Background -Obstruction of the superior vena cava (SVC) in malignant disease can cause considerable distress to patients. Symptomatic relief can be achieved by the percutaneous implantation of a selfexpanding stent (Wallstent) into the stenosis. Methods -Fourteen patients with obstruction ofthe SVC were treated with one to three Wallstent endoprostheses. They suffered from advanced bronchogenic carcinoma (n = 12), thyroid carcinoma (n = 1), and breast carcinoma (n = 1). The indication for stent placement was symptomatic obstruction of the SVC and incurable disease. Stenting was performed for symptom relief, and before, during, and after courses of radiotherapy or chemotherapy as needed. Results -Twelve patients experienced complete symptomatic relief within two days of stent placement. Two patients did not benefit. Three patients not given anticoagulation developed stent thrombosis between one week and eight months after initial placement, and within one day of endobronchial stent implantation with bronchial laser therapy or balloon dilatation in all three. Patency of the SVC was achieved again by a repeat procedure. Conclusions -Stent placement for obstruction of the SVC gives rapid symptomatic relief. Subsequent endobronchial stent implantation with bronchial laser therapy or balloon dilatation could be a risk for caval stent occlusion. Stent thrombosis remains a problem in patients who are not anticoagulated.

Purpose– To investigate the rate of false negative initial cerebral angiography in spontaneous SAH and to ascertain why aneurysms remain undetected. Furthermore to validate CCT in predicting the presence and site of an angiographically missed aneurysm. Methods– Forty‐two patients with spontaneous SAH were investigated, in whom initial cerebral angiography did not reveal any bleeding cause. Repeat‐angiography was performed in all patients 5 to 55 days (mean 15 days) after the bleeding event. All patients underwent CCT scans within 48h after the ictus. Results– In 8 of 42 patients (19%) repeat‐angiography revealed an aneurysm missed on initial angiography. The aneurysms were located on the AcomA (n = 2), the MCA (n = 2), the ACA (n= 1), the PICA (n = 2) and the junction of ICA and PcomA (n = 1). Presumable reasons for missing an aneurysm were spasms detected in four of eight cases on initial angiography and thrombosis of the aneurysm found in two cases at surgery. In two cases, multiple additional views just revealed the aneurysm appearing different in size and shape on repeat‐angiography. CCT blood distribution pattern in four cases indicated presence and site of an aneurysm, while blood distribution was non‐specific in the other four cases. Conclusion– Repeat‐angiography plays an important role in defining the site of an initially occult aneurysm and should be performed in all cases of unexplained SAH. It is of particular importance if vasospasm has compromised the initial angiogram or if one part of the vascular tree is not optimally seen.

We conclude that resection of localized pulmonary lesions, be it for diagnostic or therapeutic (or combined) purposes, can be carried out with low morbidity and mortality in patients with leukemia and severe aplastic anemia. However, early mortality is high after open or thoracoscopic lung biopsies in patients with acute-onset diffuse pulmonary disease, and little therapeutic benefit is realized in these cases.

Bilaterally antegrade selective DSA clearly is superior to aortic run-off DSA depicting tibial arteries. It requires comparatively small additional effort. Outflow vessel detection essentially is independent of advanced PVD.