Steven S. Morse

Congenital absence of the portal vein in oculoauriculovertebral dysplasia (Goldenhar syndrome)

Absence of the portal vein with systemic visceral venous return was demonstrated in an 8-year old girl with oculoauriculovertebral dysplasia (Goldenhar syndrome) during preoperative evaluation of a liver mass. Congenital absence of the portal vein is a rare malformation of potential clinical significance.

Acute dissection originating in the abdominal aorta

A primary abdominal aortic dissection was encountered in a 53-year-old hypertensive man who was admitted with a 2-week history of back pain. Treatment with an infrarenal aortic bifurcation graft complemented by reconstruction of the proximal aortic cuff was curative.

Detection of neovascular signals in a 3 day walker 256 rat carcinoma by CW doppler ultrasound

An animal model was used to study tumor blood flow by the Doppler CW technique. The objective was to determine when neovascularity could be detected as a function of tumor size and time since transplantation. A Walker 256 carcinosarcoma tumor was inoculated into the flank of 17 Sprague-Dawley rats. Doppler examinations, using a 9 MHz CW probe, were performed daily from day 0 to day 7. The contralateral flank was used as a control. No signals were detected from the control side nor from the inoculated side until day 3. By day 3, Doppler signals could be easily detected in all tumor implants with a minimum weight of only 50 mg. These signals showed a mean systolic frequency shift of 3.3 +/- 0.47 kHz at 3 days and 3.46 +/- 0.58 kHz at 7 days. The diastolic Doppler shifted frequency was 1.78 +/- 0.31 kHz at 3 days and 1.88 +/- 0.23 kHz at 7 days giving a Pourcelot index of 0.47 +/- 0.1 at 3 days and 0.46 +/- 0.09 at day 7. These figures indicate the presence of low impedance vessels with high velocity flow such as has been reported in many human tumors. The vascular morphology was further evaluated by digital angiography which demonstrated coincidence between the site of the high velocity Doppler signals and the presence of arteriovenous anastomoses manifested by simultaneous arterial and venous filling. Further infusion techniques using India ink or Microfil showed the chaotic arrangement of tumor vessels located around the growing edge of the tumor implant. The development of such vascularity is a well-recognized prerequisite for tumor growth and invasion.(ABSTRACT TRUNCATED AT 250 WORDS)

Transluminal angioplasty of the hypogastric artery for treatment of buttock claudication

Two patients with incapacitating isolated buttock claudication and bilateral hypogastric artery occlusive disease were treated by balloon dilatation of a single hypogastric artery. Symptoms were eliminated in 1 patient and reduced in the other. Percutaneous transluminal angioplasty represents an effective therapeutic approach in this relatively uncommon situation.

Postbiopsy renal allograft arteriovenous fistula: Therapeutic embolization

Two patients with large, postbiopsy renal allograft arteriovenous fistulae are presented. One patient also had a renal artery anastomotic stenosis. Prominent clinical features in these cases were deterioration of allograft function and severe hypertension. Following therapeutic embolization, combined with balloon angioplasty in the second patient, there was marked improvement in allograft function and a return to normal blood pressure.

Peptic erosion of the cystic artery with massive duodenal hemorrhage: Therapeutic embolization

Two patients with massive upper gastrointestinal hemorrhage due to duodenal ulceration underwent visceral angiography. In both cases there was extravasation of contrast from the cystic artery directly into the duodenal lumen. Selective transcatheter embolization of the right hepatic artery was performed in each patient, and in both cases, hemorrhage was controlled. Transcatheter embolization is introduced as an effective therapeutic measure in this unusual entity.

Liver transplant rejection arteritis: Serial hepatic arteriography

Two liver transplant recipients underwent serial hepatic arteriography, demonstrating a severe, rapidly progressive arteritis involving the hilar hepatic arteries. Liver biopsies in these patients demonstrated ischemic necrosis as a prominent feature. The angiographic appearance and therapeutic implications of liver transplant rejection arteritis are presented.