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The management of craniocerebral penetrating injury currently represents a challenge for neurosurgeons and neuroradiologists and requires innovative planning. This report describes the case of a worker admitted to hospital with an intracranial piece of concrete-cutting saw stuck through the right eye. At the time of admission the patient was conscious and this fact influenced the choice of a particular approach. This patient escaped without neurological deficit or complications, except for the inevitable removal of an eye. [ABSTRACT FROM AUTHOR]

A Palmaz stent had dislodged into the left pulmonary artery after TIPS. After transfemoral catheterization of the left pulmonary artery, the stent was retrieved into the right femoral vein employing an angioplastic balloon catheter and finally extracted after surgical venotomy. [ABSTRACT FROM AUTHOR]

Background: Intraprocedural aneurysm sac embolization (embo-EVAR) during endovascular abdominal aneurysm repair (EVAR) using coils and fibrin glue is a technique for preventing type II endoleak (EII). Our aim is to evaluate feasibility, safety and clinical outcome of this promising approach., Materials and Methods: A retrospective clinical case analysis of 72 patients who underwent EVAR during the period 2011-2014. Two groups were compared at 6 and 12 months follow-up with contrast media computed tomography scan and contrast-enhanced ultrasound (CEUS) imaging: consecutively, 36 patients (group A) treated with classic EVAR and 36 patients (group B) treated with embo-EVAR. Coils were released filling better as possible the aneurysm sac; the embolization was completed by injecting fibrin glue. Device and materials used, differential systemic and sac pressures, presence of any endoleak, and complication were registered., Results: In our experience, we had 100% technical success without surgical conversion. Embo-EVAR was performed, after endograft deployment, in group B patients, all with ratio of Δ-pressures (obtained from Δ-sac pressure/Δ-differential pressure) > 0.16. No early or late complications occurred and mortality was nil. Follow-up was performed with computed tomography-angiography and CEUS at 6 and 12 months. We observed 9 type II and 1 type Ia endoleak in group A and 2 type II and 1 type Ib endoleaks in group B. Mean radiation exposure time was 30.3 min in group A and 43.3 min in group B. EVAR procedure average cost was 9,000 €. The average cost of sac embolization was 1,500€., Conclusions: Although a randomized study is necessary, embo-EVAR may be a valid approach to prevent type II endoleaks and further complications. Mild costs and exposure-dose increase could be accepted to avoid reinterventions, and in our experience, it could be routinely performed with excellent results., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Purpose: To investigate the exposure parameters, effective dose, frequency, and collective dose for interventional radiology (IR) procedures performed at a single institution during a 9-year period., Materials and Methods: According to the anatomic region imaged, seven diagnostic and 16 therapeutic IR procedures performed between 2002 and 2010 were retrospectively investigated with regard to exposure setting parameters and frequency. Dose-area products (DAPs), cumulative doses (CDs), and irradiation time values were analyzed on a sample of 1,100 examinations. DAP distributions (median, mean, and percentiles) were adjunctively determined by using bootstrap resampling in PCXMC software to estimate patient effective dose. Data provided by the Radiological Information System allowed collective effective and per-capita doses to obtained., Results: The exposure parameters showed widespread variability. The median DAP values for pelvic arteriography and pelvic arterial angioplasty/stent placement were 10,015 and 19,424 cGy·cm(2), respectively. For the 23 procedures studied, the estimated average per-procedure effective dose ranged from 0.34 to 104.9 mSv. The pelvis (37%) was the region most often imaged in diagnostic procedures, and angioplasty/stent treatment of vessels was the most frequently performed therapeutic procedure (44%). During the study period, IR procedures increased in frequency (+137%), with a consequent increase in the per-capita dose (0.172 to 0.461 mSv) and collective dose (21 to 58 man-Sv/y)., Conclusions: A comprehensive Monte Carlo-aided analysis, which allowed evaluation of contributions in terms of per-procedure and collective doses to the population for the practice of IR, showed a significant growth rate during the study period., (Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.)

Purpose: To report the use of a new type of uncovered stent to treat aortic aneurysms., Case Report: Under compassionate use, an 81-year-old man with multiple comorbidities and an expanding 63-mm juxtarenal abdominal aortic aneurysm was treated with a 28×100-mm Multilayer flow-modulating stent. Immediately, the blood flow velocity inside the aneurysm sac appeared reduced on fluoroscopy. All aortic branches covered by the stent (celiac trunk, superior mesenteric artery, and renal arteries) remained patent. Serial computed tomography at up to 12 months has shown excellent stent and visceral artery patency and progressive reduction in the sac diameter (58 mm) and volume (84.9 cm(3) to 82.8 cm(3))., Conclusion: This case shows that the use of an uncovered multilayer stent reduces the flow in the aneurysm but preserves perfusion of the branch arteries, which is impossible with covered stents.

Percutaneous gastrostomy is reported to be an effective alternative to total parenteral feeding or long-term nasogastric tube in the treatment of mechanical or functional dysphagia. The authors report their personal experience with 137 percutaneous gastrostomies performed on 98 men and 39 women from January 1986 through December 1993. All the maneuvers were performed under fluoroscopic guidance in the patients with head or neck cancer, neoplastic, vascular or post-traumatic neuropathy and upper GI tract cancer. To avoid left hepatic lobe trauma, percutaneous gastrostomy needs to be performed under US guidance. A 7F nasogastric tube is used to fill the stomach with air. After distending the gastric cavity, with the Seldinger technique under local anesthesia, fascial dilators of progressively increasing caliber are introduced into the gastric cavity and the final 12F gastrostomy catheter is positioned under fluoroscopic guidance. No major complications, such as hemorrhage or peritonitis, occurred. In one case, during the maneuver, the patient complained of severe epigastric pain which regressed with no further problems two hours later. In three cases the gastrostomy catheter fell out of place and was replaced by running the fistolous tract with a venous cannula and then a guidewire for gastrostomy repositioning. With this type of treatment, the patient can be given enteral feeding the following day. The maneuver requires approximately 10 minutes to perform and is well tolerated by the patient as it requires no general anesthesia. Percutaneous gastrostomy is more cost-effective than surgery or endoscopy and hospitalization is shorter. The only contraindications to this maneuver are hepatomegaly (because of the risk of liver trauma during percutaneous maneuvers), ascites (because of the risk of infection) and finally the complications resulting from gastric resection.