Delayed carotid wallstent shortening.

INTRODUCTION: Carotid angioplasty and stenting (CAS) has been demonstrated to be safe and an acceptable alternative to surgery. Stent malpositioning can occur during the maneuvers of delivering; technical errors can lead to proximal or distal slipping of the stent that needs the placement of additional pieces. PRESENTATION OF CASE: We describe the case of a postoperative dislocation of a carotid stent that happened 1 year after placement. After the first ultrasound control confirmed the correct position of the Stent the following one, executed 9 months later, showed a severe restenosis due to a proximal dislocation of the stent. The problem was solved with the positioning of a further one more distally. DISCUSSION: We observe the possibility of Carotid Wallstent shortening during the implant due to an incorrect placement or sizing, but a delayed displacement is a rare complication that, we highlight, can occur after CAS and that needs to be considered at the moment of the preoperative planning. CONCLUSION: After CAS a closed ultrasound follow up is advisable for a long time in order to detect unexpected complications.

Unusual treatment of abdominal aortic aneurysm: Aortic stenting with covered stent.

INTRODUCTION: It is now becoming increasingly difficult to accept that some patients are not suitable for surgery due to high surgical risk. The continuous technological progress, in the endovascular field in particular, are urging surgeons to put the limit even more forth. PRESENTATION OF CASE: We are going to describe an endovascular option used to treat an infrarenal aortic aneurysm where the diameter of the iliac vessels couldn't allow the use of any device available on the market. Three covered AdvantaV12 stents were placed in series in the aorta to build the endoprosthesis body and two Bard Fluency 8mm×60mm were then placed in a "kissing way" into the common iliac arteries like legs. DISCUSSION: Continuous technological progress, particularly in the endovascular field, is driving surgeons to push the limits even further. Nevertheless, some things still seem not to be possible, but in comparison to traditional surgery where all is well demonstrated and documented, the endovascular approach is still a young discipline and allows us to try to find new solutions. CONCLUSION: We can therefore assert that in exceptional circumstances, an aortic endoprosthesis can be built inside the aortic lumen using covered stents.

Celiac artery compression syndrome: successful laparoscopic treatment-a case report.

Several authors believe the crus of the diaphragm or the arcuate ligament is largely implicated in the etiology of the celiac artery compression syndrome (CACS). An unusual case of CACS successfully treated with laparoscopic decompression is reported. While under general anesthesia, the patient underwent laparoscopic division of the hypertrophic median arcuate ligament and dissection free of the celiac trunk. Postoperative angiography demonstrated improved flow in the celiac artery. The patient was discharged on the second postoperative day. At 6 months, Doppler ultrasound scanning and magnetic resonance angiography revealed good patency of the celiac trunk. The patient reported complete resolution of symptoms and increased weight. A laparoscopic approach allows the surgeon to sufficiently dissect the celiac axis. An excellent clinical result at short-term follow-up was attained. This is the second reported experience with this new procedure and the first successfully performed with only four port sites.