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Hemodialysis Access Management: Case 1. Ken U. Ekechukwu, MD, MPH, FACP.

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These images illustrate managing peripheral and central venous stenoses associated with a thrombosed hemodialysis access. They belong to a patient whose graft failed the day after his last hemodialysis. The line diagram is a composite illustration of the anatomy of the graft, the deep veins of the upper right arm, the central veins, observations I […]

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CT-guided drainage of deep pelvic abscess

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When abscesses form deep in the pelvis and cannot be safely drained percutaneously through the anterior abdominal wall, they can be approached by inserting drainage catheters through the buttock (transgluteal), the vagina (transvaginal), or the rectum (transrectal). Often this is facilitated by the use of CT or ultrasound guidance depending on the approach chosen and […]

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Left subclavian-vertebral steal syndrome.

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The vertebral artery is the first branch of the subclavian artery and supplies the hindbrain, while the internal mammary artery is its second branch and courses behind the anterior chest wall to anastomose with the ipsilateral inferior epigastric artery in the rectus sheath; it offers a nautural route for lower body perfusion in obstructive diseases of the thoracic aorta or is grafted to […]

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Preparing patients for interventional radiological procedures

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Most interventional radiological (IR) procedures are safe and help patients immensely, but sometimes they are associated with complications. Some complications are inherent to the nature of a procedure, while some are not and are preventable by taking some precautions before, during, and after a procedure.  Here, I offer general guidelines to physicians and patients on […]

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