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CT showed significant retroperitoneal inflammation, enlarged and enhancing Rt inguinal lymph node with multiple enhancing serpentine channels in the right groin ascending upwards. - Arterio Lymphatic Fistula In next 24 hrs, reduced urine output and raised S. Creatinine.

Angio showed both A-V fistula and lymphatic fistula from SFA. Lymph node blush is seen in 2nd run. Covered stent was placed in SFA (7x37mm) Have to say our first time encountering an arterio-lymphatic fistula. Only few case reports in literature.

Case 122: with Bhavesh Popat Dr Rohan khadtare Right lower limb CLI; blackening multiple toes; ATA long set CTO; PTA diffuse ds; Antegrade crossing with balloon-Fielder FC combo; plantar arch attempted but recoil: . Images 👇 Wound healing on follow up . debridement by Dr Rajeev

Chronic PVT with recurrent GIB, calcified occlusions of SV and extensive cavernous transformation of PVs - #VIRad creativity kicks in, used all our tricks US guided percutaneous mesocaval shunt done in 4D CT Patient hasn’t bled since.

Case 123: with Bhavesh Popat . CLI with multilevel disease; Pop CTO with long seg PTA CTO; reformation at plantar arch; diffuse ATA disease; antegrade crossing with support Cath-progreat crossing/pedal plantar loop; Plasty plantar arch 2mm; PTA/ATA 2.5mm; pop f/b DEB 4mm;

Portal vein recanalisation done via both transhepatic and transsplenic accesses. Venoplasty for MPV, SV- PV, SMV- PV confluence. Thrombosed within 48hrs. PVR-TIPS done with stent extension to both SV & SMV. Case done by our chief Jagadeesh Singh R and me. SIR RFS ISVIR India

Case 124: with Bhavesh Popat Antariksh V. Vijan Dr Vaibhav T . Beauty of conventional Lipiodol TACE - for a single well defined LR-5 lesion . #irad #MedTwitter #meded #medx BackTable Vascular and Interventional Society of Interventional Radiology SIR RFS SIR ECS

Case 125: with Bhavesh Popat Antariksh V. Vijan Dr Vaibhav T . Pre-emptive TIPS for bleeding EV/UGI bleed; RPPV puncture; pre dilatation 5>8 mm; shunt 10x60 Fluency+10x80 Epic; pressure gradient 22>6mm Hg . #irad #MedTwitter #gastrotwitter #gitwitter #virad #radres #hepatology SIR RFS

Case 126: with Bhavesh Popat Antariksh V. Vijan Dr Vaibhav T . Acute on chronic pancreatitis; small pseudo cyst at head of pancreas; on and off malena; CT Angio s/o small out pouching within pseudo cyst (SMA branch); DSA s/o tiny outpouching from inferior-pancreaticoduodenal branch of

Case 127: with liver Tx team (Dr Anurag S; Dr Rohan C and team); Bhavesh Popat Antariksh V. Vijan Vaibhav Thakur . Intra-operative portal vein Stenting (IPVS) through umbilical vein approach: . 1 year old; Biliary atresia with PV hypoplasia; LDLT left lobe by Dr Anurag S, Dr Rohan

Case 128: with Antariksh V. Vijan Bhavesh Popat . Midnight bleeder🩸 ; acute on chronic pancreatitis with malena; pseudoaneurysm arising from left gastric artery with direct origin from Aorta; selective cannulation f/b glue embo; images 👇 . #irad #medtwitter #medx #meded #virad

Another night out with Karan Anandpara —no music, just mesenterics. Running on caffiene, NBCA and good synergy. ✨️🩸

Case 129: with Bhavesh Popat Dr Rohan khadtare Dr Vatsal A . Double retrograde puncture into occluded arteries for long seg PTA CTO Plasty with usage of EVUS for confirming true luminal entry . DM; PVD; CLI; non healing wound on base of great toe; PTA long seg CTO; failed

Case 130: with Bhavesh Popat Dr Rohan khadtare Dr Vatsal A . DM; HTN; PVD; CLI; mid foot wound; debridement done outside with worsening of blackening; PTA long seg CTO; antegrade luminal/subintimal crossing with support cath - Progreat microcath and Fielder/V18 combo; crossing

Case 131: with Bhavesh Popat Antariksh V. Vijan Vaibhav Thakur . Single spot image giving the diagnosis. Being wary of variants! . Post PTCA-LAD for CAD; pain in abdomen with drop in BP; displaced urinary bladder on fluoro . Angio showing possible accessory obturator artery/corona

Case 132: with Bhavesh Popat . CLI; small non-healing wound secondary to SFA-CTO with early venous opacification; improving the inflow with SFA plasty-stent (antegrade crossing with Head Hunter - straight Terrumo); images 👇 . #irad #medtwitter #meded #medX #vascular

Case 133: with Bhavesh Popat Antariksh V. Vijan . Seeing good on-table wound vascularity post plasty . CLI; ulcer on heel; post debridement showing ischemic edges; angio showing PTA long seg CTO with distal ATA CTO; antegrade crossing with support Cath-Progreat-Fielder 0.14 . Post