Recently, the addition of dexmedetomidine to sedation regimens after cardiac surgery had been reported and there is a possibility that dexmedetomidine can cause vasoconstriction. Vasopressin has been used as a prophylactic treatment for refractory vasodilatory shock during coronary artery bypass graft (CABG). Also, vasopressin may play an important role in ...

Coronary artery bypass grafting using autologous saphenous veins is a standard surgical therapy for coronary artery diseases. However, post-procedure vein graft restenosis impedes its effectiveness and often leads to a high morbidity and mortality, and a reduction in the quality of life. Neointimal hyperplasia is a major cause of vein ...

Subclavian vein thrombosis is an uncommon clinical condition which is often associated with venous catheterization or secondary to excessive effort. We present a 54-year-old female with subclavian vein thrombosis as a first presentation of renal cell carcinoma. Although this is an unusual presentation, malignancy should be considered in the differential ...

A significant proportion (∼20%) of patients with complex tibial artery occlusions cannot be treated using a conventional antegrade approach. We report our experience using the retrograde approach for the treatment of complex tibial artery occlusive disease using retrograde pedal/tibial access in 13 limbs from 12 patients. Retrograde pedal/tibial access was ...

Sarcomas of the large vessels usually present centrally in the aorta, pulmonary artery, and inferior vena cava. Peripheral arterial sarcomas are exceptionally rare. They have been reported in the iliac and common or profunda femoral arteries, and are frequently undifferentiated. In this study, we describe a differentiated intimal sarcoma of ...

Introduction: Differential diagnoses of the reversible cerebral vasoconstriction syndrome (RCVS) include all forms of intracranial stenotic disease, such as primary or secondary vasculitis of the central nervous system. Here, we tested the hypothesis that angiographic response to intra-arterial nimodipine application may be helpful in differentiating between RCVS and other entities. ...

A 58-year-old woman presented with right supplementary motor area glioblastoma multiforme and deep venous thrombosis in her legs. The tumor was resected after temporary inferior vena cava filter placement, considering that increased thrombosis during and after the operation would cause fatal pulmonary embolism. After anticoagulation with unfractionated heparin, thrombocytopenia was ...

Chronic mild hypoperfusion has been shown to enlarge pial collateral vessels in normal mouse brains. The purpose of this study was to clarify the effect of hypertension on pial collateral vessel development after chronic hypoperfusion using spontaneously hypertensive rats (SHR). In normotensive rats, unilateral common carotid artery (CCA) occlusion enlarged ...

We described a novel transradial retrograde wiring technique to treat chronic total occlusion (CTO) of the left anterior descending artery. When both retrograde wire and kissing wire technique failed to cross the CTO lesion, an antegrade microcatheter was placed in the CTO lesion. Then, a retrograde wire was manipulated into ...

Delayed occlusion time in parent artery occlusion of brain-supplying vessels might carry risk for thromboembolic complications. Vascular plug devices are successfully used in cardiopulmonary and peripheral interventions to occlude high-flow lesions and have been adapted for use in neurointerventions. The purpose of the present study was to experimentally evaluate the ...

Acute occlusion of the left circumflex (LC) artery can be difficult to diagnose. The aim of the present study was to assess the incidence of LC occlusion in patients with acute myocardial infarction (AMI) requiring percutaneous coronary intervention (PCI), the frequency of ST-segment versus non-ST-segment elevation presentation among them, and ...

Limb occlusion of an aortic endograft is uncommon, however, it can result in permanent sequelae if management is delayed. We report the first case utilizing the Trellis device to achieve localized and prompt isolated pharmacomechanical thrombectomy (PMT) for the treatment of acute limb thrombosis of a bifurcated aortic endograft.

Management of acute limb ischemia (ALI) is largely based on the etiology of arterial occlusion (embolic vs. thrombotic). To our knowledge, the ability of duplex scanning to differentiate embolic from thrombotic occlusion has not been previously reported. To determine the ability of duplex scanning to differentiate embolic from thrombotic acute ...

One of the mechanisms of technical failure in the treatment of tibial artery occlusive disease includes an inability to re-enter the true lumen of the tibial vessel distal to the occlusion following tracking of the interventional wire into the subintimal space. We report the first case using a coronary 0.014″ ...

OBJECTIVE:: To report the efficacy and safety of the Outback(R) LTD(R) Re-Entry Catheter in reentering the distal true lumen during percutaneous intentional extraluminal revascularization (PIER). BACKGROUND:: Reentry catheters are used to treat chronic, total arterial occlusions of the lower extremities when standard methods of recanalization have failed. Success and complication ...

To study retrospectively the prognostic factors for acute basilar artery occlusion treated with intraarterial thrombolysis and stent placement. Within 3-48 hours of disease onset, 52 patients with basilar artery occlusion were treated with emergency intraarterial thrombolysis with recombinant tissue plasminogen activator (rtPA) or urokinase (UK) or intraarterial thrombolysis combined with ...

PURPOSE: This study retrospectively assesses whether significantly accelerating thrombolysis with ultrasound affects fibrinogen levels in the treatment of peripheral arterial occlusions. MATERIALS AND METHODS: Between December 2005 and August 2007, 38 limbs in 38 patients (17 women; mean age, 60.5 +/- 19.7 years; age range, 17-94 years) were treated with ...

Surgical management of Sturge Weber-associated glaucoma is challenging. Choroidal effusion and expulsive choroidal hemorrhage are commonly cited potential risks. We report a case of a cilioretinal artery occlusion associated with glaucoma drainage device surgery in a child with refractory Sturge Weber-associated glaucoma.

Free tissue transfer necessitates vigilant postoperative monitoring for vessel occlusion. Unfortunately, most monitoring methods require experienced personnel and are expensive to use. Furthermore, many tests have low sensitivity, low specificity, or significant delay between vessel occlusion and detection. The authors report on a novel method of tissue monitoring that avoids ...

Isolated cilioretinal artery occlusion is a rarely reported initial manifestation of polycythemia vera. In this study, we reported a case of a 65-year-old man with polycythemia vera with cilioretinal artery occlusion as an initial manifestation.

OBJECTIVE: Microcirculatory dysfunction contributes to morbidity and mortality in vascular diseases. Here, we aimed at establishing a sensitive and valid method to measure microvascular reactivity during post-occlusive reactive hyperemia (PORH) using scanning laser Doppler perfusion imaging (LDPI) of the forearm. METHODS: In a first series, LDPI was methodologically evaluated on ...

Although endovascular therapy for peripheral arterial disease has undergone tremendous changes, chronic total occlusion (CTO) remains a significant challenge for interventionalists. Failed CTO recanalization is predominately due to unsuccessful guidewire crossing. In particular, the unique characteristics of tortuous and deeply located large vessels in the retroperitoneal cavity create challenging endovascular ...

Early reocclusion of intracranial arteries can lead to poor clinical outcome. We report reocclusion detection after endovascular clot aspiration, followed by administration of GPIIb-IIIa antagonist under continuous ultrasound monitoring. A 73-year-old man developed the right middle cerebral artery (MCA) occlusion with NIHSS 17 points, 6 days after aortic valve replacement. ...

The artery of Adamkiewicz is the most significant tributary of the anterior spinal artery in the midthoracic region; the occlusion of this artery results in a well-described phenomenon consisting of paraplegia with loss of the sensation of pain, temperature, and touch as well as loss of sphincter control. Proprioception and ...

To report experience with aggressive recanalization approaches in chronic total arterial occlusion (CTO). Chronic total arterial occlusion recanalization was attempted on 112 limbs in 99 consecutive patients between January 1999 and December 2006. There were 63 iliac arteries, 45 femoropopliteal arteries, and 4 occluded stents. Mean occlusion length was 8.7 ...

OBJECTIVE: The purpose of this study was to evaluate our experience with the use of a R?sch-Uchida needle technique to recanalize central vein occlusion that cannot be traversed with a guidewire. MATERIALS AND METHODS: We retrospectively evaluated 33 recanalization procedures performed with a R?sch-Uchida needle on 20 men and 13 ...

OBJECTIVE: To examine changes in gravity fluctuation caused by experimentally altering the area of occlusal contact. MATERIALS AND METHODS: Subjects consisted of 15 adult Japanese males with normal stomatognathic function, no missing teeth except for the third molars, and equivalent occlusal contact in the anterior and bilateral posterior regions. Silicon ...

Scimitar syndrome is a rare condition often with a separate systemic arterial supply from the abdominal aorta. Occlusion of this systemic arterial supply is frequently performed, though it can be difficult in small patients or in those with tortuous vessels. This case documents use of the new Amplatz vascular plug ...

Critical limb ischemia (CLI), defined as chronic ischemic rest pain, ulcers, or gangrene attributable to objectively proven arterial occlusive disease, is the most advanced form of peripheral arterial disease. Traditionally, open surgical bypass was the only effective treatment strategy for limb revascularization in this patient population. However, during the past ...

We report the novel application of the Controlled Antegrade and Retrograde subintimal Tracking technique for the endovascular treatment of occlusions of the external iliac artery (EIA). We hypothesized that this technique would limit the extent of subintimal dissection to the length of the EIA occlusion, thus preserving patency of the ...

The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (RA) occlusion after transradial access for diagnostic and interventional cardiac procedures. RA occlusion is a potential complication of transradial cardiac catheterization. Conventionally, unfractionated heparin is used for prevention of RA occlusion. Effectiveness of ...

This report describes a retrograde wiring technique, using intravascular ultrasound, for a blunt chronic total occlusion with a side branch at the site of occlusion of which the operator has difficulty of awareness of the proper re-entry point with the retrograde wire angiographically.

Nonatherosclerotic etiologies of arterial insufficiency are uncommon but important causes of chronic lower extremity ischemia. We report a patient with multiple hereditary exostoses (MHE) presenting with lifestyle-limiting lower extremity claudication and popliteal artery occlusion secondary to a large osteochondroma. The presence of MHE with associated osteochondroma resulting in arterial occlusion ...

BACKGROUND AND PURPOSE: Use of the Merci retriever is increasing as a means to reopen large intracranial arterial occlusions. We sought to determine whether there is an optimum number of retrieval attempts that yields the highest recanalization rates and after which the probability of success decreases. MATERIALS AND METHODS: All ...

BACKGROUND AND PURPOSE: Mechanical thrombectomy in ischemic stroke is of increasing interest as it is a promising strategy for fast and efficient recanalization. Several thrombectomy devices have been introduced to the armentarium of mechanical thrombectomy. Currently, new devices are under development and are continuously added to the neurointerventional tool box. ...

Background Aneurysm occlusion after subarachnoid haemorrhage (SAH) aims to improve outcome by reducing the rebleeding risk. With increasing age, overall prognosis decreases, and the complications of aneurysm occlusion increase. The balance of risks for aneurysm occlusion in elderly SAH patients in different age categories and clinical conditions is unknown. Methods ...

PURPOSE: To present the safety and short-term outcomes of using controlled blunt microdissection catheter-assisted revascularization of symptomatic chronic total occlusions of the lower extremity. MATERIALS AND METHODS: A retrospective study was performed on 61 patients (46 men) with a mean age of 72.3 years +/- 9.4 who underwent 67 procedures ...

BACKGROUND: Percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) remains a challenge. Multislice computed tomographic coronary angiography (CTCA) allows noninvasive evaluation of the coronary artery by visualizing vessel trajectory and morphological features at the occluded site. The aim of this study was to assess the value of CTCA to ...

Angio-Seal is a frequently used vascular closure device after arterial catheterisation. Major complications are infrequently reported. We present four cases occurring within a 2-month period in our hospital with dislodgement of an Angio-Seal causing acute arterial occlusion, resulting in loss of limb in one case. Surgical intervention was necessary in ...

Peripheral artery disease continues to increase in an ever-aging society and consumes a significant part of health resources. Chronic total occlusions account for a significant portion of the lesions encountered by endovascular interventionalists. Unlike the coronary circulation, these occlusions are often long and associated with other features of complexity. The ...

OBJECTIVE: To investigate the clinical characteristics and treatment strategy of lower extremity arterial occlusive disease in patients with Crohn's disease (CD). METHODS: Clinical information of 9 cases suffering from lower extremity arterial occlusion and CD was investigated retrospectively. RESULTS: All the cases were less than 50 years old and the ...

The Amplatzer vascular plug has been used as an embolic device in a variety of cardiovascular interventions. The present report describes successful transrenal ureter occlusion with an Amplatzer plug inserted into an excised latex cover. The procedure led to immediate ureter occlusion in a patient with vesicovaginal fistula. Further investigation ...

Targeted vascular occlusion is desirable for clinical therapies such as in the treatment of esophageal and gastric varices and varicose veins. The feasibility of ultrasound-mediated endothelial damage for vascular occlusion was studied. A segment of a rabbit auricular vein was treated in vivo with low duty cycle, high peak rarefaction ...

PURPOSE: Renal vascular clamping with ensuing warm ischemia is typically needed during robotic or laparoscopic partial nephrectomy. We developed a technique for angiographic delivery of the novel intra-arterial reverse thermoplastic polymer LeGoo-XL that allows temporary selective vascular occlusion with normal perfusion of the remaining kidney. MATERIALS AND METHODS: Eight pigs ...

Increasing prevalence of diabetes mellitus is frequently associated with complex tibioperoneal obstructive disease and a high rate of amputations. Endovascular therapy of arteries below the knee has emerged as a promising revascularization technique for patients with critical limb ischemia. Recent advances in catheter technology applied below the knee will increase ...

OBJECTIVE: To report a case of successful recanalization using the combination technique of reverse flow and downstream filtering in chronic total occlusion of the bilateral vertebral artery (VA). CLINICAL PRESENTATION: A 59-year-old man had experienced attacks consisting of vertigo and/or dysarthria more than 1 year before presentation. He experienced symptoms ...

Internal iliac artery stenosis or occlusion has been documented to cause hip pain, erectile dysfunction, and buttock claudication. Endovascular repair for patients with significant stenosis has been well documented, but chronic total occlusion revascularizations have not been reported in the literature. The reluctance to attempt percutaneous intervention may be in ...

This study aimed to correlate computed tomography (CT) findings and outcomes in patients affected by bowel infarction. Twenty-seven patients with bowel infarction due to vascular obstruction were evaluated with multidetector CT (MDCT) to establish the prognostic value of CT findings and their correlation with the origin of the ischaemia. The ...

Aims: To evaluate the safety and efficacy of the CiTop Expander guidewire in attempting to cross through chronic total occlusion in CAD patients with various coronary dimensions and morphology. Although chronic total occlusions are encountered frequently in patients with coronary artery disease, an effective strategy to deal with them has ...

RATIONALE AND OBJECTIVES: Existing density- and gradient-based automated centerline-extraction algorithms fail in severely diseased or occluded arterial segments for the generation of curved planar reformations (CPRs). We aimed to quantitatively and qualitatively assess the precision of a knowledge-based centerline-extraction algorithm in patients with occluded femoro-popliteal artery (FPA). MATERIAL AND METHODS: ...