Search

No single technique exists for lumbar phlebography. Whilst catheterisation of the ilio-lumbar veins is always the first step, it should be routinely followed by injection of the lateral sacral veins whenever the leel L5-S1 is clinically suspicious. Finally, when only poor opacification of the longitudinal epidural plexuses is obtained by filateral injection of the ilio-lumbar or ilio-lumbar and sacral systems, catheterisation of the vein in L2 on the right or L3 on the left makes it possible in virtually all cases to obtain satisfactory filling of the lumbar plexuses. It may be considered at the present time that, from a technical standpoint, failures of lumbar phlebography by bilateral femoral catheterisation do not exceed 1% of cases.

Systematic lymphographic studies in 13 cases of infection with Onchocerca volvulus have enabled a "lymphographic diagram" to be made for each infected patient. The images obtained are similar to those observed in wuchereriasis. The microfilariae in onchocerciasis, however, are not transmitted in the lymphatic system, and the lesions, which vary according to the degree of infestation, show little progression. They are found mainly in the inguino-crural ganglia which are the first main ganglionic relay system for the lower limbs.

The authors discuss the role of highly selective arteriography and embolization in the treatment of angiodysplasias with shunt, in the limbs, after analyzing the results in three cases of embolization for congenital arterio-venous fistula of the limbs. They review the arteriographic data necessary for a better understanding of the physiopathology and compare the different therapeutic methods available. The importance of highly selective arteriography in guiding therapy, where embolization is of primary value, is stressed.

Embolization of the aeso-cardiotuberositary varices, by selective catheterization of the coronary vein of the stomach and the posterior gastrics, seems to be valuable palliative treatment in portal hypertension, owing to its relative innocuousness, inspite of a certain number of failures. It is carried out by transhepatic puncture of the portal system or catheterization of the umbilical vein.

The authors review the indications of arteriography in trauma of the hand. The results are analysed and their value with regard to operative technique discussed. The method used is very simple. Study of the vascular distribution of the hand is essential both pre- and postoperatively.

Three patients with bleeding into the bile ducts were explored by angiography. Two of them (severe post-operative bleeding and following needle-biopsy of the liver) were completely cured by highly selective arterial embolus production. No definite diagnosis was established in the third case (liver angioma with large artero-portal fistula). It can be seen from these observations, that angiography is essential in patients with bleeding into the bile ducts. The reason is not to establish the diagnosis but to find the precise location of the lesion and, under certain conditions, to apply radical treatment by highly selective arterial embolus production.

By making use of the film of the substractive screen in contact printing, it is possible to reverse the films into negatives, and to obtain in this manner excellent slides at low cost.

Four cases of non-surgical extraction of iatrogenic vascular foreign bodies are reported, in two of which a basket sound was used, and two others a metallic collar. The percutaneous route was used without denuding the veins. A review of the literature showed 83 cases of non-surgical extraction of vascular foreign bodies, and the methods and materials used are discussed.