PubMed · 14123856
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B F VAUGHAN, J A HOLT. 1964. LYMPHOGRAPHY.. https://doi.org/10.1111/j.1440-1673.1964.tb01150.x
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OBJECTIVE: To evaluate the clinical application of a catheter-delivered, self-expanding occluding stent for closure of patent ductus arteriosus (PDA) in dogs. DESIGN: Prospective study. ANIMALS: 23 client-owned dogs weighing at least 3 kg (6.6 lb). PROCEDURE: Dogs were evaluated by physical examination, electrocardiography, thoracic radiography, and 2-dimensional, M-mode, spectral and color-flow Doppler echocardiography to confirm the diagnosis and obtain baseline measures. Shunt severity and ductal size and anatomy were established by means of angiography. With fluoroscopic guidance, the occluding stent, attached to a delivery cable, was maneuvered though the right side of the heart into the ductus via a prepositioned introducer sheath. After angiographic verification of appropriate stent placement, the delivery cable was detached, and the introducer sheath was withdrawn. Closure of the PDA was evaluated by means of angiography 15 minutes after stent deployment and by echocardiography 1 and 3 months after the procedure. RESULTS: There were no operative deaths. There were 2 deployment failures, both attributable to avoidable operator errors. Angiography performed after stent deployment indicated PDA closure in 13 of 20 (65%) dogs. There were 2 postoperative deaths in dogs with heart failure; both deaths were thought to be unrelated to use of the occluding stent. Complete PDA closure, determined by Doppler color-flow echocardiography, was evident in 17 of 19 dogs within 3 months and in 1 additional dog within 1 year of stent deployment, resulting in closure in 18 of 19 dogs completing the study protocol. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a catheter-delivered occluding stent can be used successfully to close PDAs in dogs.
This study evaluates the correlation of magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) with the operative vessel findings in living kidney donors. The intraoperative vessel findings of 52 living renal donors were compared with the preoperative diagnoses of each imaging technique. Sixty-seven arteries were found during explantation. Forty kidneys showed a single arterial blood supply, and 12 kidneys showed a multiple arterial blood supply. No advantage of either imaging method was found for arterial imaging. There were 55 veins identified during organ harvesting. MRA could not determine the venous system in one donor (1.9%) and failed to detect one small pole vein in another. DSA did not yield a venous diagnosis in seven patients (13.5%) and yielded misdiagnoses in four patients. The correct diagnosis of renal donor veins differed significantly in favor of MRA (kappa 0.79 vs. 0.45; P=0.008). MRA is superior to DSA in assessing the renal vasculature in living kidney donors.
This study describes the imaging features of the intrahepatic portohepatic venous (PHV) shunt, which is a potential cause of portosystemic encephalopathy in Rendu-Osler-Weber disease. Six patients with Rendu-Osler-Weber disease (two men, four women; age range 42-73 years) were retrospectively studied. There were two from one family and three from another family. Of these patients, one was diagnosed with definitive portosystemic encephalopathy because of a psychiatric disorder. We retrospectively reviewed the radiological examinations, including abdominal angiography (n=6), three-phase dynamic helical computed tomography (CT; n=3), and conventional enhanced CT (n=1). In one patient, CT during angiography and CT angioportography were also performed. Evaluation was placed on the imaging features of intrahepatic PHV shunts. On angiography, intrahepatic PHV shunts showing multiple and small shunts <5 mm in diameter in an apparent network were detected in all patents. In two patients, a large shunt with a size of either 7 or 10 mm was associated. These intrahepatic PHV shunts were predominantly distributed in the peripheral parenchyma. Intrahepatic PHV shunts would be characterized by small and multiple shunts in an apparent network on the periphery with or without a large shunt.