Endovascular Management of Extra-Peritoneal Hematoma Secondary to Bladder Catheterization.

Bladder rupture related to Foley catheter insertion is a rare condition mainly reported in patients with chronic bladder disease. In the present case, this rare condition was associated with massive hematoma due to active arterial bleeding, which was treated by embolization. We present the case of a 38-year-old woman admitted to the gastroenterology department with decompensated alcoholic liver cirrhosis, anemia, malnutrition, and diabetes. Six days after admission, she presented with hypotension and tachycardia associated with gross hematuria. An abdominal computed tomography scan revealed a Foley catheterization-related bladder perforation and a massive extra-peritoneal hematoma caused by active arterial bleeding from a distal branch of the right vesical artery. A successful embolization was performed with microparticles and coiled with complete hemorrhage control on post-procedure imaging. The bladder perforation was treated conservatively with a urinary drainage catheter, irrigation, and antibiotics. Despite these measures, the patient died 15 days later due to liver failure and sepsis. Our case highlights that commonly performed simple procedures can lead to severe complications, especially in frail patients.

Renal hematuric angiomyolipomas embolization: three cases and literature review.

We report three cases of hemorrhagic renal angiomyolipoma successfully treated using embolization. Endovascular management of this complication is highlighted.

Haemoptysis treated by bronchial artery embolisation in severe acute respiratory syndrome coronavirus 2: case report.

BACKGROUND: We found no data in the literature on the embolization of the bronchial arteries in the context of hemoptysis associated with severe acute respiratory syndrome coronavirus 2. We therefore decided to share this experience. CASE PRESENTATION: A 62-year-old patient with no significant medical history was admitted with acute respiratory distress. Chest computed tomography showed diffuse bilateral ground-glass opacities with limited consolidations. Diagnostic tests confirmed severe acute respiratory syndrome coronavirus 2 infection. The severity of respiratory failure required the implantation of veno-venous extracorporeal membrane oxygenation. The patient developed severe haemoptysis, which was successfully treated by bronchial artery embolisation. CONCLUSIONS: In the case of coronavirus-19 pneumonia, our experience suggests that the treatment of severe haemoptysis by bronchial artery embolisation is feasible and effective. The survival benefit should be assessed in the future.

Computed tomography-guided localization of breast lesions.

Magnetic resonance (MR) imaging and computed tomography (CT) of the breast allow the detection of breast lesions occult on physical examination, mammography and ultrasound. We report our experience to localize such lesions under CT-guidance. 30 patients underwent 30 CT-guided preoperative localizations of breast lesions using a sequential technique or a continuous imaging. All these lesions were initially detected by MR (n = 11) and/or CT (n = 19) and were occult for all the other techniques. In eight patients with a superficial and/or internal lesion, a skin location using a painting pen was performed. In the 23 other cases, the extremity of a hookwire was placed into the lesion or within 5 mm surrounding the target. All the lesions were localized with success under CT-guidance. The pathological analysis of the surgical specimens concluded in 11 breast cancers, four lesions of uncertain malignancy potential and 15 benign lesions. The size of these lesions ranged from 4 to 28 mm (mean: 10 mm). No significant complication related to the procedure was observed. Localization under CT guidance is a safe and effective technique to guide the surgical biopsy of breast lesions that can be seen solely on MR or CT.

Endovascular management of a rare complication of an aortic coarctation.

A 28-year-old pregnant woman presents with arterial hypertension of the upper limbs. The examination suggests an aortic coarctation. After a normal delivery, a contrast-enhanced computed tomography revealed a subocclusive aortic coarctation of the descending thoracic aorta and a 33-mm aneurysm developed from the left cervical-thoracic artery. The coarctation of the aorta was treated by a stent graft, and the aneurysm was treated by an injection of thrombin and glue.

Evaluation of abdominal aortic aneurysm after endoluminal treatment: comparison of color Doppler sonography with biphasic helical CT.

OBJECTIVE: The purpose of this study is to compare color Doppler sonography with biphasic helical CT in the evaluation of abdominal aortic aneurysms after endovascular repair. MATERIALS AND METHODS: Fifty-five patients prospectively underwent both color Doppler sonography and helical CT within 7 days after treatment by endovascular stent-graft. Aneurysmal thrombosis, the patency of the grafts, and the presence of a leak were evaluated in all patients. When a perigraft leak was observed, an attempt was made to identify its origin and outflow vessels. Helical CT was considered the gold standard technique. RESULTS: Helical CT revealed aneurysmal thrombosis in 33 patients and a perigraft leak in 22 patients. In five patients, helical CT detected a small perigraft leak not shown by color Doppler sonography. In three patients with suboptimal examinations, color Doppler sonography revealed a suspected perigraft leak that was not confirmed by helical CT. In these eight patients, the perigraft leak was sealed or no longer observed during follow-up. Compared with enhanced helical CT, the sensitivity and specificity of color Doppler sonography for the diagnosis of a perigraft leak were 77% and 90%, respectively. In seven other patients, helical CT was superior to color Doppler sonography in detecting the origin of the perigraft leak and the outflow vessels. Two iliac artery dissections and one distal migration of the prosthesis were revealed only by helical CT. CONCLUSION: Although color Doppler sonography may detect substantial perigraft leaks, helical CT is superior for detecting the origin of the perigraft leak, the outflow vessels, and the detection of complications related to the procedure.