Pulmonary hypertension (PH) is a hemodynamic state of the pulmonary circulation characterised by an elevated pulmonary artery pressure. It can be the consequence of a wide variety of etiologies requiring distinct therapeutic approaches. Enormous progress has been made over the past decade in this field. A better understanding of the ...

Sutureless aortic valve prosthesis is a new and promising tool for treatment of aortic valve stenosis. It could increase applicability of surgical aortic valve replacement in the elderly with severe comorbidities. Three devices are currently available. The 3f Enable (ATS, Minneapolis, USA) and the Perceval S (Sorin, Saluggia, Italy) have ...

A patient presented with exertional chest pain two months prior to admission. Coronary angiography revealed a subocclusive stenosis within the boundaries of the stent. Optical coherence tomography showed remarkable intimal growth inside the stent, which demonstrated a heterogeneous appearance including low-intensity areas. These findings were congruent with the morphology of ...

There are conflicting results with regard to the use of catheter-based techniques for continuous paravertebral block. Local anaesthetic spread within the paravertebral space is limited and the clinical effect is often variable. Discrepancies between needle tip position and final catheter position can also be problematic. The aim of this proof-of-concept ...

PURPOSE: To evaluate the results of stent placement for obstructive atherosclerotic aortic disease with or without involvement of the common iliac artery. MATERIALS AND METHODS: Forty patients had self-expanding stents primarily or after balloon dilatation in the abdominal aorta between January 2005 and May 2011. All patients had trouble walking. ...

To assess the incidence and clinical significance as well as predictors of in-stent restenosis (ISR) after carotid artery stenting (CAS) diagnosed with serial duplex sonography investigations. We analyzed 215 CAS procedures that had clinical and serial carotid duplex ultrasound investigations. The incidence of in-stent restenosis (ISR) and periprocedural as well ...

BACKGROUND AND PURPOSE:In clinical practice, durability of occlusion following coil embolization is superior in densely packed, compared with loosely packed, aneurysms. In a rabbit model, we probed, by using proteomics tools, the biologic mechanisms associated with densely packed and completely occluded aneurysms, compared with loosely packed and incompletely occluded aneurysms, ...

BACKGROUND AND PURPOSE:The progression of atherosclerosis is related to various factors. Although antiplatelet therapy is used for the management of acute ischemic stroke and for the prevention of recurrent stroke, the antiplatelet agent cilostazol may also reduce restenosis after stent implantation in any vessel. This study was performed to assess ...

The authors describe the case of a simultaneous mitral bioprosthesis hypertrophic scaring and native aortic valve fibrosis during benfluorex therapy in a 40-year-old woman. Four years before, she underwent a mitral valve replacement after the diagnosis of mitral regurgitation during benfluorex treatment (150 mg/day). This drug was reintroduced postoperatively. She presented ...

Transcatheter pulmonary valve implantation in the setting of right ventricle-to-pulmonary artery conduit dysfunction is a relatively new procedure with encouraging early and midterm results. Malpositioning of the valve during implantation is a potentially serious complication. This report describes a case in which valve malpositioning was avoided by the use of ...

New innovations and novel approaches to peripheral arterial occlusive disease have brought enormous benefits to the vascular patient. Diseases that were once manageable only by surgical intervention are now easily and successfully treated by minimally invasive procedures. While the early days of percutaneous intervention were filled with inventions of new ...

Although visceral vessel debranching and endovascular aneurysm exclusion represents a hybrid treatment approach in patients with thoracoabdominal aortic aneurysm, the effect of timing with regard to the visceral debranching procedure and endovascular aneurysm exclusion in this treatment strategy remains unclear. In this study, the authors analyzed their recent institutional experience ...

PURPOSE OF REVIEW: This review will report on the new aspects of management of 'malignant' middle cerebral artery (MCA) infarctions. RECENT FINDINGS: Large MCA infarctions have been associated with high death rates for years. The most reliable predictors of a 'malignant' course are hypodensity in more than 50% of the ...

BACKGROUND: To report a case of multiple additional procedures after successful endovascular treatment of abdominal aortic aneurysm. METHODS: An endovascular abdominal aortic aneurysm repair with a bifurcated aortic Vanguard endograft successfully performed in 1999 resulted in multiple complications, including endoleaks and a row separation, treated endovascularly. Subsequently, tuberculosis sepsis and ...

The popliteal artery (PA) entrapment syndrome, a rare cause of arterial thrombosis, is most often encountered in young male athletes. Here, we report a very unusual case of PA entrapment syndrome in a 14-year-old girl who presented with a 1-month history of calf claudication to our observation facility. Diagnostic work-up ...

Background and purposeFenestration of the vertebrobasilar junction (VBJ) is a rare condition which may be associated with the presence of aneurysms. The endovascular approach is usually the first-line treatment in these cases since the location of the aneurysm may be unsuitable for a surgical approach. This anatomical variation may even ...

Abstract Pulmonary venous stenosis is rare, most commonly found in association with cardiac malformations. Recent studies have associated pulmonary venous stenosis with prematurity, especially with bronchopulmonary dysplasia, though no such case has been documented at autopsy. We report the case of a 26-weeks gestation infant, who required ventilation at birth, ...

BACKGROUND: Advanced chronic obstructive pulmonary disease causes a significant reduction in functional capacity because of dyspnea and fatigue, partially related to hypoxemia and compromised oxygen delivery. Percutaneous creation of an arteriovenous shunt may increase oxygen delivery and, hence, improve patients' functional capacity. METHODS AND RESULTS: This is a prospective, single-center, ...

OBJECTIVES: Type II endoleak (T2EL) with aneurysm expansion is believed to place patients at risk for aneurysm-related mortality (ARM). Treatment with glue and/or coil embolization of the aneurysm sac, inferior mesenteric artery (IMA), and lumbar branches via translumbar or transarterial approaches has been utilized to ablate such endoleaks, and thus ...

Central venous catheters are commonly utilized to gain vascular access for varied clinical indications. Successful catheter placement requires not only technical expertise but also awareness of the potential complications. In this article, we report a malposition of a central venous catheter in a hemodialysis patient. We review the complications of ...

Background. Thrombosis of synthetic small-diameter bypass grafts remains a major problem. The aim of this article is to review the antithrombotic strategies that have been used in an attempt to reduce graft thrombogenicity. Methods. A PubMed/MEDLINE search was performed using the search terms "vascular graft thrombosis," "small-diameter graft thrombosis," "synthetic ...

Inflammatory abdominal aortic aneurysms (IAAAs) account for 5% to 10% of all abdominal aortic aneurysms, occurring primarily in males. Their true etiology is unknown. Symptoms and signs of IAAA are so variable that they present to a wide range of specialties. There is debate in the literature whether IAAA is ...

Total anomalous pulmonary venous connection is a cyanotic congenital heart defect that presents with a multitude of clinical presentations. We report a case of obstructive total anomalous pulmonary venous connection (TAPVC) which presented in a way that has not previously been described. An infant with mixed type obstructive TAPVC was ...

OBJECTIVE: To report the outcomes associated with endovascular therapy for patients with chronic mesenteric ischemia (CMI). METHODS: A retrospective review of patients who underwent endovascular therapy for CMI between April 1981 and September 2009 at a single institution was performed. Procedural details, mesenteric arteries treated, technical and clinical success rates, ...

Twin reversed arterial perfusion (TRAP) sequence is a serious complication of monochorionic twin pregnancies. Arterio-arterial anastomoses allow blood flow from the pump fetus to the acardiac fetus via the latter's reversed arterial flow. Several trial treatments for TRAP sequence have been reported; however, they were all invasive. We present a ...

Behçet's disease is a systemic inflammatory vascular disorder that may affect the cardiovascular system. Left anterior descending (LAD) artery aneurysm is a rare but potentially fatal complication of Behçet's disease. An accurate diagnosis of this clinical entity requires multimodal imaging (computerized tomography, angiography, and echocardiography) and is essential to guide ...

The persistence of a left-sided superior vena cava is the most common variant of systemic venous drainage. Increased utility of cardiac imaging, in particular cross-sectional techniques such as computed tomography and magnetic resonance (MR), will result in increased detection of the anomaly and its variants. Whilst in the typical form ...

BACKGROUND: Superficial temporal artery (STA) aneurysms are an uncommon entity and mostly described in case studies. The purpose of this review was to show the studied clinical presentation, diagnostic modalities, and treatment modalities of STA aneurysms. METHODS: A review was performed of reports on STA aneurysms published until December 2010, ...

BACKGROUND AND PURPOSE:FD stent placement is a promising therapy for challenging intracranial aneurysms. Long-term evaluations about angiographic and morphologic results are still missing. This is the aim of this multicenter series.MATERIALS AND METHODS:We report our experience and 1-year FU in a retrospective chart review of 65 consecutive subjects with 77 ...

We present the case of a 58-year-old lady with p-ANCA vasculitis who suffered a WFNS grade 1 subarachnoid haemorrhage (Fisher grade 1) secondary to a ruptured left posterior inferior cerebellar artery aneurysm and then developed a rare complication of radiologically progressive spinal arachnoiditis despite maintained clinical response to definitive treatment ...

BACKGROUND: Contralateral clipping of MCA aneurysms seems dangerous and ill advised, but could become an important technique because of the prevalence of MCA aneurysms, the limitations of endovascular therapy, and increasing interest in less invasive techniques. OBJECTIVE: To define patient selection, surgical technique, and results with contralateral MCA aneurysm clipping. ...

: Breast reconstruction using the deep inferior epigastric perforator (DIEP) flap is becoming more common and can help reduce donor site morbidity. The authors proposed that dissection of the deep inferior epigastric artery (DIEA) and vein (DIEV) to their external iliac source may not be required for safe flap transfer. ...

Fibromuscular dysplasia (FMD) involves small- and medium-sized arteries, being a well-known cause of hypertension in young Caucasian women, when renal arteries are involved. The etiology of FMD remains unknown, despite many theories. A genetic component is suspected to exist, because the pathology affects primarily Caucasians. Association between FMD and the ...

Now in its 9th year, the Vascular Interventional Advances (VIVA) Symposium has demonstrated comprehensive, objective, cutting-edge continuing education in the field of vascular medicine and intervention. With a faculty representing expertise across all specialties, and using a proprietary system of interactive educations (Laptop Learning), attendees listen to presentations and debates, ...

Crush stenting mandates a final kissing-balloon technique (KBT) for a better clinical outcome; however, recrossing the 2 overlapping stent struts with the balloon catheter is technically challenging. The efficacy of the buddy-balloon technique for facilitating completion of the final KBT during crush stenting of the left main coronary artery (LMCA) ...

Saphenous vein grafts are prone to degeneration and occlusion. Vein graft disease continues to be a significant problem in maintaining long-term benefits after coronary artery bypass surgery. The neointimal hyperplasia and aggressive atherosclerosis that occur in saphenous vein grafts make interventions particularly challenging due to plaque embolization and the no-reflow ...

Valvular complications after coronary catheterization are extremely rare and are seldom reported in the literature. We report a patient who experienced acute traumatic aortic regurgitation after repeated coronary transcatheter procedures. Despite clinical stabilization under medical treatment, his clinical course led to an aortic-valve replacement.

Patients with Fontan baffles for single ventricle may have cyanosis from right-to-left shunt through leaks in the baffle or due to intentionally created fenestrations. Typically this right-to-left shunt may be addressed with catheter-based occlusion devices. However, in narrowing of the Fontan baffle, placement of occluders within the Fontan baffle may ...

Percutaneous coronary intervention (PCI) for the treatment of chronic total occlusion (CTO) is one of the most technically challenging areas of interventional cardiology. When CTO is combined with angulation and tortuosity of the coronary artery, the technical complexity of PCI for CTO is magnified. In this report, we describe a ...

Pulmonary embolism (PE) by occlusion of the pulmonary arterial bed may lead to acute life-threatening but potentially reversible right ventricular failure, one of the most severe complications of thoracic surgery. Still, the incidence of acute pulmonary embolism after surgery is reduced by comprehensive anticoagulant prevention, improved surgical techniques, appropriate perioperative ...

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 ...

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 ...

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 ...

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 ...