Case Gallery

Restoring blood flow across chronic total occlusion of the LSFA. Ken U. Ekechukwu, MD, MPH, FACP.

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Fresh blood from the heart passes to the organs of the body through a large trunk of artery called the aorta that at about the level of the umbilicus divides into two equal arteries that cross the pelvis into the lower limbs. Each of the arteries in the lower limbs divides into two arteries in […]

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Percutaneous biopsy of vertebral metastasis. Ken U. Ekechukwu, MD, MPH, FACP.

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Sometimes it is necessary to biopsy a vertebra with metastatic disease for histopathology as in this woman in whom the T8 was the only evident site of destructive disease. Her primary site of cancer was unknown. The approach to the percutaneous biopsy in this patient is not very different from the approach during vertebroplasty for […]

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Percutaneous biopsy of a lung (left hilar) mass. Ken U. Ekechukwu, MD, MPH, FACP.

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Factors that determine whether pneumothorax will complicate percutaneous biopsy of a lung lesion are the size of the lesion, its depth in the lung, the size of the biopsy needle, and the number of needle passes during the biopsy. Fine needle aspiration (FNA) is safer than core biopsy because the needle size is smaller, but […]

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CT-guided percutaneous drainage of a deep pelvic abscess. Ken U. Ekechukwu, MD, MPH, FACP.

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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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Embolization of left renal cell carcinoma prior to surgical removal. Ken U. Ekechukwu, MD, MPH, FACP.

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Some tumors like renal cell carcinoma are very vascular and their surgical resection can be bloody. Some surgeons electively embolize such tumors before surgery to reduce intra-operative bleeding.  This patient had carcinoma of his left kidney and I embolized it with dry alcohol and gel-foam before it was removed the next day. The first image is a […]

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