The purpose of this study was to review the positive angiographic findings in patients with polyarteritis nodosa (PAN). The authors reviewed the angiograms of 56 consecutive patients (25 women and 31 men; age range, 18-81 years; mean age, 55 years) with PAN and arterial abnormalities consistent with necrotizing vasculitis. Aneurysms were present in 27 patients and segments of ectasia were present in seven patients, for a total of 34 (61%) of 56 patients with aneurysmal lesions. The remaining 22 (39%) patients had arterial lesions that were occlusive: luminal irregularity, stenosis, or occlusion. All but one of the patients with an aneurysm also had occlusive lesions. Therefore, 55 (98%) of the 56 patients were found to have occlusive lesions. Skeletal muscle arteries were affected in 18 patients, nine in the extremities. The most frequent finding in patients with PAN was occlusive arterial lesions. Although the presence of aneurysms increases specificity for the diagnosis of PAN, many patients have only occlusive lesions. Involvement of skeletal muscle arteries was common.

In ED patients with suspected PE, the CT angiogram frequently provides evidence suggesting an important alternative diagnosis to PE. Pulmonary infiltrate suggesting pneumonia was the most common non-PE finding.

Objective To assess retrospectively 30-day, 1-year and 3-year patency of chronically occluded iliofemoral venous thrombotic lesions treated with stent placement in a case series from our institution. Patients and methods Records of 189 consecutive patients treated by interventional radiology for iliofemoral venous occlusions between March 01, 2003 and December 01, 2008 were retrospectively reviewed. 89 patients (27 males, median age 46.2 years) with chronic iliac or iliofemoral deep vein thrombosis without involvement of the inferior vena cava met criteria for analysis. Results 89 patients (91 limbs) successfully underwent placement of venous self-expanding stents. Discharge patency was 100%. Following the index procedure, the mean pressure gradient across the lesion decreased from 5.63 mmHg (95% CI: 3.51 – 7.75) to 0.71 mmHg (95% CI: 0.08 – 1.34) mmHg (p<0.0001). There were no bleeding complications. Median follow-up was 11.3 months (range 0.8 – 72.4). Follow-up at 30 days demonstrated 90 of 91 limbs patent. Primary patency of treated limbs at 1 and 3 years was 81 and 71% respectively. Primary patency was lost in 17 (19.1%) cases; interventions to maintain or restore stent patency were performed in 13 (14.6%) cases. Primary assisted limb patency at 1 and 3 years was 94% and 90% respectively; secondary patency was 95%. Conclusion Angioplasty with stent placement for treatment of chronically thrombosed iliofemoral veins is a low risk procedure with acceptable patency rates for up to 3 years. The outcomes in patients treated in a quaternary referral center are similar to those reported by other centers.

Drug-eluting bead chemoembolization is a reasonable alternative to hepatic arterial embolization and chemoembolization for the treatment of metastatic neuroendocrine tumor to the liver.

No abstract