This report presents the treatment of an aortic endovascular aneurysm repair (EVAR) device failure, focusing on the use of colour duplex ultrasound (CDUS) to diagnose and confirm effective treatment of a type IIIb endoleak.
An 89 year old man with a history of EVAR was transferred to the authors' centre with complaints of abdominal pain and a pressure sensation behind the umbilicus. A previously stable 11 cm aneurysm sac was visualised on computed tomography angiography in addition to a newly suspected type IIIb endoleak, which was confirmed via CDUS. He underwent successful endovascular repair with a stent across the limb defect. The patient was discharged uneventfully and was followed for surveillance.
Type IIIb endoleak is an underreported complication after EVAR. CDUS of type IIIb endoleak aided in localisation and characterisation of the graft failure, and confirmed successful endovascular treatment of the endoleak defect in the side limb. Locating the point of graft failure using CDUS preceding endovascular repair of type IIIb endoleaks guides interventions and repair outcomes. It is a rare opportunity to report a case of acute type IIIb endoleak with CDUS that definitively localised an endograft defect.
Type IIIb endoleak is an underreported complication after EVAR. CDUS of type IIIb endoleak aided in localisation and characterisation of the graft failure, and confirmed successful endovascular treatment of the endoleak defect in the side limb. Locating the point of graft failure using CDUS preceding endovascular repair of type IIIb endoleaks guides interventions and repair outcomes. It is a rare opportunity to report a case of acute type IIIb endoleak with CDUS that definitively localised an endograft defect.
In venous thoracic outlet syndrome (VTOS), pathology around the axillosubclavian vein causes venous compression with the subsequent development of upper extremity symptoms. This case report describes the analysis of all possible compression sites and subsequent treatment of VTOS patients with multiple compression points.
A 22 year old male presented with severe pain and swelling in his right arm, which persisted after a conservatively managed primary upper extremity deep vein thrombosis. Compression of the axillosubclavian vein was seen both at the level of the pectoralis minor and the costoclavicular spaces. Both compression points were successfully treated by combining thoracic outlet decompression surgery with pectoralis minor tenotomy.
This report underlines the importance of considering the possibility of multiple compression sites in patients with VTOS. https://www.selleckchem.com/products/pbit.html Incomplete surgical release of all compression points leaves patients prone to re-thrombosis and/or persistent post-thrombotic syndrome. Timely recognition of all abnormalities on venography may allow for adjustment of surgical treatment accordingly.
This report underlines the importance of considering the possibility of multiple compression sites in patients with VTOS. Incomplete surgical release of all compression points leaves patients prone to re-thrombosis and/or persistent post-thrombotic syndrome. Timely recognition of all abnormalities on venography may allow for adjustment of surgical treatment accordingly.
Acute renal failure is a frequent major complication (24%) of endovascular repair for ruptured abdominal aneurysm (rAAA). Iodinated contrast media is known to be nephrotoxic. This report describes a case of endovascular aneurysm repair (EVAR) under fusion imaging guidance in a patient diagnosed with a rAAA after non-contrast CT. Written consent was obtained from the patient.
A 73 year old patient with stage IV chronic kidney failure and contrast-induced nephropathy was diagnosed with rAAA using non-contrast CT. Subsequently, the patient was treated with EVAR using fusion imaging.
EVAR with fusion imaging after non-contrast CT was safe in a patient with rAAA. It could represent an option for patients with acute renal failure in emergency settings.
EVAR with fusion imaging after non-contrast CT was safe in a patient with rAAA. It could represent an option for patients with acute renal failure in emergency settings.
A late aortic aneurysm at the site of previous open surgery for coarctation of the aorta (CoA) is a life threatening complication. Several strategies have been reported, however, these strategies have issues. This is the report of a case involving successful ascending to descending aortic bypass concomitant with endovascular embolisation for a pseudoaneurysm.
The patient was a 23 year old man with a history of patch aortoplasty for coarctation of the aorta (CoA) via a left thoracotomy and patch closure of a ventricular septal defect. Enhanced computed tomography (CT) angiography performed in 2014 revealed a pseudoaneurysm at the site of the previous patch aortoplasty. CT also revealed a hypoplastic and severely kinked aortic arch that made it difficult to perform conventional thoracic endovascular aortic repair for this aneurysm. Therefore in order to prevent rupture, a combination of ascending to descending aortic bypass and endovascular embolisation using Amplatzer vascular plugs and coils was employed. Transection of the aortic arch and transposition of the left subclavian artery were performed to prevent antegrade flow into the aneurysm.
The aneurysm was successfully excluded without complications. CT performed three years after the operation showed that the pseudoaneurysm had shrunk completely. Extra-anatomic bypass concomitant with endovascular embolisation for a late coarctation patched site aneurysm might be an alternative strategy that should be carefully considered in specific cases.
The aneurysm was successfully excluded without complications. CT performed three years after the operation showed that the pseudoaneurysm had shrunk completely. Extra-anatomic bypass concomitant with endovascular embolisation for a late coarctation patched site aneurysm might be an alternative strategy that should be carefully considered in specific cases.
Abdominal aortic aneurysm (AAA) concomitant with acute aortic dissection is rare.
An acute type B aortic dissection involving AAA in a 58 year old woman is described. Computed tomography angiography demonstrated that the false lumen of the abdominal aorta including the aneurysm remained patent, secondary to entry sites in the abdominal aorta, bilateral external iliac arteries, and a membrane tear of the left renal artery (LRA). The aneurysm was isolated by endovascular aneurysm repair and LRA stenting; all entry sites were occluded by endovascular treatment that included covered stenting of the LRA. Imaging performed three months after the procedure confirmed complete thrombosis of the false lumen and AAA sac shrinkage.
Endovascular treatment with covered stents is reported as an alternative strategy for treatment of AAA concomitant with acute aortic dissection involving a visceral artery.
Endovascular treatment with covered stents is reported as an alternative strategy for treatment of AAA concomitant with acute aortic dissection involving a visceral artery.
This report presents the treatment of an aortic endovascular aneurysm repair (EVAR) device failure, focusing on the use of colour duplex ultrasound (CDUS) to diagnose and confirm effective treatment of a type IIIb endoleak.
An 89 year old man with a history of EVAR was transferred to the authors' centre with complaints of abdominal pain and a pressure sensation behind the umbilicus. A previously stable 11 cm aneurysm sac was visualised on computed tomography angiography in addition to a newly suspected type IIIb endoleak, which was confirmed via CDUS. He underwent successful endovascular repair with a stent across the limb defect. The patient was discharged uneventfully and was followed for surveillance.
Type IIIb endoleak is an underreported complication after EVAR. CDUS of type IIIb endoleak aided in localisation and characterisation of the graft failure, and confirmed successful endovascular treatment of the endoleak defect in the side limb. Locating the point of graft failure using CDUS preceding endovascular repair of type IIIb endoleaks guides interventions and repair outcomes. It is a rare opportunity to report a case of acute type IIIb endoleak with CDUS that definitively localised an endograft defect.
Type IIIb endoleak is an underreported complication after EVAR. CDUS of type IIIb endoleak aided in localisation and characterisation of the graft failure, and confirmed successful endovascular treatment of the endoleak defect in the side limb. Locating the point of graft failure using CDUS preceding endovascular repair of type IIIb endoleaks guides interventions and repair outcomes. It is a rare opportunity to report a case of acute type IIIb endoleak with CDUS that definitively localised an endograft defect.
In venous thoracic outlet syndrome (VTOS), pathology around the axillosubclavian vein causes venous compression with the subsequent development of upper extremity symptoms. This case report describes the analysis of all possible compression sites and subsequent treatment of VTOS patients with multiple compression points.
A 22 year old male presented with severe pain and swelling in his right arm, which persisted after a conservatively managed primary upper extremity deep vein thrombosis. Compression of the axillosubclavian vein was seen both at the level of the pectoralis minor and the costoclavicular spaces. Both compression points were successfully treated by combining thoracic outlet decompression surgery with pectoralis minor tenotomy.
This report underlines the importance of considering the possibility of multiple compression sites in patients with VTOS. https://www.selleckchem.com/products/pbit.html Incomplete surgical release of all compression points leaves patients prone to re-thrombosis and/or persistent post-thrombotic syndrome. Timely recognition of all abnormalities on venography may allow for adjustment of surgical treatment accordingly.
This report underlines the importance of considering the possibility of multiple compression sites in patients with VTOS. Incomplete surgical release of all compression points leaves patients prone to re-thrombosis and/or persistent post-thrombotic syndrome. Timely recognition of all abnormalities on venography may allow for adjustment of surgical treatment accordingly.
Acute renal failure is a frequent major complication (24%) of endovascular repair for ruptured abdominal aneurysm (rAAA). Iodinated contrast media is known to be nephrotoxic. This report describes a case of endovascular aneurysm repair (EVAR) under fusion imaging guidance in a patient diagnosed with a rAAA after non-contrast CT. Written consent was obtained from the patient.
A 73 year old patient with stage IV chronic kidney failure and contrast-induced nephropathy was diagnosed with rAAA using non-contrast CT. Subsequently, the patient was treated with EVAR using fusion imaging.
EVAR with fusion imaging after non-contrast CT was safe in a patient with rAAA. It could represent an option for patients with acute renal failure in emergency settings.
EVAR with fusion imaging after non-contrast CT was safe in a patient with rAAA. It could represent an option for patients with acute renal failure in emergency settings.
A late aortic aneurysm at the site of previous open surgery for coarctation of the aorta (CoA) is a life threatening complication. Several strategies have been reported, however, these strategies have issues. This is the report of a case involving successful ascending to descending aortic bypass concomitant with endovascular embolisation for a pseudoaneurysm.
The patient was a 23 year old man with a history of patch aortoplasty for coarctation of the aorta (CoA) via a left thoracotomy and patch closure of a ventricular septal defect. Enhanced computed tomography (CT) angiography performed in 2014 revealed a pseudoaneurysm at the site of the previous patch aortoplasty. CT also revealed a hypoplastic and severely kinked aortic arch that made it difficult to perform conventional thoracic endovascular aortic repair for this aneurysm. Therefore in order to prevent rupture, a combination of ascending to descending aortic bypass and endovascular embolisation using Amplatzer vascular plugs and coils was employed. Transection of the aortic arch and transposition of the left subclavian artery were performed to prevent antegrade flow into the aneurysm.
The aneurysm was successfully excluded without complications. CT performed three years after the operation showed that the pseudoaneurysm had shrunk completely. Extra-anatomic bypass concomitant with endovascular embolisation for a late coarctation patched site aneurysm might be an alternative strategy that should be carefully considered in specific cases.
The aneurysm was successfully excluded without complications. CT performed three years after the operation showed that the pseudoaneurysm had shrunk completely. Extra-anatomic bypass concomitant with endovascular embolisation for a late coarctation patched site aneurysm might be an alternative strategy that should be carefully considered in specific cases.
Abdominal aortic aneurysm (AAA) concomitant with acute aortic dissection is rare.
An acute type B aortic dissection involving AAA in a 58 year old woman is described. Computed tomography angiography demonstrated that the false lumen of the abdominal aorta including the aneurysm remained patent, secondary to entry sites in the abdominal aorta, bilateral external iliac arteries, and a membrane tear of the left renal artery (LRA). The aneurysm was isolated by endovascular aneurysm repair and LRA stenting; all entry sites were occluded by endovascular treatment that included covered stenting of the LRA. Imaging performed three months after the procedure confirmed complete thrombosis of the false lumen and AAA sac shrinkage.
Endovascular treatment with covered stents is reported as an alternative strategy for treatment of AAA concomitant with acute aortic dissection involving a visceral artery.
Endovascular treatment with covered stents is reported as an alternative strategy for treatment of AAA concomitant with acute aortic dissection involving a visceral artery.
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