All previously documented regional anesthesia procedures for carotid artery surgery routinely require additional local infiltration or systemic supplementation with opioids to achieve satisfactory analgesia because of the complex innervation of the surgical site. Here, we report a reliable ultrasound-guided anesthesia method for carotid artery surgery. High-resolution ultrasound-guided regional anesthesia using ...

A 53-year-old man presented with a high grade stenotic tricuspid bioprosthesis and an inoperable state because of progressive lung disease. Valve replacement was performed transfemorally under local anaesthesia without rapid pacing. Valve positioning was facilitated by the radiopaque frame of the degenerated bioprosthesis. Echocardiography revealed a decrease of peak tricuspid ...

We would like to present a case of branch retinal artery occlusion following uneventful phacoemulsification, possibly caused by sub-Tenon's anaesthesia. There were no predisposing general health problems. There are two possible mechanisms: (1) mechanical effect of the bolus anaesthetic; (2) pharmacologically mediated changes in the vascular calibre. The latter mechanism ...

We report our experience with a case of emergent endovascular treatment of a large ruptured pseudoaneurysm of the common iliac artery. A 65-year-old male was admitted to the surgical department in hypovolemic shock, due to active retroperitoneal bleeding. A computerized tomography scan with intravenous contrast revealed a ruptured gigantic pseudoaneurysm ...

Evidence suggests a clinical benefit with patch angioplasty after carotid endarterectomy (CEA). The UK National Vascular Database has demonstrated variation in practice but does not record technical details. This study was intended to define indications and technique of patching after CEA. An electronic questionnaire was emailed to all 402 members ...

Deployment of a polytetrafluoroethylene-covered stent is a useful option to seal coronary perforation. However, the high profile and low flexibility compromise its deliverability. To facilitate stent delivery, deep-vessel intubation with a 5 Fr guiding catheter through a 6 or 7 Fr guiding catheter (mother-and-child catheter) has been used. This case ...

Tracheo-innominate artery fistula (TIF) is a serious, life-threatening complication following tracheostomy. We report a fatal TIF in a 15-year-old girl with Pelizaeus-Merzbacher disease. She received a tracheostomy for prolonged translaryngeal intubation due to acute respiratory failure without a trial of noninvasive ventilatory support before intubation. Severe hemorrhage from the TIF ...

We present the case of a 79-year-old patient with extensive metastatic malignant melanoma (MM) of the scalp. Cutaneous MM of the head and neck often presents a therapeutic challenge. Radical surgical procedures and conventional chemotherapy are often unfeasible and contraindicated because of the difficult anatomy, the extent of the tumour ...

Modern reperfusion therapy in acute ischemic stroke therapy is based on an 'as fast as possible' recanalization approach to obtain favorable clinical outcomes. However, arterial recanalization may be achieved without favorable clinical outcome, raising the question of the target population to be treated. We outline key issues that underline acute ...

Indocyanine green (ICG) and fluorescein dyes were inadvertently injected into an antecubital artery during angiography. Apart from a slightly longer arm to retina time, ICG angiography was uneventful. In contrast, intra-arterial injection of fluorescein resulted in a dramatic yellowish discoloration of the arm distal to the injection site that was ...

Accumulation of the lipid-protein complex ceroid is a characteristic of atherosclerotic plaque. The mechanism of ceroid formation has been extensively studied, because the complex is postulated to contribute to plaque irreversibility. Despite intensive research, ceroid deposits are defined through their fluorescence and histochemical staining properties, while their composition remains unknown. ...

Apolipoprotein C-I (apoC-I) is a 6.6kDa serum protein associated with high density lipoproteins (HDL) and triglyceride-rich lipoproteins. In this study, apoC-I was examined in high density lipoprotein subfractions from individuals with and without coronary artery disease (CAD). New isoforms of apoC-I, were detected in the cohort of individuals with CAD ...

This study is an evaluation of the diagnostic accuracy of gadolinium-enhanced computed tomography pulmonary angiography (CTPA) for the detection of pulmonary embolism (PE) in comparison with iodine-enhanced CTPA. PE was induced in five anesthetized pigs by administration of blood clots through an 11-F catheter inside the jugular vein. Animals underwent ...

Latex injection of cadaveric heads is an alternative to the standard technique of silicone injection. Thorough injections of the arterial and venous systems can be achieved by analyzing the anatomic and physiological variations of the vascular system of each specimen during the initial irrigation phase to tailor the subsequent latex ...

The purposes of this study were to elucidate the histomorphometry of the intrapulmonary arteries in patients undergoing univentricular type of repairs and to identify the histomorphometric characteristics, if any, that may predispose patients to postoperative Fontan failure. Operatively resected wedges of lung tissue from 44 patients undergoing univentricular type of ...

BACKGROUND AND IMPORTANCE: Early origin of the middle cerebral artery M2 segment is a normal variant. When such a vessel is occluded proximally, the parenchyma distal to the vessel may become ischemic. Targeted extracranial to intracranial bypass to such a specific branch may preserve perfusion to the end organ. We ...

Intra-arterial thrombolysis has been advocated for treatment of acute ischemic stroke and several prognostic factors were identified in these patients. Other endovascular methods aiming to recanalize occluded vessels including balloon angioplasty, stenting and use of mechanical clot retrieving devices were devised. To date, this approach is replaced by a multi-modal ...

We have previously reported the clinical efficacy of water-in-oil-in-water (W/O/W) emulsion containing anticancer agent. The purpose of this study was to evaluate the safety and effectiveness of transcatheter arterial infusion (TAI) of W/O/W emulsion via a cystic artery for hepatocellular carcinoma (HCC). TAI of a W/O/W emulsion was performed at ...

Pulse contour methods determine cardiac output semi-invasively using standard arterial access. This study assessed whether cardiac output can be determined non-invasively by replacing the intra-arterial pressure input with a non-invasive finger arterial pressure input in two methods, Nexfin CO-trek and Modelflow , in 25 awake patients after coronary artery bypass ...

Microbubbles (MBs) can augment the acoustic cavitation' (US), thereby facilitating the thrombolysis of external ultrasound. But we observed re-thrombosis after successful thrombolysis by MBs and transcutaneous ultrasound in an endothelium injury model. This study was designed to explore whether platelet-targeted MBs can prevent the reformation of thrombi. Arterial injury was ...

We have previously shown that remote ischemic preconditioning (rIPC) by transient limb ischemia leads to the release of a circulating factor(s) that induces potent myocardial protection. Intra-arterial injection of adenosine into a limb also leads to cardioprotection, but the mechanism of its signal transduction is poorly understood. Eleven groups of ...

Endovascular options for therapy for patients with vasospasm after SAH include angioplasty and intra-arterial vasodilator infusion. Preliminary studies of the effects of the calcium channel antagonist verapamil on angiographic vasospasm have yielded mixed and/or qualitative results. In this study, improvement in angiographic vasospasm after intra-arterial verapamil administration is demonstrated with ...

To describe an unusual clinical finding seen in children undergoing intra-arterial chemotherapy for retinoblastoma. A retrospective review of 69 eyes of 63 patients receiving intra-arterial chemotherapy over a 3-year period. Charts and photographs of 69 consecutive cases were reviewed, and data were collected on patients with clinical evidence of a ...

Intra-arterial therapies for unresectable hepatocellular carcinoma (HCC) consist of a catheter-based group of treatments where therapeutic and/or embolic agents are intra-arterially directed to target tumors. Here we review these therapies, which may be classified into embolotherapy/chemotherapy-based and radiotherapy-based treatments. Embolotherapy/chemotherapy-based treatments include transcatheter arterial embolization, transarterial chemoembolization, transcatheter arterial chemoeinfusion, ...

Various anatomical parameters affect on intra-aneurysmal hemodynamics. Nevertheless, how the shapes of real patient aneurysms affect on their intra-aneurysmal hemodynamics remains unanswered. Quantitative computational fluid dynamics simulation was conducted using eight patients' angiograms of internal carotid artery-ophthalmic artery aneurysms. The mean size of the intracranial aneurysms was 11.5 mm (range ...

A 5-year old neutered male cat was admitted to our hospital in the early morning with sudden onset of bilateral hindlimbs paralysis. Conservative anticoagulant therapy using heparin, warfarin, and dipyridamole, and thrombolytic therapy with urokinase administered by intravenous infusion were started. However, no improvement was noted even after 2 days ...

Intrahepatic cholangiocarcinoma (ICC) is a rare hepatic malignancy that for patients with unresectable disease is uniformly fatal. Only approximately 30% of patients are eligible for resection because of the advanced nature of the disease at the time of diagnosis. Systemic chemotherapy has been disappointing in regard to its efficacy, with ...

Intra-arterial delivery of chemotherapy is a well-established dominant treatment for hepatocellular carcinoma (HCC). This approach takes advantage of differential blood supply to the cancer, which is arterial, and to the liver, which is predominantly portal. Randomized trials demonstrating survival benefit have used transarterial chemoembolization (TACE) with arrest of blood flow ...

To investigate the safety and efficacy of endovascular therapy with combined intra-arterial and intravenous thrombolysis for severe cerebral venous sinus thrombosis. Of the 28 consecutive patients with cerebral venous sinus thrombosis admitted to our hospital in recent 3 years, six patients underwent combined intra-arterial and intravenous thrombolysis. For each patient, ...

BACKGROUND AIMS: Cell therapy with mesenchymal stromal cells (MSC) has been reported recently as a promising treatment for severe acute graft-versus-host disease (GvHD). METHODS: We designed a pilot study to treat severe hepatic or gut GvHD using MSC derived from only the donor and cultured without bovine serum. Because the ...

Recently popularised, the combined angiography and CT (angio-CT) system is useful for correctly identifying the feeding arteries and their perfusion in various organs. We applied this system for advanced maxillary cancer to expose its feeding arteries and their supplying territories. In addition to the maxillary artery, extramaxillary feeding arteries were ...

OBJECTIVE: Cerebral vasospasm remains a major cause of morbidity and mortality. Milrinone, a bipyridine phosphodiesterase III inhibitor, is a potent member of the inodilator class of cardiac agents for vasospasm and is injected intra-arterially or intracisternally. There have been no studies investigating the duration of action (context-sensitive half-life) of milrinone ...

PURPOSE: The purpose of this study was to investigate the potential pharmacokinetic advantage of pancreatic arterial infusion chemotherapy of 5-fluorouracil (5-FU) with temporary unification of the pancreatic blood supply for advanced pancreatic cancer in an animal model. MATERIALS AND METHODS: Nine pigs were divided into three groups of three pigs ...

To the anatomist, the antecubital fossa is the space through which the principal vascular and nervous trunks pass into the forearm. To the surgeon it is also the site of possible injury to the brachial artery in fractures around the elbow, with the risk of Volkmann's ischaemic contracture constantly in ...

We report here two patients with chronic disseminated intravascular coagulation (chronic DIC) secondary to aortic aneurysm, who were successfully treated with continuous subcutaneous infusion of heparin. The patients were 69- and 89-year-old males, who were admitted to our hospital because of thrombocytopenia and marked bleeding tendency. The underlying conditions were ...

OBJECTIVE: We report a case of high intra-abdominal testes (HIT) associated with the presence of the cremasteric artery (CA). The aim was to correlate the normal anatomy of the CA with the clinical finding in our patient and discuss its surgical implication. METHODS: Left primary laparoscopic testicular descent by the ...

Calibre persistent arteries (CPA) penetrate into submucosal tissue without division or reduction in calibre. Intraorally, these abnormalities have been predominantly reported in the lip. Here we report a case of CPA in the buccal vestibule. Misdiagnosis of this entity may result in profuse bleeding during surgical intervention.

Intra-arterial injection of drugs intended for intravenous delivery is a frequent and potentially devastating consequence of placing an arterial line in a patient. A system is described here that prevents this complication from occurring and its use is advocated in intensive care and operating theatre settings.

Radial artery occlusion (RAO) is an infrequent, asymptomatic, complication of transradial catheterization and probably 1 of the few. Intravenous heparin and patent hemostasis lower its incidence. A possible local effect of intra-arterially administered heparin during transradial procedures has not been evaluated. We studied 500 consecutive patients randomized to an intravenous ...

In magnetic drug targeting a chemotherapeutic agent is bound to coated magnetic nanoparticles, which are administered to the blood vessel system and subsequently focused by an external applied magnetic field. The optimization of intra-arterial magnetic drug targeting (MDT) requires detailed knowledge about the biodistribution of particles in the artery and ...

Summary: During local intra-arterial thrombolysis (LIT), management of the secondary embolization of a fragmented or dislodged clot can be cumbersome. The fate could be dismal if without pursuit and lysis of the migrated clot. Recently, we successfully managed a patient with acute ischemia due to a large clot impinged in ...

STUDY DESIGN: Prospective in vivo experimental animal model. OBJECTIVES: To determine the effect of intra-arterial injection of the steroids commonly used for transforaminal epidurals on the central nervous system. And to determine if all of the steroids have the same effect. SUMMARY OF BACKGROUND DATA.: Transforaminal epidural steroid injection is ...

Acute embolic occlusion of the common iliac artery is a rare medical emergency that is not only limb-threatening, but also potentially life-threatening. Several treatment options exist for acute limb ischemia, although no treatment is clearly best. We report a case of acute embolic occlusion of the left common iliac artery ...

BACKGROUND AND PURPOSE: Recent advances in flat panel detector angiographic equipment have provided the opportunity to obtain physiologic and anatomic information from angiographic examinations. To exploit this possibility, one must understand the factors that affect the bolus geometry of an intra-arterial injection of contrast medium. It was our purpose to ...

Standard therapy for frostbite has been unaltered for more than 20 years. Recently there have been reports of improved outcomes with the addition of a vasodilator to intra-arterial thrombolytic therapy. We report the case of severe frostbite of the hands successfully treated with transcatheter intra-arterial tPA after papaverine infusion in ...

Basilar artery thrombosis has high morbidity and mortality. Though intra-arterial thrombolytics have proven efficacy in the treatment of acute basilar artery occlusion, the elevation of procoagulant factors in the blood after intra-arterial thrombolysis could result in subsequent thrombus formation and clinical deterioration. Glycoprotein IIb/IIIa inhibitors have been shown to reduce ...

BACKGROUND AND PURPOSE: Acute stroke attributable to internal carotid artery terminus occlusion carries a poor prognosis. Vessel recanalization is crucial to improve clinical outcome. Historically, pharmacological thrombolysis alone has low recanalization rates. We sought to determine whether adjunctive mechanical approaches achieve better vessel recanalization and functional outcome. METHODS: We retrospectively ...

We report an autopsy case of segmental arterial mediolysis (SAM) of various phases occurring in both the intracranial vertebral artery (IVA) and intra-abdominal arteries. The patient was a 70-year-old male found dead in his house. The cause of death was massive intra-abdominal hemorrhage owing to a ruptured right gastroepiploic artery. ...

The vasodilatory effect of intra-cisternal infusion of magnesium sulfate solution was evaluated in 10 patients with symptomatic vasospasm after aneurysmal subarachnoid hemorrhage (SAH) who underwent early clipping surgery. Cisternal drainage was installed in the prepontine and/or sylvian fissures. Carotid angiography was performed immediately after the onset of symptomatic vasospasm, then ...

Catheter-directed thrombolytic therapy is a well-accepted treatment modality for acute arterial and graft occlusion, but intraoperative use of plasminogen activators as an adjunct to operative thrombectomy or thromboembolectomy is frequently overlooked by vascular surgeons. Evidence exists that intraoperative intraarterial infusion of lytic agents is safe and is accompanied by breakdown ...