Surgical Resection of an Intravascular Lipoma of the Superior Vena Cava.

Intravascular lipomas (IVL) located in the superior vena cava (SVS) are rare benign primary venous tumors with less than 15 cases reported in the literature. We report a case of a 64-year-old woman with IVL of the SVC extending to the right brachiocephalic vein. She was treated successfully using a hybrid procedure which involved endovascular control of the right subclavian vein and surgical approach via median sternotomy followed by mass resection and use of pericardial patch for vein defect closure.

Hybrid Procedure for Coexistence of Coarctation of the Aorta and Aberrant Right Subclavian Artery: A Case Report and Review of the Literature.

Background: Coarctation of the aorta (CoA) can either present alone as an isolated condition or in association with other aortic arch or cardiac anomalies. One percent of patients with CoA have concomitant an aberrant right subclavian artery (ARSA). Purpose: We report the case of a 35-year-old woman with uncontrolled hypertension who was found to have CoA and ARSA. Results: The patient was treated successfully using a hybrid procedure comprising ARSA ligation and subclavian to carotid transposition, followed by thoracic endovascular aortic repair. Conclusions: Patients with CoA should be carefully studied, considering the possible coexistence of other congenital aortic arch defects, such as ARSA. Hybrid repair is a safe and effective approach for this condition.

Hybrid Treatment of Aberrant Right Subclavian Artery Causing Dysphagia Lusoria by Subclavian to Carotid Transposition and Endovascular Plug.

Differences in the common aortic arch branching pattern arise from abnormal embryological development. Aberrant origin of the right subclavian artery is the most common of these anomalies. We report the case of a 47-year-old female with progressive dysphagia, found to have an aberrant right subclavian artery (ARSA) running posterior to the esophagus on computed tomography angiography. She was managed successfully with a hybrid procedure involving a right supraclavicular incision for ARSA ligation and subclavian to carotid transposition followed by endovascular closure of the ARSA origin.

[Endoluminal treatment for traumatic aortic rupture. Case report and literature review]. / Tratamiento endoluminal para ruptura aórtica por trauma. Reporte de caso y revisión de la literatura.

Traumatic rupture of the thoracic aorta is a near-lethal event presenting on-scene mortality rates of 80% and 60-80% perioperatively with an overall survival rate of 15%. Conventional treatment includes thoracotomy with aortic clamping and aortic replacement but this implies high complication and mortality rates with extended inpatient care. Endoluminal treatment has recently become an attractive treatment option with advantages such as lower death and complication rates as well as shorter inpatient care. We present an 18-year-old female victim of a frontal automobile crash who presented mediastinal enlargement and underwent CT evaluation confirming pericardial effusion, left hemothorax and a contained traumatic rupture of the thoracic aorta. She was sent to our hospital where aortography was performed identifying the injury, and a preperitoneal left iliac artery approach was made to insert a Medtronic Talent 24F endograft. Under fluoroscopic guidance the graft was placed below the subclavian ostium. There was no endoleak after the procedure. A left iliac-femoral bypass was performed and a chest tube was inserted. The patient was managed in the ICU, being later operated by reconstructive and orthopedic surgeons for injuries related to the initial trauma. The patient was released from the hospital on the 10th postoperative day after a satisfactory evolution. We present also a brief review of recent articles.