Multicentric Castleman's disease: Report of three cases.

Castleman's disease is an uncommon benign B-cell lymphoproliferative disorder. According to lymph nodes distribution, there are two distinct subtypes of disease: unicentric and multicentric. Unicentric Castleman's disease is more common, localized to one site, and locally treated. On the contrary, multicentric form is a rare systemic disease characterized by diffuse lymphadenopathy and inflammatory symptoms. We report three cases of persons that were initially suspected to have a lymphoma but were later histologically confirmed to have Multicentric Castleman's Disease. In addition, our work aims to investigate the role of fluorodeoxyglucose (FDG) PET/CT in evaluation of this rare condition.

Lung Metastasis after an Eighteen-Years-Long Disease-Free Period since Uterine Leiomyosarcoma Diagnosis.

Uterine leiomyosarcoma (ULMS) is an uncommon malignancy that accounts for one-third of uterine sarcomas and represents 1% of all uterine malignancies, with an incidence averaging 0.5-1/100,000/year. The prognosis is poor due to its intrinsic aggressiveness and its characteristic high metastatic potential with reported distant metastatic spread in lung, abdomen, soft tissue, and brain. We present the case of a 67-year-old woman with lung metastasis after eighteen years since uterine leiomyosarcoma diagnosis and its following surgical resection. The diagnosis of pulmonary metastases was obtained by reviewing the histology of the previous uterine tumor: the tumor cells were immunoreactive for CD10, PR, and smooth muscle actin (SMA), but negative for desmin, S100, CD34, CD 117, cytokeratins AE1AE3, CD68R, and ER. To our knowledge, this disease-free interval is the longest among previous reports of pulmonary metastasis of uterine leiomyosarcoma.

Responses of Pseudomonas putida to toxic aromatic carbon sources.

A number of bacteria can use toxic compounds as carbon sources and have developed complex regulatory networks to protect themselves from the toxic effects of these compounds as well as to benefit from their nutritious properties. As a model system we have studied the responses of Pseudomonas putida strains to toluene. Although this compound is highly toxic, several strains are able to use it for growth. Particular emphasis was given to the responses in the context of taxis, resistance and toluene catabolism. P. putida strains analysed showed chemotactic movements towards toluene. Strain DOT-T1E was characterised by an extreme form of chemotaxis, termed hyperchemotaxis, which is mediated by the McpT chemoreceptor encoded by plasmid pGRT1. Close McpT homologs are found in a number of other plasmids encoding degradation pathways of toxic compounds. The pGRT1 plasmid harbours also the genes for the TtgGHI efflux pump which was identified as the primary determinant for the resistance of strain DOT-T1E towards toluene. Pump expression is controlled by the TtgV repressor in response to a wide range of different mono- and biaromatic compounds. Strain DOT-T1E is able to degrade toluene, benzene and ethylbenzene via the toluene dioxygenase (TOD) pathway. The expression of the pathway operon is controlled by the TodS/T two component system. The sensor kinase TodS recognizes toluene with nanomolar affinity, which in turn triggers an increase in its autophosphorylation and consequently transcriptional activation. Data suggest that transcriptional activation of the TOD pathway occurs at very low toluene concentrations whereas TtgV mediated induction of pump expression sets in as the toluene concentration further increases.

Global regulation of food supply by Pseudomonas putida DOT-T1E.

Pseudomonas putida DOT-T1E was used as a model to develop a "phenomics" platform to investigate the ability of P. putida to grow using different carbon, nitrogen, and sulfur sources and in the presence of stress molecules. Results for growth of wild-type DOT-T1E on 90 different carbon sources revealed the existence of a number of previously uncharted catabolic pathways for compounds such as salicylate, quinate, phenylethanol, gallate, and hexanoate, among others. Subsequent screening on the subset of compounds on which wild-type DOT-TIE could grow with four knockout strains in the global regulatory genes Deltacrc, Deltacrp, DeltacyoB, and DeltaptsN allowed analysis of the global response to nutrient supply and stress. The data revealed that most global regulator mutants could grow in a wide variety of substrates, indicating that metabolic fluxes are physiologically balanced. It was found that the Crc mutant did not differ much from the wild-type regarding the use of carbon sources. However, certain pathways are under the preferential control of one global regulator, i.e., metabolism of succinate and d-fructose is influenced by CyoB, and l-arginine is influenced by PtsN. Other pathways can be influenced by more than one global regulator; i.e., l-valine catabolism can be influenced by CyoB and Crp (cyclic AMP receptor protein) while phenylethylamine is affected by Crp, CyoB, and PtsN. These results emphasize the cross talk required in order to ensure proper growth and survival. With respect to N sources, DOT-T1E can use a wide variety of inorganic and organic nitrogen sources. As with the carbon sources, more than one global regulator affected growth with some nitrogen sources; for instance, growth with nucleotides, dipeptides, d-amino acids, and ethanolamine is influenced by Crp, CyoB, and PtsN. A surprising finding was that the Crp mutant was unable to flourish on ammonium. Results for assayed sulfur sources revealed that CyoB controls multiple points in methionine/cysteine catabolism while PtsN and Crc are needed for N-acetyl-l-cysteamine utilization. Growth of global regulator mutants was also influenced by stressors of different types (antibiotics, oxidative agents, and metals). Overall and in combination with results for growth in the presence of various stressors, these phenomics assays provide multifaceted insights into the complex decision-making process involved in nutrient supply, optimization, and survival.

Accuracy of early and delayed FDG PET-CT and of contrast-enhanced CT in the evaluation of lung nodules: a preliminary study on 30 patients.

PURPOSE: The aim of our prospective study was to compare the diagnostic accuracy of early, delayed and dual-time-point positron emission tomography (PET) acquisition with contrast enhanced computed tomography (CT) within a PET-CT examination in the evaluation of pulmonary solitary nodules (SPNs). MATERIALS AND METHODS: Thirty patients were enrolled in the study. All the patients underwent a dual-time-point PET-CT examination. Whole-body PET images were acquired at 50 min after fluorine18-fluorodeoxyglucose ((18)F-FDG) administration (early), followed by a chest acquisition (delayed). Lung nodules with maximum standardised uptake value SUVmax > or =2.5 were considered malignant. SUVmax was calculated on early and delayed images; SUV increasing > or =10% (Delta SUVmax) was considered suggestive of malignancy. Absence of significant lung nodule enhancement (<15 Delta HU) at CT was considered strongly predictive of benignity. For the CT morphological assessment, the irregularity of the shape of each lesion was rated. PET-CT results were related to histological assays and clinical records. Diagnostic accuracy was assessed by area under the receiveroperarting characteristic (ROC) curves analysis. RESULTS: Early and delayed SUVmax of malignant nodules were significantly higher than those of benign disease. Early SUVmax sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 77%, 91%, 79.5% and 66.7%; delayed SUVmax corresponding values were 77%, 66%, 74% and 66%; dual-time-point SUVmax values were 83%, 67%, 75% and 74%; DeltaHU values were 94%, 34%, 67%, 96%; CT morphologic evaluation values were 61%, 46%, 60%, 47%. Area under the curve (AUC) for early SUVmax was 0.79, for delayed SUVmax 0.80, for dual-time-point SUVmax 0.85, for DeltaHU 0.63 and for CT morphologic assessment 0.58. CONCLUSIONS: In our small series of patients, early and delayed SUVmax showed comparable accuracies, whereas morphological and contrast enhanced CT evaluations showed the lowest accuracies. Dual-time-point SUVmax showed the largest AUC. However, dual-time-point SUVmax was most sensitive, whereas single-time-point SUVmax was most specific.

[Ultrasound hysterosalpingography with levovist in the diagnosis of tubaric patency]. / Ecoisterosalpingografia con Levovist nella diagnosi di pervietà tuberica.

UNLABELLED: PURPOSE AIM: To asses the diagnostic value of hysterosalpingo-contrast sonography (HyCoSy) with Levovist(R) as alternative to conventional hysterosalpingography (HSG) in the study of infertility. MATERIAL AND METHODS: From September 1988 to March 2000 we evaluated 120 patients with a history of infertility. Thirty patients underwent both HyCoSy and HSG. HyCoSy was performed in the pre-ovulatory phase of mestrual cycle. The tecnique was the same for both examinations. After administering 15 ml contrast medium, we visualized the endometrial cavity, the flow of the contrast medium along the fallopian tubes and its passage into the peritoneum. RESULTS: In all cases Color-Power Doppler allowed visualization of the uterine cavity and of the spilling of the contrast medium into the peritoneum, yielding information on tube patency that was comparable to that obtained by conventional HSG. In 28 cases (93%) we obtained optimal visualization of the contrast medium at the level of both the endometrial cavity and the fallopian tubes. HyCoSy proved to be superior to conventional HSG in evaluating adjacent myometrial structures, adnexa and degree of follicular maturation, equal to HSG in visualizing the passage of the contrast medium into the peritoneum but inferior to HSG in imaging the fallopian tubes owing to their tortuosity. DISCUSSION AND CONCLUSIONS: The absence of ionising radiation makes HyCoSy a possible first choice examination in the evaluation of fallopian tube pathology. Conventional HSG should be kept for doubtful cases or for surgical procedures to correct mono- or bilateral obstruction.

Radioguided-surgery of early breast lesions.

BACKGROUND: Radioguided-surgery has been recently proposed in patients with clinically occult breast lesions. This study aimed to evaluate the feasibility of correctly locating and eradicating, by a single intralesional injection of a radiotracer, any breast lesion and, in the case of malignancy, to perform simultaneous sentinel lymph node (SLN) biopsy procedure. PATIENTS AND METHODS: Sixty-three women with early breast lesions were enrolled: 42 were invasive carcinomas, 16 in situ ductal carcinomas (DCIS) and 5 fibroadenomas. RESULTS: Scintigraphic images clearly identified the lesions in all patients while SLN/s were evident in 88% of them. At surgery all the breast lesions were easily radiolocalized and eradicated with minimum surgical trauma and, for those patients with invasive carcinomas, the SLN technique was performed in 86% of them. No skip metastases were found. CONCLUSION: A single intralesional administration of radiotracer is an easy and reliable procedure to simultaneously locate and remove both the non-palpable breast lesion and the SLN when primary malignancy was intraoperatively confirmed.

[Embolization of the uterine artery in the treatment of uterine myoma]. / Embolizzazione delle arterie uterine nel trattamento dei miomi dell'utero.

PURPOSE: To propose uterine myoma embolization as an alternative to myomectomy or hysterectomy in the treatment of symptomatic myomas; to evaluate the efficacy of the procedure in terms of clinical outcome, adopting all procedural and technical precautions to ensure minimal X-ray exposure and preserve reproductive potential. MATERIAL AND METHODS: Between April 1998 and February 2000, 26 patients, age range 32-54 years (mean 41 years), underwent uterine arterial embolization for menorrhagia, pelvic pain, and sensation of mass and pressure. Inclusion criteria were: single myomas, intramural localization and rich vascolarization of the lesion. Dose to patient was obtained by placing a thermoluminescent dosimeter (Harshaw, Solon, Ohio) both placed in posterior fornix of the vagina and on the skin at the beam entrance site. The procedure was performed under peridural anesthesia; polyvinil alcohol particles 355-500 mu (Contour) (Target Therapeutics, Boston Scientific Corporation, Fremont CA, USA) were employed as embolic agent. The uterine arteries were incannulated with a 5F (Glidecath, Terumo, Europe NV, Belgium) and successively 3F coaxial microcatheter (Target, Boston Scientific Corporation, Fremont CA, USA); the embolic material was injected as distally as possible. Color Power Doppler Ultrasound follow-up before and after i.v. contrast media administration (Levovist SHU 508 A, Shering, Berlin, Germany) was carried out at 15 days, at 1, at 3, at 6 months, and at 1 year from embolization. Pre-procedural evaluation and follow-up at 1 year was performed by MRI using T1 and T2 weighted images before and after Gadolinium (GdDTPA Shering, Berlin, Germany) administration. RESULTS: The technical success of the interventional procedure was 100% (26/26 cases). The mean fluoroscopy time was 20 minutes, and the mean number of angiographic exposures was 10. The mean estimated ovarian dose was 18.75 cGy and the mean adsorbed skin dose was 126.71 cGy. The imaging follow-up showed a 55% reduction of myoma volume at 6 months and a 75% reduction at 1 year. All patients reported a marked decrease in symptoms. No major complications were observed. The appearance of pelvic pain in the 24-48 hours after the procedure required sedation by analgesic pump; transitorial amenorrhea was observed in 3 patients. As for term complications, 2 patients have eliminated necrotic material through the vagina four weeks after procedure. The patients reported great satisfaction with the procedure. DISCUSSION: Many treatment options are currently available for symptomatic uterine myomas. One is surgical myomectomy which is associated with increased blood loss, pain and post operative morbidity and requires an additional surgical procedure for fibroma recurrence in 20-25% of patients. Another alternative treatment is hormonal therapy, which drammatically improves symptoms and reduces fibroid size although leiomyomas regrow to their original size within a few months of discontinuing treatment. Uterine embolization is a relatively new treatment for uterine fibroids that can be considered as an alternative to surgical and medical procedures. The radiation exposure adsorbed by the patient is reduced by using pulsed fluoroscopy and taking all the precautionary measures required to minimize the dose. CONCLUSIONS: The technical success, the patient' satisfation, the short hospitalization time and preservation of fertility confer to uterine artery embolization the role of a new alternative therapy for the treatment of symptomatic uterine myomas.

[Virtual laryngoscopy of neoplastic pharyngeal and laryngeal pathology]. / La laringoscopia virtuale nelle neoplastie faringo-laringee.

PURPOSE: This study investigated the feasibility and clinical value of high-resolution virtual laryngoscopy (VL) based on helical CT data sets. MATERIAL AND METHODS: Fifteen patients with neoplastic laryngeal pathology underwent helical CT examination performed with controlled breath. The CT data were downloaded to a workstation equipped with software for three-dimensional rendering (Silicon Graphics O2, Vitrea Visualization 1.2.8). Two radiologists using Fly Through software generated both antegrade and retrograde endoluminal virtual endoscopy navigations of the larynx. The results of the radiological study were compared with conventional endoscopy findings. RESULTS AND CONCLUSIONS: Virtual laryngoscopy provided the correct diagnosis in 13 of 15 cases. VL is capable of simulating the visual findings of endoscopy in cases of laryngeal tumors and subglottic stenosis. Small and plane tumors of the vocal chords are not adequately visualized. This technique appears to be useful both as biopsy guide during conventional laryngoscopy and as a correct pre-surgery staging, particularly in stenotic tumors.

[Use of SHU 508 A Levovist contrast media in the characterization of solid lesions of the breast]. / Impiego del mezzo di contrasto Levovist SHU 508 A nella caratterizzazione delle lesioni solide della mammella.

INTRODUCTION: We investigated the effectiveness of Levovist (SHU508A, Schering AG, Berlin, Germany) in the characterization of breast lesions. MATERIAL AND METHODS: June, 1996, to May, 1997, we studied 29 solid lesions in 29 patients (aged 17 to 83 years); our patients were 28 women and 1 man. The 29 solid lesions were 20 carcinomas (15 infiltrating ductal carcinomas, 4 ductal carcinomas in situ, 1 lobular carcinoma in situ), 6 fibroadenomas, 1 suspected postoperative recurrence and 2 apparently benign lesions. We used parameters suitable for the study of slow flows. A single bolus of contrast agent (300 mg/mL) was administered at 1-2 mL/s. Before Levovist injection, we studied the lesion signal intensity and the number of vascular poles. After contrast administration we re-evaluated both these parameters and studied the changes or presence of vessels undetected on the previous images. We also investigated the beginning and duration of enhancement and the presence of vessels inside and outside the lesions. RESULTS: We observed no signal enhancement in 17% of cases, mild enhancement in 7% and strong enhancement in 76% of cases. We found 3 more vascular poles (17%) in 5 lesions and 4 more poles in 3 lesions (10%). Increased vascularization was seen inside the lesion in 17% of cases, inside and outside it in 41% and only outside in 35% of cases. Carcinomas showed a rapid and long-lasting enhancement, while fibroadenomas showed a later and weaker enhancement. CONCLUSIONS: Levovist can be useful in the differential diagnosis of benign from malignant lesions, of recurrences from postoperative fibrosis, as well as in the staging and follow-up of the patients treated with neoadjuvant chemotherapy.

[Treatment of intrahepatic arteriovenous fistula after biopsy. Results in 5 chemoembolization candidates with hepatocarcinoma]. / Trattamento delle fistole artero venose intraepatiche post bioptiche. Risultati in 5 pazienti con epatocarcinoma candidati a chemioembolizzazione.

We report our experience in the treatment of post-bioptic intrahepatic arterioportal fistulas (HAPF) in 5 patients with hepatocellular carcinoma (HCC) treated February, 1993, to May, 1995. In this retrospective study, we reviewed the imaging findings and clinical records of 3 men and 2 women (age range: 49-71 years) with HCC previously diagnosed with US, CT and biopsy. HAPF was detected by angiography (DSA) performed before chemoembolization (TACE). All HAPFs were referrable to biopsy (14-gauge Thru-Cut needle) and were treated with platinum coils positioned through coaxial catheters. TACE was performed immediately after or within a week of HAPF embolization. Therapeutic response after TACE was assessed on the basis of clinical and CT findings, while HAPF embolization success was assessed on the basis of DSA and color Doppler US findings. Reembolization was required in two patients--7 maneuvers in all in 5 patients. Complete HAPF occlusion was demonstrated in 4 patients during color Doppler follow-up and immediately after and at 13 and 24 months (in 2 patients) at DSA. Two of 5 patients died, one because of liver failure after 15 months' follow-up and the other because of complications related to liver transplantation at 11 months' follow-up. Of the extant 3 patients, one underwent liver transplantation and was followed-up for 25 months, while the other two are alive after 24 and 13 months, respectively. Our experience demonstrates that HAPF embolization in HCC patients is really useful for hemodynamic redistribution before TACE and to avoid further HAPF progression.

[Use of endoprosthesis in the treatment of airway pathology]. / L'impiego di endoprotesi nel trattamento delle patologie delle vie aeree.

In patients affected by benign or malignant inoperable airway obstructions, therapeutical options include endoscopic treatment by Nd-YAG laser therapy, tracheobronchial dilatations with rigid or flexible bronchoscope, and inflating balloon dilators. Metal self-expanding or silicone stents allow to obtain stable results. Our experience is based on the use of 14 stents (10 Dumon and 4 Wallstent) in 13 cases of stenosis either due to vegetating malignant tumours not amenable to surgery or benign stenosis. In the following 24-48 hours both subjective and objective changes of the pulmonary function, blood gas analysis and radiologic aspects were observed. The results showed an improvement in the respiratory parameters and a sensible improvement in the quality of life.

[Study of prostatic carcinoma with ultrasonography and magnetic resonance with "dedicated" surface coil]. / Studio del carcinoma prostatico mediante ecografia e Risonanza Magnetica con bobina di superficie dedicata.

We investigated the role of an experimental surface coil for low field (0.2 T) MRI of prostatic gland carcinoma; the study was performed comparing MRI with US findings and with bioptic and pathologic results. To this purpose, 16 patients with prostatic cancer suspected at US and demonstrated with US-guided biopsy, were examined with low intensity field (0.2 T) MRI performed with a dedicated saddle-shaped coil and a body coil. This experimental surface coil with perineal application is used to study the prostatic gland with low field MR equipment where no transrectal probe is available. We analyzed the results of this study and found that, in all patients but one, the neoplastic lesions exhibited low signal intensity on T2-weighted images, while the normal gland was hyperintense. Six patients underwent radical prostatectomy and diagnostic imaging findings were correlated with pathologic findings obtained with whole mount specimens and serial histologic slides. The number of tumor foci, their site and size, and stromal reaction were studied on T2-weighted images; the typical low signal intensity was absent in one of 16 patients, in which case the microscopic exam of pathologic specimens showed extensive tumor spread with infiltration of perineural lymphatic vessels, with neither nodular patterns nor stromal reactions. The correlation between MR findings and the whole mount specimens (n = 6) demonstrated MR underestimation of tumor spread. In our opinion, this technique is useful for the detection and characterization of prostatic lesions, in spite of the presence of isointense lesions and the risk of underestimating the disease, especially to the prostatic capsule. To conclude, the dedicated surface coil can improve the diagnostic accuracy of low field MRI.

[Computerized tomography assessment of bone damage following injury of the anterior cruciate ligament]. / Valutazione con Tomografia Computerizzata del danno osseo conseguente a lesione del legamento crociato anteriore.

An ACL tear causes an anterior subluxation of the tibial bone which rotates with its fulcrum on the medial collateral ligament; consequently, the lateral femoral condyle impacts on the external tibial plateau. The presence of a subcortical lesion of the spongiform bone in the posterior external tibial plateau is an indirect sign of an ACL tear. On MR images, traumatic changes are depicted as changes in bone marrow signals. To assess the diagnostic capabilities of CT in demonstrating the bone lesion subsequent to ACL trauma, 23 patients with positive MR exams of the knee were submitted to CT. Fifteen patients had complete ACL tears, 8 had partial tears and 20 exhibited an occult fracture of the posterior portion of the external tibial plateau. This study pointed out a significant correlation between ACL tears and changes in the spongiform structure of the posterolateral tibial plateau. Such changes are depicted not only by MRI but also by CT: the latter method is also a valuable tool to study these conditions long after the traumatic event. No more than 5 slices, 1-1.5 mm thick, acquired at the tibial plateau allowed the trabecular structure and its abnormal changes to be studied without markedly lengthening examination time.

A double-blind comparative study of the safety and efficacy of iomeprol in renal intra-arterial digital subtraction angiography.

This randomised, double-blind, parallel group study was to compare the safety, tolerance and diagnostic efficacy of iomeprol and iopamidol, both at an iodine concentration of 150 mgI/ml, in 40 patients with arterial hypertension who required renal intra-arterial digital subtraction angiography (IA-DSA) for suspected renovascular stenosis. All patients underwent extensive pre- and post-contrast clinical, instrumental and laboratory controls for safety assessments. The tolerance to the test contrast media was evaluated in terms of discomfort associated with the injection of the test compounds. Image quality was prospectively graded by two independent readers according to a five-point scale as follows: 1, insufficient; 2, sufficient; 3, good; 4, excellent; E, excessive. The quality of vascular opacification in the region of interest was rated as diagnostic in 87.8% of radiographs obtained in the iomeprol group and in 84.5% in the iopamidol group, without significant differences between the two study groups. The results of angiography were always useful for subsequent patient management. The procedure was always well tolerated. There were no clinically significant changes in vital signs, ECG and laboratory parameters during the study in both groups. The results of our study show that iomeprol 150 mgI/ml, and iopamidol 150 mgI/ml are equally effective, well tolerated and safe contrast agents when used for IA-DSA.

[Magnetic resonance angiography in the study of neoplastic cerebral pathology]. / L'angiografia con Risonanza Magnetica nello studio della patologia neoplastica cerebrale.

To date, magnetic resonance angiography (MRA) has been used in neuroradiology mainly to study vascular malformations and atherosclerotic changes of the carotid bifurcation. Our study was aimed at investigating the role of MRA with the time-of-flight technique in the study of intracranial neoplasms; a superconductive 1.5 T magnet was used, and FLASH and FISP 2D and 3D pulse sequences were acquired before and after Gd-DTPA administration. Fifty-five MRA examinations were performed. Our series consists in 32 meningiomas, 14 glial tumors, 3 hypophysis adenomas, 2 metastases, 1 NF2, 2 craniopharyngiomas, 1 lymphoma and 1 rhinopharyngeal carcinoma with intracranial involvement. In 27 patients MRA results were compared with DSA findings. The results showed high agreement relative to indirect angiographic patterns (dislocations, encasement, dural sinuses involvement) and poor accuracy in the demonstration of tumor vascularization (inflow and outflow, vascular neoformation).

[Interventional radiology in the treatment of acute and chronic mesenteric ischemia]. / La radiologia interventistica nel trattamento dell'ischemia mesenterica acuta e cronica.

Radiologic revascularization procedures--i.e., percutaneous transluminal angioplasty (PTA) and fibrinolysis--are a valuable alternative to surgery in the treatment of stenoses and occlusions of the visceral vessels, that is the celiac tripod and the superior and inferior mesenteric arteries. We treated 32 patients, 10 of them with acute mesenteric ischemia and 22 with chronic mesenteric ischemia and clinical signs of angina abdominis. Grüntzig or pre-shaped Cobra or Simmons balloons were employed (diameter: 5-7 mm, with variable length) when PTA was performed. Urokinase or rtPA was employed for fibrinolysis. In 3 cases acute mesenteric ischemia was not occlusive and could be successfully treated with papaverine infusion. In 7 cases, acute mesenteric ischemia was occlusive: in 5 of these patients it was successfully treated by PTA and/or fibrinolysis. Our results were positive in 80% of the cases, with remission of clinical signs in 4 of 5 patients treated for acute mesenteric ischemia. In 22 patients with chronic mesenteric ischemia, 26 stenotic occlusions were observed at angiography and 22 were treated with PTA, which was technically successful in 21 instances (early success rate: 85-95%). At 24 months, 10% of restenosis was observed. In our experience, PTA of the visceral district, possibly preceded by loco-regional infusion of fibrinolytic drugs, can be widely applied and yields excellent therapeutic results.