The term vascular anomaly represents a broad spectrum of vascular pathology, including proliferating vascular tumours and vascular malformations. While the treatment of most vascular anomalies is multifactorial, interventional radiology procedures, including embolic therapy, sclerotherapy and laser coagulation among others, are playing an increasingly important role in vascular anomaly management. This review discusses the diagnosis and treatment of common vascular malformations, with emphasis on the technique, efficacy and complications of different interventional radiology procedures.
Embolotherapy with platinum microcoils delivered through the Tracker-18 microcatheter (Target Therapeutics, San Jose, Calif) was performed in 16 patients when peripheral superselective catheterization with standard angiographic catheters was not possible. The Tracker-18 catheter could be directed distally into small peripheral vessels for delivery of the microcoils. These microcoils, with attached fiber strands, resulted in vascular occlusion within a few minutes in all cases. Embolotherapy was technically successful in all patients. The procedures were clinically successful in 15 of 16 patients (94%), and no complications were encountered. Embolization with platinum microcoils through the Tracker-18 catheter is useful when standard methods of embolization are not possible.
The deployment of a Medtronic AneuRx stent-graft system for endovascular abdominal aortic aneurysm repair requires a series of precise maneuvers that include positioning the primary delivery catheter in the infrarenal aorta, retracting the graft-covering sheath, and withdrawing the stainless steel runners. The last step allows the stent-graft to fully expand and attach to the non-aneurysmal aorta and iliac arteries. Such maneuvers may cause the stent-graft to move caudally if the device is placed in a severely angulated aortic neck. We describe a simple, coaxial, stabilization technique utilizing the contralateral introducer sheath which minimizes potential caudal migration of the stent-graft in angulated aortic necks during runner withdrawal.
This introductory chapter argues that studies of the industrialization of rural places like Hancock County can help in understanding the nature of industrial capitalism, particularly the relationship between capital mobility and the working class. Industries periodically entered periods of crisis that required a general restructuring for companies to remain profitable, and relocations were a key component in the process. In “undeveloped” rural areas, some manufacturers believed that they could create new environments free of discord and find grateful and compliant pool of rural laborers—often women and other low-wage workers—to surround the core of handpicked skilled workers. Thus, manufacturers' old labor problems and their high hopes for an improved workforce figured prominently in the migration of capital to rural places. Eventually, rural migrants and young people from local farms brought their own ideas, goals, and culture—distinct from those of the skilled craftsmen—and came to constitute a truly rural-industrial workforce.
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