Splenic decapsulation after gastroscopy.

Sanguineous splenic complications in elective treatment procedures remain a potentially life-threatening complication in patients of all age groups. In this case, the patient, as per her past medical history, underwent a laparoscopic appendectomy when she was admitted to the clinic. One of the diagnostic procedures to find the reason for the epigastric pain, a gastroscopy, can retrospectively be held responsible for decapsulation of the spleen.

Hepatic encephalopathy following transjugular intrahepatic portosystemic shunt (TIPS): management with L-ornithine-L-aspartate and stent reduction.

Hepatic encephalopathy (HE) is a common problem after insertion of a trans-jugular intrahepatic portosystemic shunt (TIPS), which may be difficult to manage. We present a case of severe post-TIPS HE unresponsive to high doses of L-ornithine-L-aspartate (LOLA) despite reduction of venous ammonia levels in a dose-dependent fashion. Ultimately, high-grade HE was successfully treated by a reduction stent and the patient subsequently underwent successful liver transplantation.

Gorham-Stout syndrome in a male adolescent-case report and review of the literature.

Gorham-Stout syndrome is a rare disease characterized by vascular proliferation in the bones, effecting osteolysis. When it is complicated by chylothorax, the prognosis is poor. The present case illustrates successful management of chylothorax by a combination of surgery (thoracic duct ligation and excision of lymphangiomatous tissue combined with pleurodesis) and treatment with alpha-2b interferon.

Cement embolization into the vena cava and pulmonal arteries after vertebroplasty: interdisciplinary management.

Purpose: To report interdisciplinary management in a case of cement embolization into the inferior vena cava and peripheral pulmonary arteries after percutaneous vertebroplasty.

Case Report: A 50-year-old female patient with an osteoporotic compression fracture of the second lumbar vertebra underwent percutaneous vertebroplasty with polymethylmetaacrylate. Thereafter, CT scanning revealed small asymptomatic cement emboli in peripheral pulmonary arteries, along with a hook-shaped cement fragment in the inferior vena cava.

Analysis of the prognostic impact of tumor embolization before definitive radiotherapy for cervical carcinoma.

Purpose: To assess whether embolization compromises the radiocurability of primary cervical cancer.

Methods And Materials: Two hundred fifty-four patients with primary cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] stages IB: 47; II: 91; IIIB: 102; IV: 14) were treated with external beam irradiation and Ir-192 high-dose-rate brachytherapy over a period of 15 years. Of these, 24 patients (9.

Crimping and repositioning of a maldeployed balloon-expandable arterial stent using a gooseneck snare.

Purpose: To describe a technique for repositioning a fully deployed iliac stent from the infrarenal aorta into the common iliac artery (CIA).

Case Report: A 58-year-old man was undergoing treatment for a significant right CIA stenosis when a 7x24-mm Palmaz Genesis medium stent was mistakenly deployed in the infrarenal aorta. With the stent still over the guidewire, an 8x60-mm balloon catheter was placed coaxially in the stent.

[Percutaneous radio-frequency ablation (PRFA) in painful metastases involving bone].

Aim: The aim of the study was to determine the efficacy of PRFA in the palliative treatment of symptomatic bone metastases in regard to pain reduction, safety, and quality of life.

Method: Over a period of 11 months, ten PRFA were performed in eight patients with painful metastases involving bone, where conventional treatment with radiation therapy, chemotherapy, and treatment with analgesics had failed to reduce the pain efficiently. Pain was measured with the visual analogue scale (VAS: 0 to 10) for the day and night before PRFA was performed, and daily for 7 days after release from the hospital via a dietary book, and at the follow-up periods of 1, 3, 6 weeks and 3 and 6 months after PRFA.

The outback catheter: a new device for true lumen re-entry after dissection during recanalization of arterial occlusions.

Purpose: To report the initial experience with a new catheter system (The Outback catheter) designed to allow fluoroscopically controlled re-entry of the true arterial lumen after subintimal guidewire passage during recanalization procedures of arterial occlusions.

Methods: The catheter was used in 10 patients with intermittent claudication caused by chronic segmental occlusions of the superficial femoral or popliteal arteries. In all patients, conventional guidewire recanalization had failed.

Transjugular intrahepatic portosystemic shunt creation with the Viatorr expanded polytetrafluoroethylene-covered stent-graft.

Purpose: To evaluate the midterm clinical results and patency of transjugular portosystemic shunts (TIPS) created with a commercially available expanded polytetrafluoroethylene (ePTFE)-covered stent-graft based on angiographic and ultrasonographic (US) criteria in a series of 71 patients.

Materials And Methods: Seventy-one patients (61 men, 10 women; mean age, 58.6 years, range, 25-78 years) were included in this series, which was performed in two centers.

Semitransparent volume-rendering CT angiography for lesion display in aortoiliac arteriosclerotic disease.

Purpose: The potential of semitransparent volume-rendering (STVR) computed tomographic (CT) angiography was evaluated for the assessment of hemodynamically significant stenoses in aortoiliac arteriosclerotic disease.

Materials And Methods: In a prospective study, 76 patients (57 men, 19 women; mean age, 70 years) underwent single-detector (n = 26) or multidetector (n = 50) CT angiography of the aortoiliac region. Intraarterial digital subtraction angiography (DSA) was performed in each patient.

Covered stents in transjugular portosystemic shunt: healing response to non-porous ePTFE covered stent grafts with and without intraluminal irradiation.

The aim of this study was to evaluate the healing response to a new commercially available ePTFE-covered stent graft used to create transjugular intrahepatic portosystemic shunts (TIPS) in an animal model with and without intraluminal irradiation. The study was designed for ten domestic normotensive pigs. The TIPS was created using a ePTFE-covered stent graft (Viatorr, Gore, Flagstaff, Ariz.

Early experience and midterm follow-up results with a new, rotational thrombectomy catheter.

Purpose: To assess the efficacy and safety of the Rotarex rotational thrombectomy catheter in treating occlusions of the femoropopliteal arteries.

Methods: The Rotarex catheter (Straub Medical, Switzerland) is a rotational thrombectomy device which is supposed to be able to remove fresh and partially organized clot material from an acutely or subacutely occluded vessel. Nineteen limbs of 18 patients (10 women, 8 men; mean age 72.

Treatment of acute aortic type B dissection with stent-grafts.

Purpose: To evaluate the feasibility of endoluminal stent-grafts in the treatment of acute type B aortic dissections.

Methods: In five patients with acute aortic type B dissections, sealing of the primary intimal tear with an endoluminal stent-graft was attempted. Indication for treatment was aneurysm formation in two patients and persistent pain in three patients.

Intentional left subclavian artery occlusion by thoracic aortic stent-grafts without surgical transposition.

Purpose: To report the consequences of endoluminal deployment of stent-grafts in the thoracic aorta with intentional occlusion of the left subclavian artery.

Case Reports: Three patients with an aortic type-B dissection and 1 with a thoracic aneurysm were treated endoluminally with Talent stent-grafts implanted over the ostium of the left subclavian artery without prior surgical subclavian-carotid transposition. The primary intimal tears were sealed and the degenerative aneurysm excluded; blood pressure in the left arm was significantly diminished immediately after the stent-graft was released, but adequate collateral retrograde perfusion via the left vertebral artery was apparent in all patients.

Placement of Hemobahn stent-grafts in femoropopliteal arteries: early experience and midterm results in 18 patients.

Purpose: To determine the outcome of a new polytetrafluoroethylene (PTFE)-covered stent-graft in the treatment of occlusive lesions of the femoropopliteal arteries.

Materials And Methods: Eighteen patients with intermittent claudication (Fontaine stages IIb-IV; Rutherford classes I/2-III/5) and occlusive lesions of the superficial femoral and/or popliteal artery were treated with use of a new PTFE-covered stent-graft (Hemobahn). Indication for stent-graft insertion was an unsatisfactory result after balloon dilation.

Endovascular treatment of proximal anastomotic aneurysms after aortic prosthetic reconstruction.

Purpose: To describe the efficacy and value of endovascular stent-grafts for the treatment of aortic anastomotic pseudoaneurysms.

Methods: Three patients with proximal aortic anastomotic pseudoaneurysms 8--15 years after prosthetic reconstruction were treated by transfemoral stent-graft implantation. In two patients the pseudoaneurysms were excluded by Talent prostheses [tube graft (n = 1), bifurcated graft (n = 1)].

Intra-hepatic haematoma complicating transjugular intra-hepatic portosystemic shunt for Budd-Chiari syndrome associated with anti-phospholipid antibodies, aplastic anaemia and chronic hepatitis C.

Portal venous decompression with transjugular intra-hepatic portosystemic shunt (TIPS) is a new approach in the treatment of Budd-Chiari syndrome. We report on a 31-year-old female with Budd-Chiari syndrome due to anti-phospholipid antibodies with compression of the inferior vena cava treated with TIPS and stenting of the inferior vena cava. TIPS was complicated by massive intra-hepatic haematoma which was managed conservatively.

[Transposition of the subclavian artery with endovascular stent graft implantation for therapy of acute type B aortic dissection].

We report about a patient with a thoracic aneurysm caused by an acute type-B dissection. Due to the concomitant affections the risk of surgery was distinctly increased, the reconstruction was performed endo vascular by stentgraft implantation (Talent, World Medical Systems, Sunrise FL) after transposition of the left subclavian artery to create a sufficient neck for the proximal stent placement. Endoluminal treatment seems to be a promising, less invasive alternative method in the treatment of acute aortic dissections.

Helical CT angiography of stent-grafts in abdominal aortic aneurysms: morphologic changes and complications.

Transfemoral placement of an endovascular stent-graft is increasingly be-ing used as an alternative to surgical repair in the treatment of abdominal aortic aneurysm, especially in high-risk patients. However, complications frequently occur after stent-graft placement. Helical computed tomographic (CT) angiography is a fast, minimally invasive procedure that is quickly becoming the imaging modality of choice for assessment of these complications.

Aortoduodenal fistula: a late complication of intraluminal exclusion of an infrarenal aortic aneurysm.

During recent years, considerable clinical experience has been gained with endoluminal stent-graft procedures. Several studies have shown promising results up to a period of 4.5 years.

Endoluminal treatment of infrarenal aortic aneurysms: clinical experience with the Talent stent-graft system.

Purpose: To evaluate the safety and efficacy of the Talent stent-graft (TSG) system in the endoluminal treatment of infrarenal abdominal aortic aneurysms (AAAs).

Patients And Methods: Endoluminal treatment of an AAA was attempted in 30 men with a mean age of 70.5 years (range, 51-83 years).

[Endoluminal therapy of infrarenal aortic aneurysms with the Talent system--initial experiences with a new endoprosthesis].

Purpose: To report the early clinical experience with the Talent stent-graft system in the treatment of infrarenal aortic aneurysms.

Materials And Methods: The study group comprised 15 males aged from 51-79 years. A bifurcated Talent stent-graft was implanted in 9 patients with type B or C aneurysms, a tube graft in 6 patients with a type A aneurysm.

Aneurysms of hemodialysis access grafts: treatment with covered stents: a report of three cases.

Three patients with dialysis access graft shunts, having a symptomatic pseudoaneurysm and a hemodynamically significant stenosis at the anastomosis between the graft shunt and the subclavian vein, were treated with percutaneous transluminal angioplasty and insertion of a Wallstent. Pseudoaneurysms were excluded by percutaneous insertion of a Cragg Endo-Pro stent-graft with a diameter of 6 mm and a length of 6-10 cm. All three aneurysms were excluded successfully.