51
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Skinner RA. A case of unusual blunt peripheral artery injuries: The expanded use of CT and endovascular embolization. THE JOURNAL OF TRAUMA 2006; 61:1532-5; discussion 1535. [PMID: 17159701 DOI: 10.1097/01.ta.0000245971.69959.c3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Ruby A Skinner
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
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52
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Puapong D, Brown CVR, Katz M, Kasotakis G, Applebaum H, Salim A, Rhee P, Demetriades D. Angiography and the pediatric trauma patient: a 10-year review. J Pediatr Surg 2006; 41:1859-63. [PMID: 17101359 DOI: 10.1016/j.jpedsurg.2006.06.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND/PURPOSE Although interventional radiology has played an increasing role in the management of adult trauma patients, little has been written regarding its application in the care of the injured child. This study analyzed the indications, results, and complications for angiography in pediatric trauma patients. METHODS A retrospective review of pediatric patients (14 years or younger) admitted to Los Angeles County-University of Southern California Medical Center, Los Angeles, Calif (an urban level I trauma center), over a 10-year period (1993-2003) was performed. Patients who underwent angiography were identified using hospital angiography records, and further information was recorded from the trauma registry and medical records. Variables collected included age, sex, mechanism of injury, and injury severity score (ISS). Angiographic data analyzed included indications, results, therapeutic interventions, and procedure-related complications. RESULTS Twenty-five pediatric trauma patients who underwent angiography were identified (18 boys, 7 girls). The average age was 11 years (range, 1-14 years), with an ISS of 16 +/- 10. Indications for angiography included suspected limb ischemia (n = 9), suspected pelvic (n = 8) or solid organ bleeding (n = 8), suspected aortic injury (n = 6), and expanding hematoma (n = 1). Eleven patients (44%) had an abnormal finding, and 10 of 11 underwent a subsequent therapeutic intervention. There was 1 minor procedure-related complication and no procedure-related mortality. CONCLUSIONS Though used infrequently in pediatric trauma patients, the result of the angiography was abnormal in almost half of the children in this series. An abnormal finding prompted further therapeutic intervention in most cases. Angiography was associated with minimal morbidity and should be considered as a useful and safe adjunct when caring for injured children.
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Affiliation(s)
- Devin Puapong
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90033, USA
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53
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Krings T, Busch C, Sellhaus B, Drexler AY, Bovi M, Hermanns-Sachweh B, Scherer K, Gilsbach JM, Thron A, Hans FJ. Long-term histological and scanning electron microscopy results of endovascular and operative treatments of experimentally induced aneurysms in the rabbit. Neurosurgery 2006; 59:911-23; discussion 923-4. [PMID: 17038956 DOI: 10.1227/01.neu.0000232841.08876.da] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Treatment strategies of cerebral aneurysms include surgical clipping and endovascular therapies. To determine the long-term results of these therapeutic strategies, the vessel wall reaction close to the former aneurysm was studied according to the assumption that an intact endothelial layer over the former aneurysm neck constitutes complete vessel wall reconstruction and stable aneurysm obliteration. METHODS Aneurysms were created in 40 rabbits by intraluminal elastase incubation of the common carotid artery. Five animals each were assigned to the following groups: untreated, porous stents, polyurethane covered stentgrafts, porous stents with subsequent coiling. Ten animals were treated with coils alone, 10 with clips. After 6 months, angiography, histology, and scanning electron microscopy was performed. RESULTS Porous stents did not obliterate the aneurysm, whereas stentgrafts did; in-stent stenosis of up to 60% was present because of neointimal multilayer proliferation. After coiling, the aneurysm dome was occluded with fibrinous and collagenous material, whereas the aneurysm neck was not covered by an endothelial lining. Coil loops lay bare within the vessel, with fresh thrombus material on their surface. After clipping, a thin layer of endothelial lining bridging the two attached vessel walls was present, thereby completely obliterating the aneurysm and reconstructing the vessel wall. CONCLUSION This study demonstrates complete and stable aneurysm obliteration with vessel wall reconstruction after clipping, a sufficient obliteration of the aneurysm dome using endovascular techniques, but a failed healing response of the aneurysm neck that might correlate to its associated higher risk of rebleed. Whether or not this is counterbalanced by the better immediate outcome after endovascular treatment remains a matter of debate.
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Affiliation(s)
- Timo Krings
- Department of Neuroradiology,University Hospital, University of Technology, Aachen, Germany.
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54
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Tran HS, Burrows BJ, Zang WA, Han DC. Brachial arteriovenous fistula as a complication of placement of a peripherally inserted central venous catheter: a case report and review of the literature. Am Surg 2006; 72:833-6. [PMID: 16986396 DOI: 10.1177/000313480607200914] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Peripherally inserted central venous catheter (PICC) lines have become a frequently used method of intravenous access for long-term administration of antibiotics, chemotherapy, and parenteral nutrition. Catheter-related complications involving the arterial tree are rare. We report a case of a 25-year-old woman with a history of difficult PICC line placement that presented with an arteriovenous fistula in the left arm. Duplex ultrasound confirmed the diagnosis of a brachial artery-to-brachial vein arteriovenous fistula (AVF), and the patient underwent surgical repair. To our knowledge, this is the first reported case of an AVF resulting from PICC line placement. Correction of AVF is indicated to alleviate symptoms as well as to prevent future complications.
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Affiliation(s)
- Hoang S Tran
- Division of Vascular Surgery, Penn State College of Medicine, Penn State Hershey Medical Center, Pennsylvania 17033, USA
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55
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Piffaretti G, Tozzi M, Lomazzi C, Rivolta N, Laganà D, Carrafiello G, Caronno R, Castelli P. Stent-Graft Repair of Peroneal Arteriovenous Fistula. Cardiovasc Intervent Radiol 2006; 30:133-5. [PMID: 17031723 DOI: 10.1007/s00270-006-0097-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Arteriovenous fistulas (AVFs) are infrequently seen in the civilian health-care system; traditionally, these lesions have been treated with ligation, or direct surgical repair with concomitant revascularization. We describe a rare case of a peroneal AVF treated with a stent-graft.
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Affiliation(s)
- Gabriele Piffaretti
- Vascular Surgery, Department of Surgery, University of Insubria, Ospedale di Circolo, Varese, Italy.
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56
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Ben Omrane S, Kaouel K, Ziadi J, Elleuch N, Ben M'rad M, Kalfat T, Khayati A, Abid A. [Anastomotic false aneurysms after under-diaphragmatic bypasses: about 25 cases]. Ann Cardiol Angeiol (Paris) 2006; 55:294-9. [PMID: 17078269 DOI: 10.1016/j.ancard.2006.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The purpose of our study is to determine the causes and the management of anastomotic aneurysms. We report the cases of 25 patients with a mean age of 64 years at the time of initial surgical revascularisation. The mean interval between the first operation and the occurrence of anastomotic aneurysm is 5 years (range 2 months-11 years). The treatment consists on the interposition of a graft in 8 patients, anastomotic angioplasty in 9 patients and the reconstruction of the anastomosis in 8 patients. Hospital mortality was 20%. Late death occurs 3 patients and the long-term morbidity was evaluated at 22%. A recurrence of anastomotic false aneurysm occurred in 4 patients (16%) (Range 7 months-1 year). In conclusion anastomotic false aneurysm is one of the major complications of vascular reconstruction; careful follow-up can detect the rare instances of anastomotic aneurysm and reoperation can be accomplished with a low-rate of adverse outcome.
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Affiliation(s)
- S Ben Omrane
- Service de chirurgie cardiovasculaire, hôpital La-Rabta, 1007 Bab-Sâadoun-Jabbari, Tunis, Tunisie.
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57
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Saratzis N, Melas N, Saratzis A, Lioupis A, Lazaridis J, Ginis G, Ktenidis K, Kiskinis D. EndoFit Stent-Graft Repair of Isolated Common Iliac Artery Aneurysms With Short Necks. J Endovasc Ther 2006; 13:667-71. [PMID: 17042664 DOI: 10.1583/06-1858.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the feasibility and efficacy of repairing isolated iliac artery aneurysms with short proximal necks (<10 mm) by implanting the EndoFit stent-graft. METHODS Seven patients (6 men; median age 73 years, range 70-78) were diagnosed with an isolated common iliac artery (CIA) aneurysm that featured a short proximal landing zone, complicating endovascular treatment. The median aneurysm diameter was 4.4 cm (range 3.5-7.0), and the median proximal neck length was 7 mm (range 5-9).The aneurysms were treated using the EndoFit stent-graft, which can be deployed in a short proximal landing zone. The modified technique involves the deployment of the graft directly above the aneurysm sac without obstructing the contralateral iliac axis, thus affixing the bare proximal stent in the terminal aorta. Follow-up was performed by clinical evaluation and computed tomography at 1, 6, and 12 months postoperatively. RESULTS The EndoFit stent-graft was successfully deployed in all cases, with complete aneurysm exclusion. In 1 case, the deployment of a second cuff was necessary to secure complete aneurysm exclusion. The median follow-up was 18 months, during which no deaths occurred, and no endoleak or stent-graft migration was observed. Endograft thrombosis occurred in 1 case due to graft angulation caused by external iliac artery stenosis and kinking. None of the aneurysms has ruptured, and there have been no serious complications. CONCLUSION Direct endoluminal repair of isolated CIA aneurysms with short proximal necks is feasible using this technique. Efficacy and long-term results are to be confirmed by larger scale series over a long time period.
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Affiliation(s)
- Nikolaos Saratzis
- First Department of Surgery, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
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58
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Endovascular therapy in the emergent management of intractable hemorrhage associated with head and neck neoplasms. Oral Radiol 2006. [DOI: 10.1007/bf02493297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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59
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Giansante Abud D, Mounayer C, Saint-Maurice JP, Rezende MTS, Houdart E, Moret J. Stent-Grafts in the Management of Hemorrhagic Complications Related to Hemostatic Closure Devices: Report of Two Cases. Cardiovasc Intervent Radiol 2006; 30:104-7. [PMID: 16967224 DOI: 10.1007/s00270-005-0321-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We report 2 cases of hemorrhagic complications related to use of the Angio-Seal hemostatic closure device that were successfully managed with stent-grafts. Two patients with subarachnoid hemorrhage were referred to our departments for endovascular treatment of ruptured intracranial aneurysms. The treatment was performed through a femoral access; the sheaths were removed immediately after the procedures, and the punctures sites closed by Angio-Seals. Both patients presented clinical signs of hypovolemic shock after treatment. The diagnosis of active bleeding through the puncture site was made by emergency digital subtraction angiography. The lesions were managed with stent-grafts. The use of stent-grafts proved to be efficient in the management of these life-threatening hemorrhagic complications following the use of the Angio-Seal hemostatic closure device.
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Affiliation(s)
- Daniel Giansante Abud
- Department of Interventional Neuroradiology, Fondation Rothschild, 25-29 rue Manin, 75940 Paris Cedex 19, France
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60
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Post-traumatic peripheral arterial pseudoaneurysms: Our experience. Indian J Thorac Cardiovasc Surg 2006. [DOI: 10.1007/s12055-006-0755-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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61
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Silva EGDSE, Moreira RWDC, Arcenio Neto E, Silva CDC, Zurstrassen CE, Ribeiro FRCDM, Barros ODC, Burihan MC, Nasser F, Ingrund JC, Neser A. Tratamento endovascular de pseudo-aneurisma da artéria subclávia em criança hemofílica. J Vasc Bras 2006. [DOI: 10.1590/s1677-54492006000200013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O uso de cateteres venosos centrais em pacientes hemofílicos é muito freqüente, devido às próprias características terapêuticas da doença. As complicações desses procedimentos, tais como pseudo-aneurisma, geralmente são mais graves nesses pacientes. A correção cirúrgica do pseudo-aneurisma que acomete a artéria subclávia constitui um dos maiores desafios da cirurgia vascular. Em pacientes hemofílicos, à dificuldade habitual de exposição cirúrgica somam-se os problemas de alteração no processo normal de coagulação. Como alternativa ao tratamento cirúrgico convencional, a utilização de técnicas endovasculares constitui uma solução segura e com bons resultados.
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62
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Kapadia S, Parakh R, Grover T, Agarwal S, Yadav A. Endovascular covered stent for management of arterial pseudoaneurysms after central venous access. J Cardiothorac Vasc Anesth 2006; 21:99-102. [PMID: 17289491 DOI: 10.1053/j.jvca.2005.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2005] [Indexed: 11/11/2022]
MESH Headings
- Adult
- Aneurysm, False/diagnosis
- Aneurysm, False/surgery
- Aneurysm, False/therapy
- Carotid Artery Injuries/etiology
- Carotid Artery Injuries/surgery
- Carotid Artery, Common/diagnostic imaging
- Carotid Artery, Common/surgery
- Catheterization/methods
- Catheterization, Central Venous/adverse effects
- Contrast Media/administration & dosage
- Female
- Follow-Up Studies
- Humans
- Iatrogenic Disease
- Imaging, Three-Dimensional/methods
- Male
- Minimally Invasive Surgical Procedures/methods
- Postoperative Complications/diagnosis
- Postoperative Complications/surgery
- Postoperative Complications/therapy
- Radiographic Image Enhancement/methods
- Stents
- Subclavian Artery/diagnostic imaging
- Subclavian Artery/injuries
- Subclavian Artery/surgery
- Tomography, X-Ray Computed/methods
- Treatment Outcome
- Ultrasonography, Doppler, Color/methods
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Affiliation(s)
- Sumit Kapadia
- Department of Vascular and Endovascular Surgery, Sir Ganga Ram Hospital, New Delhi, India
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63
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Stahnke M, Duddy MJ. Endovascular Repair of a Traumatic Axillary Pseudoaneurysm Following Anterior Shoulder Dislocation. Cardiovasc Intervent Radiol 2005; 29:298-301. [PMID: 16283573 DOI: 10.1007/s00270-005-0071-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pseudoaneurysms due to musculoskeletal trauma are rare and comprise less than 2% of all pseudoaneurysms. We report a case of axillary pseudoaneurysm following anterior dislocation of the shoulder. The patient was successfully treated by endovascular intervention.
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Affiliation(s)
- Michaela Stahnke
- Department of Radiology, Selly Oak Hospital, University Hospital Birmingham Foundation Trust, Raddlebarn Road, Birmingham, B29 6JD, UK
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64
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Karigiannis M, Pavlidis G, Papageorgiou G, Feretis C, Stamou KM, Vlachopoulos P. Delayed Presentation of Ilio-Iliac Arteriovenous Fistula Following Laparoscopic Cholecystectomy Treated with Percutaneous Graft-Covered Stent Placement. J Laparoendosc Adv Surg Tech A 2005; 15:411-4. [PMID: 16108748 DOI: 10.1089/lap.2005.15.411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Major vascular injuries during laparoscopic cholecystectomy are rare, usually readily apparent, and immediately treated. We report a case of delayed presentation of a retroperitoneal vascular injury. The patient presented with abdominal pain and increasing edema of the lower extremities 1 year after laparoscopic cholecystectomy and was found to have an ilio-iliac arteriovenous fistula. Endovascular treatment was accomplished using a graft-covered polytetrafluoroethylene stent. The patient remained free of symptoms at 1-year follow-up.
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Affiliation(s)
- Michael Karigiannis
- Department of Interventional Neuroradiology, Athens Medical Center Hospital, Athens, Greece
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65
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Nemes B, Járányi Z, Bérczi V, Hüttl K, Acsády G. Stent-graft Treatment of Carotid Pseudoaneurysms: Case Report and Review of the Literature. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.ejvsextra.2005.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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66
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Joo JY, Ahn JY, Chung YS, Chung SS, Kim SH, Yoon PH, Kim OJ. Therapeutic Endovascular Treatments for Traumatic Carotid Artery Injuries. ACTA ACUST UNITED AC 2005; 58:1159-66. [PMID: 15995463 DOI: 10.1097/01.ta.0000171550.01402.ed] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The diagnosis and management of traumatic carotid vessel injuries continue to be controversial, with direct surgical repair with parent artery preservation still presenting difficulties. The purpose of this report is to review the endovascular therapy of patients with traumatic carotid vessel injuries for preservation of the parent artery, and to determine the safety and efficacy of endovascular therapy. METHODS Ten patients with traumatic carotid lesions were treated using therapeutic endovascular methods. Endovascular therapy was accomplished by implanting balloons, porous or polytetrafluoroethylene-covered stents, and/or embolic materials including coils or glue. RESULTS All fistulas and pseudoaneurysms were successfully embolized with no periprocedural complications including vessel disruption/rupture, distal embolization, or new neurologic deficits. The parent arteries of all patients except one were preserved. The reason for the parent artery sacrifice was a thrombus formation due to coil migration into the parent artery. No additional surgical procedures for vascular lesions were required. There were no delayed neurologic or vascular complications, and no lesions recurred during the follow-up periods (mean 20.3 months). CONCLUSION The goal of endovascular therapy is the selective elimination of the vascular pathology with the normal patency of the cerebral arteries. The authors' experience demonstrates that endovascular therapy using stents, balloons, and coils is both feasible and safe for treatment of traumatic carotid injuries. Of these endovascular methods, the stent can be used to exclude the aneurysm or fistula from the circulation and preserve the parent artery in selective cases. Long-term follow-up review of these repairs will be necessary to provide a full evaluation of the safety and efficacy of these devices.
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Affiliation(s)
- Jin Yang Joo
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, South Korea
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67
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Akiyama Y, Nakahara I, Tanaka M, Iwamuro Y, Hayashi J, Harada K, Fujimoto M. Urgent Endovascular Stent-Graft Placement for a Ruptured Traumatic Pseudoaneurysm of the Extracranial Carotid Artery. ACTA ACUST UNITED AC 2005; 58:624-7. [PMID: 15761362 DOI: 10.1097/01.ta.0000096662.79685.ea] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Yasuhiko Akiyama
- Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan.
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68
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Bates MC, Aburahma AF, Crotty B. Successful urgent endovascular surgery for symptomatic subclavian artery aneurysmal compression of the trachea. Catheter Cardiovasc Interv 2005; 64:291-5. [PMID: 15736257 DOI: 10.1002/ccd.20289] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The purpose of this study is to report the progress of a patient who entered the hospital with symptomatic tracheal compression from a large right subclavian artery aneurysm that was treated with a self-expanding stent graft. The patient was at increased risk for traditional surgery, thus endovascular isolation of the aneurysm was felt to be reasonable. A flexible self-expanding stent graft was placed via a brachial artery cutdown and common femoral access without complication. The symptoms improved and the patient remained asymptomatic at 2-year follow-up with serial CT scan confirmation of aneurysm regression. This unusual case illustrates that endovascular decompression of an aneurysm may have some benefit in alleviating subacute symptoms of extrinsic encroachment into other vital structures. Technical and clinical success was achieved with the stent graft deployment and this seems to be a reasonable alternative to surgery in such patients.
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Affiliation(s)
- Mark C Bates
- Cardiovascular Research Charleston Area Medical Center Research Institute, Charleston, West Virginia, USA.
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69
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Sahin S, Cinar B, Bilgin SN, Celik L, Eren EE. Surgical Repair of a Post-traumatic Arteriovenous Fistula Complicated by Stent-Graft Misplacement. Cardiovasc Intervent Radiol 2004; 28:87-9. [PMID: 15602639 DOI: 10.1007/s00270-004-0147-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
An arteriovenous fistula (AVF) is an abnormal connection between an artery and a vein which may result from a traumatic injury or occur as a congenital abnormality. It may be asymptomatic or may present with a variety of symptoms. Surgical or endovascular treatment can be preferred. We present a case of unsuccessful percutaneous treatment of a femoral AVF due to misplacement of the stent-grafts, necessitating surgical correction.
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Affiliation(s)
- Sinan Sahin
- Department of Radiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Istanbul, Turkey.
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70
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Self ML, Mangram A, Jefferson H, Slonim S, Dunn E, Kollmeyer K. Percutaneous Stent-Graft Repair of a Traumatic Common Carotid-Internal Jugular Fistula and Pseudoaneurysm in a Patient with Cervical Spine Fractures. ACTA ACUST UNITED AC 2004; 57:1331-4. [PMID: 15625471 DOI: 10.1097/01.ta.0000151256.20476.7e] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Michael L Self
- Departments of Surgery, Methodist Hospitals of Dallas, Dallas, Texas, USA
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71
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Ahn JY, Chung YS, Lee BH, Choi SW, Kim OJ. Stent-graft placement in a traumatic internal carotid-internal jugular fistula and pseudoaneurysm. J Clin Neurosci 2004; 11:636-9. [PMID: 15261238 DOI: 10.1016/j.jocn.2003.10.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2003] [Accepted: 10/22/2003] [Indexed: 11/23/2022]
Abstract
Traumatic arteriovenous fistulas following carotid artery injuries are rare. Treatment of carotid artery-to-jugular vein fistula requires direct closure of the fistula or occlusion of the carotid artery above and below the level of the fistula, by a surgical or endovascular approach. A 32-year-old man presented with a right-sided pulsatile neck swelling 2 days following a stab wound. Neck computed tomography demonstrated a vascular mass protruding into the anterior neck. Digital subtraction arteriography demonstrated a bilobular large internal carotid artery pseudoaneurysm just distal to its bifurcation. There was simultaneous opacification of a dilated left internal jugular vein indicating a high-flow internal carotid-internal jugular fistula. A balloon-expandable stent-graft was delivered and successfully positioned across the fistula. The arteriovenous fistula and pseudoaneurysm completely disappeared and the right internal carotid artery was well preserved. The stent-graft is a promising technology to obliterate fistulae and preserve the parent artery with relative safety.
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Affiliation(s)
- Jung Yong Ahn
- Department of Neurosurgery, Pundang CHA Hospital, Pochon CHA University, Yatap-dong, Pundang-gu, Sungnam, South Korea.
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73
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Nishi S, Nakayama Y, Ishibashi-Ueda H, Matsuda T. Occlusion of Experimental Aneurysms with Heparin-loaded, Microporous Stent Grafts. Neurosurgery 2003; 53:1397-404; discussion 1404-5. [PMID: 14633306 DOI: 10.1227/01.neu.0000093427.89827.12] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE An embolization technique using a stent graft has been developed to replace the conventional type of direct surgery or neurointervention with platinum coils and/or bare stents. The utility of a commercially available metal stent wrapped with a microporous elastomeric film coated with a thin, heparin-loaded, photocured gelatinous layer for the treatment of experimental carotid artery sidewall aneurysms in dogs was evaluated. METHODS The stent graft was used for embolization of experimental carotid artery aneurysms in dogs. The aneurysms were prepared bilaterally in canine carotid arteries with branching of an external jugular vein patch. RESULTS The entries into all of the aneurysms were occluded immediately after placement of the stent grafts, and the aneurysms were embolized by thrombus formation even 1 week after deployment. All of the parent carotid arteries in which stent grafts were placed were patent, without severe stenosis, immediately (n = 2), 1 week (n = 4), 1 month (n = 3), and 3 months (n = 4) after placement. Scanning electron microscopy demonstrated that the luminal surfaces of the stent grafts were entirely endothelialized as soon as 1 week after placement, via transmural tissue ingrowth through the micropores formed in the covering film. CONCLUSION The stent graft we have developed seems to be highly promising for the treatment of aneurysms, especially with respect to immediate termination of blood inflow for aneurysm occlusion and rapid endothelialization in the aneurysm neck.
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Affiliation(s)
- Shogo Nishi
- Department of Neurosurgery, Takatsuki Red Cross Hospital, Osaka, Japan.
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74
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Mofid R, Otal P, Boyer L, Ravel A, Garcier JM, Rousseau H. Common iliac aneurysms with short or absent proximal necks: endoluminal repair with a covered endoprosthesis. Eur J Vasc Endovasc Surg 2003; 26:334-6. [PMID: 14509901 DOI: 10.1053/ejvs.2002.1901] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- R Mofid
- CHU Gabriel Montpied, Service de Radiologie, Clermont-Ferrand, France
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75
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Gawenda M, Zaehringer M, Brunkwall J. Open Versus Endovascular Repair of Para-Anastomotic Aneurysms in Patients Who Were Morphological Candidates for Endovascular Treatment. J Endovasc Ther 2003. [DOI: 10.1583/1545-1550(2003)010<0745:overop>2.0.co;2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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76
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Sadato A, Satow T, Ishii A, Takayama M, Hashimoto N. Large vertebral arteriovenous fistula treated with stent-grafts--case report. Neurol Med Chir (Tokyo) 2003; 43:250-4. [PMID: 12790285 DOI: 10.2176/nmc.43.250] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 24-year-old woman presented with neck bruit and thrill. Neurological examination revealed no focal abnormality. Angiography and magnetic resonance imaging showed an arteriovenous fistula (AVF) at the C4-5 levels of the right vertebral artery (VA). The fistula had a single orifice that drained into the epidural veins via the C4-5 intervertebral foramen. A stent-graft was made of a 3.9 cm balloon-expandable stent and an expandable polytetrafluoroethylene graft sutured outside the stent. The stent-graft was advanced through the femoral artery up to the VA but did not pass far enough distally to seal the entire fistula because of the high friction between the bulky device and the small vessel. Another 2 cm stent-graft was delivered and successfully positioned across the fistula. The AVF completely disappeared and the right VA was well preserved. Follow-up angiography at 3 weeks and 5 months after the treatment showed no fistula and no stenosis inside the stent-grafts. Stent-grafts are useful to treat AVF with a large orifice. The stent-graft is a promising technology to treat neurovascular diseases, although improvement is required for use in smaller vessels.
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Affiliation(s)
- Akiyo Sadato
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Shogoin, Kyoto, Japan.
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77
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Gaxotte V, Laurens B, Haulon S, Lions C, Mounier-Véhier C, Beregi JP. Multicenter trial of the Jostent balloon-expandable stent-graft in renal and iliac artery lesions. J Endovasc Ther 2003; 10:361-5. [PMID: 12877624 DOI: 10.1177/152660280301000231] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To report the results of a multicenter feasibility study of the Jostent balloon-expandable stent-graft in the treatment of renal and iliac artery lesions. METHODS Twenty-three patients (17 men; mean age 62 years, range 38-80) with lesions in the renal (n=12) or iliac arteries (n=12) were enrolled in 6 centers over a 1-year period. Preprocedural computed tomography (CT) and angiography were performed in all patients. The Jostent device was implanted in the 24 arteries to treat 11 in-stent stenoses, 2 arterial ruptures, 2 aneurysms, 2 dissections, 2 ulcerated stenoses, and 5 chronic occlusions. Follow-up included color duplex ultrasound examination on the day after the procedure and at 6 months; patients with renal artery stent-grafts were also evaluated with CT angiography. RESULTS Twenty-seven stent-grafts were deployed successfully in the 24 (100%) arteries. Seven (30%) patients required adjunctive procedures to address 1 acute in-stent thrombosis, 2 dissections, and 4 in-stent residual stenoses. At 6-month follow-up, 2 (8.3%) restenoses occurred in the renal arteries; these were treated successfully using balloon angioplasty. CONCLUSIONS These data suggest that a balloon-expandable stent-graft may be safe and useful in patients with selected peripheral indications.
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Affiliation(s)
- Virginia Gaxotte
- Department of Vascular Radiology, Hôpital Cardiologique, CHRU de Lille, France
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78
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Gaxotte V, Laurens B, Haulon S, Lions C, Mounier-Véhier C, Beregi JP. Multicenter Trial of the Jostent Balloon-Expandable Stent-Graft in Renal and Iliac Artery Lesions. J Endovasc Ther 2003. [DOI: 10.1583/1545-1550(2003)010<0361:mtotjb>2.0.co;2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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79
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Schoder M, Cejna M, Hölzenbein T, Bischof G, Lomoschitz F, Funovics M, Nöbauer-Huhmann I, Sulzbacher I, Lammer J. Elective and emergent endovascular treatment of subclavian artery aneurysms and injuries. J Endovasc Ther 2003; 10:58-65. [PMID: 12751932 DOI: 10.1177/152660280301000113] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To demonstrate our short and long-term results after transbrachial treatment of subclavian artery aneurysms and injuries with stent-grafts in elective and emergency settings. METHODS Ten of 12 consecutive patients (6 men; mean age 63.8 years, range 38-80) were treated electively with commercially prepared endografts delivered via a transbrachial access to repair a subclavian artery aneurysm (n=3) or an injury from a misplaced central venous catheter (n=7). Two patients required emergency treatment for a ruptured atherosclerotic aneurysm in one and an unintentional arterial puncture during placement of a central venous access in the other. Stent-graft patency during follow-up was assessed by physical examination with comparison of brachial blood pressures in all patients; computed tomography angiography (CTA) was performed in available patients. RESULTS Successful deployment of stent-grafts with sealing of the lesion was achieved in all cases. There were 2 (17%) procedural complications. One patient developed an access-site hematoma that required surgical revision. The second patient, who had a right subclavian injury, suffered an embolic cerebral infarction. The primary stent-graft patency during follow-up (mean 11.6 months) was 100%. CTA examinations in 7 patients at a mean 18 months showed strut dislocation at the thoracic outlet without luminal narrowing in 1 patient. A 50% intraluminal narrowing due to compression between the clavicle and the first rib occurred in another patient. Six patients with a mean follow-up of 23 months (range 0.3-4.5 years) are still alive with patent stent-grafts. CONCLUSIONS Endovascular stent-graft treatment of subclavian artery aneurysms and injuries is a less invasive alternative to surgical repair. Long-term results must still be confirmed in further studies.
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Affiliation(s)
- Maria Schoder
- Department of Angiography and Interventional Radiology, University of Vienna, Austria.
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80
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Schoder M, Cejna M, Hölzenbein T, Bischof G, Lomoschitz F, Funovics M, Nöbauer-Huhmann I, Sulzbacher I, Lammer J. Elective and Emergent Endovascular Treatment of Subclavian Artery Aneurysms and Injuries. J Endovasc Ther 2003. [DOI: 10.1583/1545-1550(2003)010<0058:eaeeto>2.0.co;2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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81
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Murthy R, Arbabzadeh M, Richard H, Levitin A, Lund G, Stainken B, Cooper C. Axillary artery traumatic pseudoaneurysm managed with a Wallgraft Endoprothesis. J Vasc Interv Radiol 2003; 14:117-8. [PMID: 12525598 DOI: 10.1016/s1051-0443(07)60100-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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82
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Lin PH, Johnson CK, Pullium JK, Koffron AJ, Conklin B, Terramani TT, Bush R, Chen C, Lumsden AB. Transluminal stent graft repair with Wallgraft endoprosthesis in a porcine arteriovenous graft pseudoaneurysm model. J Vasc Surg 2003; 37:175-81. [PMID: 12514597 DOI: 10.1067/mva.2002.87] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Pseudoaneurysm is a known complication of arteriovenous grafts in chronic hemodialysis and can result in graft disruption or thrombosis if left untreated. This study evaluated the safety and efficacy of endovascular repair with Wallgraft endoprosthesis (Boston Scientific, Inc, Watertown, Mass) in a porcine arteriovenous graft (AVG) pseudoaneurysm model. MATERIALS AND METHODS Bilateral groin AVG pseudoaneurysms (n = 18) were created with an oversized Dacron interposition graft within a polytetrafluoroethylene femoral AVG in nine domestic swine and allowed to mature 28 +/- 4 days (standard deviation). Transluminal placement of Wallgraft was performed to exclude the pseudoaneurysm from the AVG circulation. Hemodialysis was performed (400 mL/min x 1 hour, with intravenous heparin 30 units/kg) every 4 days for a total of 6 weeks via 15-gauge needles in the treated AVG pseudoaneurysm site. Arteriography and duplex ultrasound scan were performed to determine AVG patency and pseudoaneurysm flow. Histologic evaluation was performed to determine Wallgraft morphology. In vitro pulsatile flow chamber was used to determine maximal flow volume without peri-Wallgraft endoleak. RESULTS All AVG pseudoaneurysms were successfully excluded with the Wallgrafts. Twelve AVG (67%) remained patent at the completion of the study. No Wallgraft migration occurred from hemodialysis. Transient peri-Wallgraft endoleak (<2 hours after hemodialysis) was present in 13 of 18 (72%) and four of 12 (33%) AVG pseudoaneurysms by weeks 1 and 6, respectively. With maintenance of an intraluminal pressure of 80, 100, 120, 140, and 160 mm Hg in the pulsatile flow chamber, the maximal flow rates without peri-Wallgraft endoleak were 625 +/- 120, 650 +/- 145, 620 +/- 95, 425 +/- 110, and 262 +/- 86 mL/min. Scanning electron microscopy showed a neointimal layer covered with thrombus on the Wallgraft surface. CONCLUSION Endoluminal placement of Wallgraft endoprosthesis provides adequate structural support for continuous hemodialysis after AVG pseudoaneurysm exclusion. Transient blood flow in the pseudoaneurysm cavity may occur immediately after the hemodialysis, which may represent the effect of heparin used during hemodialysis. This study suggests Wallgraft is a safe and effective treatment for AVG pseudoaneurysm and permits continuous hemodialysis.
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Affiliation(s)
- Peter H Lin
- Division of Vascular Surgery & Endovascular Therapy, the Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston VAMC (112), 2002 Holcomb Blvd, Houston, TX 77030, USA.
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83
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Najibi S, Bush RL, Terramani TT, Chaikof EL, Gunnoud AB, Lumsden AB, Weiss VJ. Covered stent exclusion of dialysis access pseudoaneurysms. J Surg Res 2002; 106:15-9. [PMID: 12127802 DOI: 10.1006/jsre.2002.6389] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The traditional repair of hemodialysis graft pseudoaneurysms has been to surgically replace that segment of involved PTFE graft material or autogenous vein. We report a novel approach to these lesions, employing a covered stent (Wallgraft) for exclusion of arteriovenous graft (AVG) and arteriovenous fistula (AVF) pseudoaneurysms. METHODS Ten patients with AVG or AVF pseudoaneurysms were treated endoluminally by covered stent exclusion. Wallgraft implantations were performed in the operating room with interventional capabilities under local anesthesia through a percutaneous access. Follow-up included physical examination at 2 weeks and duplex ultrasound of AVG/ AVF at 6 months after surgery. RESULTS Ten patients with pseudoaneurysmal degeneration of their AVG/AVF were identified. The mean diameter of the pseudoaneurysmal segment was 3 cm (range, 1.5-5 cm). Immediately following covered stent implantation all the patients had palpable pulses in the pseudoaneurysms despite adequate coverage by angiography. At the 2-week follow-up visit all had lost the palpable pseudoaneurysm pulsation while the AVGs remained functional in nine patients. One patient had early thrombosis of the AVG. The follow-up duplex scans at 6 months showed complete exclusion of the pseudoaneurysms in seven patients. Two patients had thrombosis of their dialysis access, at 3 weeks (n = 1) and 3 months (n = 1) post-implantation. CONCLUSION Endovascular covered stent exclusion of AV dialysis access pseudoaneurysms is safe and technically feasible in eliminating flow through dialysis access pseudoaneurysms and represents a novel and simple approach to this common problem, prolonging the functional life of the access site.
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Affiliation(s)
- Sasan Najibi
- Division of Vascular Surgery, Joseph B. Whitehead Department of Surgery, Emory University School of Medicine and Emory University Hospital, Atlanta, GA 30322, USA
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84
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Patel JV, Rossbach MM, Cleveland TJ, Gaines PA, Beard JD. Endovascular stent-graft repair of traumatic carotid artery pseudoaneurysm. Clin Radiol 2002; 57:308-11. [PMID: 12014879 DOI: 10.1053/crad.2001.0808] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jai V Patel
- The Sheffield Vascular Institute, Northern General Hospital, Sheffield, UK.
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85
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Affiliation(s)
- E Card
- Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA
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86
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Redekop G, Marotta T, Weill A. Treatment of traumatic aneurysms and arteriovenous fistulas of the skull base by using endovascular stents. J Neurosurg 2001; 95:412-9. [PMID: 11565861 DOI: 10.3171/jns.2001.95.3.0412] [Citation(s) in RCA: 130] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The authors describe their preliminary clinical experience with the use of endovascular stents in the treatment of traumatic vascular lesions of the skull base region. Because adequate distal exposure and direct surgical repair of these lesions are not often possible, conventional treatment has been deliberate arterial occlusion. The purpose of this report is to demonstrate the safety and efficacy as well as limitations of endovascular stent placement in the management of craniocervical arterial injuries. METHODS Six patients with vascular injuries were treated using endovascular stents. There were two arteriovenous fistulas and two pseudoaneurysms of the distal extracranial internal carotid or vertebral arteries resulting from penetrating trauma, and two petrous carotid pseudoaneurysms associated with basal skull fractures. In one patient a porous stent placement procedure was undertaken as well as coil occlusion of an aneurysm, whereas in the remaining five patients covered stent grafts were used as definitive treatment. There were no procedural complications. One patient in whom there was extensive traumatic arterial dissection was found to have asymptomatic stent thrombosis when angiography was repeated 1 week postoperatively. This was the only patient whose associated injuries precluded routine antithrombotic or antiplatelet therapy. Follow-up examinations in the remaining five patients included standard angiography (four patients) or computerized tomography angiography (one patient), which were performed 3 to 6 months postoperatively, and clinical assessments ranging from 3 months to 1 year in duration (mean 9 months). In all five cases the vascular injury was successfully treated and the parent artery remained widely patent. No patient experienced aneurysm recurrence or hemorrhage, and there were no thromboembolic complications. CONCLUSIONS The authors' experience demonstrates that endovascular treatment of traumatic vascular lesions of the skull base region is both feasible and safe. The advantages of minimally invasive stent placement and parent artery preservation make this procedure for repair of neurovascular injuries a potentially important addition to existing methods.
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Affiliation(s)
- G Redekop
- Department of Neurosurgery, The University of British Columbia, Vancouver, Canada
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87
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Sigler L, Gutiérrez-Carreño R, Martínez-López C, Lizola RI, Sánchez-Fabela C. Aortocava fistula: experience with five patients. VASCULAR SURGERY 2001; 35:207-12. [PMID: 11452347 DOI: 10.1177/153857440103500308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Combined injuries of the aorta and inferior vena cava are rare. Mortality is over 70%, primarily from exsanguinating hemorrhage. Post-traumatic aortocava fistula can develop in survivors, who present in the postoperative period with manifestations of high output heart failure. This is a retrospective review of five male patients, age from 9 to 39 years, with aortocava fistulas that were referred with congestive heart failure, 2 days to 6 months after abdominal penetrating injuries. They had undergone surgery at another hospital and several organ injuries were treated. Retroperitoneal hematomas were not seen or were seen and left undisturbed. Four patients received a gunshot injury, had the fistula at the infrarenal level, and survived surgical repair. In one of the survivors, a left popliteal artery bullet embolism also occurred and was treated. Another patient sustained a thoracoabdominal stab injury and an aortocava fistula developed at the suprarenal level; he was in severe congestive heart failure and died during surgery. There are very few reports on this sequelae of vascular injuries at the abdominal level. Patients with aortic and cava injuries have a high mortality rate and arteriovenous fistula may develop with communicating pseudoaneurysms. If high output heart failure develops in a patient with a history of abdominal penetrating injury, an arteriovenous fistula must be suspected and arteriography will disclose the location of the fistula. Surgical treatment is necessary to prevent further heart damage. In the future endovascular procedures may have a role in the management of these difficult conditions.
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Affiliation(s)
- L Sigler
- Vascular Service and Surgical Division, Hospital de Especialidades, Centro Médico Nacional Siglo XXI del IMSS, Mexico City, Mexico.
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88
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Ino T, Yazawa K, Kawamura S, Takeoka M, Yashiro N. Secondary arteriovenous fistula after a single arterial puncture. Pediatr Int 2001; 43:179-80. [PMID: 11285075 DOI: 10.1046/j.1442-200x.2001.01357.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- T Ino
- Department of Pediatrics, Kameda Medical Center, Chiba, Japan.
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89
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Lyden SP, Srivastava SD, Waldman DL, Green RM. Common iliac artery dissection after blunt trauma: case report of endovascular repair and literature review. THE JOURNAL OF TRAUMA 2001; 50:339-42. [PMID: 11242303 DOI: 10.1097/00005373-200102000-00024] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- S P Lyden
- Division of Vascular Surgery and Interventional Radiology, The University of Rochester, Rochester, NY 14642, USA.
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90
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Kumins NH, Tober JC, Love CJ, Culbertson TA, Gerhardt MA, Irwin RJ, Smead WL. Arteriovenous fistulae complicating cardiac pacemaker lead extraction: recognition, evaluation, and management. J Vasc Surg 2000; 32:1225-8. [PMID: 11107098 DOI: 10.1067/mva.2000.107994] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Transvenous pacemaker lead extraction has become a commonly performed procedure that is associated with a small but significant risk. We report two cases where lead extraction was complicated by arteriovenous fistulae between branches of the aortic arch and the left brachiocephalic vein. Presenting signs and symptoms included severe chest or back pain, persistent or copious bleeding from the venous puncture site, unexplained hypotension or anemia, superior vena cava syndrome, and signs of central venous hypertension or acute heart failure. One patient whose injury was not recognized immediately and who did not undergo repair died rapidly, whereas the other patient who was diagnosed quickly underwent successful repair. Immediate diagnosis with arteriography and rapid intervention with surgery or percutaneous techniques are indicated and may prevent mortality.
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Affiliation(s)
- N H Kumins
- Department of Surgery, Division of Vascular Surgery, Ohio State University Medical Center, Columbus, OH 43210, USA
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91
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Brountzos EN, Malagari K, Gougoulakis A, Argentos S, Alexopoulou E, Kelekis A, Kelekis DA. Common femoral artery anastomotic pseudoaneurysm: endovascular treatment with hemobahn stent-grafts. J Vasc Interv Radiol 2000; 11:1179-83. [PMID: 11041475 DOI: 10.1016/s1051-0443(07)61360-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- E N Brountzos
- Second Department of Radiology, Eugenidion Hospital, Medical School, Athens University, Greece.
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92
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Grabs AJ, Irvine CD, Lusby RJ. Stent-graft treatment for bleeding from a presumed aortoenteric fistula. J Endovasc Ther 2000; 7:236-9. [PMID: 10883962 DOI: 10.1177/152660280000700311] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To describe a technique for the endovascular treatment of aortoenteric fistula. METHODS AND RESULTS A 67-year-old man who had undergone aortobi-iliac grafting for aneurysmal disease 8 years previously presented with life-threatening upper gastrointestinal hemorrhage. Endoscopy after resuscitation did not identify the source of the bleeding. Computed tomographic (CT) scanning and angiography revealed pseudoaneurysm formation at the upper anastomosis 1 cm below the renal arteries. Measurements were taken for endovascular repair. Uncomplicated emergency aortic endografting for exclusion of the pseudoaneurysm was performed using a 28-mm x 3.75-cm AneuRx device. Gastrointestinal hemorrhage ceased. CT scanning at 6 months confirmed the absence of a pseudoaneurysm, and the patient remains symptom free at 18 months. CONCLUSIONS Endovascular treatment of aortoenteric fistula may represent a technique for treating gastrointestinal hemorrhage and for lessening the morbidity and mortality of open repair.
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Affiliation(s)
- A J Grabs
- Department of Vascular Surgery, Concord Hospital, Sydney, Australia.
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93
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94
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Hilfiker PR, Razavi MK, Kee ST, Sze DY, Semba CP, Dake MD. Stent-graft therapy for subclavian artery aneurysms and fistulas: single-center mid-term results. J Vasc Interv Radiol 2000; 11:578-84. [PMID: 10834488 DOI: 10.1016/s1051-0443(07)61609-1] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate the potential of covered stents to replace surgery in the treatment of subclavian artery aneurysms and traumatic injuries. MATERIALS AND METHODS Nine patients (five men, four women; age range, 20-83 years; mean, 54 years) with subclavian artery aneurysms (n = 5) or fistulas (n = 4) were treated with stent-grafts. All devices used were custom-made, consisting of polytetrafluoroethylene (PTFE)-covered Palmaz (n = 5), Wallstent (n = 2), Z stents (n = 8), or a polyester-covered Z stent (n = 1). One patient was lost to follow-up after 2 months. All others were followed up with clinical evaluation, computed tomography (CT), and/or ultrasound. RESULTS All devices were deployed successfully with exclusion of the aneurysms and fistulas. There were two procedure-related complications (22%), consisting of groin pseudoaneurysms requiring surgical repair 3 and 9 days after the procedure. One of those patients required additional oral antibiotic therapy for a postsurgical groin wound infection. One patient developed a stenosis at 12 months, which required angioplasty. The stent-graft thrombosed in one patient because of a kink 2 months after placement, which was successfully treated by thrombolysis and placement of a Wallstent. The primary and secondary patencies are 89% and 100%, respectively, after a mean follow-up of 29 months (2-66 mo). CONCLUSION Mid-term results of stent-graft therapy of subclavian artery aneurysms and fistulas are encouraging, with low morbidity and excellent clinical outcome.
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Affiliation(s)
- P R Hilfiker
- Department of Cardiovascular and Interventional Radiology, Stanford University, California, USA
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95
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Phatouros CC, Higashida RT, Malek AM, Meyers PM, Lefler JE, Dowd CF, Halbach VV. Endovascular Treatment of Noncarotid Extracranial Cerebrovascular Disease. Neurosurg Clin N Am 2000. [DOI: 10.1016/s1042-3680(18)30136-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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96
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Khougeer G, Bayoumi AH. Difficult femoral arteriovenous fistula in a child. Ann Saudi Med 2000; 20:150-2. [PMID: 17322716 DOI: 10.5144/0256-4947.2000.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- G Khougeer
- Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Umscheid T, Stelter WJ. Endovascular treatment of an aortic aneurysm ruptured into the inferior vena cava. J Endovasc Ther 2000; 7:31-5. [PMID: 10772746 DOI: 10.1177/152660280000700105] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To report the endovascular repair of a rare abdominal aortic aneurysm (AAA) rupture into the inferior vena cava. METHODS AND RESULTS A 74-year-old man with a 6.0-cm saccular aortic aneurysm and a previously undiagnosed aortocaval fistula of more than 2 weeks' duration was treated successfully with a Vanguard bifurcated stent-graft. The aneurysm was excluded and no endoleak or communication between the aorta and inferior vena cava was seen on computed tomographic imaging at the 6-month evaluation. CONCLUSIONS Aortic endografting in this life-threatening complication is an effective treatment option that avoids the significant blood loss encountered in conventional repair.
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Affiliation(s)
- T Umscheid
- Städtische Kliniken Frankfurt-Höchst, Frankfurt, Germany.
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Malone A, Ingledew N, Cheshire N, Al-Kutoubi A, Stansby G. Endovascular repair of an iatrogenic left common carotid to innominate vein fistula. Eur J Vasc Endovasc Surg 1999; 18:532-3. [PMID: 10637153 DOI: 10.1053/ejvs.1999.0928] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A Malone
- Academic Surgical Unit, St. Mary's Hospital, Imperial College, London, UK
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