RESUMO
PURPOSE: Stent migration into the right atrium is a potentially fatal complication of stenting in the venous system and is most likely to occur during the treatment of superior vena cava obstruction. Endovascular approaches that can salvage this hazardous situation are described and the keys to successful treatment are highlighted. MATERIALS AND METHODS: Four different strategies are reviewed: (1) snaring the stent directly, (2) angioplasty balloon-assisted snaring of the stent, (3) guide wire-assisted snaring of the stent, and (4) superior vena cava-to-inferior vena cava bridging stent. RESULTS: These techniques have been employed in the successful management of four cases. No short- or long-term complications as a result of these maneuvers have been identified. Additional treatment of the underlying disease was possible at the same time in each case. CONCLUSION: We conclude that prompt management of right atrial stent migration is essential and can be successfully achieved by a variety of "bale-out" techniques which are within the technical range of most interventional radiologists.
Assuntos
Angioplastia com Balão/instrumentação , Migração de Corpo Estranho/terapia , Stents , Síndrome da Veia Cava Superior/terapia , Veia Cava Superior , Adulto , Idoso de 80 Anos ou mais , Angioplastia com Balão/efeitos adversos , Feminino , Migração de Corpo Estranho/etiologia , Átrios do Coração , Humanos , Pessoa de Meia-Idade , Flebografia , Radiografia Intervencionista , Síndrome da Veia Cava Superior/diagnóstico por imagem , Veia Cava Superior/diagnóstico por imagemAssuntos
Angioplastia com Balão , Obstrução da Artéria Renal/terapia , Artéria Renal , Stents , Idoso , Seguimentos , Humanos , Masculino , Artéria Mesentérica Superior/diagnóstico por imagem , Artéria Mesentérica Superior/patologia , Oclusão Vascular Mesentérica/diagnóstico por imagem , Oclusão Vascular Mesentérica/terapia , Artéria Renal/diagnóstico por imagem , Artéria Renal/patologia , Obstrução da Artéria Renal/diagnóstico por imagem , UltrassonografiaRESUMO
We report a case of percutaneous retrieval of a misplaced embolization coil which threatened the segmental arterial supply of a single kidney. The renal artery was steeply angulated due to a spinal scoliosis but retrieval was rapidly performed using an Amplatz gooseneck snare. This device is particularly useful when the arterial anatomy is tortuous.
Assuntos
Cateterismo/métodos , Embolização Terapêutica/efeitos adversos , Artéria Renal , Idoso , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/terapia , Angiografia Digital , Cateterismo/instrumentação , Feminino , Humanos , Punções/instrumentação , Artéria Renal/diagnóstico por imagemRESUMO
Pelvic pain syndrome, without an apparent organic cause, is a common gynaecological complaint. Investigations, including laparoscopy are frequently negative but ovarian venography has demonstrated that pelvic varices are a consistent finding in these patients. The aetiology of pelvic varices has been the subject of debate, but it has recently been suggested that the primary problem is venous reflux in dilated, incompetent ovarian veins. Surgical ligation of the ovarian veins has been used effectively in small series of patients with this condition. We report a patient with the clinical and radiological features of this syndrome in which treatment by bilateral ovarian venous embolization produced prolonged symptomatic relief.
Assuntos
Embolização Terapêutica , Ovário/irrigação sanguínea , Manejo da Dor , Pelve , Adulto , Feminino , Humanos , Pelve/irrigação sanguínea , Pelve/diagnóstico por imagem , Flebografia , Síndrome , Varizes/terapia , VeiasRESUMO
Nasal and retrobulbar infection caused by the Oomycete Pythium insidiosum is described in a cat. The diagnosis was established on three criteria. The staining of broad, sparsely septate hyphal elements in biopsy tissue using a fluorescein-labelled antiglobulin specific for P. insidiosum, detection of antibodies to P. insidiosum by an immunodiffusion test, and isolation of the aetiological agent in pure culture from the biopsy tissue. Treatment with ketoconazole for 6 weeks resulted in clinical improvement, but proptosis of the left eye slowly appeared after the discontinuation of treatment. This case represents a new host for P. insidiosum, namely, a domestic, shorthaired cat, from North Carolina, U.S.A.