Image guided preoperative abdominal wall botox injection for large ventral hernia repair: A case series.

This case series aims to explore the application of preoperative CT guided Botox injections in three different cases of abdominal wall reconstructions. Each of the three cases highlights the role of chemical component separation in achieving myofascial release and contributing to a successful surgical repair. The use of Botox in the preoperative planning of abdominal wall repair aims at creating a tension-free environment for midline closure and promoting an overall positive postoperative course for the patient. This case series presents as a valuable contribution to the different surgical approaches in abdominal wall reconstruction and the collaboration between Interventional Radiology and Surgery in treating such patients.

Acute presentation of renal pseudoaneurysms in a patient with systemic lupus erythematosus after percutaneous renal biopsy.

The development of renal pseudoaneurysms following percutaneous kidney biopsy is a rare but potentially dangerous complication due to the risk of rupture with subsequent hemorrhage. We describe a female patient in her 20s with long-standing lupus nephritis who presented to the hospital for elective CT-guided left renal biopsy that was complicated by pseudoaneurysms in the bilateral kidneys. Post-biopsy, she developed a perinephric hematoma that extended to the upper pelvis with resultant superior displacement and diminished blood flow to the left kidney. Successful endovascular coil embolization was performed after left renal artery angiography confirmed contrast extravasation in one of the branches that supplied the inferior pole of the left kidney. Despite the embolization, her hemoglobin continued to decline, and a subsequent CT-scan demonstrated a persistent loculated hyperdense fluid collection in the beforementioned area. Repeat angiography revealed multiple left renal pseudoaneurysms and a single pseudoaneurysm in the upper pole of the right kidney, neither of which were previously visualized. The acute development of pseudoaneurysms due to accidental or non-accidental trauma is a well-established entity. Here we present a patient that acutely developed numerous arterial pseudoaneurysms after renal biopsy and has never been reported in the literature. Special caution should be undertaken in the case of high-risk patients predisposed to these pseudoaneurysms.

Embolization of Renal Cell Carcinoma Skeletal Metastases Preceding Orthopedic Surgery.

Renal cell carcinoma (RCC) is the most common type of renal malignancy in adults. Bone is a major site of metastatic disease from RCC. Osseous metastatic disease from RCC is often seen in the spine, pelvis, and femur, and is usually hypervascular in nature like its primary tumor source. This can cause significant pain, reduced function, pathological fracture, nerve compression, and decreased quality of life during cancer treatment and disease course. Surgical treatments for pathological fracture of the femur include resection, reconstruction, and stabilization with arthroplasty or placement of an intramedullary nail. This series looks at three cases of renal cell carcinoma metastases to the hip with pre-procedural embolization and orthopedic stabilization. Interventional radiology embolization of the arterial supply to the metastatic hypervascular bone lesions can reduce intraoperative blood loss and associated complications.