Guillermo Velasquez

Phaeochromocytoma and cardiomyopathy

Phaeochromocytoma is a rare endocrine tumour. There are several reports dealing with isolated complications due to the systemic effects of its metabolites. We would like to report a patient seen at our institution with a right adrenal phaeochromocytoma who had many associated complications: cardiomyopathy with congestive heart failure, intracavitary left ventricular thrombus, invasion of the inferior vena cava and peripheral vascular embolus. A discussion of the findings and review of the literature is presented stressing the fact that cardiomyopathy may be the initial presentation in these patients, a situation not reported in the radiological literature. A 23-year-old man was admitted to the hospital with a history of fever, chills, night sweats, anorexia, arthralgias and a 10 lb weight loss over a period of two weeks. He also had right pleuritic pain, a productive cough and occasional haemoptysis. He had a history of gastrectomy at the age of 13 for peptic ulcer disease, and crossed fused ectopia with ...

Therapeutic Embolization of Facial Arteriovenous Fistulae

Two cases of percutaneous transfemoral embolization of facial hemangiomas and arteriovenous (AV) malformations are reported. In both cases, Ivalon shavings were injected through a percutaneously placed catheter to permanently occlude peripheral feeders of the AV malformation. In one case, because of the size of the large venous sacs associated with the malformation, a steel coil was introduced to form a baffle, over which several additional strands of surgical silk were introduced to obliterate these sacs. These cases emphasize the need for embolization of small feeding arteries to prevent recurrence by collateral channels. To achieve this, specific-sized emboli are necessary; Ivalon is a suitable embolic material.

Aberrant left subclavian artery in tetralogy of Fallot

The anatomy of the aberrant left subclavian artery in a right-sided aortic arch is different in patients with tetralogy of Fallot than in persons with a normal heart. In all eight patients with tetralogy of Fallot and aberrant left subclavian artery in this series, the left subclavian artery arose directly from the distal aortic arch. In contrast, normal persons with right aortic arch and aberrant left subclavian artery invariably have an aortic diverticulum from which the left subclavian artery and the left ductus arteriosus originate. The possible different embryologic events responsible for these two forms of aberrant left subclavian artery are discussed.

Mirror-image right aortic arch: A proposed mechanism in symptomatic vascular ring

We describe a rare case of right aortic arch with mirror-image branching and a left ductus arteriosus that form an anomalous vascular ring. The unusual feature of this symptomatic vascular ring is presence of a left (posterior) circumflex descending aorta in lieu of an aortic diverticulum which usually represents the posterior element of the vascular ring associated with right aortic arch and mirror-image branching. This we believe is the seventh reported case of Type 1 right aortic arch and only the third such case with a left circumflex descending aorta. Accurate diagnosis was made by barium esophagogram and angiocardiogram and was confirmed surgically. We propose a new theory as to why some vascular rings formed by the right aortic arch are symptomatic while others are not.

Nonsurgical treatment of childhood hypertension: Embolization of an intrarenal aneurysm

Renal artery aneurysms are an unusual cause of renovascular hypertension in children. When present in an intrarenal location, they pose a difficult surgical problem and transcatheter embolization may represent an effective alternative treatment.

Calcified thrombus of the inferior vena cava in transposition of the great vessels

Calcified thrombus of the inferior vena cava (IVC) in children is an entity usually not associated with significant complications. The possibility of pulmonary embolism from the soft thrombus, however, has been suggested but never reported. We give an account of a child with transposition of the great vessels who suffered embolization from a calcified thrombus in the IVC that entered the systemic circulation.

The value of abdominal angiography in Turner's syndrome: A case report

In patients with Turners syndrome, there is a relatively high incidence of gastrointestinal bleeding due to telangiectasias of the intestine. Despite the importance of preoperative diagnosis of the lesion in planning surgical treatment, the related angiographic findings have never been reported. We have studied one patient in whom the diagnosis was established by preoperative angiography.