Vascular Specialist International最新文献

{"title":"Right Gastroepiploic Artery Transposition for a Common Hepatic Artery and Proper Hepatic Artery Aneurysm Repair.","authors":"Deokbi Hwang,&nbsp;Hyeon Ju Kim,&nbsp;Hyung-Kee Kim,&nbsp;Seung Huh,&nbsp;Woo-Sung Yun","doi":"10.5758/vsi.230011","DOIUrl":"https://doi.org/10.5758/vsi.230011","url":null,"abstract":"<p><p>Although hepatic artery aneurysms (HAAs) are uncommon, they are associated with risk of rupture. HAAs >2 cm in diameter require endovascular or open surgical repairs. For HAAs involving the proper hepatic artery or gastroduodenal artery, which is a collateral artery from the superior mesenteric artery, hepatic arterial reconstruction is especially important to avoid ischemic liver injury. In this study, right gastroepiploic artery transposition was performed in a 53-year-old man after a 4 cm common hepatic artery and proper hepatic artery aneurysm was identified. The patient was discharged without any complications on postoperative day 8.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"5"},"PeriodicalIF":0.9,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/e2/vsi-39-5.PMC10063399.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9597625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Type III Endoleak after Loss of Component Overlap after EVAR with AFX2 Device: A Case Report.","authors":"Myeonghyeon Ko,&nbsp;Sanghyun Ahn,&nbsp;Seung-Kee Min,&nbsp;Ahram Han","doi":"10.5758/vsi.230005","DOIUrl":"https://doi.org/10.5758/vsi.230005","url":null,"abstract":"<p><p>Addressing the high incidence of late type III endoleaks in previous AFX models, Endologix upgraded the device material and updated its recommendation regarding component overlap. However, whether upgraded AFX2 models are safe for endoleaks remains controversial. Here we report a case of a 67-year-old male with an AFX2-implanted abdominal aortic aneurysm experiencing a delayed type IIIa endoleak. Aneurysmal sac enlargement occurred 36 months post-endovascular aneurysm repair (EVAR), with a computed tomography scan at 52 months revealing component overlap loss and a significant type IIIa endoleak. We performed endograft explantation and endoaneurysmal aorto-bi-iliac interposition grafting. Our findings suggest that sufficient component overlap is necessary when using an AFX2 endograft outside the manufacturer's instructions for use to prevent late type IIIa endoleaks. Moreover, patients who undergo EVAR with AFX2 for tortuous large aortic aneurysms should be carefully monitored for conformational changes.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"6"},"PeriodicalIF":0.9,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/6e/vsi-39-6.PMC10063397.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9597626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Tibial Artery Pseudoaneurysm Following Thrombectomy in a Patient with Traumatic Tibiofibular Fracture.","authors":"Hyeon Ju Kim,&nbsp;Deokbi Hwang","doi":"10.5758/vsi.230015","DOIUrl":"https://doi.org/10.5758/vsi.230015","url":null,"abstract":"The frequency of vascular injury resulting from extremity trauma varies depending on an individual’s social or natural environment [1-4]. Traffic accidents appear to be a major threat to public safety in South Korea, where war-related or gunshot injuries are rare. Here, we present a trauma case of combined vascular and orthopedic injuries. A 77-year-old woman was brought to our emergency room as a pedestrian, who had been trapped under the wheel of a limousine. The crushed bones were exposed in both ankles, and the left leg had simultaneous fractures of the distal tibia and midshaft fibula (Fig. 1). There was no arterial pulse at the level of the ankle wound. Initial computed tomography (CT) angiography revealed an occluded anterior tibial artery (ATA) and diminished flow from the tibioperoneal trunk (TPT) (Fig. 2). Given its ease and combined degloving injury, we decided to repair the posterior tibial artery (PTA) first without exploring the ATA, which might have required a vein Im ge of Vacular Srgery Posterior Tibial Artery Pseudoaneurysm Following Thrombectomy in a Patient with Traumatic Tibiofibular Fracture","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"4"},"PeriodicalIF":0.9,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/36/vsi-39-4.PMC10041159.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9281305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic, Sedation, and Analgesic Technique for Successful Local Anesthetic EndoSuture Aneurysm Repair.","authors":"Martin Hennessy,&nbsp;Keith Kelso Hussey","doi":"10.5758/vsi.230003","DOIUrl":"https://doi.org/10.5758/vsi.230003","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to describe our technique for and experience with elective endovascular aneurysm repair using EndoAnchors under local anesthesia.</p><p><strong>Materials and methods: </strong>We included seven patients with abdominal aortic aneurysms who underwent endovascular aneurysm repair using EndoAnchors with a standard regimen consisting of local anesthesia, intravenous sedation, and analgesia. The procedural and follow-up details were retrospectively reviewed.</p><p><strong>Results: </strong>Six out of seven infrarenal abdominal aortic aneurysms were successfully treated with endovascular aneurysm repair using primary EndoAnchors under local anesthesia. One patient was converted to general anesthesia due to acute aneurysm thrombosis independent of EndoAnchor deployment during the procedure. Remifentanyl infusions of up to 3.2 mg/min, morphine doses up to 6 mg (median, 0.5 mg), and midazolam doses of up to 4 mg (mean, 1.4 mg) were used. The mean theater time was 83 minutes (range, 60-130 minutes). Two patients were discharged on day 0, and the mean hospital stay was one day. All patients were alive between 484 and 1,128 days post-procedure, with no aneurysm-specific reintervention.</p><p><strong>Conclusion: </strong>The combination of local anesthesia, intravenous sedation, and analgesia is a viable strategy for timely and effective endovascular aneurysm repair using EndoAnchors. This technique may allow endovascular repair of more ruptured aneurysms using EndoAnchors with potential survival benefits.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"3"},"PeriodicalIF":0.9,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/8a/vsi-39-3.PMC10040298.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9197246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type Ic Endoleak after LifeStream Balloon-Expandable Stent Graft and Zenith Iliac Branch Device Placement.","authors":"Hyeon Ju Kim,&nbsp;Woo-Sung Yun,&nbsp;Hyung-Kee Kim","doi":"10.5758/vsi.230002","DOIUrl":"https://doi.org/10.5758/vsi.230002","url":null,"abstract":"<p><p>Considering the recent advancements in endovascular management of aortoiliac aneurysms, the use of an iliac branch device (IBD) to preserve pelvic blood flow and reduce complications caused by embolization of the internal iliac artery (IIA) is recommended by various guidelines. Although the outcomes reported following IBD placement are mainly positive and durable, IBD-specific complications such as a type Ic endoleak and associated reintervention may occur. Moreover, only one IBD device and one type of balloon-expandable bridging stent graft for IIA are currently available on the domestic market. Here we present two cases of type Ic endoleak following IBD placement. In both cases, IIA diameter was slightly larger than the basic instructions for use. Notably, the initial procedures were considered successful; however, type Ic endoleaks were detected on 1-month follow-up imaging. This finding emphasizes the need for a precise preoperative evaluation, intraoperative manipulation, and postoperative follow-up.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"2"},"PeriodicalIF":0.9,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/ea/vsi-39-2.PMC9986725.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10856711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Management of Hepatic Artery Pseudoaneurysms: A Case Series.","authors":"Pui Lam Cheung,&nbsp;Yat Sing Lee,&nbsp;Chong Boon Tan,&nbsp;Hin Yue Lau,&nbsp;Chi Wai Siu,&nbsp;Chik Xing Chan,&nbsp;Wai Tat Chan,&nbsp;Cheuk Him Ho","doi":"10.5758/vsi.220053","DOIUrl":"https://doi.org/10.5758/vsi.220053","url":null,"abstract":"<p><p>Although rare, hepatic artery aneurysms are associated with a high morbidity and mortality, necessitating a prompt diagnosis. A significant proportion of hepatic artery aneurysms are pseudoaneurysms, and the major risk factors of which have already been identified in previous literatures. Presentation can be variable, but diagnosis almost relies entirely on computed tomography and digital subtraction angiography. The endovascular approach has progressively become the preferred option due to its better performance when compared to the traditional surgical approach. However, formulation of an endovascular treatment plan for these lesions remains difficult as multiple factors should be considered to identify the best endovascular treatment modality. Five cases of pseudoaneurysm due to recent Whipple operation, hepatobiliary infections, and underlying malignancy are presented in this article to illustrate the effectiveness and complexity of endovascular treatment in this disease entity.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"1"},"PeriodicalIF":0.9,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/2a/vsi-39-1.PMC9925290.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10792993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Iliac Endobypass Solution in Iliac Artery Rupture during TEVAR Procedure: A Case Report and Review of the Literature.","authors":"Diego Moniaci,&nbsp;Francesco Maiorano,&nbsp;Federica Corrado","doi":"10.5758/vsi.220042","DOIUrl":"https://doi.org/10.5758/vsi.220042","url":null,"abstract":"<p><p>Iliac artery rupture is a demanding complication that can occur during endovascular procedures, particularly when large-caliber introducers are required. We present the first case in the literature on the endobypass technique, a quick and effective reconstruction method for the iliofemoral axis. This clinical case highlights that thoracic endovascular aortic repair procedures require large-caliber introducers into the femoral and iliac arteries to allow passage of the delivery system. These arteries may be diseased, representing a high risk of rupture. In our case, placing a 20 Fr introducer, the iliac artery ruptured bilaterally. Therefore, we performed an endobypass deploying Viabahn stent-grafts into the common iliac artery and manually performed distal anastomosis on the femoral bifurcation.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"35"},"PeriodicalIF":0.9,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/f7/vsi-38-35.PMC9806451.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10502334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Vein Thrombosis after COVID-19 mRNA Vaccination in a Young Man with Inferior Vena Cava Anomaly Leading to Recurrent Deep Vein Thrombosis.","authors":"So Yun Nam,&nbsp;Hyunseok Roh,&nbsp;Kyunglim Koo,&nbsp;Woo Sung Yun,&nbsp;Hyun Chul Kim","doi":"10.5758/vsi.220045","DOIUrl":"https://doi.org/10.5758/vsi.220045","url":null,"abstract":"<p><p>Severe side effects of adenoviral-vectored-DNA COVID-19 vaccines such as thrombosis have been reported. Herein, we report a case of sudden massive deep vein thrombosis (DVT) in a young man with inferior vena cava anomaly 20 hours after the second dose of the mRNA vaccine for COVID-19. There was recurrence of iliofemoral DVT after one year, despite complete resolution and administration of prophylactic anticoagulants. We suggest that the sudden episode was triggered by the vaccine rather than the venous anomaly, which can be associated with recurrence due to inadequate venous return through the small and tortuous infrarenal veins or increased venous pressure and stasis. There are no standard guidelines for the management of DVT following mRNA vaccination. However, we highlight the importance of initial workups, regular follow-ups, and standard treatment options, including the continuous administration of prophylactic anticoagulants which should be considered to prevent recurrence.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"40"},"PeriodicalIF":0.9,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/e2/vsi-38-40.PMC9812686.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10524324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Stent Graft Treatment of an Iatrogenic Symptomatic Extracranial Carotid-Jugular Arteriovenous Fistula.","authors":"Tiago F Ribeiro,&nbsp;Rita S Ferreira,&nbsp;Alberto Henrique,&nbsp;Carlos Amaral","doi":"10.5758/vsi.220056","DOIUrl":"https://doi.org/10.5758/vsi.220056","url":null,"abstract":"Trauma is a major health concern, and despite the development of solid trauma systems, the associated morbidity and mortality continue to rise [1]. Cervical trauma, in particular, is notoriously difficult to treat, mainly because of the complex anatomy in a narrow anatomic space. Due to its multiple mechanisms and locations, surgical techniques can also be highly variable. In Zone II cervical vascular injuries, open surgical repair is the norm due to its feasibility, ability to explore other cervical structures and relatively low risks when compared to other proximal or distal locations [2,3]. However, in highly-unstable patients, a lengthy procedure with risks of severe hemorrhage can offset a successful outcome, when compared to an endovascular approach. We describe the case of a 56-year-old male admitted in critical care for septic shock due to severe pneumonia, along with acute renal failure. After an inadvertent right carotid puncture during an attempt to place a temporary dialysis catheter in the internal jugular vein, he developed sudden hemodynamic and ventilatory deterioration. He also presented a carotid bruit and neck engorgement. Ultrasound revealed a right common carotid–internal jugular arteriovenous fistula and allowed precise location marking, as well as the measurement of the diameter and proximal and distal seal lengths (proximal to the carotid bifurcation). Due to the unfavorable neck anatomy and high surgical risk, endovascular treatment was preferred. Right femoral access was used, and unfractionated heparin administered. After selective catheterization of the innominate artery and angiographic marking the fistula and carotid side branches (Fig. 1A), a covered stentgraft 9 mm×38 mm (Advanta V12; Atrium Medical Corp., Hudson, NH, USA) was successfully deployed, covering the fistula without branch compromise (Fig. 1B). The procedure required 25 minutes and 20 mL of iodinated contrast. The patient experienced immediate relief of the hemodynamic and ventilatory burden of the fistula; however, he was unable to withstand the severity of his underlying pathology and died after a prolonged hospitalization (41 days). Im ge of Vacular Srgery Endovascular Stent Graft Treatment of an Iatrogenic Symptomatic Extracranial Carotid-Jugular Arteriovenous Fistula","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"39"},"PeriodicalIF":0.9,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/03/vsi-38-39.PMC9808494.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10512755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Reintervention for Stent-Graft Dislocation after Open Surgical Conversion for Thoracoabdominal Aortic Aneurysm Treated by Thoracic Endovascular Aortic Repair.","authors":"Tomoki Nakatsu,&nbsp;Shinsuke Kikuchi,&nbsp;Hiroyuki Miyamoto,&nbsp;Fumiaki Kimura","doi":"10.5758/vsi.220049","DOIUrl":"https://doi.org/10.5758/vsi.220049","url":null,"abstract":"<p><p>Complex anatomical restrictions can lead to further interventions after the emergence of a postoperative aneurysm enlargement in thoracic endovascular aortic repair (TEVAR) for a thoracoabdominal aortic aneurysm (TAAA). A 75-year-old male underwent a TEVAR for a Crawford extent I TAAA. The main device and the distal extension were placed using a fenestrated technique, outside of the instructions for use. The aneurysm expanded because of an endoleak and stent graft migration; and was surgically repaired by fully salvaging the previous endografts 38 months after the first TEVAR. However, the distal extension, which was the proximal anastomosis site with a prosthetic graft, became completely dislocated from the main device eight months after the open surgical conversion, resulting again in the enlargement of the aneurysm. An additional TEVAR was successfully performed to correct the dislocated stent graft. An appropriate treatment strategy is crucial to prevent multiple reinterventions for TAAA with complex anatomical restrictions.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"38"},"PeriodicalIF":0.9,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/71/vsi-38-38.PMC9808497.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10519652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}