Techniques in vascular and interventional radiology
-
Atherosclerotic renal artery stenosis (ARAS) is the most common cause of renal artery stenosis in the adult population. ARAS may result in progressive renal impairment, renovascular hypertension, and/or cardiac disturbance syndromes. ⋯ When performed correctly, renal artery stenting has been shown to stabilize or improve renal function and/or renovascular hypertension in 65-70% of carefully selected patients with ARAS. Therefore, percutaneous renal artery stenting should be considered the primary treatment for patients with symptomatic ARAS.
-
Massive hemoptysis is a life-threatening emergency. Chest radiograph, computed tomography, and bronchoscopy play a complementary role in diagnosing the underlying cause of hemorrhage and localizing the bleeding site. ⋯ Immediate cessation of bleeding occurs in more than 75% of patients; however, long-term recurrences are common in patients with progressive lung disease. Complications are infrequent except for a rare occurrence of spinal cord ischemia.
-
Tech Vasc Interv Radiol · Jun 2009
ReviewEmergent nephrostomy tube placement for acute urinary obstruction.
Obstructive uropathy and urosepsis constitute a medical emergency and require emergent decompression of the urinary collecting system. Image-guided percutaneous nephrostomy tube placement using ultrasound and fluoroscopy allows for decompression of the obstructed renal collecting system with minimal complications.
-
Tech Vasc Interv Radiol · Mar 2009
ReviewTreatment of facet and sacroiliac joint arthropathy: steroid injections and radiofrequency ablation.
Facet and sacroiliac joint arthropathy are common, specific causes of low back pain. With a combination of a focused physical examination and image guidance, pain originating from these joints can be accurately targeted and these joints respond well to the direct application of long-acting deposition preparation steroids. ⋯ Image guidance is a critical tool in targeting facet joint innervation, performing a central role in the techniques used in both preprocedure testing and the RFA treatment. This article reviews the basic image-guided fluoroscopic and computed tomographic-guided approaches to steroid treatment of the facet and sacroiliac joints and further discusses of the painful facet through RFA.