Nael Saad - Vascular and Interventional Imaging: Case Review Series

Vascular and Interventional Imaging
CASE REVIEW

Series Editor

David M. Yousem, MD, MBA

Professor of Radiology,

Director of Neuroradiology,

Russell H. Morgan Department of Radiology Science,

The Johns Hopkins Medical Institutions,

Baltimore, MD

Other Volumes in the CASE REVIEW Series

Brain Imaging, Second Edition

Breast Imaging

Cardiac Imaging

Emergency Radiology

Gastrointestinal Imaging, Second Edition

General and Vascular Ultrasound, Second Edition

Genitourinary Imaging, Second Edition

Head and Neck Imaging, Second Edition

Musculoskeletal Imaging, Second Edition

Nuclear Medicine

Obstetric and Gynecologic Ultrasound, Second Edition

Pediatric Imaging

Spine Imaging, Second Edition

Thoracic Imaging

CASE REVIEW

SECOND EDITION

Nael E. A. Saad, MB, BCh

Instructor

Department of Radiology, Section of Vascular and Interventional Radiology

Mallinckrodt Institute of Radiology

Washington University School of Medicine

St. Louis, Missouri

Suresh Vedantham, MD

Professor

Department of Radiology and Surgery

Mallinckrodt Institute of Radiology

Washington University School of Medicine

St. Louis, Missouri

Jennifer E. Gould, MD

Assistant Professor

Department of Radiology, Section of Vascular and Interventional Radiology

Mallinckrodt Institute of Radiology

Washington University School of Medicine

St. Louis, Missouri

CASE REVIEW SERIES

1600 John F. Kennedy Blvd.

Suite 1800

Philadelphia, PA 19103-2899

VASCULAR AND INTERVENTIONAL IMAGING, CASE REVIEW

ISBN-13: 978-0-323-05249-8

ISBN-10: 0-323-05249-5

Copyright 2010, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elseviers Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: .

NOTICE

Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment, and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured; or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Editors assume any liability for any injury and/or damage to persons or property arising out or related to any use of the material contained in this book.

Library of Congress Cataloging-in-Publication Data

Saad, Nael E. A.

Vascular and interventional imaging : case review / Nael E. A.

Saad, Jennifer E. Gould, Suresh Vedantham. 2nd ed.

p. ; cm. (Case review series)

Rev. ed. of: Vascular & interventional imaging / Suresh Vedantham, Jennifer E. Gould. 2004.

Cross referenced to: Vascular and interventional radiology : the requisites / John A.

Kaufman, Michael J. Lee. 2004.

Includes bibliographical references and index.

ISBN 978-0-323-05249-8 (alk. paper)

1. Blood-vesselsImagingCase studies. 2. Blood-vesselsInterventional radiologyCase studies.

I. Gould, Jennifer E. II. Vedantham, Suresh. III. Vedantham, Suresh. Vascular & interventional imaging. IV. Kaufman, John A. Vascular and interventional radiology. V. Title. VI. Series: Case review series.

[DNLM: 1. Vascular DiseasesradiographyCase Reports. 2. Vascular DiseasesradiographyProblems and Exercises. 3. Radiography, InterventionalmethodsCase Reports. 4. Radiography, InterventionalmethodsProblems and Exercises. WG 18.2 S111v 2010]

RC691.6.I52V43 2010

616.130754dc22

2009014660

Acquisitions Editor: Rebecca Gaertner

Developmental Editor: Colleen McGonigal

Project Manager: Nayagi Athmanathan

Design Direction: Steven Stave

For my parents and my brother Wael

NS

For my parents, Vasanth, Tanya, and Shrey

SV

For my parents, my husband Jim, and our daughter Ava.

JG

I have been very gratified by the popularity and positive feedback that the authors of the Case Review Series have received upon the publication of the first edition of their volumes. Reviews in journals and word-of-mouth comments have been uniformly favorable. The authors have done an outstanding job in filling the niche of an affordable, easy-reading, case-based learning tool that supplements the material in THE REQUISITES series. I have been told by residents, fellows, and practicing radiologists that the Case Review Series books are the ideal means for studying for oral Boards and subspecialty certification tests.

It was recognized that while some students learn best in a non-interactive study-book mode, others need the anxiety or excitement of being quizzed, being put on the hot seat. The format that was selected for the Case Review Series, i.e., showing a limited number of images needed to construct a differential diagnosis and asking a few clinical and imaging questions was designed to simulate the Boards experience (the only difference is that the Case Review books provide the correct answer and immediate feedback). Cases are scaled from relatively easy to very hard to test the limit of the readers knowledge. In addition, a brief authors commentary, a link back to THE REQUISITES volume, and an up-to-date reference in the literature are provided.

Because of the popularity of the series, we have been rolling out the second editions of the Case Review Series volumes. The expectation is that the second editions will bring the content up to the current knowledge limits of the field, introduce new modalities and new techniques, and provide new and even more graphic examples of pathology.

This volume of the Case Review Series, Vascular and Interventional Imaging, authored by Nael Saad, Suresh Vedantham, and Jennifer Gould, reflects the unique philosophy of clinical care that now permeates the field of Interventional Radiology (IR) (and to some extent Breast Imaging). The physicians in IR are the nexus to surgeons, internists, hospitalists, and radiologists. They take care of the whole patientinpatient and outpatient, preoperatively, intraoperatively, and postoperatively. The authors have provided a wonderful set of cases that not only are applicable as a review of the practice for Boards and to enhance ones knowledge base. The cases also bring to fore the need for clinical judgment and compassion when practicing in this unique field. The latest edition also provides more evidence-based data on outcomes of existing and newly developed interventional techniques.