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NoneoftheauthorshaveidentifiedaconflictofthetreatmentofanAVM.EVOHalsohasbeenwidelyusedinperipheralapplications.ThisretrievalapproachembolizationusingOnyx.WethankXinwieZhangforhiseffortsinthepreserva-tionofallimagingdata.MichaelSG,SwarnkarAS,LatorreJG,RamachandranTS,LodiYM.RevascularizationofOnyxinducedintraoperativeocclusionofvertebrobasilararteryusingtheMercidevice.NeurocritCare2010;12:269271.Saatc,GeyikS,YavuzK,CekirgeHS.EndovasculartreatmentofbrainarteriovenousmalformationswithprolongedintranidalOnyxinjectiontechnique:longtermresultsin350consecutivepatientswithcompletedendovasculartreatmentcourse.JNeurosurg2011;115:7888.CastanoC,DoradoL,GuerreroC,etal.Mechanicalthrombectomywithapilotstudy.Stroke2010;41:18361840.DelayedCardiacTamponadefollowingInjuryduringRetrievalofaSuperiorVenaCavalFilterFrom:PrasadS.Dalvie,MDNarendraBabuGutta,MBBSJohnC.McDermott,MDDepartmentofRadiologyUniversityofWisconsinMadison600HighlandAve.Comparedwithinferiorvenacava(IVC)filters,reportedexperiencewithretrievablefiltersinthesuperiorvenacava(SVC)islimited.Wereportacaseofdelayedcardiactamponadethatoccurred16daysafterSVCfilterretrievalandwassuccessfullymanagedbypericardiocentesis.Ourinstitutionalreviewboarddoesnotrequireapprovalforcasereportsinvolvingfewerthanfivepatients.A51-year-oldwomanwithpancreatitiswasadmittedmechanicalventilation.Theembolicsourcewasattrib-utedtoextensiveleftupper-extremitythrombusaroundUltrasound(US)confirmeddeepveinthrombosisinvol-vingtheleftjugular,brachial,axillary,subclavian,andbrachiocephalicveins,soanticoagulationwithintrave-nousheparinwasinitiated.Follow-upUSafter5daysshowedpersistentocclusivethrombus,sotheperipher-allyinsertedcentralcatheterwasremovedandtrans-catheterthrombolysiswasperformedwiththeuseoftissuesminogenactivator(altese)infusedatarateof0.51mg/h.Follow-upvenographyafter72hoursofcontinuousandthedevelopmentofasubcapsularliverhematomarequireddiscontinuationofanticoagulation.ThepatientwasthenreferredforcementofaSVC(Cook,Bloo-mington,na)wascedviatherightjugularroute.Itwasdeployedbetweentheconfluenceofthebrachio-cephalicveinsandtheSVC/rightatriumjunction.Postcementvenographyconfirmedsatisfactoryfilterpositionwithoutevidenceensuing2weeks.Anticoagulationwasresumed,andcement.ThiswasperformedwiththeGüntherTulipVenaCavaFilterRetrievalSet(Cook)viaarightfemoralapproach.Apreretrievalvenogramshowedthefilterincewithoutevidenceofperforation(Fig,a).Thefilterwasretrievedbyusingstandardtechnique(Fig,b).Apost-retrievalvenogramsuggestedcontrastmediumwithinthepericardialspaceondelayedimages(Fig,c),whichwasconfirmedbyanoncontrastCTscanofthechest(Fig,d).Asthepatientremainedinhemodynamicallystableinterventionwasperformed.Thepatientremainedaninpatientandwasmonitoredwithserialchestduringthenext2weeks.AgraduallyreasingSixteendaysafterfilterretrieval,thepatientacuydevelopedshortnessofbreathandhypotension.Echocar-diographyshowedcardiactamponadephysiologyindi-catedbydiastoliccollapseoftherightatriumandventricle.Emergentpericardiocentesiswasperformed,withevacuationof1,200mLofbloodpatientwasdischargedhomeafter34daysfollowingtreatmentforpancreatitisandhadnorecurrentcardiacAlituresearchofcardiactamponaderelatedtoatotaloffourpatientsinwhomtamponadedevelopedfollowingcementofpermanentfilters.Allhadanprocedure.UsohetalSVCfiltercementsoveraperiodof11years.Intwo

perforationfollowingGreenfieldfiltercement.Hussaal(2)reporteda Figure.ImagesobtainedduringSVCfilterretrieval.(a)PreretrievalvenogramshowsSVCfilter(longarrow)incewithitslegsembeddedbelowtheconfluenceofthebrachiocephalicveins(shortarrow),withoutevidenceofanyextravasation.(b)Fluoroscopicimageduringretrievalshowsthecollapsedfilter(longarrow)engagedbythesnare(shortarrow)andwithdrawnintotheretrievalsheath(arrowhead).(c)Delayedimagefromthepostretrievalvenogramshowscontrastmediuminthepericardialspace(arrows).(d)NoncontrastCTscanconfirmscontrastmediumextravasationinthepericardium(arrows)afterfiltercaseofacutecardiactamponadefromanSVCtearduringpericardialwindowwithevacuationof500mLofblood. CardiactamponadefollowingSVCinterventionsgen-erallypresentsintheacutesettingfollowinginterven-tionssuchasangiosty,stentcement,andcentralcathetercement,especiallyinpatientswithmediast-inaltumorinvolvementorahistoryofradiationtothechest.Rapidaccumulationoffluidcancause whereasslowlyprogressingeffusionscangrowto2L

retrieval.AnticoagulationmayhavecontributedtothelateappearanceofcardiactamponadeinthesettingofinjurytotheintrapericardialSVCduringretrieval.tearandpericardialhemorrhageexistsduringcementandretrievaloffilters.Postcementandpostretrievalvenographyisusefultolookforcontrastmediumwithoutsymptoms.Latetamponademustbe inanypatientinwhomhypotensiondevelopsmoresymptomaticcardiactamponade16daysafter 1.UsohF,HingoraniA,AscherE,ShifersonA,TranV, N,etal.maleslessthan60yearsofage.Vascular2009;17:4450.HussainSM,McLaffertyRB,SittlingZC,ZakariaAM,RamseyDE,LarsonJL,HodgsonKJ.Superiorvenacavaperforationandcardiac Noneoftheauthorshaveidentifiedaconflictoftamponadeafterfiltercementinthesuperiorvenacava.Vasc EndovascularSurg2005;39(4):367370.AscherE,HingoraniA,TsemekhinB,YorkovichW,GunduzY.Lessonslearnedfroma6yearclinicalexperiencewithsuperiorvenacavaGreenfieldfilters.JVascSurg2000;32:881887.SpenceLD,GirontaMG,MaldeHM,MickolickCT,GeisingerMA,DolmatchBL.Acuteupperextremitydeepvenousthrombosis:53HypertensiveP withMinimallyInvasivePercutaneousRafaelDahmerRocha,MDAntonioRahal,Jr,MDRodrigoGobboGarcia,MDMarcosRobertoQueiroz,MDDepartmentofInterventionalRadiologyHospitalIsraelitaAlbertEinsteinSãoPaulo,Tensionpoperitoisaseriousclinicalcondi-tion;themainfeatureisarapidreaseinintraabdom-inalpressure,evolvingwithreducedvisceralperfusion,stimulationofanaerobicmetabolism,lacticacidosis,andtissueischemiacausinglife-threateninghemodynamicandrespiratorychanges.Themaausesofpo-peritoareperforatedulcers,tumors,andabdom-inaltrauma.Poperitoisalsoacomplicationofminimallyinvasiveorconventionalinterventionsintheabdominal,suchasanastomoticdehiscence,percutaneousbiopsies,anduppergastrointestinalendos-copies.Theinitialclinicalmanifestationsarenonspecific,characterizedbyabdominalpainanddistention,evol-vingtodecreasedvenousreturnandsystolicvolume,hypovolemicshock,renalfailure,andrespiratorycom-promise(1).withthiscondition,rapididentificationoftheeventandquickimplementationofearlytreatmentareessential.Treatmentconsistsofintraabdominaldecompressionthroughdrainage,laparoscopy,orlaparotomy,depend-reportdemonstratestheimportanceofinterventionalradiologyinthetreatmentofhypertensivepoper-itousingaminimallyinvasiveapproach.presentcasereport.A44-year-oldmanwithnohistoryofillnesswasseenintheemergencydepartmentwithandlaboratoryevaluation,adiagnosisofpancreatitiswasconfirmed.Thepatientunderwentmaicreson-ancecholangiopancreatography,whichintrahepaticandextrahepaticbileduct.Endoscopicexophyticmassinthemajorpapilla.Agastroduodenopancreatectomyanasto-mosisoftheHistologicexaminationshowedthepresenceofaInthelatepostoperativeperiod,thepatientdevelopedabdominalpainandrecurrentepisodesofpancreatitis. (CT) dilationof and were thepancrea-ticductpuncture.A7-Fpancreatic developedabdominalpaintopercussion,distentionamountofgasintheperitoneal,confirmingthediagnosisofhypertensivep (Fig,a,Thepatientwasreferredtointerventionalradiologyandunderwentpercutaneousdrainageoftheabdominalwitha14-FWaynechesttube ,na)(Fig,c).Af spirationoflargeamountsofairandreversalofabdominaldistentionandhypotension,thedrainwasconnectedtoaHeimlichvalve(Cook, ),makingairflowunidirectional(Fig,d).Thepatientimprovedclinically,andthechesttubewasremovedin2daysafterimagingshowednoevidenceofp o-perito .Ontheday5ofhospitalization,thepatientwasdischargedwith Maicresonanceimagingperformedthedaybeforedischargeshowednoevidenceofgasorabdominalliquid.At14monthsoffollow-up,serial recurrenceofp In90%ofcases,poperitoisduetoaperforatedhollowgutandusuallyrequiressurgicalintervention(2).Thediagnosisismadeandbloatinganddecreasedvenousreturnasmeasuredbyimagingmethodsluding

andtomography.Imme-diatetreatmentconsistsofabdominaldecompressionbyneedlepuncturetoachieveclinicalstabilization.Subsequentsurgicalexplorationisstandard(1).Inthepresentcase,thisrarecomplicationwascausedbypancreatogastrostomyguidedbyendoscopicultrasound.266号’20156XinwieZhangSG、AS、拉托雷JG、钱TS、YM。使用Merci装置对Onyx进行血运重建诱导术中椎基底动脉闭塞。神经临界护理2010；12：269-271。管内治疗：350,2011;115：78-88CastanoC、DoradoL、GuerreroCSolitaireAB栓切除术：一项试点研究。中风2010；41：1836–1840。上腔静脉滤器回收期间受伤后延迟心脏压塞来自：PrasadS.Dalvie，医学博士NarendraBabuGutta，MBBSJohnC.McDermott，医学博士放射科威斯康星大学分校600HighlandAve.Madison,WI(IVC(SVC)例迟发性心包填塞病例，该病例发生在SVC滤过器取出后16天，并通过心包穿刺术成功处理。我们的机构审查委员会不要求批准涉及少于5名患者的病例报告。一名51岁女性胰腺炎患者因双侧广泛肺栓塞入院，需要机械通气。栓塞来源归因于留置的经外周脉、锁骨下静脉和头臂静脉，因此开始静脉注射肝素抗凝。5天后随访超声显示持续性闭塞性血以0.5-1毫克/小时的速度输注组织纤溶酶原激活剂（普酶）（印第安纳州顿）。它被部署在头臂静脉汇合处和上腔静脉/右心房交界处之间放置SVC左上肢血栓减少。恢复抗凝治疗，患者在放置后14天返回进行滤过器回收。这是通过右股骨入路使用GtherTulip腔静脉过滤器回收装置(Cook)进行的。取回前的静脉造影显示过滤器已就位，没有穿孔的迹象（图a）。使用标准技术检索.filter（图b）。检索后静脉造影显示延迟图像上心包腔内存在造影剂（图c），胸部非造影CT扫描证实了这一点（图d）X明心脏压塞生理学。进行紧急心包穿刺术，抽吸1,200mL血液并放置心包引流管48小时。这致症状迅速改善。患者在接受胰腺炎治疗34SVC(1,24性过滤器后发生心包填塞的患者。所有患者均早期发病，即手术后立即或5天内发病。等人