Postcatheterization retroperitoneal hematoma due to spontaneous lumbar arterial hemorrhage.

A patient developed retroperitoneal hemorrhage after cardiac catheterization, initially thought to be a complication of the puncture. Diagnostic evaluation revealed the source to be spontaneous bleeding from a lumber artery, which was successfully embolized. Spontaneous hemorrhage is a recognized complication of anticoagulation therapy and must be considered in the differential diagnosis even in the face of a seemingly obvious source of bleeding.

Percutaneous radiologic, surgical endoscopic, and percutaneous endoscopic gastrostomy/gastrojejunostomy: comparative study and cost analysis.

Purpose: To compare the results and costs of three different means of achieving direct percutaneous gastroenteric access.

Methods: Three groups of patients received the following procedures: fluoroscopically guided percutaneous gastrostomy/gastrojejunostomy (FPG, n = 42); percutaneous endoscopic gastrostomy/gastrojejunostomy (PEG, n = 45); and surgical endoscopic gastrostomy/gastrojejunostomy (SEG, n = 34). Retrospective review of the medical records was performed to evaluate indications for the procedure, procedure technical success, and outcome.

Radiologic percutaneous gastrostomy: results in 56 patients with head and neck cancer.

Objective: The establishment of a direct enteral feeding route is critical in the overall treatment of many patients with head and neck cancer. Use of radiologic percutaneous gastrostomy (RPG), the newest technique for gaining enteral access, has not been studied in such patients extensively. This study evaluated the indications, technique, success rate, and complications associated with RPG in patients with head and neck cancer.

Tissue response to covered Wallstents.

Purpose: To evaluate and compare the healing response related to two types of graft-covered Wallstents (WSs) and an uncovered WS in the canine iliac artery.

Materials And Methods: Eight bare mesh WSs, 10 polyethylene terephthalate interbraided WSs (PET-WSs), and six polytetrafluoroethylene covered WSs (ePTFE-WSs) were placed in the iliac arteries of 12 dogs. Arteriograms were obtained before and after implantation and at explantation.

Tunneled hemodialysis catheters: use of a silver-coated catheter for prevention of infection--a randomized study.

Purpose: To determine whether silver-coated tunneled hemodialysis catheters reduce infection and to determine the frequency of central venous thrombosis and stenosis with percutaneous placement of right internal jugular vein dialysis catheters by interventional radiologists.

Materials And Methods: Ninety-one patients were randomly assigned to a treatment (silver-coated catheter; n = 47) or control (identical catheter without silver coating; n = 44) arm. Baseline venography was performed.

Possible pulmonary embolus: evaluation with digital subtraction versus cut-film angiography--prospective study in 80 patients.

Purpose: To determine whether intraarterial digital subtraction angiography (DSA) is as accurate as cut-film (film hard-copy) angiography (CFA) in the evaluation of suspected pulmonary embolus.

Materials And Methods: Under a protocol approved by the institutional review board, CFA and DSA images were obtained in identical posteroanterior and oblique projections in one lung of each patient undergoing pulmonary angiography (n = 80). Diagnoses based on results of blinded review of each study (CFA vs DSA) by three separate reviewers (80 patients x three reviewers = 240 diagnoses for each modality) were compared with the diagnoses made by the physician who performed the procedure on the basis of CFA, DSA, and clinical data and with the consensus diagnoses obtained by means of group review of both studies together if necessary.

Treatment of thrombosed hemodialysis access grafts: Arrow-Trerotola percutaneous thrombolytic device versus pulse-spray thrombolysis. Arrow-Trerotola Percutaneous Thrombolytic Device Clinical Trial.

Purpose: To evaluate a percutaneous thrombolytic device (PTD) designed for treating thrombosed hemodialysis access grafts.

Materials And Methods: To compare the PTD with pulse-spray pharmacomechanical thrombolysis (PSPMT) by using urokinase, 122 randomly chosen patients with synthetic, thrombosed hemodialysis access grafts from multiple centers prospectively underwent thrombolysis with the PTD (5-F, low-speed rotational mechanical device) or PSPMT. Major outcome variables included the procedure time, the immediate technical patency rate, the complication rate, and the 3-month patency rate.

Comparison of digital subtraction and cut film arteriography in the evaluation of suspected thoracic aortic injury.

Purpose: To determine whether intraarterial digital subtraction arteriography (DSA) is as sensitive and specific as cut film arteriography (CFA) in the evaluation of suspected aortic injury resulting from blunt chest trauma.

Materials And Methods: Both CFA and DSA images of the thoracic aorta were obtained in the right posterior oblique (RPO) projection in 100 of 103 consecutive patients undergoing arteriography after blunt chest trauma. Diagnoses based on blinded separate review of both studies (CFA vs DSA) by four independent reviewers were compared.

In vitro cytotoxicity of silver-impregnated collagen cuffs designed to decrease infection in tunneled catheters.

Purpose: To examine in vitro the effects of silver-impregnated collagen cuff material from central venous catheters on human fibroblast growth.

Materials And Methods: In culture flasks, hybrid cells were exposed to silver-impregnated collagen cuff material, and human fibroblasts were exposed to silver-impregnated or silver-free collagen cuff material. After 72 hours of growth, cells were stained and digitally imaged, and the relative areas of cytotoxicity were determined.

Incidence and management of arterial emboli from hemodialysis graft surgical thrombectomy.

Purpose: To determine the incidence and significance of arterial emboli resulting from surgical thrombectomy/revision of hemodialysis grafts. This information may help in determining the significance and management of similar emboli resulting from percutaneous hemodialysis graft thrombolysis.

Patients And Methods: Patients undergoing surgical thrombectomy/revision of clotted hemodialysis grafts are studied with postoperative fistulography per institutional protocol whenever possible.

Outcome of tunneled hemodialysis catheters placed via the right internal jugular vein by interventional radiologists.

Purpose: To assess the outcome of interventional radiologic placement of tunneled hemodialysis catheters via the right internal jugular vein.

Materials And Methods: In 194 patients, the catheter was placed via the right internal jugular vein unless thrombosis was present. Real-time ultrasound-guided puncture and fluoroscopic guidance were used.

Preclinical in vivo testing of a rotational mechanical thrombolytic device.

Purpose: To establish the safety and efficacy of the Arrow Trerotola mechanical percutaneous thrombolytic device (PTD) for restoring patency of thrombosed hemodialysis grafts.

Materials And Methods: The hindlimb model of dialysis grafts was created in six dogs. Animals had either unilateral (n = 4) or bilateral (n = 2) polytetrafluoroethylene grafts, totaling eight grafts.

Pulmonary emboli from pulse-spray and mechanical thrombolysis: evaluation with an animal dialysis-graft model.

Purpose: To compare pulmonary emboli resulting from pulse-spray pharmacomechanical thrombolysis (PSPMT) and mechanical thrombolysis performed to declot dialysis-access grafts.

Materials And Methods: Polytetrafluoroethylene arteriovenous shunts were created in eight dogs and were deliberately clotted at monthly intervals. Animals were randomly assigned to treatment with pulse-spray urokinase thrombolysis or a low-speed rotational percutaneous thrombolytic device.

Transjugular intrahepatic portosystemic shunt procedure: efficacy of 10-mm versus 12-mm Wallstents.

Purpose: To compare results of transjugular intrahepatic portosystemic shunt (TIPS) placement with 10- and 12-mm Wallstents.

Materials And Methods: Forty-six TIPS procedures in 47 patients were retrospectively reviewed. Wallstents that were 10 mm in diameter were used in 23 patients, and those that were 12 mm in diameter were used in 23 patients.

Complex biliary stones: treatment with a small choledochoscope and laser lithotripsy.

Purpose: To evaluate the use of a small choledochoscope and laser lithotripsy in the treatment of complex biliary stone disease.

Materials And Methods: Twenty-five consecutive patients with complex biliary stone disease not amenable to surgical therapy, peroral endoscopic removal, or simple percutaneous retrieval techniques underwent 35 stone-removal procedures. A 3.