ABSTRACT
Transvenous embolization has gained wide acceptance as a primary therapeutic technique in the management of varicocele. In most cases incompetence of the internal spermatic vein is the main cause of the disorder. In 18 of 165 patients treated with embolization, venography demonstrated competence of the internal spermatic vein; the varicocele was due to incompetence of some other anastomotic connection to the vein or the pampiniform plexus. The finding of valvular competence during embolization in a patient with clinical or ultrasonographic evidence of varicocele should not lead to termination of the procedure; instead, a concerted effort should be made to cross the valve to allow therapeutic embolization.
Subject(s)
Embolization, Therapeutic , Varicocele/therapy , Adolescent , Adult , Humans , Male , Middle Aged , Phlebography , Ultrasonography , Varicocele/diagnostic imagingABSTRACT
Significant venous bleeding after nephrolithotomy is a relatively frequent and well-described complication. The authors report a case of renal vein perforation and its management through combined flank and groin access to the site of bleeding.
Subject(s)
Hemostasis, Surgical/methods , Intraoperative Complications/therapy , Kidney Calculi/surgery , Renal Veins/injuries , Female , Humans , Middle Aged , Tampons, Surgical , Wounds and Injuries/complicationsABSTRACT
Between 1982 and 1986 intravenous digital subtraction arteriography was used to evaluate vascular grafts in 97 patients (54 males, 43 females). Indications included recurrent symptoms, absent or diminished pulses, a drop in Doppler pressure measurements, and clinical uncertainty with respect to graft patency. Problems identified included graft stenosis, stenosis of the anastomosis or its distal vessels, false aneurysm, arteriovenous fistula and emboli. Forty-eight operations were carried out following intravenous digital subtraction arteriography, and radiographic findings were verified surgically. Twice, intravenous digital subtraction arteriography did not show significant graft findings which were discovered at surgery. Thus intravenous digital subtraction arteriography showed a sensitivity of 95.8% and specificity of 100%. Complications following intravenous digital subtraction arteriography were: two patients developed urticaria, and one superficial thrombophlebitis. There were no cases of pulmonary edema or death. In conclusion intravenous digital subtraction arteriography is very useful in the diagnosis of graft-related problems if done on a selective basis looking at graft and anastomosis site only. Intravenous digital subtraction arteriography is done on an outpatient basis, has high sensitivity and specificity, good patient acceptance, is safe, fast and is less expensive than conventional arteriography.
Subject(s)
Angiography, Digital Subtraction , Graft Occlusion, Vascular/diagnostic imaging , Adult , Aged , Aged, 80 and over , Angiography, Digital Subtraction/adverse effects , Female , Humans , Male , Middle Aged , Sensitivity and SpecificitySubject(s)
Aorta, Abdominal/diagnostic imaging , Aortic Aneurysm/chemically induced , Contrast Media/adverse effects , Aged , Aortic Aneurysm/surgery , Aortic Rupture , Contrast Media/administration & dosage , Gastrointestinal Hemorrhage/etiology , Humans , Male , Mesenteric Arteries/diagnostic imaging , RadiographyABSTRACT
Intracranial epidermoids are uncommon benign tumors in the subarachnoid spaces. We have studied two patients with these tumors originating in the basal cisterns using magnetic resonance (MR) imaging, computed tomography (CT), and cerebral angiography. Both CT and MR showed the extraaxial position of these tumors and their extension into the posterior fossa well. Angiography did not show any abnormal vasculature but displacement of vessels by the tumor mass was well demonstrated. MR was found to be relatively specific in characterizing these tumors.
