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Vascular Specialist International

Sang Don Kwon, Kyung Ah Chun, Eun Jung Kong, Ihn Ho Cho
The authors report the case of a 34-year-old male, who underwent a fluorine-18 fluoro deoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) scan 7 years after trauma for the evaluation of multifocal masses in the right iliac and right inguinal areas. CT findings showed multifocal low density masses and (18)F-FDG PET revealed slightly increased uptake (maximum standardized uptake value [SUVmax] 3.1). These findings did not exclude the possibility of a benign or malignant lesion. To achieve differential diagnosis, partial surgical excision was performed and a pathologic examination subsequently revealed lymphangioma...
September 2016: Vascular Specialist International
Daniele Bissacco, Maurizio Domanin, Giuseppina Schinco, Livio Gabrielli
Anatomical variations of carotid arteries may be related to their development (agenesis, aplasia, hypoplasia) or course (coiling, kinking, tortuosity). Partial or total aberrancies in carotid vessel anatomy rarely occur. We describe the case of a 95-year-old woman presented with sudden onset of confusion and disorientation together with upper limb clonus. Computed tomography (CT)-scan revealed a left frontal brain injury with a not conclusive carotid doppler ultrasound. CT angiography reported a bovine aortic arch with bilateral retroesophageal course of both common carotid arteries and left severe (>70%) internal carotid artery stenosis...
September 2016: Vascular Specialist International
Lee Chan Jang, Sung Su Park
This is a case report that suggests the possible association between multiple splanchnic arterial aneurysms and long-distance running. The clinical features of one patient admitted at Chungbuk National University Hospital for treatment of multiple splanchnic arterial aneurysms were reviewed. A 54-year-old man had a recurrent, intermittent and epigastric pain for 2 months. There was no abnormality in gastroscopy and colonoscopy. An abdominal computed tomography angiography documented calcified superior mesenteric artery (SMA) and splenic artery aneurysms...
September 2016: Vascular Specialist International
Hyung-Kee Kim, Deokbi Hwang, Sujin Park, Won-Ju Jeong, An Na Seo, Seung Huh
In this study, we describe our diagnosis and treatment of two patients who presented with femoral vessel compression caused by a cystic lesion in the groin. One case was diagnosed as adventitial cystic disease (ACD) of the common femoral artery resulting in leg claudication and the other was diagnosed as a ganglion cyst (GC) causing femoral vein compression and unilateral leg swelling. The operative findings differed between these two cases with respect to the dissection of the cyst and femoral vessel, but the postoperative histological examination results were similar...
September 2016: Vascular Specialist International
Sotirios Giannakakis, George Galyfos, Georgios Geropapas, Stavros Kerasidis, Gerasimos Papacharalampous, Georgios Kastrisios, Chrisostomos Maltezos
A 75-year-old patient with severe comorbidities was treated with an Endurant(®) (Medtronic, USA) II endograft due to a ruptured abdominal aortic aneurysm (AAA). After four years of unremarkable follow-up, bilateral limb separation was detected. The patient underwent endovascular bridging without any complication. Although rarely detected in newer grafts, late bilateral type IIIa endoleaks can present and should be promptly repaired. Complex or ruptured AAAs treated with off-label use of endografts should be under closer surveillance using imaging tools for potential endoleaks or aneurysm sac growth...
September 2016: Vascular Specialist International
Suh Min Kim, Seung-Kee Min, Sanghyun Ahn, Sang-Il Min, Jongwon Ha
PURPOSE: This retrospective review aimed to report the outcomes of arteriovenous fistula (AVF) and to evaluate the suitability of AVF as a permanent vascular access in pediatric populations. MATERIALS AND METHODS: Data were collected for all patients aged 0 to 19 years who underwent AVF creation for hemodialysis between January 2000 and June 2014. RESULTS: Fifty-two AVFs were created in 47 patients. Mean age was 15.7±3.2 years and mean body weight was 46...
September 2016: Vascular Specialist International
Khalil Mahmoodi, Leila Nasehi, Elham Karami, Mohammad Soleiman Soltanpour
PURPOSE: The endothelial nitric oxide synthase (eNOS) G894T polymorphism has been reported to cause endothelial dysfunction and may have a role in the development of coronary artery disease (CAD). The aim of the present study was to investigate the association of eNOS G894T genetic polymorphism and plasma levels of nitric oxide (NO) with CAD risk in an Iranian population. MATERIALS AND METHODS: We studied 200 patients with angiographically documented CAD and 100 matched controls...
September 2016: Vascular Specialist International
Seung-Kee Min, Young Hwan Kim, Jin Hyun Joh, Jin Mo Kang, Ui Jun Park, Hyung-Kee Kim, Jeong-Hwan Chang, Sang Jun Park, Jang Yong Kim, Jae Ik Bae, Sun Young Choi, Chang Won Kim, Sung Il Park, Nam Yeol Yim, Yong Sun Jeon, Hyun-Ki Yoon, Ki Hyuk Park
Lower extremity deep vein thrombosis is a serious medical condition that can result in death or major disability due to pulmonary embolism or post-thrombotic syndrome. Appropriate diagnosis and treatment are required to improve symptoms and salvage the affected limb. Early thrombus clearance rapidly resolves symptoms related to venous obstruction, restores valve function and reduces the incidence of post-thrombotic syndrome. Recently, endovascular treatment has been established as a standard method for early thrombus removal...
September 2016: Vascular Specialist International
Jung Hak Kwak, Sang Il Min, Song-Yi Kim, Ahram Han, Chanjoong Choi, Sanghyun Ahn, Jongwon Ha, Seung-Kee Min
Although endovenous heat-induced thrombosis (EHIT) is frequently reported after endovenous laser ablation (EVLA), the incidence and timing of occurrence of EHIT are not fully understood. We present a case of EHIT successfully treated with a combination of surgical and endovascular treatments. A 57-year-old woman, two months post bilateral EVLA, presented with a swollen leg. Deep vein thrombosis was diagnosed by Doppler ultrasonography and computerized tomographic venography. We treated the patient with catheter-directed thrombolysis with urokinase after insertion of an inferior vena cava filter...
June 2016: Vascular Specialist International
Pranit N Chotai, Kalenda Kasangana, Abhinav B Chandra, Atul S Rao
Acute limb ischemia (ALI) is a common vascular emergency. Hematologic malignancies are commonly associated with derangement of normal hemostasis and thrombo-hemorrhagic symptoms during the course of the disease are common. However, ALI as an initial presenting feature of acute leukemia is rare. Due to the rarity of this presentation, there is a scarcity of prospective randomized data to optimally guide the management of these patients. Current knowledge is mainly based on isolated cases. We report our experience managing a patient who presented with ALI and was found to have occult leukemia...
June 2016: Vascular Specialist International
Masaya Nakashima, Hideaki Kobayashi, Masayoshi Kobayashi
The treatment tactics for subclavian artery occlusion include the more commonly used endovascular therapy rather than surgical intervention. We present a case of a 61-year-old woman with dialysis-dependent chronic renal failure who experienced left finger necrosis in the left upper extremity. To salvage the limb, we performed femoro-axillary (fem-ax) artery bypass using an autologous saphenous vein graft. However, 10 months later, she experienced coldness in the left forearm. Angiography revealed chronic total occlusion of the venous bypass...
June 2016: Vascular Specialist International
Carlos A Hinojosa, Javier E Anaya-Ayala, Hugo Laparra-Escareno, Rene Lizola, Adriana Torres-Machorro
The aortic bifurcation and iliac vessels are common sites of atherosclerotic occlusive disease causing the clinical expression known as "Leriche's syndrome". An aortobifemoral bypass grafting in the setting of a septic groin remains a significant challenge to vascular surgeons. We present a 65-year-old male with complete occlusion of the distal aorta and iliac arteries; he had undergone a left axillo-femoral and femoral-femoral artery bypass 2 years prior to our evaluation. Owing to a complex graft infection in the right groin and worsening lower extremity ischemia, we performed an aortobifemoral reconstruction through the right obturator membrane...
June 2016: Vascular Specialist International
Yunhee Lee, Dan Song, Myung Jin Kim, Sang Chul Yun
PURPOSE: The population of end-stage renal failure patients dependent on hemodialysis continues to expand with an increasing number of patients having an unsuitable cephalic vein or failed radio- and brachio-cephalic fistula. In these patients, the transposed basilic vein to brachial artery arteriovenous fistula (BaVT) provides autologous choice for hemodialysis. The results of basilic vein transposition arteriovenous fistula were assessed. MATERIALS AND METHODS: Three hundred cases of BaVT performed at a single center during the period of January 2005 to December 2011 were reviewed retrospectively...
June 2016: Vascular Specialist International
Hye Ryeon Choi, Ki Hyuk Park, Jae Hoon Lee
PURPOSE: Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) involving the common iliac artery requires extension of the stent-graft limb into the external iliac artery. For this procedure, internal iliac artery (IIA) embolization is performed to prevent type II endoleak. In this study, we investigated the frequency and risk factor of buttock claudication (BC) in patients having interventional embolization of the IIA. MATERIALS AND METHODS: From January 2010 to December 2013, a total of 110 patients with AAA were treated with EVAR in our institution...
June 2016: Vascular Specialist International
Young-Wook Kim
Spontaneous isolated superior mesenteric artery dissection (SISMAD) has been known as a rare vascular disease. However it is increasingly reported in these days with the development of advanced imaging technology. Underlying etiology, natural course or an optimal management strategy of SISMAD is not exactly known at the moment. During the past 10 years, we have had an interest in this rare vascular disease and collected clinical and image data in 100 or more patients with SISMAD. In this review article, I would like to describe my current understanding of SISMAD on the base of our recent publications in the major vascular surgery journals...
June 2016: Vascular Specialist International
Sun Han, Jae Wook Ryu
A 48-year old man presented with left popliteal pain. A 2.2×1.6 cm sized saccular aneurysm at the level of the left popliteal fossa was diagnosed by ultrasonography. Tangential aneurysmectomy and popliteal vein repair was performed uneventfully. The patient fared well for a year without symptoms. Popliteal vein aneurysms are rare and typically found in patients with fatal thromboembolic features without warning symptoms. Fortunately, our patient had localized pain which was helpful in its early diagnosis and treatment...
March 2016: Vascular Specialist International
Sang Tae Choi, Keon Kuk Kim, Jin Mo Kang
A 62-year-old male with a smoking history of 30 pack-years presented with a 1-year history of a periumbilical pulsating mass. He had been treated for hypertension for 2 years. Physical examination revealed a huge pulsating mass in the periumbilical abdomen. Femoral and popliteal arterial pulses were palpable. Computed tomography showed arterial dissection in the proximal segment of the superior mesenteric artery, a huge aneurysm (52×50 mm) with mural thrombus and two smaller aneurysms (20×20 mm) in the right ileocolic and ileal branches, along with atherosclerotic changes...
March 2016: Vascular Specialist International
Jong-Beom Shin, Mi-Hwa Park, Sang-Ho Jeong, Sung Woo Kwon, Sung-Hee Shin, Seong-Ill Woo, Sang-Don Park
Endovascular aneurysm repair (EVAR) has been recommended as an alternative to open aneurysm repair. The risk of severe perioperative complications is lower than that in open surgical repair; however, late complications are more likely. After EVAR, regular yearly surveillance by duplex ultrasonography or computed tomography is recommended. We report the case of a 67-year-old man with a severely kinked left iliac branch of the stent graft 10 years after EVAR. He had not undergone regular follow-up during the last 4 years...
March 2016: Vascular Specialist International
Kanghaeng Lee, Hyung Sub Park, Taeseung Lee
Coil migration during endovascular procedures is not an unusual complication, but there is no standard management strategy for bailout. Here, we describe a technique for removal of a migrated coil using a snare. During embolization of type II endoleak from the inferior mesenteric artery in a post-endovascular aneurysm repair patient, the coil migrated to the sigmoidal artery causing an occlusion. We used a microsnare loop and successfully retrieved the migrated coil. This is the first case in Korea that uses a loop snare for the removal of a migrated coil during visceral endovascular treatment to our knowledge...
March 2016: Vascular Specialist International
Hyung-Kee Kim, Incheol Song, Seung Huh
Endovascular aneurysm repair has become the first-line treatment for abdominal aortic aneurysms and iliac artery aneurysms in recent years. However, the diameter of the infrarenal aorta is larger than that of the aortic bifurcation, especially with small aortic diameters, for which a reversed tapered device is necessary. We describe the off-label use of the upside-down Gore Excluder limb and double-barrel sandwich technique for the treatment of a penetrating abdominal aortic ulcer with a large common iliac artery aneurysm...
March 2016: Vascular Specialist International
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