Teaching Atlas of Vascular and Non-vascular Interventional Radiology PDF
Preview Teaching Atlas of Vascular and Non-vascular Interventional Radiology
Teaching Atlas of Vascular and Non-vascular Interventional Radiology Teaching Atlas of Vascular and Non-vascular Interventional Radiology Brian Funaki, M.D. Associate Professor Section Chief, Vascular and Interventional Radiology Department of Radiology University of Chicago Chicago, Illinois Editor in Chief Seminars in Interventional Radiology Jonathan Lorenz, M.D. Associate Professor Department of Radiology University of Chicago Chicago, Illinois Thuong Van Ha, M.D. Assistant Professor Department of Radiology University of Chicago Chicago, Illinois Thieme New York •Stuttgart Thieme Medical Publishers, Inc. 333 Seventh Ave. New York, NY 10001 Editor: Timothy Hiscock Editorial Assistant: David Price Vice President, Production and Electronic Publishing: Anne T. Vinnicombe Production Editor: Print Matters, Inc. Vice President, International Marketing: Cornelia Schulze Sales Director: Ross Lumpkin Chief Financial Officer: Peter van Woerden President: Brian D. Scanlan Compositor: Compset, Inc. Printer: Edwards Brothers Library of Congress Cataloging-in-Publication Data Funaki, Brian. Teaching atlas of vascular and non-vascular interventional radiology : a teaching atlas / Brian Funaki, Jonathan Lorenz, Thuong Van Ha. p. ; cm. Includes bibliographical references and index. ISBN-13: 978-1-58890-625-0 (Americas : alk. paper) ISBN-13: 978-3-13-144181-2 (rest of world : alk. paper) 1. Interventional radiology—Atlases. 2. Interventional radiology—Case studies. I. Lorenz, Jonathan. II. Ha, Thuong Van. III. Title. [DNLM: 1. Radiology, Interventional—methods—Atlases. WN 17 F978i 2007] RD33.55.F86 2007 617’.05—dc22 2006102650 Copyright ©2008 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation without the publisher’s consent is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing or duplication ofany kind, translating, preparation ofmicrofilms, and electronic data processing and storage. Important note:Medical knowledge is ever-changing. As new research and clinical experience broaden our knowl- edge, changes in treatment and drug therapy may be required. The authors and editors ofthe material herein have consulted sources believed to be reliable in their efforts to provide information that is complete and in accord with the standards ac- cepted at the time ofpublication. However, in view ofthe possibility ofhuman error by the authors, editors, or publisher of the work herein or changes in medical knowledge, neither the authors, editors, or publisher, nor any other party who has been involved in the preparation ofthis work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use ofsuch informa- tion. Readers are encouraged to confirm the information contained herein with other sources. For example, readers are ad- vised to check the product information sheet included in the package ofeach drug they plan to administer to be certain that the information contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is ofparticular importance in connection with new or infrequently used drugs. Some ofthe product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance ofa name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain. Printed in the United States 5 4 3 2 1 The Americas ISBN 978-1-58890-625-0 Rest ofthe World ISBN 978-3-13-144181-2 To Alex, Christopher, and Eva Brian Funaki To Cynthia Jonathan Lorenz To Ka Yee, Nigel, Elizabeth, Ethan, Grace Broderick, Angelica, and Sonya Klingler Thuong Van Ha CONTENTS Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi CASE 1 Embolization of Colonic Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 CASE 2 Inferior Vena Cava Stenting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 CASE 3 Cutting Balloon Angioplasty of a Hard-to-Dilate Venous Stenosis. . . . . . . . . . . . . . . . . . . . . 10 CASE 4 Embolization of Traumatic Hepatic Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 CASE 5 Embolization for an Upper Gastrointestinal Hemorrhage. . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 CASE 6 Mushroom Gastrostomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 CASE 7 Catheter Pinch-Off with a Foreign Body Remover. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 CASE 8 Leriche Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 CASE 9 Chest Port Insertion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 CASE 10 Arterial Thrombolysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 CASE 11 Catheter-Directed Thrombolysis of Pelvic and Leg Deep Venous Thrombosis Associated with Absence of the Inferior Vena Cava. . . . . . . . . . . . . . . . . . . . . . . 42 CASE 12 Infrapopliteal Angioplasty. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 CASE 13 Transplant Renal Artery Stenosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 CASE 14 May-Thurner Syndrome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 CASE 15 Aortoenteric Fistula. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 CASE 16 Paget-Schroetter Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 CASE 17 Aortic Dissection with Lower Extremity Ischemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 CASE 18 Megacava with Bilateral Iliac Vein Filtration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 CASE 19 Arterial Thoracic Outlet Syndrome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 CASE 20 Median Arcuate Ligament Syndrome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 CASE 21 Popliteal Entrapment Syndrome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 CASE 22 Hypothenar Hammer Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 CASE 23 Mesenteric Stenting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 CASE 24 Filter Insertion in Caval Duplication. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 CASE 25 Aortic Infection with Aneurysm Formation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 CASE 26 Stent Graft Repair of External Iliac Stab Wound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 CASE 27 Polyarteritis Nodosa. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 CASE 28 Embolization for Type 2 Endoleak after Aortic Stent Graft . . . . . . . . . . . . . . . . . . . . . . . . . . 109 CASE 29 Central Vein Recanalizaton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 vii viii CONTENTS CASE 30 Replaced Right Hepatic Artery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .118 CASE 31 Bronchial Artery Embolizaton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122 CASE 32 Rupture of Outflow Vein of Arteriovenous Dialysis Graft . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127 CASE 33 Embolization of Renal Arteriovenous Fistula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .130 CASE 34 Dialysis Fistula Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 CASE 35 Infrapopliteal Atherectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .139 CASE 36 External Iliac Angioplasty and Stent Insertion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .144 CASE 37 Superficial Femoral Artery Angioplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149 CASE 38 Embolizaton of Pelvic Hemmorhage after Blunt Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154 CASE 39 Kissing Angioplasty and Stent Insertion for Aortoiliac Stenoses . . . . . . . . . . . . . . . . . . . . . . . .160 CASE 40 Replaced Right Subclavian Artery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165 CASE 41 Oriental Cholangiohepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .169 CASE 42 Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Budd-Chiari . . . . . . . . . . . . . . . . . . .174 CASE 43 Stenting Malignant Biliary Obstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179 CASE 44 Acalculous Cholecystitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .184 CASE 45 Hemodialysis Catheter Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188 CASE 46 Pneumothorax after Chest Tube . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .194 CASE 47 Persistent Left Superior Vena Cava . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .200 CASE 48 Central Venous Stenting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .203 CASE 49 Variocele Embolization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .208 CASE 50 Abscess Drainage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .213 CASE 51 Dialysis Graft Declotting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .219 CASE 52 Radiofrequency Ablation of Liver Tumor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224 CASE 53 Retrievable Inferior Vena Cava Filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .230 CASE 54 Suprarenal Inferior Vena Cava Filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .236 CASE 55 Duplicated Right Renal Vein . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .241 CASE 56 Extralobar Bronchopulmonary Sequestration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .247 CASE 57 Popliteal Artery Aneurysm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .253 CASE 58 Pulmonary Embolus and Thrombolysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258 CASE 59 Renal Artery Fibromuscular Dysplasia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .264 CASE 60 Chemoembolization of Liver Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .269 CASE 61 Transjugular Portosystemic Shunt for Refractory Variceal Bleeding . . . . . . . . . . . . . . . . . . . .275 CASE 62 Uterine Artery Embolization for Symptomatic Fibroids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .283 CASE 63 Nephrostomy Catheter Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .290 CASE 64 Angiomyolipoma Embolization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .296 CASE 65 Transrectal Abscess Drainage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .301 CASE 66 Superficial Femoral Artery Cryoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .306 CASE 67 Islet Cell Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .311 CASE 68 Abdominal Cyst Sclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .315 CASE 69 Atherosclerotic Renal Artery Stenosis with Stent Insertion . . . . . . . . . . . . . . . . . . . . . . . . . . . .320 CASE 70 Biliary to Transjugular Intrahepatic Portosystemic Shunt (TIPS) Fistula . . . . . . . . . . . . . . . . .327 CASE 71 Liver Biopsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .333 CASE 72 Portal Vein Thrombosis in a Newborn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .339 CASE 73 Portal Vein Stenosis after a Liver Transplant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .344 CASE 74 Traumatic Aortic Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .351 CASE 75 Catheter Repositioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .356 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .361 FOREWORD Interventional radiology is not getting easier; it is getting more complicated and more time con- suming. On the other hand, it is generating more interest around the world. As radiologists compete with nonradiologists, it is essential that books like this one are available not only to the senior prac- titioner, but also to the senior and junior resident. Interventional radiology, unlike some disciplines, is not best taught in the lecture hall. On the contrary, it is best taught in a small classroom setting with a question-and-answer-type format based on experience and case studies. What Dr. Funaki and his colleagues, Dr. Jonathan Lorenz and Dr. Fung Van Ha, have produced in book form is the ideal approach of the small-classroom setting with multiple case studies in both vascular and non-vascu- lar radiology. Significantly, the book is produced by busy practitioners who handle these everyday problems. Brian Funaki has become a national and international figure in interventional radiology and is now the editor-in-chief of Seminars in Interventional Radiology. He has wide experience and global approach to these difficult subjects. Both Dr. Jonathan Lorenz and Dr. Thuong Van Ha work in Dr. Funaki’s department. The composition of this group in fact adds to the depth of the book because the editors cover a range of experience in interventional radiology. Almost every subject in Teaching Atlas of Vascular and Non-vascular Interventional Radiology focuses more on vascular than non-vascular intervention, however, major points of non-vascular intervention are indeed included. Interventional radiology is a give-and-take specialty, and Dr. Funaki and his colleagues have generated a book to reflect that. Peter Mueller, M.D. Professor Department of Radiology Harvard Medical School Division Head, Abdominal Imaging and Interventional Radiology Massachusetts General Hospital Boston, Massachusetts ix
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