scholarly journals Endovascular correction of a traumatic internal iliac arteriovenous fistula with a covered stent

2014 ◽  
Vol 13 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Edson Pedroza dos Santos Junior ◽  
Rodolfo Rógers Américo Batista ◽  
Fernanda Medina Felici ◽  
Vinicius Evaristo Correia ◽  
Maykon Brescancin Oliveira ◽  
...  
Keyword(s):  
Young Adult ◽  
Gunshot Wound ◽  
Covered Stent ◽  
Lower Limbs ◽  
Emergency Laparotomy ◽  
Total Occlusion ◽  
Arteriovenous Fistulae ◽  
Iatrogenic Injuries ◽  
Internal Iliac ◽  
Late Postoperative Period

Arteriovenous fistulae (AVFs) are anomalous communications between an artery and a vein, bypassing the capillary network. They can be subdivided on the basis of etiology into congenital and acquired fistulae. The latter may be caused by closed or penetrating traumas, or may be iatrogenic injuries. We report on a case of a young adult female gunshot wound victim treated with emergency laparotomy who developed asymmetrical edema of the lower limbs during the late postoperative period. Imaging exams showed the presence of a left internal iliac AVF, treated using endovascular surgery with placement of a covered stent, resulting in total occlusion of arteriovenous communication.

scholarly journals Endovascular repair of traumatic external iliac vessel pseudoaneurysm and arteriovenous fistulae

2013 ◽  
Vol 12 (3) ◽  
pp. 257-259
Author(s):  
Juan Marin ◽  
Beatriz Retamales ◽  
Camila Onetto ◽  
Enrique Ceroni ◽  
Cristian Marin
Keyword(s):  
Gunshot Wound ◽  
Hypovolemic Shock ◽  
External Iliac Artery ◽  
Vascular Trauma ◽  
Arteriovenous Fistulae ◽  
Iliac Vessel ◽  
Satisfactory Outcome ◽  
Severe Hemorrhage ◽  
External Iliac Vessel ◽  
Late Postoperative Period

A 17-year-old male patient presenting with an abdominal gunshot wound and severe hypovolemic shock was initially operated and presented several injuries to the small bowel and cecum associated with severe hemorrhage. The patient had to be operated twice due to hypothermia, acidosis, and coagulopathy. In the late postoperative period, murmur and fremitus were observed. Angiography revealed a pseudoaneurysm associated with arteriovenous fistulae at the left external iliac vessels. Lesions were repaired with a stent graft placed in the external iliac artery, with a satisfactory outcome. Control computed tomography performed 6 months later evidenced artery integrity with closure of the fistulae. Endovascular therapy should be the preferred method in this type of vascular trauma complications.

Up-and-Over Technique for Implantation of Iliac Branch Devices After Prior Aortic Endograft Repair

2018 ◽  
Vol 25 (1) ◽  
pp. 21-27 ◽  
Author(s):  
David L. Dawson ◽  
Giuliano de Almeida Sandri ◽  
Emanuel Tenorio ◽  
Gustavo S. Oderich
Keyword(s):  
Stent Graft ◽  
Iliac Artery ◽  
Endovascular Aneurysm Repair ◽  
Covered Stent ◽  
Femoral Access ◽  
Aortic Stent Graft ◽  
Flow Divider ◽  
Device Placement ◽  
Internal Iliac ◽  
Aneurysm Repair

Purpose: To describe a modified up-and-over access technique for treatment of iliac artery aneurysms in patients with prior bifurcated stent-grafts for endovascular aneurysm repair (EVAR). Technique: This technique uses a coaxial 12-F flexible sheath that is docked with a through-and-through wire into a 7-F sheath advanced from the contralateral femoral approach. This maneuver allows both sheaths to be moved as a unit while maintaining position of the apex of the system as it loops over the flow divider, avoiding damage to or displacing the extant endograft. Once the 12-F sheath is positioned in the iliac limb of the aortic stent-graft and secured in place with the through-and-through wire, the repair is extended into the internal iliac artery using a bridging stent-graft or covered stent introduced via a coaxial sheath. Conclusion: The up-and-over technique with a flexible 12-F sheath mated with a 7-F sheath from the opposite side allows bilateral femoral access to be used for iliac branch device placement after prior aortic endograft procedures that create a higher, acutely angled bifurcation. Use of a through-and-through wire and a coaxial sheath for stent delivery creates a very stable platform for intervention.

Creatine supplementation elicits greater muscle hypertrophy in upper than lower limbs and trunk in resistance-trained men

2017 ◽  
Vol 23 (4) ◽  
pp. 223-229 ◽  
Author(s):  
João Pedro Nunes ◽  
Alex S Ribeiro ◽  
Brad J Schoenfeld ◽  
Crisieli M Tomeleri ◽  
Ademar Avelar ◽  
...  
Keyword(s):  
Young Adult ◽  
Resistance Training ◽  
Soft Tissue ◽  
Muscle Hypertrophy ◽  
Creatine Supplementation ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Double Blind ◽  
Adult Men ◽  
Significant Difference

Background: Creatine (Cr) supplementation associated with resistance training produces greater muscular strength improvements in the upper compared with the lower body; however, no study has investigated if such region-specific results are seen with gains in muscle mass. Aim: We aimed to evaluate the effect of Cr supplementation in combination with resistance training on lean soft tissue changes in the upper and lower limbs and trunk in resistance-trained young adult men. Methods: In a randomized, double-blind and placebo-controlled design, 43 resistance-trained men (22.7 ± 3.0 years, 72.9 ± 8.7 kg, 177.9 ± 5.7 cm, 23.0 ± 2.5 kg/m2) received either creatine (Cr, n = 22) or placebo (PLA, n = 21) over an 8-week study period. The supplementation protocol included a loading phase (7 days, four doses of 0.3 g/kg per day) and a maintenance phase (7 weeks, single dose of 0.03 g/kg per day). During the same period, subjects performed resistance training four times per week using the following two-way split routine: Monday and Thursday = pectoral, shoulders, triceps, and abdomen, Tuesday and Friday = back, biceps, thighs, and calves. Lean soft tissue of the upper limbs (ULLST), lower limbs (LLLST), and trunk (TLST) was assessed by dual-energy X-ray absorptiometry before and after the intervention. Results: Both groups showed significant ( p < 0.001) improvements in ULLST, LLLST, TLST, and the Cr group achieved greater ( p < 0.001) increases in these outcomes compared with PLA. For the Cr group, improvements in ULLST (7.1 ± 2.9%) were higher than those observed in LLLST (3.2 ± 2.1%) and TLST (2.1 ± 2.2%). Otherwise, for PLA group there was no significant difference in the magnitude of segmental muscle hypertrophy (ULLST = 1.6 ± 3.0%; LLLST = 0.7 ± 2.8%; TLST = 0.7 ± 2.8%). Conclusion: Our results suggest that Cr supplementation can positively augment muscle hypertrophy in resistance-trained young adult men, particularly in the upper limbs.

Acute myocardial infarction in a young adult patient with simultaneous total occlusion of double coronary arteries

2010 ◽  
Vol 8 (4) ◽  
pp. 126-128
Author(s):  
Motoki Miyauchi ◽  
Masaki Izumo ◽  
Yoshihiro J. Akashi ◽  
Kengo Suzuki ◽  
Shonosuke Ryu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adult ◽  
Adult Patient ◽  
Coronary Arteries ◽  
Total Occlusion ◽  
Young Adult Patient

scholarly journals Direct Bare Metal Needle Puncture and Balloon Angioplasty in Calcified Plaques of the Common Femoral Artery Guided by Angiography (“BAMBOO SPEAR”)

2021 ◽  
Author(s):  
Naoki Hayakawa ◽  
Satoshi Kodera ◽  
Masataka Arakawa ◽  
Satoshi Hirano ◽  
Sandeep Shakya ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Balloon Angioplasty ◽  
Common Femoral Artery ◽  
Lower Limbs ◽  
Bare Metal ◽  
Needle Puncture ◽  
Total Occlusion ◽  
Calcified Plaque ◽  
The Common ◽  
Metal Needle

Abstract BackgroundSurgical endarterectomy for common femoral artery (CFA) disease is still considered the gold standard for treatment. Development of various techniques and devices has improved the clinical results of endovascular therapy (EVT) for CFA. However, severe conditions remain, especially for occlusive lesions owing to calcified plaque. We developed a useful technique for passing a lesion by directly penetrating the calcified plaque of the CFA using a bare metal needle and then passing through a balloon or dilating it. We named this technique “direct bare metal needle puncture and balloon angioplasty in calcified plaques of the common femoral artery guided by angiography” or “BAMBOO SPEAR.” Main textThis report describes our technique for crossing a lesion by directly penetrating the calcified plaque of the CFA using a needle. We report a case of a 73-year-old male with hemodialysis who presented with cyanosis and ischemic rest pain of both lower limbs. Control angiography showed total occlusion of the left CFA with a calcified plaque. We advanced a 21-G metal needle that was slightly curved into the blood vessel from where the lumen of the distal CFA was located. The needle was advanced into the center of the calcified plaque, while observing from multiple directions with a fluoroscopic guide. We succeeded in advancing the needle into the lumen of the distal external iliac artery. After guidewire crossing, intravascular ultrasound (IVUS) showed that guidewire was able to completely pass through the center of the calcified plaque. We could dilate the lesion by scoring balloon and drug-coated balloon. The final angiography showed sufficient results. We named this technique ‘‘direct BAre Metal needle puncture and BallOOn angioplaSty in calcified PlaquEs of the common femoral ARtery guided by angiography” (BAMBOO SPEAR).ConclusionsThe BAMBOO SPEAR technique may be considered a useful option in EVT for occlusive CFA with calcified plaques.

scholarly journals Arterial Thromboembolism in a patient with Ischemic Dilated Cradiomypathy (IDCM)

KYAMC Journal ◽  
2013 ◽  
Vol 2 (1) ◽  
pp. 149-151
Author(s):  
Md Saiful Islam ◽  
Md Alamgir Hossain ◽  
Ranjan Talukder ◽  
Md Moniruzzaman
Keyword(s):  
Lower Limb ◽  
Severe Pain ◽  
Coronary Angiogram ◽  
Total Occlusion ◽  
Tibial Arteries ◽  
Internal Iliac ◽  
History Of ◽  
Ct Coronary Angiogram ◽  
History Of Formation ◽  
Bluish Discoloration

Mrs. Shikha, 51 years old pleasant lady presented to us with the complaints of acute severe pain in the left leg associated with bluish discoloration for 5 days. She is a known case of Ischemic Dilated cardiomyopathy (IDCM) for last 6 years & had history of formation of LV thrombus for repeated times. She was on regular anti-platelets, anti-ischemic & anti-coagulant drugs. Recently her echocardiogram report revealed- IDCM, Mitral regurgitation (gr-11), spontaneous echo contrast within LV, LVEF- 24%. On this admission her CT coronary angiogram of lower limb vessels revealed total occlusion associated with thrombosis of left common iliac, external iliac & internal iliac, distal popliteal, ant. & post. tibial, peroneal arteries, & on right side diffuse atherosclerosis of distal popliteal, ant & post tibial arteries. Patient was treated with anticoagulants, anti platelet, anti-ischemic & other relevant medications & referred to vascular surgeon.DOI: http://dx.doi.org/10.3329/kyamcj.v2i1.13521 KYAMC Journal Vol.2(1) 2011 pp.149-151

scholarly journals Implantation of Covered Stent for Coarctation of the Aorta and Secondary Hypertension in Adolescents—Case Report

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1018
Author(s):  
Simina-Elena Ghiragosian-Rusu ◽  
Cristina Blesneac ◽  
Anca Sglimbea ◽  
Claudiu Ghiragosian ◽  
Laszlo Hadadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Arterial Hypertension ◽  
Coarctation Of The Aorta ◽  
Holter Monitoring ◽  
Secondary Hypertension ◽  
Covered Stent ◽  
Lower Limbs ◽  
Interventional Treatment ◽  
High Morbidity

Introduction: Coarctation of the aorta represents a narrowing of the thoracic aorta. Hypertensive patients with blood pressure differences ≥20 millimetres of mercury have an indication for surgical or interventional treatment. Implantation of a covered stent became the preferred therapy for the management of this pathology in adolescents/adults. Case report: We report the case of a 14-year-old male sportsman, who presented in the emergency room with headache, dizziness, and tinnitus. The clinical exam revealed blood pressure differences between the upper and lower limbs of up to 50 mmHg. Based on the clinical and paraclinical data, we established the diagnosis of coarctation of the aorta and severe secondary arterial hypertension. The case was discussed by a multidisciplinary team and accepted for covered stent implantation. The 24 h blood pressure Holter monitoring after the procedure indicated the persistence of stage I arterial hypertension. Conclusions: Coarctation of the aorta is a congenital cardiovascular anomaly with high morbidity and mortality rates. Arterial hypertension, heart failure, and aortic dissection are complications of this pathology, some of them being sometimes direct consequences of secondary hypertension. Periodic cardiology follow up after the procedure is mandatory to assess the hemodynamic response, to identify potential complications, and to stratify the cardiovascular risk.

PS01.079: OF BARRIERS AND BALLOONS- SURGICAL MANAGEMENT OF ESOPHAGEAL IATROGENIC INJURIES USING PRIMARY REPAIR WITH A ROTATION DIAPHRAGMATIC FLAP: A SERIES FROM OMAN

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 72-72
Author(s):  
Raad Almehdi ◽  
Salim Al Riyami ◽  
Reda Rabie
Keyword(s):  
Conflicts Of Interest ◽  
Primary Repair ◽  
Case Series ◽  
Duplication Cyst ◽  
Covered Stent ◽  
Aorta Aneurysm ◽  
Inflated Balloon ◽  
Rotation Flap ◽  
Iatrogenic Injuries ◽  
Small Series

Abstract Background Background Iatrogenic injuries of the Esophagus remain a challenging turf to dwell upon. Although the timing of surgical intervention, when indicated, may be controlled and hence is more favourable than other types of uncontrolled traumas, however the patient's pre-morbid state as well as the Esophagus’ presenting condition at the time of injury may confound the desired outcome. The Royal Hospital of Muscat is the biggest tertiary centre in Oman. The Upper GI surgical unit was established in 2010. In this small series, we highlight the valuable role of rotational diaphragmatic flaps in perforations of the lower Esophagus. Methods A case series of 4 patients presenting with iatrogenic esophageal injuries, who underwent primary repair with a rotation flap between 2012 and 2016. Results All patients had iatrogenic lower esophageal tears. The first was from an over inflated balloon of a calibrating tube, misplaced in the esophagus during a standard Sleeve Gastrectomy for Obesity. The second was an intraoperative perforation during a Thoracic surgical procedure for a duplication cyst. The third was a complication of an endovascular stent for a dissecting thoracic aorta aneurysm. The fourth was due to covered stent placed to seal a small perforation following variceal injection in a patient with Child's B liver cirrhosis. The average tear length was 3cms. All were operated within 48hours, before full sepsis had set in. The extent of contamination was localised and its degree minimal to moderate. All underwent a primary repair with a diaphragmatic rotation flap used as a second cover layer. Postoperative fluoroscopy showed intact surgical repair with good flow of contrast. The first three patients were discharged after an average of 12 days. The fourth succumbed to his liver failure and expired after two months in hospital. Conclusion Primary repair of iatrogenic lower esophageal injuries, when done early, could be consolidated with reasonable success using a diaphragmatic rotation flap. The flap's length is fashioned as required on a well vascularised pedicle. In comparison to other supportive techniques this flap is more flexible and its tissue more enduring as a good repair harness. Disclosure All authors have declared no conflicts of interest.

scholarly journals Retrograde venous bullet embolism after thoracic gunshot

2013 ◽  
Vol 12 (4) ◽  
pp. 324-328 ◽  
Author(s):  
Leonardo Pessoa Cavalcante ◽  
Marcos Velludo Bernardes ◽  
Ricardo Dias da Rocha ◽  
Marcos Henrique Parisati ◽  
Jose Emerson dos Santos Souza ◽  
...  
Keyword(s):  
Ct Scan ◽  
Gunshot Wound ◽  
Rare Complication ◽  
Iliac Vein ◽  
X Rays ◽  
Abdominal Injuries ◽  
Internal Iliac Vein ◽  
Internal Iliac ◽  
The Right

Bullet embolism is a rare complication of penetrating gunshots. We present a case of a 24-year-old man with a gunshot wound in the left scapular area, with no exit wound. Abdominal X-rays and a computed tomography (CT) scan suggested that the bullet was located within the intra-abdominal topography (intrahepatic), but laparotomy revealed no intra-abdominal injuries. After surgery, a sequential CT scan showed that the bullet had migrated to the right internal iliac vein (IIV). Venography confirmed the diagnosis of right IIV embolism and the decision was taken to attempt snare retrieval of the bullet, which was unsuccessful. It was therefore decided to leave the missile impacted inside the right IIV and the patient was put on oral anticoagulation. The patient recovered and was event free at 6 months' follow up.

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