[Renal tumor embolization]. / Nierentumorembolisation.

We present an update on the technical aspects and clinical efficacy of the concept of capillary embolization for the treatment of renal cell carcinoma. In preoperative indications, it is shown that only this type of occlusion can safely achieve a reliable breakdown of the peritumor vasculature to meet the surgical requirements for excision of huge tumors associated with abundant retroperitoneal tributaries. In particular, in tumors infiltrating the renal vein and the vena cava, capillary embolization proved to be extremely helpful. In palliative embolization the concept achieved local and clinical efficacy comparable to nephrectomy when applied in patients free of metastatic disease. In palliative embolization of patients with metastatic disease, no change in the natural history was found. A new but still experimental concept is the combination of chemoperfusion and chemoembolization for tumor nodules in a solitary kidney and for reoccurring retroperitoneal tumors. The application of a coaxial system that features perfect maneuverability enables tumor treatment on the level of subsegmental vessels. The first short-term results seem to be promising. If definite proof of the validity of such a concept is to be obtained, however, further long-term research needs to be conducted on larger numbers of patients.

Percutaneous placement of a balloon-expandable intraluminal graft for life-threatening subclavian arterial hemorrhage.

A balloon-expandable intraluminal graft was percutaneously deployed in the left subclavian artery of a 43-year-old woman. This graft was made of a stainless steel, 30-mm Palmaz balloon-expandable iliac stent completely covered with a thin coat of silicone. The procedure was successful in managing and preventing life-threatening hemorrhage as a large-bore catheter was removed from the subclavian artery via its subcutaneous tunnel. Surgical repair of the high brachial-axillary sheath insertion site was required after percutaneous deployment of the graft. However, the grafting procedure succeeded in obviating a thoracotomy. At follow-up of 6 months, despite diminution in brachial pulse volume recordings, the patient is asymptomatic at rest. She experiences mild fatigue with extremes of upper extremity exercise and declines angiographic follow-up and further intervention.

[Examinations to cAMP-levels in plasma (author's transl)]. / Untersuchungen zur Frage einer cAMP-Rhythmik im Plasma.

Plasma cAMP levels were measured by a competetive protein binding method in nine healthy volunteers every 30 minutes over a period of 24 hours under standardized conditions. No circadian variation was observed. Upright posture after 32 hours bedrest increased cAMP significantly.