A case report of life-threatening hemothorax after percutaneous lung biopsy successfully managed with embolization.

CT-guided lung biopsy is a widely used procedure for tissue identification. The complications are divided into minor and major with the latter being described as low rate. Hemothorax is reported at a rate of 0.092% and predominantly results from the injury of intercostals or internal mammary arteries. We present the case of 81-year old woman with a right upper lobe mass referred for a CT-guided biopsy. Four hours after the procedure, rapid deterioration of patient's status was observed. A massive hemothorax was reported due to the transection of an intratumoral pulmonary branch. The following management involved successful emergent embolization of the injured branch of the pulmonary artery using a combination of coils and gel foam. One of the theories possibly explaining this extremely rare complication involves the possibility of underlying pulmonary hypertension.

Life threatening, subclavian artery mycotic aneurysm rupture into a gigantic supraclavicular abscess in an intravenous drug user.

Subclavian artery injuries are sporadic, and the most common aetiology is trauma. Self-injury of the vessel in those misusing intravenous drugs is a rare complication, as most reports describe injury to the femoral artery. Thus, erosion and potential rupture of the arterial wall is possible due infection and phlegmon or abscess formation. We present a case of a young, female, hemodynamically unstable intravenous drug user admitted to the emergency department with a life-threatening, purulent haemorrhagic mass located at her right lateral cervical region. The patient admitted an inadvertent arterial puncture 10 days prior and an effort to self-manage the bleeding with the application of self-pressure and antibiotics. Computed tomography arteriogram of the neck revealed a gigantic, multicompartment, thick-walled collection with hyperdense fluid in her right supraclavicular region while active extravasation derived from the right subclavian artery was evident in late arterial phase. The patient was treated with endovascular graft stenting, despite the given presence of infection, as a salvage operation due to time limitation in open surgical repair.

Total Endovascular Therapy of Abdominal Aortic Aneurysm, Peripheral Artery Disease, and Chronic Mesenteric Ischemia: A Challenging Case.

We presented a challenging case of a patient diagnosed with abdominal aortic aneurysm (AAA), peripheral artery disease, and chronic mesenteric ischemia (CMI). Herein, we describe the treatment in this high-risk patient diagnosed with CMI who also had critical limb ischemia and his AAA had rapidly expanded. First we performed angioplasty and celiac arterial stenting. Afterwards, we proceeded to perform balloon angioplasty of the iliac arteries and chimney endovascular aneurysm repair (Ch-EVAR) preserving the inferior mesenteric artery (IMA). The patient was discharged three days later and his IMA remained patent eighteen months post-operation. A thorough pre-operative assessment is essential in such challenging cases. Minimally invasive procedures like endovascular therapy and the chimney technique extend the prognoses in high-risk patients.