EJVES Short Reports

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Post-endarterectomy pseudoaneurysms (PEPA) are a rare complication of carotid endarterectomy (CEA), but are associated with high morbidity risk. Therefore, once they are diagnosed, treatment is urgent to prevent possible complications such as rupture, embolisation, thrombosis, or airway and cranial nerve compression. In this video, the surgical procedure is shown in a case of PEPA 10 years after CEA with patch angioplasty, which was successfully managed by surgical excision and interposition of great saphenous vein graft...

Introduction: This case describes a brachial artery mycotic aneurysm (BAMA) secondary to infective endocarditis caused by Enterococcus faecalis . BAMAs are rare and potentially limb or life threatening. A literature review revealed 61 cases since 1950, primarily caused by intravenous drug use, with Staphylococcus aureus being the most common causative bacteria. Report: A 71 year old man with known infective endocarditis presented with pulsatile swelling in his right antecubital fossa...

INTRODUCTION: The preferred venous access site for percutaneous management of deep venous thrombosis (DVT) is the popliteal vein, with the patient in the prone position. Owing to the need for additional venous access, including the jugular or femoral veins, popliteal access in the prone position requires supine repositioning of the patient. A technique for puncturing the popliteal vein in the supine position is proposed, which allows for additional venous access in the same position in patients with DVT...

Background: Aortic injuries during non-aortic related procedures are rare but potentially catastrophic. Endovascular aortic repair has been described as a viable option in similar circumstances. However, most reports involve aortic injury from orthopaedic hardware after spine surgery or trocar injury during abdominal surgery. Report: This is a report of a thoracic aortic injury during thoracostomy tube placement and summary of the management paradigm. The patient was treated with a thoracic stent graft and was seen at four-month follow up, with imaging showing the endograft in stable position...

No abstract text is available yet for this article.

INTRODUCTION: The management of peri-aortitis, a rare complication after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA), is described in a patient with a solitary kidney. REPORT: A 64 year old man who developed peri-aortitis after elective EVAR for a 6.6 cm infrarenal AAA is reported. Peri-aortitis was diagnosed two months after the procedure and was successfully treated with corticosteroids. CONCLUSION: There is no clear consensus on the best medical therapy for peri-aortitis secondary to EVAR...

Introduction: Since the introduction of the Gore C3 device, which allows level re-positioning and contralateral gate cannulation, there have been very few reported complications due to excessive readjustment attempts. A case is reported of ipsilateral limb twisting and severe stenosis caused by extensive rotational re-orientation of the C3 system during a challenging intra-operative gate catheterisation. Report: Endovascular aortic aneurysm repair (EVAR) was performed for an infrarenal abdominal aortic aneurysm...

Introduction: Management of clot in transit in patients with pulmonary embolism, who are candidates for percutaneous intervention, can be challenging. This is a case report of simultaneous right atrial mechanical thrombectomy under echocardiography guidance and pulmonary artery embolectomy under fluoroscopy guidance, using the recently introduced FlowTriever system (Inari Medical Inc., Irvine, CA, USA). Report: An 88 year old female, resuscitated from cardiopulmonary arrest near the end of a total right hip arthroplasty, presented for management of suspected massive pulmonary embolism...

Introduction: Untreated congenital aortic coarctation and valvular abnormalities are rare in an adult patient and require complex management. Report: A 68 year old woman with congenital aortic coarctation and bicuspid aortic valve with severe aortic stenosis is described. She was treated by a two week, staged, hybrid approach: (i) aortic valvuloplasty, (ii) endovascular aortic repair and (iii) surgical aortic valve replacement with tricuspid ring annuloplasty and left atrial appendage ligation...

Objectives: This report presents the endovascular treatment of a large isolated common iliac artery aneurysm, focusing on the use of on table ultrasonography to characterise and treat an early endoleak that could not be defined by angiography alone. Report: A 58 year old man presented with an asymptomatic, large (13cm) left common iliac artery aneurysm (LCIAA) whilst being investigated for change in bowel habit. This was treated successfully via a percutaneous approach using left internal iliac embolisation followed by endovascular aneurysm repair (EVAR) with deployment of an aorto-uni-iliac converter system from the LCIA origin to the external iliac artery...

Introduction: Aneurysms of the extracranial carotid artery are rare. They are often asymptomatic but can lead to disabling stroke. This report describes a case of bilateral internal carotid artery aneurysms in a patient with Marfan syndrome. Report: A 65 year old woman with Marfan syndrome presented with an asymptomatic swelling in the right anterior triangle of the neck. Imaging revealed bilateral extracranial fusiform internal carotid artery aneurysms. Staged open repair was performed...

Introduction: Visceral aneurysms are rare and a life threatening condition in the case of rupture. Report: A 78 year old woman presented with sudden brief loss of consciousness and complained of abdominal tenderness on examination. Computed tomography revealed a gigantic 100 × 130 × 200 mm ruptured true aneurysm of the gastroduodenal artery, which was successfully treated by endovascular coiling. Post-operative observation was uneventful and the six week follow up duplex ultrasound confirmed absence of luminal flow in the aneurysm...

Introduction: Complications due to venous thrombectomy and iliofemoral stenting in a patient with May-Thurner syndrome are reported. Report: The patient presented with a third episode of deep vein thrombosis (DVT). A computed tomography (CT) scan confirmed the clinical suspicion of left iliofemoral vein thrombosis. After thrombectomy and stenting, the patient complained of left foot paralysis. CT showed the misplaced stent to be in the intrarachidial space. Surgical removal of the stent and new endovascular stenting resulted in complete recovery...

Objectives: Endovascular revascularisation is the mainstay of the treatment of lower extremity peripheral arterial disease. Improvement in perfusion after treatment is often quantified by a corresponding increment in ankle or toe brachial indices. These measurements are difficult to obtain in patients with foot wounds, and have to be performed at a separate time and setting after revascularisation. This preliminary study aimed to evaluate the use of parametric colour coding and analysis of time attenuation curves as a real time quantitative measure of perfusion after endovascular revascularisation...

Introduction: Chronic aortic dissection rarely causes consumptive coagulopathy due to disseminated intravascular coagulation (DIC). Report: A 69 year old man who had previously undergone total arch replacement with the frozen elephant trunk procedure for chronic aortic dissection was transferred to our hospital because of sudden back pain. He had a bleeding from the right subscapular artery due to consumptive DIC caused by retrograde blood flow into a residual false lumen (FL)...

Introduction: Acute aortic dissection after endovascular repair of an aortic aneurysm is a rare but serious condition, with potential complications that can result in the death of the patient. Report: This is the case of a patient diagnosed with a type IV thoraco-abdominal aneurysm with involvement of both iliac arteries who underwent endovascular repair with a four fenestration device and a left iliac branch. One month after the procedure, the patient presented with a type B acute aortic dissection that extended from the left subclavian artery to the proximal stent of the fenestrated graft...

Objectives: The aim is to present the technique of successful management of a superior mesenteric artery (SMA) dissecting aneurysm by a purely endovascular approach. Methods: This was a single centre case report. Results: Isolated spontaneous SMA dissecting aneurysm is rare, and previously was usually treated by an open or hybrid approach. This is a single centre case report of the successful management of a SMA dissecting aneurysm by a purely endovascular approach...

Introduction: This is the report of an unusual case of a dorsalis pedis artery pseudo-aneurysm resulting from trauma in a 61 year old farmer. Report: One year previously, the patient's right foot had been crushed under a tractor wheel. The patient complained of pain and pulsatile soaring swelling on his right foot which he noticed two months before presentation. Radiological examinations revealed a pseudo-aneurysm of the dorsalis pedis artery. Resection of the aneurysm was completed without complications...

Posterior circumflex humeral artery (PCHA) aneurysm is a rare condition. It mostly affects young professional sports player and might be career threatening. This is the report of the case of a 28 year old volleyball player presenting with symptoms of right digital ischaemia caused by a PCHA aneurysm. Surgical treatment by resection of the aneurysm without revascularisation was performed. The post-operative course was uneventful and the patient returned to professional competition one month after surgery. A literature review is also presented in an attempt to provide recommendations for PCHA aneurysm diagnosis and management...