High-spatial-resolution steady-state MR angiography allowed for better agreement with DSA regarding stenosis grade in patients with arterial disease compared with standard-resolution arterial-phase first-pass MR angiography.

Since its approval as an innovative stent system for peripheral aneurysm management in May 2009, the Cardiatis Multilayer Stent (Cardiatis, Isnes, Belgium) has been applied in several clinical cases. The unique design of this multilayer stent decreases mean velocity and vorticity within the aneurysm sac immediate and causes thrombus to form, resulting in physiological exclusion of the aneurysm from the circulation, whereas branches and collaterals sprouting from the aneurysm remain patent. Here we present a case of a complex renal artery aneurysm successfully treated with a 6×30-mm Cardiatis Multilayer Stent.

Incidental DVT was prevalent in 11% of patients with clinically suspected PAOD. MRA with blood pool contrast agent has a potential role in the simultaneous assessment of arteries and veins and can detect concomitant venous disease affecting therapeutic management.

Background Visceral artery aneurysms (VAA) are rare vascular lesions. Clinically silent VAA are increasingly detected by cross-sectional imaging but some lesions are at risk for rupture with severe bleeding. The aim of the present study was to evaluate the trends in the interdisciplinary management at a tertiary center. Methods Patients who underwent treatment for VAA at University Hospital of Bonn between 2005 and 2018 were enrolled in this retrospective study. Demographic, clinical, VAA-specific data as well as information on therapy, early and long-term outcome were collected and statistically analyzed. Results Forty-two consecutive patients, 19 females and 23 males with a median age of 59 years (range 30–91 years), were diagnosed with 56 VAA. The majority were true aneurysms ( N = 32; 57%), whereas 43% ( N = 24) were pseudoaneurysms. The most common localization was the splenic artery ( N = 18; 32%) and the average diameter was 3 cm (range 1–5 cm). Twenty-five patients (59.5%) had VAA-related symptoms such as chronic abdominal pain and hemorrhage at primary diagnosis, while the diagnosis was incidental in 17 patients (40.5%). Eleven patients (26%) underwent open surgery whereas 29 patients (69%) received an endovascular treatment. Patients with pseudoaneurysms were significantly older ( P = 0.003), suffered more often from associated symptoms ( P < 0.001) and required more emergency interventions ( P < 0.0001) compared to those with true VAA. In the last years, the number and proportion of true VAA increased significantly ( P < 0.001) while a significantly larger proportion could be managed interventionally ( P = 0.017). Conclusions VAA are increasingly detected on imaging with lesions presenting very heterogeneously. Due to the risk of lethal rupture and in the absence of reliable prognostic markers, all the patients with VAA should be offered definite treatment. Localization, anatomy and the end-organ perfusion after intervention or operation are the most important aspects to consider when planning a treatment for VAA. For this reason, a multidisciplinary evaluation of every individual patient is necessary for an optimized outcome.

Our results indicate that determination of ABI alone, with and without provocation, is sufficient as a postoperative follow-up examination to appraise decompression and for quality assurance of PAES. Compared with other more elaborate instrumental methods, measurement of ABI is relatively noninvasive, quick and easy to carry out, effective, and inexpensive.