Case Reports in Vascular Medicine最新文献

{"title":"Life-Threatening Rupture of an Idiopathic Left Hepatic Artery Pseudoaneurysm Successfully Treated with Endovascular Coil Embolization.","authors":"Jorge E Sandelis-Pérez,&nbsp;Andrés Córdova-Toro,&nbsp;Steven García-Santiago,&nbsp;Erica G Otero-Cárdenas,&nbsp;Pedro Gil de Rubio-Cruz,&nbsp;Suheiry Márquez-Márquez,&nbsp;Mary J Rodríguez-Malavé,&nbsp;Arelis Febles-Negrón,&nbsp;José A Colon-Márquez,&nbsp;Alejandro Hidalgo-Ríos","doi":"10.1155/2020/8835573","DOIUrl":"https://doi.org/10.1155/2020/8835573","url":null,"abstract":"<p><p>Hepatic artery pseudoaneurysm is a rare condition; they are multifactorial, most of them locating in the extrahepatic vasculature and the mortality associated to its rupture may reach up to 70%. We report a 77 years old female who was admitted due to headache and uncontrolled hypertension and that on her second hospital day developed sudden hemodynamic instability, abdominal pain, fatigue, skin-mucosa pallor, and anemia. Abdominal CT scan with contrast showed a left hepatic artery pseudoaneurysm associated with extensive hemoperitoneum. Patient required emergent hemodynamic stabilization and finally was treated successfully with a superselective endovascular coil embolization. Our patient represents an atypical case of a spontaneous rupture of an idiopathic hepatic artery pseudoaneurysm. Hence, the importance of having a high index of clinical suspicion. Endovascular coil embolization has become the first-line treatment.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2020 ","pages":"8835573"},"PeriodicalIF":0.0,"publicationDate":"2020-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8835573","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38509263","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":"Use of Edoxaban for the Treatment of Heparin-Induced Thrombocytopenia.","authors":"Ryo Kanamoto,&nbsp;Shinichi Hiromatsu,&nbsp;Tomoyuki Anegawa,&nbsp;Kanako Sakurai,&nbsp;Shohei Yoshida,&nbsp;Yusuke Shintani,&nbsp;Hiroyuki Otsuka,&nbsp;Satoru Tobinaga,&nbsp;Hiroyuki Tanaka","doi":"10.1155/2020/2367095","DOIUrl":"https://doi.org/10.1155/2020/2367095","url":null,"abstract":"<p><p>Heparin-induced thrombocytopenia (HIT) is a life-threatening adverse drug reaction of heparin therapy, which increases a patient's risk of developing venous and/or arterial thromboembolism. HIT should be treated through discontinuation of heparin and administration of nonheparin anticoagulants such as argatroban. For long-term anticoagulation, parenteral nonheparin anticoagulants are generally converted to oral treatment with a vitamin K antagonist such as warfarin. Although administration of warfarin is recommended to overlap with a nonheparin anticoagulant for a minimum of 5 days, overlapping with argatroban and warfarin presents high risks of bleeding. We describe a case of HIT treated with edoxaban. A 78-year-old man underwent surgery for esophageal cancer and was administered heparin perioperatively. After surgery, he was diagnosed with HIT and venous thromboembolism. We immediately stopped heparin and initiated parenteral argatroban. The patient was subsequently started on edoxaban without any overlap between the two drugs. The treatment was successful. The treatment of edoxaban following argatroban for HIT could reduce bleeding complications and shorten the length of hospital stay. To the best of our knowledge, this is the first report of the use of edoxaban for HIT treatment.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2020 ","pages":"2367095"},"PeriodicalIF":0.0,"publicationDate":"2020-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2367095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38509262","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":"Intravascular Leiomyomatosis as a Rare Cause of Nonthrombotic Pulmonary Embolism.","authors":"Julie Van Maercke,&nbsp;Anne-Sophie Van Rompuy,&nbsp;Willy Poppe,&nbsp;Tom Verbelen,&nbsp;Marion Delcroix,&nbsp;Catharina Belge","doi":"10.1155/2020/6084061","DOIUrl":"https://doi.org/10.1155/2020/6084061","url":null,"abstract":"<p><p>Intravascular leiomyomatosis (IVL) is a very rare condition. It is characterized by the proliferation of benign smooth muscle cells within vascular structures without invasion of these tissues. Symptoms depend on the site of origin and the extent of invasion. Rarely, this neoplasm is located in the inferior vena cava or in the pulmonary vasculature potentially causing symptoms of dyspnea, chest pain, or syncope. We report the case of a 53-year-old woman who was referred to our hospital with extensive pulmonary embolism comprising of a subtotal occlusion of the right pulmonary artery with extension into the left pulmonary artery. Due to persistent dyspnea (New York Heart Association class II) despite anticoagulation, after a six-week period, imaging was repeated and showed stable findings. As she was not responding to adequate anticoagulant therapy, intima sarcoma of the pulmonary artery was suspected, and a pulmonary endarterectomy (PEA) was performed. A smooth, white, intravascular mass was easily and completely removed. Analysis demonstrated a lesion consisting of cells without atypia, showing expression of alpha-smooth muscle actin (alpha SMA) and desmin with partial expression of estrogen receptor (ER) and progesterone receptor (PR), leading to the diagnosis of intravascular leiomyomatosis. The patient fully recovered. Complete surgical removal of the intravascular tumor is recommended to relieve symptoms and prevent possible complications. Clinicians have to be aware that in unresolved pulmonary embolism, nonthrombotic and rare causes, like an intima sarcoma or intravascular leiomyomatosis, should be considered.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2020 ","pages":"6084061"},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6084061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38213378","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":"Cyclist Endofibrosis (Exercise-Induced Arterial Endofibrosis) Treated by Drug-Coated Balloon Angioplasty.","authors":"Ahmed S Zugail,&nbsp;Hossam I Shaabi,&nbsp;Slimane Idir,&nbsp;Jean-Pierre Becquemin","doi":"10.1155/2020/4290271","DOIUrl":"https://doi.org/10.1155/2020/4290271","url":null,"abstract":"<p><p>Exercise-induced arterial endofibrosis is an uncommon entity that is most frequently identified in high-performance athletes, especially cyclists. We present this disease in a male professional cyclist of 22 years of age. The course of his condition, clinical manifestations, modalities of investigation, and a nonprecedent treatment plan are demonstrated.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2020 ","pages":"4290271"},"PeriodicalIF":0.0,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4290271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38203901","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 Spontaneous Isolated Superior Mesenteric Artery Dissection Associated with Cocaine Abuse: A Pathomechanistic Association.","authors":"Rayan S El-Zein,&nbsp;Jeffrey Sobecki,&nbsp;Roy Greenberg,&nbsp;Michael Keleher,&nbsp;Robert A Palma","doi":"10.1155/2020/2514687","DOIUrl":"https://doi.org/10.1155/2020/2514687","url":null,"abstract":"<p><p>Spontaneous isolated superior mesenteric artery dissection (SISMAD) is a rare potentially fatal disease. We present a case of cocaine-related SISMAD in a patient with abdominal pain. A 38-year-old African American male with hypertension and alcohol, cocaine, and tobacco abuse presented with abdominal pain and recent cocaine use. A CT angiogram revealed SISMAD; he was treated with conservative management. Cocaine and SISMAD share similar pathophysiologic mechanisms pertaining to vascular smooth muscle cell apoptosis and increased shear stress at fixed vascular positions. Our report emphasizes the need to consider cocaine abuse in SISMAD pathophysiology, risk stratification, and treatment algorithms in future studies.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2020 ","pages":"2514687"},"PeriodicalIF":0.0,"publicationDate":"2020-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2514687","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38073539","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":"Successful Endovascular Repair of a Ruptured Popliteal Artery Aneurysm: A Case Report and Literature Review.","authors":"Duncan Muir,&nbsp;Sachin R Kulkarni","doi":"10.1155/2020/8745780","DOIUrl":"https://doi.org/10.1155/2020/8745780","url":null,"abstract":"<p><p><i>Introduction</i>. It is rare for a popliteal artery aneurysm (PAA) to present with rupture. This case reports a longer-term success in the management of a large ruptured popliteal artery aneurysm with an endovascular approach, with a literature review of management of such cases. <i>Case Report</i>. An 80-year-old man presented to the accident and emergency department with pain and swelling behind the left knee and at the back of the thigh. An ultrasound scan and subsequent CT angiogram revealed a large 9.4 cm ruptured PAA. The patient had significant comorbidities deeming him unfit for a major surgical intervention of drainage of haematoma and exclusion bypass. Therefore, he underwent urgent endovascular treatment of the ruptured PAA with a covered stent graft. A follow-up duplex scan at 1 year showed a patent stent with no evidence of endoleak, and the patient remained asymptomatic. A clinical follow-up at 18- and 24-month postprocedure showed a patent stent graft and complete resolution of haematoma. <i>Conclusion</i>. Whilst open repair with exclusion bypass may still be a treatment of choice, an endovascular approach is both safe and effective in the management of a ruptured PAA in an unfit patient with an acceptable longer-term outcome.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2020 ","pages":"8745780"},"PeriodicalIF":0.0,"publicationDate":"2020-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8745780","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37808977","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 Treatment of Venous Bypass Graft Pseudoaneurysm with the New Solaris Self-Expanding Covered Stent.","authors":"Enrique M San Norberto,&nbsp;Liliana A Fidalgo-Domingos,&nbsp;Noelia Cenizo,&nbsp;Álvaro Revilla,&nbsp;James H Taylor,&nbsp;Carlos Vaquero","doi":"10.1155/2020/4871814","DOIUrl":"https://doi.org/10.1155/2020/4871814","url":null,"abstract":"<p><p>Nonanastomotic pseudoaneurysm formation after vascular reconstruction is a rarely encountered problem. Covered stent graft constitutes a minimal approach. To our knowledge, the present study constitutes the first case of implantation of Solaris stent graft in Europe. A 69-year-old man with severe cardiac dysfunction presented a pseudoaneurysm of a popliteal to popliteal artery reversed saphenous vein bypass graft. The patient was successfully treated by the percutaneous placement of a Solaris self-expanding covered stent. The postimplantation arteriogram demonstrated exclusion of the pseudoaneurysm, complete apposition of the stent, and adequate runoff. No complications occurred, and the patient was discharged from the hospital one day later receiving 75 mg of clopidogrel. Endovascular exclusion by covered stent deployment offers a safe, rapid, and minimally invasive alternative to open surgical resection in patients with lower limb venous graft pseudoaneurysm. The Solaris covered stent provides a new catheter-based device with adequate navigability and exceptional accurate delivery system.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2020 ","pages":"4871814"},"PeriodicalIF":0.0,"publicationDate":"2020-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4871814","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37788970","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":"Phlegmasia Cerulea Dolens in a Patient with Breast Cancer and Inferior Vena Cava Hypoplasia.","authors":"A Bianchi,&nbsp;S Pozza,&nbsp;L Giovannacci,&nbsp;Jos C van den Berg","doi":"10.1155/2020/2176848","DOIUrl":"https://doi.org/10.1155/2020/2176848","url":null,"abstract":"<p><strong>Background: </strong>No clear guidelines exist for the management of phlegmasia cerulea dolens. This case report shows how a hybrid approach might be successful. It also shows how rare pathologies can combine to create a life- and limb-threatening condition. <i>Case Presentation</i>. A 75-year-old man, known for nephrotic syndrome currently under investigation, presented to the emergency department with a 24-hour history of left leg swelling followed by intense pain. The left lower limb showed a phlegmasia cerulean dolens. Renal function, coagulation profile, and inflammatory parameters were normal; D-Dimers 5,6 mg/L. The CT scan showed juxtarenal thrombosis of the hypoplastic IVC, involving both renal veins, reaching the left iliac-femoral-popliteal axis, with collateralization to the pelvic and mesenteric veins, associated with bilateral segmental pulmonary embolisms. A suspected left breast nodule was also found. Intravenous heparin was immediately administered, and urgent hybrid procedure with surgical thrombectomy and venous angiography and thromboaspiration, liberating the iliolumbar collaterals, was performed. A lateral leg fasciotomy was mandatory due to the phlegmasia cerulea. Postoperative Doppler US showed a good venous compressibility of the left leg. Thrombophilia screening was negative. The breast nodule was biopsied showing an invasive ductal carcinoma. The patient was discharged with oral rivaroxaban and indication for left mastectomy and oncological therapy with aromatase inhibitors.</p><p><strong>Conclusion: </strong>This case highlights the dramatic consequence of different risk factors for venous thromboembolism as cancer and nephrotic syndrome in a patient with hypoplasia of the inferior cava vein. Venous thromboaspiration has been used in order to timely recanalize important collaterals. Phlegmasia cerulea dolens was resolved after the procedure and lateral calf fasciotomy. Further evidence is needed to clearly define the role of venous thromboaspiration in the treatment of complex proximal deep venous thrombosis of the lower extremity.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2020 ","pages":"2176848"},"PeriodicalIF":0.0,"publicationDate":"2020-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2176848","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37745016","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":"Spontaneous Renal Artery Dissection in a Man with Previous Spontaneous Superior Mesenteric Artery Dissection.","authors":"Yujiro Yokoyama,&nbsp;Masato Nakajima","doi":"10.1155/2020/4726381","DOIUrl":"https://doi.org/10.1155/2020/4726381","url":null,"abstract":"<p><p>Both spontaneous superior mesenteric artery dissection (SMAD) and spontaneous renal artery dissection (SRAD) are very rare conditions. Their etiologies and natural histories are not precisely defined, but they are thought to be associated with underlying conditions. In this report, we describe an extremely rare case of SRAD in a man who had a history of spontaneous SMAD. We successfully treated SRAD with endovascular intervention. Isolated spontaneous SMAD and SRAD are both rare conditions. Their optimal treatment has not been established due to their rare entities, but endovascular treatment is a good option because it can prevent both advancement of infarction and renovascular hypertension, and it has become safer as device technology has improved. Patients with isolated visceral artery dissection should be carefully followed up.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2020 ","pages":"4726381"},"PeriodicalIF":0.0,"publicationDate":"2020-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4726381","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37674723","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":"Angioembolization of Scrotal Arteriovenous Malformations: A Case Report and Literature Review.","authors":"Ammar Mohammad,&nbsp;Wael Sahyouni,&nbsp;Taisser Almeree,&nbsp;Bayan Alsaid","doi":"10.1155/2020/8373816","DOIUrl":"https://doi.org/10.1155/2020/8373816","url":null,"abstract":"<p><p>Arteriovenous malformations (AVMs) of the scrotum are rare lesions, usually diagnosed incidentally during the evaluation of scrotal masses or infertility. It could be presented with acute bleeding or acute pain. We are presenting a case of painless bilateral infiltrated scrotal mass (more advanced in the left side) developed dramatically over a year, no other symptoms existed. The diagnosis was made using duplex ultrasound (DUS), computed tomography arteriography (CTA), and digital subtraction angiography (DSA). Three sessions of angioembolization were performed and followed by surgical resection of the left side of the scrotum.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2020 ","pages":"8373816"},"PeriodicalIF":0.0,"publicationDate":"2020-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8373816","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37670406","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}