Ultrasound guided puncture of the subclavian vein and port implantation by radiologists is a save procedure. A low risk approach to the subclavian vein is possible at any location. The long approach through the cubital vein with brachial port implantation is not necessary.
The increased knowledge of the natural course of cystic echinococcosis has also improved our understanding of the typical imaging features ("cysts in the cyst pattern") which can be nicely shown by imaging modalities, e. g., ultrasound and computed tomography. In the very early stages of echinococcosis without calcifications, ultrasound can depict the specific intralesional morphology in detail.
Compared with manual compression HPCD is faster and more accurate for sealing the arterial puncture defect following angioplasty. After an initial learning curve, it is easy to handle and time-saving as well as convenient for the patient. Furthermore, immediate and full anticoagulation is possible and arterial inflow is not compromised. A drawback is the necessity of an 8 Fr sheath. Nevertheless, the complication rate is comparably low for both methods.
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