CVIR Endovascular最新文献

{"title":"Pulmonary arteriovenous fistula secondary to historic thoracic shrapnel injury: presenting features and interventional approach.","authors":"Kate Chiswell, Ahmed Al-Hindawi, Richard Dunn, Richard Waugh, Rachael Cordina","doi":"10.1186/s42155-024-00494-y","DOIUrl":"https://doi.org/10.1186/s42155-024-00494-y","url":null,"abstract":"<p><strong>Background: </strong>A chronic pulmonary arteriovenous fistula (PAVF) post penetrating thoracic injury is rare; this case demonstrates the presentation, diagnostic implications and a successful endovascular approach to close it.</p><p><strong>Case presentation: </strong>We report the case of a rare pulmonary arteriovenous fistula in a 50-year-old man secondary to historic thoracic shrapnel injury. He had a positive bubble study on echocardiography; CT pulmonary angiogram identified a pulmonary arteriovenous fistula. He underwent successful repair with an endovascular approach.</p><p><strong>Conclusion: </strong>PAVF can result from penetrating chest trauma. An intra-pulmonary shunt should be suspected in the setting of hypoxaemia refractory to oxygen therapy and when there is no evidence of an intra-cardiac shunt. Endovascular intervention can facilitate definitive treatment by employing a plug-in-stent technique.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"30"},"PeriodicalIF":1.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039143","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":"Contemporary carotid artery stenting practices and peri-procedural outcomes in different European countries: ROADSAVER study multicentric insights.","authors":"Stefan Müller-Hülsbeck, Zsolt Vajda, Piotr Odrowąż-Pieniążek, Zoltán Ruzsa, Roel Beelen, Aleksandar Gjoreski, Koen Deloose, Sérgio Castro, Benjamin Faurie, Alejandro Tomasello Weitz, Arne Schwindt, Paweł Latacz, Antonio Orgaz Pérez-Grueso, Vladimir Cvetić, Ralf Langhoff, Sasko Kedev","doi":"10.1186/s42155-025-00528-z","DOIUrl":"https://doi.org/10.1186/s42155-025-00528-z","url":null,"abstract":"<p><strong>Background: </strong>Regional variations in patient selection and procedural techniques for carotid artery stenting have been well documented. However, their impact on procedural outcomes, especially with the use of dual-layer micromesh stents, is not fully understood.</p><p><strong>Methods: </strong>This prospective, multi-center observational study included 1965 patients with asymptomatic or symptomatic carotid artery stenosis treated with the Roadsaver dual-layer micromesh stent. The primary outcome measure was the 30-day rate of major adverse events, defined as any death or stroke occurring within 30 days post-procedure. This sub-analysis compared patient characteristics and procedural techniques across 13 participating countries and investigated differences in outcomes via logistic regression modelling.</p><p><strong>Results: </strong>Patient demographics, comorbidities, and symptom presentation varied widely among countries. Similarly, the frequency of use of duplex ultrasound and diffusion-weighted magnetic resonance imaging at baseline and 30-day follow-up differed. Procedural approaches also varied, with differences in femoral access site selection (18.2% to 100.0%), use of embolic protection devices (0.0% to 100.0%), pre-dilatation (4.3% to 46.7%) and post-dilatation (66.7% to 100.0%). Although 30-day major adverse event rates differed across the compared countries, after adjusting for post-dilatation balloon pressure (categorized as no post-dilatation vs. ≤ 11atm vs. > 11atm), and the number of enrolled patients per study site, the difference became statistically non-significant.</p><p><strong>Conclusion: </strong>Our study reveals variability in patient selection, procedural carotid stenting practices and clinical outcomes across European countries. The differences in 30-day any death or stroke rates between countries may be attributed to differing post-dilatation practices and the number of enrolled patients per study site.</p><p><strong>Level of evidence: </strong>Level 3, observational study.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov identifier: NCT03504228.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"29"},"PeriodicalIF":1.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059902","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 embolization of post-tonsillectomy pseudoaneurysm in adults.","authors":"Xiaodong Yang, Jiani Zhao, Rongrong Quan, Qiang Liu","doi":"10.1186/s42155-025-00539-w","DOIUrl":"10.1186/s42155-025-00539-w","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the efficacy and safety of endovascular embolization in the treatment of post-tonsillectomy pseudoaneurysms.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of four consecutive adults who experienced secondary post-tonsillectomy hemorrhage (PTH) due to pseudoaneurysms. Hemoglobin loss was identified to access the blood loss of patients. All patients underwent endovascular embolization of the injured artery using superselective catheterization techniques.</p><p><strong>Results: </strong>The angiogram revealed pseudoaneurysms in the ascending palatine artery in two patients, the facial artery in one patient, and the lingual artery in the other patient. Two patients were treated with endovascular embolization using n-butyl-2-cyanoacrylate (NBCA) glue, one patient was treated with coils, and one received a combination of coils and NBCA glue for embolization. All procedures were successful, with no clinical complications or rehemorrhage reported.</p><p><strong>Conclusion: </strong>Endovascular embolization is an effective, feasible, and safe treatment option for the patients with post-tonsillectomy pseudoaneurysm. NBCA glue can be an effective and appropriate embolic material, but attention must be paid to the critical techniques involved.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"28"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755847","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":"Controversies in treating nutcracker syndrome.","authors":"Vitorio Perić, Thomas Ferenc, Tomica Bratić, Jana Bebek, Ivan Antun Mašić, Filip Ferega, Vid Vrčić, Danko Milošević, Helga Sertić Milić, Vinko Vidjak","doi":"10.1186/s42155-025-00544-z","DOIUrl":"10.1186/s42155-025-00544-z","url":null,"abstract":"<p><p>Nutcracker syndrome (NCS) is a relatively uncommon vascular condition characterized by compression of the left renal vein (LRV), resulting in a variable spectrum of nonspecific symptoms, including hematuria, flank pain, varicocele, and pelvic congestion syndrome. NCS can be classified into anterior and posterior types regarding the origin of LRV compression: anterior NCS occurs when LRV is compressed between the aorta and superior mesenteric artery, whereas posterior NCS involves LRV compression between the aorta and the spine. Despite advancements in diagnostic modalities, including Doppler ultrasound, computed tomography, magnetic resonance imaging, and invasive techniques like phlebography, there is still no globally accepted diagnostic algorithm, leading to inconsistencies in diagnosis. Moreover, due to the lack of standardized treatment guidelines, the optimal management of anterior NCS remains a topic of debate. While conservative management is usually recommended in the pediatric population, invasive treatments-including surgical options like LRV transposition and renal autotransplantation, as well as interventional radiology procedures like stenting, present challenges such as stent migration, restenosis, and long-term material durability. Nevertheless, the emergence of 3D-printed stents offers potential improvements in patient-specific treatment, particularly in the pediatric population, yet their clinical efficacy and safety remain under investigation. This brief communication addresses the current discussions regarding anterior NCS management, emphasizing the need for standardized diagnostic algorithms, a multidisciplinary approach, and continued technological advancements to refine treatment possibilities and strategies. Further research is critical to resolve these controversies and establish a consensus on best practices.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"26"},"PeriodicalIF":1.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733008","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":"Future liver remnant hypertrophy and postoperative outcomes: a retrospective comparison between segmental and main right portal vein embolization.","authors":"Elif Can, Aboelyazid Elkilany, Sophia Paparoditis, Bernhard Gebauer, Dominik Geisel, Felix Krenzien, Anne Pohrt, Wibke Uller, Michael Doppler, Sebastian Ebel, Holger Gößmann, Uli Fehrenbach","doi":"10.1186/s42155-025-00537-y","DOIUrl":"10.1186/s42155-025-00537-y","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of segmental right portal vein embolization (SRPVE) versus main right portal vein embolization (MRPVE) in preoperative preparation for major hepatectomy.</p><p><strong>Methods: </strong>This retrospective single-center study included 220 consecutive patients who underwent portal vein embolization (PVE) before (extended) right hemihepatectomy between January 2014 and June 2021. Seventy-one patients underwent selective segmental embolization (SRPVE) and 149 patients underwent MRPVE. Volumetric analysis was conducted before PVE and before surgery. Key endpoints included evaluation of future liver remnant (FLR) hypertrophy, intraoperative complexity, and postoperative complications, technical success, clinical success, complications (Clavien-Dindo and CIRSE classifications), as well as evaluation of different factors which may influence hypertrophy of the FLR.</p><p><strong>Results: </strong>Technical success rate was 100% in the SRPVE group and 99.3% in the MRPVE group (p = 0.15). Clinical success rate was comparable between both techniques, measuring 95.8% in the SRPVE group and 95.3% in the MRPVE group (p = 0.18). Absolute hypertrophy (FLRabh) of the FLR was comparable between both techniques, measuring 47.15% in the SRPVE group and 40.78% in the MRPVE group (p = 0.54). Complication rates did not differ significantly (p = 0.12). Partial thrombosis involving the left portal vein, main portal vein, or mesentericosplenic region was observed in 2.8% of the patients in the SRPVE group vs 3.4% in the MRPVE group (p = 0.95). CIRSE Class II-VI complications were slightly higher in the MRPVE group (10.7% vs 9.8%, p = 0.82). Postoperative complications with Clavien-Dindo class ≥ IIIa occurred in 10.1% % in the MRPVE group vs 9.9% the SRPVE group (p = 0.92). Liver cirrhosis had a significant negative correlation with sFLR % increase following PVE (r = -0.54; p = 0.027). Neoadjuvant chemotherapy was also associated with reduced FLR hypertrophy following PVE, with a median sFLR% change of 63.8% (IQR: 60.8% - 75.2%) in patients who received neoadjuvant chemotherapy (n = 66 patients, 30%) compared to 82.6% (IQR: 77.4% - 84.2%) in those without chemotherapy (n = 154 patients, 70%).</p><p><strong>Conclusion: </strong>Selective segmental right portal vein embolization, sparing the main right portal vein, offers a safe and effective alternative to MRPVE, achieving comparable FLR hypertrophy while potentially simplifying intraoperative procedures and reducing postprocedural complications. Future research should focus on conducting large, prospective, multicenter trials to further compare the long-term outcomes of this technique, particularly with regard to liver regeneration, postoperative liver function, complications and overall survival.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"27"},"PeriodicalIF":1.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733009","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":"Transcatheter arterial and venous embolisation with α-hexyl cyanoacrylate MagicGlue®: short-term safety and efficacy outcomes.","authors":"Hamza Sawalha, Olivier Chevallier, Mohamed Fouad, Taninokuchi Tomassini Makoto, Comby Pierre-Olivier, Ludwig Serge Aho-Glele, Romaric Loffroy","doi":"10.1186/s42155-025-00535-0","DOIUrl":"10.1186/s42155-025-00535-0","url":null,"abstract":"<p><strong>Purpose: </strong>Our purpose was to assess the feasibility and the short-term safety and efficacy outcomes of a wide range of transcatheter arterial and venous embolisation procedures done using α-hexyl-cyanoacrylate (AHCA)-MagicGlue® in patients with bleeding and non-bleeding disorders.</p><p><strong>Methods: </strong>This single-centre retrospective study included consecutive patients who underwent emergent or planned AHCA-MagicGlue® transcatheter embolisation between February 2019 and September 2023. Technical success, clinical success, 30-day mortality, and complication rates were evaluated.</p><p><strong>Results: </strong>We included 101 patients with a mean age of 49.9 ± 20.5 years who underwent arterial (n = 43, 42.6%) or venous (n = 58, 57.4%) embolisation for bleeding (n = 16, 15.8%) or other reasons (n = 85, 84.2%). The technical success rate was 100%. After a mean follow-up of 2.2 months, the clinical success rate was 94% in patients with bleeding and 95% in other patients; 1 patient died of multi-organ failure unrelated to the procedure. In the 22 patients with prostatic artery embolisation, statistically significant improvements were recorded at 3 months versus baseline for the International Prostate Symptoms Score (IPSS) (10.0 ± 5.8 vs. 20.8 ± 7.3, p = 0.001), IPSS quality-of-life score (2.0 ± 1.4 vs. 5.0 ± 1.0; p = 0.001), and prostate volume (67.8 ± 38.0 mL vs. 96.7 ± 47.4 mL, p = 0.001). Adverse events occurred in 11 (10.9%) patients and were major in 4 and minor in 7 patients.</p><p><strong>Conclusions: </strong>MagicGlue® transcatheter arterial and venous embolisation is feasible, effective, and safe for bleeding and non-bleeding conditions across a broad range of anatomic sites.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"25"},"PeriodicalIF":1.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671727","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":"Portal vein reconstruction in iatrogenic portal vein ligation.","authors":"Tony Rizk, Derek Groskreutz, Carl Forsberg, Stephen Stringfellow, Ricardo Yamada, Marcelo Guimaraes, Yara Younan, Antony Gayed","doi":"10.1186/s42155-025-00525-2","DOIUrl":"10.1186/s42155-025-00525-2","url":null,"abstract":"<p><p>Laparoscopic cholecystectomy for acute cholecystitis is one of the most performed surgeries and is generally regarded as a safe procedure with a low risk of complications. Vascular and biliary injuries are rare but have severe consequences. No systematic studies have been performed to delineate optimal treatment strategies in these scenarios, which are typically managed on a case-by-case basis. The present report describes a patient who underwent a laparoscopic cholecystectomy, complicated by common bile duct and main portal vein ligation, resulting in hepatic infarcts, perihepatic abscess, and portal hypertension with ascites and portomesenteric congestive enteropathy. This case focuses on management of this patient's vascular injury, which was successfully treated by endovascular portal venous reconstruction using trans-splenic and right internal jugular vein access.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"24"},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664040","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":"Interventional treatment of peripancreatic aneurysms: can one strategy fit all?","authors":"Marilia B Voigt, Patrick A Kupczyk, Alexander Kania, Carsten Meyer, Julia Wagenpfeil, Tatjana Dell, Claus-Christian Pieper, Julian A Luetkens, Daniel Kuetting","doi":"10.1186/s42155-025-00533-2","DOIUrl":"10.1186/s42155-025-00533-2","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the frequency and association of visceral arterial (VA) stenosis in peripancreatic aneurysms (PPAs) and to develop a uniform, more detailed treatment strategy for PPAs in case of accompanying VA stenosis, as current guidelines do not adequately address this constellation.</p><p><strong>Materials and methods: </strong>Patients with PPAs diagnosed at a tertiary care hospital were retrospectively analyzed. In case of multiple PPAs, the aneurysm with the highest aneurysm-to-vessel ratio (AVR) within the celiac-mesenteric collateral circulation was classified as the primary aneurysm and categorized as \"critical\" or \"non-critical\" based on the risk of organ ischemia. Celiac artery and superior mesenteric artery stenoses were graded as low (< 50%), high (> 50%), or total occlusion. Treatment strategies were based on VA stenosis severity, aneurysm classification, and morphology. Treatment strategies included endovascular, surgical and watch-and-wait management.</p><p><strong>Results: </strong>Thirty-one patients with PPAs were included with a total of 53 aneurysms; mean aneurysm size: 12.5 ± 7.9 mm (range 5-38 mm), AVR: 3.5 ± 2.1 (range 1-11.3). The superior and inferior pancreaticoduodenal arteries as well as the pancreaticoduodenal arcade were affected in most cases (67.9%). AVR was significantly higher in cases of aneurysm rupture (6.2 ± 2.8; p = 0.031). Celiac artery stenosis was present in 87.1%. Aneurysm size and occurrence of active bleeding did not correlate (p = 0.925). 11 patients presented with critical aneurysms, with 10 patients requiring individually tailored treatment. Non-critical aneurysms were treated with coil embolization in most cases.</p><p><strong>Conclusion: </strong>CA stenosis, aneurysm position, and AVR significantly influence treatment decisions. Individualized approaches based on anatomical and hemodynamic factors are needed in PPA treatment.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"23"},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665342","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":"PseuSeal technique: endovascular repair of Iatrogenic pseudoaneurysm using ExoSeal.","authors":"Takuya Haraguchi, Yuhei Kasai, Masanaga Tsujimoto, Yoshifumi Kashima, Katsuhiko Sato, Tsutomu Fujita","doi":"10.1186/s42155-025-00536-z","DOIUrl":"10.1186/s42155-025-00536-z","url":null,"abstract":"<p><strong>Introduction: </strong>The ExoSeal^® (Cordis, Florida, USA) is a bioabsorbable vascular closure device that facilitates hemostasis by deploying a polyglycolic acid (PGA) plug. This report presents the \"PseuSeal technique,\" a novel approach to seal pseudoaneurysm using ExoSeal in an off-label manner.</p><p><strong>Methods: </strong>The PseuSeal technique includes the PseuSeal Snare and PseuSeal Rendezvous, both performed via a contralateral crossover approach. The choice of approach depends on whether a 4-Fr catheter can be advanced into the pseudoaneurysm cavity. If feasible, the PseuSeal Snare is selected; otherwise, the PseuSeal Rendezvous is employed. In the PseuSeal Snare, a snare is deployed from a 4-Fr catheter within the pseudoaneurysm cavity. An 18-gauge needle is then used to retrogradely puncture the snare loop. A 0.035-inch guidewire is passed through the needle lumen, captured by the snare, and externalized. In the PseuSeal Rendezvous, an 18-gauge needle retrogradely punctures the guidewire within the cavity, and the guidewire is advanced into the needle lumen for externalization. After externalizing the guidewire in both approaches, an ExoSeal-specific sheath is inserted over the guidewire through the pseudoaneurysm neck into the main vessel. A balloon is advanced from the crossover sheath into the main trunk to cover the pseudoaneurysm ostium. The ExoSeal system is then inserted through the second sheath. As the ExoSeal's indicator wire is withdrawn, the balloon is inflated to stabilize the indicator wire, ensuring precise deployment of the PGA plug at the pseudoaneurysm neck. Balloon inflation is maintained for 5 minutes, with an additional 5 minutes if necessary. Hemostasis is confirmed by angiography.</p><p><strong>Results: </strong>The PseuSeal technique was successfully applied in five common femoral artery　pseudoaneurysms, all of which had failed ultrasound-guided compression. Each case was treated using a 6-Fr ExoSeal device, with no complications or recurrences observed during follow-up. Case 1 involved an 87-year-old female who developed a pseudoaneurysm following a peripheral intervention. The PseuSeal Snare achieved hemostasis in 32 minutes. Case 2 involved a 60-year-old male presenting with a pseudoaneurysm after a coronary intervention. The PseuSeal Rendezvous achieved hemostasis in 50 minutes.</p><p><strong>Conclusion: </strong>The PseuSeal technique provides an effective alternative for pseudoaneurysm closure.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"21"},"PeriodicalIF":1.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651983","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":"Percutaneous vascular plug in management of an acquired broncho pleural cutaneous fistula.","authors":"Ajay Alex, Praveen A, Niwin George, Vinu C V, Radhika Devi B, Neetha Jose","doi":"10.1186/s42155-024-00508-9","DOIUrl":"10.1186/s42155-024-00508-9","url":null,"abstract":"<p><strong>Background: </strong>Bronchopleural fistula (BPF) / broncho pleural cutaneous fistula is an abnormal communication between the peripheral bronchial tree and pleural space which can further also open to the skin surface. It is associated with significant morbidity and mortality in addition to poor quality of life. Management requires a multidisciplinary approach with careful evaluation to choose the best approach to treatment.</p><p><strong>Case presentation: </strong>A 36-year-old male presented with a left chest wall tumor with multiple surgeries and CT revealing a left apico-posterior segment broncho pleural cutaneous fistula. Various options for the management of the BPCF including surgery and bronchoscopic occlusion were considered however an IR approach was planned. Plan was for vascular plug occlusion with/without glue embolization of the apico-posterior segmental bronchus. A 6F sheath was placed under direct vision and a 12 mm CERA plug was deployed. After plain plug occlusion, there were no signs of air leak. Various options for management including surgery and bronchoscopy procedures are limited in patients with poor pulmonary reserve. The IR approach offers the advantage of doing the procedure under real-time fluoroscopy, and no airway compromise. However, literature describes the use of glue to seal the interstices of the device which if not sealed was a cause of recurrence later. In our case, we report the percutaneous use of a CERA vascular plug as the sole device, especially since it has a polytetrafluoroethylene (PTFE) membrane which ensures occlusion, in addition to its titanium nitride coating which improves epithelialization. This ensures sustained occlusion as the sole agent, unlike other devices including the Amplatzer vascular plug.</p><p><strong>Conclusions: </strong>This highlights the relatively easy percutaneous route and the first report of CERA vascular plug usage for managing a case of broncho pleural cutaneous fistula.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"22"},"PeriodicalIF":1.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651980","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}