Renal Autotransplantation in a Patient with Bilateral Renal Artery Stenosis Secondary to Takayasu Arteritis.

Involvement of the renal artery is common in Takayasu arteritis. We, herein, present on a patient with Takayasu arteritis causing severe renal failure and a successful auto-transplantation. This case shows that early diagnosis and immediate appropriate interventions are life-saving in patients with Takayasu arteritis. Renal auto-transplantation performed in selected cases increases dialysis-free survival.

Percutaneous transluminal angioplasty of the inferior right hepatic vein for the treatment of Budd-Chiari syndrome.

Budd-Chiari Syndrome is one of the several causes of portal hypertension and is characterised by hepatomegaly, ascites and abdominal pain. The treatment requires either medical or interventional/surgical procedures. A case of Budd-Chiari Syndrome with a membranous web that causes obstruction in the ostium of the inferior right hepatic vein is reported here which was treated by percutaneous transluminal angioplasty (PTA). The patient was asymptomatic and off medication and there was no recurrence after 18-months follow-up.

Comparison of effective doses obtained from dose-area product and air kerma measurements in interventional radiology.

In this study, measurements of dose-area product (DAP) and entrance dose were carried out simultaneously in a sample of 162 adult patients who underwent different interventional examinations. Effective doses for each measurement technique were estimated using the conversion factors that have been determined for specific X-ray views in a mathematical phantom. Exposure conditions used in clinical practice never match these theoretical models exactly, and deviations from the assumed standard conditions cause uncertainties in effective dose estimations. Higher effective dose values are found if the air kerma results are used rather than DAP readings, both for patient and Rando phantom studies. Comparison of DAP, fluoroscopy times and skin doses were made with published data. DAP measurement for the effective dose calculation and thermoluminescent dosimeter for the skin dose estimates are found to be the most reliable methods for patient dosimetry.

Intrarenal varices in portal hypertension: demonstration by color Doppler imaging.

The gray-scale ultrasonographic appearances of dilated intrarenal vascular structures may mimic peripelvic cysts or hydronephrosis. We report a patient with portal hypertension in whom color Doppler ultrasound was found to be a very practical imaging technique in demonstrating varices of the renal segmental veins.

The effect of intrathecal sodium nitroprusside on severe chronic vasospasm.

The efficacy of sodium nitroprusside in resolving cerebral vasospasm was evaluated with multicisternal injections. Twelve animals received fresh, unheparinized arterial blood via three injections (15 ml total) into the cisterna magna. Selective vertebral arteriography was performed on Day 0, and blood injections were performed on the second and third days after the first injection. On the seventh day selective arteriography was performed to evaluate the diameter of the basilar artery. In the sodium nitroprusside group, intrathecal injections of the drug were started on Day 4 and continued for two days (25 micrograms/kg/day). The diameter of the basilar artery was reduced 72.98 +/- 11.07% in control experiments. For the animals treated with intrathecal sodium nitroprusside, the mean diameter of the basilar artery was reduced 29.25 +/- 4.54%. The effect of intrathecal sodium nitroprusside on intracranial pressure (ICP), blood pressure (BP) and electrocardiogram (ECG) was also evaluated in 14 animals. There were no prominent changes in ICP, BP, or ECG when sodium nitroprusside was given intrathecally, but BP decreased and ICP and heart rate increased with intravenous doses of sodium nitroprusside. These results support the hypothesis that sodium nitroprusside administered intrathecally is an effective treatment for cerebral vasospasm.

Transclival approach to rabbit basilar artery for experimental induction of chronic vasospasm.

An experimental technique for producing delayed cerebral vasospasm in a rabbit model is described. The basilar artery is punctured via the transclival route and angiographic verification is illustrated.

Management of ureterosigmoidal anastomotic stricture by balloon dilatation.

Ureterosigmoidal anastomotic stricture is seen in nearly half of the patients who had ureterosigmoidostomy. Many of these patients are in need of reoperation. Balloon dilatation via percutaneous nephrostomy is an alternative method which avoids reoperation.

Fibromuscular dysplasia of the renal arteries treated with percutaneous transluminal renal angioplasty: a case report.

A nine-year-old girl with renovascular hypertension is presented. The diagnosis of fibromuscular dysplasia was established by selective renal angiography, and percutaneous transluminal renal angioplasty was performed. After successful dilation, the blood pressure returned to normal. The patient has been followed for a year and there is no evidence of hypertension.