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Objective: To report our experience with endovascular stentgraft repair of diseases of the descending thoracic aorta in high risk patients. Methods: Twenty-one procedures were performed in 20 patients (10 women), aged 22–81 years, for disease of the descending thoracic aorta with the Gore Excluder thoracic endoprosthesis™ (WL Gore) (n=11) and the Talent LPS Stent Graft System (Medtronic AVE) (n=10). All patients were considered high operative risk. Diagnoses included saccular aneurysm, aneurysm rupture, mycotic aneurysm, penetrating atherosclerotic ulcer, aortic dissection and aortitis. The access vessels were a tube graft of the (thoraco-) abdominal aorta (n=4), the common iliac (n=6) and the common femoral artery (n=11). Several patients needed major cardiovascular surgery for concomitant disease during the same stay. Computed tomography scan and chest X-ray was performed at 3 and 6 months and thereafter every sixth month postoperatively. Results: Two patients died. One had a colon perforation 8 days postoperatively and died after 3.5 months, and the other with preoperative sepsis and a mycotic aneurysm died on day 11 from cardiac and renal failure. In one patient the stentgraft dislocated during release, and an additional stentgraft had to be implanted 1 week later to treat the proximal leak. In another patient the stentgraft could not be released from the introducer, and was pulled back to the aortic bifurcation and retrieved through laparotomy. Eighteen patients have been followed for 1–24 months, and no migration, wire fractures or endoleak have been seen. There were no neurologic complications. One patient treated for infected pseudoaneurysm had a chronic graft infection. Conclusion: In this small number of patients with high operative risk, short-term results of endovascular stentgraft repair of variable diseases of the descending aorta have been satisfactory. Stentgraft repair could be a valuable supplement to surgery for patients with complex multilevel or multiorgan disease. [Copyright &y& Elsevier]

Background: Radical resection is the only long-term cure for malignant liver tumours. An important contraindication for surgery is that the liver remnant would be too small. Embolization of the portal vein in the tumour-bearing side of the liver may induce growth of the healthy part and thereby render liver resection possible., Material and Methods: 18 patients, aged 35 - 71 years, underwent portal vein embolization in the period 2002 - 2006. An interventional radiological percutaneous transhepatic technique was used., Results: The liver remnant increased with 45 % (median), range 9 - 100 %, in all patients. Liver resection could be done and was performed in 10 patients. Due to tumour progression, resection could not be done in seven patients. One patient was excluded from surgery due to serious side effects of chemotherapy. Four-year survival for patients with metastases from colorectal cancer (n=9) was 58 %., Interpretation: Portal vein embolization results in a substantial increase of liver volume. The technique effectively increases the number of patients eligible for liver surgery. It is possible for patients treated with this technique to obtain the same long-term survival as those primarily regarded to be operable. Advanced radiological technology is needed to exclude patients who would not profit from the procedure.

Background: In recent years, interventional radiology has gained in importance in patient treatment. In order to assess the impact of this trend, the executive committee of the Norwegian Society for Interventional Radiology made a registration of all interventional procedures in Norwegian hospitals in the year 2000., Material and Methods: Data were collected by a questionnaire sent to all Norwegian hospitals. Coronary interventions were not included., Results: Forty-four out of 58 departments returned the questionnaire; 33 stated that they performed interventional procedures. A total of 18 135 procedures were performed in Norway in 2000; we present data on the distribution of types of procedures on different categories of hospitals., Interpretation: A large number of interventional radiological procedures were performed in Norwegian hospitals in the year 2000, types of intervention that are considered very important in patient management in small hospitals, too.

Background: Endovascular stent-graft repair of abdominal aortic aneurysms was introduced in 1991. Long-term results from randomised studies are still not available. Aneurysm ruptures after stent-graft repair have been reported, and there has been a considerable need for redo procedures., Material and Results: At Rikshospitalet in Oslo, Norway, 26 stent-graft implantations for abdominal aortic aneurysms were performed during the years 1996-2000, two of which were primary technical failures immediately converted to open repair. During follow-up, two patients have died from unrelated causes after six and 12 months. Eight patients were converted to open repair 8-50 months (median 31) after implantation. Indications for conversion were migration (n = 4), increasing aneurysm diameter (n = 3) and rupture (n = 1). Of the 14 patients still under observation, six have had one or more endovascular interventions (a total of 10) for failing graft., Interpretation: Continuous technology development has been used as an argument to postpone randomised studies, as improved results are expected with new generations of stent-grafts. There is a need for discussion of the strategy for the further use of endovascular repair of abdominal aortic aneurysm.