Victor Goncharenko

Gastric varices secondary to splenic vein occlusion: radiographic diagnosis and clinical significance.

The radiographic appearance and clinical significance of gastric varices in the absence of esophageal varices and secondary to splenic vein occlusion were studied. Eighteen patients were evaluated through medical records, angiography, and barium studies of the stomach and esophagus. The presence of splenic vein occlusion was determined by arteriography in 18 patients and its etiology confirmed by surgery in 17 patients. This condition should be suspected in patients with chronic abdominal pain, weight loss, and iron deficiency anemia who show fundal polypoid filling defects or prominent gastric folds on an upper GI series.

Radiation-Induced Stenosis of the Renal Artery Causing Hypertension: Case Report

A case is presented of renal artery stenosis causing renin-dependent hypertension 11 1/2 years after irradiation for Wilms tumor. The literature was reviewed briefly for other cases of large artery damage after irradiation therapy.

Angiography of intimal and intramural arterial injuries.

Fifteen patients with injuries disrupting the tunica intima and media are reviewed and 5 cases demonstrating the typical angiographic appearance of these injuries described. In all 15, the tunica adventitia remained intact and pulses were present on the initial physical examination. Injuries described include subintimal hemorrhages with and without an associated tear of the intima and a complete tear of both the tunica intima and media with the tunica adventitia intact. The authors conclude that angiography is the best preoperative diagnostic procedure for these injuries; it should be used whenever the trauma involves a site near a major vessel.

Angiographic findings following surgical treatment for renovascular hypertension.

The authors present the postoperative angiographic appearance of the revascularized renal artery in 128 patients. The angiographic findings in four types of surgical procedures (saphenous bypass graft, dacron graft, endarterectomy, and reimplantation of the renal artery) are discussed. Postoperative angiography accurately demonstrates graft patency or occlusion.

Right Posterior Oblique: The Projection of Choice in Aortography of Hypertensive Patients

The right posterior oblique (RPO) is the most helpful aortographic projection for demonstrating the origins of the renal arteries. In 59% of the 692 hypertensive patients studied, the origins of both renal arteries were seen in this projection. The second most helpful aortographic projection was the anteroposterior (AP) view, which showed the origins of the renal arteries in 22.6% of these patients. The remaining 18.4% of the patients required both the AP and RPO projections in order to show the origins of both renal arteries.

The epinephrine effect in renal angiography revisited

The effect of various doses of epinephrine on the renal vessels was studied angiographically in 15 kidneys including three renal tumours. Commonly used doses (10--25 microgram) are often too high as demonstrated in this study. Our findings indicate that the optimal dose for pharmacoangiography of renal masses should be 2--5 microgram of epinephrine. The time interval between drug administration and angiography should be less than 1 min and optimally in the range of 10--30s.

Evaluation of the Dorsalis Pedis Free Flap Donor Site by Angiography

Six patients were evaluated by angiography for dorsalis pedis free flap transfer because the course of the dorsalis pedis artery could not be traced by palpation. Two were subsequently excluded because they showed vascular occlusions. Successful transfer depends on the dorsalis pedis artery and its branches being intact, while healing of the donor site depends on the function of the posterior tibial artery. Angiography was found to be helpful in determining both of these factors.

Renal Venographic Findings in 29 Kidneys with Fibromuscular Dysplasia of the Renal Artery

Renal venography was performed in 21 hypertensive patients, all of whom had the classical appearance of fibromuscular dysplasia of the renal arteries. None showed any evidence of fibromuscular dysplasia of the renal veins.

Percutaneous transluminal angioplasty of the iliac artery

Stenosis in the right common iliac artery of a 61-year-old man was manifested as pain in the right leg and foot and cyanosis of the second and third toes. Dilatation of the lesion was performed using a Grüntzig catheter; arteriography and measurement of femoral artery pressure confirmed a successful result. The patient was pain free at six-month follow-up. Dilatation of stenoses by percutaneous transluminal angioplasty provides an alternative to conventional operative procedures, with lower cost and morbidity plus an acceptable success rate.