ABSTRACT
Infected popliteal aneurysm is a rare high-risk condition that can present as an emergency with acute rupture and sepsis. Management of acute ischemia in the presence of local and systemic sepsis is challenging. Open surgery is not always possible and carries a high risk of morbidity and death. An endovascular approach has been advocated in infected aneurysms elsewhere in the body, with good short-term and medium-term outcomes encouraging such approach in the popliteal artery. We report a case of successful endovascular treatment of an infected ruptured popliteal aneurysm with favorable outcome after 2-year follow-up and a related review of the literature.
Subject(s)
Aneurysm, Infected/surgery , Aneurysm, Ruptured/surgery , Blood Vessel Prosthesis Implantation , Endovascular Procedures , Popliteal Artery/surgery , Aged, 80 and over , Aneurysm, Infected/diagnosis , Aneurysm, Infected/microbiology , Aneurysm, Ruptured/diagnosis , Aneurysm, Ruptured/microbiology , Angiography, Digital Subtraction , Angioplasty , Anti-Bacterial Agents/therapeutic use , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation/instrumentation , Endovascular Procedures/instrumentation , Humans , Magnetic Resonance Angiography , Male , Popliteal Artery/diagnostic imaging , Popliteal Artery/microbiology , Popliteal Artery/pathology , Staphylococcus aureus/isolation & purification , Stents , Streptococcus/isolation & purification , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Spinal cord ischemia (SCI) is a rare disease that leads to variable degrees of neurological deficit including permanent paraplegia. It has been reported after open and endovascular interventions of the thoracic and abdominal aorta, but it is extremely rare after interventions involving peripheral vessels. We present a case of permanent paraplegia after iliac angioplasty and stenting for critical limb ischemia and a related review of the literature.
Subject(s)
Angioplasty/adverse effects , Arterial Occlusive Diseases/therapy , Iliac Artery , Spinal Cord Ischemia/etiology , Aged , Angioplasty/instrumentation , Arterial Occlusive Diseases/diagnosis , Constriction, Pathologic , Humans , Iliac Artery/diagnostic imaging , Iliac Artery/pathology , Magnetic Resonance Angiography , Male , Paraplegia/etiology , Spinal Cord Ischemia/diagnosis , Stents , Tomography, X-Ray ComputedABSTRACT
PURPOSE: To evaluate retrievability of the Celect vena cava filter over time and to assess the safety of the retrieval procedure in a prospective multicenter registry. MATERIALS AND METHODS: Between October 2005 and March 2008, Celect filters were placed in 95 patients (61 men; mean age, 51 years +/- 18.5) with a temporary need for an inferior vena cava (IVC) filter. All patients satisfied requirements for filter placement; the primary indications for placement were pulmonary embolism (PE) with a contraindication to or failure of anticoagulation (n = 40), high risk for further PE (n = 29), trauma (n = 23), or massive PE with residual deep vein thrombosis and risk for further PE (n = 3). Filter orientation, vena cava injury, and other device-related incidents were evaluated at implantation and retrieval. The degree of difficulty associated with retrieval was also assessed. RESULTS: Filter retrieval was attempted in 58 patients (mean indwell time of 179 days; median, 168.5 d; range, 5-466 d). Fifty-six filters (96.6%) were successfully retrieved. Unsuccessful retrieval attempts were attributed to filter tilt (n = 1) or excessive tissue growth with the hook embedded in the endothelium (n = 1). No adverse events were associated with the inability to retrieve these filters. A Kaplan-Meier product-limit survival estimate revealed that the probability of successful filter retrieval remained at 100% at 50 weeks and at more than 74% at 55 weeks after implantation. No adverse events were related to the retrieval procedures. CONCLUSIONS: Retrieval of the Celect filter was performed safely as long as 466 days after implantation.
