BackgroundMost cavernous sinus dural arteriovenous fistulas (CSDAVFs) present with benign ocular symptoms; isolated CSDAVFs with aggressive behavior are extremely rare. The treatment goal is to occlude the fistula totally. However, transarterial or venous access may not be possible because of complex angioarchitecture.Case descriptionA woman in her late 70s presented with ...

The complex anatomic features of wide-necked anterior communicating artery aneurysms represent an endovascular challenge. Compliant balloons and microstents are frequently required to achieve aneurysm occlusion. When the angle between the A1 and A2 segments is acute, microcatheter navigation is hazardous, and may be difficult or sometimes impossible with standard techniques. ...

Internal mammary artery (IMA) graft fistula to the pulmonary arteries is a cause of myocardial ischaemia after coronary artery bypass grafting (CABG). Surgical and percutaneous interventional treatments are available, both with their inherent risk and benefits. Optimised medical management is therefore essential. A pre CABG IMA angiographic image may assist ...

Late-term thrombosis associated with drug-eluting stents may be due to the non-selective actions of antimitogenic drugs on endothelial cells, leading to delayed vascular healing after stenting angioplasty. Currently, there is a need for stent-based therapies that can both attenuate neointimal hyperplasia and promote re-endothelialization. The aim of this study was ...

SummaryThe first known use of Onyx delivered via a dual lumen balloon catheter is reported. A mandibular arteriovenous malformation was successfully embolized with Onyx via an Ascent balloon catheter.Case presentationA teenage girl presented with facial deformity and episodes of oral bleeding. Angiogram showed an extensive left mandibular arteriovenous malformation with ...

This report describes a case with double outlet right ventricle and doubly committed ventricular septal defect associated with congenital diaphragmatic hernia. The patient underwent pulmonary artery banding and clipping of patent ductus arteriosus after repair of the diaphragmatic hernia. At 6 months, cardiac catheterization revealed anomalous origin of a single ...

This study describes an alternative arteriovenous fistula (AVF) model in the rat in which the animals develop significant neointimal hyperplasia (NIH) not only at the distal anastomotic site, but also throughout the fistula body. This aortocaval fistula was established by anastomosing the distal end of the renal vein to the ...

Fistula between saphenous vein graft (SVG) and a cardiac chamber or structure is a rare complication after coronary artery bypass grafting (CABG). We report the first case of a fistula between SVG and the right atrium (RA) as an immediate complication after a percutaneous coronary intervention (PCI) in an 86-year-old ...

Purpose: To quantify diameters of central vein segments in patients with autogenous hemodialysis fistulas. Materials and Methods: A retrospective review of patients within the last year who underwent arterial venous fistula assessment identified 218 patients. Of these, 32 also had computed tomography (CT) of the thorax performed from which venous ...

ObjectiveAlthough intracranial stents have expanded the spectrum of aneurysms amenable to coiling, closed cell design variants can be prone to incomplete stent apposition around tightly curved arterial bends. A case is presented illustrating the technical ramifications of this phenomenon during subsequent treatment.Clinical presentationA 49-year-old woman who had previously undergone Enterprise ...

OBJECTIVESIn aortic valve repair, reduction and stabilization of the ventriculo-aortic junction (VAJ) is generally recommended. In this in vitro study, we compare three techniques of annuloplasty: the subcommissural annuloplasty (SCA), the internal ring (IR) and the external ring (ER) annuloplasty.METHODSTen fresh porcine aortic valve preparations were tested in a pulsatile ...

We describe a new technique wherein we have used the Ionescu Ross Wooler stent for housing the pulmonary autograft. We believe that this technique is easy and reproducible and offers many advantages over the previously described techniques.

We present the case of a 5-year-old boy with a caroticoazygous fistula, which is an extremely rare congenital vascular malformation. The patient also had patent ductus arteriosus, a common cause of continuous murmur. The murmur continued despite successful coil embolization of the ductus. Repeated catheter-angiography revealed a large caroticoazygous fistula. ...

Cerebral arteriovenous malformations and intracranial dural arteriovenous fistulas represent two important classes of intracranial vascular lesions. This article recalls the history on which current technical advances, including diagnoses, characterization, and treatment, is based. It also describes modern therapeutic options, including microsurgical, endovascular, and radiosurgery techniques.

Dural arteriovenous fistulas of the cavernous sinus are no longer difficult to diagnose or treat. Specific ocular manifestations allow these fistulas to be diagnosed clinically. Noninvasive imaging techniques can be used to confirm the diagnosis. The most common treatment is endovascular occlusion of the lesion via a transarterial or transvenous ...

See article in J. Gastroenterol. Hepatol. 2012; 27: 137-141.

Coronary artery fistulae are rare congenital or acquired coronary artery anomalies that can lead to significant cardiovascular morbidity and mortality. Surgical ligation has long been utilized in the treatment of these abnormalities. However, there is a high rate of recurrence due to incomplete closure of the fistulae, especially when multiple ...

The hepatic arterial anatomy is highly variable. A 67 year female with pancreatic mass and replaced common hepatic artery originating from the superior mesenteric artery underwent pancreaticoduodenectomy (PD). The anomalous vessel was discovered on preoperative CT scan and MRI. The vessel was dissected and preserved as it passed dorsal to ...

This study sought to evaluate post-dilation strategies in bifurcation stenting. In bifurcation stenting practice, it is still controversial how post-dilation should be performed and whether the kissing balloon (KB) technique is mandatory when only the main vessel (MV) receives a stent. A series of drug-eluting stents (DES) (n = 26) ...

Dorsal variant proximal carotid blister aneurysms are treacherous lesions to manage. It is important to recognize this variant on preoperative angiographic imaging, in anticipation of surgical strategies for their treatment. Strategies include trapping the involved segment and revascularization if necessary. Other options include repair of the aneurysm rupture site directly. ...

BACKGROUND: Paradoxical pulmonary embolisms are uncommon emergencies and can occur as a consequence of an aortocaval fistula due to unrecognized dislodgement of thrombus from aortic sac into pulmonary circulation. This study reviewed current literature and therapeutic options in this emergency condition requiring prompt management and repair. METHODS: Literature was systematically ...

We describe a case of successful recanalization of a longstanding right common iliac occlusion with a radiofrequency (RF) guidewire. The patient had been symptomatic with claudication for 3 years, and a preliminary attempt to cross the lesion using conventional techniques proved unsuccessful. Using low and medium intensity RF pulses and a ...

A 50-year-old man showed massive lower gastrointestinal bleeding without a triggering episode. An emergency colonoscopy revealed a protruding vessel in the lower rectum with no active bleeding. No underlying ulcer was seen within the surrounding mucosa. These findings were consistent with rectal Dieulafoy's lesion. Angiography was requested to identify the ...

Treating flush iliac artery occlusion by endovascular means can be very challenging and is a cause of technical failure requiring open surgical intervention. We describe a simple endovascular technique that can be valuable in increasing technical success and avoiding the use of a re-entry device. The technique involves placing an ...

The endowedge technique refers to the use of balloons to align the scallops of the Gore Excluder endoprosthesis (W. L. Gore and Associates, Flagstaff, Ariz) to the renal artery to increase juxtarenal seal during endovascular repair of aneurysms with challenging anatomy. With the availability of a reconstrainable deployment system, this ...

Fistula aneurysms are commonly seen and usually do not affect fistula function for hemodialysis. However, these aneurysms are associated with complications that increase the risk of fistula bleeding and loss. The common feature of these complications is that the diseased tissues usually affect a localized area of an aneurysm. Accordingly, ...

Hemodialysis catheterization through the right internal jugular vein (IJV) is widely used for mid- to long-term hemodialysis for patients with renal failure. The purpose of this report is to address a serious complication in conjunction with this procedure. This is a case report of an iatrogenic jugular-carotid fistula (JCF) and ...

Introduction: We report 2 cases where the Outback catheter facilitated extra-anatomical bypass after vessel perforation during attempted subintimal vessel dissection. Report: Attempted subintimal angioplasty of the superficial femoral artery (SFA) resulted in vessel perforation in 2 patients with chronic SFA occlusion and limb ischemia. Due to the lack of other ...

A type-B acute aortic dissection patient required renal artery revascularization for renal artery stenosis resulting from the compression by a false lumen. Renal artery stenting was complicated by unclear opacification of the ostia resulting from the collapsed true lumen of both renal artery and aorta. The use of the "Szabo" ...

We report the case of a patient with placenta previa accreta. A 29-year-old multipara, who had previously undergone a cesarean section, was admitted to our hospital for vaginal bleeding. An emergency cesarean section was carried out at the 33rd week of gestation. Uterine bleeding was uncontrollable, and hence, hysterectomy was ...

Abstract  Aortoesophageal fistula is a rare manifestation of thoracic aortic surgery or esophageal disease. We describe a patient who underwent emergent endovascular repair of an aortoesophageal fistula due to a ruptured penetrating ulcer of the descending thoracic aorta and review the literature on this subject. (J Card Surg 2011; **:1-3).

The "SAFARI" technique or subintimal arterial flossing with antegrade-retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal ...

Abstract Purpose: To evaluate the feasibility of using covered stents vs. bare stents in a model of central vein stenosis with an arteriovenous graft created to mimic the conditions in hemodialysis patients. Methods: In 7 mongrel dogs, an expanded polytetrafluoroethylene-covered nitinol stent was placed in one common iliac vein and ...

During aortic arch replacement, construction of the distal anastomosis represents the crucial step because of the time limit of circulatory arrest. If the aneurysmal neck is located at the level of the 5(th) thoracic vertebra, it becomes difficult to carry out through a sternotomy approach. We describe a case in ...

Endoscopic hemostasis is a useful treatment modality for gastric ulcer bleeding. However, it is sometimes difficult to achieve hemostasis in cases with arterial bleeding, especially those complicated with vascular abnormalities. We describe a case with gastric ulcer bleeding from a variant left gastric artery accompanied by congenital absence of the ...

To highlight gender-related differences in octogenarians with a congenital coronary artery fistula (CAF). We present two elderly female patients with a congenital fistula, a septuagenarian and a nonagenarian, and review the world literature between 1954-2010. The septuagenarian patient presented with easy fatigability and the nonagenarian patient with acute myocardial infarction ...

Congenital coronary arteriovenous fistulas represent abnormal communication between coronary arteries and any cardiac chambers, pulmonary artery, coronary sinus, superior vena cava or pulmonary vein. We reported an interesting case of very long and tortuous coronary arteriovenous fistulas originated from the left circumflex coronary artery, which drained into bronchial arteries in ...

A 60-year-old man presented with complaints of chronic hemoptysis present for many years and a six-month history of chest pain. Physical examination showed a grade II/VI continuous murmur at the left sternal border. Electrocardiography showed normal sinus rhythm and nonspecific ST-T changes in lateral leads. Echocardiography showed mild left ventricular ...

Introduction. Native arteriovenous fistula (AVF) is the recommended vascular access for HD patients by the Dialysis Outcomes Quality Initiative (DOQI) guidelines. The aim of our study was to determine the correlation between diameter and maturation of vessels in radiocephalic AVF. Methods. A prospective cross-sectional study carried out during 2006-2007 on ...

OBJECTIVES: To evaluate the effect of a polymer-free Biolimus A9-eluting stent [BioFreedom™ (BF)], compared with that of a biodegradable polymer-based Biolimus A9-eluting stent [BioMatrix Flex™ (BMF)] and a bare metal stent (BMS) in balloon denuded and radiated hypercholesterolemic rabbit iliac arteries. METHODS: Rabbits were fed with 1% cholesterol diet (n=14) ...

OBJECTIVES: To assess the effect of the duration of stent inflation on stent expansion using digital stent enhancement (DSE). BACKGROUND: Optimal stent expansion and apposition to the vessel wall are of critical importance to optimize the results of percutaneous coronary intervention (PCI). However, it is not known if stent inflation ...

BACKGROUND: Indirect carotid-cavernous fistulae are dural arteriovenous shunts between dural branches of the internal and/or external carotid arteries and the cavernous sinuses. METHODS: We present an uncommon case of bilateral dural carotid-cavernous fistula with aggressive angioarchitectural features that was successfully treated with bilateral coil embolization using an unusual unilateral transvenous ...

ABSTRACT: BACKGROUND: In coronary artery bypass grafting surgery, arterial conduits are preferred because of more favourable long-term patency and outcome. Anyway the greater saphenous vein continues to be the most commonly used bypass conduit. Minimally invasive endoscopic saphenous vein harvesting is increasingly being investigated in order to reduce the morbidity ...

Bilateral coronary artery fistulas with the coronary artery stenosis are rare. In this case, we successfully performed closure of coronary artery fistulas with coronary artery bypass grafting. Furthermore, we were able to measure the flow in the coronary artery fistulas using transit-time flow measurement.

A case of an iatrogenic direct carotid cavernous fistula in a patient with a history of Ehlers-Danlos syndrome and multiple aneurysms is reported. The fistula developed after unsuccessful surgical thrombectomy and revision of an occluded interposition graft inserted to treat a right internal carotid artery aneurysm. Direct puncture of the ...

A 49-year-old female who presented with 3 weeks of exertional chest pain had an abnormal mediastinal finding at chest x-ray imaging. Conventional, nongated computed tomography of the chest revealed a "mass" in proximity to the right atrium. 64-slice, cardiac gated computed tomographic coronary angiography, and transesophageal echocardiography delineated the "mass" ...

The endoscopic laser balloon ablation system affords a unique view of the beating heart for visual guidance in pulmonary vein (PV) isolation. A 66-year-old patient was admitted for catheter ablation of atrial fibrillation (AF). While encircling the left superior PV, AF terminated into sinus rhythm, which was diagnosed by observing ...

PURPOSE: Although left-sided hepatectomy, such as a left hepatectomy or left trisectionectomy with resection of the caudate lobe and extrahepatic bile duct, is used to treat hilar cholangiocarcinoma predominantly involving the left side of the hepatic hilum, it is associated with several difficult technical points. The important points during left-sided ...

Coronary artery fistula is a rare abnormality of coronary circulation. It is mostly congenital but acquired forms can also occur. Fistulae are usually asymptomatic and can sometimes be visualized during cardiac imaging such as transthoracic echocardiogram, cardiac magnetic resonance imaging, coronary computed tomography angiography and coronary angiography.

BACKGROUND: and Importance: Dural arteriovenous fistulas (dAVF) represent 10-15% of all intracranial arteriovenous malformations. Most often, embolization is accomplished using transfemoral catheter techniques. We present a case in which embolization of a cavernous sinus dAVF was made possible using transcranial cannulation of a cortical draining vein. CLINICAL PRESENTATION: An 82 ...