Case Reports in Vascular Medicine

Independently, superior vena cava (SVC) occlusion and inferior vena cava (IVC) occlusion are usually seen in the setting of SVC syndrome and iliocaval venous obstruction (ICVO), respectively. Concomitant occlusion of the SVC and IVC is rare and most commonly seen in the setting of malignancy or other hypercoagulable states. Venous hypertension can lead to the formation of "downhill" varices in the esophagus and can be a rare source of gastrointestinal bleeding. We present a rare case of combined SVC and IVC occlusion and its management...

Postcarotid endarterectomy (CEA) hematomas are common although they are rarely threatening and necessitate reoperation. We aim to report a rare case of an expanding hematoma that caused a cardiac arrhythmia (bigeminy) which was reversed after hematoma evacuation.

BACKGROUND: Previous reports have revealed various endovascular intervention techniques for prosthetic femoropopliteal bypass occlusion (PFPBO); however, treatment for PFPBO remains challenging for most interventionalists and vascular surgeons because the procedure is complicated. Most of the reported techniques involve device implantation. In the present study, we performed a combination of surgical graft thrombectomy and drug-coated balloon angioplasty for PFPBO without implanting any additional devices...

MATERIALS AND METHODS: Between January 2018 and December 2020, twenty patients (7 men and 13 women) with peripheral high-flow arteriovenous malformations who were treated primarily with arterial embolization using squid were retrospectively included. Anatomical sites being treated included the head and neck (16), extremities (2), uterus (1), and pelvis (1). Squid was used as the sole embolic agent in 15 patients, and transarterial embolization was employed in all cases except one where direct puncture embolization was used...

Reported vascular complications following mRNA-based COVID-19 vaccines are consisting of myocarditis, cerebral venous thrombosis, cerebral vascular thrombosis, and vaccine-induced thrombocytopenia. Here, we describe a case of a 49-year-old woman with left-sided pain above the middle common carotid artery (carotidynia) starting a few days after her second vaccination with an mRNA-based COVID-19 vaccine (Spikevax). Imaging was indicative of transient perivascular inflammation of the carotid artery (TIPIC) syndrome...

Introduction . Large thrombi in the inferior vena cava pose a high risk for a pulmonary embolism. Percutaneous extracorporeal circulation-based vacuum-assisted thrombus aspiration is a viable option for removal. Wall adherence of thrombotic material can compromise procedural success. Case Report . A 46-year-old female presented with a subtotal thrombotic occlusion of the inferior vena cava and the proximal right common iliac vein after weaning from extracorporeal life support. Due to severe wall adherence of the thrombotic material, the patient was treated with the combination of percutaneous extracorporeal circulation-based thrombus aspiration using the AngioVac system and a rotational thrombectomy device...

Livedoid vasculopathy is a thromboocclusive cutaneous vasculopathy manifested by livedoid changes, atrophie blanche, and ulceration. The pathogenesis is speculated to involve increasing coagulation or impaired thrombolysis leading to the occlusion of dermal blood vessels with fibrin thrombi. Livedoid vasculopathy is known to primarily affect the lower extremities. We report the first case of livedoid vasculopathy affecting the penis. A 60-year-old male was evaluated for a split urine stream with associated irritation and peeling of the skin of the glans penis...

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...

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...

BACKGROUND: Ankle arteriovenous fistulas are the rarest vascular access type among lower extremity fistulas for hemodialysis patients with end-stage renal disease. Here, we present a case of a tibial-saphenous fistula that remained open for a long time despite a recurrent anastomotic aneurysm. Case Presentation. A 43-year-old female patient who had been undergoing hemodialysis via a right femoral tunnel catheter for six months was referred for recurrent catheter infection and a 4 cm pulsatile mass in the anterior aspect of the ankle...

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...

Background: 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 . Case Presentation . 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...

Background: 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. Method: 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)...

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...

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...

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...

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...

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...

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...

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...