Annals of Vascular Surgery

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Endovascular treatment of an external iliac artery dissection causing early renal graft dysfunction

20 April 2019 - 12:00am
Vascular complications such as renal artery or renal vein thrombosis and laceration, and iliac artery dissection are rarely encountered following renal transplantation. A timely management of these vascular complications is important to prevent ischemic injury of a transplanted kidney. We hereby report a 60-year-old male who had acute renal dysfunction due to iatrogenic left external iliac artery dissection, following renal transplantation. An endovascular stenting of dissected iliac artery resulted in brisk flow across both iliac and transplanted renal artery.

Endovascular treatment of aortic arch vessels stents migration: 3case reports

19 April 2019 - 12:00am
Percutaneous angioplasty and stenting is nowadays the treatment of choice in atherosclerotic stenosic lesions of the supra aortic trunks. Stent migration is a seldom published complication that can alter the short term results of these procedures.Herein, we report three cases, from three different institutions, of secondary auto expandable stent migration, following endovascular treatment of major arch vessels stenosis, and their subsequent endovascular management using three different retrieval techniques.

Splenic Infarct After Warfarin Overdose Treatment; Is it coincidence or complication?

19 April 2019 - 12:00am
The Splenic infarct is a rare clinical condition seen in the emergency department and can mimic acute abdomen. Hematologic, vascular and thromboembolic events are considered in the etiology. Treatment options are varying between symptomatic treatment and splenectomy. Warfarin is a vitamin K antagonist used for prevention and treatment of the thromboembolic disorders. In overdose situations there is a possibility for bleeding in every part of the body. Prothrombin complex concentrates, vitamin K and fresh frozen plasma (FFP) are used in the treatment of warfarin overdose.

Incidence, management and outcomes of aortic graft infection.R1 Aortic graft infection

19 April 2019 - 12:00am
Infection complicates 1% of aortic grafts, and although uncommon, the associated morbidity and mortality are significant. We sought to determine risk factors for aortic graft infection (AGI), the long-term outcomes in patients managed both non-operatively and via explantation

The clinical impact of splanchnic ischemia in patients affected by thoracoabdominal aortic aneurysms treated with fenestrated and branched endograft

19 April 2019 - 12:00am
Fenestrated/branched endografts (FB-EVAR) are valid options to treat thoraco-abdominal aortic aneurysms (TAAA). Successful repair requires target-visceral-vessels (TVV) manipulation with possible splanchnic ischemia. Aim of the study was to evaluate the clinical impact of splanchnic ischemia occurring in FB-EVAR for TAAA.

THE V -BLOCK OCCLUSION STENT AND SCLEROTHERAPY DEVICE FOR VARICOSE VEIN TREATMENT - A RETROSPECTIVE ANALYSIS

19 April 2019 - 12:00am
The procedure aims to show our results with a novel non-tumescent, non-thermal technique to treat varicose veins.The V Block occlusion stent is a minimally invasive device for treating reflux of the great saphenous vein. It is an office-based procedure that does not require tumescence anesthesia. The V-block stent is a self-expandable device which functions as a vein occluder and blood clot trap. Once the V-block is in place, further treatment of the saphenous vein such as ultrasound guided sclerotherapy can be performed.

STENT GRAFT LENGTH IS ASSOCIATED WITH DECREASED PATENCY IN TREATMENT OF CENTRAL VENOUS STENOSIS IN HEMODIALYSIS PATIENTS

19 April 2019 - 12:00am
Central venous occlusion may occur in hemodialysis patients resulting in arm or facial swelling and failure of dialysis access. Endovascular management with balloon angioplasty or stenting has been described, but there is minimal data on the use of covered stents in this pathology. We sought to review a single institution’s experience with the use of covered stents for central venous occlusive disease in hemodialysis patients.

Retrograde Type A intramural hematoma treated endovascularly in two cases.

19 April 2019 - 12:00am
Type A aortic dissection is a highly lethal condition, which warrants swift open surgical intervention to prevent death by rupture or malperfusion. Aim is to resect the proximal intimal tear and realign the dissected wall layers.We describe two patients who recently presented in our centre with a retrograde Type A intramural hematoma and a clear intimal tear distal to the left subclavian artery, that were treated in emergency by endovascular means instead of open surgery, with satisfactory short and one year follow-up results.

Hybrid Repair of an Intrathoracic Bi-Lobed Subclavian Artery Aneurysm

19 April 2019 - 12:00am
Intrathoracic subclavian artery aneurysms are extremely rare, <1% of all aneurysms. The formation of these aneurysms is often multifactorial, with the most common contributing factor being atherosclerosis. This case report describes a right subclavian artery aneurysm that required a surgical hybrid approach. These operations can be a safe and effective treatment option, particularly in patients with high risk factors.

Local Anesthetic Block of the Anterior Scalene Muscle Increases Muscle Height in Patients with Neurogenic Thoracic Outlet Syndrome

19 April 2019 - 12:00am
Local anesthetic (LA) blocks of the anterior scalene muscle are used to predict which patients with neurogenic thoracic outlet syndrome (TOS) may benefit from surgical decompression. The block is thought to work through both analgesic and muscle relaxation effects, but evidence of the latter is lacking. The aim of our study was to assess the effects of LA block on anterior scalene muscle anatomy as captured by magnetic resonance imaging (MRI).

Cerebral Hemodynamic Variations in the Early Stage after Carotid Artery Stenting in Patients with and without Near Occlusion

19 April 2019 - 12:00am
To evaluate the unclear cerebral hemodynamic variations in patients with and without near occlusion (NO) in hours following carotid artery stenting (CAS) by transcranial Doppler (TCD).

Perioperative and follow-up results of Carotid Artery Stenting and Carotid Endarterectomy in Patients with carotid near-occlusion

19 April 2019 - 12:00am
Comparing perioperative and follow-up results of Carotid Artery Stenting (CAS) and Carotid Endarterectomy (CEA) in Patients with carotid near-occlusion (NO).

Thrombolysis for Management of Phlegmasia Cerulea Dolens in the First Trimester of Pregnancy

19 April 2019 - 12:00am
Pregnancy is a hypercoagulable state associated with a fivefold increase in risk of venous thromboembolism. Thrombolysis is the preferred level of care for patients with acute ilio-femoral deep vein thrombosis, however most studies exclude pregnant patients, highlighting the lack of data regarding the efficacy and safety of thrombolytic therapy for the mother and fetus.

The Application of Virtual Reality in Patient Education

19 April 2019 - 12:00am
Virtual reality (VR) provides an immersive image viewing experience that has recently been expanding in use in clinical medicine. We developed a three-dimensional (3D) model of an abdominal aortic aneurysm (AAA) for patients with a diagnosis of an AAA to view in VR to assess the utility of VR in patient education.

Demystifying the Use of Self Expandable Interwoven Nitinol Stents in Femoropopliteal Peripheral Arterial Disease

19 April 2019 - 12:00am
Femoropopliteal atherosclerosis affects a significant percentage of the world population leading to intermittent claudication and critical limb ischemia. The femoropopliteal segment has a unique set of biomechanical challenges that must be considered and overcome for treatment. The use of stents is a reality and a necessity in peripheral interventions. The success of first-generation femoropopliteal stents was limited by their rigidity and deformability. The standard nitinol stents overcame certain biomechanical challenges due to their superelasticity and thermal shape memory, although stent fracture still an issue.

A study on Pressure Lowering Effect of the Multilayer Stent

19 April 2019 - 12:00am
To investigate the hemodynamic changes of the blood flow in the aneurysm model after the multilayer stent placement using fluid dynamic method, in order to analyze the effectiveness and properties of the multilayer stent in the treatment of aortic aneurysms.

Esophageal resection, gastric tube reconstruction and omental flap coverage of iatrogenic aortoesophageal fistula after secondary thoracic stentgraft infection: a case report

19 April 2019 - 12:00am
Secondary stentgraft infection is a life-threatening complication after thoracic endovascular aortic repair (TEVAR). There is no consensus on optimal treatment strategy, but combined antibiotic and surgical treatment is advocated. Two years after his TEVAR procedure, a 70-year old patient was admitted to the hospital with a secondary peri-aortic abscess. At first, the abscess was managed with clindamycin and transesophageal drainage. The abscess would not dissipate and an infected iatrogenic aortoesophageal fistula was formed, which was surgically treated with esophageal resection, gastric tube reconstruction and omental flap coverage.

SINGLE-CENTER EXPERIENCE IN THE TREATMENT OF VISCERAL ARTERY ANEURYSMS

19 April 2019 - 12:00am
Visceral artery aneurysms (VAAs), although rare, represent a life-threatening disease with high mortality rates. With the more frequent use of diagnostic tests, there has been an incidental detection of these lesions which are mostly asymptomatic. It follows that surgeons are increasingly called to decide the most appropriate management of VAAs between an open surgical or endovascular approach and among the different endovascular options currently available. The aim of this retrospective study was to evaluate the results of open surgery and interventional endovascular strategies of visceral artery aneurysms with respect to technical success, therapy-associated complications and post- interventional follow-up in the elective and emergency situation.

Laparoscopic Surgery in Chronic Mesenteric Ischaemia: Release of the Superior Mesenteric Artery from the Median Arcuate Ligament using the Transperitoneal Left Retrorenal Approach

19 April 2019 - 12:00am
Median arcuate ligament (MAL) syndrome usually involves the celiac artery (CA) only. Far less frequently, both the CA and superior mesenteric artery (SMA) are compressed, leading to chronic mesenteric ischaemia.We report the case of a 46-year-old woman with a 4-year history of permanent nausea, postprandial abdominal pain and asthenia. A clear epigastric bruit was observed on physical examination. Duplex ultrasound and computed tomography angiography revealed an occlusion of the CA and a highly compressed proximal SMA by the MAL, with an important collateral mesenteric network.

Predisposing factors for migration of the iliac limb and reintervention after endovascular abdominal aortic aneurysm repair.

19 April 2019 - 12:00am
Migration of the iliac limb after endovascular abdominal aortic aneurysm repair (EVAR) can result in type 1b and 3 endoleaks that are relatively common causes of reintervention after EVAR. The aim of the present study was to investigate the factors influencing migration of the iliac limb and methods of treatment.