Stroke is the fifth leading cause of death in the United States and is one of the leading causes of patient disability. Treatments for intracranial intravascular damage as a result of stroke have evolved extensively over recent decades, as management has become increasingly innovative. Various prospective studies and years of data have refined the current guidelines for treatment of acute ischemic stroke (AIS) and also reflect on the novel interventions for stroke management. Nonetheless, AIS remains a difficult and multifactorial etiology of disease to treat. As physicians adapt evidence-based knowledge to their interventional management of patients with AIS, the accompanied use of intravascular devices, such as steerable microcatheters, reduces radiation and procedure time. Considering all of the applications for steerable microcatheters, the use of these devices for AIS interventions may be most necessary.

Infections of the lumbar spine can have serious sequelae, including neurological deficits, paralysis, and death. Prolonged infection can result in fracture of the vertebrae, local abscesses, and infiltration and compression of local vascular structures. In cases with significant instability or neurological compromise, a common treatment approach is vertebral corpectomy with interbody cage followed by long-term antibiotics. The following case describes a patient with a three-month history of progressively worsening lower back pain, lower extremity radiculopathy, and bilateral lower extremity edema, in the setting of a nontraumatic three-column fracture dislocation of L5 with grade 4 retrolisthesis of L4 on L5. A posterior-only corpectomy with placement of an expandable cage, to be followed by pedicle screw placement from L3-S1/ilium, was performed. The procedure was successful, and the patient was discharged on postoperative day 5 without complication and with resolution of his edema. Histopathological analysis demonstrated acute and chronic inflammation, but extensive tests and cultures failed to identify a causative organism. This case highlights several interesting features, including a technically challenging and seldom-performed procedure, as well as the ability of lumbar spinal infections to present with leg edema due to involvement the inferior vena cava and iliac vessels. For patients with three-column fractures of L5 due to an inflammatory process or trauma, a single-stage posterior corpectomy with placement of an expandable cage may be considered as an appropriate treatment option.

Techniques in vascular and interventional radiology are adapted to the ever-evolving clinical challenges that interventional operators face. In the case of rare diseases, supporting literature that guides an operator's plan for intervention is limited. As a result, published case reports and series can be utilized to direct future intervention and potentially help others tasked with similar clinical scenarios. The proceeding case offers an interventional solution to a clinical manifestation of an otherwise rare disease, Osler-Weber-Rendu (OWR) syndrome. The supporting literature for techniques in embolization of pulmonary arteriovenous malformations (AVMs) in OWR syndrome is limited due to disease rarity. Therefore, the objective of the following case is to offer clinical insights on how to perform this procedure successfully and critique methods previously utilized.

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