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https://www.readbyqxmd.com/read/28924068/-endovascular-treatment-for-carotid-blowout-syndrome-after-radiation-for-esophageal-cancer-a-case-report
#1
Shigefumi Takahashi, Tomohiro Kawaguchi, Kuniyasu Niizuma, Atsuhiro Nakagawa, Miki Fujimura, Takenori Ogawa, Yukio Katori, Teiji Tominaga
Here, we discuss a case of carotid blowout syndrome successfully treated with endovascular parent artery occlusion. A 71-year-old woman underwent treatment for esophageal cancer resection, followed by 50-Gy radiotherapy, 19 years prior. Due to local recurrence, she underwent 66- and 72-Gy radiation treatments at 2 and 4 years after the initial treatment, respectively. Afterward, tracheostomy and enterostomy were performed. This time, she was transported to our emergency department because of acute eruptive bleeding from the tracheal tube...
September 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28877355/sonographic-evaluation-of-complications-of-extracranial-carotid-artery-interventions
#2
John D Millet, Joseph J Cavallo, Leslie M Scoutt, Gowthaman Gunabushanam
Carotid endarterectomy and carotid artery stenting are among the most common peripheral vascular procedures performed worldwide. Sonography is the initial and often only imaging modality used in the evaluation of iatrogenic carotid arterial injuries. This pictorial essay provides an overview of the clinical and sonographic findings of complications after interventions in the extracranial carotid arteries, including dissection, fluid collections, pseudoaneurysm, thrombosis, thromboembolism, restenosis, and stent deformation...
September 6, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28864273/transtympanic-pseudoaneurysm-of-the-internal-carotid-artery-complicating-a-myringotomy-in-a-four-year-old-child-case-report-and-literature-review
#3
Damien Bonnard, Erwan de Monès, Thomas Sagardoy, Valérie Franco-Vidal, Vincent Darrouzet, Sylvestre Fierens
We report the first case of a transtympanic iatrogenic internal carotid artery (ICA) pseudoaneurysm diagnosed in a 4-year-old child following a myringotomy. An endovascular treatment with a covered-stent was decided; spontaneous thrombosis was found during the therapeutic arteriography, and the procedure was aborted. Otoscopy and computed tomography (CT) scan monitoring showed a prolonged thrombosis and the disappearance of the pseudoaneurysm 18months after the diagnostic arteriography. Based on literature review, endovascular techniques seem to be preferred to the surgical approach for treatment of intrapetrous ICA pseudoaneurysm, however clinical and CT scan monitoring may also be a valid option...
August 24, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28851683/delayed-extrusion-of-embolic-coils-into-the-airway-after-embolization-of-an-external-carotid-artery-pseudoaneurysm
#4
Zachary Wilseck, Luis Savastano, Neeraj Chaudhary, Aditya S Pandey, Julius Griauzde, Sumanna Sankaran, D Andrew Wilkinson, Joseph J Gemmete
Carotid blowout syndrome (CBS) is a known devastating complication of head and neck surgery. The risk of developing CBS increases in the setting of radiation therapy, wound breakdown, or tumor recurrence. Traditionally, the treatment of choice for CBS is surgical ligation of the bleeding artery; however, recently, endovascular occlusion has become a more common option. If a pseudoaneurysm is present, treatment consists of trapping with endovascular coils or occlusion with a liquid embolic agent. Delayed migration of embolization coils into the airway causing acute respiratory distress is a rare occurrence...
August 29, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28844469/a-systematic-review-of-primary-endovascular-repair-of-the-ascending-aorta
#5
REVIEW
Corbin E Muetterties, Rohan Menon, Grayson H Wheatley
OBJECTIVE: Endovascular repair of the ascending aorta is currently limited to patients at high surgical risk with aortic diseases originating above the sinotubular junction. A number of different endovascular technologies and approaches have been used, although no consensus exists regarding a standardized technique. To better understand real-world endovascular approaches to the ascending aorta, we performed a comprehensive review of the types of endovascular aortic stents and associated vascular access used in repair of the ascending aorta...
August 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28764608/rare-post-tonsillectomy-internal-carotid-artery-pseudoaneurysm-management-by-parent-artery-occlusion-using-detachable-balloons
#6
Arun Sharma, Sanjeev Kumar, S Leve Joseph Devarajan, Himanshu Agarwal
Iatrogenic cervical internal carotid artery pseudoaneurysm is a rare and potentially lethal complication following tonsillectomy. It can be complicated by thromboembolism, mass effect and eventually may rupture leading to death. Various endovascular treatment options are available for the management of these pseudoaneurysms, including coil embolization, detachable balloon occlusion, or stent graft placement. Parent artery occlusion using detachable balloons can be a therapeutic option in a subset of patients...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28705843/headache-tia-and-subarachnoid-haemorrhage-dissecting-an-unusual-cause-for-stroke-like-symptoms
#7
Elliot T Dawson, Desmond A Brown, Alejandro A Rabinstein
We present a case of supraclinoid internal carotid artery dissection. Eleven months prior, the patient developed isolated periorbital pain and was diagnosed with giant-cell arteritis with iritis. The patient experienced recurrent spells concerning for transient ischaemic attacks and was transferred to our institution for endovascular intervention after head CT revealed an embolic infarct with a 'dense middle cerebral artery sign.' Digital subtraction angiography was negative for occlusion, instead demonstrating luminal stenosis and poststenotic dilatation...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28689955/flow-diverting-stent-in-the-treatment-of-cervical-carotid-dissection-and-pseudoaneurysm-review-of-literature-and-case-report
#8
REVIEW
Anna Paula Weinhardt Baptista-Sincos, Aline Bigatão Simplício, Igor Rafael Sincos, Alex Leaderman, Fernando Saliture Neto, Adjaldes Moraes, Ricardo Aun
BACKGROUND: The endovascular technique has been recommended over the past few years to extracranial carotid dissection and pseudoaneurysm with promising results, especially after medical therapy failure. Flow-diverting stents are an alternative for complex cases. These stents have proven to be effective treatment devices for intracranial aneurysms. METHODS: The reference list of Pham's systematic review, published in 2011, and Seward's literature review, published in 2015, was considered, as well as all new articles with eligible features...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28664029/endovascular-therapy-for-a-post-irradiated-cervical-pseudoaneurysm-at-the-carotid-stump-a-case-report
#9
Masayasu Arihara, Kei Miyata, Satoshi Iihoshi, Hiroyuki Yamaguchi, Kentaro Toyama, Katsuya Komatsu, Atsumu Hashimoto, Masahiko Wanibuchi, Nobuhiro Mikuni
A nearly 80-year-old man with a history of radiotherapy (RT) and total laryngectomy for laryngeal cancer 25 years previously presented with a rapidly growing mass on the right side of his neck. A huge pseudoaneurysm (pseudoAN) was detected at the right carotid bifurcation, though angiography performed four years previously had shown total occlusion of the internal carotid artery. Stent-assisted coil embolization enabled aneurysm sac shrinkage. Clinicians must be aware that the stump of an arterial occlusion associated with RT can change into a pseudoAN over the long term and must provide follow-up in such cases...
April 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28664025/traumatic-carotid-cavernous-fistula-with-a-connection-between-the-supraclinoid-internal-carotid-artery-and-cavernous-sinus-via-a-pseudoaneurysm-presenting-with-delayed-life-threatening-epistaxis
#10
Jun Kyeung Ko, Sang Weon Lee, Tae Hong Lee, Chang Hwa Choi
Traumatic carotid cavernous fistula (CCF) presents most commonly as a direct connection between the cavernous segment of internal carotid artery (ICA) and cavernous sinus (CS), and often accompanies basal skull fracture (BSF). The most frequently reported signs and symptoms are proptosis, chemosis, and bruit. Epistaxis is uncommon symptom of CCF. A 63-year-old man with a history of BSF due to blunt head trauma eight months previously was referred to our emergency room for massive epistaxis. Cerebral angiography demonstrated a high-flow CCF with a connection between the supraclinoid portion of left ICA and CS via a pseudoaneurysm, suggesting the life-threatening epistaxis had been caused by high-flow shunting, through the gap created by the BSF...
April 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28621574/endovascular-plug-for-internal-carotid-artery-occlusion-in-the-management-of-a-cavernous-pseudoaneurysm-with-bifrontal-subdural-empyema-technical-note
#11
Sunil Manjila, Gagandeep Singh, Obinna Ndubuizu, Zoe Jones, Daniel P Hsu, Alan R Cohen
The authors demonstrate the use of an endovascular plug in securing a carotid artery pseudoaneurysm in an emergent setting requiring craniotomy for a concurrent subdural empyema. They describe the case of a 14-year-old boy with sinusitis and bifrontal subdural empyema who underwent transsphenoidal exploration at an outside hospital. An injury to the right cavernous segment of the ICA caused torrential epistaxis. Bleeding was successfully controlled by inflating a Foley balloon catheter within the sphenoid sinus, and the patient was transferred to the authors' institution...
September 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28619972/staged-curative-treatment-of-a-complex-direct-carotid-cavernous-fistula-with-a-large-arterial-defect-and-an-oversized-internal-carotid-artery
#12
Matthew T Bender, Li-Mei Lin, Alexander L Coon, Geoffrey P Colby
This is a case of a high-flow, post-traumatic direct carotid-cavernous fistula with a widened arterial defect and a large-diameter internal carotid artery (ICA). The unique aspect of this case is the oversized ICA, >8mm in diameter, which is both a pathological and a therapeutic challenge, given the lack of available neuroendovascular devices for full vessel reconstruction. We present a planned two-stage embolisation paradigm for definitive treatment. Transarterial coil embolisation is performed as the first stage to disconnect the fistula and normalise flow in the ICA...
June 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28576528/endovascular-management-of-iatrogenic-cervical-internal-carotid-artery-pseudoaneurysm-in-a-9-year-old-child-case-report-and-literature-review
#13
REVIEW
Martín Pinzón, Nelson Oswaldo Lobelo, María Claudia Rodríguez, Perla Villamor, Ana María Otoya
Extracranial internal carotid artery (ICA) pseudoaneurysms are uncommon in the pediatric population and are usually secondary to direct trauma to the vessel. Treatment options include surgery (ligation), anticoagulation therapy and endovascular treatment. Endovascular covered stents have shown good results in adult populations, resulting in occlusion of the aneurysm and preservation of the artery without significant complications. However, there have been only limited reports in the literature reporting endovascular carotid stent placement in the pediatric population...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28574627/ct-versus-mr-techniques-in-the-detection-of-cervical-artery-dissection
#14
Uta Hanning, Peter B Sporns, Meilin Schmiedel, Erich B Ringelstein, Walter Heindel, Heinz Wiendl, Thomas Niederstadt, Ralf Dittrich
BACKGROUND: Spontaneous cervical artery dissection (sCAD) is an important etiology of juvenile stroke. The gold standard for the diagnosis of sCAD is convential angiography. However, magnetic resonance imaging (MRI)/MR angiography (MRA) and computed tomography (CT)/CT angiography (CTA) are frequently used alternatives. New developments such as multislice CT/CTA have enabled routine acquisition of thinner sections with rapid imaging times. The goal of this study was to compare the capability of recent developed 128-slice CT/CTA to MRI/MRA to detect radiologic features of sCAD...
June 2, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28565993/use-of-the-pipeline-embolization-device-in-the-treatment-of-iatrogenic-intracranial-vascular-injuries-a-bi-institutional-experience
#15
Julius Griauzde, Vijay M Ravindra, Neeraj Chaudhary, Joseph J Gemmete, Marcus D Mazur, Christopher D Roark, William T Couldwell, Min S Park, Philipp Taussky, Aditya S Pandey
OBJECTIVE Flow-diverting devices have been used for the treatment of complex intracranial vascular pathology with success, but the role of these devices in treating iatrogenic intracranial vascular injuries has yet to be clearly defined. Here, the authors report their bi-institutional experience with the use of the Pipeline embolization device (PED) for the treatment of iatrogenic intracranial vascular injuries. METHODS The authors reviewed a retrospective cohort of patients with iatrogenic injuries to the intracranial vasculature that were treated with the PED between 2012 and 2016...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565978/off-label-uses-of-the-pipeline-embolization-device-a-review-of-the-literature
#16
Purvee D Patel, Nohra Chalouhi, Elias Atallah, Stavropoula Tjoumakaris, David Hasan, Hekmat Zarzour, Robert Rosenwasser, Pascal Jabbour
The Pipeline embolization device (PED) is the most widely used flow diverter in endovascular neurosurgery. In 2011, the device received FDA approval for the treatment of large and giant aneurysms in the internal carotid artery extending from the petrous to the superior hypophyseal segments. However, as popularity of the device grew and neurosurgeons gained more experience, its use has extended to several other indications. Some of these off-label uses include previously treated aneurysms, acutely ruptured aneurysms, small aneurysms, distal circulation aneurysms, posterior circulation aneurysms, fusiform aneurysms, dissecting aneurysms, pseudoaneurysms, and even carotid-cavernous fistulas...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28549960/mycotic-pseudoaneurysm-of-internal-carotid-artery-secondary-to-lemierre-s-syndrome-how-to-do-it
#17
Filippo Benedetto, David Barillà, Narayana Pipitò, Graziana Derone, Andrea Cutrupi, Chiara Barillà
We report the case of a patient with ICA mycotic pseudo-aneurysm secondary to Lemierre's syndrome, urgently treated. A 75 years old man presented to E.R. with a left swelling lesion of the neck and complaining left visions lost since that morning, fever, hypotension and dyspnoea. Since fifteen days before developing symptoms, he had sore throat and odynophagia treated with a broad coverage of antibiotic therapy for presumed streptococcal pharyngitis. Preoperative CTA images revealed a circular lesion, involving the common carotid artery, carotid bulb, and the proximal part of the internal and external carotid arteries...
May 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28548474/aortic-aneurysm-endovascular-treatment-with-the-parallel-graft-technique-from-the-aortic-arch-to-the-iliac-axis
#18
Gian F Fadda, Mario Marino, Holta Kasemi, Costantino L DI Angelo, Carlo P Dionisi, Valeria Cammalleri, Carlo Setacci
BACKGROUND: The chimney technique has been developed for the treatment of complex aortic aneurysms. We analyzed the midterm to long-term outcomes of this approach from a single- centre experience. METHODS: From October 2008 to July 2016, 58 patients underwent endovascular aortic aneurysm repair using the chimney technique. Indications for treatment were thoracic aortic aneurysm (TAA) (n = 11), thoracoabdominal aortic aneurysm (TAAA) (n = 2), pararenal aortic aneurysm (PAAA) (n= 15), aortoiliac/isolated hypogastric artery aneurysm (n = 25), type I endoleak after previous TEVAR/EVAR (n=4), proximal pseudoaneurysm after AAA open repair (n = 1)...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28501661/extensive-cerebrovascular-and-visceral-artery-dissection-and-pseudoaneurysm-with-underlying-segmental-arterial-mediolysis
#19
Abhishek Sethi, Jonathan R Hyde, Christina M Thaler, Nedaa Skeik
Segmental arterial mediolysis (SAM) is a non-atherosclerotic, non-hereditary vasculopathy that most commonly involves abdominal aortic branches and predominantly affects middle-age and elderly populations. Lysis of the outer arterial media results in separation of the media from the adventitia leading to dissecting aneurysms and/or pseudoaneurysms. We report a unique case of a 47-year-old man who presented with bilateral internal carotid artery dissection followed by dissections and aneurysms involving multiple visceral arteries...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28499862/successful-revascularization-of-aortic-arch-in-a-39-year-old-blunt-trauma-patient-with-acute-diffuse-axonal-injury-without-the-use-of-systemic-anticoagulation
#20
Andrew M Abi-Chaker, Keith M Jones, Priscilla Sanchez, Jordan Sasson, Xiaoyi Li, Jorge Rey
BACKGROUND: Blunt traumatic aortic injury is the second leading cause of death in trauma patients age 4 to 34. Of the patients that are able to receive treatment, mortality rates as high as 40% have been reported. Endovascular repair options have allowed for more expeditious repairs with reduced iatrogenic trauma; however, when the injury involves the ascending aorta or arch, current endografts lack fenestrations needed for cerebral blood flow. Traditionally, on pump cardiopulmonary bypass with systemic anticoagulation has been used to repair these injuries...
May 9, 2017: Annals of Vascular Surgery
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