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The purpose of this phase III clinical trial was to compare two different extracellular contrast agents, 1.0 M gadobutrol and 0.5 M gadopentate dimeglumine, for magnetic resonance imaging (MRI) in patients with known or suspected focal renal lesions. Using a multicenter, single-blind, interindividual, randomized study design, both contrast agents were compared in a total of 471 patients regarding their diagnostic accuracy, sensitivity, and specificity to correctly classify focal lesions of the kidney. To test for noninferiority the diagnostic accuracy rates for both contrast agents were compared with CT results based on a blinded reading. The average diagnostic accuracy across the three blinded readers ('average reader') was 83.7% for gadobutrol and 87.3% for gadopentate dimeglumine. The increase in accuracy from precontrast to combined precontrast and postcontrast MRI was 8.0% for gadobutrol and 6.9% for gadopentate dimeglumine. Sensitivity of the average reader was 85.2% for gadobutrol and 88.7% for gadopentate dimeglumine. Specificity of the average reader was 82.1% for gadobutrol and 86.1% for gadopentate dimeglumine. In conclusion, this study documents evidence for the noninferiority of a single i.v. bolus injection of 1.0 M gadobutrol compared with 0.5 M gadopentate dimeglumine in the diagnostic assessment of renal lesions with CE-MRI.

We present a 59 year old patient with advanced heart failure who underwent lead extraction. The lead was implanted 11 years ago, and 2 years later looped spontaneously following its fracture. The transvenous extraction process through inferior vena cava was complicated by knotting of the inactive lead over the active ventricular lead. The patient was pacemaker-dependent. Finally, the old lead was successfuly explanted. The active intact lead was used to create resynchronisation system.

We present a complication of the infected pacing system extraction by lobular pneumonia in a 73-year-old female patient. The pacing system involved DDD pacemaker, atrial and ventricular endocardial leads implanted 12 year beforehand. The defect of the atrial lead emerged during the pacemaker replacement 4 years ago. The diagnosis of the injury cause and its reparation were not undertaken at that time. An interruption of the atrial lead which resulted in the formation of a loop inside the cardiac chamber was found when purulant pacemaker pocket infection had been diagnosed. The patient was referred for the pacing system extraction after preoperative specific antibiotic treatment. After a long-lasting, difficult, two-step leads extraction procedure, pneumonia developed. An echocardiogram revealed enlargement of the right atrium and ventricle, with elevated pulmonary artery pressure up to 40 mmHg. An atypical chest X-ray with the presence of a large pleural liquid volume led to the work-up of hemorrhagic complications and postponed the antithrombotic therapy. With the delay of 1.5 month the pulmonary scintigraphy showed features of pulmonary embolism. The embolism was most likely caused by a vegetation mobilized from the endocardial lead and/or endocardium during the extraction maneuvers. Before the surgery, the vegetations attached to the leads or to the endocardium had not been visualized. Anticoagulant therapy with antivitamins K was successful, which resulted in the pulmonary pressure normalization. The patient has remained in a good condition for the next 3 months of follow-up.

Purpose: The Palmaz Genesis Peripheral Stainless Steel Balloon Expandable Stent in Renal Artery Treatment (GREAT) Trial was designed to assess the safety and performance of a low-profile stent for the treatment of obstructive renal artery disease by looking at 6-month renal artery patency uniformly analyzed by a Core Lab., Materials and Methods: Fifty-two consecutive patients (mean age, 63.7 years) were successfully treated with the Palmaz Genesis Peripheral Stent (Cordis, Miami, FL) on the Slalom 0.018-inch Delivery System (Cordis Europe N.V., Oosteinde 8, NLO-9301 LJ Roden, The Netherlands) at 11 investigational centers. Patients with severe renal failure and > 8-mm renal artery were excluded. Primary endpoint was angiographic determination of in-stent percent diameter stenosis at 6 months. Fifty-one patients were treated with one stent, one patient was treated with two stents to cover the complete lesion., Results: Mean percentage diameter stenosis before renal angioplasty was 68.2% +/- 12.0%. No stent implantation failure, displacement, need for additional stent implantation, or procedural complication was observed. Six-month angiography was performed in 41 of 52 patients (79%) resulting in a mean in-stent percent diameter stenosis or Quantitative Vessel analysis (QVA) at 6 months of 23.9%. The in-stent binary (percent diameter stenosis > 50%) restenosis rate at 6 months was 14.3%. No fatal events occurred up to 6 months after implantation. Major adverse events occurred in five patients: four patients (7.7%) required a revascularization and one patient (1.9%) experienced a cerebrovascular event, which regressed spontaneously., Conclusions: The Palmaz Genesis stent (Cordis) provides good results for renal artery stent placement, with an in-stent binary restenosis rate (percent diameter stenosis > 50%) at 6 months of 14.3% as determined with angiography.

Background: A well-functioning mature arteriovenous fistula is essential for the maintenance of haemodialysis in patients with chronic renal failure. The Brescia-Cimino arteriovenous fistula has the best survival characteristics and low rate of complications. The most common reason of fistula failure is thrombosis caused by stenosis. Colour Doppler ultrasonography has proven to be effective in the assessment of anatomical vascular features. The majority of studies were done in patients with clinically presumed arteriovenous fistula complications. However, only limited data are available about the well-functioning mature arteriovenous fistulas. The purpose of the present study was to evaluate completely asymptomatic, mature arteriovenous fistulas with colour Doppler ultrasound., Materials and Methods: From July 2001 to April 2003, we examined 139 patients with the end-stage renal disease. They were in the range of 19-79 years of age (mean, 46.7 years). The study included only the patients who met the following criteria: (1) no difficulties with haemodialysis (as reported by nurses); (2) normal venous diastolic blood pressure (<150 mmHg) at monthly evaluation; (3) normal urea clearance x time/urea volume of distribution; (4) blood cells count, plasma electrolytes, and liver function at monthly evaluation. The mean fistula age was 26 months (S.D.=21.9). The mean time of dialysis therapy was 49 months. Thirty-eight percent patients had primary fistulas, 23%--secondary, 11%--third and 11%--fourth, 4%--fifth, 5%--sixth, and 8% patients had more than sixth., Results: There was no correlation between: (1) patient's age and fistula age; (2) patient's age and number of fistulas in one patient; (3) fistula age and number of fistulas in one patient; (4) localization of fistula and fistula age. There was a strong correlation between dialysis therapy period and number of fistulas in one patient. The mean flow volume was 1204.1 ml/min (S.D.=554). It was significantly higher in the fistulas with aneurysms, calcifications and tortuous vessels and lower in those with stenosis. There was no correlation between the flow volume or presence of stenosis and fistula age. Stenosis was detected in 64% fistulas. Fifty-seven percent of stenoses were located in the anastomotic region, 22% stenoses were in vein junction, 19% were at one or both ends of aneurysm, and 2% in the remaining region of the efferent vein. Perivascular colour artefacts were present at the 94% fistulas with stenosis. Chronic venous occlusion with collateral veins was detected in 6% of fistulas. The aneurysms were observed in 54% fistulas. The mean diameter of aneurysms was 12.4 mm. Ninety-six percent of aneurysms were located at puncture sites. Ten patients had a small thrombus in an aneurysm and at puncture sites., Conclusions: We conclude that there was a high level of abnormalities present in well-functioning mature arteriovenous fistulas. However, these abnormalities were not sufficient to affect the functioning of the dialysis fistula.

Juvenile angiofibroma is a rare, benign, hypervascular, nasopharyngeal tumour. The aim of the study was to assess the value of CT and MR in determining therapeutic approach and follow-up in patients with this condition. There were 40 patients with juvenile angiofibroma. All patients underwent angiography. In 24 patients CT and 5 patients MRI was performed. Most patients (67%) presented with tumour stage III according to Chandler. Preoperative tumour staging based on CT was in accordance with surgical evaluation in 92% of cases. In 4 (17%) of 24 patients CT and MRI showed a recurrence after surgery. On the bases of radiological findings 2 patients were referred to irradiation instead of surgery. CT allows correct tumour staging in 92% of patients. It well demonstrates the presence and extension of the recurrence.

Background: To evaluate the diagnostic efficacy of ultrasound imaging of renal arteries after Levovist administration., Material/methods: During a 20-month period, 100 hypertensive patients with suspected renal artery stenosis were referred to the Department of Interventional Radiology. In all patients, angiography and ultrasound examinations of renal arteries were performed (100 right, 100 left and 23 additional), before and after Levovist injection, using color and spectral Doppler. Results of Doppler examinations before and after Levovist administration were compared with results of angiography ('gold standard '). Hemodynamically significant renal artery stenoses (> 50% in angiography)were diagnosed following Doppler parameters: Vmax > 2 m/s, V min > 1.5 m/s, RAR > 3.5, acceleration time > 0.08 s., Results: The diagnostic efficacy of Doppler examinations of the right renal artery (RRA)increased from 68% before to 98% after Levovist enhancement and diagnostic efficacy for the left renal artery (LRA) increased from 61% to 97%. In conventional study, 7 additional renal arteries (30.4%) were visualized, after Levovist administration this number increased to 15 (65.2%). Before Levovist injection, 3 stenoses of RRA and 1 stenosis of LRA were diagnosed. After Levovist enhancement, the number of RRA stenoses increased to 5 and that of LRA stenoses increased to 2, later confirmed by angiography., Conclusions: The use of Levovist increases the diagnostic efficacy of Doppler ultrasound examinations of renal arteries and makes it comparable to angiography.

The Aim: Of the study was to present own experience in imaging forearm blood vessels before creating hemodialysis access., Material and Methods: The studied group consisted of 45 hemodialysed patients. Colour duplex sonography (US) was performed in 17 patients before creating the first hemodialysis fistula and phlebography in 27 patients before creating next fistula. In the first group diameter and blood flow parameters in the arteries and deep veins of the upper limb were evaluated. In the second group diameter of patients' veins was assessed. In patients before creating the first fistula the US examination in 4/17 cases showed blood vessels, which were insufficient to create fistula. Among 27 patients who underwent phlebography in 13 cases a stenosis or occlusion was demonstrated and in 6 lack of appropriate superficial veins., Conclusions: Colour duplex sonography and phlebography are useful in evaluation of blood vessels before creating a vascular access. Phlebography is a method of choice in imaging subclavian and brachiocephalic vein.

Vascular access malfunctions can be diagnosed by means of imaging and non-imaging methods. The former are: ultrasound (US), colour Doppler ultrasonography, arteriography and phlebography. Radiological imaging allows for direct assessment of the morphology and function of the hemodialysis fistula, and shows precisely the kind and location of lesions, that may lead to access failure. The aim of the study was to present the algorithm of methods employed in evaluation of hemodialysis fistulae, that had been developed by the authors. From March 1995 to July 2001, 1020 colour Doppler ultrasonography examinations were performed, followed by 250 angiographies of hemodialysis fistulae. In the studied group there were 170 well functioning hemo-dialysis fistulae. They were evaluated in order to establish normal blood flow parameters in the fistula. In 135 patients with symptoms of fistula failure US revealed the presence of pathological lesions, such as thrombosis or aneurysm of the venous branch. In 193 cases the presence of stenosis was stated. Three hundred eleven hemodialysis fistulae were sonographically evaluated before the patient was referred to surgical (81) or intravascular (230) treatment. Post-operative assessment was performed in 125 cases. In 231 cases, angiography confirmed the results of US. In 19 cases the degree of fistula stenosis was underestimated in colour Doppler sonography. Colour Doppler sonography is a method of choice in evaluation of arteriovenous hemodialysis fistulae. Abnormal results of physical examinations, dialysis parameters, as well as patients complaints associated with the fistula are indications to perform an ultrasound examination. Angiography is required in case of dubious US findings or as the first step in endovascular treatment.

The Aim: Of the study was to evaluate utility of magnetic resonance (MR) in the assessment of the women who fulfilled inclusion criteria for uterine artery embolisation as a symptomatic leiomyoma treatment and outcome of procedures., Materials and Methods: MR examination was performed in 220 patients. Uterine artery embolizations were performed in 170 patients., Results: The reasons for disqualification were: no correlation between symptoms and size an position of leiomyoma--61%, adenomyosis--20%. In MR imaging dominant leiomyoma volumes were diminished by 59.6% (p < 0.05) over a period of 3 months., Conclusions: MR is the method of choice in the assessment of women referred to uterine artery embolisation as a symptomatic leiomyoma treatment. MR imaging is effective and objective method of evaluation outcomes of uterine embolisation.

Purpose: To assess the diagnostic value of Levovist in the ultrasound imaging of visceral arteries in patients with clinical symptoms of abdominal angina, before and after percutaneous transluminal angioplasty (PTA)., Material and Method: During a 12-month period (2000/2001) five patients with visceral arterial stenoses had ultrasound examinations and a subsequent PTA procedure. Indications for ultrasound examination were abdominal angina symptoms persisting for 3-5 years, (postprandial abdominal pain, diarrhea, and vomiting). In all patients ultrasound examinations were performed using color and spectral Doppler before and after Levovist injections. Color Doppler images and maximum blood flow velocity in stenosed visceral arteries were assessed. Patients underwent control Doppler examinations with Levovist injections to assess the effect of PTA., Results: In three patients conventional Doppler examination did not allow proper evaluation of visceral arteries, because of weak color and spectral Doppler signal and in two remaining patients visceral arteries were not visualized at all. In all five patients strong enhancement of color and spectral Doppler signal was observed after Levovist administration. In all these cases a hemodynamically significant stenosis was diagnosed: coeliac trunk-2 and superior mesenteric artery-3. PTA was performed successfully in these patients. In one of them ultrasound examination done before Levovist injection allowed good visualization of treated SMA and showed good PTA result. In the remaining four patients Doppler examination with the use of Levovist demonstrated visceral arteries well and confirmed successful PTA procedures., Conclusions: The use of Levovist makes the diagnostic efficiency of Doppler examinations much higher. In most cases it allows an unequivocal diagnosis of visceral artery stenosis in patients with abdominal angina symptoms. The Doppler examination with the use of Levovist is the method of choice in follow-up after PTA.

Surgical clipping has been considered for years a "golden standard" in the treatment of middle cerebral artery (MCA) aneurysms. The recent development of materials and endovascular techniques has permitted the use of embolization for the treatment of intracranial aneurysms regardless of their locations and size. In 30 patients with 32 MCA aneurysms (group I) the endovascular approach with GDC-10 coils was used, while in other 30 patients with 31 aneurysms (group II) surgical clipping was performed. On completion of the diagnostic process the patients were randomly assigned either to the endovascular or microsurgical treatment. Group I: 21 (70%) embolization procedures were carried out, while in 9 (30%) cases with 10 aneurysms embolisation was impossible or regarded as too risky due to various causes. The total occlusion of aneurysm SAC was achieved in 17 (77%) aneurysms, subtotal in 5 (23%). The morbidity rate was 8%, mortality-0%. Group II: Microsurgical clipping was performed in 27 (90%) cases, 3 (10%) patients were disqualified from treatment due to their poor clinical status. An excellent technical result was achieved in 24 (86%) patients, in 4 (14%) cases the neck remnant was observed in control angiography. The morbidity rate was 14%, mortality-0%.

Uterine artery embolization is a new method of treating uterine leiomyomata, first carried out in France in the early 90s. The procedures involve placing a small catheter into an artery in the groin and directing it to the blood supply of the fibroid. Little plugs of polyvinyl alcohol are injected through the catheter to block these arteries. This cause the fibroid to shrink. Indications for uterine fibroid embolization include menorrhagia, pelvic pain or pressure, other "bulk" syndrome (low-back pain, urinary frequency and constipation. The fluoroscopic-guided procedure is performed under local anesthesia. Most patients are discharged within 72 hours. Post-embolization syndrome including severe pain is managed with morphine via patient-controlled pump. Paper reviews long term outcomes. Uterine artery embolization has several advantages: high efficacy, less invasiveness, ability to treat multifocal changes, uterine preservation, shorter hospitalisation and recovery (low cost) and disadvantages: postembolic syndrome (pain and fever), unknown relations to pregnancy and lack of long term results.

We present a case of a man with concentric significant stenoses in the superior mesenteric artery and the celiac trunk, in whom percutaneous transluminal angioplasty did not provide sufficient technical result. We report the successful use of balloon expandable Perflex stent to treat superior mesenteric artery stenosis.

The aim of our study was to check the significance of portal blood velocity /PBV/ in evaluation of the severity of liver disease. Duplex doppler sonography evaluation of PBV was performed in 20 patients (pts) with liver cirrhosis (7 women, 13 men, aged 34-75) and 10 pts with normal liver function (controls). We checked it during fasting and 30 minutes after a meal. The diagnosis of liver cirrhosis was based on clinical, laboratory and sonographic criteria. The severity of liver cirrhosis was classified according the Child-Pugh score as class A--6 pts.; class B--10 pts. and class C--4 pts. The lowest values of the mean baseline PBV (during fasting) were observed in cirrhotic pts class C (15.9+/-4.2 cm/s vs class B 18,1+/-7.8 cm/s vs class A 20.4+/-8.6 cm/s vs controls 21.6+/-3.8 cm/s). A similar situation appeared after our evaluation of PBV values in the postprandial state (class C 16.5+/-4.8 cm/s vs class B 19.8+/-9.1cm/s vs class A 22.4+/-6.4 cm/s vs controls 29.6+/-10.6 cm/s). The increment of PBV after a meal in pts with the Child-Pugh class C was significantly diminished compared to control group (0.6+/-4.1cm/s vs 8.0+/-5.2 cm/s; p< 0.05). We concluded that the postprandial portal blood velocity assessment is useful for evaluation of the severity of liver disease.

The paper describes case of a patient (43 year old) suffering from submucosal symptomatic leiomyoma. She was treated with transcatheter uterine artery embolization. After a 3 month follow-up the patient was asymptomatic and a great reduction of leiomyoma was seen in MR.

Due to improvement in intravascular therapeutic procedures significant stenoses of vertebral and basilar arteries can presently be treated by means of percutaneous transluminal angioplasty (PTA). The reported case was a 34-year-old man with symptomatic stenosis of the distal left vertebral artery and hypoplastic right vertebral artery. The patient underwent PTA and the lesion was sufficiently dilated. No complications occurred during or after the procedure. After a year duplex Doppler follow-up examination showed normal blood flow and patency of both vertebral arteries. PTA may prove to be a useful therapeutic option in patients with symptoms of vertebro-basilar insufficiency.

Background: The goal of our research was to evaluate the efficacy of endovascular treatment in stenosis of the superior mesenteric artery and the celiac trunk., Material/methods: During the period 1996-2001, 6 patients (1 woman, 5 men, ages 46 to 73) were referred to our department with abdominal angina. Angiograms were performed in order to establish the reasons. All these patients presented with postprandial abdominal pain and weight loss. Angiography showed stenosis in the superior mesenteric artery in 2 patients, in the celiac trunk in 1 patient, and in both vessels in 3 patients. Typical balloon angioplasty (PTA) was performed with a balloon catheter, 5-8 mm in diameter, inflated up to 18 atm. If more than 30% stenosis remained after PTA, the patient was referred for stenting., Results: In 5 of the 6 patients (83%) PTA was successful. In one patient (17%) with poor results from PTA, a Perflex stent (diameter 7 mm) was implanted in the superior mesenteric artery. The follow-up protocol included clinical and Doppler ultrasonographic examination at 6, 12, and 18 months after surgery. A good clinical and ultrasound outcome was found in 6 patients at 6 and 12 months, and in 4 patients at 18 months., Conclusions: Balloon angioplasty and stent placement seem to be efficient and safe methods of treatment for abdominal angina in stenosis of the superior mesenteric artery and celiac trunk.

Thoracic aortic aneurysm (TAA) is life threatening disease. 76 to 50% of untreated patients die during 5 years. Mortality rate increases to 93% in patients with cardiopulmonary disease. Perioperative mortality rate is 15% and in patients with cardiopulmonary disease or urgent surgery, it amounts even 50%. Endovascular treatment of TAA was first reported in 1994. The introduction of stent-grafts has been a big progress in the treatment. A patient, 59 year-old man with TAA was described. He was admitted to our hospital for endovascular treatment of TAA. Both spiral CT and angiography were performed. The placement of the stent-graft was technically successful, but angiography showed the small leakage. Second stent was added. Angiogram confirmed the proper position of stent-grafts and complete exclusion of aneurysm. There was no incidence of neurological deficits. Spiral CT and angiography obtained at 3 month after procedure confirmed exclusion of aneurysm and satisfactory stent-graft position. The placement of endoluminal stent-grafts for repair of thoracic aortic aneurysms is technically feasible and safe procedure. Long-term studies are needed to compare its results with surgical treatment.

The main reasons of fistula dysfunction are stenosis and thrombosis. There are two kinds of thrombosis: acute and chronic. Acute thrombosis is total fistula occlusion while chronic occlusion is partial venous occlusion with collateral veins, which lead to impair fistula's function. 450 dialysis fistulas were referred to US (ultrasound) examination. Among 392 patients with fistula dysfunction, 71 presented chronic venous occlusion in hemodialysis shunt. 35 patients were qualified to endovascular recanalization. The mean length of the occluded segment was 3-35 cm (subclavian vein 2-4 cm). 38 patients underwent angiography (35 before endovascular treatment). Technique of recanalization included antegrade venous puncture, insertion guidewire (0.021'), catheter (5 Fr), balloon catheter (5-8 mm) and in 2 cases stent placement. Colour Doppler allowed to diagnose 34 (97%) cases of chronic venous occlusion in hemodialysis shunt. Decrease of mean flow volume in brachial artery--709 +/- 395 ml/min. (50-1500 ml/min) was statistically significant (p = 0.0015). Normal mean flow volume was 1242 +/- 641 ml/min. 20 of 35 recanalization procedures were performed successfully. The main reason of failure was perforation or false channel. Mean primary patency was 75% after 3 months. Mean cumulative was 85% (10/12) after 6 months. Chronic venous occlusion is often present in hemodialysis shunt and reduces flow volume. Percutaneous recanalization results aren't magnificent but there is only kind treatment for many patients with fistula failure.

A giant, unclippable right ICA aneurysm located partially intracavernously is reported with neck deriving at C3 level. The aneurysm caused optic chiasm compression, progressive left eye vision loss and exophthalmus as well as persistent headache. The presence of the aneurysm was first found in CT and confirmed by angiography. After having performed the temporary occlusion test of right ICA the ICA was permanently occluded with a detachable balloon. Control angiography showed complete occlusion of right ICA and no opacification of the aneurysm sac from vertebral and left carotid arteries.

Many specialists: nephrologists, surgeons, radiologists and nurses pay much attention to dialyzed patient using different terminology. The presented work establishes the principal rules of describing hemodialysis fistula to find convergence in terminology.

Background: Pulsating mass located close to peripheral arteries is usually considered as a result of arterial wall injury. Clinically important is to distinct pseudoaneurysm from haematoma and also to evaluate proximal and distal arterial bed for the assessment of the injury extent. A few previous reports claim good results of duplex Doppler US diagnosis of iatrogenic (post-catheterization) femoral artery injuries. This paper presents diagnostic findings of arterial injuries caused by accidental trauma., Patients and Methods: A retrospective analysis of 49 patients with post-traumatic pulsating mass close to peripheral artery was performed. The diagnostic results of both sonography and angiography were reviewed. All the patients underwent B-mode and duplex Doppler US examination using PW-, color- and power Doppler imaging techniques., Results: 34 pseudoaneurysms were diagnosed correctly with typical B-mode, color/power Doppler images and PW-Doppler spectral waveforms. The lack of flow signal and distinctive B-mode images enabled proper diagnosis of 13 haematomas. In 2 patients duplex Doppler US misdiagnosis occurred, because of secondary pseudoaneurysm formation, primary diagnosed as haematoma. The 47 correct US findings gave 96% efficacy in distinguishing pseudoaneurysm from haematoma, which compares well with the other studies. In 20 patients suffering from peripheral ischemia, US examination, in spite of proper distinction between pseudoaneurysm and haematoma was unable for precise estimation of proximal and distal arterial damage. Thus, it was successfully supported with angiography before surgical decision making. Angiography was also necessary in 8 patients with severe injuries of carotid, subclavian and palmar arch arteries, hardly accessible for ultrasound penetration., Conclusions: We conclude that duplex Doppler US is essential for noninvasive, unequivocal distinction between pseudoaneurysm and haematoma but it could not completely replace contrast angiography in the evaluation of post-traumatic pulsating mass caused by severe, extensive trauma, frequently complicated with peripheral ischemia or located in regions with poor access for ultrasound penetration.

Embolization of bronchial and systemic arteries is a method of choice in treatment of pulmonary hemorrhages in patients with existing contraindications to surgical therapy. Embolization was carried out in 57 patients with pulmonary hemorrhages in the course of pulmonary tuberculosis, mycetomas, bronchiectases, malignancy, vessel malformations and post-traumatic changes. In all patients it terminated hemorrhages. During the 5 year follow-up period recurrencies were seen in 14% of the patients warranting additional embolization.

The method of the experiment has been presented. It was found, that after 8 weeks of hydrocortisonum hemisuccinatum administration, 20 mg per day in two doses the braking force decreased by 15 per cent. The calculation of the measurements at 150 g of animal body weight proved to be useful.

The experiments were performed in the healthy mongrel dogs aged 5 to 8 years whose body weight ranged from 10-20 kg. Just after the coeliac arteriography the hepatic artery was embolized. The dogs were divided into 2 groups because of the application of two different embolizing materials. Spongostan was used as the embolizing material in group I consisting of 7 dogs. In group II consisting of 5 dogs the embolizing material was absolute ethyl alcohol with urogranic acid. The symptoms of the postembolization syndrome were observed in all dogs after the embolization for 1-5 days. In most dogs the transient increase of the aminotransferase activity was observed while the results of thymol turbidity test and bilirubin levels in serum were not significantly changed. In dogs of group II the clinical picture after the embolization was clearly more severe. The anatomo- and histopathological examinations in dogs after the hepatic artery embolization were carried out. In group I no hepatic changes were found macroscopically. In the histopathological studies of liver the numerous, tiny foci of coagulative necrosis with the resorptive reactions were noticed. In group II multifocal deliquescent necrosis in the liver, numerous, small perivascular and extravascular foci of coagulative-deliquescent necrosis with the inflammatory and the resorptive reactions were noted.

9 patients with life-threatening renal bleeding of non-malignant origin, including trauma, AV fistulas, pseudoaneurysms and polycystic kidneys, were embolised after angiographic demonstration of the leakage. In all cases, the bleeding was stopped and in one case only nephrectomy was necessary 3 days after the initial embolisation procedure. Transcatheter renal embolisation should be performed as selectively as possible. With this technique most of the renal parenchyma can be saved. Embolisation is a safe and inexpensive procedure which also can be performed in critically ill patients.

In cases of acute, life-threatening pulmonary haemorrhage, immediate angiographic localisation of the source of haemorrhage is mandatory. Instead of a surgical intervention, transcatheter angiographic therapeutic embolisation may be performed. Embolisation is an effective method with only minimal complications, in favourable contrast to the 23 to 30% mortality encountered with surgical procedures. Embolisation, therefore, should be the first procedure in patients presenting with acute pulmonary haemorrhage. It must be emphasised that in cases of chronic pleuro-pulmonary diseases bleeding occurs not only from bronchial arteries. In 64% of these cases, the bleeding artery originates from a thoracic or diaphragmatic artery. The authors were able to treat 26 of 34 pulmonary haemorrhages (76%) by transcatheter embolisation. In 4 of these patients recurrent haemorrhage was treated by transcatheter embolisation. Severe complications were not noted in any case.

A female patient is reported who had subarachnoid haemorrhage and in whom angiography demonstrated presence of an aneurysm and an arteriovenous angioma in the territory of the left middle cerebral artery. During surgical intervention an intracerebral haematoma was found additionally in the posterior part of the left temporal lobe. The postoperative course was uneventful. The patient was discharged without evidence of focal brain injury.