Arteriographic embolization of visceral artery pseudoaneurysms.

The purpose of this study was to determine the safety and efficacy of transcatheter embolization in the management of bleeding visceral artery pseudoaneurysms. Eight patients (four women and four men) whose mean age was 61.0 years (range 44 to 77 years) underwent emergency transcatheter embolization for acute hemorrhage from a visceral artery pseudoaneurysm. Arteriographic technique was used to localize and selectively embolize these seven visceral artery pseudoaneurysms (three inferior pancreaticoduodenal, one gastroduodenal, two hepatic, and one splenic) by means of intravascular steel coils. Arteriography demonstrated visceral artery pseudoaneurysms in all eight patients. Acute hemorrhage was documented by endoscopy, falling hematocrit levels, CT scans, and arteriography. Successful embolization of these visceral artery pseudoaneurysms was achieved in seven (88%) of eight patients. In one patient embolization was not attempted because of a worsening clinical status, and this patient subsequently underwent emergency surgical resection. There was no significant morbidity associated with the procedures and seven patients remain asymptomatic with no further bleeding at a mean follow-up of 21.1 months (range 11 to 46 months). Arteriographic embolization of visceral artery pseudoaneurysms is a safe and highly successful technique for the effective identification and treatment of hemorrhage even in critically ill patients.

Glomerular and tubular alpha 1- and alpha 2-adrenoceptors in the rat kidney: distribution in basolateral and brush border membranes of tubular cells.

Rat kidney glomeruli and cortical tubules were obtained by a combination of sieving and differential centrifugation technique. [3H]Prazosin and [3H]rauwolscine were used to identify and quantify the alpha 1- and alpha 2-adrenergic receptors, respectively. In the glomeruli, the alpha 1-adrenoceptor concentration was 27% and alpha 2-adrenoceptor concentration was 33% of the corresponding values in the tubules. Further localization of the tubular alpha-adrenoceptors was undertaken by studies in the isolated basolateral membrane and comparison with values in the crude plasma membrane. alpha 1-Adrenoceptors were enriched 1.54 +/- 0.1 times and alpha 2-adrenoceptors were enriched 1.73 +/- 0.04 times in the basolateral membrane as compared to crude plasma membrane. However, these values were significantly (p less than 0.05) less than the enrichment value of 2.77 +/- 0.3 obtained for the basolateral membrane marker (Na+ + K+)-ATPase. These results suggested the possibility that alpha 1- and alpha 2-adrenoceptors may also be distributed in the brush border membrane. Direct-binding studies in the purified renal brush border membrane indicated alpha 1-adrenoceptor concentration of 82.1 +/- 3.8 and alpha 2-adrenoceptor concentration of 108.2 +/- 9.3 fmol/mg protein. These values were 32 and 17% of the corresponding values in the basolateral membrane. Overall, our results suggest that alpha 1- and alpha 2-adrenoceptors are present both in the basolateral and brush border membranes analogous to what has been reported for angiotensin and insulin receptors; their primary concentration, however, is in the basolateral membranes.