M Travis Caton, Nityanand Miskin, Jeffrey P Guenette
OBJECTIVES: Acute hemorrhage in the head and neck (AHNH) is life-threatening due to asphyxiation and hemorrhagic shock. When conservative measures fail, some patients benefit from endovascular therapy (EVT). While CTA is routinely used to localize bleeding and plan EVT in gastrointestinal hemorrhage, the diagnostic value of CTA in AHNH and role of CTA in treatment-planning are uncertain. METHODS: We retrospectively reviewed neck CTAs from June 2015 to October 2018 indicated for AHNH...
August 5, 2020: Emergency Radiology
Abby L Perrenoud, Garret Heiberger, Jackson Shriver, Douglas Yim
The complication of uretero-arterial fistula after prolong ureteral stenting is well recognized. The treatment is primarily endovascular stenting across the fistulous communication accepting the potential risk of stent graft infection. Herein we present a case of a 71-year-old female who developed an uretero-arterial fistula after prolong ureteral stenting and exchanges following ileal conduit obstruction. Initial treatment with left common iliac stenting controlled the hematuria, but only temporarily. Repeat angiography revealed a type 1b endoleak requiring stent extension...
June 25, 2020: Curēus
Andrew C Berry
Large-volume paracentesis carries roughly a 1% risk of overall complications. Hemorrhagic complications are classified as abdominal wall hematomas, pseudoaneurysms, and hemoperitoneum. Severe hemorrhage is rare (<0.2%), with death following this complication seen in <0.02% of cases. We present a fatal case of an ultrasound-guided paracentesis leading to subsequent hemoperitoneum from an aberrant intercostal artery, causing hemorrhagic shock and death. A 47-year-old black male with decompensated alcoholic cirrhosis, model for end-stage liver disease (MELD) score of 22, and Child-Pugh class C presented with a distended abdomen, international normalized ratio (INR) 1...
June 25, 2020: Curēus
Gaik Nersesian, Natalia Solowjowa, Volkmar Falk, Evgenij Potapov, Semih Buz
INTRODUCTION: Outflow graft (OG) obstruction is a dangerous complication that may occur for various reasons after the implantation of the left ventricular assist device (LVAD). CASE REPORT: In this study, we describe the case of a 67-year-old patient on LVAD support who developed a late pseudoaneurysm of the OG anastomosis (to the descending aorta) causing OG stenosis at the level of the anastomosis. The patient was treated with a customized fenestrated endovascular stent graft placed into the descending aorta and stent implantation into the OG...
August 2, 2020: Journal of Cardiac Surgery
Roberto Nerla, Clara Villa, Paolo Panisi, Antonio Micari, Fausto Castriota, Alberto Cremonesi
No abstract text is available yet for this article.
July 17, 2020: Journal of Cardiovascular Medicine
Irappa Madabhavi, Malay Sarkar, Chidanand Chauhan, Mitul Modi
Tuberculous pseudoaneurysm of the descending thoracic aorta is quite rare, life-threatening, and fatal if not diagnosed in time. This lesion exposes patients to a very high risk of unpredictable rupture. We describe a case of tuberculous pseudoaneurysm of the aorta in association with tuberculosis of the spine (Pott's spine). A 73-year-old man presented with a 2-month history of back pain. Chest roentgenography and contrast-enhanced computed tomography showed a descending thoracic aortic pseudoaneurysm with destruction of the fourth and fifth thoracic vertebrae (T4-T5)...
April 2020: Aorta (Stamford, Conn.)
Yongtao Zheng, Zheng Lu, Jianguo Shen, Feng Xu
Intracranial pseudoaneurysms account for about 1% of intracranial aneurysms with a high mortality. The natural history of intracranial pseudoaneurysm is not well-understood, and its management remains controversial. This review provides an overview of the etiology, pathophysiology, clinical presentation, imaging, and management of intracranial pseudoaneurysms. Especially, this article emphasizes the factors that should be considered for the most appropriate management strategy based on the risks and benefits of each treatment option...
2020: Frontiers in Neurology
Katriel E Lee, Aqib Zehri, Sauson Soldozy, Hasan Syed, Joshua S Catapano, Robert Maurer, Felipe C Albuquerque, Kenneth C Liu, Stacey Q Wolfe, Sandra Brown, Michael R Levitt, Kyle M Fargen
BACKGROUND: Dural venous sinus stenting (VSS) is an effective treatment for idiopathic intracranial hypertension (IIH) in adult patients. There are no published series to date evaluating safety and efficacy of VSS in pediatric patients. OBJECTIVE: To report on procedural device selection and technique as well as safety and efficacy of VSS for pediatric patients with medically refractory IIH due to underlying venous sinus stenosis. METHODS: A multi-institutional retrospective case series identified patients with medically refractory IIH aged less than 18 years who underwent VSS...
July 30, 2020: Journal of Neurointerventional Surgery
Hiroki Mitsuoka, Yuki Orimoto, Takahiro Arima, Tsuneo Ishiguchi, Hiroyuki Ishibashi
BACKGROUND: Pseudoaneurysms that develop after surgical repair of a patent ductus arteriosus (PDA) are more likely to rupture, but open surgery including a repeat thoracotomy would be highly invasive. We report 2 cases of thoracic endovascular aortic repair (TEVAR) for such pseudoaneurysms. METHODS/RESULTS: A 59-year-old woman who underwent PDA surgical ligation at 13 years of age presented with sudden hemoptysis. She was diagnosed with a ruptured distorted pseudoaneurysm sized 26 mm; emergency TEVAR was performed...
July 30, 2020: Vascular and Endovascular Surgery
Andrei M Beliaev, Jens Lund, Colleen J Bergin
No abstract text is available yet for this article.
July 29, 2020: Asian Cardiovascular & Thoracic Annals
Mahmut Buğrahan Çiçek, Ahmet Karaduman, İsmail Balaban, Alev Kılıçgedik, Cevat Kırma
No abstract text is available yet for this article.
June 8, 2020: Korean Circulation Journal
Lara Walkoff, Prashant Nagpal, Ashish Khandelwal
The use of computed tomography angiography (CTA) for the evaluation of peripheral vascular trauma has become increasingly prevalent in the past decade with the development of multidetector CT (MDCT) and multiple studies subsequently demonstrating high sensitivity, specificity, and diagnostic accuracy when compared with conventional angiography. Additional benefits of MDCT include the ability to rapidly acquire the images, perform multiplanar and 3D reconstructions, and assess the adjacent soft tissues and bones...
July 28, 2020: Emergency Radiology
Vladimir Cvetic, Borivoje Lukic
No abstract text is available yet for this article.
July 25, 2020: European Journal of Vascular and Endovascular Surgery
Louis-Xavier Barrette, Ansar Z Vance, Mark P Mantell, Kathleen M Kratz, Jonas W Redmond, Timothy W I Clark
PURPOSE: Vascular closure device (VCD) use following antegrade femoral access may present unique challenges relative to retrograde access. We retrospectively compared safety and efficacy of these devices between antegrade and retrograde patient cohorts undergoing percutaneous intervention. MATERIALS AND METHODS: Over a 5-year period, a consecutive series of 107 limbs in 84 patients underwent VCD arteriotomy closure following percutaneous revascularization using an antegrade approach (VCD-A)...
July 28, 2020: Vascular and Endovascular Surgery
Dragan Savić, Tarik M Alsheikh, Ahmad Kh Alhaj, Lazar Lazovic, Lamya Alsarraf, Petar Bosnjakovic, Waleed Yousef
The clinical manifestations of coronavirus disease 2019 (COVID-19) are non-specific and multi-inflammatory. They vary from mild to severe manifestations that can be life-threatening. The association of SARS-CoV-2 infection and pseudoaneurysm formation or rupture of an already existing aneurysm is still unexplored. Several mechanisms may be involved, including the direct destruction to the artery by the viral infection or through the release of the inflammatory cytokines. We are presenting a case of a 13-year-old girl with a ruptured cerebral pseudoaneurysm of the left middle cerebral artery (M2 segment) with severe intracerebral hemorrhage as the earliest manifestation of COVID-19 infection...
July 27, 2020: Acta Neurochirurgica
Lauranne Rossard, Gilles Body, Lobna Ouldamer
We present the case of a young woman with abnormal vaginal bleeding two weeks after an abdominal myomectomy. The intervention was initially considered uncomplicated. Transvaginal sonography detected a pulsatile cystic area, just above the endometrium in the anterior wall of the lower uterine segment. Color Doppler analysis revealed the communication between an artery and a vein. Although, the ultrasound was completely sufficient for diagnosis, computed tomographic angiography was performed and confirmed the diagnosis of uterine pseudoanevrysm within the uterine myometrium...
July 24, 2020: Journal of Gynecology Obstetrics and Human Reproduction
Bianca Kwan, Peadar S Waters, Emily Olive, Andrew Nathanson, Roger Bain, Richard D Bryant, Nick O'Rourke, David J Cavallucci
No abstract text is available yet for this article.
July 27, 2020: ANZ Journal of Surgery
Reid C Mahoney, Ryan Hagino, Elna Masuda
We present the case of a patient in whom a mycotic radial artery false aneurysm developed after removal of a radial arterial line; anatomic constraints precluded simple resection and ligation of the infected artery. The patient was successfully treated nonoperatively by compression bandaging, intravenous antifungals, and serial imaging. This case represents an alternative to standard management of a mycotic aneurysm and demonstrates the importance of an individualized approach to patient care.
September 2020: Journal of Vascular Surgery Cases and Innovative Techniques
Orlando López, Carlos Piñana, Laura Ludovica Gramegna, José Rodríguez, David Hernández, Alejandro Tomasello
Extracranial carotid artery dissection represents up to 22% of acute neurovascular disease in young patients. There are no specific guidelines regarding indication for endovascular management of carotid artery dissection with stenting and its complications. We describe three patients with carotid artery dissection and associated dissecting aneurysm who underwent endovascular stenting with the multilayer flow modulator. At 12-month follow-up, the dissecting aneurysms were resolved, and positive clinical outcome was achieved in all patients...
September 2020: Journal of Vascular Surgery Cases and Innovative Techniques
Stephen D Dingley, Timothy C Oskin, Jay B Fisher
We present the case of a 68-year-old man with a tibioperoneal trunk mycotic pseudoaneurysm, a rarity in the modern age of antibiotics. We describe the patient's hospitalizations and workups that ultimately led to this diagnosis and our management with open ligation without bypass. This case highlights the importance of combining a thorough history and physical examination with laboratory and imaging data while keeping in mind a broad differential diagnosis.
September 2020: Journal of Vascular Surgery Cases and Innovative Techniques
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