VIABAHN® stent grafts have a significantly lower clinical patency and higher rates of amputation when they extend across the knee joint.

To emphasize the utility of contrast enhanced MRI for identifying the extent of disease in herpes zoster ophthalmicus with intracranial extension to help determine proper management. We present a rare case of herpes zoster ophthalmicus (HZ/HZO) with intracranial extension and MRI demonstration of involvement of the trigeminal nerve, the trigeminal nucleus, and the spinal trigeminal nucleus and tract. Herpes zoster is caused by reactivation of varicella zoster virus. Herpes zoster ophthalmicus with involvement of the ophthalmic division of the trigeminal nerve has been estimated to account for 10-20% of the cases (Yawn et al. in Mayo Clin Proc 88:562-570, 2013). While postherpetic neuralgia is the most common complication, HZ/HZO can rarely manifest in a more sinister manner resulting in multi-dermatomal involvement, disseminated disease, cranial arteritis (Walker in Radiology 107:109-110, 1973), cranial nerve paresis (O.d in Clinical Eye and Vision Care 11:75-80, 1999), hemiplegia (Cavaletti in The Italian Journal of Neurological Sciences 11:297-300, 1990), ocular/dysfunction (Kocaoğlu in Türk Oftalmoloji Dergisi 48:42-46, 2018), and intracranial extension (Chen in BMC Infectious Diseases 17:213, 2017; Yawn in Mayo Clin Proc. 88:562-570, 2013). Contrast enhanced MRI (CE-MRI) can be of great benefit to elucidate the extent of disease and intracranial involvement for institution of more aggressive management to prevent further complications.

Background: Mycotic aneurysms are rare vascular lesions, occurring in 0.6-2% of arterial aneurysms but with no reported venous cases. Venous aneurysms unrelated to an underlying infectious process have been previously described and are typically surgically repaired due to risk of thromboembolic events. Only a few reported cases have been successfully treated with endovascular repair. Case presentation: This case reports a bleeding external iliac vein mycotic aneurysm secondary to erosion of a chronic pelvic abscess, successfully treated with endovascular stenting. Conclusion: Venous aneurysms are uncommon vascular lesions which have historically been treated with open surgical repair. Given the lower degree of procedural morbidity, endovascular management of these lesions may be an effective option in the appropriate setting.

Background Mycotic aneurysms are rare vascular lesions, occurring in 0.6–2% of arterial aneurysms but with no reported venous cases. Venous aneurysms unrelated to an underlying infectious process have been previously described and are typically surgically repaired due to risk of thromboembolic events. Case presentation This case reports a bleeding external iliac vein mycotic aneurysm secondary to erosion of a chronic pelvic abscess, successfully treated with endovascular stenting, in an oncologic patient without alternative therapeutic options. Conclusion Venous aneurysms are uncommon vascular lesions which have historically been treated with open surgical repair. Given the lower degree of procedural morbidity, endovascular management of these lesions may be an effective option in the appropriate setting, particularly as a last resort in patients without surgical treatment options.

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To characterize risk factors for bleeding complications after renal biopsy Materials and Methods: A single-center database of all adult patients who underwent random renal biopsy between July 2017 and November 2019 was compiled. Demographic, clinical, procedural, and follow-up data including pathologic diagnoses were documented. 30-day bleeding complications were assessed using the Society of Interventional Radiology Adverse Event Severity Scale. Multivariate logistic regression was performed to assess association between predetermined clinical variables and bleeding complications. Results: 399 renal biopsies were performed (49% female; median age 51 y; 21% inpatient). Common comorbidities included hypertension (59%), rheumatologic disease (36%), and diabetes (21%). 31% of the cohort was on an antithrombotic agent. Most biopsies were performed on native left kidneys (87%). Typical indications included proteinuria (33%), acute kidney injury (26%), and systemic diseases with renal involvement (19%). Pathologic diagnoses were made for 97% of biopsies; hypertensive nephropathy (20%), lupus (19%), and IgA nephropathy (11%) were the most common. The total 30-day bleeding complication rate was 17.8% (55 mild, 10 moderate, 6 severe). There were 3 deaths, and none were attributable to hemorrhage. On multivariate analysis, rheumatologic comorbidities (OR: 4.9, P< 0.0001) and hypertension (OR: 5.1, P ¼ 0.01) portended significantly increased odds of bleeding complications, while periprocedural coagulation assays, anticoagulation/antiplatelet use, technical factors such as the number of passes and biopsy device, and pathologic diagnosis were not associated with bleeding complications. Conclusions: Less than 5% of kidney biopsies had bleeding complications requiring intervention. Practitioners should carefully assess the risk-benefit ratio of renal biopsy, particularly for patients with rheumatologic comorbidities and hypertension, given their higher bleeding complication rates. The protocol-based decision to hold or continue anticoagulation/antiplatelet therapy periprocedurally did not affect bleeding risk.