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Inguinal intravenous digital subtraction angiography (DSA) was performed in 14 patients referred for preoperative evaluation of a renal tumor previously diagnosed by CT and ultrasound. Conventional cavography and aortography were used as reference methods for comparison. Both DSA and conventional angiography were carried out following selective arterial injection to the abnormal kidney. The diagnostic value of DSA in examination of the inferior vena cava was generally comparable to that of conventional cavography. Intravenous aortography was unsuccessful in 2 patients due to motion artifacts. In all other patients, the information provided by DSA regarding the aorta, renal arteries and renal veins was similar to that of conventional aortography. Intrarenal vascular detail, however, was far superior on conventional films and was only useful with DSA when intra-arterial injection was implemented. In one of the 12 diagnostic examinations, localization of the renal mass could not be established by intravenous DSA, but was possible in all others. The inguinal approach advocated permits simultaneous inferior vena cavography and intravenous aortography with one single injection of contrast medium; the method is less traumatic than aortography , and does not require hospitalization of the patient. DSA may also be of value in those cases still requiring selective catheterization of the renal arteries, i.e. for angiotherapy . Intra-arterial DSA then allows reduction of the amount of contrast medium and a rapid processing of the images without detriment to the quality of the examination.

In 93 patients with cirrhosis of the liver and portal venous hypertension the main tributaries of the portal vein were examined by percutaneous transhepatic catheterization. The appearance and degree of porto-systemic collaterals were analysed. Esophageal varices were demonstrated in 82 patients. No correlation was found between the portal venous pressure and the extent of porto-systemic communications.

Adrenal angiography was performed in 8 patients with Sipple's syndrome. Seven patients had pheochromocytomas and one bilateral adrenal medullary hyperplasia. In 4 cases the pheochromocytomas were bilateral. The angiographic findings are discussed and it is concluded that no typical angiographic appearance of pheochromocytoma appears to exist.

The technique and experiences with a double-curve catheter are described for rapid left transaxillary catheterization of the abdominal aorta. Successful catheterization was achieved in 98.6 per cent of 140 patients. A large hematoma complicated the examination in 2.8 per cent of the cases. The only permanent lesion was an incomplete palsy of the median nerve in one (0.7%) patient.

The technique, indications, contraindications and complications of percutaneous transhepatic portography and selective catheterization of the major and minor veins draining the splanchnic organs based on the experience of 200 cases are described. The advantage of this method is discussed and compared with transjugular and transumbilical portography.

The angiographic findings in 34 patients with adrenal lesions were reviewed, including 11 adrenal metastases, 9 adrenal pheochromocytomas, 4 adrenal cortical carcinomas, 4 adrenal cortical adenomas, 3 cases of adrenal hyperplasia and 3 cases of adrenal invasion from carcinoma of the upper pole of the kidney. The results indicate differential diagnostic difficulties in distinguishing among these various entities by angiography.

A rare case of life-threatening hemorrhage from a vascular neoplasm of the esophagus is presented. The exact nature of the lesion remained obscure in spite of careful histomorphologic analysis. After tumor extirpation no signs of recurrence were observed during a four-year follow-up period.

The complications of percutaneous transhepatic catheterization of the portal vein and its tributaries were assessed in 406 patients in whom 440 examinations had been performed and 8 unsuccessful attempts. Clinically relevant complications consisting of abdominal or external hemorrhage occurred in 24 cases with fatal outcome in 3. Complications involving the right pleural space occurred in 13 patients: collection of ascitic fluid in 6, bile effusion in 5 and bleeding in 2. Laparotomy was needed in 7 cases due to intraabdominal hemorrhage. The gallbladder was unintentionally punctured in 4 cases. Furthermore, a variety of minor complications of little clinical significance, such as extravasation of contrast medium, subintimal injection of contrast medium and minor intrahepatic hematomas, were observed.