Learning Vascular and Interventional Radiology (eBook)

Learning Imaging Vascular and Interventional Radiology 2
Preface 5
Contents 6
Contributing Authors 10
1: Fundamentals of Diagnostic Angiography 12
Case 1.1Catheters, Guides, and Introducer Sheaths 13
Comments 14
Case 1.2Seldinger Technique. Retrograde and Antegrade Approach Through the Femoral Artery 15
Comments 15
Procedure Steps 16
Equipment List 16
Case 1.3Brachial Arterial Access with a Micropuncture System 17
Comments 18
Procedure Steps 18
Equipment List 18
Case 1.4Hemostasis Systems. Femoral Artery Closure with Angio-Seal Vascular Closure Device 19
Comments 20
Procedure Steps 20
Equipment List 20
Case 1.5Complications of Vascular Access. Pseudoaneurysm of the Femoral Artery 21
Comments 22
Procedure Steps 22
Equipment List 22
Case 1.6The Thoracic Aorta. Obtaining a Thoracic Aortogram 23
Comments 24
Procedure Steps 24
Equipment List 24
Case 1.7The Abdominal Aorta. Obtaining an Aortogram 25
Comments 26
Procedure Steps 26
Equipment List 26
Case 1.8The Pelvis. Angiographic Study 27
Comments 28
Procedure Steps 28
Equipment List 28
Case 1.9Lower Limbs. Angiographic Study 29
Comments 30
Procedure Steps 30
Equipment List 30
Case 1.10Upper Limbs. Angiographic Study 31
Comments 32
Procedure Steps 32
Equipment List 32
Further Reading 33
2: Noninvasive Vascular and Nonvascular Diagnosis 34
Case 2.1Coronary Artery Stenosis 35
Comments 36
Procedure 36
Case 2.2Evaluating a Coronary Bypass with MDCT 37
Comments 38
Procedure 38
Case 2.3Congenital Anomaly of the Coronary Vessels 39
Comments 40
Procedure 40
Equipment Required 40
Case 2.4Stenosis in a Carotid Stent due to Intimal Hyperplasia 41
Comments 42
Case 2.5Significant Stenosis in the Middle Portion of the Cephalic Vein 43
Comments 44
Case 2.6Fibromuscular Dysplasia of the Right Renal Artery 45
Comments 46
Case 2.7Vesical Carcinoma with Extension to the Right Ureter 47
Comments 48
Case 2.8Cholangiocarcinoma 49
Comments 50
Case 2.9Choledocolithiasis and Caroli’s Disease 51
Comments 52
Case 2.10Renal Lithiasis and Nonobstructive Ureterolithiasis 53
Comments 54
Further Reading 55
3: Fundamentals of Vascular Interventions 57
Case 3.1Renal Artery Fibrodysplasia. Treatment with Angioplasty 58
Comments 59
Procedure Steps 60
Equipment List 60
Case 3.2Tibiofibular Angioplasty 61
Comments 62
Procedure Steps 63
Equipment List 63
Case 3.3Transjugular Portosystemic Shunt 64
Comments 65
Procedure Steps 65
Equipment List 66
Case 3.4Digestive Visceral Artery Stenting 67
Comments 68
Procedure Steps 69
Equipment List 69
Case 3.5Embolization of Traumatic Hemorrhage 70
Comments 71
Procedure Steps 71
Equipment List 71
Case 3.6Embolization of Hepatocellular Carcinoma 72
Comments 73
Procedure Steps 73
Equipment List 74
Case 3.7Breakage of a Central Venous Catheter from a Reservoir 75
Comments 76
Procedure Steps 76
Equipment List 76
Case 3.8Breakage of a Venous Catheter in the Left Pulmonary Artery 77
Comments 78
Procedure Steps 78
Equipment List 78
Case 3.9Aortobifemoral Graft Thrombolysis 79
Comments 80
Procedure Steps 80
Equipment List 81
Case 3.10Native Artery Thrombolysis 82
Comments 83
Procedure Steps 84
Equipment List 84
Further Reading 85
4: Lower Extremity Arteries 89
Case 4.1Severe Stenosis in the Left Common Iliac Artery 90
Comments 91
Procedure 91
Equipment List 91
Case 4.2Bilateral Iliac Artery Lesions 92
Comments 93
Procedure Steps 93
Equipment List 93
Case 4.3Recanalization of a Unilateral Obstruction of the Iliac Artery 94
Comments 95
Procedure Steps 95
Equipment List 95
Case 4.4External Iliac Artery Lesions 96
Comments 97
Procedure Steps 97
Equipment List 97
Case 4.5Stenosis in the Superficial Femoral Artery 98
Comments 99
Procedure Steps 99
Equipment List 99
Case 4.6Deep Femoral Artery Arteriovenous Fistula and Pseudoaneurysm due to an Incised Wound 100
Comments 101
Procedure Steps 101
Equipment List 101
Case 4.7Femoral Arteriovenous Fistula after Cardiac Catheterization 102
Comments 103
Procedure Steps 103
Equipment List 103
Case 4.8Popliteal Stenosis 104
Comments 105
Procedure Steps 105
Equipment List 105
Case 4.9Infrapopliteal Lesions: Proximal Obstruction of the Left Anterior Tibial and Peroneal Arteries 106
Comments 107
Procedure Steps 107
Equipment List 107
Case 4.10Infrapopliteal Lesions 108
Comments 109
Procedure Steps 109
Equipment List 109
Further Reading 110
5: Visceral Arteries 111
Case 5.1Hepatic Artery Aneurysm Treated with a Stent-Graft 112
Comments 113
Procedure Steps 113
Equipment List 113
Case 5.2Hepatic Artery Graft Stenosis After Liver Transplantation Treated by Angioplasty 114
Comments 115
Procedure Steps 115
Equipment List 115
Case 5.3Splenic Trauma Treated by Embolization 116
Comments 117
Procedure Steps 117
Equipment List 117
Case 5.4Surgical Marking for Acute Digestive Hemorrhage Due to an Ileal Ulcer 118
Comments 119
Procedure Steps 119
Equipment List 119
Case 5.5Lower Digestive Tract Bleeding. Treatment of Rectorrhagia by Embolization 120
Comments 121
Procedure Steps 121
Equipment List 121
Case 5.6Embolization to Treat Hematuria Due to Pelvic Trauma Treated 122
Comments 123
Procedure Steps 123
Equipment List 123
Case 5.7Obstetric Bleeding Treated with Embolization 124
Comments 125
Procedure Steps 125
Equipment List 125
Case 5.8Embolization to Treat Hemoperitoneum Due to Ruptured Hepatocellular Carcinoma 126
Comments 127
Procedure Steps 127
Equipment List 127
Case 5.9Embolization to Treat Renal Hematoma Due to Angiomyolipoma 128
Comments 129
Procedure Steps 129
Equipment List 129
Case 5.10Renal Artery Stenosis Treated with Stenting 130
Comments 131
Procedure Steps 131
Equipment List 131
Further Reading 132
6: Upper Extremity, Central Thoracic and Abdominal Veins 133
Case 6.1 Venous Angioplasty of a Hemodialysis Fistula 134
Comments 135
Procedure Steps 135
Equipment List 135
Case 6.2 Permanent Femoral Catheter for Hemodialysis 136
Comments 137
Procedure Steps 137
Equipment List 137
Case 6.3 Percutaneous Extraction of an Intrapulmonary Foreign Body 138
Comments 139
Procedure Steps 139
Equipment List 139
Case 6.4 Embolization of a Renal Arteriovenous Malformation 140
Comments 141
Procedure Steps 141
Equipment List 141
Case 6.5 Recanalization of the Left Iliac Vein in May–Thurner Syndrome 142
Comments 143
Procedure Steps 143
Equipment List 143
Case 6.6 Paget–Schroetter Disease Resolved with Fibrinolysis 144
Comments 145
Procedure Steps 145
Equipment List 145
Case 6.7 Treatment of Superior Vena Cava Syndrome with Metallic Stents 146
Comments 147
Procedure Steps 147
Equipment List 147
Case 6.8 Percutaneous Thrombectomy of a Hemodialysis Access 148
Comments 149
Procedure Steps 149
Equipment List 149
Case 6.9 Inferior Vena Cava Thrombolysis 150
Comments 151
Procedure Steps 152
Equipment List 152
Case 6.10Endovascular Treatment of a Varicocele 153
Comments 154
Procedure Steps 154
Equipment List 154
Further Reading 155
7: Thoracic and Abdominal Aorta 156
Case 7.1 Aneurysm of the Ascending Aorta and Aortic Arch. Hybrid Treatment 157
Comments 158
Procedure Steps 158
Equipment List 159
Case 7.2 Endovascular Treatment of an Aortobronchial Fistula 160
Comments 161
Procedure Steps 162
Equipment List 162
Case 7.3Stanford Type B Chronic Aortic Dissection Treated Endovascularly with a Stent-graft 163
Comments 164
Procedure Steps 164
Equipment List 165
Case 7.4 Aneurysm of the Right Common Iliac Artery Treated with a Contralateral Aortomonoiliac Stent-Graft, Ipsilateral Vascul 166
Comments 167
Procedure Steps 167
Equipment List 168
Case 7.5 Acute Thoracic Aortic Syndrome Treated with a Stent-Graft 169
Comments 170
Procedure Steps 171
Equipment List 171
Case 7.6 Traumatic Dissection of the Descending Aorta Treated in the Acute Phase with a Stent-Graft 172
Comments 173
Procedure Steps 173
Equipment List 174
Case 7.7Endovascular Treatment of Rupture of the Thoracic Aorta in the Acute Phase Using a Stent-Graft 175
Comments 176
Procedure Steps 177
Equipment List 177
Case 7.8Penetrating Ulcer of the Descending Thoracic Aorta: Endovascular Treatment with an Aortobifemoral Graft 178
Comments 179
Procedure Steps 180
Equipment List 180
Case 7.9Endovascular Treatment of an Infrarenal Aneurysm of the Abdominal Aorta with a Bifurcated Stent-Graft 181
Comments 182
Procedure Steps 182
Equipment List 183
Case 7.10Treatment of an Aneurysm of the Abdominal Aorta with a Stent-Graft: Type II Leak (Endoleak) 184
Comments 185
Procedure Steps 185
Equipment List 186
Further Reading 187
8: Percutaneous Drainage of Abdominal Fluid Collections 188
Case 8.1 189
Comments 190
Equipment List 190
Procedure Steps 190
Case 8.2 Percutaneous Cholecystostomy 191
Comments 192
Interventional Procedure 192
Case 8.3Postoperative Retroperitoneal Collection 194
Comments 195
Interventional Procedure 195
Case 8.4 Collections in the Psoas Muscle 196
Comments 197
Interventional Procedure 197
Case 8.5 Postcholecystectomy Collection 198
Comments 199
Interventional Procedure 199
Case 8.6 Crohn’s Disease 200
Comments 201
Interventional Procedure 201
Case 8.7Urinoma 202
Comments 203
Interventional Procedure 203
Procedure Steps 203
Case 8.8 Transgluteal Drainage 204
Comments 205
Interventional Procedure 205
Case 8.9 Peripancreatic Collection 206
Comments 207
Interventional Procedure 207
Case 8.10 Pleural Drainage 208
Comments 209
Interventional Procedure 209
Further Reading 211
9: Biliary Interventions and Treatment of Focal Hepatic Lesions 212
Case 9.1Percutaneous External Biliary Drainage 213
Comments 214
Procedure Steps 214
Equipment 215
Case 9.2Complications of Percutaneous Biliary Drainage: Hemobilia 216
Comments 217
Procedure Steps 218
Equipment 218
Case 9.3Percutaneous Treatment of Multiple Choledocholithiasis 219
Comments 220
Procedure Steps 221
Equipment 221
Case 9.4Percutaneous Treatment of Residual Biliary Lithiasis 222
Comments 223
Procedure Steps 223
Equipment 223
Case 9.5Balloon Dilation of Stenosis of a Biliodigestive Anastomosis 224
Comments 225
Procedure Steps 225
Equipment 225
Case 9.6Iatrogenic or Postsurgical Biliary Fistula 226
Comments 226
Procedure Steps 227
Equipment 227
Case 9.7Transpapillary Stenting 228
Comments 229
Procedure Steps 229
Equipment 229
Case 9.8A Single Stent to Treat a Type Ii Hilar Tumor from the Right Side 230
Comments 231
Procedure Steps 231
Equipment 231
Case 9.9Stent from the Right Side to Treat a Type B-Iii Hilar Tumor. 232
Comments 233
Procedure Steps 233
Equipment 233
Case 9.10Obstruction of a Metallic Biliary Stent 234
Comments 235
Equipment 236
Procedure Steps 236
Further Reading 237
10: Percutaneous Genitourinary Interventions 238
Case 10.1Radiofrequency Ablation of a Renal Mass 239
Comments 240
Procedure Steps and Equipment 240
Case 10.2 Ureteral Stenosis in a Transplanted Kidney: Treatment with a Metallic Stent 241
Comments 242
Procedure Steps and Equipment 242
Case 10.3 Wunderlich Syndrome. Spontaneous Extracapsular Renal Hemorrhage Secondary to a Renal Angiomyolipoma 243
Comments 244
Procedure Steps and Equipment 244
Case 10.4 Bilateral Renal Fibromuscular Dysplasia 245
Comments 246
Procedure Steps and Equipment 246
Case 10.5 Arteriocalyceal Fistula After Renal Biopsy. Percutaneous Treatment 247
Comments 248
Procedure Steps and Equipment 248
Case 10.6 Stenosis of an Ureteroileal Anastomosis: Treatment with a Temporary Metallic Stent 249
Comments 250
Procedure Steps and Equipment 250
Case 10.7 Intrarenal Saccular Aneurysm. Treatment by Embolization 251
Comments 252
Procedure Steps and Equipment 252
Case 10.8 Angioplasty of the Renal Artery in a Patient with Takayasu’s Arteritis 253
Comments 254
Procedure Steps and Equipment 255
Case 10.9 Embolization of an Arteriovenous Fistula in a Renal Graft 256
Comments 257
Procedure Steps and Equipment 257
Case 10.10 Presurgical Embolization of Renal Cell Carcinoma 258
Comments 259
Procedure Steps and Equipment 259
Further Reading 260