Evaluation of the effectiveness of partial splenic endovascular embolization in patients with refractory thrombocytopaenia.

Purpose: Partial splenic endovascular embolization (PSEE) could be an option for patients with thrombocytopaenia (TCP). We selected a group of 22 patients diagnosed with refractory TCP to undergo PSEE, and we followed them for detailed analysis. Material and methods: Twenty-two patients aged 27-75 years (mean 46.5 ± 3.5 years) underwent PSEE, and 5 participants underwent a second PSEE due to the lack of effectiveness after the first procedure. A total of 27 PSEEs were performed. A semi-quantitative scale was used to assess the severity of the post-embolization syndrome. The percentage of spleen parenchyma excluded from circulation was 30-70%. We used the mixture of Histoacryl N-butyl cyanoacry-late glue and Lipiodol in 10 cases, spirals in 10 cases, and polyvinyl alcohol in 7 cases, for the embolization. Results: The mean value of platelet count (PLT) before procedure increased from 22.0 ± 15.0 to 87.7 ± 67.9 (p < 0.05) in a mean period of 194 days. In 2 cases severe post-embolization syndrome was observed. Closure less than 50% of the spleen circulation was associated with poorly expressed post-embolization symptoms. Serious complications occurred in 1 patient (3.5%). A strong positive correlation (r = 0.8, p < 0.05) was found between C-reactive protein (CRP) and the severity of post-embolization syndrome. Increased symptoms of post-embolization syndrome were also associated with a significant increase in hospitalization time - 27.0 vs. 7.2 days (r = 0.66, p < 0.05). Conclusions: Partial endovascular embolization of the spleen (PSEE) may be a valuable therapeutic option for patients with refractory TCP. PSEE is a safe method with a low complication rate.

Intra-arterial computed tomography angiography with ultra-low volume of iodine contrast and stent implantation in transplant renal artery stenosis in terms of contrast-induced kidney injury - a preliminary report.

PURPOSE: Traditional digital subtraction angiography is still regarded as the gold standard in the diagnostics of transplant renal artery stenosis (TRAS). However, this procedure requires a high volume of iodine contrast medium for optimal visualisation of the renal artery. The aim of this study was to analyse both the usefulness and the safety of intra-arterial computed tomography angiography (IA-CTA) with ultra-low-volume iodine contrast administration in the diagnostic and therapeutic management of TRAS in patients with impaired renal transplant function. MATERIAL AND METHODS: Thirty-three patients with a suspicion of TRAS based on Doppler-ultrasound and clinical setting underwent IA-CTA with ultra-low iodine contrast volume. A special, author-elaborated CTA protocol was used. The volume of 8-18 ml of diluted iodine contrast medium was administered through a catheter with the tip placed 2 cm below the aortic bifurcation. RESULTS: In six patients the CTA examinations revealed TRAS in three configurations: in the anastomosis, in the trunk (critical and high-grade), or in both sections. Stenoses were treated with primary stenting obtaining favourable anatomical outcome. No intervention-related complications were observed. No contrast-induced acute kidney injury was diagnosed in this study. Mean serum creatinine concentration was 2.93 ± 0.89 mg/dl at the baseline and 2.89 ± 1.73 mg/dl and 2.17 ± 0.51 mg/dl after three and seven days from IA-CTA, respectively. CONCLUSIONS: Intra-arterial CTA with ultra-low volume of iodine contrast seems to be a safe and reliable diagnostic tool to detect and assess TRAS in the aspect of stent implantation. Application of this imaging modality eliminates the need for a high volume of iodine contrast and thus does not adversely influence renal transplant function.

Repeating enlargement, recanalisations, and subarachnoid haemorrhages after middle cerebral artery aneurysm embolisation using pCONus stent and coils - a case report.

PURPOSE: Large and wide-necked bifurcation aneurysms remain technically challenging to treat by the endovascular approach. Several endovascular strategies have been established in recent years for treating wide-necked bifurcation aneurysms, such as balloon-assisted coiling, stent-assisted coiling, waffle cone technique (WCT), and intrasaccular flow disruptors. CASE REPORT: A 64-year-old woman was diagnosed with three intracranial aneurysms of the right and left middle cerebral artery and right internal carotid artery. She was qualified for endovascular treatment of the left middle cerebral artery (LMCA) aneurysm because it posed the greatest risk of rupture. Due to complicated morphology, a pCONus stent and coils were chosen for treatment. Three months later the right middle cerebral artery aneurysm was embolised and the woman was scheduled for second-stage treatment of the LMCA aneurysm. One week before the planned admission the woman was diagnosed with subarachnoid haemorrhage (SAH) in the region of the previously treated LMCA aneurysm, and the second-stage treatment was conducted with a good result. The woman was discharged in improved condition. Three months later the woman was once again admitted with SAH - an enlarged LMCA aneurysm was observed and immediate third-stage embolisation was performed, but due to complications of SAH the woman eventually died. CONCLUSIONS: On the basis of the presented case we would like to emphasise the importance of sufficient initial coil packing and frequent control of neck region of the aneurysm for the long-term stability and safety after pCONus-assisted coiling of intracranial aneurysms.

Bilateral thalamic stroke after tonsillectomy in a patient with collateral extracranial anastomosis - case report.

Haemorrhage remains the most frequent and serious complication of tonsillectomy. When bleeding is recurrent, gushing, and ceases spontaneously, pseudoaneurysm of the injured artery in the proximity of the tonsillar bed should be suspected. Haemorrhage related to pseudoaneurysm occurs most commonly in the first 30 days after surgery. It can sometimes be excessive and requires a revision procedure such as external carotid artery (ECA) ligation or embolisation. During those procedures, ECA should be checked for possible anastomoses, otherwise the bleeding may persist despite the intervention. We report an unusual case of a patient with recurrent post-tonsillectomy haemorrhage due to pseudoaneurysm of the facial artery, which persisted after ECA ligation because of the presence of collateral occipital-vertebral anastomosis. Due to the recurrence of bleeding episodes, endovascular treatment was implemented. However, the embolisation was complicated by bilateral thalamic stroke with unclear mechanism. This case highlights the importance of anastomosis between ECA and the vertebrobasilar system, both in recurrence of significant post-tonsillectomy bleeding and in potential thromboembolic complications. Therefore, ECA ligation should always be accompanied by exclusion of possible anastomoses. In cases of non-life-threatening bleeding, embolisation seems to be the proper and more selective therapy.

Arterio-biliary fistulas: What to choose as endovascular treatment?

Objectives Endovascular procedures are the treatment of choice in cases of intrahepatic fistulas. Arterio-biliary fistulas are the rarest and most difficult to treat, due to high risk of infection. Methods Eight cases of persistent hemobilia that developed as a result of arterio-biliary fistulas are presented. Five cases developed as a result of iatrogenic injury, two cases as a result of chronic infection, one case as a consequence of trauma. Results Patients were treated using endovascular embolization or combined endovascular and endoscopic biliary tract revision. The results were monitored after six to seven days and one month after embolization. The embolizations were considered effective in all cases. One patient had four asynchronous fistulas requiring separate treatments sessions. Four patients required a revision of their biliary ducts after embolization and restoration of patency. In one patient, a migration of the coil to biliary ducts occurred. Conclusion Endovascular treatment of arterio-biliary fistulas is safe and effective. The use of embolization with soft and biodegradable materials like histoacrylic glue or thrombin may be the optimal method of treatment in comparison with coils which have a risk of migration or chronic infection.

Triple-phase abdomen and pelvis computed tomography: standard unenhanced phase can be replaced with reduced-dose scan.

PURPOSE: The aim of the study was to test the hypothesis that unenhanced phase does not require as high image quality as subsequent phases acquired after contrast administration in triple-phase abdomen and pelvis computed tomography (CT), and to assess if attenuation value (AV) measurements may be obtained from unenhanced images acquired with three-fold reduced radiation dose. MATERIAL AND METHODS: In the standard triple-phase abdomen and pelvis CT protocol (unenhanced, late arterial, and portal venous phase) we decreased the tube current time product only in the unenhanced phase. Arterial and venous phases were performed with the standard scanner settings used in our Institution for routine abdomen and pelvis CT. We compared the AV in manually drawn circular-shaped regions of interest (ROIs) obtained from reduced-dose and standard-dose unenhanced images in 52 patients. All ROIs were set in homogeneous parts of psoas muscle, fat tissue, liver, spleen, aorta, and bladder. RESULTS: There was no statistically significant difference in AV measurements for all considered areas. More noise does not alter the mean AV inside the ROIs. Radiation dose of unenhanced scans was reduced three times and the total dose length product (DLP) in the triple-phase study was decreased by 22%. CONCLUSIONS: Unenhanced images performed with three-fold reduced radiation dose allows reliable AV measurements. The unenhanced phase does not require as high image quality as subsequent phases acquired after contrast administration.

Biological Properties of Low-Toxic PLGA and PLGA/PHB Fibrous Nanocomposite Scaffolds for Osseous Tissue Regeneration. Evaluation of Potential Bioactivity.

Abstracts: The aim of the study was to evaluate the biocompatibility and bioactivity of two new prototype implants for bone tissue regeneration made from biodegradable fibrous materials. The first is a newly developed poly(l-lactide-co-glycolide), (PLGA), and the second is a blend of PLGA with synthetic poly([R,S]-3-hydroxybutyrate) (PLGA/PHB). The implant prototypes comprise PLGA or PLGA/PHB nonwoven fabrics with designed pore structures to create the best conditions for cell proliferation. The bioactivity of the proposed implants was enhanced by introducing a hydroxyapatite material and a biologically active agent, namely, growth factor IGF1, encapsulated in calcium alginate microspheres. To assess the biocompatibility and bioactivity, allergenic tests and an assessment of the local reaction of bone tissue after implantation were performed. Comparative studies of local tissue response after implantation into trochanters for a period of 12 months were performed on New Zealand rabbits. Based on the results of the in vivo evaluation of the allergenic effects and the local tissue reaction 12 months after implantation, it was concluded that the two implant prototypes, PLGA + IGF1 and PLGA/PHB + IGF1, were characterized by high biocompatibility with the soft and bone tissues of the tested animals.

Balloon Dilatation for Removal of an Irretrievable Permanent Hemodialysis Catheter: The Safest Approach.

Long-term hemodialysis catheter dwell time in the central vein predisposes to fibrin sheath development, which subsequently causes catheter malfunction or occlusion. In very rare cases, the catheter can be overgrown with fibrin and rigidly connected with the vein or heart structures. This makes its removal almost impossible and dangerous because of the possibility of serious complications, namely vein and heart wall perforation, bleeding, or catheter abruption in deep tissues. We describe two cases in which standard retrieval of long-term catheters was not possible. Balloon dilatation of catheter lumens was successfully used to increase the catheter diameter with simultaneous tearing of the fibrin sheath surrounding it. This allowed the catheter to be set free safely. Based on this experience, we present recent literature and our point of view.

Embolization of a True Giant Splenic Artery Aneurysm Using NBCA Glue - Case Report and Literature Review.

BACKGROUND: Although splenic artery aneurysms (SAAs) are common, their giant forms (more than 10 cm in diameter) are rare. Because of the variety of forms and locations of these aneurysms, there are a lot of therapeutic methods to choose. In our case of a giant true aneurysm we performed an endovascular embolization with N-butyl-cyano-acrylate (NBCA) glue. To our knowledge it is the first reported case of this method of treatment of true giant SAA. CASE REPORT: A 74-year-old male patient with symptomatic giant SAA (13 cm) was urgently admitted to our hospital for the diagnostic and therapeutic procedures. Due to the general health condition, advanced age and the large size of the aneurysm we decided to perform an endovascular treatment with N-butyl-cyano-acrylate (NBCA) glue. CONCLUSIONS: The preaneurysmal part of splenic artery was occluded completely with exclusion of the aneurysm. No splenectomy was needed. The patient was discharged in good general condition Embolization with NBCA can be an efficient method to treat the giant SAA.

Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast - Own Experiences.

BACKGROUND: High volume of intravenous contrast in CT-angiography may result in contrast-induced nephropathy. Intraarterial ultra-low volume of contrast medium results in its satisfactory blood concentration with potentially good image quality. The first main purpose was to assess the influence of the method on function of transplanted kidney in patients with impaired graft function. The second main purpose of the study was to evaluate the usefulness of this method for detection of gastrointestinal and head-and-neck haemorrhages. MATERIAL/METHODS: Between 2010 and 2013 intraarterial CT-angiography was performed in 56 patients, including 28 with chronic kidney disease (CKD). There were three main subgroups: 18 patients after kidney transplantation, 10 patients with gastrointestinal hemorrhage, 8 patients with head-and-neck hemorrhage. Contralateral or ipsilateral inguinal arterial approach was performed. The 4-French vascular sheaths and 4F-catheters were introduced under fluoroscopy. Intraarterial CT was performed using 64-slice scanner. The scanning protocol was as follows: slice thickness 0.625 mm, pitch 1.3, gantry rotation 0.6 sec., scanning delay 1-2 sec. The extent of the study was established on the basis of scout image. In patients with CKD 6-8 mL of Iodixanol (320 mg/mL) diluted with saline to 18-24 mL was administered at a speed of 4-5 mL/s. RESULTS: Vasculature was properly visualized in all patients. In patients with impaired renal function creatinine/eGFR levels remained stable in all but one case. Traditional arteriography failed and CT-angiography demonstrated the site of bleeding in 3 of 10 patients with symptoms of gastrointestinal bleeding (30%). In 8 patients with head-and-neck bleeding CT-angiography did not prove beneficial when compared to traditional arteriography. CONCLUSIONS: 1. Ultra-low contrast intraarterial CT-angiography does not deteriorate the function of transplanted kidneys in patients with impaired graft function. 2. 3D reconstructions allow for excellent visualization of vascular anatomy of renal transplants. 3. Intraarterial CT-angiography is useful for detection of the bleeding site.

Consider use of a collateral venous circuit before abandoning the arteriovenous fistula--the experience of a complex vascular access case.

We describe a 65-year-old woman with diabetes on hemodialysis maintenance, with a number of complications associated with high-flow arteriovenous fistula (AVF, anastomosis between brachial artery and medial vein of the forearm) requiring an extended diagnostic and individual approach. The patient was admitted to our hospital because of pain, edema of the limb, hand ischemia, and infection caused by steal syndrome. To reduce fistula flow, banding of the proximal cephalic vein was performed. Simultaneously because of necrosis, amputation of the fifth finger was necessary. Following this procedure, the cephalic vein on the arm thrombosed. The fistula was patent through the collateral circuit, which was diagnosed in detail during the late course. A long course of antibiotics and sessions in a hyperbaric chamber allowed limb rescue. Single-needle dialysis was carried out because of problems in finding an appropriate second place. After an episode of bleeding from the puncture site caused by ulceration, we were forced to search for an alternative needling point. On the basis of ultrasound scans, an anatomic schema of the blood circuit was created. The fistula demonstrated flow from the brachial artery resulting in retrograde flow in the section of the cephalic vein distal to the anastomosis in the upper forearm. This was then seen to drain in an antegrade direction via the median vein of the forearm after the 2 vessels connected in the mid forearm. Using the diagram, 2 alternative places for needling were found and it allowed the adequate hemodialysis to be continued. Complex and complicated cases associated with native AVF could be resolved using simple diagnostic tools to preserve the fistula use for hemodialysis. Both clinical examination and ultrasound scan with the Doppler option appear to be valuable methods for finding the optimal cannulation place.

Iatrogenic hemobilia in 10-year-old boy.

BACKGROUND: Hemobilia in children is a rare phenomenon which has been described mostly in the context of traumas. The descriptions of massive hemobilia in children after liver biopsy are a rarity in the scientific literature because there are only a few examples of it. Hemobilia rarely develops spontaneously. Generally, this is a complication after a blunt abdominal trauma or after medical (especially surgical) procedures. Correct diagnosis and treatment of hemobilia are essential, especially in the case of patients with severe - sometimes life-threatening - haemorrhage from biliary ducts. It should be remembered that the symptoms of hemobilia do not necessarily occur immediately after surgery or trauma. In some cases hemobilia occurs after a changeable, asymptomatic period of time. CASE REPORT: We would like to present a case of a severe form of hemobilia caused by arterio-biliary fistula which developed incidentally after liver biopsy in a 10-year-old boy with chronic hepatitis B. Symptoms of hemobilia appeared on the seventh day after the diagnostic biopsy when the patient's general condition began to deteriorate. The diagnosis of arterio-biliary fistula was established after angio-CT examination of the liver. A selective embolization of the right hepatic artery was carried out. Hemobilia in children is a rare phenomenon which has been described mostly in the context of traumas. The cases of massive hemobilia in children after liver biopsy are a rarity in the scientific literature because there are only a few examples of it. Hemobilia very rarely develops spontaneously. Generally, this is a complication after a blunt abdominal trauma or after medical (especially surgical) procedures. RESULTS: Correct diagnosis and treatment of hemobilia are essential, especially in the case of patients with severe - sometimes life-threatening - haemorrhage from biliary ducts. It should be remembered that the symptoms of hemobilia do not necessarily occur immediately after surgery or trauma. In some cases hemobilia occurs after a changeable, asymptomatic period of time.

[Radiation hygiene in interventional radiology suite]. / Higiena radiacyjna w pracowniach radiologicznych.

Exposure of both patients and medical staff to relatively high doses of radiation is one of the features characteristic of interventional radiology (IR). Regulations regarding this kind of therapeutic management can be found in many legal references and recommendations of European Union Law. The purpose of the paper is collection and systematic analysis of activities and procedures associated with the question of radiation hygiene which should be observed in IR suites. Requirements regarding equipment of the IR suite, as well as radiation protection of patients and medical staff, constitute main questions included in the paper, worked out on the basis of valid regulations and occupational experience of the authors. Particular attention is paid to borderline requirements regarding modern IR suite equipment and its organization. Part of the paper is devoted to the understanding of physical laws of ionizing radiation in biological space and its surroundings. Understanding of physical laws, proper utilization of IR suite equipment, and strict compliance with recommendations of radiation protection by both patients and medical staff are critical for limitation of the harmful influence of radiation during interventional therapeutic procedures. An additional role of the paper is to make it easier to take decisions when creating new IR suites, in accordance with valid regulations and the rule of functionality.

[Examination of influence of microstructure of grafts on TiO2 base on the process of bone tissue forming]. / Badanie wplywu mikrostruktury wszczepów na osnowie TiO2 na proces formowania sie tkanki kostnej.

AIM OF THE STUDY: Evaluation of the influence of the introduced structure modification in porous ceramic grafts on TiO2 base on overgrowing with bone tissue, in examinations with use of scanning microscopy and X-rays was the subject of the examinations. MATERIAL AND METHOD: New ceramic materials based on TiO2 with high values of mechanical resistance, large sintering degree and biocompatibility in in vitro conditions were prepared. Those properties cause that they are worth interest as potential osteosubstitutive materials. Two kinds of grafts were created from ceramics based on TiO2: with compact and porous structure. The introduced structure modification - macroporosity - had the purpose to give osteoconductive properties to the grafts, to evoke processes favorable for bone tissue forming. In examinations of the local reaction of bone tissue after implantation of the formed porous grafts, degree of their osteointegration, the essential issue is the evaluation of the settling of the inner spaces with supporting tissues. Samples of the tested compact and porous materials in the form of cylinders were implanted in femoral bones of rabbits for a period till 6 months. The surfaces of grafts and the degree of their settling with supporting tissues were evaluated in cross-sections of the implants with light and scanning microscopic methods and they were confirmed in X-ray tests. RESULTS: Analysis of the obtained data showed that, the surface of solid ceramic on TiO2 base was covered mainly with increasing with a time of observation quantities of extracellular substance and lamellas of bone. The macrporous structure of porous ceramic on TiO2 base enabled settling of the inner spaces of graft with supporting tissue cells, partly in the 1st month, more intensively in the 3rd and it was not completed in the 6th month after implantation. CONCLUSIONS: Porous grafts in the form of ceramic foam on TiO2 base showed osteoconductive properties, though process of colonization after 6th month observation was not completed and the condition of the cells inside of the implant was reduced.

[Atypical biliary stenting in patient with obstructive biliary jaundice]. / Przypadek niestandardowego stentowania dróg zólciowych w zóltaczce mechanicznej o etiologii nowotworowej.

Obstructive biliary jaundice is a common complication in patients with malignancies which infiltrate biliary ducts. If untreated efficiently the jaundice is fatal a short period of time. We present a case of 60-year-old male patient who had undergone Whipple procedure in the past and presented with local recurrence treated successfully by percutaneous stenting of obstructed biliary duct. When passing through the obstruction we observed a contrast-bile leakage at the level of occluded segment and instability of implanted stent which was a complication that extorted atypical approach. We applied a covered stent in association with oversized nitinol stent which allowed to form a funnel-like construction efficiently decompressing biliary tree. Thanks to this management we also avoided further complications.

[Endovascular treatment of recurrent hemorrhage after tonsillectomy]. / Embolizacja wewnatrznaczyniowa w nawracajacym krwawieniu po tonsillektomii.

Bleeding from the lodge after tonsillectomy is a rare complication--approximately 3% of all cases. In most cases pharmacological treatment or reoperation is effective. In unique situ. ations, when particular severe bleeding is observed, it is necessary to perform endovascular therapy. We present a case of efficient endo-vascular embolization in 31-year-old patient with a recurrent bleeding after tonsillectomy. Superselective embolization of the ascending palatine artery can be an effective therapeutic method in severe bleeding after tonsillectomy

[Aortocaval fistula in abdominal aorta aneurysm treated by stentgraft and embolization with histoacrylate glue]. / Przetoka aortalno-czcza w tetniaku aorty brzusznej leczona stentgraftem i embolizacja przy pomocy kleju histoakrylowego.

Aortocaval fistula (ACF) associated with abdominal aortic aneurysm (AAA) constitutes a relatively uncommon complication of AAA, nevertheless it worsens to a great extent the prognosis and its curable treatment is difficult. The fistula itself, in particular high-output ACF, deteriorates the general patient condition and requires an emergency intervention. The simultaneous exclusion of AAA fromcirculation and closure of site of the fistula is the treatment. The typical treatment includes open surgery or alternatively stentgraft implantation. We report a case of a giant non-thrombosed AAA complicated by formation of ACF at the level of origin of the right common iliac artery. Bifurcated stentgraft implantation did not result in closure of ACF. The fistula was definitely closed by means of injection of cyanoacrylate glue between the stentgraft limb and the wall of the native vessel.

[Simultaneous manifestation of thrombocytopenia -induced endoleak type IV and II as late complication following abdominal stentgraft implantation]. / Jednoczasowe wystapienie indukowanego maloplytkowoscia zacieku typu IV oraz II jako pózne powiklanie po implantacji stentgraftu brzusznego.

Endoleak type IV occurs very rarely and typically was observed 4-8 weeks following implantation of previous generation stentgrafts. Endoleak type II, although relatively common, typically presents early after stentgraft implantation. In our case combined thrombocytopenia-induced endoleaks type II and IV manifested 22 months following stentgraft implantation. The patient presented with abdominal pain and rapid increase in aneurysm diameter. The patient did not require endovascular intervention, medical treatment proved sufficient to relieve clinical symptoms and to prevent progression of the aneurysmal sac. Thrombocytopenia has not manifested itself again so far. The patient is followed-up with increased frequency. It should be noted that occurrence of type IV endoleak, in particular when associated with other type of endoleak, can result from thrombocytopenia. This type of endoleak should be included in differential diagnosis not only in early postinterventional period but also in long-term follow-up, first of all in patients with first generation stentgrafts implanted, featured by porosity of covering material.

[Endovascular treatment of haemorrhagic complication of HELLP syndrome]. / Wewnatrznaczyniowe leczenie powiklania krwotocznego zespolu HELLP.

HELLP syndrome, which consists of haemolytic anaemia, elevated liver enzymes and thrombocytopenia, typically occurs in women in perinatal period. Rare life-threatening complications of this syndrome include haemorrhages, in particular these originating from hepatic artery branches for they usually result in subcapsular hematoma formation. The rupture of hepatic capsule secondary to hepatomegaly results in intraperitoneal haemorrhage. In case of suspicion of HELLP syndrome complicated by hepatic haemorrhage it is crucial to perform imaging modalities as emergency, first of all US and CT of abdomen and pelvis. Selective embolization of hepatic artery branches seems to be a valuable, alternative or complementary to surgery method of stopping the bleeding.

[Use of Gianturco-Wallace and tornado coils in perforators embolisation in chronic venous ulcers treatment]. / Zastosowanie spirali Gianturco-Wallace i Tornado w embolizacji niewydolnych zyl przeszywajacych jako metody leczenia przewleklych owrzodzeí zylnych.

AIM OF THE STUDY: Embolisation is a endovascular technique of vessels closure using embolisation material, which is applied into vessels throw catheter. As an embolisation material coils Gianturco-Wallace i Tornado (Cook) were used. Length and size of coils was determined individually during precedure. MATERIALS AND METHODS: 38 patients of Vascular Surgery Department and Radiology Department of Medical University in Wroclaw were treated by endovascular embolisation of insufficient perforators. Procedures were made on 40 limbs with post-thrombotic complex and venous ulcers (6th degree of CEAP classification). 68 endovascular procedures were made, 143 metal coils were used. RESULTS: Using endovascular method 85% of ulcers were comletely cured. CONCLUSIONS: Endovascular embolisation is safe and effective method of veonous ulcers curing. Itmay be used at outpatients clinic.