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Compared with the traditional pedal lymphangiography, intranodal lymphangiography and MR lymphangiography have made imaging of the lymphatic system less challenging. Improvements in imaging and availability of newer catheters have allowed embolization of lymphatic system much more feasible that previously envisioned. In this article, we briefly review the anatomy, imaging, and current and future of lymphatic interventions.

Iatrogenic complications due to renal biopsy majorly include formation of an arterio-venous fistula, pseudoaneurysm or arterio-ureteral fistula. These complications are observed within a span of few days post biopsy and are rare after few years. We reported a case of  32-year-old renal allograft recipient male presenting 6 years post biopsy of the left kidney with left lumbar region pain who was eventually diagnosed with arterio-venous fistula and pseudoaneurysm involving inferior interlobular branch of left renal artery. Superselective embolization was achieved using coils and high concentration glue and transient placement of a venous occlusion balloon with complete technical and clinical success.

Failure of retrograde approach for ureteric stenting warrants percutaneous nephrostomy with antergrade stenting to relieve the pressure symptoms and prevent the need for external drainage. However, in some tight ureteric strictures with grossly dilated tortuous ureter it may not be possible to navigate a ureteric stent across. In such instances pull through or rendezvous techniques have been advocated. Here, we have illustrated simple and novel techniques for traversing tortuous ureters with tight strictures. In one instance, a guide wire was snared via the perurethral approach and the system stabilized from both ends; the flexometallic sheath was then advanced into the urinary bladder across the stricture and a ureteric stent was deployed. In the other situation where the ureter was very tortuous, plain twisting and turning maneuver with retraction of whole assembly was done to straighten the ureter followed by advancement of the flexometallic sheath and stationing of the ureteric stent. In both the cases no significant procedure-related complications were seen and patients were discharged in stable condition. Our experience has led us to believe that occasionally all facilities may not be accessible immediately or the desired armamentarium may be unavailable for interventional radiologists, especially when the patient is on the table; in such cases, simple improvisation and techniques can come in handy to place a ureteric stent across a dilated tortuous ureter.

).Presentation of metastasis as a solitary focal lesion at an intravascular location is encountered quite infrequently. Owing to its intravascular location, accessing the lesion for sampling and obtaining an adequate amount of tissue are technically difficult. Among the various methods of obtaining an adequate sample from intravascular lesions, scoop and trucut biopsies appear to be safer and more advantageous. The authors present a case of a 65-year-old woman with symptoms of superior vena cava syndrome secondary to a solitary focal fluorodeoxyglucose (FDG)-avid thrombus within the superior vena cava lumen 14 years after complete remission of breast carcinoma. This lesion was approached via transjugular venous access and biopsied under fluoroscopic guidance with continuous contrast injection and real-time needle visualization in two planes. AbstractKeywords ► intravascular biopsy ► intracaval metastasis ► superior vena cava syndrome

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