Thrombolysis of occluded peripheral arteries and veins with tenecteplase: a pilot study.

Purpose: To prospectively assess the feasibility, risk profile, and effect on fibrinogen levels of tenecteplase in transcatheter thrombolysis for peripheral arterial and venous occlusive disease.

Materials And Methods: Between March 2001 and January 2002, 18 consecutive patients (14 men, four women) with arterial (n = 13) or venous (n = 5) occlusive disease were treated with tenecteplase infusions of 0.25 mg/h.

Treatment of acute thoracic aortic injury with commercially available abdominal aortic stent-grafts.

Traumatic rupture of the thoracic aorta is a common cause of death after vehicle collisions. Associated injuries are common, and patients with lung injury, cardiac contusion, abdominal bleeding, and head injury comprise a group at high risk for conventional surgical or medical therapy. In this particular population, existing commercially available stent-grafts may provide a life-saving repair option.

Angiographic description of blunt traumatic injuries to the thoracic aorta with specific relevance to endograft repair.

Purpose: To describe the precise anatomical location and extent of injury (based on angiography) in a series of patients with blunt thoracic aortic injury (BTAI) and evaluate the findings relative to the potential for endograft repair.

Methods: Thoracic aortograms from 50 trauma patients (37 men; mean age 37 years, range 13-87) with BTAI were retrospectively reviewed. Parameters important for endograft repair were recorded, including the length of the pseudoaneurysm, the distance between the origin of the most distal arch vessel and the pseudoaneurysm, the diameter of the aorta both above and below the pseudoaneurysm, and finally, the curvature of the aorta in the vicinity of the pseudoaneurysm.

Intermittent opacification of an injured artery: a potential aid to superselective transcatheter embolization.

Purpose: To evaluate the prevalence of intermittent opacification, a finding previously described as diagnostic of active bleeding that allows identification of an injured vessel at initial aortography or first-order selective angiography.

Materials And Methods: Retrospective review was performed of 35 consecutive cases that were positive for true or false aneurysm, arteriovenous fistula or malformation, or hemorrhage when a lesion was located beyond a first-order branch of the aorta. An artery that potentially supplied the lesion was considered positive if it filled with contrast material, emptied, and filled again while adjacent vessels demonstrated progressive opacification.