Outcome of proximal internal iliac artery coil embolization prior to stent-graft extension in patients previously treated by endovascular aortic repair.

Purpose: To assess the safety, feasibility, and effectiveness of coil embolization of the proximal internal iliac artery (IIA) before stent-graft extension in patients previously treated by endovascular aortic repair (EVAR).

Materials And Methods: Over a period of 9 years, 16 ipsilateral, proximal IIA coil embolization procedures were performed before stent-graft extension in 13 patients previously treated by a modular aortic stent graft. Indication for coil embolization and concomitant stent-graft extension were secondary (ie, late) distal type I endoleak (n = 9) and late onset of an isolated common iliac artery aneurysm (n = 7) as a result of increasing dilation of a common iliac artery during follow-up after EVAR; mean common iliac artery diameter before coil embolization was 26.

Percutaneous isolated liver perfusion with occlusion balloons and a catheter-based stent-graft-like perfusion device: an experimental study in a porcine model.

Objective: To evaluate the feasibility and safety of a novel percutaneous isolated liver perfusion (PILP) system in a porcine model.

Methods: The PILP catheter set, consisting of a portal vein and hepatic artery occlusion balloon and an hourglass-shaped vena cava stent-graft, was tested in six Dutch Landrace pigs. A veno-venous bypass between the distal portal vein and the right femoral vein, and isolated perfusion between the proximal portal vein and the hepatic veins were also created.

Catheter-directed thrombolytic therapy for thoracic deep vein thrombosis is safe and effective in selected patients with and without cancer.

Objective: To assess the safety, feasibility and efficacy of catheter-directed thrombolysis for thoracic central venous thrombosis in both cancer and non-cancer patients.

Materials And Methods: A retrospective case series of 68 patients, including 35 with active cancer and 33 without cancer, was analysed. They all received catheter-directed thrombolysis with alteplase or urokinase for symptomatic acute major thoracic vein thrombosis.

Paraparesis after thoracic stent-graft relining for an unrecognized type III endoleak.

Background: We examined the reasons for missing a type III endoleak on conventional imaging and the pathophysiology of paraparesis after relining this stent graft.

Methods And Results: A 46-year-old man was treated with a thoracic stent graft for thoracic rupture of a chronic type B thoracoabdominal dissection with aneurysm formation. In a second intervention, retrograde revascularization of the visceral and renal arteries was performed in combination with insertion of an abdominal stent graft.

Preoperative mapping for haemodialysis access surgery with CO(2) venography of the upper limb.

Objective: This study aims to evaluate the impact of CO(2) venography on the planning and outcome of native arteriovenous fistula (AVF) creation.

Methods: Records of patients who underwent CO(2) venography prior to access surgery between January 2000 and December 2008 were reviewed. CO(2) venography was performed selectively in chronic kidney disease (CKD) in stage IV-V patients without suitable veins on clinical examination.

Endovascular treatment of an iliocaval arteriovenous fistula presenting with multiple organ failure.

Iliocaval arteriovenous fistula is an uncommon, but challenging condition. The most common cause is spontaneous rupture of the iliac artery into the venous system due to aneurismal dilatation. We report a case of iliocaval fistula after previous aortic surgery presenting as acute liver failure as most prominent part of multiple organ failure and successful endovascular repair.

Rescue of a marginal liver graft by sequential treatment with molecular adsorbent recirculating system and transjugular intrahepatic portosystemic shunt: a case report.

A 53-year-old man with alcoholic liver cirrhosis underwent orthotopic liver transplantation (OLT) using a marginal graft. Persistent cholestasis post-OLT was successfully treated using a molecular adsorbent recirculating system (MARS). Afterwards, the patient developed refractory ascites, which was controlled by a transjugular intrahepatic portosystemic shunt (TIPS).

Severe hypertension due to renal polar artery stenosis in an adolescent treated with coil embolization.

A 12-year-old boy presented with severe arterial hypertension due to a severe subsegmental renal artery stenosis. Treatment consisted of selective embolization of the stenosed polar artery, which resulted in near normalization of the arterial pressures. Renal artery stenosis should always be considered, even in young adolescents, as a cause for arterial hypertension.

Transcatheter chemoembolization of unresectable hepatocellular carcinoma: current knowledge and future directions.

Transarterial chemoembolization (TACE) is considered the gold standard for the treatment of unresectable hepatocellular carcinoma (HCC) in patients with a preserved liver function and in the absence of clear extrahepatic tumor spread. This review article deals with the radiological and clinical workup, the interventional technique of chemoembolization for HCC and gives an overview of the common as well as some rare and dramatic complications of TACE. Finally, some new trends and advances in clinical research with regard to the interventional management of HCC are discussed.

Post-catheterization pseudoaneurysm in a one-year-old child treated by ultrasound-guided human thrombin injection.

We report a successful treatment of iatrogenic post-catheterization pseudoaneurysm of the right common femoral artery in a one-year-old boy with ultrasound-guided percutaneous injection of human thrombin under general anesthesia. Physical examination after 2 months follow-up showed complete disappearance of the pulsating lump.

Long-term outcome of transcatheter embolotherapy for acute lower gastrointestinal hemorrhage.

Objectives: We sought to assess the safety, short- and long-term efficacy, and durability of transcatheter embolization for lower gastrointestinal hemorrhage (LGH) unresponsive to endoscopic therapy and to analyze the overall survival of the embolized patients.

Methods: Between January 1997 and January 2008, 122 patients were referred for angiographic evaluation to control major LGH. Overall, 43 patients (35.

Outcome of carotid artery stenting at 2 years follow-up: comparison of nitinol open cell versus stainless steel closed cell stent design.

Aim: The aim of this study was to compare the clinical and ultrasound outcome of carotid artery stenting at 2-year follow-up in patients treated with open-cell nitinol stents versus patients treated with closed cell stainless steel stents.

Methods: This was a non-randomized, retrospective study including 123 patients in whom 132 carotid stent-procedures were performed. Nine patients were treated bilaterally.

Stenosis detection in native hemodialysis fistulas with MDCT angiography.

Objective: The objective of our study was to assess the diagnostic value of 64-MDCT angiography in the evaluation of failing hemodialysis arteriovenous fistulas (AVFs) in comparison with conventional digital subtraction angiography (DSA).

Subjects And Methods: Thirty-six patients (22 men; mean age +/- SD, 65 +/- 15 years) with hemodialysis fistula dysfunction underwent MDCT angiography before DSA. Linear weighted kappa was used to calculate interobserver agreement for stenosis for both MDCT angiography and DSA on a 5-point scale.

Complications after endovascular aneurysm repair.

Endovascular aneurysm repair (EVAR) has become an established technique for the treatment of many infrarenal aortic aneurysms. Although EVAR is obviously less invasive than open surgical repair, it is not free of complications. These can potentially result in severe morbidity or even mortality, stressing the need for an early detection and subsequent treatment.

A pilot trial of microplasmin in patients with long-term venous access catheter thrombosis.

Background: Microplasmin, a truncated form of plasmin, degrades fibrin and reacts with the circulating inhibitor alpha(2)-antiplasmin. We investigated the safety and efficacy of intra-catheter microplasmin bolus administration for the restoration of catheter function in long-term venous access catheter thrombosis.

Methods: This open-label, ascending-dose, pilot study enrolled 31 subjects.

Transcatheter embolization of an isolated lumbar arterial bleeding complicating radical nephrectomy for renal infarction with infected perirenal haematoma.

Lumbar arterial bleedings are rare but potentially life threatening. We report a case of an isolated right lumbar arterial bleeding after radical nephrectomy for renal infarction with infected perirenal haematoma. The diagnosis was suggested by computed tomography and confirmed with angiography.

Endovascular aneurysm repair or open surgery for treatment of abdominal aortic aneurysm with involvement of both common iliac arteries?

Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA) involving the entire common iliac arteries requires proximal coil embolisation of both internal iliac arteries and extension of the stent graft into the external iliac arteries (type E according to the Eurostar classification). A potential complication of this treatment is pelvic ischemia. Therefore, this type of aneurysm is a relative contra-indication for EVAR.

Mural thrombotic deposits in abdominal aortic endografts are common and do not require additional treatment at short-term and midterm follow-up.

Purpose: To assess the incidence and clinical significance of thrombotic, nonocclusive mural deposits in abdominal aortic stent-grafts incidentally found on follow-up computed tomography scans after endovascular aneurysm repair (EVAR).

Materials And Methods: Between 1998 and 2007, 288 patients underwent EVAR of an infrarenal aortic aneurysm. In the majority of cases, a Zenith stent-graft (n = 187) or Excluder stent-graft (n = 71) was implanted.

Limb occlusion after endovascular repair of abdominal aortic aneurysms with supported endografts.

Purpose: To assess the time period of onset, etiology, and outcomes of limb occlusion after endovascular repair of abdominal aortic aneurysms with supported endografts.

Materials And Methods: From 1998 to 2007, 288 patients underwent endovascular aneurysm repair (EVAR) to exclude an infrarenal aortic aneurysm. In the majority of patients, a Zenith stent-graft (n = 187) or Excluder stent-graft (n = 71) was implanted.

Pseudoaneurysm complicating protocol renal transplant biopsies: case reports.

Pseudoaneurysm is a rare complication of a renal biopsy procedure. We describe two cases of kidney transplant recipients who were diagnosed with a pseudoaneurysm more than 48 hours after protocol renal allograft biopsy and were successfully treated by selective embolization of the afferent artery.

Textiloma complicated by abscess-formation, three years after surgical repair of abdominal aortic aneurysm.

This report deals with a late complication of open surgery for inflammatory abdominal aortic aneurysm. A surgical sponge was retained and three years later, the patient presented with acute onset of back pain. Radiological evaluation by means of abdominal plain film and CT-scan, respectively revealed metallic wires projecting in the left hypochondrium and a rounded hypodense mass-lesion located retroperitoneally above the left kidney, containing the metallic wires and presenting with a contrast-enhancing peripheral rim, corresponding to abscess-formation around the retained sponge.