Hepatic arterial loop with accessory right hepatic artery aneurysm with celiac atresia: endovascular therapy with a stent and detachable coils.

The present report describes an unusual case of an aneurysm of a right hepatic artery (RHA) branching from the superior mesenteric artery; the accessory RHA was looped to the left hepatic artery arising from the celiac axis (CA) and was associated with congenital atresia of the CA. The accessory RHA aneurysm was treated with the placement of a bare stent and detachable coils through the mesh of the stent. Complete and prompt exclusion of the aneurysm was achieved with blood flow preservation in the parent artery at midterm follow-up.

Bilateral adventitial cystic disease of the popliteal artery: a case report.

Adventitial cystic disease (ACD) of the popliteal artery is an uncommon vascular condition of unknown etiology. In the present case report, we describe a case of bilateral ACD of the popliteal artery in a 58-year-old male. To the best of our knowledge, this is the first case of bilateral ACD of the popliteal artery reported in the literature.

Gastroduodenal stent placement: current status.

Gastroduodenal obstruction is a preterminal event in patients with advanced malignancies of the stomach, pancreas, and duodenum. It severely limits the quality of life in affected patients due to constant emesis and associated malnutrition. Surgical gastrojejunostomy has been the traditional palliative treatment but is associated with a high complication rate, and delayed gastric emptying is a frequent problem.

A simplified arteriovenous malformation model in sheep: feasibility study.

Background And Purpose: Recently, a swine model of a cerebral arteriovenous malformation (AVM) has been developed that closely resembles a human AVM of the brain. The creation of such a model requires sophisticated neurointerventional techniques. The purpose of this study was to develop a simple and cost-effective AVM animal model that does not require additional endovascular techniques.

Percutaneous implantation of non-small-cell lung carcinoma: technique and observations.

Rationale And Objectives: The authors performed this study to determine whether intrathoracic inoculation of non-small-cell lung carcinoma with fluoroscopic guidance would provide for more accurate implantation.

Materials And Methods: A tumor cell inoculum (2 x 10(6) cells per 0.15 mL) was injected percutaneously under fluoroscopic guidance at the posterior midaxillary line in 22 athymic nude mice.

Cragg Endopro System I: early experience. I. Femoral arteries.

Purpose: This work describes the early experience with the Cragg Endopro System I. The safety and efficacy of this device in the treatment of atherosclerotic lesions of the femoral arteries are evaluated.

Materials And Methods: Eleven patients with complex femoral artery lesions were treated.

Effect of transjugular intrahepatic portosystemic shunt on quality of life.

Objective: The objective of this study was to determine the effect of the transjugular intrahepatic portosystemic shunt (TIPS) procedure on the quality of life.

Subjects And Methods: Data were collected on 99 patients who underwent the TIPS procedure between September 1991 and September 1995. Quality of life was assessed by the Karnofsky scale before and at intervals after the procedure.

Venous recanalization by metallic stents after failure of balloon angioplasty or surgery: four-year experience.

Purpose: This retrospective study describes our updated experience in treating venous stenoses and occlusions with metallic endovascular stents.

Methods: Gianturco, Palmaz, and Wallstent stents were placed in 55 patients over a 4-year period. Stent sites included the subclavian veins (9), innominate veins (3), superior vena cava (4), inferior vena cava (3), iliac veins (29), femoral veins (5), and portal veins (6).

Duplex sonography after transjugular intrahepatic portosystemic shunts (TIPS): normal hemodynamic findings and efficacy in predicting shunt patency and stenosis.

Objective: Portal hemodynamics are altered by placement of a transjugular intrahepatic portosystemic shunt (TIPS). Normal duplex sonographic findings after TIPS placement and hemodynamic alterations indicating shunt failure have not yet been well described. The purposes of this study were to determine normal hemodynamic changes on duplex sonography after TIPS placement and to assess the efficacy of duplex sonography in detecting shunt dysfunction.

Femoral neuropathy following percutaneous nephrolithotomy of a pelvic kidney.

Management of nephrolithiasis within a pelvic kidney presents a novel challenge to the urologist. We report on a patient who underwent ureteral stent placement prior to extracorporeal shock-wave lithotripsy (ESWL). Following ESWL, the ureteral stent calcified at the vesical and renal ends, requiring "sandwich therapy" of percutaneous nephrolithotripsy, ESWL, and percutaneous nephroscopy.

The forgotten indwelling ureteral stent: a urological dilemma.

Ureteral stents are an integral part of urological practice. However, stents that migrate, fragment or are forgotten pose a management and legal dilemma. Our series consists of 31 patients, 22 with forgotten stents that were left indwelling for more than 6 months (mean 22.

Chronic iliac artery occlusions: primary recanalization with endovascular stents.

Purpose: The authors describe treatment of chronic iliac artery occlusions with primary stent placement without prior thrombolysis or angioplasty.

Patients And Methods: Eight patients with chronic iliac artery occlusions (six men and two women) underwent primary stent placement without prior use of thrombolytic agents or angioplasty. Palmaz stents were placed in seven patients and a Wallstent device was placed in one.

In vitro metal fatigue testing of inferior vena cava filters.

Rationale And Objectives: Inferior vena cava filter fractures have been described in vivo on several occasions. No studies have compared the fatigue life of the different filter types. Four different, frequently used filters (Vena-Tech filters [VTF], stainless-steel Greenfield filters [SSGF], Simon nitinol filters [SNF], and titanium Greenfield filters [TGF]) were, therefore, tested with regard to fatigue life.

Development of stenoses in transjugular intrahepatic portosystemic shunts.

Purpose: To evaluate the frequency and significance of stenoses or occlusions developing within transjugular intrahepatic portosystemic shunts (TIPS) and identify predictive factors.

Materials And Methods: Medical records of 52 patients who underwent TIPS placement between September 1991 and October 1993 were reviewed. Various shunt parameters were correlated with the development of shunt abnormalities.

Color Doppler sonography of transjugular intrahepatic portosystemic shunts (TIPS).

Transjugular intrahepatic portosystemic shunts (TIPS) have largely replaced surgically created shunts in the treatment of life-threatening sequelae of portal venous hypertension [1-5]. Conventional duplex and color Doppler sonography are proving to be useful tools in the assessment of the stents and their associated hemodynamic changes [2-5]. A thorough Doppler survey before and immediately after TIPS placement provides a baseline for evaluation of shunt function and procedure-related complications.

Intraureteral metallic self-expanding endoprosthesis (Wallstent) in the treatment of difficult ureteral strictures.

Intractable and recurrent ureteral stricture presents a continuous challenge to the urologist. We report on 5 patients with severe ureteral stricture who were successfully treated with self-expanding metallic stents. Ureteral stricture occurred at ureteroileal anastomotic sites after neoplasm resection in 2 cases, multiple upper ureteral strictures were related to multiple surgical procedures for correction of bladder exstrophy in 1 and a ureteral kink developed in 1.

In vitro and in vivo experimental evaluation of a new vena caval filter.

Purpose: A new stainless steel (MP35N alloy) vena cava filter without a central stasis point was evaluated in vitro and in vivo.

Materials And Methods: The clot-trapping efficiency and hemodynamic flow pattern of the filter were assessed in a flow model and were compared with those of currently available commercial filters including the Vena Tech-LGM, Simon nitinol, Greenfield, and Bird's Nest filters. The new filter was placed in the inferior vena cava (IVC) of 31 dogs; 21 of the 31 dogs were followed up with cavography for up to 3 months.