Transfemoral treatment for iliac occlusive disease with endoluminal stent-grafts

Objectives:Percutaneous treatment of iliac artery occlusive disease has replaced open vascular reconstruction for several indications. A balloon angioplasty with or without stent is not an option in the presence of infrainguinal extension of the disease. The authors describe a technique that allows the construction of an aorto- or iliofemoral graft through a single groin incision, using a 4 mm PTFE graft, anchoring it proximally with a Palmaz stent and dilating both to the desired diameter.Design:Retrospective non-randomised study.Materials and Methods:Nineteen procedures were performed in 16 patients mainly because of ischaemic rest pain, often with trophic skin changes or minor gangrene. Three patients had a bilateral procedure. Twelve patients had one or more associated procedures: 10 distal bypasses, one thrombectomy, one reimplantation of a distal bypass on the iliofemoral graft, one contralateral profundaplasty and two stents of the contralateral common iliac artery.Results:Two patients died, one of small bowel ischaemia and the other of a myocardial infarction. During the mean follow-up of 8.8 months, two graft thromboses occurred. In another patient bilateral stenting of a residual stenosis was necessary.Conclusions:Our experience shows that the reported technique is feasible. Whether the procedure is truly “less invasive” and the long-term results acceptable remains to be shown

CVIR award 2012-2013: Dr H. Westerlinck. An unusual complication after renal biopsy

Major complications after renal biopsy are those that don’t resolve spontaneously and are in need of an intervention (blood transfusion, angiography, cystoscopy, etc.). They occur in only 6,4% of the cases and include massive hematuria, hematoma, arteriovenous fistula, renal obstruction, acute renal failure, hemoglobin drop or septicemia

Influence of coprecipitation on quantitative estimations of ribonuclease activities by precipitation methods

We investigated coprecipitation effects occurring in three precipitation methods used for the determination of RNase activities. In this study we examined exclusively the coprecipitation of the nonprecipitable degradation products themselves along with the precipitable substrate. This was done in two ways: (1) by precipitating RNA in various concentrations in the presence of the same amount of nonprecipitable degradation products; (2) by precipitating the same amount of RNA in the presence of various concentrations of degradation products. It was shown that the results yielded by precipitation in media containing different amounts of substrate cannot be trusted. In kinetic studies on the influence of substrate concentration of RNase activities they will occasionally lead to erroneous conclusions and reveal apparent substrate inhibitions that do not exist or exist only at higher substrate concentrations. From our data it follows that such studies can be performed using those techniques, provided that the proportion of nonprecipitable to precipitable substances is kept as constant as possible (e.g., by adequate dilution of the more concentrated solutions). It was also shown in one case that the coprecipitation is a rectilinear function of the concentration of degradation products in the range of the practical application of the method. In this way it fits the Langmuir adsorption isotherm

Educational governance for the regulation of industry sponsored continuing medical education in interventional and device based therapies

The relationship between industry and clinicians in educational programmes needs to be regulated. Industry may be best placed to deliver educational programmes in "craft" related specialties and particularly in areas where device implantation/technology based therapy has a major clinical role. The authors supervise industry sponsored clinical teaching at a purpose built independent teaching facility, and have developed the concept of educational governance to regulate their relationship with their industry sponsor and that concept is presented