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trauma endovascular

Chris W Piercecchi, Julio C Vasquez, Stephen J Kaplan, Jordan Hoffman, John D Puskas, Jacob DeLaRosa
We present a rare late complication after inferior vena cava filter (IVC) placement. A 52-year-old woman with an IVC presented with sudden onset of chest pain. Cardiac catheterisation and echocardiography revealed an embolised IVC filter strut penetrating the right ventricle. Endovascular retrieval was considered but deemed unsafe due to proximity to the right coronary artery and concern for migration to pulmonary circulation. Urgent removal of the strut was performed via sternotomy. The postoperative course was uneventful...
September 5, 2016: Heart, Lung & Circulation
M J Ramdass, P Harnarayan
INTRODUCTION Trinidad and Tobago is a trans-shipment point for the illegal trade of drugs, arms and ammunition and, as such, has a high incidence of gang-related warfare and drug-related crimes. This has led to a high incidence of gunshot and stab wounds, with associated major vascular injuries. We describe our management strategies learned from a decade of vascular trauma experience. METHODS A retrospective analysis of age, gender, type of trauma, vessel injured, procedure and outcome for all cases of vascular trauma between 2006 and 2015 at two surgical units in Trinidad and Tobago...
September 23, 2016: Annals of the Royal College of Surgeons of England
Jennifer J Robertson, Alex Koyfman
BACKGROUND: Cervical artery dissection (CeAD) is an infrequent, yet potentially devastating, cause of stroke. While uncommon, CeAD is important for emergency physicians to quickly diagnose and treat because of the potential for cerebral ischemia, stroke, blindness, or death. To our knowledge, no review articles in the emergency medicine literature have been published on CeAD. A literature search of MEDLINE/PubMed, Embase, and other major abstracts in the English language was performed for the following terms: cervical artery, vertebral artery, and carotid artery dissection...
September 12, 2016: Journal of Emergency Medicine
J Gómez-Salazar, J Tovar-López, G Hernández-Rodríguez, H De la Concha-Ureta
Arterial pseudoaneurysm of the lower limb is an infrequent entity, particularly in the infrapopliteal segment. It is commonly associated to vascular repairs or follows a localized arterial lesion, a fracture or a surgical procedure. There is little information in Mexico about this entity in cases involving the anterior tibial artery, and secondary to trauma and osteosynthesis. Given that sudden bleeding due to rupture of the pseudoaneurysm is a possible catastrophic outcome for the viability of the segment, it is important to timely detect and diagnose the pseudoaneurysm...
January 2016: Acta Ortopédica Mexicana
S E van Oostendorp, E C T H Tan, L M G Geeraedts
INTRODUCTION: Exsanguination following trauma is potentially preventable. Extremity tourniquets have been successfully implemented in military and civilian prehospital care. Prehospital control of bleeding from the torso and junctional area's remains challenging but offers a great potential to improve survival rates. This review aims to provide an overview of potential treatment options in both clinical as preclinical state of research on truncal and junctional bleeding. Since many options have been developed for application in the military primarily, translation to the civilian situation is discussed...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Anders J Davidson, Lucas P Neff, Joseph J Dubose, James B Sampson, Christopher M Abbot, Timothy K Williams
Peripheral vascular injuries carry significant risk for permanent functional impairment, limb loss, and death. Definitive correction of these injuries requires significant operative time and has traditionally been resource and skill set intensive. In the initial surgical treatment of the physiologically depleted trauma patient, faster techniques may prove more appropriate. Damage control techniques, including vascular shunting, rapidly restore distal flow, but require additional vascular intervention and risk shunt thrombosis with prolonged use...
September 16, 2016: Journal of Trauma and Acute Care Surgery
Rizvi Humaira, Chiu Yuen To, Shyam Moudgil, Richard Fessler
BACKGROUND: Brown-Séquard syndrome is typically caused by penetrating trauma to the cervical spinal cord; however, other compressive and vascular occlusive etiologies have been previously described. It is extremely uncommon to have a delayed presentation as an extramedullary compressive lesion from the venous varix of an acquired spinal arteriovenous fistula. CASE DESCRIPTION: We present a case of a patient in the fifth decade of life, with a remote history of gunshot wound to the left thorax with progressive left-sided weakness and contralateral pain and temperature sensory loss secondary to cord compression from an acquired spinal arteriovenous fistula...
September 2, 2016: World Neurosurgery
F Gentile, G Lundberg, R Hultgren
OBJECTIVE/BACKGROUND: To describe the risk factor distribution and outcome for patients with critical limb ischemia (CLI) due to infrapopliteal arterial lesions treated by endovascular or open procedures, with special consideration of diabetic patients. METHODS: Data were collected from the Swedish Vascular Registry, Swedvasc, covering all procedures performed on 549 consecutive patients between May 2008 and January 2014 at the Karolinska University Hospital. Diagnosis of ischemic rest pain and/or tissue loss and treatment of infrapopliteal arterial occlusive disease were considered...
September 1, 2016: European Journal of Vascular and Endovascular Surgery
Shan Zhong, Xiquan Zhang, Zhong Chen, Peng Dong, Yequan Sun, Wei Zhu, Xiaolin Pan, Deming Qi
OBJECTIVE: To evaluate the feasibility and effectiveness of endovascular repair for blunt popliteal arterial injuries. MATERIALS AND METHODS: A retrospective analysis of seven patients with clinical suspicion of popliteal arterial injuries that were confirmed by arteriography was performed from September 2009 to July 2014. Clinical data included demographics, mechanism of injury, type of injury, location of injury, concomitant injuries, time of endovascular procedures, time interval from trauma to blood flow restoration, instrument utilized, and follow-up...
September 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Ravi Kumar, Atin Kumar, Vinit Baliyan, Shivanand Gamanagatti, Ashu Seith Bhalla, Raju Sharma, Amit Gupta, Subodh Kumar, M C Misra
The aim of the study was to correlate multi-detector computed tomography (MDCT) grading with clinical severity and outcome in liver trauma patients without significant extrahepatic injury. Over a period of 2 years (2011-2013), all patients showing evidence of liver injury on contrast-enhanced CT (CECT) abdomen and without significant extrahepatic trauma were prospectively included in the study. Correlation between the CT injury grade and outcome in terms of mortality, duration of ICU/hospital stay, fluid and blood requirements, need for intervention and complications were assessed...
August 2016: Indian Journal of Surgery
Carl Beyer, Scott Zakaluzny, Misty Humphries, David Shatz
BACKGROUND: Injury to the renal artery is a rare but serious concern in patients suffering blunt trauma. Complications of renovascular injury include prolonged hospitalization, kidney loss, and death. There remains considerable controversy regarding the optimal treatment of blunt renal artery injury. CASE REPORT: We describe the management of a 39 year old woman following blunt polytrauma who underwent a multidisciplinary collaborative procedure with open splenectomy and endovascular repair of an occluded renal artery...
August 20, 2016: Annals of Vascular Surgery
Matthew J Bradley, Brandon W Bonds, Luke Chang, Shiming Yang, Peter Hu, Hsiao-Chi Li, Megan L Brenner, Thomas M Scalea, Deborah M Stein
BACKGROUND: Open chest cardiac massage (OCCM) is a commonly performed procedure after traumatic cardiac arrest (TCA). OCCM has been reported to be superior to closed chest compressions (CCC) in animal models and in non-traumatic cardiac arrest. The purpose of this study is to prospectively compare OCCM versus CCC in traumatic cardiac arrest using end-tidal carbon dioxide (ETCO2), the gold standard for determining the effectiveness of chest compressions and detection of return of spontaneous circulation (ROSC), as the surrogate for cardiac output and marker for adequacy of resuscitation...
August 18, 2016: Journal of Trauma and Acute Care Surgery
Noa Kezurer, Nairouz Farah, Yossi Mandel
Hemorrhagic shock accounts for 30-40 percent of trauma mortality, as bleeding may sometimes be hard to control. Application of short electrical pulses on blood vessels was recently shown to elicit robust vasoconstriction and reduction of blood loss following vascular injury. In this study we present a novel approach for vasoconstriction based on endovascular application of electrical pulses for situations where access to the vessel is limited. In addition to ease of access, we hypothesize that this novel approach will result in a localized and efficient vasoconstriction...
2016: Scientific Reports
A Faucon, G Bobrie, A S Jannot, A Azarine, L Amar, P F Plouin, M Azizi
OBJECTIVE: Renal infarction (RI) is a rare disease (0.004% of patients admitted to emergency units), due to a disruption of renal blood flow of the main ipsilateral renal artery (RA) or of one of its segmental branches due to either a local in-situ or a general mechanism. The local mechanism includes RA occlusion, dissection, aneurysm or stenosis which 1) may lead to in-situ RA thrombosis or renal emboli and 2) can be due to various etiologies including atherosclerosis disease (ASD), fibromuscular dysplasia (FMD), dissecting hematoma (DH), extension of an aortic dissection (AoD) to the RA, miscellaneous arterial disease (AD), iatrogenic post-RA catheterization/surgery complication (IC) or post-renal trauma complication (T)...
September 2016: Journal of Hypertension
Abdullah Alfawaz, Xiaoyi Li, Stefan Kénel-Pierre, Jane Yang, Jorge Rey, Handel Robinson
OBJECTIVE: Penetrating carotid trauma in a hemodynamically stable patient invariably presents with a pseudoaneurysm on initial imaging. Although extremely rare, delayed pseudoaneurysm formation has been reported. The purpose of this paper is to define this rare entity and propose a diagnostic and treatment plan. METHODS: We present a case of delayed presentation of carotid pseudoaneurysm following penetrating neck trauma. A systematic review of the literature was performed...
2016: SAGE Open Med Case Rep
Robert C Rennert, Jeffrey A Steinberg, Jayson Sack, J Scott Pannell, Alexander A Khalessi
Penetrating brain trauma commonly results in occult neurovascular injury. Detailed cerebrovascular imaging can evaluate the relationship of intracranial foreign bodies to major vascular structures, assess for traumatic pseudoaneurysms, and ensure hemostasis during surgical removal. We report a case of a self-inflicted intracranial nail gun injury causing a communicating ventricular tract hemorrhage upon removal, as well as a delayed pseudoaneurysm. Pre- and post-operative vascular imaging, as well as intra-operative endovascular assistance, was critical to successful foreign body removal in this patient...
2016: Frontiers in Neurology
Michael C Dewan, Vijay M Ravindra, Stephen Gannon, Colin T Prather, George L Yang, Lori C Jordan, David Limbrick, Andrew Jea, Jay Riva-Cambrin, Robert P Naftel
BACKGROUND: Pediatric blunt cerebrovascular injury (BCVI) lacks accepted treatment algorithms, and postinjury outcomes are ill defined. OBJECTIVE: To compare treatment practices among pediatric trauma centers and to describe outcomes for available treatment modalities. METHODS: Clinical and radiographic data were collected from a patient cohort with BCVI between 2003 and 2013 at 4 academic pediatric trauma centers. RESULTS: Among 645 pediatric patients evaluated with computed tomography angiography for BCVI, 57 vascular injuries (82% carotid artery, 18% vertebral artery) were diagnosed in 52 patients...
July 25, 2016: Neurosurgery
Anna Sandstrom, Pankhaj Jha
INTRODUCTION: Visceral artery aneurysms (VAA) are an uncommon vascular pathology with an incidence estimated at 0.01% to 2%. The likely aetiology of visceral artery aneurysms is uncertain includes atherosclerosis, trauma and inflammation. VAAs are often asymptomatic until rupture which causes life threatening haemorrhage and is associated with a high mortality. Gastric artery aneurysms (GAA) form a very small proportion of VAAs (<4%). CASE DESCRIPTION: This is a case series of three patients who presented to Nambour Hospital with a ruptured left gastric aneurysm...
July 14, 2016: Annals of Vascular Surgery
José E Cohen, John M Gomori, Gustavo Rajz, Guy Rosenthal, Hosni Abu El Hassan, Samuel Moscovici, Eyal Itshayek
Extracranial vertebral pseudoaneurysms that develop following blunt trauma to the cervical area may have a benign course; however, embolic or ischemic stroke and progressive pseudoaneurysm enlargement may occur. We review the presentation and endovascular management of pseudoaneurysms of the cervical vertebral artery (VA) due to blunt trauma in nine patients (eight male, mean age 27years). Pseudoaneurysms occurred in dominant vessels in seven patients and coexisted with segmental narrowing in six. We favored endovascular intervention during the acute phase only in cases with significant narrowing of a dominant VA, especially when anticoagulation was contraindicated...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Kokichi Miyamoto, Mototaka Inaba, Toru Kojima, Takefumi Niguma, Tetsushige Mimura
INTRODUCTION: Secondary aortoduodenal fistula (SADF) is a rare but life-threatening complication after aortic reconstruction. Although a number of reports describing treatments for SADF have been published, the optimal management is unclear. A review of the literature suggested methods of reconstruction, control of bleeding, and reduction of infection in the management of SADF. The most important factor for acute intervention is controlling the bleeding from the fistula. We report one case treated using intra-aortic balloon occlusion (IABO) for SADF...
2016: International Journal of Surgery Case Reports
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