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Xu Y, Zhu T, Chen G, Wu S, Li X. A combined endovascular and open repair of innominate artery bifurcation pseudoaneurysm: a case report. BMC Cardiovasc Disord 2024; 24:369. [PMID: 39020283 PMCID: PMC11253463 DOI: 10.1186/s12872-024-04043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 07/11/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Innominate artery aneurysms (IAAs) are rare and may result in rupture, distal arterial embolization, or local compression without timely treatment. Rupture is the most dangerous of these complications. This article reports a case of innominate artery bifurcation pseudoaneurysm. CASE PRESENTATION The patient was a 45-year-old man who was admitted to the emergency department due to chest discomfort. The computed tomographic angiography (CTA) imaging indicated the presence of a 3.6*2.4 cm saccular aneurysm in the bifurcation of the innominate artery, involving both the right proximal subclavian and common carotid arteries. The patient's vital signs were normal, there was equal blood pressure in the upper arms and no neurological dysfunction was observed. Gadolinium-enhanced magnetic resonance angiography indicated that the circle of Willis was intact. The treatment involved open surgery combined with endovascular therapy. The external carotid artery was first transposed to the right subclavian artery (RSA) and an 8-mm woven Dacron graft was inserted in the middle. The covered stent graft was then placed in the proximal part of the innominate artery to close the entrance of the aneurysm. Lastly, an occluder was implanted at the origin of the RSA. There were no perioperative or postoperative complications. At 1-year follow-up, no aneurysm was observed on CTA and the right vertebral artery was patent. CONCLUSIONS This study indicated that the combined use of endovascular therapy and open repair surgery is an effective strategy to treat innominate artery bifurcation pseudoaneurysm.
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Affiliation(s)
- Youyao Xu
- Department of Cardiovascular Surgery, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No. 100 Minjiang Avenue, Quzhou City, 324000, Zhejiang Province, PR China
| | - Tao Zhu
- Department of Cardiovascular Surgery, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No. 100 Minjiang Avenue, Quzhou City, 324000, Zhejiang Province, PR China
| | - Guobin Chen
- Department of Cardiovascular Surgery, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No. 100 Minjiang Avenue, Quzhou City, 324000, Zhejiang Province, PR China
| | - Senyan Wu
- Department of Cardiovascular Surgery, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No. 100 Minjiang Avenue, Quzhou City, 324000, Zhejiang Province, PR China
| | - Xiaoyang Li
- Department of Cardiovascular Surgery, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No. 100 Minjiang Avenue, Quzhou City, 324000, Zhejiang Province, PR China.
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Al Tannir AH, Biesboer EA, Pokrzywa C, Golestani S, Kukushliev V, Jean X, Harding E, de Moya MA, Morris R, Kugler N, Schellenberg M, Murphy PB. Open versus endovascular repair of penetrating non-aortic arterial injuries: A systematic review and meta analysis. Injury 2024; 55:111368. [PMID: 38309083 DOI: 10.1016/j.injury.2024.111368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Non-aortic arterial injuries are common and are associated with high morbidity and mortality. Historically, open surgical repair (OSR) was the conventional method of repair. With recent advancements in minimally invasive techniques, endovascular repair (ER) has gained popularity. We sought to compare outcomes in patients undergoing endovascular and open repairs of traumatic non-aortic penetrating arterial injuries. METHODS A systematic review and meta-analysis was conducted using MEDLINE (OVID), Web of Science, Cochrane Library, and Scopus Database from January 1st, 1990, to March 20th, 2023. Titles and abstracts were screened, followed by full text review. Articles assessing clinically important outcomes between OSR and ER in penetrating arterial injuries were included. Exclusion criteria included blunt injuries, aortic injuries, pediatric populations, review articles, and non-English articles. Odds ratios (OR) and Cohen's d ratios were used to quantify differences in morbidity and mortality. RESULTS A total of 3770 articles were identified, of which 8 met inclusion criteria and were included in the review. The articles comprised a total of 8369 patients of whom 90 % were male with a median age of 28 years. 85 % of patients were treated with OSR while 15 % underwent ER. With regards to injury characteristics, those who underwent ER were less likely to present with concurrent venous injuries (OR: 0.41; 95 %CI: 0.18, 0.94; p = 0.03). Regarding hospital outcomes, patients who underwent ER had a lower likelihood of in-hospital or 30-day mortality (OR: 0.72; 95 %CI: 0.55, 0.95; p = 0.02) and compartment syndrome (OR: 0.29, 95 %CI: 0.12, 0.71; p = 0.007). The overall risk of bias was moderate. CONCLUSION Endovascular repair of non-aortic penetrating arterial injuries is increasingly common, however open repair remains the most common approach. Compared to ER, OSR was associated with higher odds of compartment syndrome and mortality. Further prospective research is warranted to determine the patient populations and injury patterns that most significantly benefit from an endovascular approach. LEVEL OF EVIDENCE Level III, Systematic Reviews & Meta-Analyses.
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Affiliation(s)
- Abdul Hafiz Al Tannir
- Department of Surgery, Division of Trauma & Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Elise A Biesboer
- Department of Surgery, Division of Trauma & Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Courtney Pokrzywa
- Department of Surgery, Division of Trauma & Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Simin Golestani
- Department of Surgery, Division of Trauma & Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Vasil Kukushliev
- Department of Surgery, Division of Trauma & Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Xavier Jean
- Department of Surgery, Division of Trauma & Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Eric Harding
- Department of Surgery, Division of Trauma & Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Marc A de Moya
- Department of Surgery, Division of Trauma & Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rachel Morris
- Department of Surgery, Division of Trauma & Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Nathan Kugler
- Department of Surgery, Division of Vascular & Endovascular Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Morgan Schellenberg
- Department of Surgery, Division of Acute Care Surgery, University of Southern California, Los Angeles, CA, USA
| | - Patrick B Murphy
- Department of Surgery, Division of Trauma & Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
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Kania T, Kimyaghalam A, Scarsella J, Guerges M, Breier Y, Deitch J, Malekpour F, Schor J, Singh K. Supra-Aortic Arterial Injuries Following Central Venous Catheterization Managed with Percutaneous Closure Devices: A Comprehensive Literature Review of Current Evidence. Ann Vasc Surg 2023; 96:301-307. [PMID: 37169251 DOI: 10.1016/j.avsg.2023.04.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 04/02/2023] [Accepted: 04/30/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Inadvertent supra-aortic arterial injuries during central venous catheterization can lead to devastating outcomes. These have been traditionally been managed with open repair or covered stent placement; only recently have percutaneous closure been incorporated into the management of these iatrogenic arterial injuries. METHODS We performed a MEDLINE literature search in the English language, using the PubMed web-based search engine across years 2000 to 2020. This report reviews 34 published case reports and series reporting 71 iatrogenic supra-aortic arterial injuries managed with percutaneous vascular closure devices. RESULTS In our review, the use of a closure device was successful in 87% of cases, even in some cases involving sheath sizes greater than 8F. The devices used in these situations caused minimal complications and offered a quick means to control bleeding. Thus, percutaneous closure devices are a helpful tool that offers an alternative to more invasive open surgical repair. CONCLUSIONS Vascular closure devices offer a minimally invasive and effective approach to the treatment of inadvertent supra-aortic arterial injury following CVC.
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Affiliation(s)
- Thomas Kania
- Staten Island University Hospital, Staten Island, NY.
| | | | | | - Mina Guerges
- Staten Island University Hospital, Staten Island, NY
| | - Yuli Breier
- Touro College of Osteopathic Medicine, New York, NY
| | | | | | | | - Kuldeep Singh
- Staten Island University Hospital, Staten Island, NY
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Balakrishnan S. CT angiography of non-aortic thoracic arterial trauma. Emerg Radiol 2023; 30:667-681. [PMID: 37704920 DOI: 10.1007/s10140-023-02170-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/28/2023] [Indexed: 09/15/2023]
Abstract
While aortic injury is the most commonly cited thoracic arterial injury, non-aortic arterial injuries represent an uncommon but significant source of morbidity and mortality in blunt and penetrating thoracic trauma patients. Knowledge of the spectrum of vascular injury and anatomic considerations that dictate patterns of associated thoracic hemorrhage will assist the radiologist in the accurate and efficient diagnosis of these injuries. This article provides a review of anatomy, pertinent clinical exam and CT angiography findings, as well as therapeutic options for non-aortic thoracic arterial trauma.
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Affiliation(s)
- Sudheer Balakrishnan
- Department of Radiology, Division of Emergency and Trauma Imaging, Emory University School of Medicine, Atlanta, GA, USA.
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5
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Stafforini NA, Singh N. Management of Vascular Injuries in Penetrating Trauma. Surg Clin North Am 2023; 103:801-825. [PMID: 37455038 DOI: 10.1016/j.suc.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Management of vascular trauma remains a challenge and traumatic injuries result in significant morbidity and mortality. Vascular trauma can be broadly classified according to mechanism of injury (iatrogenic, blunt, penetrating, and combination injuries). In addition, this can be further classified by anatomical area (neck, thoracic, abdominal, pelvic, and extremities) or contextual circumstances (civilian and military).
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Affiliation(s)
- Nicolas A Stafforini
- Division of Vascular Surgery, Department of Surgery, University of Washington, 325 9th Avenue, Box 359908, Seattle, WA 98104, USA
| | - Niten Singh
- Division of Vascular Surgery, Department of Surgery, University of Washington, 325 9th Avenue, Box 359908, Seattle, WA 98104, USA.
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6
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Chitragari G, Warner A, Agarwal G, Lee R, Shukla M. Management of a Stab Wound to the Innominate Artery With Endovascular Balloon Placement as a Precautionary Measure. Am Surg 2023; 89:487-489. [PMID: 33285074 DOI: 10.1177/0003134820954852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Gautham Chitragari
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Georgia, 160343Augusta University, USA
| | - Alexander Warner
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Georgia, 160343Augusta University, USA
| | - Gautam Agarwal
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Georgia, 160343Augusta University, USA
| | - Richard Lee
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Georgia, 160343Augusta University, USA
| | - Mrinal Shukla
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Georgia, 160343Augusta University, USA
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7
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Dang T, Bui A, Katz M, Wooster M. Successful endovascular repair of blunt traumatic innominate artery transection with covered stent graft. J Vasc Surg Cases Innov Tech 2022; 8:353-355. [PMID: 35898569 PMCID: PMC9309581 DOI: 10.1016/j.jvscit.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/16/2022] [Indexed: 11/28/2022] Open
Abstract
We have presented the case of a 20-year-old woman who had been involved in a motor vehicle collision with innominate artery transection. Because of her concomitant possible cerebral injury, she was deemed at extremely high risk of postoperative neurologic dysfunction if undergoing open surgical repair. Using intravascular ultrasound and angiography, the lesion was evaluated, and covered stents were deployed across the lesion. The patient tolerated the procedure well and was discharged without complications. Duplex ultrasound scans at 1 and 6 months showed satisfactory results. Thus, endovascular repair is a feasible alternative approach to open repair for patients with blunt traumatic innominate artery injury.
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Affiliation(s)
- Tru Dang
- Division of Vascular Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC
- Correspondence: Tru Dang, MD, Division of Vascular Surgery, Department of Surgery, Medical University of South Carolina, 171 Ashley Ave, Charleston, SC 29425
| | - Allen Bui
- Division of Vascular Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC
| | - Marc Katz
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC
| | - Mathew Wooster
- Division of Vascular Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC
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8
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Huang W, Ge H, Ding Y, Zhu Y. Endovascular repair of blunt traumatic injury of the innominate artery and aortic isthmus: A case report. Asian J Surg 2021; 44:1204-1205. [PMID: 34147331 DOI: 10.1016/j.asjsur.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Weibin Huang
- Department of Vascular Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Hongwei Ge
- Department of Vascular Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yun Ding
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
| | - Yunfeng Zhu
- Department of Vascular Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, China
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9
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Oliveira VC, Coutinho G, Fonseca M, Antunes LF. Innominate artery post-traumatic pseudoaneurysm presenting with Horner's syndrome. Interact Cardiovasc Thorac Surg 2021; 33:829-831. [PMID: 34027554 DOI: 10.1093/icvts/ivab156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/27/2021] [Accepted: 04/26/2021] [Indexed: 11/14/2022] Open
Abstract
Isolated innominate artery trauma after blunt thoracic contusion is rare and occurs mostly at its origin. We report a case of a post-traumatic distal innominate artery pseudoaneurysm presenting with Horner's syndrome treated by conventional surgical approach.
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Affiliation(s)
- Vânia Constâncio Oliveira
- Department of Angiology and Vascular Surgery, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
| | - Gonçalo Coutinho
- Department of Cardiothoracic Surgery, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
| | - Manuel Fonseca
- Department of Angiology and Vascular Surgery, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
| | - Luis F Antunes
- Department of Angiology and Vascular Surgery, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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10
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Jones KA, Sadri S, Ahmad N, Weintraub JR, Reis SP. Thoracic Trauma, Nonaortic Injuries. Semin Intervent Radiol 2021; 38:75-83. [PMID: 33883804 DOI: 10.1055/s-0041-1726005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Trauma is one of the leading causes of death worldwide. Approximately two-thirds of trauma patients have thoracic injuries. Nonvascular injury to the chest is most common; however, while vascular injuries to the chest make up a small minority of injuries in thoracic trauma, these injuries are most likely to require intervention by interventional radiology (IR). IR plays a vital role, with much to offer, in the evaluation and management of patients with both vascular and nonvascular thoracic trauma; in many cases, IR treatments obviate the need for these patients to go to the operating room. This article reviews the role of IR in the treatment of vascular an nonvascular traumatic thoracic injuries.
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Affiliation(s)
- Kai A Jones
- Columbia University Vegelos College of Physicians and Surgeons, New York, New York
| | - Shirin Sadri
- Columbia University Vegelos College of Physicians and Surgeons, New York, New York
| | - Noor Ahmad
- Division of Interventional Radiology, Columbia University Irving Medical Center, New York, New York
| | | | - Stephen P Reis
- Division of Interventional Radiology, Columbia University Irving Medical Center, New York, New York
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Hu SL, Wang CX, Lu HJ, Yuan Y. Management of injuries near the innominate artery bifurcation using an accurate kissing Viabahn stent technique. J Int Med Res 2021; 48:300060520912104. [PMID: 32393137 PMCID: PMC7221169 DOI: 10.1177/0300060520912104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To evaluate the feasibility, safety, and efficacy of an accurate kissing Viabahn stent technique to manage injuries near the innominate artery bifurcation. METHODS This retrospective study included patients with injuries near the innominate artery bifurcation who were treated with an accurate kissing Viabahn stent technique. Perioperative and follow-up data were extracted and analysed. RESULTS A total of 10 patients were included (mean age, 52.8 years; six male and four female patients) with injuries at the following sites: the distal end of the innominate artery (n = 2), the innominate artery bifurcation (n = 5), the root of the right common carotid artery (n = 2) and the origin of the right subclavian artery (n = 1). All were successfully treated with the accurate kissing Viabahn stent technique. During follow-up (mean duration, 16.8 months), there were no complications, such as right upper limb ischaemia, neurological dysfunction, stent occlusion or migration. CONCLUSIONS The accurate kissing Viabahn stent technique to manage injuries near the bifurcation of the innominate artery was safe and effective, with good perioperative and long-term follow-up results.
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Affiliation(s)
- Shuang-Long Hu
- Department of Vascular Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| | - Chun-Xin Wang
- Department of Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| | - Hui-Jun Lu
- Department of Vascular Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| | - Ye Yuan
- Department of Vascular Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
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12
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About the Published Article "Successfully Kissing Stent of Innominate Artery and Left Common Carotid Artery Subsequent to Blunt Injury, in the Setting of a Bovine Aortic Arch". Ann Vasc Surg 2020; 68:e582-e583. [PMID: 32569815 DOI: 10.1016/j.avsg.2020.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 06/03/2020] [Indexed: 11/22/2022]
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Jia W, Liu JL, Li JY, Tian X, Jiang P, Cheng ZY, Zhang YX. Treatment strategy for traumatic innominate arterial injury. Chin J Traumatol 2020; 23:10-14. [PMID: 31992478 PMCID: PMC7049603 DOI: 10.1016/j.cjtee.2019.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/29/2019] [Accepted: 11/01/2019] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To discuss and share the experience of treatment of traumatic innominate arterial injury. METHODS A retrospective analysis was performed on patients with innominate arterial injuries admitted from January 2016 to July 2018 at the department of vascular surgery, Beijing Jishuitan Hospital, China. All the arterial injuries were confirmed by arteriography. Clinical data including mechanism of injury, type of injury, demographics, concomitant injuries, time interval from trauma to blood flow reconstruction, and operation methods were collected. Follow-up program included outpatient visit and duplex-ultrasonography. SPSS version 23.0 was adopted for data analysis. Categorical variables are presented as number and/or frequency and continuous variables as mean ± standard deviation. RESULT Altogether 7 patients were included and 6 (85.7%) were male. The mean age of patients was (29.43 ± 7.98) years, range 19-43 years. Six patients had isolated innominate arterial injuries and the rest 1 combined innominate arterial and vein injuries. The injury causes were road accidents in 3 patients, stab wound in 2, gunshot wound in 1, and crush injury in 1. All the 7 patients presented hemorrhagic shock at admission, which was timely and effectively corrected. No perioperative death or technical complications occurred. Intimal injury (n = 2) and partial transaction (n = 2) of the innominate artery were treated with covered stents. Two patients with complete transection of artery received vascular reconstruction by artificial grafts. One patient with partial transaction received balloon dilation and open surgical repair (hybrid operation). The mean time interval from trauma to blood flow reconstruction was (4.27 ± 0.18) h, range 4.0-4.5 h; while the operation time was (48.57 ± 19.94) min, range 25-75 min. Cerebral infarction occurred in one patient with brain injury due to anticoagulation contraindication. The average follow-up was (13.29 ± 5.65) months, range 6-24 months. No severe stenosis, occlusion, and thrombosis of covered stents or artificial vessels were found by color Doppler ultrasound. CONCLUSION Urgent control of hemorrhage and restoration of blood supply are critical for the treatment of traumatic innominate arterial injury. Endovascular therapy is a feasible and effective method with short operation time and less trauma.
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Liu JL, Li JY, Jiang P, Jia W, Tian X, Cheng ZY, Zhang YX. Literature review of peripheral vascular trauma: Is the era of intervention coming? Chin J Traumatol 2020; 23:5-9. [PMID: 32014343 PMCID: PMC7049612 DOI: 10.1016/j.cjtee.2019.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/25/2019] [Accepted: 11/25/2019] [Indexed: 02/04/2023] Open
Abstract
Traumatic peripheral vascular injury is a significant cause of disability and death either in civilian environments or on the battlefield. Penetrating trauma and blunt trauma are the most common forms of vascular injuries. Besides, iatrogenic arterial injury (IAI) is another pattern of vascular trauma. The management of peripheral vascular injuries has been improved in different environments and wars. There are different types of vascular injuries, such as vasospasm, contusion, intimal flaps, intimal disruption or hematoma, external compression, laceration, transection and focal wall defects, etc. The main clinical manifestations of vascular injuries are shock following massive hemorrhage and limb necrosis due to tissue and organ ischemia. Ultrasound, computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are most valuable for assessment of peripheral vascular injuries. Angiography remains the gold standard for diagnosing vascular trauma. Immediate hemorrhage control and rapid restoration of blood flow are the primary goals of vascular trauma treatment. There are many operative treatment methods for vascular injuries, such as vascular suture or ligation, vascular wall repair and vascular reconstruction with blood vessel prostheses or vascular grafts. Embolization, balloon dilation and covered stent implantation are the main endovascular techniques. Surgical operation is still the primary treatment for vascular injuries. Endovascular treatment is a promising alternative, proved to be safe and effective, and preferred selection for patients. In summary, rapid diagnosis and timely surgical intervention remain the mainstays of the treatment. However, many issues need to be resolved by further studies.
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Affiliation(s)
- Jian-Long Liu
- Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
| | - Jin-Yong Li
- Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Peng Jiang
- Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Wei Jia
- Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Xuan Tian
- Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Zhi-Yuan Cheng
- Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Yun-Xin Zhang
- Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
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Safran B, Garg K, Scher L, Shariff S, Lipsitz E. Repair of Isolated Innominate Artery Pathology with a Modified Endovascular Graft. Ann Vasc Surg 2019; 60:475.e5-475.e10. [DOI: 10.1016/j.avsg.2019.02.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 02/05/2019] [Accepted: 02/08/2019] [Indexed: 11/26/2022]
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Palermo C, Sanfiorenzo A, Giaquinta AT, Virgilo C, Veroux M, Veroux P. Mini-invasive treatment of a large pseudoaneurysm of the neck related to central venous catheter placement: A case report. Medicine (Baltimore) 2018; 97:e11262. [PMID: 30024504 PMCID: PMC6086494 DOI: 10.1097/md.0000000000011262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
RATIONALE Central venous catheter (CVC) placement, particularly in emergency setting, may be associated with significant morbidity and mortality. PATIENT CONCERNS A 33-year old woman with suspected pulmonary embolism, developed a pseudoaneurysm of the neck three days after a CVC placement in the right internal jugular vein, determining compression to adjacent neck structures. DIAGNOSES Computed tomography angiography and selective angiography demonstrated the presence of the pseudoaneurysm originating from the thyro-cervical trunk. INTERVENTIONS The treatment was minimally invasive with endovascular exclusion first, and an open thrombectomy to resolve compressive syndrome two days later. OUTCOMES The color Doppler ultrasound confirmed the complete exclusion of the pseudoaneurysm with patency of the thyroid artery. A comprehensive review of literature on the risk factors and management of the unintended artery puncture was included. LESSONS A correct technique under ultrasound guidance may reduce the incidence of unintended arterial injury during CVC placement. In patients with suitable anatomy and unfit for open repair, a minimally invasive approach provides a safe alternative to open surgery with excellent results.
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Howe KL, Guirgis M, Woodman G, Victor Chu F, Cooper MJ, Rapanos T, Szalay D. Blunt innominate artery trauma requiring repair and carotid ligation. Trauma Case Rep 2018; 12:24-27. [PMID: 29644279 PMCID: PMC5887091 DOI: 10.1016/j.tcr.2017.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 11/25/2022] Open
Abstract
Traumatic dissection of the innominate artery is a rare clinical entity. Management of a patient with motorsensory compromise and dissection extending to the subclavian and right common carotid arteries is quite rare and can be quite involved. Here we present such a case and discuss the unique peri-operative decision-making in the context of what is reported in the literature. Restoration of motorsensory function is critical and in this case, requiring a multi-disciplinary team.
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Affiliation(s)
- Kathryn L Howe
- Division of Vascular Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Mina Guirgis
- Division of Vascular Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Grant Woodman
- Division of Vascular Surgery, McMaster University, Hamilton, Ontario, Canada
| | - F Victor Chu
- Division of Cardiac Surgery, McMaster University, Hamilton, Ontario, Canada
| | - M J Cooper
- Division of Plastic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Theodore Rapanos
- Division of Vascular Surgery, McMaster University, Hamilton, Ontario, Canada
| | - David Szalay
- Division of Vascular Surgery, McMaster University, Hamilton, Ontario, Canada
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19
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Choufani C, Aoun O, Mlynski A, Boddaert G, de Kerangal X, Pierret C. Endovascular treatment of brachiocephalic artery war-related injury. Acta Chir Belg 2017; 117:256-259. [PMID: 27827564 DOI: 10.1080/00015458.2016.1253236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Injuries to the innominate artery are rare, but potentially fatal. Early diagnosis and treatment may avoid life-threatening complications. Endovascular surgery often has lower morbidity and mortality rates than conventional surgery. CLINICAL CASE We reported the case of a 28-year-old Yemenite soldier who presented with a shrapnel-related chest puncture wound following a shell explosion in Djibouti causing a 5 mm pseudoaneurysm of the innominate artery without associated complications. After medical repatriation to France, the pseudoaneurysm was treated by endovascular exclusion using a covered stent. DISCUSSION Endovascular treatment of supra-aortic trunk lesions is an alternative to surgery with fewer postoperative complications, but long-term follow-up is lacking.
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Affiliation(s)
| | - Olivier Aoun
- Colmar Armed Forces Medical Center, Colmar, France
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20
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Alonso-Argüeso G, Rodriguez-Morata A, Vera-Arroyo B, Lara-Villoslada MJ, Gomez-Medialdea R. Endovascular Treatment of Complex Carotid-Jugular Fistula. Vasc Endovascular Surg 2016; 50:566-570. [PMID: 27852880 DOI: 10.1177/1538574416675675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Inadvertent complications of jugular vein catheterization are not uncommon, however, a persistent symptomatic carotid-jugular fistula has been rarely reported. A 72-year-old male with infected surgical wound after coxofemoral disarticulation for sarcoma presented with symptoms of acute right heart failure. A fistula between the right common carotid artery (CCA) and the internal jugular vein was demonstrated on Doppler ultrasound and confirmed on computed tomography angiogram. Catheterization of the right CCA seemed not possible using a conventional femoral approach due to the tortuosity and elongation of the brachiocephalic artery. A small incision in the right temporal area was used to access the superficial temporal artery and a wire was advanced retrograde into the aorta where it was snared from below, allowing for successful treatment of the fistula with a covered stent. This alternative technique may facilitate safe and stable carotid artery stenting even in patients with a severely tortuous access route due to atherosclerotic disease.
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Affiliation(s)
- Gonzalo Alonso-Argüeso
- 1 Department of Angiology and Vascular Surgery, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Alejandro Rodriguez-Morata
- 1 Department of Angiology and Vascular Surgery, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Blanca Vera-Arroyo
- 1 Department of Angiology and Vascular Surgery, Virgen de la Victoria University Hospital, Málaga, Spain
| | | | - Rafael Gomez-Medialdea
- 1 Department of Angiology and Vascular Surgery, Virgen de la Victoria University Hospital, Málaga, Spain
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21
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Okada Y, Narumiya H, Ishii W, Ryoji I. Damage control management of innominate artery injury with tracheostomy. Surg Case Rep 2016; 2:17. [PMID: 26943693 PMCID: PMC4754233 DOI: 10.1186/s40792-016-0144-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 02/12/2016] [Indexed: 11/23/2022] Open
Abstract
Innominate artery injury is a rare, but catastrophic complication of tracheostomy. We present a case of severe hemorrhagic shock in a 79-year-old male with innominate artery injury that occurred during tracheostomy. Despite temporary innominate artery isolation, the regional forehead saturation was 60 % without laterality. Because adequate cerebral blood flow was apparently maintained through collateral flow, we ligated the innominate, right carotid, and subclavian arteries. We confirmed adequate blood flow to the brain and the right subclavian artery through collateral circulation after ligation using computed tomographic angiography. A damage control management, which involves ligating the injured innominate artery to arrest hemorrhage and monitoring regional forehead saturation for brain ischemia, can be a considerable procedure for the treatment of severe hemorrhagic shock due to innominate artery injury.
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Affiliation(s)
- Yohei Okada
- Department of Emergency and Critical Care Medicine, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan.
| | - Hiromichi Narumiya
- Department of Emergency and Critical Care Medicine, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan.
| | - Wataru Ishii
- Department of Emergency and Critical Care Medicine, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan.
| | - Iiduka Ryoji
- Department of Emergency and Critical Care Medicine, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan.
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22
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Branco BC, Boutrous ML, DuBose JJ, Leake SS, Charlton-Ouw K, Rhee P, Mills JL, Azizzadeh A. Outcome comparison between open and endovascular management of axillosubclavian arterial injuries. J Vasc Surg 2015; 63:702-9. [PMID: 26506937 DOI: 10.1016/j.jvs.2015.08.117] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 08/27/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Endovascular repair (ER) of axillosubclavian arterial injuries is a minimally invasive alternative to open repair (OR). The purpose of this study was to compare the outcomes of ER vs OR. METHODS A retrospective study was performed of patients who sustained axillosubclavian arterial injuries admitted to two high-volume academic trauma centers between 2003 and 2013. Patients undergoing ER and OR were matched according to 25 different demographic and clinical variables in a 1:3 ratio using propensity scores. The primary outcome was in-hospital mortality. Secondary outcomes were complications and length of stay. RESULTS Among 153 patients (79.7% male; mean age, 32.7 ± 15.9 years) who sustained axillosubclavian arterial injuries, 18 (11.8%) underwent ER and 135 (88.2%) had OR. Matched cases (ER, n = 18) and controls (OR, n = 54) had similar demographic and clinical data, such as age, gender, admission systolic blood pressure and Glasgow Coma Scale score, body Abbreviated Injury Scale scores, Injury Severity Score, and transfusion requirements. Patients undergoing ER had significantly lower in-hospital mortality compared with patients undergoing OR (5.6% vs 27.8%; P = .040; odds ratio, 0.7; 95% confidence interval, 0.6-0.9). Similarly, patients undergoing ER had substantially lower rates of surgical site infections and a trend toward lower rates of sepsis. Outpatient follow-up was available in 88.2% (n = 15) of the patients at a median time of 8 months (1-30 months). Two ER patients required open reintervention for stent-related complications (one for a type Ia endoleak and another for stent thrombosis). CONCLUSIONS In our experience with axillosubclavian arterial injuries, ER was associated with improved mortality and lower complication rates. Patient follow-up demonstrates an acceptable reintervention rate after ER. Further multicenter prospective evaluation is warranted to determine long-term outcomes.
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Affiliation(s)
| | - Mina L Boutrous
- Division of Vascular and Endovascular Surgery, Department of Cardiothoracic and Vascular Surgery, The University of Texas Medical School at Houston and Memorial Hermann Heart & Vascular Institute, Houston, Tex
| | - Joseph J DuBose
- Division of Vascular and Endovascular Surgery, Department of Cardiothoracic and Vascular Surgery, The University of Texas Medical School at Houston and Memorial Hermann Heart & Vascular Institute, Houston, Tex
| | - Samuel S Leake
- Division of Vascular and Endovascular Surgery, Department of Cardiothoracic and Vascular Surgery, The University of Texas Medical School at Houston and Memorial Hermann Heart & Vascular Institute, Houston, Tex
| | - Kristopher Charlton-Ouw
- Division of Vascular and Endovascular Surgery, Department of Cardiothoracic and Vascular Surgery, The University of Texas Medical School at Houston and Memorial Hermann Heart & Vascular Institute, Houston, Tex
| | - Peter Rhee
- Division of Trauma, Emergency Surgery, Critical Care, and Burns, University of Arizona, Tucson, Ariz
| | - Joseph L Mills
- Division of Vascular and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex
| | - Ali Azizzadeh
- Division of Vascular and Endovascular Surgery, Department of Cardiothoracic and Vascular Surgery, The University of Texas Medical School at Houston and Memorial Hermann Heart & Vascular Institute, Houston, Tex.
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23
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Kooraki S, Grohmann J, Elshikh S, Urbach H, Meckel S. Covered stents for exclusion of iatrogenic common carotid artery-internal jugular vein fistula and brachiocephalic artery pseudoaneurysm. J Neurointerv Surg 2015; 8:e31. [PMID: 26122326 DOI: 10.1136/neurintsurg-2015-011760.rep] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2015] [Indexed: 12/25/2022]
Abstract
Covered stents have rarely been used in neuroendovascular procedures. We report the case of a 74-year-old woman with a complex iatrogenic vascular injury from attempted insertion of a hemodialysis catheter: concurrent brachiocephalic artery pseudoaneurysm and common carotid artery to internal jugular vein fistula. Both lesions were excluded successfully by using two balloon-expandable covered stents with a satisfactory short-term clinical and angiographic outcome.
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Affiliation(s)
- Soheil Kooraki
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of) Department of Neuroradiology, University Hospital Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany
| | - Jochen Grohmann
- Department of Pediatric Cardiology, University Hospital Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany
| | - Samer Elshikh
- Department of Neuroradiology, University Hospital Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany
| | - Horst Urbach
- Department of Neuroradiology, University Hospital Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany
| | - Stephan Meckel
- Department of Neuroradiology, University Hospital Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany
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24
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Kooraki S, Grohmann J, Elshikh S, Urbach H, Meckel S. Covered stents for exclusion of iatrogenic common carotid artery-internal jugular vein fistula and brachiocephalic artery pseudoaneurysm. BMJ Case Rep 2015; 2015:bcr-2015-011760. [PMID: 26106173 DOI: 10.1136/bcr-2015-011760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Covered stents have rarely been used in neuroendovascular procedures. We report the case of a 74-year-old woman with a complex iatrogenic vascular injury from attempted insertion of a hemodialysis catheter: concurrent brachiocephalic artery pseudoaneurysm and common carotid artery to internal jugular vein fistula. Both lesions were excluded successfully by using two balloon-expandable covered stents with a satisfactory short-term clinical and angiographic outcome.
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Affiliation(s)
- Soheil Kooraki
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of) Department of Neuroradiology, University Hospital Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany
| | - Jochen Grohmann
- Department of Pediatric Cardiology, University Hospital Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany
| | - Samer Elshikh
- Department of Neuroradiology, University Hospital Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany
| | - Horst Urbach
- Department of Neuroradiology, University Hospital Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany
| | - Stephan Meckel
- Department of Neuroradiology, University Hospital Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany
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25
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Roussel A, Fabre D, Fadel E, Angel C, Dartevelle P. Hybrid treatment of an aortic pseudoaneurysm arising at the innominate artery junction secondary to superior vena cava stenting. J Vasc Surg Cases 2015; 1:127-129. [PMID: 31724612 PMCID: PMC6849922 DOI: 10.1016/j.jvsc.2015.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 03/15/2015] [Indexed: 12/03/2022] Open
Abstract
Pseudoaneurysm of the innominate artery secondary to superior vena cava stenting has never been reported. We report the case of a 42-year-old woman previously treated for a Masaoka stage III thymoma with superior vena cava replacement through median sternotomy followed by adjuvant radiation therapy. Four years later, the patient came back with a large pseudoaneurysm at the junction of the innominate artery and ascending aorta. To avoid resternotomy, endovascular deployment of a stent graft in the ascending aorta with a periscope stenting in the left common carotid artery after axilloaxillary bypass was performed to treat this aortic pseudoaneurysm.
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Affiliation(s)
- Arnaud Roussel
- Reprint requests: Arnaud Roussel, MD, Department of Vascular and Thoracic Surgery and Lung Transplantation, Bichat Hospital, 46 rue Henri Huchard, 75018 Paris, France
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26
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Sinha S, Patterson BO, Ma J, Holt PJ, Thompson MM, Carrell T, Tai N, Loosemore TM. Systematic review and meta-analysis of open surgical and endovascular management of thoracic outlet vascular injuries. J Vasc Surg 2013; 57:547-567.e8. [DOI: 10.1016/j.jvs.2012.10.077] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 09/26/2012] [Accepted: 10/04/2012] [Indexed: 10/27/2022]
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27
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Gonçalves R, Saad Júnior R. [Surgical accesses to the major mediastinal vessels in thoracic trauma]. Rev Col Bras Cir 2012; 39:64-73. [PMID: 22481709 DOI: 10.1590/s0100-69912012000100013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2010] [Accepted: 11/15/2010] [Indexed: 08/30/2023] Open
Abstract
Trauma is the most common cause of death in the economically active population and thoracic trauma is directly or indirectly responsible for one quarter of these deaths. Lesions to the large thoracic vessels are associated with immediate or early death in the hospital setting. Patients admitted alive can be classified as stable or unstable. The access route to be elected for management of these veins will depend on this status, as well as on the anatomical particularities of the patient, which may require combined incisions for adequate access. This article provides a review and discussion of lesions to these structures as well as access routes to them.
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28
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Angiletta D, Marinazzo D, Guido G, Fullone M, Pulli R, Regina G. Eight-year follow-up of endovascular repair of a brachiocephalic trunk aneurysm due to Takayasu's arteritis. J Vasc Surg 2012; 56:504-7. [PMID: 22554423 DOI: 10.1016/j.jvs.2012.02.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2011] [Revised: 02/07/2012] [Accepted: 02/09/2012] [Indexed: 10/28/2022]
Abstract
Aneurysms of the brachiocephalic trunk are rare but their clinical outcomes are potentially devastating; they include rupture, cerebral or arm ischemia secondary to thromboembolism, and compression of the surrounding structures. Although open repair has proven successful, it is associated with significant morbidity and mortality rates. Endovascular treatment, if anatomically feasible, may offer a safer and less invasive approach to these lesions, especially in high-surgical-risk patients. We report the good long-term outcome of endovascular repair of a large innominate artery true aneurysm due to Takayasu's arteritis. A stent graft was safely and successfully deployed to exclude the aneurysm; assessment by vascular imaging at 8-year follow-up demonstrated the efficacy of the procedure.
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Affiliation(s)
- Domenico Angiletta
- Department of Vascular and Endovascular Surgery, University of Bari, Bari, Italy
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29
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Repair of Blunt Thoracic Outlet Arterial Injuries: An Evolution From Open to Endovascular Approach. ACTA ACUST UNITED AC 2011; 71:E114-21. [DOI: 10.1097/ta.0b013e31822cf359] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Davidovic L, Koncar I, Markovic D, Sindjelic R, Colic M. Injuries of the thoracic aorta and its branches. VOJNOSANIT PREGL 2011; 68:257-65. [DOI: 10.2298/vsp1103257d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Lazar Davidovic
- Klinički centar Srbije, Klinika za vaskularnu hirurgiju i endovaskularnu hirurgiju, Beograd + Medicinski fakultet, Beograd
| | - Igor Koncar
- Klinički centar Srbije, Klinika za vaskularnu hirurgiju i endovaskularnu hirurgiju, Beograd + Medicinski fakultet, Beograd
| | - Dejan Markovic
- Klinički centar Srbije, Klinika za vaskularnu hirurgiju i endovaskularnu hirurgiju, Beograd + Medicinski fakultet, Beograd
| | - Radomir Sindjelic
- Klinički centar Srbije, Klinika za vaskularnu hirurgiju i endovaskularnu hirurgiju, Beograd + Medicinski fakultet, Beograd
| | - Momcilo Colic
- Klinički centar Srbije, Klinika za vaskularnu hirurgiju i endovaskularnu hirurgiju, Beograd + Medicinski fakultet, Beograd
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31
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Ahmed I, Katsanos K, Ahmad F, Dourado R, Lyons O, Reidy J. Endovascular Treatment of a Brachiocephalic Artery Pseudoaneurysm Secondary to Biopsy at Mediastinoscopy. Cardiovasc Intervent Radiol 2008; 32:792-5. [DOI: 10.1007/s00270-008-9450-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 09/04/2008] [Accepted: 09/09/2008] [Indexed: 10/21/2022]
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