Objective: To assess the short-and long-term outcomes of vena cava filter (VCF) placement for prophylaxis against pulmonary embolism in patients at high risk due to trauma.Design and Setting: Case series at a level I trauma center.Patients: Patients were considered for prophylactic VCF placement if they met 1 of the injury criteria-spinal cord injuries with neurologic deficit, severe fractures of the pelvis or long bone (or both), and severe head injuryand had a contraindication to anticoagulation.Intervention: Vena cava filters were placed percutaneously by the interventional radiologists when the acute trauma condition was stabilized following admission. Main Outcome Measures:Filter tilt of 14°or more, strut malposition, insertion-related deep vein thrombosis, pulmonary embolism, or inferior vena cava patency.Results: There were 132 prophylactic VCFs placed. A 3.1% rate of insertion-related deep vein thrombosis occurred, all of which were asymptomatic. Filter tilt occurred in 5.5% of patients and strut malposition in 38%. Three cases of pulmonary embolism (1 fatal) occurred in a prophylactic VCF, and all patients had either filter tilt or strut malposition. The risk of pulmonary embolism developing was higher in those patients with filter tilt or strut malposition than in those who did not have these complications (6.3% vs 0%; P=.05; Fisher exact test). The 1-, 2-, and 3-year inferior vena cava patency rates (±SD) were 97%±3%.Conclusions: Prophylactic VCF can be placed safely with an acceptable rate of insertion-related deep vein thrombosis and long-term inferior vena cava patency. Patients with prophylactic VCF remain at risk for pulmonary embolism if the filter is tilted 14°or more or has strut malposition. In such patients, consideration should be given to placing a second filter.

Over the past decade, computed tomographic (CT) urography has emerged as the primary imaging modality for evaluating the urinary tract in various clinical settings, including the initial workup of hematuria. With the widespread implementation of CT urography, it is critical for radiologists to understand normal ureteral anatomy and the varied appearance of pathologic ureteral conditions at CT urography. Pathologic findings at CT urography include congenital abnormalities, filling defects, dilatation, narrowing, and deviations in course. These abnormalities are reviewed, along with the indications for CT urography, current imaging protocols with specific techniques for optimal evaluation of the ureter, and dose reduction strategies.

The "gastrografin challenge" has been used for decades in the evaluation of small bowel obstruction (SBO). This type of study involves enteric administration of a water-soluble contrast followed by serial abdominal radiographs. While its diagnostic role is well established, its therapeutic role remains controversial. Following an algorithm for gastrografin challenge cases can help with interpretation. An understanding of the appearance of diluted contrast in the small bowel, the concentrating effect of contrast in the colon, and knowledge of surgical history and anatomy is paramount for diagnosis. In this article, we review the approach to acute SBO and the use of gastrografin along with reviewing image interpretation of cases of partial and complete SBO. Gastrografin use in adynamic ileus along with other potential future uses is also discussed.

To examine the histological changes caused by the presence of the endovascular stented graft in the native aorta. Design and Intervention: Case series. Twenty Western crossbred adult male sheep underwent endovascular placement of an infrarenal aortic stented graft, using the Bard aortic aneurysm repair device catheter delivery system (Bard Vascular Systems, Dovermill, Mass). Six self-expanding wire hooks at the proximal anchor allow fixation to the aorta. After 1 month (n=6), 3 months (n=6), and 6 months (n=8), the animals underwent repeated angiography and intravascular ultrasonography to study the aorta and the graft. The aorta was explanted en bloc with the left renal artery, pressure perfused with a formalin gluteraldehyde solution, and then underwent histological examination with hematoxylin-eosin, trichrome, and elastic tissue staining. Main Outcome Measures: Description of histological changes at various intervals after endovascular stented graft placement.

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