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Drug abuse may affect lower extremity vessels due to ischemia following intra-arterial injections, vasospasm, arterial and venous pseudoaneurysms, arteriovenous fistulae, vasculitis and complicated abscesses. Little is known about the outcomes of Lower Extremity Bypass (LEB) for peripheral arteries disease (PAD) in patients with a history of drug abuse disorder. The aim of this study is to evaluate the outcomes of LEB in this patient population.
Spinal cord ischemia is one of the most unpredictable and feared complication following open surgical or endovascular thoracic aortic repair. Protection of collateral network branches that contribute blood supply to spinal cord is fundamental in the prevention of this catastrophic condition. We report the case of a patient who underwent emergent endovascular treatment for a type B aortic dissection complicated by rupture of the false lumen, with intentional coverage of the left subclavian artery without rev...
Retrograde type A dissection (RTAD) is a serious complication after ascending aorta involved endovascular repair (AAIER). We here report our surgical approach to this serious complication.
Bilateral limb occlusion after aortobifemoral prosthesis occurs in 1-3% patients. Multiple remedial choices are known in literature to manage a bilateral occluded ABF such as "redo" aortobifemoral bypass (rABF), axillobifemoral bypass, endovascular recanalization of the native aortoiliac system and thrombectomy. We present a patient with an occluded aortibifemoral bypass since 2001. A new minimal invasive treatment strategy was performed by traversing the occluded limbs with aortic re-entry using stiff Teru...
The aims of this study were to explore (i) the dynamic changes in cerebral microbleeds (CMBs) in symptomatic cerebral artery stenosis patients who received endovascular stent-assisted angioplasty and (ii) the risk factors associated with the new incidence of CMBs as well as whether CMBs increased the risk of vascular events in these patients.
Hughes-Stovin syndrome is a disorder characterized by deep vein thrombosis and pulmonary artery aneurysms with potentially life-threatening complications. The case of a 22-year-old Moroccan male patient, presenting with signs of sepsis of unclear etiology, is presented here. CT scan revealed thrombosis of the inferior vena cava up to the hepatic veins, thrombosis of both common iliac veins and a thrombus in the right atrium. Primarily suspecting septic thrombosis, surgical thrombectomy was performed. The pa...
An 87-year-old man with severe intermittent claudication and lower limb pain at rest was referred to our hospital for examination. Computed tomography (CT) angiography imaging showed a severe stenosis in the infrarenal abdominal aorta. The ankle brachial indices (ABIs) were 0.62 (right) and 0.60 (left). Endovascular aortic repair was performed with distal protection. The postoperative course was uneventful, and postoperative CT showed no stenosis or distal embolization. The ABI improved to the normal values...
A case of a femoro-popliteal recanalization procedure using a new bailout technical maneuver to aid re-entry into the true lumen is described. Following a failed standard re-entry attempt, at the level of the vessel reconstitution in the subintimal space, the guidewire was exchanged for a Gooseneck-Snare-Kit. A needle was inserted across the target artery, piercing both arterial walls, and passing through the snare loop. Once the needle had exited the artery, a wire was inserted and the needle withdrawn. Th...
Axillary artery aneurysms necessitate repair due to potential neurovascular complications. With increasing endovascular interventions for these uncommon lesions, there is a need to evaluate their usage against conventional open repair.
Isolated external iliac artery aneurysms are a very rare occurrence. We present the case of a patient with a very large symptomatic isolated external iliac artery aneurysm found incidentally on imaging for other reasons. Due to his compressive symptoms, he underwent uncomplicated open repair of his aneurysm. We also discuss the etiology and management options for this rare entity.
The aim of this paper is to report a case of filter associated inferior vena cava (IVC) thrombosis with perforation of the duodenum and penetration of a vertebral body by the filter struts.
We present a case of successfully treated abdominal aortic aneurysm in a 24-year old patient with Marfan's syndrome. Following initial physical and ultrasound examination, the multislice computed tomography scan revealed infrarenal aortic aneurysm of 6 cm in diameter, 10 cm long, along with slightly dilated iliac arteries. However, dimensions of aortic root, aortic arch and descending suprarenal aorta were within normal limits. Further on, since the patient presented with signs of impending rupture, an urge...
The treatment of type A acute aortic dissection is a challenge for the surgeon, and serious late-complications may occur even after surgical repair. We report treatment following a type A post-dissection thoraco-abdominal aneurysm in a patient who previously underwent ascending aortic reconstruction using a biological aortic valve and Dacron prosthetic graft implantation in emergency conditions. The multi-staged approach consisted in removing the right kidney and performing a heterotopic autotransplantation...
To report perioperative and 1-year results of total endovascular repair of contained ruptured thoracoabdominal aortic aneurysms (TAAAs).
Primary closure (PC) and patch angioplasty (PA) during carotid endarterectomy (CEA) have been disputed in many studies. Some studies announced that PC is associated with a higher restenosis rate. The aim of this study was to evaluate the outcomes of PC and PA using propensity score matching (PSM).
Primary aortoesophageal fistula in the absence of prosthetic graft replacement or aortic endovascular therapy can develop as a rare but life threatening complication of acute aortic dissection. This case demonstrates that primary AEF should be maintained on the clinical differential of a patient presenting with massive GI bleed in the context of an aortic dissection.
Endovascular aneurysm sealing (EVAS) was developed with the intention of expanding the anatomical limitations of conventional endovascular repair (EVAR) devices, as well as decrease rates of re-intervention secondary to migration and type II endoleaks in treatment of abdominal aortic aneurysms (AAA). Since its inception, EVAS has gained much popularity especially for patients with concomitant common iliac aneurysms, with good long term durability suggested by several studies. Currently, the known complicati...
Totally occluded aortic aneurysm is a rare pathology. The medical history and the evolution are unknown. We present a case of a regular followed 60 years old man with chronic thrombosed aneurysm presenting with mycotic acute rupture. As an original treatment, the patient was treated by aortic ligation without distal revascularization. A literature review from 1974 to 2015 enhances the contemporary understanding of the pathology, by exploring the thrombus interaction, pressure and the wall shear stress. The ...
Free digital platforms are smartphone-compatible and permit self-directed curriculum development based on learner interests and educational needs. We developed a free mobile Vascular Surgery handbook initiated, authored, and edited by surgical house officers and surveyed on the content and users.
Fenestrated endovascular aortic repair (FEVAR) of complex aneurysm can require the coverage of polar renal artery. The aim of this study was to investigate the impact of the procedure on post-operative outcomes in patients with juxta-renal or thoraco-abdominal aortic aneurysms.
The main objective of this study was to identify the changes that have occurred in the treatment of abdominal aortic aneurysms (AAA) in France over a period of 10 years.
The current results of the endovascular repair of abdominal aortic aneurysms (EVAR) and the generalization of the percutaneous closure systems suggest that ambulatory treatment is feasible in selected patients. The objective of this study was to evaluate the rate of eligibility to ambulatory EVAR (EVAR-Ambu) and its potential medico-economic impact.
Inflammatory aortic abdominal aneurysm (IAAA) remained a rare cause of aneurysmal aortic disease with incidences between 5-10%. The current treatment of IAAA consists of open surgical repair (OSR) and endovascular aneurysm repair (EVAR). Avoiding an inflamed, fibrotic retroperitoneum is the driving force behind the desire to repair IAAA endovascularly. The latest published works confirm the promising results following EVAR for IAAA but there is still a paucity of data regarding hydroureter and hydronephrosi...
Neoplasias affecting the aorta are usually due to a variety of thoracic and abdominal tumours, which are more common than primary tumours of the aortic wall. Those tumors that can invade the abdominal aorta are usually sarcomas, which are able to mimic, both clinically and radiologically, an aortic disease such as an aneurysm or a dissection. There are few clinical scenarios where surgical resection and aortic repair needs to be performed, and indications have not still been clearly established in the liter...