Subject(s)
Aorta, Abdominal/surgery , Aorta, Thoracic/surgery , Aortic Aneurysm, Thoracic/surgery , Endovascular Procedures/methods , Minimally Invasive Surgical Procedures/methods , Stents , Aged , Aorta, Abdominal/diagnostic imaging , Aorta, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/diagnostic imaging , Endovascular Procedures/instrumentation , Humans , Male , Minimally Invasive Surgical Procedures/instrumentation , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The conventional elective open procedures for abdominal aortic aneurysm repair are reliable and yield durable results. The aortoaortic tube graft has the lowest morbidity incidence when compared with different techniques. Albeit infrequent, thrombosis can be present in the first 30 days. Its treatment consists in thrombectomy and anastomosis evaluation, but with an increase in morbidity, especially in patients with urgent reintervention. This is a case report of a patient with aortoaortic tube graft, who present critical left limb ischemia immediately after surgical procedure. Angiography showed complete occlusion of left common iliac artery, affecting the distal graft anastomosis. The occlusion was resolved with endovascular treatment, and a noncovered, self-expanding, nitinol stent was deployed (primary stenting) covering the distal bypass anastomosis, with no complications and complete lower limb perfusion recovery. One month later, the patient was still asymptomatic, with distal pulse palpable and ankle-brachial index 1.
ABSTRACT
Endovascular treatment can be considered the first line therapy in the majority of dysfunctioning arteriovenous fistula. However, when early thrombosis of the arteriovenous access occurs, surgical treatment is recommended. In these cases, technical problems are the most frequent cause of the malfunction. We report a case of a subacute thrombosis of an arteriovenous fistula, femoral artery to femoral vein looped ePTFE with venous anastomosis occlusion and subocclusion lesion at the arterial anastomosis. Both anastomoses were treated using self-expandable stents, and no other intervention was necessary until the one-year follow-up for maintain patency.
Subject(s)
Arteriovenous Fistula/therapy , Arteriovenous Shunt, Surgical/adverse effects , Femoral Vein , Renal Dialysis/adverse effects , Aged , Angiography , Angioplasty, Balloon, Coronary , Arteriovenous Shunt, Surgical/methods , Humans , Male , Treatment Failure , Vascular Surgical Procedures/adverse effects , Vascular Surgical Procedures/methodsSubject(s)
Angioplasty, Balloon/instrumentation , Graft Occlusion, Vascular/therapy , Leg/blood supply , Stents , Acute Disease , Angiography/methods , Angioplasty, Balloon/methods , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/methods , Femoral Artery/diagnostic imaging , Follow-Up Studies , Graft Occlusion, Vascular/diagnostic imaging , Humans , Ischemia/diagnostic imaging , Ischemia/surgery , Male , Middle Aged , Popliteal Artery/diagnostic imaging , Risk Assessment , Tomography, X-Ray Computed/methods , Treatment Outcome , Vascular PatencyABSTRACT
Endoleak is a frequent complication after endovascular repair of aortic rupture. We describe the case of a female patient with traumatic aortic injury, treated with endograft, who developed a type II endoleak through the left subclavian and vertebral arteries. Both arteries originated independently from the aortic arch, and were managed with coil embolization of each vessel. We also report our experience with treating the left vertebral artery by placing a microcatheter through the right vertebral one.
