No abstract

The technique and indications for colonoscopic polypectomy are reviewed. The results compare very favourahly with those of surgical polypectomy and represent a major advance. Three hundred polyps of up to 4.5 cm diameter were removed with the diathermy snare ,from 169 patients, and a further 107 smaller polyps were destroyed with a new 'hot-biopsy' technique. There were no serious complications, but I patient sustained a 'closed' perforation, which was managed conservatively, and in 2 others signifcant haemorrhage occurred. Comparison of colonoscopy with the Malmo double contrast enema shows that up to 95 per cent of polyps over 5 mrn in diameter can be demonstrated radiologically. High quality X-rays allow limited colonoscopy and justqy radiological rather than colonoscopic follow-up. Colonoscopic removal of all polyps saves the patient unnecessary irradiation, since barium enema examination need then be repeated only every 3-5 years.

Most peripheral arterial aneurysms are pseudoaneurysms and are iatrogenic or related to trauma. They can be treated by several techniques that can be performed by the radiologist, negating the need for surgery. Ultrasound guided compression repair is usually the treatment of choice, but is not always successful. The number of available treatment options reflects the varying site and nature of pseudoaneurysms and perhaps the lack of a consistently reliable method. We have successfully treated 13 patients with peripheral aneurysms (11 femoral, 1 popliteal and 1 posterior tibial aneurysm) using a commercial fibrin tissue adhesive. The method involves percutaneous injection of the adhesive components using ultrasound and screening control, following successful occlusion of the aneurysm neck by angioplasty balloon.

Methods: A total of 135 eligible patients were identified, of whom 55 (44%) were randomised. Eligible patients had sustained hypertension, with a minimum diastolic BP of 95 mm Hg on at least two anti-hypertensive drugs. Renal artery stenosis was defined by renal angiography as at least 50% stenosis in the affected vessel. All patients were observed during an initial 4-week run-in period on a fixed drug regimen and subsequent changes measured from this 4-week baseline. Results: Blood pressure fell during the run-in period in all groups. In patients with bilateral renal artery stenosis randomised to angioplasty, a statistically significant (P Ͻ 0.05) fall in BP was observed at latest follow-up (range 3-54 months). The mean fall in BP at latest follow-