ABSTRACT
Purpose@#The treatment of aneurysms with characteristics such as complex morphology, fusiform, blister-like, wide neck, or large size has been revolutionized with the introduction of flow diverters. Though flow diverters have several advantages over coiling, they also have certain important disadvantages such as the lack of immediate protection against rupture, the risk of ischemic stroke, the need for antiplatelet therapy, and long latency for complete effect. The Derivo Embolization Device (DED) is a second-generation self-expanding device that is claimed to be less thrombogenic than conventional devices. We retrospectively evaluated the periprocedural safety and risks associated with the DED across 5 centers in India. @*Materials and Methods@#This is a multicentric, retrospective, observational study of DED, conducted at 5 high volume endovascular therapy centers in India from May 2018 to June 2020. Periprocedural demographic, clinical, and angiographic data were collected from a retrospective review of patient charts. @*Results@#A total of 96 patients, including 56 (58.3%) females, aged between 16–80 years (60±12.7 years) harboring 106 aneurysms were studied. Seven (7.3%) were noted to harbor multiple aneurysms: 6 had 3 aneurysms each, while 1 patient had 5 aneurysms. The following aneurysm characteristics were noted: average size, 9.8±8.2 mm; average neck size, 6.9±8.5 mm; wide-necked (>4 mm), 63 (59.4%); giant (>25 mm), 8 (7.5%); and anterior circulation location, 98 (92.5%). Eighteen (17%) of these were ruptured. Additional balloon angioplasty was performed in 5 (5.2%) patients. Intraprocedural problems were encountered in 3 (3.1%), of which only 1 had clinical implications, the device fish-mouthing with stent thrombosis resulting in a malignant middle cerebral artery territory infarction. The modified Rankin scale at 3 months was worse in 1 patient. @*Conclusion@#DED is a newer generation flow diverter stent with a low periprocedural complication rate.
ABSTRACT
An Internal hernia is a protrusion of abdominal viscera through the opening in the peritoneum or mesentery. We report the case of a left paraduodenal hernia (LPDH) combined with a small bowel obstruction in a 50-years-old male with pain abdomen and vomiting and no previous abdominal surgeries. An anteroposterior abdominal radiograph showed a clustered small bowel loops towards the left side of the abdomen and few air-fluid levels suggestive of obstruction. CECT abdomen showed a focal crowding of small bowel loops noted in the left anterior pararenal space with crowding of mesenteric vasculature and displacement of ascending left colic artery and inferior mesenteric vein anteriorly. The surgical intervention provided definitive diagnosis and treatment for LPDH. A paraduodenal hernia is a relatively rare cause of acute abdomen, and its diagnosis is often incorrect or delayed owing to its variable clinical manifestations. Therefore, it is important for the clinicians to recognize this condition, diagnose it early, and avoid making a wrong diagnosisowing to its high overall mortality rate
ABSTRACT
Pseudoaneurysms represent a pulsating encapsulated hematoma in communication with the lumen of a ruptured vessel. We present a 33-year-old male with a pseudoaneurysm of the profunda femoris artery. At presentation and on further evaluation, he was diagnosed with a possible soft tissue sarcoma of the distal thigh. Catastrophic haemorrhage occurred at the time of a planned, elective open biopsy. This case report emphasises the importance of considering pseudoaneurysm as a crucial differential diagnosis in atypical swellings and scrutinising all suspected soft tissue tumours with a contrast study or a Doppler ultrasound.