Neurocritical care
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Case Reports
Endovascular treatment of inadvertent cannulation of the vertebro-subclavian arterial junction.
Inadvertent arterial cannulation at a noncompressible site is a highly risky complication of central venous line placement. ⋯ Due to the complex site of cannulation, and the patient being fully anticoagulated, the use of a percutaneous closure device was not attempted. Open vascular surgery was not a treatment option due to high surgical risk. After determining left VA dominance, the right VA was occluded distal to the catheter entry point with platinum coils. Subsequently, a covered stent was placed into the SCA across the origin of the VA. The sheath was then removed safely without complications. A minor leak was initially present, which was stopped by repeating balloon inflation within the stent above nominal pressure.
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Case Reports
Successful endovascular treatment of a ruptured mycotic intracavernous carotid artery aneurysm in an AIDS patient.
As the medical treatment for human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) continues to advance, the HIV-related aneurysms may pose a clinical problem of increasing magnitude. The authors report on a successfully treated ruptured mycotic intracavernous carotid artery aneurysm case in an AIDS patient. ⋯ The cerebral aneurysms in HIV/AIDS patients can be generally categorized into two groups: the mycotic aneurysms from bacterial or fungal infections and the HIV-associated aneurysms as a distinct entity. To plan appropriate interventions, a high degree of clinical suspicion must be exercised to promptly recognize the mycotic nature of many HIV-related aneurysms.
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Editorial Comment
Continuous intravenous NSAID administration for fever control.