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Purpose: To evaluate the efficacy of metallic stents for palliation of malignant gastro-duodenal stenosis., Materials and Methods: Twenty-three patients aged from 36 to 88 years old presented with nausea, vomiting and weight loss due to duodenal (n = 16) or antro-pyloric (n = 7) malignant stenosis and underwent placement of 37 Wallstents (1 to 3 per patient) under fluoroscopic guidance., Results: After initial stent placement 17 patients had normal food intake. One patient was able to eat fractionated meals. Five patients did not experience any improvement due to the presence of a jejunal stenosis downstream in 2, or insufficient stenosis coverage in 2 and stent migration in 1. Nine of the 18 patients with improvement died without symptoms within 101 +/- 56 days after stent placement and 6 were alive and symptom-free after a mean follow up of 176 +/- 83 days. Three asymptomatic patients were lost to follow up after 3 days, 1 and 2 months, respectively., Conclusions: Metallic stents appear to be a valuable option for the treatment of malignant gastro-duodenal stenoses.

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.

Four patients with single or multiple pulmonary arteriovenous aneurysms, including three with Rendu-Osler's disease, were treated by occlusion with metallic spirals of the supplying pedicles during angiography. Results are compared with those of 16 cases treated by the same method and reported in the literature. The technique and its therapeutic indications are discussed based on these 20 cases and a review of documented data concerning 502 other cases with these aneurysms.

The authors report six cases of massive lower gastro-intestinal tract haemorrhage, diagnosed by angiography. They emphasize the value of angiography performed on an emergency basis. It is the most reliable diagnostic modality to know before surgery the precise localization of the bleeding point and sometimes its aetiology. The interest and the problems of therapeutic angiography are discussed.

Presentation of a polyethylene catheter formed by the end-to-end apposition of two tubes of different calibre, the proximal being of a wide calibre and thus easy to manipulate, and the distal being of fine calibre and very useful for hyperselective catheterisation.

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.

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.

Takayasu's disease rarely presents as acute episodes of vascular thrombosis, and the authors describe such a case in order to emphasize this fact. A description is given of the various types of clinical picture seen in this disease, for which a final diagnosis can only be made by combining angiographic and histology findings.

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.

Thirty five cases of hepatic arterial embolisation are reported. The analgesic effect in association with tumour pathology (27 cases) was virtually constant (80% of cases). Arterial embolisation should thus replace surgical disarterialisation in the management of malignant tumours of the liver. It improves the quality of survival in painful tumours, above all when they are hypervascularised. Two fatal complications as a result of the technique emphasise the absolute need to respect its contraindications: portal thrombosis, even segmental, or hepatic failure. Two cavernous haemangiomas and one angioma with arterioportal fistula complicated by haemobilia were also successfully embolised. Five traumatic vascular lesions, two of which resulted in severe haemobilia, also benefited from superselective embolisation.