BACKGROUND: Subintimal angioplasty may be more successful than conventional (intraluminal) angioplasty for treatment of long femoropopliteal occlusions. This study assessed the clinical and haemodynamic outcome of subintimal angioplasty. METHODS: All patients with femoropopliteal occlusions treated by subintimal angioplasty over a 3-year period at two centres were reviewed. Clinical assessment and colour duplex imaging were carried out. RESULTS: Sixty-nine procedures were performed in 33 men and 33 women of median age 74 (range 47-92) years. Indications for treatment were intermittent claudication in 26 (38 per cent) and critical limb ischaemia in 43 (62 per cent). Median occlusion length was 10 (range 2-50) cm. Primary technical success was achieved in 51 occlusions (74 per cent). There were 11 complications (16 per cent); the majority were minor but surgical intervention was required in two patients (3 per cent). At 6 months the cumulative symptomatic and haemodynamic primary patency rates were 60 and 51 per cent respectively, analysed on an intention-to-treat basis. The symptomatic and haemodynamic patency rates for technically successful procedures were 80 and 77 per cent respectively. CONCLUSION: In this series the short-term clinical success of subintimal angioplasty was poor because of a high incidence of reocclusion and restenosis, despite a relatively high initial technical success rate.

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PubMed1999

Ultrasound guided percutaneous thrombin injection for the treatment of iatrogenic pseudoaneurysms.

Iatrogenic aneurysms are usually postcatheterisation pseudoaneurysms of the femoral artery. Until recently, the treatment of choice was ultrasound guided compression repair. A case of pseudoaneurysm of the axillary artery, arising as a complication of pacemaker insertion in an 83 year old man is reported. Compression repair was not possible in this case, and so the aneurysm was occluded by percutaneous ultrasound guided thrombin injection directly into the aneurysm sac. Percutaneous ultrasound guided thrombin injection is a promising new minimally invasive technique for the treatment of iatrogenic pseudoaneurysms.

Aged↗

PubMed1997

Obstructive uropathy caused by massive pelvic haematoma: a report of two cases.

Explore the source record for details and available documents.

Adult↗

PubMed1995

Variations in the radiological management of intussusception: results of a postal survey.

A survey of the radiological reduction of intussusception in a selection of British hospitals was performed using a questionnaire. Replies were received from radiologists working in 51 district general hospitals and 25 teaching hospitals or specialist paediatric institutions. Most district general hospitals still use barium as the sole method of reduction of intussusception. Most teaching hospitals and specialist paediatric units have changed to a pneumatic method. The contra-indications, details of patient preparation and technical details of each method varied considerably.

Air Pressure↗

PubMed1993

A modified papaverine test and the use of venous constriction in erectile dysfunction.

A simple technique employing a penoscrotal tourniquet in the investigation and management of impotence due to venous leakage is described. Fifteen patients were investigated using a constriction band and intracorporeal injection of papaverine. Colour doppler ultrasound studies demonstrated that the tourniquet abolished venous leakage in 11 cases and there was a close correlation between clinical and ultrasonographic findings. Most of the patients with venogenic impotence found the device to be of therapeutic benefit. The technique is simple and provides reliable clinical information about the likely cause of erectile failure and is an effective and acceptable aid to treatment in correctly selected cases.

Adult↗

PubMedDate not supplied

Endovascular embolization of varicoceles: resorption of tungsten coils in the spermatic vein.

PURPOSE: To investigate whether resorption of tungsten coils occurs in patients with varicoceles treated by endovascular embolization of the spermatic vein. METHODS: Patients who had previously had varicocele embolization were requested by letter to attend the radiology department. Blood levels of tungsten were compared with a group of controls. Fluoroscopic images of the coils were taken and compared with those obtained during the original procedures. RESULTS: Nineteen patients attended, whose procedure had been done 19-57 months previously (mean 40 months). Blood levels of tungsten were raised in 18 patients compared with the controls. Radiographic evidence of loss of substance of the coils was seen in four patients. CONCLUSION: Tungsten coil resorption occurs in varicocele embolization. In view of the unknown long-term effects of raised blood tungsten levels and the availability of alternative embolization agents, we feel that it is unwise to persist in the use of tungsten coils in this application.

Adult↗