Coronary artery fistulae can present late in adult life. We describe the case of a 71-year-old woman who developed a right coronary fistula, which was managed by percutaneous transbrachial coil embolization. Complete closure of the fistula was confirmed by follow-up angiography at 10 months.

BackgroundPartial splenic artery embolization is an effective treatment for hypersplenism but often lacks long-term benefits.PurposeTo evaluate the long-term effects of coil embolization of the splenic artery in patients with liver cirrhosis and hypersplenism.Material and MethodsForty-nine patients with liver cirrhosis and hypersplenism underwent coil embolization of the main splenic artery. The ...

In the presence of resistance to circumferential expansion of atherosclerotic plaques due to mechanical dilation high shear stresses between stiff plaques and normal vessel segments may occur and thus may result in coronary dissection. Limited data are available on the clinical and angiographic outcome of severe (type E, type F) ...

The presence of an aberrant right subclavian artery arising from the proximal descending aorta is a relatively common anomaly of the aortic arch. These vessels may be involved in aortic dissections, either as the site of the primary intimal tear or as a dissected aortic branch, subject to flow limitation ...

We report a redo coronary artery bypass grafting (CABG) in a 55-year-old man. Angina recurred 7 years after the initial surgery. Coronary angiography showed all patent grafts except a faint visualization of the in situ right gastroepiploic artery (RGEA) graft, which was anastomosed to the posterior descending coronary artery, associated ...

Guide catheter kinking and fracture is an uncommon complication of percutaneous coronary intervention and may require emergency surgical intervention if percutaneous retrieval fails. We present a case of guide catheter kinking and fracture during attempts to engage the left main coronary artery in a patient with marked iliac tortuosity. The ...

The novel approach of using excimer laser in a contrast medium for treating an under-expanded stent in a calcified coronary artery is described. In this first reported case, the laser in a contrast medium was used to treat an under-expanded stent deployed 18 months prior in a calcified non-dilatable coronary ...

Bleeding from the proximal suture line is not uncommon after composite graft anastomosis in the Bentall procedure. The passage of valve sutures through the aortic valve leaflets interposed between the pledgets and the cuff of the composite valved conduit strengthens the repair.

We investigated the effect of perindopril on pulse-wave velocity (as indicator of arterial elasticity) and endothelin-1 (ET-1) levels in black hypertensive patients. Forty-four newly diagnosed hypertensive patients who received 4 mg perindopril daily were monitored for nine months. Pulse-wave velocity (PWV) was measured noninvasively along the carotid-femoral arterial segment (high ...

We describe a successful case of direct superior mesenteric artery fenestration for an acute type B dissection complicated by bowel necrosis in a 68-year-old man. At 11 days after the onset, computed tomography showed superior mesenteric artery obstruction. We fenestrated and connected the true lumen to the false lumen of ...

Endovascular embolization has become part of the management of postpartum hemorrhage. We report a case of bilateral extensive gluteal skin and muscle necrosis with concurrent severe lumbosacral plexopathy after bilateral internal iliac artery embolization for postpartum hemorrhage. The ischemic plexopathy was treated conservatively, with a fair outcome. The complex gluteal ...

Objectives- The criteria for evaluating cerebral artery stenosis by transcranial Doppler sonography are inconsistent. We aimed to identify the accuracy of transcranial Doppler criteria compared with digital subtraction angiography for diagnosis of anterior circulation artery stenosis. Methods- A total of 170 patients who underwent transcranial Doppler sonography and digital subtraction ...

: Postpartum hemorrhage is an obstetric emergency and is a major preventable cause of maternal morbidity and mortality. An arteriovenous fistula is a rare cause of concealed postpartum hemorrhage. : A 20-year-old woman spontaneously delivered at 40 0/7 weeks of gestation. Twelve hours after delivery, she became hemodynamically unstable, developing ...

Carotid intima-media thickness assessed by ultrasonography of carotid arteries is a safe, non-expensive, feasible and accurate method for detecting early signs of atherosclerosis and carotid intima-media thickness and change in carotid intima-media thickness over time reflect cardiovascular disease risk. Technical aspects impact on the measurement, variability and interpretation of carotid ...

Descending thoracic aorta to femoral artery bypass has been used as a remedial operation after aortic or axillofemoral graft failure or graft infection and other intra-abdominal pathologies not amenable to standard aortofemoral revascularization. It can avoid abdomen approach and has been known as a durable procedure with excellent long-term patency. ...

Isolated peripheral pulmonary artery stenosis presenting in adulthood is an uncommon cause of right ventricular hypertension and may be misdiagnosed as primary or thromboembolic pulmonary hypertension. Treatment consists of balloon angioplasty and stenting of the affected vessels, although the procedure can be complicated by reperfusion pulmonary edema.

Purpose: To describe a technique in which percutaneous orbital atherectomy is used to debulk heavily calcified superior mesenteric artery (SMA) occlusions as an adjunct in patients undergoing angioplasty and stenting. Technique: The technique is demonstrated in a 62-year-old woman with a replaced right hepatic artery originating from an SMA occluded ...

Wound complications following cardiac surgery are typically infectious and associated with a high morbidity and mortality. Calciphylaxis, vascular calcification of small and medium sized vessels, often associated with end-stage renal disease, can result in extensive tissue necrosis. We hypothesize that calciphylaxis is an under-recognized and under-reported precipitating wound and breast ...

The hepatic artery is the second most common site for aneurysms formation within the splanchnic circulation. Most hepatic artery aneurysms (HAA) are diagnosed incidentally by a computed tomography(CT) scan or a Doppler ultrasonography. We present the case of a HAA diagnosed preoperatively in a 82-year old man, who was treated ...

Percutaneous mitral valvuloplasty is the procedure of choice for the treatment of patients with mitral stenosis and suitable valve anatomy. Papillary muscle rupture is the most worrisome complication of this procedure. Three-dimensional transesophageal echocardiography (3D TTE) is additive to conventional two-dimensional imaging in these patients in terms of three-dimensional perspective ...

Celiac trunk usually trifurcates and supplies the organs in the supracolic compartment. The vascular variations are common in this region. There are reports on the variant course of right hepatic artery (RHA). The tortuous RHA forming a caterpillar hump is a rare finding and also its providing origin to gastroduodenal ...

The aim of this paper was to study the effect on patency rate of different types of vein collar (Miller's original or St Mary's boot), different length/height shapes of vein collar, and different vein collar volumes at the distal anastomosis of PTFE-bypass grafts to below-knee arteries in patients with critical ...

Objectives- Carotid duplex sonography is the primary tool for surveillance after carotid artery stenting, but the course of sonographic velocities over time after successful stenting is unclear. The purpose of this study was to describe carotid duplex sonographic velocity parameters after successful carotid artery stenting and to determine the predictors ...

Purpose: To describe the endovascular management of a spontaneous rupture of the visceral abdominal aorta. Case Report: A 69-year-old man presented as an emergency with a ruptured non-aneurysmal visceral abdominal aorta that extended from just below the celiac trunk to the right renal artery; the superior mesenteric artery (SMA) appeared ...

The aim of the present study was to evaluate the independent predictors of coronary artery stenosis in patients with type 2 diabetes mellitus (DM) and subclinical atherosclerosis. A total of 232 patients with type 2 DM and subclinical atherosclerosis underwent multislice computed tomography coronary angiography. Subclinical atherosclerosis was determined by ...

Objectives: Our aim was to establish the frequency of arterial anatomic variations and its relation to coronary procedural outcome in patients undergoing a first transradial coronary procedure. Methods: This was a single center prospective study. A total of 1,446 consecutive patients undergoing their first transradial coronary procedure were recruited. Retrograde ...

Obstructive sleep apnea (OSA), a risk factor for coronary artery disease, remains under diagnosed. We investigated if OSA identified by the Berlin Questionnaire (BQ) is associated with the risk of coronary artery disease. Cases were patients referred for elective coronariography. The cases were classified with significant coronary lesions (stenosis > ...

Our aim was to establish a novel model of abdominal aortic aneurysms (AAA) in mice using application of peri-adventitial elastase. C57BL/6J male mice underwent infrarenal peri-adventitial application of either (1) sodium chloride (control; n = 7), (2) porcine pancreatic elastase (PPE; n = 14), or (3) PPE and doxycycline (PPE ...

To decrease the risk of traumatic injury or dissection of the aorta in patients with diffuse atherosclerotic disease or calcification of the ascending aorta, we have devised a simple method that uses an Embol-X aortic cannula with a Fogarty occlusion catheter.

Purpose: To report the use of a technique (AFTER: aortic false lumen thrombosis induction by embolotherapy) to achieve false lumen (FL) thrombosis and aortic remodeling in patients with residual FL patency after initial endovascular repair of aortic dissection. Methods: Between January 2003 and January 2010, 31 patients underwent staged total ...

A 30-year-old man presented with chest pain and was diagnosed with biatrial myxomas and pulmonary embolism. He underwent resection of the biatrial myxomas and tumor embolectomy from the pulmonary artery. The histological diagnosis was multiple cardiac myxomas. Further examination showed that this patient also had spotty pigmentations, cutaneous myxomas, and ...

Aortic valve sparing operations were developed to preserve the native aortic valve during surgery for aortic root aneurysm as well as surgery for ascending aortic aneurysms with associated aortic insufficiency. There are basically two types of aortic valve sparing oprations: remodeling of the aortic root and reimplantation of the aortic ...

This study reports detailed surgery procedures on a patient with cardiac myxoma and multiple embolization in the aortic artery, lower extremities, and the superior mesenteric and renal arteries, which is quite uncommon. As the first step in the surgery, conventional thrombectomy was used to remove emboli in abdominal aorta and ...

Background: advantages in the use of arterial grafts for coronary artery revascularizations have been reported previously. Objectives: we aimed to compare the outcome and survival rates of different conduits in patients with poor ventricular function (ejection fraction <30%). Methods: in a 10-year period, 979 patients with an ejection fraction <30%, ...

Several patterns of anomalous pulmonary venous drainage have been described in the literature, and bilateral partial pulmonary anomalous vein connection (PAPVC) has been described as a rare congenital cardiac anomaly. We report an unusual type of bilateral PAPVC, involving both the superior right and left pulmonary veins draining into the ...

We present a case of a neonate with a huge congenital fistula from the left anterior descending coronary artery to the right ventricle and additional heart defects. The circumflex coronary artery was supplied by the right coronary artery. The fistula was closed surgically at both ends.

A 73-year-old woman with severe aortic stenosis was accepted for transcatheter aortic valve implantation. There was minimal paravalvular leakage after the implantation, and the patient was stable. Twelve minutes after the implantation, the arterial pressure suddenly dropped. Transesophageal echocardiography showed severe left ventricular dysfunction. Cardiopulmonary resuscitation was started, and initially ...

Purpose: To evaluate the outcomes of endografts designed with renal fenestrations alone vs. more complex designs that accommodate mesenteric arteries in a consecutive series of patients with pararenal aortic aneurysms undergoing endovascular aneurysm repair (EVAR). Methods: A retrospective review of data prospectively collected over a 5-year period identified 42 consecutive ...

Aortic valve rupture after blunt trauma to the chest is an infrequent complication that should be considered at the outset in examination of an accident victim. The presence of aortic regurgitation with hemodynamic instability is an indication for surgery. We implanted a stentless bioprosthesis after aortic valve rupture due to ...

Coronary trifurcation lesions are a complex subset of lesions. We present a case of a percutaneous intervention of a trifurcation lesion involving the left anterior descending artery and 2 diagonal branches completely treated with one single device, the novel stent-on-a-wire (SOAW) (Svelte Medical Systems), for the whole procedure. The SOAW ...

INTRODUCTION: Previous studies have noted formation of saccular aneurysms along the distal basilar artery/P1 segments after carotid ligation in rabbits. In this prospective study we employed MICROFIL®, a polymer, which was used to fill the entire arterial tree, to examine the incidence of microaneurysm formation following right common carotid artery ...

The proximal course of an anomalously arising coronary artery is a decisive factor in the surgical approach for tetralogy of Fallot (TOF). Studies have shown that echocardiography provides a good anatomic definition of the ostium and proximal epicardial course of coronary arteries [1, 2]. This report describes a case of ...

Spinal osteochondromas constitute a small percentage of all intraspinal tumours, and are a rare cause of neurological symptoms. We describe a patient with a vertebral artery occlusion secondary to an osteochondroma of the C1 vertebra presenting with symptoms of cerebral ischaemia. This case is reported because of its extreme rarity.

Vein grafts fail as the result of wall maladaptations to surgical injury and hemodynamic perturbations. Interleukin-1 signaling has emerged as an important mediator of the vascular response to trauma and hemodynamically induced vascular lesions. We therefore hypothesized that interleukin-1 signaling drives early vein graft wall adaptations. Using interleukin-1 type I ...

BACKGROUND: Pulmonary atresia with ventricular septal defect (PA/VSD) and major aortopulmonary collateral arteries (MAPCAs) is a complex form of congenital heart defect. One identifiable subset has small (<2.5 mm) intrapericardial branch pulmonary arteries that are (1) confluent, (2) have normal arborization, and (3) have dual-supplied collateral vessels. When this anatomy ...

OBJECTIVE AND DESIGN: α1-Antitrypsin deficiency (AATD) is a genetic disorder that may be a pathogenic factor in vascular aneurysms and dissection. The aim of this study was to measure the diameters of the Valsalva sinuses (VS), sinotubular junction (STJ), ascending aorta (AA) and aortic arch (AAr) and elastic properties of ...

Background Patients with vascular Ehlers-Danlos syndrome (EDS) can develop internal carotid artery (ICA) aneurysms. Any surgical procedure is hazardous and often unrewarding because of fragile blood vessels. Endovascular treatment may be an alternative approach to the treatment of ICA aneurysms in patients with vascular EDS.Case A 23-year-old woman with vascular ...

Introduction In this article, we report the first patient with Ehlers-Danlos syndrome type IV (EDS IV) who developed multiple spontaneous contralateral direct carotid-cavernous fistulas (CCFs) after permanent occlusion of left internal carotid artery CCF 2 years before. We occluded the multiple fistulas and preserved the internal carotid artery (ICA) by ...

A best evidence topic was written according to a structured protocol. The question addressed was 'is the saphenous vein graft or right gastroepiploic artery a better conduit for revascularization of the right coronary artery?' One hundred and five articles were found using a designated search, of which 10 articles were ...

An attempt at parent vessel reconstruction with Pipeline embolization devices to treat a mycotic pseudoaneurysm of the internal carotid artery at the skull base is presented. A 50-year-old woman with malignant otitis externa and bilateral temporal bone osteomyelitis presented with brisk bleeding from her left ear. She had bony dehiscence ...