A Bianchi, S Pozza, L Giovannacci, Jos C van den Berg
{"title":"Phlegmasia Cerulea Dolens in a Patient with Breast Cancer and Inferior Vena Cava Hypoplasia.","authors":"A Bianchi, S Pozza, L Giovannacci, 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, 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}
Ammar Mohammad, Wael Sahyouni, Taisser Almeree, Bayan Alsaid
{"title":"Angioembolization of Scrotal Arteriovenous Malformations: A Case Report and Literature Review.","authors":"Ammar Mohammad, Wael Sahyouni, Taisser Almeree, 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}
Graham T Endler, Karleigh R Curfman, Jason H Hwang, John L Gray
{"title":"A Complicated Entity: Acute Celiac Artery Dissection with Resultant Pancreatitis, Duodenitis, and Cholecystitis.","authors":"Graham T Endler, Karleigh R Curfman, Jason H Hwang, John L Gray","doi":"10.1155/2020/8453168","DOIUrl":"https://doi.org/10.1155/2020/8453168","url":null,"abstract":"<p><p>Arterial dissection is a well-recognized pathology often seen in Vascular Surgery offices and Emergency Departments alike; however, visceral arterial dissection is an extremely rare, small subset of this entity. With that, an isolated celiac artery dissection as presented within this report is an exceptionally unique pathology that has scarcely been reported, and due to this, management guidelines are undefined. Given the viscera supplied by the celiac artery, many intra-abdominal structures are at risk for ischemia when damage to the celiac artery occurs, potentially witnessed by this report. Due to the exclusivity of this pathology, we are compelled to report the case of a 71-year-old male who presented with complaints of abdominal pain and was found to have an acute celiac artery dissection, which likely resulted in severe ischemic duodenitis, as well as possibly acute pancreatitis, and questionable influence on cholecystitis.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2020 ","pages":"8453168"},"PeriodicalIF":0.0,"publicationDate":"2020-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8453168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37580304","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":"One Case Report of Delayed True Aortic Aneurysm Caused by Blunt Violence","authors":"泽鹏 史","doi":"10.12677/acrvm.2020.81001","DOIUrl":"https://doi.org/10.12677/acrvm.2020.81001","url":null,"abstract":"","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"41 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79394194","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}
{"title":"The Relationship between Bundle Branch Block and Myocardial Infarction and Its Impact on Cardiac Resynchronization Therapy","authors":"羽中 张","doi":"10.12677/acrvm.2020.82002","DOIUrl":"https://doi.org/10.12677/acrvm.2020.82002","url":null,"abstract":"","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"1 1","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89090455","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}
Kevin Lee, Sophia Toraby, Robert Cotterman, Babatunde Oriowo, John Fish
{"title":"A Tumultuous Course of Exogenous Testosterone by a Bodybuilder Causing a Catastrophic Hypercoagulable State in the Surgical Intensive Care Unit.","authors":"Kevin Lee, Sophia Toraby, Robert Cotterman, Babatunde Oriowo, John Fish","doi":"10.1155/2019/3097865","DOIUrl":"https://doi.org/10.1155/2019/3097865","url":null,"abstract":"<p><p>Present literature demonstrates an equivocal relationship between testosterone and thrombogenicity. Herein, we describe a case in which a patient used an unspecified amount and duration of exogenous testosterone injections, subsequently developing thrombotic events in his: right radial artery, right iliac artery, superficial femoral artery, splenic artery and a bilateral lower lobe pulmonary embolism. As a result, clinicians should consider exogenous testosterone use as a potential risk factor when the etiology of a patient's thrombotic events are not clear. We also completed a literature review of the molecular mechanisms in which testosterone can increase the clot burden through an increases human platelet thromboxane A2 receptor density and an increase in erythropoiesis.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2019 ","pages":"3097865"},"PeriodicalIF":0.0,"publicationDate":"2019-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/3097865","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37498502","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":"Massive Scrotal Hematoma due to Ruptured Anastomotic Pseudoaneurysm in a Patient with Aortobifemoral Bypass Surgery: CTA Evaluation.","authors":"Magdalini Smarda, Dimitrios Fagkrezos, Ilias Dodos, Anastasios Potouridis, Dimitrios Staramos, Charikleia Triantopoulou, Petros Maniatis","doi":"10.1155/2019/9013697","DOIUrl":"https://doi.org/10.1155/2019/9013697","url":null,"abstract":"<p><p>A 74-year-old male patient was presented with scrotal swelling and a pulsatile mass of the left femoro-inguinal region. His medical history included hypertension, coronary artery disease, respiratory failure, and an aortobifemoral bypass surgery performed 7 years ago. Ultrasound evaluation revealed a massive scrotal hematoma. Computed tomography angiography (CTA) was conducted, confirming the aortobifemoral graft existence and revealing bilateral anastomotic pseudoaneurysms with the left one being ruptured, resulting in extension of the hematoma to the left femoro-inguinal region and the scrotum. An emergency surgery was performed, where proximal control of the left limb of the synthetic graft as well as distal control of the iliac vessels were accomplished. After the control of the hemorrhage, an iliofemoral bypass with a Polytetrafluoroethylene (PTFE) 6 mm synthetic graft was placed. Unfortunately, the patient passed away during the first postoperative day due to myocardial infarction.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2019 ","pages":"9013697"},"PeriodicalIF":0.0,"publicationDate":"2019-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9013697","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37486888","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}
Yae Hyun Rhee, Lucas Busch, Roberto Sansone, Neslihan Ertas, Nikolaos Floros, Hubert Schelzig, Joscha Mulorz, Markus Udo Wagenhäuser
{"title":"Endovascular Occlusion of a Renal Arteriovenous Fistula with Renal Vein Aneurysm Formation for Rupture Prevention.","authors":"Yae Hyun Rhee, Lucas Busch, Roberto Sansone, Neslihan Ertas, Nikolaos Floros, Hubert Schelzig, Joscha Mulorz, Markus Udo Wagenhäuser","doi":"10.1155/2019/8530641","DOIUrl":"https://doi.org/10.1155/2019/8530641","url":null,"abstract":"<p><strong>Purpose: </strong>To report the effectiveness of left renal artery (LRA) occlusion using Amplatzer Vascular Plug (AVP) II as treatment for a high-flow renal arteriovenous fistula (RAVF) with multiple renal vein aneurysms (RVA) to prevent aneurysm rupture and cardiac decompensation.</p><p><strong>Case report: </strong>A 59-year-old female suffering from a post-traumatic RAVF presented with tachycardia and increased cardiac output (CO). Doppler ultrasonography and computed tomography (CT) scan revealed a high-flow RAVF with multiple RVAs and unilateral critically reduced kidney function. Appreciating recent interventional therapeutic advances, the patient was treated with endovascular placement of AVP II into the left renal artery (LRA) resulting in complete occlusion of the RAVF to effectively reduce the risk of RVA rupture and cardiac decompensation. No anti-platelet medication was administrated after the occlusion of the LRA. The patient's physical capacity improved since right heart volume strain was normalized, and CO was reduced.</p><p><strong>Conclusion: </strong>Transbrachial AVP II occlusion of the LRA is effective to occlude high-flow RAVFs to prevent risk of life-threatening RVA rupture. Additional follow-up is warranted to verify long-term effectiveness of this approach.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2019 ","pages":"8530641"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/8530641","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37524658","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":"Ruptured Superficial Femoral Artery Anastomotic Pseudoaneurysm after 30 Years","authors":"D. Baldwin, H. Mashbari, K. L. Chow, M. Sarhan","doi":"10.1155/2019/1679214","DOIUrl":"https://doi.org/10.1155/2019/1679214","url":null,"abstract":"Introduction Anastomotic pseudoaneurysms are a complication of vascular reconstructive surgery with the majority in the femoral region. Although rare, ruptured femoral anastomotic pseudoaneurysms have high mortality and require emergency surgery. Case Presentation A 60-year-old male with a history of a left leg crush injury was treated with a superficial femoral artery interposition vein graft 30 years ago. He presented nowadays with a three-day history of severe pain in his left thigh. CT angiography demonstrated a ruptured anastomotic pseudoaneurysm with contrast extravasation into an intramuscular hematoma. He had significant scarring from his previous surgeries which made the leg hostile for an open repair. Therefore, percutaneous access selectively cannulated the left iliofemoral vasculature. An angiogram showed a distal superficial femoral artery pseudoaneurysm. Subsequently, two 10mmx15cm Viabahn covered stents (Gore & Associates, Flagstaff, AZ) were placed bridging healthy superficial femoral artery. A completion angiogram demonstrated no extravasation into the pseudoaneurysm. The patient recovered and was discharged home two days postoperatively. Conclusion Ruptured femoral anastomotic pseudoaneurysms are traditionally repaired with open pseudoaneurysm excision and arterial reconstruction, although endovascular repair has been reported. Furthermore, most femoral anastomotic pseudoaneurysms form less than 10 years after initial operation. We present a unique case of ruptured superficial femoral artery pseudoaneurysm, 30 years after the initial operation. Endovascular stents offer effective treatment for ruptured anastomotic pseudoaneurysms.","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"118 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82864699","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}