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Arun AS, Yue JJ, Khachane VB, Sumpio B, Tonnessen BH. Endovascular stenting of external iliac vein injury during anterior spine exposure. J Vasc Surg Cases Innov Tech 2024; 10:101506. [PMID: 38812729 PMCID: PMC11133885 DOI: 10.1016/j.jvscit.2024.101506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/26/2024] [Indexed: 05/31/2024] Open
Abstract
Anterior lumbar interbody fusion (ALIF) is a standard approach for the surgical management of patients with severe degenerative disease at the L4-L5 and lumbosacral (L5-S1) levels. ALIF is performed through retroperitoneal exposure but harbors a small risk of major vascular injury. In this case, we describe an emergent endovascular repair of an external iliac vein injury that occurred during ALIF with long-term follow-up. We discuss specific strategies in the decision making and technique that led to a successful outcome in this case. Endovascular stent grafting is a potential bailout option for serious iliac vein injury.
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Affiliation(s)
| | - James J. Yue
- Connecticut Orthopaedics, Hamden, CT
- HeartCare Associates of Connecticut, LLC, Hamden, CT
| | - Vasant B. Khachane
- HeartCare Associates of Connecticut, LLC, Hamden, CT
- Yale New Haven Hospital, New Haven, CT
| | - Bauer Sumpio
- Division of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, CT
| | - Britt H. Tonnessen
- Division of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, CT
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Wei W, Zhao Q, Liu C, Yang L, Li J, Fu P, Zhao Y, Cui T. Stents migration into right atrium from severely calcified superior vena cava in a hemodialysis patient. Heliyon 2024; 10:e23621. [PMID: 38173496 PMCID: PMC10761771 DOI: 10.1016/j.heliyon.2023.e23621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
Vascular calcification is common among hemodialysis patients. In this report, we presented a case of superior vena cava (SVC) stent migration during endovascular angioplasty in a 50-year-old female hemodialysis patient with severe SVC calcification. The stent migration was refractory to the deployment of a second anchor stent, which shortly resulted in pericardium tamponade and was successfully rescued by emergent thoracotomy. The potential role of vascular calcification as a risk factor to stent migration was discussed. Patients with severe vascular calcification receiving endovascular angioplasty might need a careful risk screening for stent migration.
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Affiliation(s)
- Wei Wei
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Qiuyan Zhao
- Outpatient Department, West China Hospital of Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Caihong Liu
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Letian Yang
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Li
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Fu
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Yuliang Zhao
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Tianlei Cui
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
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Zhou H, Wang B, Pan J, Qiu C, Yu X, He Y, Zhu Q, Yu L, Wu Z, Li D, Zhang H. Percutaneous snare-retrieval of intracardiac thrombus under fluoroscopic and transesophageal echocardiography guidance: case report and systematic review. Front Cardiovasc Med 2023; 10:1127131. [PMID: 37229221 PMCID: PMC10203901 DOI: 10.3389/fcvm.2023.1127131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
Intracardiac foreign bodies (IFB) are rare clinical conditions. There are now several reports on the percutaneous retrieval of IFB under fluoroscopy. However, some IFB are not radiopaque, and retrieval requires combined fluoroscopic and ultrasound guidance. We report the case of a bedridden 23-year-old male patient with T-lymphoblastic lymphoma treated with long-term chemotherapy. Ultrasound examination diagnosed a huge thrombus in the right atrium near the opening of the inferior vena cava which affected the patency of his PICC line. Ten days of anticoagulant therapy did not modify the thrombus size. Open heart surgery was not feasible because of the patient clinical condition. Snare-capture of the non-opaque thrombus was done from the femoral vein under fluoroscopic and ultrasound guidance with excellent outcomes. We also present a systematic review of IFB. We found out that percutaneous removal of IFBs is a safe and effective procedure. The youngest patient who received percutaneous IFB retrieval was 10 days old and weighed only 800 g, while the oldest patient was 70 years old. Port catheters (43.5%) and PICC lines (42.3%) were the most commonly found IFBs. Snare catheters and forceps were the most commonly used instruments.
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Affiliation(s)
- Huaji Zhou
- Department of Vascular Surgery, The NO.1 People’s Hospital of Pinghu, Jiaxing, China
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Bing Wang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jun Pan
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chenyang Qiu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xinyu Yu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yangyan He
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qianqian Zhu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lei Yu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ziheng Wu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Donglin Li
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongkun Zhang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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