BACKGROUND: Induced hypertension is an established therapy to treat cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH) to prevent delayed ischemic deficits. Currently, there is minimal evidence available assessing the risk of induced hypertension in the presence of unsecured aneurysms. The aim of this study was to investigate the impact of ...

BACKGROUND AND IMPORTANCE:: Galenic dural arteriovenous fistulas (DAVFs) are a subtype of the rare falcotentorial DAVFs with a high risk of hemorrhage and an aggressive clinical course. Microsurgical treatment is often necessary because endovascular obliteration will rarely completely obliterate the DAVF. CLINICAL PRESENTATION:: We present a unique case of a ...

The aim of this study was to evaluate the correlation of clinical characteristics with serial imaging findings of symptomatic spontaneous celiac artery dissection treated by conservative management. Eight consecutive, hemodynamically stable patients with symptomatic spontaneous celiac artery dissection without associated aortic dissection that received non-operative treatments were included in this ...

A traditional method for internal jugular vein catheterization has been through the transjugular approach. These days, ultrasound-guided cannulation is the preferred mode because of the higher success and lower complication rates. Complications associated with the transjugular approach include neck hematoma caused by carotid artery puncture, pleural puncture leading to pneumothorax ...

Objective: The purpose of our investigation was to determine the safety and usefulness of embolisation procedures in balloon occluded retrograde transvenous obliteration (BRTO) as treatment of gastric varices after portal hypertension. Materials and Methods: Between June 2004 and August 2009, 40 patients underwent BRTO for gastric varices that occurred after ...

Recently, percutaneous aortic valve replacement has emerged as a therapeutic option for patients with severe symptomatic aortic stenosis and a high surgical risk. We report our initial experience in four patients with percutaneous implantation of a CoreValve aortic prosthesis to treat aortic bioprosthesis dysfunction involving aortic stenosis or regurgitation. In-hospital ...

We sought to determine the circadian, weekly, and seasonal variation of coronary stent thrombosis. Other adverse cardiovascular events such as acute myocardial infarction are known to have higher incidences during the early morning hours, Mondays, and winter months. The Mayo Clinic Percutaneous Coronary Intervention Registry was searched for patients admitted ...

Arteriovenous (AV) shunts are relatively uncommon in the liver and usually associated with advanced hepatocellular carcinoma (HCC). In patients with massive AV shunts complicating advanced HCC, transarterial chemoinfusion therapy is not effective because chemotherapeutic agents go through the shunts and may cause systemic toxicity as well as decrease the chemotherapeutic ...

The irrigation of the upper third of the nasal fossa is supplied by the anterior ethmoidal artery. We describe a surgical technique to deal with epistaxis due to anterior ethmoidal artery bleeding. From January 2006 to March 2010 transcaruncular coagulation of the anterior ethmoidal artery was done on nine patients ...

Surgery for a complicated Stanford B acute aortic dissection, such as rupture or malperfusion, is still a challenge. We undertook endovascular therapy for ruptured Stanford B acute aortic dissection in two patients. A homemade stent graft was deployed in an 84-year-old woman with a massive mediastinal hematoma; and an aortic ...

Antiplatelet therapy has been demonstrated to reduce the risk of cardiac events in patients presenting with acute coronary syndrome, yet all effective therapies also increase the risk of bleeding. This study aimed to test the hypothesis that patients undergoing coronary artery bypass grafting, who received clopidogrel within 5 days before ...

Purpose: To present the early and midterm results of endovascular stent reconstruction of the occluded aortoiliac segment with selective use of the Outback LTD re-entry catheter. Methods: Between April 2004 and February 2010, 8 patients (5 women; mean age 58.4 years, range 47-68) with occlusion of the infrarenal aorta extending to ...

To report one-stage hybrid procedures combining debranching surgery and antegrade stent-graft placement in eight patients with aortic arch aneurysms. Eight patients with atherosclerotic aneurysms (n = 7) or traumatic pseudoaneurysm (n = 1) were enrolled. Proximal landing zones were in zones 1 (n = 2), 2 (n = 5), and ...

Pulmonary and aortic en bloc resection may be performed with cardiopulmonary bypass support, but is associated with high surgical morbidity and mortality. A 59-year-old man with left lower lobe cancer invading the aorta was considered to be unsuitable for such an extended operation because of previous myocardial infarction, coronary bypass ...

Endovascular carotid artery stenting has evolved over recent years to become a favorable alternative treatment option for cervical carotid artery stenosis. Potential complications include procedural embolism, carotid artery dissection, and hemodynamic instability. Events caused by device defect are unusual. We hereafter present a case in which the metallic marker ring ...

To study the safety and short and intermediate term efficacy of drug-eluting balloon (DEB) in the treatment of de-novo and in-stent restenotic coronary artery disease (CAD). Of the total 100 patients so far enrolled in a prospective DEB registry using a Paclitaxel-coated balloon at our hospital, 36 patients were studied ...

Aortic injury following blunt trauma can be potentially devastating, particularly when it occurs in multiply injured patients. This injury normally occurs just distal to the left subclavian artery. Recently, stent grafting has become a mainstay in therapy. Although technical challenges certainly exist in stent grafting aortic injuries in this location, ...

We report a case in which a calcification in mid left anterior descending (LAD) artery was not apparent initially on angiogram and stenting was done after inappropriate predilation resulting in underexpansion of stent. High pressure inflation, buddy wire technique, scoring and cutting balloon inflation failed to achieve the full expansion ...

Objective: To improve the long-term results of acute type A dissection repair, we developed a technique that combines radical surgical resection, and, at the same time, creates a safe and long landing zone for subsequent endovascular procedure on the descending aorta. Methods: Since November 2006, 23 patients (62±13 years) underwent ...

This report presents an unusual case of late, aortic hemorrhage that occurred during the removal of the stabilizing bar 3 years after a Nuss operation. The primary reason for this complication was a rotation of the sternum bar, which caused chronic damage to the aorta and development of an aortomediastinal ...

Percutaneous intervention of peripheral chronic total occlusions (CTO) is increasingly common, but Interventionalists still face significant barriers to successful treatment of CTO lesions in the coronary and peripheral anatomy. The greatest overall challenges are in crossing the CTO lesion and re-entering the true lumen from a successful subintimal crossing. We ...

OBJECTIVE: Hybrid thoracic endovascular aortic repair (TEVAR) has expanded the surgical management of complex thoracic aneurysms. Aortic arch debranching generally requires a sternotomy. We describe our experience performing a right anterior minithoracotomy for hybrid TEVAR. METHOD: During a 3-year period, 7 patients (aged 76 ± 15 years; 57% were male) ...

BACKGROUND: Primary pulmonary vein stenosis is often associated with relentless restenosis and early death. During the last 2 decades, we have developed a sutureless repair to improve prognosis. METHODS: Hospital records for patients undergoing repair of primary pulmonary vein stenosis from 1989 to 2008 were reviewed. Pulmonary vein stenosis was ...

Application of the "chimney" stent technique is described in a case of complex multilevel atherosclerotic disease involving the juxtarenal aorta. A patient with significant comorbidities was unsuitable for major open reconstructive surgery. He was treated with a combined procedure consisting of chimney stent placement in the juxtarenal aorta, iliac "kissing" ...

Abstract The nutcracker syndrome (NS) is a rare condition characterized by the entrapment of the left renal vein (LRV) between the superior mesenteric artery (SMA) and the aorta. Clinically, it presents with flank pain, hematuria, and symptoms of pelvic venous congestion. Several surgical techniques have been described including left renal ...

Axillosubclavian arterial transection due to blunt traumatic injury poses a treatment challenge in the multiply injured patient. Endovascular repair can be technically successful if the injury is focal. We describe an endovascular technique utilizing combined brachial and femoral access to create a through-and-through brachial-femoral wire and repair the arterial injury ...

BACKGROUND: To report a single-center experience of aortic stent-grafting for the treatment of acute, complicated, type B aortic dissections. METHODS: A retrospective review was conducted of the data obtained from all patients who underwent endovascular stent-grafting for acute, type B aortic dissection between 2006 and 2009. The primary and secondary ...

To describe the spectrum of axillary artery pathology seen in high-performance overhead athletes and the outcomes of current treatment. A retrospective review of patients that had undergone management of axillary artery lesions in a specialized center for thoracic outlet syndrome (TOS). Treatment outcomes were assessed with respect to arterial pathology ...

Spontaneous dissection of the superior mesenteric artery (SMA) is rare. We report a case of rupture of the SMA after spontaneous dissection in a 51-year-old male who presented with acute onset of abdominal pain and hypotension. The patient was initially treated with intravenous fluid resuscitation and endovascular intervention followed by ...

Successful endovascular exclusion of abdominal aortic aneurysms is largely dependent on adequate apposition of the stent graft to the aortic wall. Proximal endoleaks at the time of stent graft placement are uncommon but are more prevalent in patients with challenging neck anatomy. If these initial leaks do not respond to ...

BACKGROUND:: Aneurysms of the carotid-ophthalmic artery present unique challenges to cerebrovascular neurosurgeons given their proximity to vital anatomic structures. OBJECTIVE:: To report our experience with a combined-modality treatment of unruptured carotid-ophthalmic aneurysms over a twelve year period. METHODS:: A retrospective review 161 patients who underwent open, endovascular, or combined treatment ...

BACKGROUND: Many individuals who are candidates for thoracic endovascular aortic repair (TEVAR) are found to have iliac artery anatomy and/or disease that preclude transfemoral endovascular access and require retroperitoneal surgical approach through more proximal arteries. This relatively more invasive technique could potentially affect the procedural outcomes. This study compares the ...

BACKGROUND: Loss of side-branch vessels is a serious complication following stent implantation in parent vessels of bifurcation lesions. The purpose of this study was to introduce and test a new stent design for the protection of side-branch vessels in the management of bifurcation lesions. METHODS AND MATERIALS: This stent has ...

We describe a case of hepatic artery dissection in a 65-year-old woman. This is the 22nd reported case of hepatic artery dissection, and the first associated with mild acute pancreatitis. The incidence of this condition may be increasing with rising rates of intervention affecting the biliary system. Recognition may also ...

We report the case of a 38-year-old man who developed a false aneurysm of the anterior tibial artery after a true-cut needle biopsy of the shinbone. Although arterial damages are a known theoretical risk of such a procedure, to our knowledge, this is the first case to be reported. Repair ...

Extracranial internal carotid artery stenosis is a risk factor for perioperative stroke in patients undergoing coronary artery bypass surgery (CAB). Although selective and non-selective methods of preoperative carotid screening have been advocated, it remains unclear if this screening is clinically relevant. To test whether selective carotid screening is as effective ...

OBJECTIVES: The study aimed to evaluate a wide range of apoptotic markers in the vein wall of patients with superficial chronic venous disease (SCVD) compared with normal veins. DESIGN: This was an observational study. METHODS: Vein specimens were obtained from 19 patients suffering from SCVD. From each patient, a specimen ...

Aneurysms arising from the lenticulostriate artery (LSA) are rare. So far, only 23 cases have been reported in the literature (Ahn et al. 2007 [1], Gandhi et al. 2008 [2], Harreld et al. 2010 [3]). Early detection and treatment of these aneurysms is difficult because of their small size, deep ...

Objectives: Ascending aorta false aneurysms after cardiac surgery are uncommon. Resternotomy is hazardous and may result in massive and uncontrollable hemorrhage if the false aneurysm is entered. Here we report our experience with the use of deep hypothermia and circulatory arrest to avoid this risk. Methods: From March 2000 to ...

Objectives: Endovascular aneurysm repair (EVAR), may elicit an unexpected systemic inflammatory response, which has been named post-implantation syndrome (PIS). The aim of this study was to prospectively evaluate the association of PIS with clinical and laboratory parameters in patients who undergoing EVAR for abdominal aortic aneurysms (AAA). Methods: Forty consecutive ...

A 71-year-old man received carotid artery stenting (CAS) to the left internal carotid artery (ICA) after repeated minor ischemic strokes, with symptoms including transient right arm numbness, right arm weakness, and blurred vision in the left eye. Fundus examination showed central retinal artery occlusion. Brain magnetic resonance image (MRI) showed ...

Prolonged endovascular procedures requiring a large diameter sheath in each groin can be associated with significant intraoperative lower limb ischemia, particularly in those with pre-existing peripheral vascular disease. We report the case of a patient who suffered severe ischemia-reperfusion injury following endovascular repair of a pararenal aortic aneurysm using a ...

To ascertain the relationship between angiographic changes of the anterior choroidal and posterior communicating arteries (AChA-PComA) and cerebrovascular lesions in adult patients with moyamoya disease (MMD), we reviewed cerebral angiograms from 132 adult patients with MMD (68 with ischemia and 64 with hemorrhage). The angiographic findings of the AChA-PComA in ...

BACKGROUND:: Carotid and vertebral artery dissections are one of the leading causes of stroke in young individuals. OBJECTIVE:: To examine the published safety and efficacy of endovascular stenting for extracranial artery dissection. METHODS:: We conducted a systematic review of the literature to identify all cases of endovascular management of extracranial ...

BACKGROUND:: There is a theoretical concern that a thrombus may be dislodged distally when crossing the occluded segment during recanalization of a complete occlusion. OBJECTIVE:: To assess the immediate post-procedural brain diffusion weighted image (DWI) findings following endovascular recanalization using an embolic protection device for proximal internal carotid artery (ICA) ...

A 56-year-old Asian woman was admitted to hospital for the consideration of hemodialysis (HD). A right femoral dialysis catheter was inserted for HD. Three months after removal of catheter, she was admitted because of right inguinal swelling. A thrill and bruit were felt and heard at the inguinal area. Color ...

Stent infection following percutaneous transluminal coronary angioplasty is rare. We present such a case involving a drug-eluting stent placed in the left anterior descending coronary artery that was managed surgically with removal of the stent with concomitant coronary artery bypass grafting. Early surgical intervention directed at removal of the infected ...

Objective: Patients with supracoronary ascending aortic aneurysms can have aortic insufficiency (AI) due to dilatation of the sinotubular junction and/or associated cusp pathology. The incidence and types of cusp lesions as well as the effect of AI severity and cusp repair techniques on outcome in this patient population is not ...

This case report describes the repair of an aortoesophageal fistula caused by a previously placed aortic arch graft. A 62-year-old man underwent total aortic arch graft replacement one year ago. He was readmitted with hematemesis and a high fever. Examination by endoscopy revealed a perforation and two swollen lesions in ...

To evaluate the outcomes of carotid artery stenting (CAS) and open surgical repair (OR) for treatment of radiation-induced carotid stenosis (RICS). We retrospectively reviewed 60 patients treated for 73 RICSs from a group of 5,824 patients who had carotid interventions between 1992 and 2009. Thirty-three patients (37 arteries) were treated ...