1/41. Endovascular repair of a descending thoracic aortic aneurysm: a tip for systemic pressure reduction.A proposed technique for systemic pressure reduction during deployment of a stent graft was studied. A 67-year-old man, who had a descending thoracic aneurysm, was successfully treated with an endovascular procedure. An occluding balloon was introduced into the inferior vena cava (IVC) through the femoral vein. The balloon volume was manipulated with carbon dioxide gas to reduce the venous return, resulting in a transient and well-controlled hypotension. This IVC-occluding technique for systemic pressure reduction may be safe and convenient to minimize distal migration of stent grafts.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/41. Post-procedure migration of Guglielmi detachable coils and Mechanical detachable spirals.We describe a previously unreported complication of the use of Guglielmi detachable coils and Mechanical detachable spirals in endovascular treatment of intracranial aneurysms. We document four cases in which migration of part of a coil into the parent artery occurred after completion of the procedure. Possible mechanisms are discussed.- - - - - - - - - - ranking = 0.2keywords = aneurysm (Clic here for more details about this article) |
3/41. Aortoduodenal fistula: a late complication of intraluminal exclusion of an infrarenal aortic aneurysm.During recent years, considerable clinical experience has been gained with endoluminal stent-graft procedures. Several studies have shown promising results up to a period of 4.5 years. However, long-term follow-up studies are still limited. Late endoleaks caused by stent-graft migration, disconnection of single components in modular stent-grafts, and limb thrombosis have been observed as long-term complications. We report a case in which a migrated and kinked bifurcated stent-graft caused an aortoduodenal fistula 20 months after stent-graft insertion. To our knowledge, such a complication has not been reported before.- - - - - - - - - - ranking = 0.8keywords = aneurysm (Clic here for more details about this article) |
4/41. Aortoduodenal fistula after endovascular stent-graft of an abdominal aortic aneurysm.Despite satisfying short- and middle-term effectiveness and feasibility, endovascular stent-grafting for abdominal aortic aneurysm is still under evaluation. We report a case of an aortoduodenal fistula after the use of this technique. Enlargement of the upper aneurysmal neck was followed by caudal migration of the major portion of the stent-graft, which resulted in kinking of the device in the aneurysmal sac. Ulcerations were found on adjacent portions of both the aneurysmal sac and the adjacent duodenum. Only the textile portion of the prosthetic contralateral limb separated the aortic lumen from the corresponding duodenal lumen. Early detection of complications after stent-grafting is essential to allow successful treatment, either surgical or endoluminal.- - - - - - - - - - ranking = 1.6keywords = aneurysm (Clic here for more details about this article) |
5/41. Surgical treatment of a distal arch pseudoaneurysm and migrated stent-graft after interrupted aortic arch repair.A 13-year-old girl, who had undergone a modified Blalock-Park operation using an equine pericardial patch for a type A aortic arch interruption at 10 days of age, and patch repair of a ventricular septal defect at 1 year, presented with recurrent stenosis of the aorta. She underwent balloon angioplasty which resulted in a pseudoaneurysm at the distal suture line of the patch. Endovascular stent-grafting was employed. Soon after placement, the stent-graft had migrated into the distal portion of the descending aorta. The distal aortic arch and proximal descending thoracic aorta were replaced with a prosthetic graft. The migrated stent-graft was removed. The operation was performed through an anterior approach under hypothermic circulatory arrest and selective cerebral perfusion. The postoperative course was uneventful. The migration was likely caused by the limited ability to bend the stent-graft to match the curvature of the arch, the stiffness of the scarred equine pericardial patch, and the shape of the aorta.- - - - - - - - - - ranking = 3.265496307095keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
6/41. Aneurysm expansion and retroperitoneal hematoma after thrombolysis for stent-graft limb occlusion caused by distal endograft migration.PURPOSE: To describe a complication of thrombolytic therapy used to treat graft limb occlusion precipitated by distal migration and kinking of an abdominal aortic stent-graft. CASE REPORT: A 5.5-cm abdominal aortic aneurysm (AAA) in a 66-year-old woman was treated with Vanguard bifurcated stent-graft. At the 1-year follow-up, she complained of left leg claudication. Computed tomography (CT) showed a 36% reduction in maximum AAA diameter, but the stent-graft had migrated distally approximately 5 mm, and the left graft limb was occluded. Thrombolysis was initiated, but after approximately 8 hours, abdominal pain began. Emergent CT scanning revealed rapid aneurysm expansion and a retroperitoneal hematoma. Thrombolytic treatment was stopped; transfusions and thrombogenic drugs were given to restore hemodynamic stability. The aneurysm began to decrease in size. The occluded graft limb had been reopened by the lytic therapy, uncovering a stenosis in the native artery distal to the graft limb. Stent placement restored outflow. The retroperitoneal hematoma resolved over time, and the aneurysm sac shrank to its prelytic diameter. The patient is well with a functioning endograft 18 months after the occlusion (30 months after stent-grafting). CONCLUSIONS: Caution must be taken when using thrombolysis in patients with endovascular aortic grafts because unexpected bleeding complications might arise. thrombectomy, femorofemoral bypass, or stent or stent-graft extensions might be safer alternatives for treating occluded stent-graft limbs.- - - - - - - - - - ranking = 0.8keywords = aneurysm (Clic here for more details about this article) |
7/41. Migration of steel-wire coils into the stomach after transcatheter arterial embolization for a bleeding splenic artery pseudoaneurysm: report of a case.Transcatheter arterial embolization (TAE) represents the primary, and often definitive, mode of therapy for bleeding splanchnic artery pseudoaneurysms (PSA). Nevertheless, a number of complications associated with this procedure have been described. We report herein the case of a 59-year-old man with chronic pancreatitis who was referred to us with hematemesis and hemorrhagic shock. Computed tomography revealed a splenic artery PSA bleeding into a pancreatic pseudocyst, and TAE was performed using steel-wire coils, placed inside the aneurysmal cavity, which resulted in the immediate cessation of bleeding. However, several weeks later some of the coils were found to have dislodged through a gastropseudocystic fistula. Furthermore, an early gastric cancer was incidentally found proximal to the fistula. We finally performed open surgery to treat both disorders; primarily for the gastric cancer, but also for the pseudocyst and fistula, with the intermittent discharge of the steel-wire coils. To our knowledge, migration into the stomach of steel-wire coils after TAE has not been described before. It is generally believed that the embolization procedure should occlude normal portions of the artery both distal and proximal to the PSA with embolization materials. By occluding the PSA in this way, the subsequent migration of steel-wire coils into the pseudocyst and stomach might have been prevented in our patient.- - - - - - - - - - ranking = 3.465496307095keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
8/41. axillary artery pseudoaneurysm.axillary artery aneurysms are extremely rare. We report a case of an axillary artery aneurysm in a keen rugby player who had previous internal fixation of the shoulder for recurrent dislocation.- - - - - - - - - - ranking = 3.012397045676keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
9/41. Aortic graft in the jejunum without bleeding. A real surprise at endoscopy.It is known that prosthetic infection, graft-duodenal fistula, and erosion are possible late complications after aortic reconstruction, and that all these reported complications are accompanied generally by variable bleeding with different presentations. We report the case of a 63-year-old man who underwent a diagnostic upper gastrointestinal endoscopy for investigation of nausea, anorexia, asthenia, fever, and mild leukocytosis. The patient's medical history included a gastric resection for ulcer, with Billroth II gastrojejunostomy reconstruction and implantation of a Dacron vascular graft for abdominal aortic aneurysm 20 years and 3 years earlier, respectively. abdomen ultrasonography showed hypoechoic area around an aortic prosthesis. endoscopy found a foreign body corresponding to the vascular graft at the jejunum. No signs of bleeding were recorded. The patient was hospitalized and submitted to surgery that involved extra-anatomic axillofemoral bypass, bowel resection with a gastrojejunum Roux anastomosis, and prosthesis removal.- - - - - - - - - - ranking = 0.2keywords = aneurysm (Clic here for more details about this article) |
10/41. Transvascular coil hooking procedure to retrieve an unraveled Guglielmi detachable coil: technical note.OBJECTIVE: A patient with an anterior communicating artery aneurysm was treated by use of endovascular coiling, and a Guglielmi detachable coil (boston Scientific/Target, Fremont, CA) fractured distal to its connection to the delivering catheter. The unraveled coil floated out from the aneurysm to extend into the bifurcation of the left middle cerebral artery. We describe the microsurgical procedure used to retrieve the coil after an endovascular approach failed. methods: The left anterior cerebral artery was punctured just below the aneurysm neck, and a titanium microhook was introduced to anchor the coil and pull it out. Slight traction was exerted before sectioning the coil to avoid protrusion of the stump into the parent vessel. RESULTS: The unraveled coil was removed in totality without permanent morbidity. CONCLUSION: This report describes the case of a rare complication of coil embolization treated with a minimal transarterial coil hooking procedure.- - - - - - - - - - ranking = 0.6keywords = aneurysm (Clic here for more details about this article) |
| | Next -> |