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A case of hepatic arterial haemorrhage after percutaneous biliary drainage catheter placement is presented. Temporary control of the haemorrhage was obtained by placement of a larger drainage catheter which tamponaded the bleeding artery. Hepatic angiography followed by transcatheter embolotherapy provided a definitive control of bleeding.

Osler-Rendu-Weber disease, or hereditary hemorrhagic telangiectasia, is a vascular disease with autosomal dominant transmission. The liver is involved in 31% of patients with hereditary hemorrhagic telangiectasia (1). It appears that the lesions uncommonly causes serious disease. We report the imaging findings and the therapy in a case with extensive telangiectasis in the liver.

Spinal epidural hematoma is an unusual condition requiring urgent neurosurgical intervention. Imaging plays an important role in the preoperative work-up. Although MR imaging is the examination of choice, a myelogram and CT myelogram are often performed in an emergency situation. The association with ankylosing spondylitis has been described and is considered a risk factor for developing a hematoma.

Uterine arteriovenous malformations are very rare. Transcatheter embolization has become the treatment of choice. It is safe and effective. Moreover the reproductive capacity can be preserved. We report a successful pregnancy after hyperselective transcatheter embolization of an arteriovenous malformation in a 27-year-old woman and present an overview of the literature.

We present the case of a young comatose female patient in whom a massive pulmonary embolism was diagnosed by pulmonary angiography. During the angiography, not only successful thrombolytic therapy with recombinant human tissue-type plasminogen activator (rt-PA) (100 mg) was performed, but measuring of the pulmonary artery pressures, oxygen and carbon dioxide levels was also possible. Thrombolysis seems to be a good alternative to surgical thrombectomy.

We report the case of an iliopsoas hematoma caused by an iliolumbar branch pseudoaneurysm, following a relatively minor blunt pelvic trauma. Laboratory investigation revealed an as yet undiagnosed von Willebrand's disease. The pseudoaneurysm was successfully embolized superselectively and the hematoma, causing femoral neuropathy, was subsequently drained surgically without major bleeding.

Between July 1994 and April 1995, 14 patients with a chronic occlusion of the femoropopliteal artery were treated by percutaneous intentional extraluminal recanalisation (PIER). It concerned 11 males and 3 females with a mean age of 65 years (50-76 years). Twelve patients were smokers, two patients had diabetes mellitus. Ten patients had severe claudication, four patients suffered from rest pain, three of the latter had ulcerations. In all patients, recanalisation and balloon dilatation could be established. However, angiographic result was unsatisfactory in one case. There were no complications. Clinical follow-up varied from 2 weeks to 9 months. Two patients needed a surgical femoropopliteal bypass respectively 4 and 7 months after recanalisation because of claudication recurrence. A third patient had two percutaneous redilatations of a restenosis. The remaining 11 patients became free of complaints. PIER seems to be a feasible treatment for patients with chronic femoropopliteal occlusions with a very good technical success, low complication rate and promising initial clinical outcome. Follow-up studies have to prove its superiority over the established revascularisation techniques.

Intimal hypertrophy with venous spur formation caused by compression of the left common iliac vein by the right common iliac artery is advanced as the etiology of the higher incidence of deep venous thrombosis involving the left leg. In most cases of left iliofemoral thrombosis no underlying compression syndrome is detected or treated because the left common iliac vein has to be cleared from thrombi before compression can be identified. A series of 6 consecutive retrospectively analyzed patients with acute left iliofemoral thrombosis is presented. In these patients a left iliac vein compression syndrome was detected after percutaneous intraluminal thrombolysis with Actilyse (rt-PA). This compression was successfully relieved by insertion of a wall stent. Percutaneous treatment of Cockett's syndrome seems an attractive alternative for conservative and/or surgical management.

A case of successful wire coil embolization of a bleeding gastroduodenal pseudoaneurysm secondary to necrotizing pancreatitis with pseudocyst formation is reported. The embolization technique using multiple coils is discussed and compared with other techniques previously described.

We report a patient in the "atherosclerotic age" with symptomatic fibromuscular hyperplasia of both external iliac arteries. Our patient had a history of bilateral intermittent claudication secondary to a concentric narrowing of a long segment of both external iliac arteries. A typical associated involvement of both internal carotid arteries was present.

Spiral CT angiography has been successfully applied to the detection and grading of renal artery stenoses. In this manuscript the technique, the diagnostic accuracy and the advantages and limitations of this new method are discussed.

A prospective double blind randomized comparative study was performed in patients with insufficient distal artery opacification during peripheral arteriography, in order to compare the vasodilating capabilities of intraarterially injected nitroglycerin, tolazoline and buflomedyl versus placebo. All three vasodilating agents showed statistically significant improvement of distal artery opacification as compared to the placebo (p < 0.0001). Overall results were better for buflomedyl (p = 0.231) then for tolazoline (p = 0.142) and nitroglycerin, but these differences were statistically not significant. It is concluded that buflomedyl is an excellent vasodilating agent in peripheral arteriography.

Although patients with peripheral arterial occlusive disease due to thromboangiitis obliterans (TAO) have been well characterized and the relationship of this disease to tobacco is stressed, little attention has been focused on its ability to involve the mesenteric vasculature and its ability to affect women. We report a rare case of a known TAO female patient who presented with abdominal pain due to inflammatory changes of the mesenteric vessels. The resulting small bowel ischemic changes and formation of intramural gas were demonstrated on a small bowel follow-through and a plain abdominal film. An angiography finally showed a superior mesenteric artery occlusion.

The authors describe one case and report four other of pathologically proven spontaneous retroperitoneal renal hemorrhage due to a ruptured hemorrhagic cyst (2 cases), a renal cell carcinoma, an angiomyolipoma, and a tubular adenoma. The contribution of US, CT, and angiography to the diagnosis is discussed and the recent literature is reviewed.

Hepatic artery aneurysms are uncommon lesions, often with a nonspecific clinical presentation and difficult to diagnose before rupture. The authors report a case which was correctly diagnosed with non-invasive procedures (duplex sonography and color Doppler).

The authors report a case of prostatic abscess in a patient without significant clinical manifestation. Transrectal ultrasonography and computed tomography demonstrated a lesion suggestive of an abscess which was finally confirmed by transurethral resection revealing pus.