Endovascular Stent Treatment for Symptomatic Benign Iliofemoral Venous Occlusive Disease: Long-Term Results 1987–2009

Venous stenting has been shown to effectively treat iliofemoral venous obstruction with good short- and mid-term results. The aim of this study was to investigate long-term clinical outcome and stent patency. Twenty patients were treated with venous stenting for benign disease at our institution between 1987 and 2005. Fifteen of 20 patients (15 female, mean age at time of stent implantation 38 years [range 18–66]) returned for a clinical visit, a plain X-ray of the stent, and a Duplex ultrasound. Four patients were lost to follow-up, and one patient died 277 months after stent placement although a good clinical result was documented 267 months after stent placement. Mean follow-up after stent placement was 167.8 months (13.9 years) (range 71 (6 years) to 267 months [22 years]). No patient needed an additional venous intervention after stent implantation. No significant difference between the circumference of the thigh on the stented side (mean 55.1 cm [range 47.0–70.0]) compared with the contralateral thigh (mean 54.9 cm [range 47.0–70.0]) (p = 0.684) was seen. There was a nonsignificant trend toward higher flow velocities within the stent (mean 30.8 cm/s [range 10.0–48.0]) and the corresponding vein segment on the contralateral side (mean 25.2 cm/s [range 12.0–47.0]) (p = 0.065). Stent integrity was confirmed in 14 of 15 cases. Only one stent showed a fracture, as documented on x-ray, without any impairment of flow. Venous stenting using Wallstents showed excellent long-term clinical outcome and primary patency rate

Tetraventricular hydrocephalus due to ruptured intracranial dermoid cyst.

We present the MR imaging findings in a patient who developed tetraventricular hydrocephalus after massive rupture of dermoid cysts with generalized subarachnoid and ventricular spread of cyst contents. The development of tetraventricular hydrocephalus due to ruptured dermoid is a very unusual complication, and was attributed to cyst contents interfering with passage of cerebrospinal fluid through the arachnoid granulations and fourth ventricular outlet foramina

Color Doppler analysis of vertebral arteries - Correlative study with angiographic data

Objective. Color Doppler ultrasonography is the most widespread diagnostic procedure in obstructive disease of the arteries supplying the brain. To our knowledge, there are only a few correlative color Doppler ultrasonographic and angiographic studies of the vertebral arteries, especially in patients who have flow-restrictive stenosis at the carotid bifurcation. The main purpose of this prospective study was to, evaluate diameter, flow volume, and time-averaged mean velocities of angiographically verified normal vertebral arteries without collateral flow. The second purpose was to, try to establish a threshold value for the flow volume of the vertebral artery. Methods. One hundred twenty patients referred for carotid angiography with a normal vertebrobasilar system and with no patent posterior communicating arteries were investigated with color Doppler ultrasonography. Luminal diameter, time-averaged mean velocity, peak systolic velocity, and flow volume values were calculated for each patient. The parameters were compared between sexes, in different age groups, in patients with carotid stenosis of 50% or less and greater than 50%, and in patients who had clinical signs of vertebrobasilar insufficiency versus those who had not. Results. We have found no significant difference in evaluated parameters with the degree of associated. carotid stenosis or vertebrobasilar insufficiency. Diameter and flow volume values on the left side were, higher than on the right side. Conclusions. We found similar flow volume values of vertebral arteries in both sexes and both groups of patients with carotid stenosis of 50% or less and greater than 50%. All parameters did not differ in patients with stenosis of 50% or less and greater than 50% and in patients with and without clinical signs of vertebrobasilar insufficiency