Intermittent opacification of an injured artery: a potential aid to superselective transcatheter embolization.
OBJECTIVE
To evaluate the prevalence of intermittent opacification, a finding previously described as diagnostic of active bleeding that allows identification of an injured vessel at initial aortography or first-order selective angiography.


METHODS
Retrospective review was performed of 35 consecutive cases that were positive for true or false aneurysm, arteriovenous fistula or malformation, or hemorrhage when a lesion was located beyond a first-order branch of the aorta. An artery that potentially supplied the lesion was considered positive if it filled with contrast material, emptied, and filled again while adjacent vessels demonstrated progressive opacification.


RESULTS
Nine (26%) of the 35 cases demonstrated intermittent opacification of an injured artery. All were confirmed as true-positive with superselective catheterization or additional projections, and seven were successfully treated with transcatheter embolization. Intermittent opacification was associated only with false aneurysm and hemorrhage. No congenital arteriovenous malformations or congenital aneurysms demonstrated intermittent opacification.


CONCLUSIONS
If present, the intermittent opacification of an artery is a valuable finding that assists in superselective transcatheter embolization of the arterial branch that supplies a false aneurysm or hemorrhage.
Hoffer
Eric K
EK
Department of Radiology, Section of Vascular and Interventional Radiology, Harborview Medical Center, University of Washington, 325 Ninth Ave, Box 359728, Seattle, WA 98104, USA. rhoffer@u.washington.edu
Borsa
John J
JJ
Bloch
Robert D
RD
Fontaine
Arthur B
AB
Nelsen
Michael R
MR
D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy; D000792:Angiography / Q000379:methods*; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000628:therapy*; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
D003287:Contrast Media