{"title":"May-Thurner Syndrome Presenting with Pelvic Hemorrhage in the Setting of Blunt Trauma.","authors":"Dan F Laney, Alexandra H Fairchild","doi":"10.1155/2023/9003408","DOIUrl":"https://doi.org/10.1155/2023/9003408","url":null,"abstract":"<p><p>May-Thurner Syndrome is a vascular condition in which chronic compression of the left common iliac vein by the overlying right common iliac artery causes impaired venous return from the left lower extremity as well as possible development of pelvic varicosities. The condition typically presents with acute left lower extremity deep vein thrombosis or with signs and symptoms of pelvic or lower extremity venous insufficiency. In our patient, however, the presenting symptom was hemorrhage of pelvic varicosities in the setting of extensive pelvic fractures sustained during a motor vehicle collision. Acute hemorrhage in the setting of pelvic fractures is typically associated with the need for arterial angiography and possible embolization. This patient was instead treated with venography and stenting of her May-Thurner lesion which resulted in the resolution of her bleeding pelvic varicosities and improvement in her pre-existing pelvic and lower extremity venous symptoms.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2023 ","pages":"9003408"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10260311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9635623","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}
Madiha Khan, Youssef Mourad, Alan Zeitlin, Martine Alice Louis, Syed Ali Rizvi, Kelly L Cervellione
{"title":"An Infected, Noncoronary, Bare Metal Stent Presenting as a Right Groin Abscess.","authors":"Madiha Khan, Youssef Mourad, Alan Zeitlin, Martine Alice Louis, Syed Ali Rizvi, Kelly L Cervellione","doi":"10.1155/2023/6777086","DOIUrl":"https://doi.org/10.1155/2023/6777086","url":null,"abstract":"<p><p>Bare metal stent infections complicating peripheral endovascular stenting are rare but can be associated with devastating morbidities. The current standard of care necessitates explantation and extra-anatomical bypass of the affected limb. We report the case of a patient presenting with a right groin abscess with draining sinuses secondary to an infected common femoral and right external iliac artery bare metal stent. In addition, a portion of the stent was explanted into the subcutaneous tissues instead of where it was placed intravascularly one year prior. The patient was not an ideal candidate for explantation and bypass due to significant medical comorbidities and underwent local debridement and long-term antibiotic management instead. His postoperative course was uncomplicated, and he had a successful outcome with management utilizing antibiotics and debridement. We aim to highlight the importance of recognizing bare metal stent infections along with their deceptive cutaneous manifestations in order to prevent the development of significant morbidity and mortality.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2023 ","pages":"6777086"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10089672","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":"May-Thurner Syndrome-a Rare Cause of Extensive Pelvic DVT, but Is there More to Know?","authors":"Vikash Kumar, Michelle Koifman, Bhavyakumar Vachhani, Dhir Gala, Sumeet Bahl","doi":"10.1155/2022/7978470","DOIUrl":"https://doi.org/10.1155/2022/7978470","url":null,"abstract":"<p><p>May-Thurner Syndrome (MTS) is a rare anatomical variant characterized by the compression of the left common iliac artery by the right common iliac artery against the fifth lumbar vertebrae. It can present as acute or chronic deep vein thrombosis (DVT), leg pain, varicosities, skin ulceration, and hyperpigmentation. In this case report, we present an interesting case of a young male with no obvious risk factors, who presented with back and left lower extremity pain later diagnosed with MTS on computed tomography angiography (CTA) and venogram. The patient was treated with venoplasty and pharmacomechanical thrombolysis and was discharged on apixaban.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":" ","pages":"7978470"},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9626237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40679841","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":"A Rare Cardiac Cavernous Hemangioma Treated with Radiotherapy.","authors":"Pule Wang, Daniel Chapman, Farzan Siddiqui","doi":"10.1155/2022/5698475","DOIUrl":"https://doi.org/10.1155/2022/5698475","url":null,"abstract":"<p><strong>Background: </strong>Although cardiac hemangiomas, as rare benign cardiac tumors, have been described in previous case reports, the role of radiation therapy in an unresectable cardiac hemangioma in adult has not been reported. We present a case report of a rare unresectable cardiac cavernous hemangioma treated with radiotherapy<i>. Case Presentation</i>. A 45-year-old female with new onset of coughing and worsening shortness of breath was found to have a biopsy proven cardiac cavernous hemangioma. Surgery was aborted due to excessive bleeding, and she was then treated with radiotherapy. A total dose of 30 Gy in 15 fractions was given using intensity-modulated radiation therapy (IMRT) to the mass with a modified 1 cm margin. Complete clinical symptomatic relief was achieved with reduction of the mass posttreatment. Ten-year follow-up revealed a stable, reduced hemangioma with no recurrence of symptoms.</p><p><strong>Conclusions: </strong>This is a rare example of cardiac hemangioma that developed in the right ventricle and compressed several major vessels. Radiotherapy may be safely used for treatment of unresectable cardiac hemangioma.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":" ","pages":"5698475"},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40359284","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}
Jinbo Liu, Tianrun Li, Wei Huang, Na Zhao, Hongwei Zhao, Hongyu Wang
{"title":"Angiojet System Used in the Treatment of Submassive Pulmonary Embolism: A Case Report of Two Patients.","authors":"Jinbo Liu, Tianrun Li, Wei Huang, Na Zhao, Hongwei Zhao, Hongyu Wang","doi":"10.1155/2022/6867338","DOIUrl":"https://doi.org/10.1155/2022/6867338","url":null,"abstract":"<p><strong>Background: </strong>Massive or submassive pulmonary embolism (PE) carries a high mortality. Percutaneous mechanical thrombectomy using the Angiojet system is accepted for the treatment of PE. Here, we reported two submassive PE cases who were treated with the Angiojet system successfully, to provide some advice for the therapy of submassive PE.</p><p><strong>Method: </strong>Two patients with suffocation were admitted to our hospital. One patient was accompanied by lower blood pressure (20% lower than basal blood pressure) and higher pulmonary artery pressure (89 mmHg); the other patient had larger right ventricular transverse diameter (46 mm), decreased left ventricular end diastolic anteroposterior diameter (34 mm), and higher heartbeats (107 heartbeats per minute). Pulmonary artery computed tomography angiography showed bilateral pulmonary embolism.</p><p><strong>Result: </strong>The Angiojet system with a high-pressure jet spray pattern (urokinase 25 wiu + sodium chloride injection 50 ml) was used. Intravascular thrombolysis by urokinase (100 wiu/day for 1 day) was done after being back in the ward. And low molecular weight heparin was used in hospitalization, and rivaroxaban was used after discharge. Both patients were treated successfully. However, the level of platelet was significantly lower in one patient after Angiojet system usage and recovered to the preoperative level the next day. Another patient suffered from bradyarrhythmias during the usage of Angiojet, and bradyarrhythmias disappeared when the Angiojet system stopped. Pulmonary embolism was cured after 3 months in both patients.</p><p><strong>Conclusion: </strong>Angiojet could be a simple, safe, and well-tolerated treatment for massive or submassive PE. And hematocrit, platelet, kidney function, and heart rhythm should be monitored during perioperation.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":" ","pages":"6867338"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40340689","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}
Nicholas J Murphy, Loay S Kabbani, Alexander D Shepard, Farzan Siddiqui
{"title":"Lingual Raynaud's Phenomenon after Surgical and Radiotherapeutic Intervention for Oral Squamous Cell Carcinoma.","authors":"Nicholas J Murphy, Loay S Kabbani, Alexander D Shepard, Farzan Siddiqui","doi":"10.1155/2022/1567581","DOIUrl":"https://doi.org/10.1155/2022/1567581","url":null,"abstract":"<p><p>Raynaud's phenomenon of the tongue after radiation therapy with or without chemotherapy is an exceedingly rare complication. Symptoms are similar to Raynaud's disease of other sites and involve pallor and discomfort on exposure to cold temperatures that resolve with rewarming. Presentation occurs approximately 18-24 months after radiotherapy on average and can usually be managed effectively with lifestyle modification and pharmacotherapy. Here, we present a case of lingual Raynaud's following surgery and adjuvant radiation therapy in a patient with squamous cell carcinoma of the oral cavity.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":" ","pages":"1567581"},"PeriodicalIF":0.0,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9417770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33444540","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 Hypothenar Hammer Syndrome Case Presentation and Literature Review.","authors":"Andrés-Trasahedo Estíbaliz, Labrador-Sánchez Eztizen, Salazar-Asencio Osman-Alberto, Flores-Robles Bryan-Josué, Pinillos-Aransay Valvanera, Laura Torrecilla Lerena, López-Martín Juan-Antonio","doi":"10.1155/2022/2078772","DOIUrl":"https://doi.org/10.1155/2022/2078772","url":null,"abstract":"<p><p>Hypothenar hammer syndrome is a rare cause of vascular insufficiency. Generally, patients report a history of repetitive trauma to the hypothenar region of the hand. Symptoms often consist of cold intolerance, pain, paleness, and paresthesia due to digital ischemia. The severity of these symptoms will depend on the extent of ulnar artery occlusion and the presence or absence of collaterals between this artery's superficial and deep branches. It is a rare clinical entity, which on multiple occasions requires a surgical approach. We present a 63-year-old man with bilateral Raynaud's phenomenon secondary to hypothenar hammer syndrome successfully treated by vascular repair surgery. In patients with Raynaud's phenomenon, it is important to know that there are reversible causes such as hypothenar hammer syndrome.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":" ","pages":"2078772"},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9256417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40580384","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}
Andy Y Wang, Ali Al Jabri, Edward R Jewell, Angela L Jellison
{"title":"Iatrogenic Femoral Arteriovenous Fistula with Pseudoaneurysm Associated with Worsening Heart Failure Years after Percutaneous Impella Placement.","authors":"Andy Y Wang, Ali Al Jabri, Edward R Jewell, Angela L Jellison","doi":"10.1155/2022/7005236","DOIUrl":"10.1155/2022/7005236","url":null,"abstract":"<p><p>Iatrogenic arteriovenous fistulas (AVFs) and pseudoaneurysms (PSAs) are rare complications that may develop years after vascular access, and high-volume flow through these AVFs have been hypothesized to contribute to chronic heart failure. Formation of an AVF or PSA following Impella placement has rarely been described in the literature. Here, we describe a patient who had percutaneous placement of an Impella ventricular assist device through his right groin three years prior, now presenting with worsening heart failure and symptoms of volume overload. He was discovered to have a new, high-flow common femoral artery to femoral vein AVF with an associated PSA. The AVF and associated PSA were resected and repaired. This case study highlights a rare access-site complication from percutaneous Impella placement associated with worsening heart failure, strategies for preventing this complication during peripheral access, and the need to consider this differential in such a patient with a history of peripheral access who has an unexplained worsening of heart failure.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":" ","pages":"7005236"},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40465960","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":"Laparoscopic Release for Median Arcuate Ligament Compression Syndrome Associated with a Celiac-Mesenteric Trunk","authors":"S. Cawich, D. Harnanan, L. Pran","doi":"10.1155/2022/3595603","DOIUrl":"https://doi.org/10.1155/2022/3595603","url":null,"abstract":"The median arcuate ligament compression syndrome is a rare entity that occurs in 2 per 100,000 unselected individuals. We present a case where the median arcuate ligament compression syndrome was associated with an equally uncommon anatomic variation—a celiac-mesenteric trunk, which occurs in 0.42-2.7% of unselected individuals. We could find no prior report of a celiac-mesenteric trunk being associated with the median arcuate ligament compression syndrome. This report also adds to the literature to show that a laparoscopic approach to median arcuate ligament release is feasible.","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80131450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Dukkipati, A. Benjo, A. Jimenez, I. Lukitsch, Gift Echefu, D. Kumbala
{"title":"Iatrogenic Fistula in Hemodialysis Patients: An Alternative Approach to Thrombectomy of Arteriovenous Graft (AVG) Thrombosis","authors":"R. Dukkipati, A. Benjo, A. Jimenez, I. Lukitsch, Gift Echefu, D. Kumbala","doi":"10.1155/2022/2417980","DOIUrl":"https://doi.org/10.1155/2022/2417980","url":null,"abstract":"Arterial venous (AV) fistula is the first choice of vascular access to perform hemodialysis in the vast majority of suitable patients followed by arteriovenous grafts (AVG). An iatrogenic fistula can occur when a second vein adjacent to the graft is punctured and the needle traverses the vein. In normal circumstances, this has no clinical repercussions and does not need correction, and in prior reports, it has helped to maintain the patency of partially occluded grafts but rarely can lead to thrombosis of the graft due to reduced flow and pressure in the graft lumen. We report here what we believe is a unique approach to perform thrombectomy of an occluded graft in a 71-year-old patient on hemodialysis to avoid placement of tunneled hemodialysis catheters and complications associated with catheters. When the outflow of basilic vein in this patient was thrombosed and could not be traversed, we successfully used an iatrogenic fistula as main outflow vein for the graft and created an alternative vein for drainage thus avoiding placement of a tunneled catheter for hemodialysis.","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86074532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}