Radiation-induced vessel injury is described more than a century ago and remains a persistent clinical problem, despite advances in the field of radiation oncology. Treatment of pelvic neoplasms with radiotherapy may result in chronic radiation toxicity, especially Haemorrhagic radiation cystitis and chronic radiation proctitis. We discussed the computed tomography (CT) findings of three cases with a history of radiotherapy to the pelvis presenting with hematuria and hematochezia. Contrast-enhanced CT could diagnose the cause and site of bleed. All these patients were managed successfully by endoscopic coagulation.

/non tunneled dialysis catheters or through arteriovenous fistulas/grafts. The tunneled dialysis catheters act as bridge dialysis devices during maturation period of arteriovenous fistulas/grafts and also serve as the last option for end stage renal disease patients who have exhausted all the other dialysis accesses. The aim and objective is to review the basic key concepts of internal Jugular, External Jugular and Subclavian tunneled venous catheter placement, techniques utilized, complications encountered, issues of suboptimal functioning and their management. Subjects and Methods: This was a prospective observational study done in department of Radio diagnosis, Narayana medical college, Nellore. About 54 cases were performed in our institution from December 2018 to Mar 2020 (including three pediatric patients). The age range of these patients is 10 to 75 years. Results: Out of 54 cases, one case had failed, as the guide wire didn’t pass across the brachiocephalic vein. Venogram revealed high grade stenosis of right brachiocephalic vein. There were major complications in two cases, minor complications in five cases with delayed complications in two cases. Conclusion: Tunneled catheters play a key role in serving as bridging devices during maturation of AVF/AVG or as the last option in chronic kidney disease patients in whom all other options have exhausted. Intervention radiologist should have good experience and an overall knowledge of the issues involved in placement of tunneled dialysis catheters, knowledge about the complications, technical issues of suboptimal functioning, for optimal catheter placement and also for improving catheter function.

Background: The incidence of end stage renal disease is on the rise and most of these patients are undergoing dialysis either through tunnelled/non tunnelled dialysis catheters or through arteriovenous fistulas/grafts. The dialysis grafts and fistulas have limited durability of about 3 years and are more prone for thrombosis and stenosis. Catheter directed interventions are successful in establishing flow in most of the thrombosed fistulas, but require dedicated Cath lab and tertiary care centre. Needle directed thrombolysis is a novel economical, safe technique for thrombolysis of dialysis fistulas and grafts. The aim of the studt is to review the technique, safety, efficacy of needle directed pulse spray pharmacomechanical thrombolysis of dialysis fistulas and grafts with short term follow up. Subjects and Methods: This was a prospective observational study done in department of Radio diagnosis, Narayana medical college, Nellore. Selectively 25 patients with thrombosed AV fistulas were referred from nephrology OPD for needle directed thrombolysis to our department from December 2018 to May 2019. The procedure was performed on OPD basis in ultrasound procedure room. Regular Doppler follow up of patients is done up to 6 months. Results: Out of twenty five cases about seventeen cases (68%) were successful in achieving adequate recanalization in single session. four cases (16%) required repeat sessions of thrombolysis and were successful in second attempt. In four cases (16%) there was failure in attaining adequate recanalization due to marked multisegment attenuation/flow limiting stenosis of the draining vein. Conclusion: Needle directed Pulse spray pharmacomechanical thrombolysis is a novel technique, which can be done bedside, under portable ultrasound guidance and is an economical procedure as no intervention hardware is required. Continuous monitoring allows procedure to be stopped at the earliest once there is optimal recanalization, minimizing the systemic side effects of thrombolytic agents.