ABSTRACT
We report a case of aortoenteric fistula (AEF) that occurred four years after endovascular abdominal aortic aneurysm repair (EVAR) with the original Gore Excluder endoprosthesis despite uncomplicated stent graft placement without endoleaks or migration on postoperative imaging studies; the patient was reoperated with a Cook aortouniiliac converter for endotension three months before the diagnosis of AEF. To our knowledge, this is the first reported case in the literature of an AEF after EVAR with the Excluder stent graft. Our case demonstrates that EVAR is not a guarantee against the development of AEF, and we suggest that all the patients with the first generation Excluder device should be closely followed-up; if sac enlargement is detected, early conversion to open repair or reinforcement of the entire old endograft should be considered.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Aortic Diseases/etiology , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis , Duodenal Diseases/etiology , Endovascular Procedures/instrumentation , Intestinal Fistula/etiology , Stents , Vascular Fistula/etiology , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Aneurysm, Abdominal/physiopathology , Aortic Diseases/diagnostic imaging , Aortic Diseases/surgery , Aortography/methods , Blood Vessel Prosthesis Implantation/adverse effects , Duodenal Diseases/diagnostic imaging , Duodenal Diseases/surgery , Endovascular Procedures/adverse effects , Fatal Outcome , Humans , Intestinal Fistula/diagnostic imaging , Intestinal Fistula/surgery , Male , Middle Aged , Prosthesis Design , Reoperation , Time Factors , Tomography, X-Ray Computed , Vascular Fistula/diagnostic imaging , Vascular Fistula/surgeryABSTRACT
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No disponible
Subject(s)
Humans , Female , Aged , Embolization, Therapeutic , Aneurysm, False/diagnosis , Aneurysm, False/surgery , Subclavian Artery , Magnetic Resonance AngiographyABSTRACT
PURPOSE: To evaluate angiographic and clinical results in patients with a dural arteriovenous fistula (AVF) who underwent percutaneous transvenous embolization. MATERIALS AND METHODS: Retrospective chart analysis and radiologic studies were performed in 24 patients (aged 20-87 years) with a dural AVF treated with percutaneous transvenous embolization. Lesions were located in the transverse and/or sigmoid or superior sagittal sinus. Clinical follow-up was 3-44 (mean, 10.8) months. RESULTS: After percutaneous transvenous embolization of 24 dural AVFs, there was complete occlusion in 17 patients, important flow reduction in three, and moderate flow reduction in four. Twenty patients were clinically cured, 17 with complete occlusion and three with important flow reduction. In patients with moderate flow reduction, clinical improvement was good in two and moderate in one. One patient remained clinically unchanged. A transient complication was seen in one patient, and a permanent complication was seen in one patient. One patient, whose preexisting clinical status was poor, died. During long-term follow-up, the condition of two patients worsened. CONCLUSION: Percutaneous transvenous embolization appears to be effective in the treatment of dural AVFs. More experience is needed to evaluate long-term results.
Subject(s)
Arteriovenous Fistula/therapy , Cerebral Arterial Diseases/therapy , Cranial Sinuses , Embolization, Therapeutic , Adult , Aged , Aged, 80 and over , Arteriovenous Fistula/diagnostic imaging , Cerebral Angiography , Cerebral Arterial Diseases/diagnostic imaging , Dura Mater/blood supply , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
Ten of 73 kidney neoplasms (14%) collected from the files of the Hospital de Navarra over a five-year period were urothelial carcinomas of the renal pelvis (UCRP). In 54 of 73 kidney neoplasms fine needle aspiration biopsy (FNAB) was performed. In seven cases a cytologic diagnosis of urothelial carcinoma was made. The majority of patients presented with pain and hematuria of short duration. In three cases a renal mass was detected by roentgenography. A filling defect in the collector system, with no conclusive roentgenographic diagnosis, was observed in the remaining cases. Computed tomography-guided FNAB was performed in all cases. Voided urine was collected for microscopic study in six cases. The cytologic pattern of all cases was similar to that of bladder urothelial carcinoma. This feature was particularly frequent in well-differentiated papillary carcinomas. The differential diagnosis with other kidney lesions based on cytologic findings was established. FNAB is useful not only in the preoperative diagnosis of UCRP but also in follow-up.
