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Usami K, Iwata Y, Aoyama R, Okino S, Fukuzawa S. A case of chronic limb threatening ischemia with kinking of the external iliac artery due to downward deviation of abdominal aortic stent graft. Cardiovasc Interv Ther 2023; 38:436-437. [PMID: 37369951 DOI: 10.1007/s12928-023-00943-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023]
Affiliation(s)
- Kota Usami
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba, 273-8588, Japan.
| | - Yo Iwata
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba, 273-8588, Japan
| | - Rie Aoyama
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba, 273-8588, Japan
| | - Shinichi Okino
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba, 273-8588, Japan
| | - Shigeru Fukuzawa
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba, 273-8588, Japan
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Rao IR, Paramasivam G, Devasia T, Prabhu AR, Nagaraju SP. Accordion effect: A red herring during percutaneous angioplasty of arteriovenous dialysis access. J Vasc Access 2020; 22:670-672. [PMID: 32519567 DOI: 10.1177/1129729820927248] [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: 11/15/2022] Open
Abstract
Accordion or concertina effect is the angiographic appearance of pseudostenosis caused by interaction of a stiff guidewire with a tortuous vessel during endovascular procedures. This phenomenon may often mislead the interventionist into performing unnecessary and potentially harmful procedures in a bid to treat the 'stenotic' lesion. The resolution of 'stenosis' on withdrawal of the guidewire clinches the diagnosis. While well described in coronary vessels, the occurrence of this phenomenon in arteriovenous fistula or graft has not been reported. We describe a case of accordion effect observed during endovascular intervention for arteriovenous graft salvage.
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Affiliation(s)
- Indu Ramachandra Rao
- Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Ganesh Paramasivam
- Department of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Tom Devasia
- Department of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Attur Ravindra Prabhu
- Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Shankar Prasad Nagaraju
- Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
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Koge J, Iwata T, Mizuta S, Nakamura Y, Matsumoto SI, Yamada T. Successful carotid artery stenting of a dissected, highly tortuous internal carotid artery after straightening with a peripheral microguidewire. J Clin Neurosci 2018; 53:265-268. [DOI: 10.1016/j.jocn.2018.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 03/12/2018] [Accepted: 04/08/2018] [Indexed: 12/28/2022]
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Shibuya K, Koyama Y, Tsushima Y. Accordion phenomenon of the hepatic artery: mimicker of vasospasm or intimal injury. Acta Radiol Open 2016; 5:2058460116651900. [PMID: 27570635 PMCID: PMC4984317 DOI: 10.1177/2058460116651900] [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: 12/28/2015] [Accepted: 05/02/2016] [Indexed: 11/17/2022] Open
Abstract
The accordion phenomenon occurs because of mechanical distortion of a straightened vessel during coronary and vascular interventions. To date, however, this phenomenon has not been reported in vessels of the upper abdomen. We therefore describe the accordion phenomenon of the hepatic artery during transarterial chemoembolization seen while treating a liver tumor. As the accordion phenomenon is now known to involve hepatic arteries, it should be differentiated from vascular complications such as vasospasm or intimal injury.
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Affiliation(s)
- Kei Shibuya
- Department of Diagnostic and Interventional Radiology, Gunma University Hospital, Maebashi, Japan
| | - Yoshinori Koyama
- Department of Diagnostic and Interventional Radiology, Gunma University Hospital, Maebashi, Japan
| | - Yoshito Tsushima
- Department of Diagnostic and Interventional Radiology, Gunma University Hospital, Maebashi, Japan
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Gindre J, Bel-Brunon A, Kaladji A, Duménil A, Rochette M, Lucas A, Haigron P, Combescure A. Finite element simulation of the insertion of guidewires during an EVAR procedure: example of a complex patient case, a first step toward patient-specific parameterized models. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2015; 31:e02716. [PMID: 25820933 DOI: 10.1002/cnm.2716] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 03/20/2015] [Indexed: 06/04/2023]
Abstract
Deformations of the vascular structure due to the insertion of tools during endovascular treatment of aneurysms of the abdominal aorta, unless properly anticipated during the preoperative planning phase, may be the source of intraoperative or postoperative complications. We propose here an explicit finite element simulation method which enables one to predict such deformations. This method is based on a mechanical model of the vascular structure which takes into account the nonlinear behavior of the arterial wall, the prestressing effect induced by the blood pressure and the mechanical support of the surrounding organs and structures. An analysis of the model sensitivity to the parameters used to represent this environment is done. This allows determining the parameters that have the largest influence on the quality of the prediction and also provides realistic values for each of them as no experimental data are available in the literature. Moreover, for the first time, the results are compared with 3D intraoperative data. This is done for a patient-specific case with a complex anatomy in order to assess the feasibility of the method. Finally, the predictive capability of the simulation is evaluated on a group of nine patients. The error between the final simulated and intraoperatively measured tool positions was 2.1 mm after the calibration phase on one patient. It results in a 4.6 ± 2.5 mm in average error for the blind evaluation on nine patients.
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Affiliation(s)
- Juliette Gindre
- Université de Lyon, Lyon, F-69000, France
- LaMCoS CNRS UMR5259, INSA-Lyon, Villeurbanne, F-69621, France
- INSERM U1099, Rennes, F-35000, France
- LTSI, Université de Rennes 1, Rennes, F-35000, France
- ANSYS, Villeurbanne, F-69100, France
| | - Aline Bel-Brunon
- Université de Lyon, Lyon, F-69000, France
- LaMCoS CNRS UMR5259, INSA-Lyon, Villeurbanne, F-69621, France
| | - Adrien Kaladji
- INSERM U1099, Rennes, F-35000, France
- LTSI, Université de Rennes 1, Rennes, F-35000, France
- Department of Vascular Surgery, CHU Rennes, Rennes, F-35000, France
| | - Aurélien Duménil
- INSERM U1099, Rennes, F-35000, France
- LTSI, Université de Rennes 1, Rennes, F-35000, France
- THERENVA, Rennes, F-35000, France
| | | | - Antoine Lucas
- INSERM U1099, Rennes, F-35000, France
- LTSI, Université de Rennes 1, Rennes, F-35000, France
- Department of Vascular Surgery, CHU Rennes, Rennes, F-35000, France
| | - Pascal Haigron
- INSERM U1099, Rennes, F-35000, France
- LTSI, Université de Rennes 1, Rennes, F-35000, France
| | - Alain Combescure
- Université de Lyon, Lyon, F-69000, France
- LaMCoS CNRS UMR5259, INSA-Lyon, Villeurbanne, F-69621, France
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Sallam M, Al-Riyami A. Concertina effect: A memorable phenomenon during coronary intervention. Egypt Heart J 2014. [DOI: 10.1016/j.ehj.2013.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Culverwell AD, Kent P, Puppala S. Iliac Artery Occlusion With “Oxbow Lake” Formation Following Stent Deployment in a Tortuous External Iliac Artery During EVAR. Vasc Endovascular Surg 2011; 45:668-71. [PMID: 21788283 DOI: 10.1177/1538574411414922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this case report, we describe a complication that we term the “oxbow lake” deformity. This phenomenon occurs when a tortuous elongated external iliac artery segment is artificially straightened by an iliac stent resulting in kinking and compression of a redundant loop with lumen compromise. We describe the anatomy, corrective treatment, and outcome. This occurrence is potentially foreseeable with tortuous vascular anatomy and recognition can allow appropriate management planning avoiding complications for the patient.
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Affiliation(s)
- Adam D. Culverwell
- Department of Vascular Radiology and Surgery, Leeds Teaching Hospitals, Leeds, West Yorkshire, UK
| | - Patrick Kent
- Department of Vascular Radiology and Surgery, Leeds Teaching Hospitals, Leeds, West Yorkshire, UK
| | - Sapna Puppala
- Department of Vascular Radiology and Surgery, Leeds Teaching Hospitals, Leeds, West Yorkshire, UK
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O'Flynn PM, O'Sullivan G, Pandit AS. Methods for Three-Dimensional Geometric Characterization of the Arterial Vasculature. Ann Biomed Eng 2007; 35:1368-81. [PMID: 17431787 DOI: 10.1007/s10439-007-9307-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2006] [Accepted: 03/30/2007] [Indexed: 11/27/2022]
Abstract
Complex vascular anatomy often affects endovascular procedural outcome. Accurate quantitative assessment of three-dimensional (3D) in-vivo arterial morphology is therefore vital for endovascular device design, and preoperative planning of percutaneous interventions. The aim of this work was to establish geometric parameters describing arterial branch origin, trajectory, and vessel curvature in 3D space that eliminate the errors implicit in planar measurements. 3D branching parameters at visceral and aortic bifurcation sites, as well as arterial tortuosity were determined from vessel centerlines derived from magnetic resonance angiography data for three subjects. Errors in coronal measurements of 3D branching angles for the right and left renal arteries were 3.1 +/- 3.4 degrees and 7.5 +/- 3.7 degrees , respectively. Distortion of the anterior visceral branching angles from sagittal measurements was less pronounced. Asymmetry in branching and planarity of the common iliac arteries was observed at aortic bifurcations. The renal arteries possessed considerably greater 3D curvature than the abdominal aorta and common iliac vessels with mean average values of 0.114 +/- 0.015 and 0.070 +/- 0.019 mm(-1) for the left and right, respectively. In conclusion, planar projections misrepresented branch trajectory, vessel length, and tortuosity proving the importance of 3D geometric characterization for possible applications in planning of endovascular interventional procedures and providing parameters for endovascular device design.
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Affiliation(s)
- Padraig M O'Flynn
- Department of Mechanical and Biomedical Engineering, National University of Ireland, University Road, Galway, Ireland
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