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Vascular and Endovascular Surgery

Joakim Nordanstig, Kristina Törngren, Kristian Smidfelt, Håkan Roos, Marcus Langenskiöld
BACKGROUND: Primary infection of the abdominal aorta is a rare pathology that may threaten the integrity of the aortic wall, while secondary aortic prosthesis infection represents a devastating complication to open surgical and endovascular aortic surgery. Curative treatment is achievable by removal of all infected prosthetic material followed by a vascular reconstruction. DESIGN AND METHODS: Twelve consecutive patients treated with the neo-aortoiliac system bypass (NAIS) procedure were reviewed...
September 19, 2018: Vascular and Endovascular Surgery
Kallie Roberts, Betty Fan, Robert Brightwell
True renal artery aneurysms are rare. Ruptured aneurysms are even rarer but can have devastating consequences. Renal artery aneurysms most commonly occur in patients with hypertension, atherosclerosis, or fibromuscular dysplasia. Treatment options can range from embolization to nephrectomy. We describe an interesting case of spontaneous accessory renal artery aneurysm rupture in a 44-year-old female with neurofibromatosis type 1 (NF1) who otherwise had no medical problems. She was successfully treated with selective coil embolization, recovered without complications, and maintained preoperative renal function...
September 17, 2018: Vascular and Endovascular Surgery
Fabien Lareyre, Julie Reverso-Meinietti, Joseph Carboni, Alice Gaudart, Réda Hassen-Khodja, Juliette Raffort
Although intravesical therapy with bacillus Calmette-Guérin (BCG) has proven its efficiency in the treatment of early-stage bladder cancer, infectious complications can occur and mycotic aneurysms represent a rare but life-threatening complication. Here, we report the case of an aortic graft infection in a patient with abdominal aortic aneurysm who received BCG instillations for the treatment of bladder cancer. Based on the current knowledge on this rare vascular complication, we discuss factors that may have contributed to its occurrence and review issues to optimize its management and early detection...
September 13, 2018: Vascular and Endovascular Surgery
Sven Zhorzel, Albert Busch, Matthias Trenner, Benedikt Reutersberg, Michael Salvermoser, Hans-Henning Eckstein, Alexander Zimmermann
PURPOSE: Outcomes of open iliac artery repair (OIR) and endovascular iliac artery repair (EVIR) were compared at a tertiary referral vascular center. METHODS: From 2004 to 2015, all patients treated for isolated iliac artery aneurysms (IAAs) were retrospectively identified, and patient records and computed tomography (CT) scans were analyzed. The primary end point was overall survival; secondary end points were 30-day mortality and morbidity and freedom from reintervention...
September 4, 2018: Vascular and Endovascular Surgery
Victor A Rodriguez-Rapale, Jorge L Martinez-Trabal
INTRODUCTION: Little has been reported regarding endovascular therapy with stent of renal artery hilar aneurysms. To that end, we herein report the outcomes of 3 hilar renal artery aneurysms (RAA) treated with an endovascular technique that makes use of a covered stent and coil embolization in the repair of hilar RAA and deem using this technique is better than traditional open approach with back-table repair and autotransplatation. METHODS: Since November 2014, 3 consecutive patients have been referred to the vascular surgery service for evaluation of a right RAA; these patients' aneurysms were diagnosed with a CT arteriogram prior to evaluation...
September 4, 2018: Vascular and Endovascular Surgery
Vikram Puram, Danielle Lyon, Nedaa Skeik
Hypersensitivity vasculitis (HV) or leukocytoclastic vasculitis is a rare small-vessel vasculitis that may occur as a manifestation of the body's extreme allergic reaction to a drug, infection, or other foreign substance. Characterized by the presence of inflammatory neutrophils in vessel walls, HV results in inflammation and damage to blood vessels, primarily in the skin. Histologically, when neutrophils undergo leukocytoclasia and release nuclear debris into the vasculature, vascular damage manifests as palpable purpura...
August 20, 2018: Vascular and Endovascular Surgery
Christiana Anastasiadou, Angelos Megalopoulos, Karmen Tasiopoulou, Vasileios Intzos
Aneurysmal arterial dilatation is an infrequent complication following arteriovenous fistula ligation. Herein, we are describing a case in which a 49-year-old transplanted patient developed a true, symptomatic, brachial artery aneurysm 25 years after transplantation and 12 years after ligation of his radiocephalic wrist fistula. Treating strategy included aneurysmectomy and reversed vein interposition using ipsilateral, dilated branch of cephalic vein. Two years postoperatively, the patient remains without complications...
August 20, 2018: Vascular and Endovascular Surgery
Kara A Rothenberg, Graeme E McFarland, Jordan R Stern
We describe successful endovascular treatment of a patient with fibromuscular dysplasia of the celiac axis leading to development of a common hepatic artery pseudoaneurysm with contained rupture. An 81-year-old woman was transferred to our quaternary care center with concern for a hepatic artery rupture. Further imaging demonstrated a common hepatic artery pseudoaneurysm with surrounding hematoma as well as multifocal areas of narrowing and dilatation in the celiac trunk consistent with fibromuscular dysplasia...
August 16, 2018: Vascular and Endovascular Surgery
Nathan Todnem, Joseph Kilianski, Vamsi Reddy, Scott Rahimi
Thoracic outlet syndrome (TOS) is an infrequent entity encountered by medical practitioners attributed to compression of the neurovascular structures passing through the thoracic outlet. Here, we report the presentation of a young adult who was referred for workup of cervical radiculopathy and was planned to undergo an anterior cervical discectomy and fusion. A dynamic cerebral angiogram was performed and confirmed the diagnosis of arteriogenic TOS. The etiology, presentation, and diagnostic workup of TOS are briefly discussed with emphasis placed on maintaining a healthy suspicion in order to differentiate from cervical radiculopathy, make an accurate diagnosis, and avoid inappropriate surgery...
August 14, 2018: Vascular and Endovascular Surgery
Young Jin Youn, Salman Khalid, Michael Azrin, Juyong Lee
Vascular closing devices (VCDs) are widely used to replace manual compression at the femoral puncture site and to reduce the discomfort of patients undergoing percutaneous coronary procedure by shortening bed rest. Among the vascular complications related to these devices, the femoral artery stenosis or occlusion is rarely reported, and its standard management is not well established. We report a case of symptomatic femoral artery stenosis caused by suture-mediated VCD and managed using rotational atherectomy device and balloon angioplasty...
August 9, 2018: Vascular and Endovascular Surgery
Yoshito Kadoya, Kan Zen, Yohei Oda, Satoaki Matoba
A 60-year-old man with a history of Raynaud's phenomenon presented with bilateral intermittent claudication and an ulcer on his right toe. The ankle-brachial index of the right and left legs was 0.77 and 0.75, respectively. Laboratory data showed prolongation of the activated partial thromboplastin time and a positive result on the lupus anticoagulant test. Computed tomography angiography revealed isolated infrarenal aortic stenosis with irregular surface and noncalcified plaques. Intravascular ultrasonography examination demonstrated a noncalcified, irregular, and mobile plaque, suggestive of abdominal aortic thrombosis...
August 9, 2018: Vascular and Endovascular Surgery
Wai Kin Chi, Gormin Tam, Bryan P Yan
No abstract text is available yet for this article.
August 9, 2018: Vascular and Endovascular Surgery
Salman Khalid, Young Jin Youn, Michael Azrin, Juyong Lee
May-Thurner syndrome (MTS) refers to venous outflow obstruction caused by extrinsic compression of the left common iliac vein (LCIV) by the overlying pulsatile right common iliac artery against lumbar vertebrae. The classic clinical presentation is acute unilateral left leg painful swelling due to deep venous thrombosis in a young woman in the second or third decade of life. We present a case of a 66-year-old woman who presented with late-onset left leg swelling caused by nonthrombotic venous hypertension due to degenerative lumbar disc bulge leading to LCIV compression against the left common iliac artery which was confirmed by computed tomography and intravascular ultrasound...
August 9, 2018: Vascular and Endovascular Surgery
Martin Rabellino, Pedro Moltini, Vanesa Di Caro, Ricardo García-Mónaco
INTRODUCTION: Proximal (iliocaval and iliofemoral) deep vein thrombosis (DVT) and pulmonary thromboembolism are the second cause of death in patients with cancer. MATERIAL AND METHODS: A retrospective analysis was performed in 35 patients with cancer treated with endovascular therapy for proximal DVT. The primary objective was to evaluate the technical success of the procedure and the 30-day and long-term symptom improvement. RESULTS: Thirty-five patients with a mean age of 57...
August 5, 2018: Vascular and Endovascular Surgery
Mariano E Casciaro, Javier Dottori, Salma El-Batti, Jean-Marc Alsac, Elie Mousseaux, Ignacio Larrabide, Damian Craiem
OBJECTIVES: To evaluate the effects on aortoiliac fluid dynamics after the implantation of an endograft based on endovascular aneurysm sealing (EVAS) versus endovascular aneurysm repair (EVAR) strategy. METHODS: An adaptive geometrical deformable model was used for aortic lumen segmentation in 8 patients before and after the surgery. Abdominal aneurysms were treated with an endograft based on the EVAS system (Nellix, n = 4) and with a device based on an anatomical fixation technology (n = 4)...
July 29, 2018: Vascular and Endovascular Surgery
Daniel A Crawford, Sailen G Naidu, Adil A Shah, Victor J Davila, William M Stone
Patent foramen ovale (PFO) is a common heart condition in adults. Closure with a septal occluder device is a safe, well-established treatment option with excellent clinical outcomes. One rare complication of percutaneous PFO closure is embolization of the device to the heart chambers or distal vasculature. Most device migrations are recognized during or shortly after implantation. While many endovascular retrievals of migrated devices are successful, there are still a high percentage of surgical interventions performed...
July 29, 2018: Vascular and Endovascular Surgery
Danielle Lowry, Mujahid Saeed, Parth Narendran, Alok Tiwari
OBJECTIVE: There is a generally accepted hypothesis that patients with diabetes mellitus (DM) have a higher burden of atherosclerotic disease below the knee compared to patients without DM (NDM). The aim of this review was to summarize the evidence regarding this hypothesis. METHODS: The literature was searched for papers that compared the anatomical distribution of atherosclerotic disease in patients with DM and those without using radiological imaging. Search terms used included "diabetes mellitus," "peripheral vascular disease," "distribution of disease," "angiography," "computed tomography angiography," and "magnetic resonance angiography...
October 2018: Vascular and Endovascular Surgery
Yaping Zhao, Zhong Chen, Wayne W Zhang, Sheng Wang, Yaoguo Yang, Liao Yang
OBJECTIVE: This study aimed to compare, using optical coherence tomography (OCT), the outcomes of bioabsorbable drug-eluting stent with those of bare metal stent (BMS) following implantation in porcine iliac artery. METHODS: After the placement of BMS and bioabsorbable drug-eluting stents, we used OCT and digital subtraction angiography to investigate stent appositions, arterial neointima, evagination, and restenosis at 1 and 3 months. RESULTS: At 1 and 3 months after stent implantation, OCT study was performed to investigate 32 stents and 21 788 struts...
October 2018: Vascular and Endovascular Surgery
Nitheesha Ganta, Shahabuddin Soherwadi, Kakra Hughes, Richard F Gillum
BACKGROUND: The estimated global prevalence of Peripheral artery disease (PAD) increased by 24% in span of 10 years (2000-2010) from 164 to 202 million. Despite scarcity of data on PAD in sub-Saharan Africa (SSA) and the Caribbean, estimates for PAD from these regions may be helpful for health-care providers. METHODS: The Global Burden of Disease Study 2015 quantified health loss from hundreds of diseases using systematic reviews and multilevel computer modeling...
October 2018: Vascular and Endovascular Surgery
Neil P Reddy, Vincent L Rowe
Since the transition time in surgical technique of vascular repair to current civilian practice, the great saphenous vein (GSV) remains unarguably the preferred conduit for surgical reconstruction in the lower extremity. With qualities such as accessibility, expendability, and long-term durability, it is easy to understand the enthusiasm with using the GSV in arterial or venous vascular injuries. However, the question does arise whether these detailed benefits of the GSV warrant harvest from an uninjured limb for vascular reconstruction on an injured limb...
October 2018: Vascular and Endovascular Surgery
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