Gift Echefu, R. Mahat, Raju Vatsavai, S. Zuckerman
{"title":"Spontaneous Dissections of Bilateral Internal Carotid and Vertebral Arteries due to Intractable Vomiting","authors":"Gift Echefu, R. Mahat, Raju Vatsavai, S. Zuckerman","doi":"10.1155/2022/8156047","DOIUrl":"https://doi.org/10.1155/2022/8156047","url":null,"abstract":"In young adults, spontaneous craniocervical arterial dissections (sCAD), which involve the major arteries of the head and neck, are associated with an increased risk of stroke. sCAD occurs in the absence of major trauma as seen in traumatic craniocervical artery dissection. It may affect unilateral or bilateral carotid or vertebral arteries. Cases of spontaneous bilateral carotid and vertebral artery dissections occurring simultaneously are extremely rare. We present a case of a 49-year-old female with no history of arteriopathy who presented with aphasia and right upper extremity weakness and was found to have dissections in bilateral extracranial and intracranial carotid arteries, as well as the bilateral vertebral arteries. She had symptomatic improvement with antithrombotic therapy and aggressive outpatient rehabilitation.","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76609466","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}
Van Dan Nguyen, Xuan Tuan Nguyen, Van Tung Pham, L. Pham
{"title":"Successful Radiofrequency Ablation of the Right Lateral Accessory Pathway with Modified Carpentier Reconstruction Surgery in a Patient with Ebstein Anomaly Concomitant of Secundum Atrial Septal Defect, Atrial Fibrillation, and Wolff–Parkinson–White Syndrome","authors":"Van Dan Nguyen, Xuan Tuan Nguyen, Van Tung Pham, L. Pham","doi":"10.1155/2022/8343943","DOIUrl":"https://doi.org/10.1155/2022/8343943","url":null,"abstract":"Ebstein anomaly (EA) results from the failure of proper delamination of the tricuspid valve leaflets from the right ventricle (RV) myocardium. The severity of EA occurs on a spectrum that results in varying degrees of tricuspid regurgitation, atrial dilation, RV dilation, and dysfunction. These effects have the potential to create substrates that can give rise to atrial arrhythmia, ventricular arrhythmia, and a greater incidence of Wolff–Parkinson–White (WPW) syndrome Wackel et al. (2018) accounting for 0.5% of all congenital heart diseases (Oh et al. 1985). In the case of atrial fibrillation and WPW, it is very dangerous for the patient because of hemodynamic compromise, syncope, and sudden death. In this case report, we share our experience in using radiofrequency ablation to ablate right lateral accessory pathway, with modified Carpentier technique in operation to treat an adult patient diagnosed with Ebstein anomaly, atrial septal defect, atrial fibrillation, and WPW syndrome.","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83070147","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}
M. S. Momen Majumder, Shamim Ahmed, Tajkia Haque, S. Haq, S. Chakravarty, M. Shahin, D. M. F. Osmany, J. Rasker
{"title":"Digital Gangrene: An Unusual Manifestation of Non-Hodgkin Lymphoma","authors":"M. S. Momen Majumder, Shamim Ahmed, Tajkia Haque, S. Haq, S. Chakravarty, M. Shahin, D. M. F. Osmany, J. Rasker","doi":"10.1155/2022/8963753","DOIUrl":"https://doi.org/10.1155/2022/8963753","url":null,"abstract":"Background Non-Hodgkin lymphomas (NHLs) comprise a group of haematologic malignancies with different histologic subtypes. The clinical picture varies from indolent to aggressive presentation and nodal (lymphadenopathy) to extranodal (central nervous system, gastrointestinal, cutaneous plaque, or ulcer) involvement. Digital gangrene is seldom reported. Here, we describe a patient with pain and blackening of all fingers and toes as presenting symptoms of NHL. Case Presentation. A 32-year-old male weaver had been smoking three to five cannabis-containing cigarettes daily for about ten years and methamphetamine four to five tablets daily for five years. He had no history of Raynaud's phenomenon, fever, cough, weight loss, skin rash, joint pain, and atherogenic or thrombogenic risk factors. We found normal blood pressure and absent peripheral pulses in arms and legs, dry gangrene of all fingers and toes, generalized lymphadenopathy, and hepatomegaly with ascites. The chest X-ray was normal, as were blood sugar, lipid profile, and hepatic and renal function. Rheumatoid factor, antinuclear and antiphospholipid antibodies, C-ANCA and P-ANCA, hepatitis B and C, and HIV were negative. CT abdomen revealed hepatosplenomegaly with multiple intra-abdominal lymphadenopathies. The peripheral angiogram showed 90-99% stenosis of radial and dorsalis pedis arteries with normal proximal vessels. Diagnosis of non-Hodgkin lymphoma was confirmed by histopathology of cervical lymph node (diffuse type), immunohistochemically subtyped as peripheral T cell lymphoma (not otherwise specified). The digital ischemia worsened despite cessation of cannabis and methamphetamine and starting CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) treatment, making amputation necessary. Conclusion We present, to our knowledge, the first report of peripheral T cell lymphoma, NOS presenting with gangrene in all digits complicated by methamphetamine and cannabis abuse. This uncommon vascular manifestation of non-Hodgkin lymphoma may cause a diagnostic dilemma and delayed initiation of treatment.","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81586563","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}
Kenji Fukutome, S. Aketa, Tsukasa Nakajima, Hiromichi Hayami, H. Sasaki, Ryuta Matsuoka, Rinsei Tei, Y. Shin, Y. Motoyama
{"title":"A Novel Approach for Transvenous Embolization of Dural Arteriovenous Fistula Using a Balloon and a Coil as Walls: Case Presentation","authors":"Kenji Fukutome, S. Aketa, Tsukasa Nakajima, Hiromichi Hayami, H. Sasaki, Ryuta Matsuoka, Rinsei Tei, Y. Shin, Y. Motoyama","doi":"10.1155/2022/5164452","DOIUrl":"https://doi.org/10.1155/2022/5164452","url":null,"abstract":"Background Transvenous embolization (TVE) for dural arteriovenous fistula (DAVF) is difficult depending on an accessible route. Reported herein is a case of transvenous embolization using a balloon and a coil as “walls.” Case Description. A 56-year-old male patient presented with a 1-month history of mild motor aphasia. The magnetic resonance imaging showed a hemorrhagic lesion in his left temporal lobe, and the cerebral angiography showed a DAVF, with parasinus shunt points near the torcula and the left transverse sinus. Access to the shunt point was very difficult; however, TVE was performed using a balloon as a wall. Furthermore, all lesion embolization was possible using a coil as a wall. Conclusions Using a balloon or coil as a wall during a TVE is useful.","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74620807","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}
M. Paulson, Ricardo A. Torres-Guzman, Francisco R. Avila, Karla C. Maita, John P. Garcia, A. Eldaly, Luiza Palmieri-Serrano, A. Forte, Jonathan C Thompson, M. Maniaci
{"title":"85-Year-Old Postsurgical Complex Patient Successfully Managed Remotely at the Novel Mayo Clinic's Hospital at Home","authors":"M. Paulson, Ricardo A. Torres-Guzman, Francisco R. Avila, Karla C. Maita, John P. Garcia, A. Eldaly, Luiza Palmieri-Serrano, A. Forte, Jonathan C Thompson, M. Maniaci","doi":"10.1155/2022/1439435","DOIUrl":"https://doi.org/10.1155/2022/1439435","url":null,"abstract":"An 85-year-old male presented to the podiatry clinic following a 1st to 5th left toe amputation as a complication of severe peripheral arterial disease and nonhealing wound despite endovascular intervention with an angiogram. At the visit, cellulitis with gangrene of the surgical site was noted. The patient was admitted to the brick and mortar (BAM) hospital and taken to surgery for a transmetatarsal amputation of the left limb. In the immediate postoperative period, the incisional margins appeared dusky creating concern for flap viability. The medical team recommended a vascular bypass versus a below-knee amputation. However, given the age, comorbidities, and nutritional status, the family refused further surgical intervention. As such, Mayo Clinic's home hospital program, Advanced Care at Home (ACH), was consulted for continued nonsurgical acute management at home. The patient was transferred to ACH and transported home three days after BAM admission to continue IV antibiotic therapy and wound care. Discharge from ACH occurred 11 days after admission to the BAM hospital. This case highlights the importance of developing health care alternatives to traditional hospitalization and demonstrates that ACH can manage highly complex, elder postoperative patients from the comfort of their homes.","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78959100","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}
A. Berbéri, G. Aoun, G. Aad, S. Khairallah, G. A. Chedid
{"title":"Angiographic Embolization with Histoacryl in Combination with Direct Injection of Bone Cement of an Intraosseous Venous Malformation of the Mandible: Report of a Case with 22-Year Follow-Up","authors":"A. Berbéri, G. Aoun, G. Aad, S. Khairallah, G. A. Chedid","doi":"10.1155/2022/6842968","DOIUrl":"https://doi.org/10.1155/2022/6842968","url":null,"abstract":"Vascular malformations of the maxillofacial region are unusual, and they occur more rarely in bone than in soft tissue. Mandibular intraosseous vascular lesions represent 0.5-1.0% of all bone tumors, and they are classified as venous malformation, lymphatic malformation, arterial malformation, arteriovenous malformations, and arteriovenous fistulae. Venous malformation is the most common vascular malformation, accounting for 44-64% of all vascular malformations, and is considered a low-flow malformation. Endovascular therapy as selective angiographic embolization is considered as the first-choice treatment associated or not with emboli injections with a success rate of 70%, and this evades mutilating surgery and related sequelae. We report a case of mandibular venous malformation on a 45-year-old female complaining of unilateral swelling of the left body of the mandible with facial deformation. The computed tomography scan images and the T1-weighted MR images showed a lesion that expresses an expansible lesion in the spongy bone of the left of the mandible with a buccal cortical rupture. Signal voids were not identified, suggesting a low-flow vascular lesion. The T2-weighted images exposed hypersignals; accordingly, a vascular lesion was suspected. The treatment was done under locoregional analgesia; after selective angiography, direct histoacryl injection was completed, followed by bone cement injection. The patient was followed yearly since1998. Radiological images of 10-year follow-up MRI showed a stabilization of the lesion without any new extensions. The panoramic radiograph after 22 years showed a bone formation inside the body of the mandible. The long follow-up period and the absence of any complications are favorable for the adopted treatment plan.","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79807237","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}
Michael H Chiu, Youri Kaitoukov, Amanda Roze des Ordons
{"title":"Late Stent Thrombosis in a Patient with Endovascular Aortic Repair for Blunt Thoracic Aortic Injury.","authors":"Michael H Chiu, Youri Kaitoukov, Amanda Roze des Ordons","doi":"10.1155/2022/5583120","DOIUrl":"https://doi.org/10.1155/2022/5583120","url":null,"abstract":"<p><p>Blunt thoracic aortic injury (BTAI) is associated with high mortality and morbidity. Thoracic endovascular aortic repair has become the recommended treatment modality given improved short-term results compared to open repair. We present a case of a 19-year-old male who presented with acute paralysis and multiorgan dysfunction from acute TEVAR thrombosis. Systemic thrombolysis, catheter-directed thrombolysis followed by aspiration thrombectomy, and angioplasty were initially successful in restoring perfusion. However, he developed progressive multiorgan failure related to prompt reocclusion within 48 hours. This case is the first to describe thrombolysis and angioplasty as a management strategy for acute TEVAR thrombosis. We also review the literature surrounding this uncommon complication.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":" ","pages":"5583120"},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8860563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39659265","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":"Renal Artery Thrombectomy Causing Functional and Symptomatic Recovery after 50-Hour Delay in Reperfusion of Acute Main Renal Artery Thrombosis.","authors":"Kevin Singh Kang, John Steven Wilson","doi":"10.1155/2022/1021683","DOIUrl":"https://doi.org/10.1155/2022/1021683","url":null,"abstract":"<p><p>Acute renal artery thrombosis is rare and even rarer in the thrombus occluding the main renal artery and compromising the entire kidney. We report on a 46-year-old female smoker with no past medical history and no hypercoagulability who developed sudden severe left flank pain, hematuria, acute renal failure, and severe hypertension. A CT angiogram showed totally occluded renal artery at the ostium with a thrombus and severely hypoperfused left kidney with multiple infarcts. Initial course of treatment was with intravenous heparin but with no improvement after 50 hours since symptom onset; angiography was done. This revealed totally occluded renal artery at ostium with no vessels or kidney blush seen. After aspiration thrombectomy, blush was seen in kidney parenchyma along with flow in the arcuate renal arteries although with some distal embolic events. The ostial lesion was treated with a drug eluting stent with excellent result angiographically. However, 8 months later, severe restenosis occurred. This time, the patient did not flank pain or renal failure but had progressive hypertension. The patient was treated this time with rheolytic thrombectomy followed by intravascular ultrasound-guided drug-eluting stenting. The patient has been followed for a year and a half since and recent CT scan revealed widely patent renal arteries bilaterally with normal kidney function, BP, and good perfusion to the left kidney with only tiny areas of infarct. Ultrasound of the kidneys also showed the size of the left kidney as within normal range now, and she has good distal flow velocities in the branch renal arteries. Our case report shows that even delayed reperfusion of complete renal artery occlusion with jeopardized arterial flow to the entire kidney could result in restoration of function to most of the kidney.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":" ","pages":"1021683"},"PeriodicalIF":0.0,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8846983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39933686","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":"An Abdominal Aortic Pseudoaneurysm Revealing Behçet's Disease.","authors":"Zineb Baba, Ahmed Mougui, Imane El Bouchti","doi":"10.1155/2022/8286579","DOIUrl":"https://doi.org/10.1155/2022/8286579","url":null,"abstract":"<p><p>Behçet's disease (BD) is a vasculitis with multisystemic manifestations. Articular involvement is frequent and benign whereas vascular complications are rare but serious and can form the onset of the disease. The assessment of the thickness of the common femoral vein wall is a new tool for the diagnosis of BD with good sensitivity and specificity. We report the case of a 52-year-old man diagnosed with BD revealed by an abdominal aortic pseudoaneurysm and a chronic monoarthritis. The first flare-up of BD can occur in men over 50 years of age. In a context of a multisystemic disease, lumbar pain should lead to the search of abdominal aortic aneurysm. The assessment of the thickness of the common femoral vein wall is accessible and should be used especially in challenging cases.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":" ","pages":"8286579"},"PeriodicalIF":0.0,"publicationDate":"2022-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8813256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39771165","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}
Amro Daoud, Bisher Mustafa, Hamza Alsaid, Zeid Khitan
{"title":"Renovascular Hypertension with Superimposed Aortic Arch Baroreceptor Failure: Case Report and Review of Literature.","authors":"Amro Daoud, Bisher Mustafa, Hamza Alsaid, Zeid Khitan","doi":"10.1155/2022/4754027","DOIUrl":"https://doi.org/10.1155/2022/4754027","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerotic renal artery diseases are among the most common causes of secondary hypertension. Baroreceptors, as carotid and aortic, are important regulatory mechanisms of blood pressure; their disruption can lead to labile blood pressure due to sympathetic overactivity: an entity called neurogenic hypertension. A disease such as aortic dissection can lead to a challenging combined etiology of secondary hypertension. It can affect both or one of the renal arteries leading to a renovascular pathology that can cause hypertension through RAAS activation. Also, surgical repair of the dissected aortic arch can disrupt baroreceptors leading to neurogenic hypertension. <i>Case Report</i>. We report a case of an 83-year-old female patient investigated for recurrent episodes of aphasia. She has a history of hypertension and coronary artery disease. Surgical history is significant for aortic valve replacement complicated by type A aortic dissection requiring surgical repair. Following surgery, the patient developed difficult-to-control and labile blood pressure. Workup included a CT angiogram of the abdominal aorta that showed an infrarenal dominant abdominal aortic aneurysm with juxtarenal aortic dissection; these findings were similar to previous findings. A diagnosis of aortic baroreceptor failure following aortic dissection repair was established, which lead to labile hypertension with superimposed renovascular pathology due to unilateral compromised renal artery blood flow following aortic dissection and thrombosis.</p><p><strong>Conclusions: </strong>This report highlights the importance of accurate diagnosis of secondary hypertension and its underlying mechanisms, as this has a huge impact on the choice of therapy to avoid undertreatment or overtreatment of hypertension.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":" ","pages":"4754027"},"PeriodicalIF":0.0,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8808237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39756930","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}