Practice guidelines have been published to minimize the likelihood of directly encountering vulnerable

arterial structures. However, retrograde learn more flow into a vertebral or medullary artery has not been considered in the literature.

This case demonstrates retrograde flow into a common arterial trunk with subsequent antegrade flow of intravenous contrast into a thoracic spinal artery during thoracic transforaminal injection.

Antegrade flow of particulate steroids through direct cannulation of a vertebral or medullary artery has been advocated as one explanation for complications involving brain or spinal cord infarction. The possibility of retrograde flow into a common arterial trunk with subsequent antegrade flow into vulnerable arteries should also be considered as a possible mechanism by which embolic spinal cord or brain injury may occur.

Retrograde flow into medullary or vertebral arteries without direct cannulation can occur, and provides an alternative mechanism of potential injury to the spinal cord or brain during transforaminal Belnacasan mouse injections.”
“Treatment

of patients with staghorn calculi with percutaneous nephrolithotomy can be challenging, often necessitating multiple tracts or sessions for complete stone clearance. Although open anatrophic nephrolithotomy can result in higher stone-free rates, it is rarely performed because of increased morbidity. To provide a minimally invasive alternative, we developed the technique of robot-assisted anatrophic nephrolithotomy (RANL) incorporating ice slush for renal hypothermia.

Three patients with staghorn calculi (mean total stone volume 12887.67mm(3)) underwent RANL with iced cold ischemia. A GelPOINT port was used for ice slush insertion. Intracorporeal temperatures were <9 degrees C within 30 minutes of cold ischemia. Mean console and cold ischemia times Selleckchem Etomoxir were 167 and 56.7 minutes, respectively. Mean blood loss was 100mL. There were no complications. Two patients had residual fragments measuring 13mm, and two 9mm stones, respectively. RANL with iced cold ischemia is a safe and feasible option that may be considered in patients with staghorn stones. Further study is needed to refine the technique and assess long-term functional outcomes.”
“Comb-push ultrasound shear elastography (CUSE) has recently been shown to be a fast and accurate 2-D elasticity imaging technique that can provide a full field-of-view (FOV) shear wave speed map with only one rapid data acquisition. The initial version of CUSE was termed U-CUSE because unfocused ultrasound push beams were used. In this paper, we present two new versions of CUSE-focused CUSE (F-CUSE) and marching CUSE (M-CUSE), which use focused ultrasound push beams to improve acoustic radiation force penetration and produce stronger shear waves in deep tissues (e. g., kidney and liver). F-CUSE divides transducer elements into several subgroups which transmit multiple focused ultrasound beams simultaneously.