Carotid artery dissection is a cause of stroke, especially in young and middle-aged patients. A dissections occurs when there is an intimal tear or rupture of the vasa vasorum, leading to an intramural hematoma, which is thought to result from trauma or can occur spontaneously, and is likely multifactorial, involving ...

This article presents the case of a 42-year-old man who presented with superior vena cava (SVC) syndrome due to fibrosing mediastinitis with multiple failed attempts at recanalization. We initially treated him with unilateral sharp needle recanalization of the right innominate vein into the SVC stump followed by stenting. Although his ...

We describe a 61-year-old patient with an infected aneurysm of the abdominal aorta due to Salmonella sepsis. Treatment was successful and included aneurysm resection, extensive debridement, and reconstruction of the abdominal aorta using the superficial femoral vein, combined with long-term antibiotic therapy.

Abstract Purpose: To report the early results of a multicenter registry of endovascular aneurysm repair (EVAR) using the Endurant stent-graft. Methods: Patients having elective treatment of infrarenal abdominal aortic aneurysm (AAA) with the Endurant stent-graft at 3 Canadian centers were enrolled in a prospective registry between September 2008 and January ...

Transcatheter aortic valve implantation has been established as an alternative treatment option for those patients with aortic stenosis (AO), who are high risk or unsuitable for surgical aortic valve replacement. Since its introduction, transcatheter aortic valve implantation has been mainly performed either by a percutaneous approach through the femoral arteries ...

Intravascular ultrasonography (IVUS) has been widely used in percutaneous coronary artery interventions to ensure optimal stent expansion. Entrapment of the IVUS catheter is potentially lethal. We report a case of successful emergent surgical removal of an entrapped catheter within the sirolimus-eluting stent and coronary revascularization.

Tracheoinnominate artery fistula (TIF) is an often fatal complication of laryngotracheal separation (LTS) for which there has been no systematic therapeutic strategy for prevention or management of TIF. The aim of this study was to establish such a strategy based on our clinical experience. From 2000 to 2010, 14 patients ...

To review results of orbital angiography performed during intra-arterial chemotherapy (chemosurgery) for treatment of retinoblastoma to assess the association of angiographic variability in orbitovascular anatomy with tumor response and outcomes. Medical records and 64 orbital angiograms were reviewed for 56 pediatric patients with retinoblastoma undergoing chemosurgery using a combination of ...

Aneurysm of the left atrial appendage is extremely rare, and afflicted patients most commonly present with atrial tachyarrhythmia or thromboembolism. For these patients, resection of the aneurysm is the recommended and preferred therapy. We present the case of a 57-year-old woman who was found incidentally to have a large aneurysm ...

Aortic pseudoaneurysm is a rare complication after blunt chest trauma or cardiac surgical procedures and can occur at the site of cannulation or root vent insertion on the ascending aorta. These pseudoaneurysms have the potential to expand, erode, and rupture, and detecting this condition before complications occur is the key ...

The inferior vena cava (IVC) filter is known as an effective and safe method for preventing fatal pulmonary thromboembolism in patients with deep vein thrombosis. Usually, the remaining IVC filters are asymptomatic and do not cause clinical problems. We report a case of duodenal perforation caused by a remaining IVC ...

The pathophysiology and time course of an individual converting from asymptomatic peripheral artery disease (PAD) to symptomatic claudication is unclear. The objectives of this study were: (1) to characterize the extent of atherosclerotic disease in individuals with an abnormal ankle-brachial index (ABI), but without claudication; and over 1 year of ...

Acute pulmonary embolism is a common complication in hospitalized patients, spanning multiple patient populations and crossing various therapeutic disciplines. Due to the heterogeneous clinical manifestations, the selection of management strategies for patients with acute pulmonary embolism is a challenge for clinicians, and a nuanced understanding of the relevant literature is ...

Coronary artery disease is the most important cause of mortality in patients with systemic lupus erythematous (SLE). After stenting for coronary artery disease in SLE patients similar to non-SLE patients, the risk of stent thrombosis is always present. Although there are reports of stent thrombosis in SLE patients, very late ...

Aortic aneurysm is one several well-known cardiovascular complications in patients with autosomal dominant polycystic kidney disease (ADPCKD). Commonly affected site of aortic aneurysm and its related dissection in ADPCKD is abdominal aorta. Long standing hypertension, haemodialysis, old age are closely related with discovering of aortic aneurysm and dissection in ADPCKD. ...

Assessment of safety and efficacy within the porcine coronary artery model remains a standard requirement for new therapies delivered to the coronary arteries before proceeding to clinical testing. Human coronary procedures carry a very low mortality rate; however, procedural mortality for porcine experiments is often high, despite these animals being ...

Upper extremity deep vein thrombosis (UEDVT) is an increasingly important clinical entity with potential for considerable morbidity, especially pulmonary embolism (PE). Here, the authors report a fatal case of the massive PE after spinal surgery, along with the UEDVT of superior vena cava (SVC).

Carotid stenting in standard risk patients has recently received supportive recommendations from the American Heart Association, in a guideline document endorsed by 14 societies with diverse but vested interest in carotid intervention. The procedural hazard i.e. the composite endpoint: all-stroke/death/myocardial infarction (MI) for carotid stenting and endarterectomy are equivalent, as ...

During the last several decades, the endovascular management of patients with aortic connective tissue disorders (CTD) has greatly evolved. While open surgery remains the gold standard, endovascular strategies can play an important role in the overall management of arterial lesions. CTD result from mutations in specific genes responsible for maintaining ...

Since the introduction of endovascular techniques for the treatment of aortic pathologies, clinical application of these lesser invasive procedures has increased exponentially during the last two decades and changed daily vascular practice completely. Starting in the infra-renal aorta, the indications for endovascular repair have gradually extended to the suprarenal aorta, ...

This review article presents the latest published clinical series evaluating fenestrated and branched endografts for the treatment of complex aortic aneurysms incorporating the visceral branches, iliac arteries and supra-aortic trunks. In addition, an overview of the recent developments in devices and imaging modalities is also proposed.

Acute aortic syndrome (AAS) is a modern term to describe interrelated emergency aortic conditions with similar clinical characteristics and challenges. These conditions include aortic dissection, intramural hematoma (IMH), and penetrating aortic ulcer (PAU). Population-based studies suggest that the incidence of aortic dissection ranges from 2.6-3.5 cases per 100,000 person/year; hypertension ...

Technical aspects are crucial for planning and performing successful endovascular repair of abdominal aortic aneurysms (AAA). Planning should be based on high-quality computed tomography angiography scans with a slice thickness of ≤1 mm. However, even without a workstation for image postprocessing, important angle estimations can be easily performed. Several devices ...

Although there is currently a trend using endovascular methods to treat long and/or complex distal lesions, there are some interesting new approaches, technical modifications and simplifications in open surgery. Some of these are new, and some are older, but their effectiveness is now starting to be recognized. 1) Anatomical concepts: ...

Treatment modalities for extensive chronic occlusive disease of the superficial femoral artery (SFA) have changed during the last decades. In this chapter we provide an overview of current treatment modalities for extensive chronic occlusive disease of the SFA. Although the autologous venous conduit is still considered the gold standard for ...

Endovascular treatment and stent implantation for peripheral arterial disease have been proposed for over 20 years. However, the first experiments with stainless stents were relatively disappointing. The first improvement consisted in the introduction of nitinol self-expanding stents. This technology allowed an initial improvement of clinical performances, but the first generation ...

We presented a case that an acute in-stent thrombosis after the deployment of a Wingspan stent was successfully managed with a stent in-stent technique. Because vessel perforation and subarachnoid hemorrhage were iatrogenically developed during the procedure, we were unable to use the thrombolytic agents to correct the in-stent thrombosis. When ...

Stent-assisted coiling allows embolization and parent vessel reconstruction of wide-necked intracranial aneurysms. The Neuroform EZ (Boston Scientific, Fremont, CA, U.S.A.) stent delivery system offers deployment of a Neuroform stent with fewer steps and improved operator control. Initial experience, technical considerations, and treatment outcomes using the Neuroform EZ stent delivery system ...

To optimize the recanalization of acute cerebral stroke that were not effectively resolved by conventional intraarterial thrombolysis (IAT), we designed a double device technique to allow for rapid and effective reopening. In this article, we describe the feasibility and efficacy of this technique. From January 2008 to September 2009, twenty ...

This guideline focuses on antithrombotic drug therapies for primary and secondary prevention of cardiovascular disease as well as for the relief of lower-extremity symptoms and critical ischemia in persons with peripheral arterial disease (PAD). The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy ...

OBJECTIVES: Dural arteriovenous fistulas (DAVFs) are arteriovenous shunts from a dural arterial supply to a dural venous channel, typically supplied by pachymeningeal arteries and located near a major venous sinus. A retrospective review was conducted to present the results of endovascular obliteration of DAVFs, with particular emphasis of newer liquid ...

An abdominal aortic aneurysm (AAA) is an irreversible dilation of the abdominal artery. Once an aneurysm is detected by doctors, clinical intervention is usually recommended. The interventions involve traditional open surgery repair and endovascular aneurysm repair with a stent graft. Both types of prophylactic procedures are expensive and not without ...

BACKGROUND: The prevalence, determinants and prognosis of pulmonary hypertension among long-term hemodialysis patients in the USA are poorly understood.METHODS: A cross-sectional survey of prevalence and determinants of pulmonary hypertension was performed, followed by longitudinal follow-up for all-cause mortality. Pulmonary hypertension was defined as an estimated systolic pulmonary artery pressure of ...

AIMS: High-risk patients with severe aortic stenosis (AS) who are candidates for transcatheter valve implantation (TAVI) or balloon aortic valvuloplasty (BAV) may additionally require revascularization of the unprotected left main coronary artery (UPLM). We aimed to assess the feasibility and procedural safety of UPLM stenting in such patients. METHODS AND ...

ABSTRACT: BACKGROUND: The left internal mammary artery (LIMA) is the choice for grafting of the left anterior descending coronary artery (LAD). One possible mechanism of the rare graft failure involve the presence of competitive flow. METHOD: 105 patients who had undergone coronary bypass grafting between 1998 and 2000 were included ...

Transcatheter aortic valve implantation (TAVI) enables treatment of aortic stenosis with no need for open heart surgery. According to current guidelines, only patients considered at high surgical risk can be treated with TAVI. In this study, patient-specific analyses were performed to explore the feasibility of TAVI in morphologies, which are ...

Fatal rupture of abdominal aortic aneurysm (AAA) remains a feared complication. Development of vascular surgery techniques over 50 years ago has fulfilled the promise of preventing rupture, but the significant morbidity associated with open repair causes physicians and their older patients pause. With the advent of less invasive endovascular techniques and ...

The identification of the coronary "vulnerable plaque" that is prone to disruption and thrombosis remains a "holy grail" in the treatment of coronary artery disease. The widespread use of coronary angiography for the identification of coronary atherosclerotic disease has led to numerous earlier studies exploring the role of angiography in ...

PURPOSE: To evaluate the efficacy and safety of balloon-expandable stent grafts in the emergency treatment of acute arterial hemorrhage. MATERIALS AND METHODS: Between July 2008 and December 2009, 15 patients with acute arterial hemorrhage from inflammatory vessel erosion or pseudoaneurysms (n = 9), noninflammatory pseudoaneurysms (n = 3), or iatrogenic ...

IntroductionDevice developments and evolution in technique over the past decade make the treatment of aneurysms which were previously considered poor candidates for coiling more feasible. The authors describe their experience treating aneurysms at a single high-volume tertiary care center, focusing particularly on the use of adjunctive devices.MethodsA retrospective review was ...

A 77-year old male patient was admitted for the treatment of a thoracic aortic aneurysm (TAA) and primary lung cancer. A saccular aneurysm, 4.8 cm in diameter, located in the proximal segment of the descending thoracic aorta and a pulmonary tumour, 3 cm in diameter, located at the right lower lobe, with ...

Clinical images: A 52 year old man presented with signs of a stroke in the territory of the right middle cerebral artery. He was also found to have a large pulsatile mass at the base of his neck on the right side. Subsequent clinical imaging revealed a pseudoaneurysm (false aneurysm) ...

Abstract  Polycythemia vera (PV) is a chronic myeloproliferative disorder with a predilection for thrombotic complications in affected patients. Intracardiac thrombosis is a rare manifestation of this disease, as documented in only a few published cases. In this report, we describe a PV patient who suddenly developed extensive thrombosis within all ...

BACKGROUND AND PURPOSE: Flow Diverters (FD) are a new emerging therapy for intracranial aneurysms. Initial reports focused on the treatment of proximally located aneurysms. We report our experience with FDs in the treatment of aneurysms at and beyond the circle of Willis. METHODS: We treated 30 aneurysms at and beyond ...

BACKGROUND AND PURPOSE: Determinants of successful recanalization likely differ for Merci thrombectomy and intra-arterial pharmacological fibrinolysis interventions. Although the amount of thrombotic material to be digested is an important consideration for chemical lysis, mechanical debulking may be more greatly influenced by other target lesion characteristics. METHODS: In consecutive patients with ...

OBJECTIVES: To assess the effect of pulmonary involvement on the course and outcome of multisystem Langerhans cell histiocytosis (MS-LCH) in children. STUDY DESIGN: We conducted a retrospective analysis of 420 consecutive patients with MS-LCH. In this analysis, the term "risk organs" is defined as involvement of the liver, spleen, and/or ...

BACKGROUND: To present an unusual case of blunt aortic injury in a 30-year-old male patient with an aberrant right subclavian artery. METHODS AND RESULTS: Driven by the complicated and challenging nature of the case, we decided to treat the patient by a combined approach-right subclavian artery transposition and endograft implantation ...

BACKGROUND: The purpose of this study was to evaluate the 10-year outcome of patients presenting with asymptomatic moderate carotid artery stenosis, and to determine which factors correlate with progression of disease to stroke or revascularization. METHODS: A retrospective review of all new patients presenting with asymptomatic moderate carotid artery stenosis ...

Hybrid repair of thoracic aortic aneurysm has been used with increasing frequency over the past decade, as indications for endovascular therapy have continued to expand. Hybrid techniques may avoid and limit the morbidity and mortality associated with sternotomy or thoracotomy, mechanical circulatory support, and hypothermic arrest. We present the case ...

Endovascular treatment has emerged as a first-line treatment for venous occlusions, but is sometimes challenging with conventional approaches. This article describes a helpful technique using a Rösch-Uchida needle to cross a chronic occlusion of the iliac vein when conventional techniques have failed.