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Venous stent placement of symptomatic occlusion of the superior and inferior vena cava is considered the treatment of choice in malignant disease because this technique can restore patency and achieve a relief of symptoms. However, tumor thrombus extension into the right atrium harbors the potential risk of stent migration and perforation. One strategy to avoid this potential life-threatening complication could be the placement of a bridging stent from the superior vena cava-to-inferior vena cava. This case reports describes the superior vena cava-to-inferior vena cava bridging stent technique in 2 patients with malignant occlusion of the superior and inferior vena cava. Special considerations such as technical details of the devices and potential complications are discussed. [ABSTRACT FROM AUTHOR]

Revascularization of infrainguinal vessels is still a challenge. Complications such as flow-limiting dissections or perforation are responsible for a limited success rate. Failed revascularization attempt leads to amputation in a significant number of patients and increases mortality. We report the use of a novel percutaneous device using the CROSSER catheter® system in two patients with peripheral vascular disease. In case # 1 anterior tibial artery patency was restored in a diabetic foot and in case # 2 a chronic traumatic occlusion of the superficial femoral artery was revascularized. In both cases the lesion was recanalized in a short time without any procedure-related complications. The CROSSER catheter® system can overcome technical problems and make reentry devices and retrograde distal accesses less relevant. It opens new horizons for the treatment of complex below-the-knee lesions. [ABSTRACT FROM AUTHOR]

All about the Pancreas Abstract. Ultrasound has made tremendous progress with the use of contrast media and elastography, particularly in patients with small, solid pancreatic lesions (SPL) <20mm and cystic tumors (CPL) of any size. In the case of solid and cystic pancreatic lesions, the differential diagnosis must first be evaluated after detection in order to define the indications for radical surgery, strategies for preserving the pancreatic parenchyma or simply for control examinations. Contrast-enhanced transcutaneous (TUS, CEUS) and endoscopic (EUS, CE-EUS) ultrasound and elastography facilitate further characterization of SPL and ZPL. Pancreatic ductal adenocarcinomas (PDAC) show hypoenhancement in contrast-enhanced ultrasound. The majority of the important differential diagnoses, on the other hand, are multi-enhancing. PDAC are almost always harder than healthy pancreatic parenchyma. In contrast, elastographically soft SPL are - with very few exceptions - benign. This review provides an overview of the use of modern ultrasound techniques to detect and characterize solid and cystic pancreatic lesions.

Endoluminal occlusion has been performed since the early beginning of interventional radiology. Over recent decades, major technological advances have improved the techniques used and different devices have been developed for changing conditions. Most of these occlusion devices have been implemented in the vascular territory. Early embolization materials included glass particles, hot contrast, paraffin, fibrin, and tissue fragments such as muscle fibers and blood clots; today, occlusion materials include metallic devices, particles, and liquid materials, which can be indicated for proximal or distal occlusion, high-flow and low-flow situations, and in large-caliber and small-caliber vessels, based on need. Technological progress has led to a decreased size of delivery catheters, and an increase in safety due to release systems that permit the withdrawing and replacement of embolization material. Furthermore, bioactive embolization materials have been developed to increase the efficacy of embolization or the biological effect of medication. Finally, materials have been modified for changing indications. Intravascular stents were initially developed to keep an artery open; however, by adding a covering membrane, these stents can be used to occlude the wall of a vessel or other endoluminal structures. This article gives an overview of the devices most utilized for occlusion of endoluminal structures, as well as their major purpose in the endovascular territory.

Revascularization of infrainguinal vessels is still a challenge. Complications such as flow-limiting dissections or perforation are responsible for a limited success rate. Failed revascularization attempt leads to amputation in a significant number of patients and increases mortality. We report the use of a novel percutaneous device using the CROSSER catheter system in two patients with peripheral vascular disease. In case # 1 anterior tibial artery patency was restored in a diabetic foot and in case # 2 a chronic traumatic occlusion of the superficial femoral artery was revascularized. In both cases the lesion was recanalized in a short time without any procedure-related complications. The CROSSER catheter system can overcome technical problems and make reentry devices and retrograde distal accesses less relevant. It opens new horizons for the treatment of complex below-the-knee lesions.