Case Reports in Vascular Medicine最新文献

{"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}

{"title":"A Rare Case of Bilateral Posterior Tibial Artery Aneurysm Presenting as Unilateral Acute Limb Ischemia","authors":"A. Hattam, M. Krishnaswamy","doi":"10.1155/2019/5647380","DOIUrl":"https://doi.org/10.1155/2019/5647380","url":null,"abstract":"True aneurysms of the tibial arteries are extremely rare. Of the few previously described tibial artery aneurysms, there are scant reports of isolated true aneurysms of the posterior tibial artery (PTA). In this report, we describe the second documented case of bilateral true PTA aneurysms. Unique aspects of this case are that the aneurysmal PTA were the only patent tibial arteries bilaterally, the aneurysms were degenerative in nature, and initial patient presentation was due to aneurysm thrombosis causing acute foot ischemia. The clinical and radiological features of this case, as well as surgical decision making and management, are discussed.","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85653240","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":"Endovenous Laser Ablation for Treatment of a Partially Thrombosed Proximal Great Saphenous Vein.","authors":"Luca Spinedi,&nbsp;Hans Stricker,&nbsp;Daniel Staub,&nbsp;Heiko Uthoff","doi":"10.1155/2019/1726978","DOIUrl":"https://doi.org/10.1155/2019/1726978","url":null,"abstract":"<p><strong>Introduction: </strong>Superficial vein thrombosis of the great saphenous vein near to the saphenofemoral junction is generally treated with anticoagulation or surgically.</p><p><strong>Report: </strong>We present the case of a 70-year-old man with varicosities and a partially thrombosed great saphenous vein near to the saphenofemoral junction, treated with endovenous laser ablation of the great saphenous vein.</p><p><strong>Discussion: </strong>The case illustrates an alternative treatment option for superficial vein thrombosis of the great saphenous vein, which permits avoiding a prolonged anticoagulation or surgical procedure.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2019 ","pages":"1726978"},"PeriodicalIF":0.0,"publicationDate":"2019-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/1726978","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37128798","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 a Dissected External Carotid Artery Pseudoaneurysm in a Young Female with Neurofibromatosis Complicated by Preeclampsia.","authors":"Sasha Lalla,&nbsp;Rajeev Seecheran,&nbsp;Valmiki Seecheran,&nbsp;Sangeeta Persad,&nbsp;Ronald Henry,&nbsp;Naveen Anand Seecheran","doi":"10.1155/2019/6020393","DOIUrl":"https://doi.org/10.1155/2019/6020393","url":null,"abstract":"<p><p>Carotid artery pseudoaneurysms are infrequently encountered in clinical practice. Major contributory etiologies include blunt trauma, infections, cystic medial necrosis, fibromuscular dysplasia, arteriosclerosis, and congenital abnormalities. The authors report an exceedingly rare case of a dissected external carotid artery pseudoaneurysm in a 26-year-old female patient with neurofibromatosis complicated by preeclampsia at 28-week period of gestation, safely and successfully treated by coil embolization.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2019 ","pages":"6020393"},"PeriodicalIF":0.0,"publicationDate":"2019-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/6020393","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37142381","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":"Rare Clinical Course of Immunoglobulin G4-Related Inflammatory Abdominal Aortic Aneurysm with Multiple Rare Complications.","authors":"Yuji Naito,&nbsp;Tsukasa Miyatake,&nbsp;Manami Iwasaki,&nbsp;Atsushi Okuyama,&nbsp;Akio Takada,&nbsp;Koji Chiba,&nbsp;Masahiko Obata,&nbsp;Junichi Oba","doi":"10.1155/2019/8249061","DOIUrl":"https://doi.org/10.1155/2019/8249061","url":null,"abstract":"<p><p>Immunoglobulin G4- (IgG4-) related inflammatory abdominal aortic aneurysm (AAA) has been recognized as a manifestation of IgG4-related disease (IgG4-RD). We experienced one patient with multiple consecutive manifestations before and after endovascular stent grafting for IgG4-related inflammatory AAA (IAAA). A 71-year-old man was diagnosed with IgG4-RD due to increased IgG4 serum concentration, typical findings of parotid gland biopsy, and periaortitis in another hospital 2 years and 7 months before visiting our hospital. He came to our hospital because of abdominal pain and IAAA. He developed paraplegia after hospitalization and underwent endovascular stent grafting for the IAAA. About one month after stent grafting, he developed perforation of the sigmoid colon due to enteritis. He also had myocardial infarction. Finally, he died of intestinal bleeding. Here, we describe this case with rare, multiple, consecutive manifestations of IgG4-RD, some of which might be caused by IgG4-related IAAA or side effects of treatments rather than by IgG4-RD itself. We report this case because the clinical course seemed rare for IgG4-RD or IgG4-related IAAA. For treating IgG4-RD with IgG4-related IAAA, we should consider factors causing the symptoms and carefully select the proper treatment.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2019 ","pages":"8249061"},"PeriodicalIF":0.0,"publicationDate":"2019-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/8249061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37119924","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 with Large Abdominal Varicosity, Treated Successfully Using Multiple Approaches.","authors":"Lori Jia,&nbsp;Jason Alexander,&nbsp;Nedaa Skeik","doi":"10.1155/2019/7079307","DOIUrl":"https://doi.org/10.1155/2019/7079307","url":null,"abstract":"<p><p>May-Thurner syndrome (MTS) is a venous outflow obstruction disorder characterized by compression of the left common iliac vein by an overriding right common iliac artery. MTS primarily affects young to middle-aged women, although many patients remain entirely asymptomatic. Anatomic variations of MTS, while uncommon, have been described. Treatment usually involves endovascular management, including thrombolysis and/or thrombectomy with or without inferior vena cava filter placement, followed by angioplasty and stenting of the left common iliac vein. We report a unique case of a 31-year-old woman who presented with MTS-related deep vein thrombosis accompanied by symptomatic abdominal and pelvic varicosities. The varicosities were treated successfully using multiple procedures, resulting in complete resolution of all symptoms. Our case discusses a treatment approach for an unusual presentation of MTS-related postthrombotic syndrome, and provides a brief literature review of MTS complications and management.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2019 ","pages":"7079307"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7079307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37315159","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":"Combined Use of Excimer Laser and High-Speed Rotational Atherectomy to Overcome a Severely Calcified Lesion in Endovascular Therapy.","authors":"Keisuke Nakabayashi,&nbsp;Shinya Hata,&nbsp;Nobuhito Kaneko,&nbsp;Akihiro Matsui,&nbsp;Kazuhiko Tanaka,&nbsp;Hiroshi Ando,&nbsp;Minoru Shimizu","doi":"10.1155/2019/1719035","DOIUrl":"https://doi.org/10.1155/2019/1719035","url":null,"abstract":"<p><p>Although endovascular therapy (EVT) is commonly used in treatment of peripheral artery disease (PAD), severely calcified lesions pose a challenge, in spite of the technical advancement. In this report, we discuss the case of a 74-year-old male with coronary artery disease and end-stage renal disease who presented at our institution with bilateral intermittent claudication. Angiography showed chronic total occlusion (CTO) of the right superficial femoral arteries (SFA). Because the bilateral external iliac arteries demonstrated moderate stenosis, we performed endovascular therapy on the right SFA-CTO using a contralateral approach. With the antegrade wire progressing into the subintimal space, direct distal-SFA puncture was performed and wire externalization was established. However, no devices (minimal balloon, microcatheter, or Crosser system) were able to pass the lesion in antegrade or retrograde manner, even though the child catheter support or needle cracking technique from outside/inside was applied. Therefore, we used a combination of an excimer laser and high-speed rotational atherectomy to overcome the severely calcified lesion. First, the excimer laser catheter (Turbo Elite 0.9 mm) ablated the entry to the CTO; however, it did not pass through completely. Thereafter, the thin microcatheter (Caravel) succeeded in crossing the CTO in an antegrade manner using the BAlloon Deployment using FORcible Manner (BADFORM) technique. After wire-exchange to the Rota-wire, rotational atherectomy (RotaLink Plus 1.5 mm) passed through the CTO. Subsequently, we could dilate the CTO lesion with a conventional balloon followed by bare metal stent deployment. The right ankle-brachial index of the patient improved from being unmeasurable to 0.79, and the intermittent claudication disappeared. This combination therapy, described as the \"RASER\" technique in coronary section, is accepted for reimbursement. However, these devices in EVT section are considered off-label use in Japan. Therefore, we have to refrain from frequent use of this strategy; however, this method provides an option for severely calcified lesions.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2019 ","pages":"1719035"},"PeriodicalIF":0.0,"publicationDate":"2019-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/1719035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37284295","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 Off-Label Use of a Unibody Aortic Stent-Graft System for the Treatment of Infrarenal Abdominal Aortic Dissections.","authors":"Joseph Faraj,&nbsp;Rebekah L W Tan,&nbsp;Bibombe P Mwipatayi","doi":"10.1155/2019/6853135","DOIUrl":"https://doi.org/10.1155/2019/6853135","url":null,"abstract":"<p><p>Infrarenal abdominal aortic dissections (IAAD) are exceedingly rare, accounting for 1-4% of all aortic dissections. The evidence is scarce on how to best manage IAAD when they become symptomatic. Two main interventional approaches exist, open surgery and the endovascular approach. Conventional stent-graft systems make it difficult to treat nonaneurysmal aortic disease due to limb competition in a narrow distal aorta. Thus, we present a novel use of the Endologix Anatomical Fixation 2 (AFX2) Abdominal Aortic Aneurysm (AAA) endograft system for the treatment of four patients with IAAD. We also highlight an individual case study that was treated with an alternative endovascular approach and the complications that followed. This was to highlight and compare our successful experience with Endologix AFX2 AAA endograft system. There were multiple benefits for choosing this stent-graft; however the main advantage is its suitability in the narrow distal aorta. Our aim was to highlight an alternative endovascular approach for the successful treatment of a rare, challenging, and potentially fatal pathology.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2019 ","pages":"6853135"},"PeriodicalIF":0.0,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/6853135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37244796","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 Case Study of Malrotated Kidneys with Asymmetric Multiple Renal Arteries, Variant Venous Drainage, and Unilateral Ureteral Duplication.","authors":"Martine Dunnwald,&nbsp;Marc A Pizzimenti","doi":"10.1155/2019/1893137","DOIUrl":"https://doi.org/10.1155/2019/1893137","url":null,"abstract":"<p><p>Variations in the arterial, venous, and ureteral patterning of the right (r) and left (l) kidneys are common; however, concomitant involvement with all three systems is rare. Specimens that demonstrate anatomic variation across multiple systems provide an opportunity to illustrate links between anatomic concepts, embryologic development, clinical practice, and education. During anatomic study of the abdominal cavity, a total of five major arteries (3l and 2r) emerged from the aortic and common iliac axes in a cadaveric donor. Through continued study, multiple contributing veins, of different caliber, coalesced into four major renal veins (2l and 2r) that returned blood from the kidneys to the inferior vena cava (IVC) at different locations. In addition, unilateral duplication of the kidney with concomitant ureters was evident on the right side. Both ureters continued inferiorly and independently entered the bladder, each with an observable orifice adjacent to the bladder trigone. Most evident in the specimen was the anteriorly directed hilum for both kidneys. Reported measures for each of the observed anatomic variations suggest that the current specimen has an estimated incidence of less than 0.3%. This comparatively rare specimen provides an example of important anatomic concepts that are relevant to educational and clinical practices.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2019 ","pages":"1893137"},"PeriodicalIF":0.0,"publicationDate":"2019-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/1893137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37177080","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":"Popliteal Artery Entrapment Syndrome (PAES) in a 17-Year-Old Adolescent.","authors":"Viktor Labmayr,&nbsp;Aryan Aliabadi,&nbsp;Kurt Tiesenhausen,&nbsp;Marianne Brodmann,&nbsp;Florian Schmid,&nbsp;Dana Moore","doi":"10.1155/2019/8540631","DOIUrl":"https://doi.org/10.1155/2019/8540631","url":null,"abstract":"<p><strong>Introduction: </strong>Popliteal artery entrapment syndrome (PAES) is caused by compression of the popliteal artery (PA) due to deranged myotendinous structures. It can be asymptomatic or may present with exercise intolerance, claudication, or even limb-threatening ischemia. The clinical picture depends on the anatomy and degree of vascular compromise.</p><p><strong>Case description: </strong>We report a case of a 17-year-old Caucasian male with PAES Type II presenting with intermittent claudication and progression towards acute limb ischemia.</p><p><strong>Diagnostics: </strong>MRI and MRA helped identifying the aberrant anatomy and thrombotic occlusion. Doppler ultrasound and conventional angiography have also been employed in a stepwise approach.</p><p><strong>Intervention: </strong>The thrombus at the site of occlusion was removed by the use of catheter-directed lysis. Subsequently, popliteal artery release was achieved by myotomy of the aberrant medial head of gastrocnemius muscle (MHGM) and muscle transfer to the medial femoral condyle. A three-month regimen of 60mg edoxaban was recommended after surgery.</p><p><strong>Outcome: </strong>Surgical correction of the anomalous anatomy and postoperative anticoagulation led to freedom of symptoms.</p><p><strong>Lesson: </strong>Clinical presentation of PAES mimicking peripheral artery occlusive disease is very rare but potentially limb-threatening. PAES should be considered in young and otherwise healthy individuals.</p>","PeriodicalId":9632,"journal":{"name":"Case Reports in Vascular Medicine","volume":"2019 ","pages":"8540631"},"PeriodicalIF":0.0,"publicationDate":"2019-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/8540631","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37150764","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}