Case Gallery

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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Internal stenting of the left ureter Ken U. Ekechukwu, MD, MPH, FACP.

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These images illustrate the benefit of ureteral stenting. They are of a male patient with benign prostatic hypertrophy, who recently underwent surgical resection of a colonic malignancy. His imaging workup uncovered left hydronephrosis caused by a retroperitonal mass encasing his distal left ureter. It was not possible stent the ureter from a urethral approach, so […]

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Bilateral insertion of nephroureteral stents after balloon dilation of malignant obstruction of the distal ureters. Ken U. Ekechukwu, MD, MPH, FACP.

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The above images belong to a middle-aged woman with cervical cancer, who developed impaired renal function when the cancer  invaded and obstructed her distal ureters. Efforts by urologists to stent her ureters from below through her urethra failed, because the ureteral orifices were invisible. She was referred to the interventional radiology service for ante-grade intervention […]

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Case 1: Bilateral percutaneous biliary drainage for obstructive jaundice due to cholangiocarcinoma. Ken U. Ekechukwu, MD, MPH, FACP.

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History: An 87-year-old man was admitted to a hospital because of jaundice. He was found to have conjugated and unconjugated hyperbilirubinemia, the former more than the latter. His cross-sectional imaging revealed marked dilation of his extra-hepatic and intra-hepatic bile ducts that proved inaccessible at endoscopic retrograde cholangiopancreatography (ERCP). He was referred to interventional radiology for […]

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Combining atherectomy and angioplasty to heal diabetic foot ulcer Ken U. Ekechukwu, MD, MPH, FACP

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  Diabetic foot ulcers are frequently difficult to treat for a number of reasons: diminished ability of the body to fight infections and heal; polymicrobial colonization of wounds; poor glycemic control; neuropathy and vasculopathy. Vasculopathy occurs at visible and occult levels and is a frequent reason for lost tissue in limbs and ultimately limb amputation. […]

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