ABSTRACT
Objective To evaluate subclavicular angiography with brachial-axillary artery externally and temporally occluded in depicting hemoptysis-related ectopic arteries originating from shoulder, neck and chest wall in the interventional treatment of hemoptysis. Methods A retrospective analysis of the medical records and angiograms of 103 patients who underwent transarterial procedures for hemoptysis was carried out. The arteries originating from the subclavicular arteries supplying the shoulder, the neck and the chest wall, ectopic bronchial arteries (EBA) as well as non bronchial systemic arteries (NBSA), were depicted by subclavicular angiography with brachial-axillary artery externally and temporally occluded. The number and distribution of the responsible aberrant arteries were investigated. Results Of the hemoptysis-related arteries(n=372) depicted and embolized in the studies, 51.9% was normally-originated bronchial arteries(n=193),6.7% was ectopic bronchial arteries (n=25),41.4% was NBSA(n=154).Both anomalous and NBSA arising from subclavicular-axillary area(n=80) were accounted for 21.5% (80/372) of all aberrant arteries, and 44.7%(80/179) of all anomalous and NBSA (n=25+154=179).Of those arising from subclavicular-axillary arteries,56.3%(45/80) were found to be originated from the internal thoracic artery (n=45),98.2%(112/114)of responsible internal thoracic arteries and their distal branches were well depicted by subclavicular angiography with brachial-axillary artery externally and temporally occluded. Conclusion Subclavicular-axillary artery is a very important vessel where EBA and NBSA originate. Subclavicular angiography with brachial-axillary artery externally and temporally occluded could help to determine the abnormal arteries in the region quickly. The method should be taken as a routine procedure for interventional treatment of hemoptysis.
ABSTRACT
Objective To investigate the renal angiographic manifestations of severe hemorrhage following minimally invasive pereutaneous nephrostolithotomy (MPCNL), and to evaluate the technique of super-selective renal arterial embolization in treating the condition. Methods Forty-eight cases of severe hemorrhage following MPCNL treated with super selective renal arterial embolization in our department were retrospectively reviewed. The angiographic findings, results and complications of embolization procedures were analyzed. Results Two cases were of acute hemorrhage immediately after MPCNL, and the other 46 cases were of delayed hemorrhage 2 to 7 days after MPCNL. Of these 48 cases, 25 (52.1%) showed simple pseudo-aneurysms, 6 (12.5%) pseudo-aneurysms accompanied with arterial-venous shunts, 1 (2.1%) pseudo-aneurysm with extravasated contrast medium, 11 (22.9%) arterial-venous fistulas, 2 (4.2%) extravasated contrast medium from arterial branches, 1 (2.1%) renal capsular branches varix, 2 (4.2%) no lesion detected. Successful super-selective embolization was achieved in all 46 positive cases, and renal hemorrhage was stanched consequently. Polyvinyl alcohol foam embolization particles (PVA), gelfoam and coils were used in the procedures (PVA in 18 procedures, PVA +coil in 5, gelfoam in 10, geffoam + coil in 11, PVA + gelfoam + coil in 2). Post-embolization syndrome of various degrees were seen in all treated patients. A slight rise in blood creatinine levels was observed in 12 cases. Conclusion Super selective renal arterial angiography and embolization is the treatment of choice in patients who suffered severe hemorrhage due to MPCNL.
ABSTRACT
Objective To investigate angiographic manifestations and interventional treatment of non-acquired renal arterio-venous fistula.Methods Images of 13 cases of renal angiography were studied.Results The diagnosis of renal arteriovenous fistula was achieved,the rich findings were discussed.Conclusion Renal angiography is belived to be the best diagnostic method of the disease.Superselective renal arterial thrombosis is safe and effective and become the first choice in treatment.