Sidney Glanz

The role of percutaneous angioplasty in the management of chronic hemodialysis fistulas.

One hundred forty-one dilatations of stenotic lesions in dialysis access fistulas were performed. The initial success rate was 82%. The one-year patency rate was 45%, with a 2-year patency rate of 24%. Best results were obtained with a discrete stenosis at a graft-to-vein anastomosis. The procedure can be done on an outpatient basis and, although long-term results are poor, in appropriate patients multiple dilatations can be performed to keep a fistula functioning for many years.

Interventional radiology in the management of hepatic trauma.

Interventional radiology (catheter placement under radiologic guidance) is a safe and effective technique in the management of hemorrhage and infection after hepatic trauma. Twenty procedures in 17 patients were reviewed. All patients with hemorrhage, vascular lesions, and intra-abdominal fluid collections were successfully treated without mortality or substantial morbidity. These techniques are recommended in complicated liver trauma.

Percutaneous coil embolization in the management of peripheral mycotic aneurysms

Traditional surgical treatment of a peripheral mycotic aneurysm has included emergency ligation and bypass. Occlusion of vessels just proximal and distal to a mycotic aneurysm can be safely accomplished via percutaneous embolization with coils. Surgery can be performed electively in a noninfected field. Coils can be placed near the site of vessel disruption minimizing loss of collateral flow.

Interventional radiologic procedures in the management of the renal transplant patient

Interventional radiologic procedures have become an important adjunct to the management of the renal transplant patient. Numerous problems can be dealt with, and in our experience these have included the diagnosis and treatment of ureteric obstruction, dilatation of renal artery stenoses, drainage of abscesses, hematomas and lymphoceles, management of complications of pancreatitis and treatment of bleeding due to fistulas and pseudoaneurysms.

CT demonstration of giant choledochal cysts in adults.

The initial diagnosis for three adult patients with giant choledochal cysts was confused because of the enormous size of the cysts. Jaundice in association with marked upper gastrointestinal displacement was the dominant feature in two of our cases. Intrahepatic ductal dilatation is common when choledochal cysts present in the adult. The malignant potential of choledochal cysts is discussed.

Unusual manifestations of aortic dissection

Two unusual manifestations of aortic dissection, rupture into the main pulmonary artery and rupture into the inferior vena cava, are presented. The latter complication has not been reported previously in the literature. The value of inferior vena caval oximetry to delineate the site of fistulous communication is stressed.

Computed Tomography and Angiography in the Cruveilhier-Baumgarten Syndrome

Abstract: The Cruveilhier-Baumgarten syndrome is a rare clinical entity that can be confirmed by angiography. Computed tomography can provide an alternative, noninvasive method of diagnosis as well as supply information relevant to the patients portal hypertension.

Anomalous origin of the right coronary artery from the pulmonary artery

Anomalous origin of the right coronary artery from the pulmonary artery was diagnosed by selective left coronary artery angiography in an asymptomatic five-year-old boy with a continuous murmur. The anomalous coronary artery, along with a cuff of the pulmonary artery, was re-implanted into the aorta. The patient is asymptomatic five years postoperatively.

Strategies for the radiologic management of genitourinary trauma

The imaging evaluation of the patient with genitourinary injuries must be tailored to provide accurate and clinically relevant data that can be used to make treatment decisions. This radiologic evaluation should consider the patient’s hemodynamic status, the mechanism of injury, and the possible associated injuries.

Right aortic arch with left descent.

A right aortic arch may descend either to the right or left of the spine. When the aorta crosses from right to left posterior to the esophagus, the findings on plain chest film and barium swallow studies may simulate those of a mediastinal mass, especially in older patients. Although aortography is definitive, computed tomography can accurately display the retroesophageal aorta, allowing rapid and hazard free diagnosis.