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Steal phenomenon

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https://www.readbyqxmd.com/read/29503240/coronary-artery-fistulae-anatomy-diagnosis-and-management-strategies
#1
REVIEW
Dario Buccheri, Paola Rosa Chirco, Salvatore Geraci, Giuseppe Caramanno, Bernardo Cortese
Coronary artery fistula (CAF) is a relatively rare anatomic abnormality of the coronary arteries that afflicts 0.002% of the general population and represents 14% of all the anomalies of coronary arteries. Its clinical relevance focusses mainly on the mechanism of "coronary steal phenomenon", causing myocardial functional ischaemia even in the absence of stenosis, hence common symptoms are angina or effort dyspnoea. The suggested diagnostic approach is guided by the patient's symptoms and consists of a number of instrumental examinations like ECG, treadmill test, echocardiography, computed tomography scan, cardiac magnetic resonance and coronary angiography...
February 9, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29214780/mismatch-between-tof-mr-angiography-and-ct-angiography-of-the-middle-cerebral-artery-may-be-a-critical-sign-in-cerebrovascular-dynamics
#2
Keiji Igase, Michiya Igase, Ichiro Matsubara, Kazuhiko Sadamoto
PURPOSE: Although time-of-flight (TOF)-magnetic resonance angiography (MRA) can clearly depict intracranial arteries, the arterial flow of middle cerebral artery (MCA) is occasionally not detected. We evaluated this phenomenon with reference to cerebrovascular dynamics. MATERIALS AND METHODS: Seventeen patients with suspected occlusion of MCA or internal carotid artery on TOF-MRA were enrolled. All patients underwent CT angiography (CTA) and quantitative cerebral blood flow (CBF) examination for measurement of resting CBF and cerebrovascular reactivity (CVR)...
January 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29198686/orthotopic-kidney-transplantation-in-an-elderly-patient-with-various-severe-comorbid-conditions-a-case-report
#3
H Sasaki, R Nakazawa, T Iwata, W Usuba, H Yoshie, E Fujimoto, H Metoki, Y Katsuoka, K Aida, H Kudo, K Koitabashi, M Yazawa, Y Shibagaki, Y Marui, T Chikaraishi
In recent years, the frequency of high-risk kidney transplantations has increased. We report a case in which a 72-year-old man with various severe comorbidities (prostate cancer, diabetes mellitus, complete atrioventricular block, coronary artery stenosis, severe stenosis of the popliteal arteries, and severe calcification of the iliac arteries) who received an orthotopic kidney transplantation. To prevent the occurrence of acute limb ischemia due to the steal phenomenon (caused by the kidney graft), we decided that a heterotopic kidney transplantation involving the iliac arteries was not an appropriate option...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29142494/endovascular-treatment-of-abdominal-aortic-aneurysm-with-complete-iliac-occlusion-case-series-and-literature-review
#4
Randall W Franz, M Taha Ibrahim, Christopher F Tanga, David A Epstein
In patients with abdominal aortic aneurysms (AAA) and complete iliac occlusion, endovascular aortic aneurysm repair (EVAR) using a bifurcated stent graft has clear advantages over aortouniiliac stent grafts. Bifurcated stent grafts had improved hemodynamic flow and increased primary and secondary patency rates compared with aortouniiliac stent grafts. The use of aortouniiliac stent grafts with femorofemoral crossover bypass is associated with complications including infection of the prosthesis, steal phenomenon, and the associated difficulties for further endovascular access at the site of the femoral anastomosis...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29117811/a-new-endovascular-technique-for-the-treatment-of-dialysis-associated-steal-syndrome
#5
Enrico Ascher, Jacob E Mandel, Natalie A Marks, Anil P Hingorani
Background Dialysis access-associated steal syndrome is a major complication of arteriovenous fistula creation whereby the low-resistance venous conduit shunts arterial inflow through the anastomosis, resulting in clinically significant distal artery insufficiency. Herein, we describe a case of severe steal phenomenon with gangrene of a digit following placement of an arteriovenous fistula that was treated with a novel, entirely endovascular technique. To our knowledge, this was the first totally endovascular approach to dialysis access-associated steal syndrome...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29116947/cerebrovascular-steal-phenomenon-and-electroconvulsive-therapy-a-case-report-and-review-of-the-literature
#6
Ana Hategan, Calvin H Hirsch
Electroconvulsive therapy (ECT) is a safe and effective treatment for major depressive disorder, but cerebrovascular and cardiovascular complications, although rare, remain the most concerning. This is particularly notable in those with preexisting cerebrovascular disease, which impacts dynamic cerebral autoregulation. In these patients, the increased blood flow to the seizing portions of the brain induced by ECT potentially can reduce cerebral blood flow to ischemic areas, possibly causing adverse neurological events...
November 8, 2017: Journal of ECT
https://www.readbyqxmd.com/read/29104204/-surgical-treatment-of-systemic-and-left-circumflex-coronary-pulmonary-artery-fistulas-with-aneurysm-report-of-a-case
#7
Hiroki Nakabori, Katsuyuki Miyazu, Masahiro Ikeda
Congenital coronary-pulmonary artery fistulas complicated by continuity to a systemic artery and aneurysm are extremely rare. A 78-year-old woman was admitted to our hospital with a complaint of chest discomfort. Coronary angiography showed a coronary aneurysm and coronary-pulmonary artery fistula arising from the left circumflex artery and entering into the right lower pulmonary artery. Computed tomography angiography revealed a left subclavian artery-pulmonary artery fistula communicating with the coronary-pulmonary artery fistula...
November 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28967593/measurement-of-cerebrovascular-reactivity-as-blood-oxygen-level-dependent-magnetic-resonance-imaging-signal-response-to-a-hypercapnic-stimulus-in-mechanically-ventilated-patients
#8
Lashmi Venkatraghavan, Julien Poublanc, Jay S Han, Olivia Sobczyk, Casey Rozen, Kevin Sam, James Duffin, David J Mikulis, Joseph A Fisher
BACKGROUND: Impaired cerebrovascular reactivity (CVR) is an important prognostic marker of stroke. Most measures of CVR lack (1) a reproducible vasoactive stimulus and (2) a high time and spatial resolution measure of cerebral blood flow (CBF), particularly for mechanically ventilated patients. The aim of our study was to investigate the feasibility of measuring CVR using sequential gas delivery circuit and gas blender for precise targeting of end-tidal PCO2 (PetCO2 ), and blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI) signal as a surrogate of CBF, in mechanically ventilated patients...
February 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28965152/high-incidence-of-progressive-stenosis-in-aberrant-left-subclavian-artery-with-right-aortic-arch
#9
Mamoru Muraoka, Hazumu Nagata, Yuichiro Hirata, Kiyoshi Uike, Eiko Terashi, Eiji Morihana, Masayuki Ochiai, Yasuyuki Fujita, Kiyoko Kato, Kenichiro Yamamura, Shouichi Ohga
Right aortic arch with aberrant left subclavian artery (RAA/aLSCA) is a rare aortic arch anomaly. The clinical association of aLSCA stenosis with RAA/aLSCA has not yet been fully elucidated. The aim of this study was to investigate the diagnosis, incidence, management and outcome of aLSCA stenosis in infants with prenatally diagnosed RAA/aLSCA. Ten fetuses who were diagnosed as having RAA/aLSCA in Kyushu University Hospital between January 2011 and December 2014 were enrolled. The maternal and child medical records were reviewed to investigate sex, gestational age at the fetal diagnosis, gestational age and body weight at birth, the findings of computed tomography (CT), Doppler ultrasonography of the vertebral artery and angiography, and the complications and outcomes of aLSCA stenosis...
September 30, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28951393/arteriovenous-fistulae-of-the-filum-terminale
#10
REVIEW
Enrico Giordan, Waleed Brinjikji, Elisa Ciceri, Giuseppe Lanzino
Filum terminale arteriovenous fistulae are a rare type of arteriovenous shunt generally characterized by a single direct communication between the artery of the filum terminale and a single draining vein. These intradural arteriovenous shunts are three times more common in men than women (mean age 55 years). Symptoms are related to venous congestion, vascular hypertension, and a putative chronic steal phenomenon which result in spinal cord ischemia and myelopathy. Interestingly, hemorrhage has never been reported as a mode of presentation...
February 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28948802/-subclavian-steal-carotid-recovery-phenomenon-old-school-surgical-procedure
#11
D Janák, K Vik, V Rohn
Subclavian steal-carotid recovery phenomenon appears to be related to the occlusion of the truncus brachiocephalicus and can be a rare cause of neurological deficit. In this syndrome, the right common carotid artery and right subclavian artery are filled with retrograde flow from the ipsilateral vertebral artery. We present a patient with this type of steal syndrome managed by a classical surgical procedure for stent reocclusion in the truncus brachiocephalicus.Key words: steal phenomenon endarterectomy truncus brachiocephalicus...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28701298/carotid-stenting-for-unilateral-stenosis-can-increase-contralateral-hemispheric-cerebral-blood-flow
#12
Akiyo Sadato, Shingo Maeda, Motoharu Hayakawa, Kazuhide Adachi, Hiroshi Toyama, Ichiro Nakahara, Yuichi Hirose
BACKGROUND: The revascularization of carotid stenosis can increase ipsilateral cerebral blood flow (CBF). Occasionally, elevated CBF is also evident on the contralateral side, but this phenomenon is poorly understood. OBJECTIVE: To analyze retrospectively the relationship between a contralateral CBF increase and several clinical and radiologic features. MATERIALS AND METHODS: We retrospectively analyzed 40 patients with unilateral cervical carotid stenosis treated by carotid artery stenting (CAS)...
July 12, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28684367/endovascular-therapy-for-the-steal-phenomenon-due-to-the-innominate-artery-severe-stenosis-and-bilateral-internal-carotid-artery-severe-stenosis
#13
Shuta Aketa, Daisuke Wajima, Masahiro Kishi, Yudai Morisaki, Taiji Yonezawa, Ichiro Nakagawa, Hiroyuki Nakase
BACKGROUND: Symptomatic innominate artery stenosis presenting as hemodynamic bilateral cerebral ischemia is uncommon. We present a rare case of the severe stenosis of the origin of an innominate artery and severe stenosis of bilateral internal carotid artery that induced hemodynamic cerebral ischemia after ipsilateral axillary artery-bilateral femoral artery bypass and was treated with stent replacement of the innominate artery and right internal carotid artery. CASE REPORT: A 64-year-old woman who previously had undergone right axillary artery-bilateral femoral artery anastomosis for abdominal aorta high obstruction had been suffering from chronic dizziness and so visited our department...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28579507/a-case-of-ruptured-vertebrobasilar-junction-aneurysm-associated-with-subclavian-steal-phenomenon
#14
Tetsuya Okuhara, Koji Hashimoto, Kazuya Kanemaru, Hideyuki Yoshioka, Takashi Yagi, Jun-Ei Obata, Kiyotaka Kugiyama, Hiroyuki Kinouchi
A 77-year-old woman with arteriovenous shunt for hemodialysis in the left forearm suffered from subarachnoid hemorrhage due to the rupture of a saccular aneurysm located on the left lateral wall of vertebrobasilar junction. Her left subclavian artery was severely stenosed and subclavian steal phenomenon was demonstrated on the digital subtraction angiography. Embolization of the parent artery including the aneurysm using detachable coils resulted in the successful obliteration of the aneurysm through the revascularized left subclavian artery...
August 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28568976/percutaneous-obliteration-of-left-ventricular-cavity-to-eliminate-aortic-regurgitation-and-presumed-coronary-steal-in-an-infant-with-hypoplastic-left-heart-syndrome
#15
Howaida G El-Said, Charissa R Pockett, John W Moore
The phenomenon of coronary steal is well known in the setting of HLHS (Hypoplastic Left Heart Syndrome) early after the Classical Norwood Operation. We report a rare case of an infant with HLHS [Severe Aortic Stenosis (AS), Mitral Stenosis (MS) and small Left Ventricle (LV)], who developed aortic regurgitation and presumed coronary steal late after the Sano Modification of the Norwood Procedure. Coronary steal developed secondary to progressive aortic and mitral regurgitation and resulted in poor right ventricular function and severe tricuspid regurgitation...
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28518124/direct-re-implantation-of-left-coronary-artery-into-the-aorta-in-adults-with-anomalous-origin-of-left-coronary-artery-from-the-pulmonary-artery-alcapa
#16
Reza Tavakoli, Peiman Jamshidi, Nassrin Yamani, Max Gassmann
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly which is one of leading causes of myocardial ischemia and infarction in children. If left untreated, it results in a 90% mortality rate in the first year of life. In patients who survive to the adulthood, the coronary steal phenomenon and retrograde left-sided coronary flow provide a substrate for chronic subendocardial ischemia, which may lead to left ventricular dysfunction, ischemic mitral regurgitation, malignant ventricular arrhythmias, and sudden cardiac death...
April 24, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28498910/extra-anatomical-bypass-in-complex-and-recurrent-aortic-coarctation-and-hypoplastic-arch
#17
Eva Maria Delmo Walter, Mariano Francisco Del Maria Javier, Roland Hetzer
OBJECTIVES: Our goal was to report the selection schemes, technical variations and long-term outcome of extra-anatomical bypass to correct complex, recurrent aortic coarctation and hypoplastic aortic arch. METHODS: Between 1989 and 2012, 53 patients (mean age 13.2 ± 4.3, median 11.6, range 9-23 years) with complex aortic coarctation (n = 33; long-segment hypoplastic aortic arch in 15), recurrent coarctation (n = 20; anastomosic pseudoaneurysm in 10), underwent correction using extra-anatomical bypass, either with (n = 18: femoral bypass = 13, left heart bypass = 5) or without (n = 35) extracorporeal circulation via a left lateral thoracotomy (n= 48) and combined median sternotomy and median laparotomy (n = 5)...
September 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28496514/anomalous-intercoronary-communication-with-unidirectional-flow-in-the-absence-of-obstructive-coronary-artery-disease-a-case-report
#18
Arash Gholoobi, Mohammad Vojdanparast
Large intercoronary communications in the absence of obstructive coronary artery disease constitute a very rare coronary artery anomaly in which there is a readily visible connection between the 2 coronary arteries with a unidirectional or bidirectional blood flow; consequently, this anomaly may be misinterpreted as a functioning collateral vessel, indicative of an unrecognized proximal coronary artery occlusion. In contrast to collateral vessels that are seen in the presence of critical coronary artery stenosis and total occlusions, these arterial communications are vessels that are single, extramural, straight, and large in diameter...
October 3, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/28457478/mechanical-concepts-applied-in-congenital-heart-disease-and-cardiac-surgery
#19
REVIEW
Rabin Gerrah, Stephen J Haller, Isaac George
All biological processes are governed by principles of physics that dictate the pathophysiology and even the treatment of congenital heart diseases. In this review, basic concepts such as flow, pressure, resistance, and velocity are introduced, followed by more complex laws that describe the relationship between these variables and the disease processes. Finally, physical phenomena such as turbulence, steal and runoff phenomenon, and energy loss are discussed. By application of these principles, one can accurately quantify modifications undertaken to treat diseases, for example, the size of a patch that augments a vessel and the angle of an anastomosis to allow a certain flow...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28420337/right-aortic-arch-analysis-anatomical-variant-or-serious-vascular-defect
#20
Agata Arazińska, Michał Polguj, Konrad Szymczyk, Magdalena Kaczmarska, Łukasz Trębiński, Ludomir Stefańczyk
BACKGROUND: The right-sided aortic arch (RAA) is a rare congenital defect of the aorta. The aim of the study was to assess the occurrence of RAA in diagnoses performed by the University Radiology Department and analyze the frequency of concomitant vascular abnormalities. METHODS: The database of the Radiology Department was retrospectively analyzed between January 2008 and May 2016 with the keyword "right aortic arch". Twenty patients with this diagnosis were identified from a total of 11,690 CT examinations of the chest area, 19,623 CT examinations of brain-supplying vessels, and 1863 MRI examinations of the heart and aortic arch or brain-supplying arteries...
April 19, 2017: BMC Cardiovascular Disorders
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