Mechanical Thrombectomy Using the Solitaire FR system for Occlusion of the Top of the Basilar Artery: Intentional Detachment of the Device after Partial Retrieval.

Acute, distal, basilar artery occlusion is a challenging neurovascular emergency. There have been several reports regarding the successful application of the Solitaire FR device for treating this lesion. However, due to the lack of a suitable, balloon-tipped, guiding catheter for the vertebral artery, during this procedure we frequently experience the occurrence of clot fragmentation and distal migration. There may be some technical solutions to solve this problem. The purpose of this report is to present a technical variation of using the Solitaire FR, and which is referred to as the 'intentional device detachment technique.' As a clot tends to re-embolize during its passage through the tortuous cranio-cervical junction level of the vertebral artery or its passage through the tip of the guiding catheter, due to the lack of proximal flow arrest, we thought that not removing the stent segment of the device which is capturing the clot could avoid this problem. We were able to successfully apply this technique in two cases. We believe that this technique can be a possible technical option for using the Solitaire FR device when a patient has little concern regarding the subsequent use of antiplatelets.

Medications as causes of intraluminal hyperdensities: what radiologists need to know.

In computed tomography (CT) angiogram or some dedicated CT studies of the abdomen, the use of positive enteric contrast should be avoided as its presence could decrease the sensitivity of the test. There are, however, cases of CT scans with unexpected hyperdense intraluminal contents detected due to the use of certain oral or rectal medications. Reports on medications as causes of intraluminal hyperdensities are sparse in the English literature. We have studied several commonly used medications and revealed that many drugs appear hyperdense in CT scans. The presence of unexpected intraluminal hyperdensities can potentially cause erroneous interpretation of images and in some cases decrease the sensitivity of the test. The hyperdense bowel contents may be mistaken as acute hemorrhage in CT angiogram for detection of GI bleeding. Active GI bleeding, presented as intraluminal extravasation of contrast material, can also be obscured. Certain intra-abdominal pathologies could be masked, for example, in plain CT scan for detection of urinary tract stones or in contrast CT study for suspected bowel ischaemia. It is important for radiologists and clinicians to be aware of this situation in order to prevent misinterpretation of images and to select the most appropriate imaging modality when such unexpected intraluminal hyperdensities are encountered.

US findings of melamine-related renal disorders in Hong Kong children.

BACKGROUND: The melamine-tainted milk incident has caused renal disorders in more than 290,000 children from mainland China since the start of the outbreak in 2008. Since then, more than 27,000 children in Hong Kong have undergone renal US screening. OBJECTIVE: To present and discuss the US features of melamine-related renal abnormalities in Hong Kong children. MATERIALS AND METHODS: Between September 2008 and February 2009, 3,835 children attended the Department of Radiology of Princess Margaret Hospital for renal US examination. CT or plain abdominal radiography was performed in those with inconclusive findings. The US findings of detected melamine-related renal disorders were analysed. RESULTS: Echogenic foci in the kidneys were found in 22 children (0.6%). These were located in the renal pelvicalyceal system (in 12 children) and in the renal medulla (in 10 children). The echogenic foci measured 0.1-0.7 cm, with 6 children showing posterior acoustic shadowing, 14 showing comet-tail artefacts, and 2 showing echogenic dots. CONCLUSION: The incidence of renal disorders amongst Hong Kong children exposed to melamine was lower than in their mainland China counterparts. The renal stones detected were also relatively small, with most demonstrating comet-tail artefacts instead of posterior acoustic shadowing.