Friday, May 15, 2009

5/9/2009 Case 3 - Answer



The first image demonstrates a narrowing in the cephalic vein. The second image shows angioplasty of the vein. The third image (which is the image from the Rob's Radiology fan page) demonstrates extravasation after angioplasty.
The procedure is a fistulogram with resultant complication from angioplasty.
Surprisingly, treatment often is easily treated with inflating the balloon until the bleeding stops. The vein often seals after the inflation and no further problems are usually seen. Other treatments include compression or stent-grafts. But stent-grafts are not ideal for crossing joints as in this case which is at the elbow.
Other acute complications - thrombosis and dissection. Thrombosis can be treated by drug or mechanical. Dissection can also be treated with balloon.
References - VIR Requisites (Kaufman et al) and Handbook for Interventional Radiologic Procedures (Kandarpa and Aruny)



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