Vascular
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Case Reports
Don't get in a flap!: a case report of progression through the spectrum of an acute aortic syndrome.
To present a single case that clearly demonstrates the progression through the whole spectrum of an acute aortic syndrome, from a solitary penetrating aortic ulcer (PAU) through to multiple PAUs with intra-mural haematoma (IMH) progression. The index images show that despite the clinical presentation of an acute type B aortic dissection, a classical dissection flap is never demonstrated in this patient and thus highlights the need for early input from vascular surgery for all potential acute aortic syndromes. ⋯ This case along with index images demonstrates the whole spectrum of the acute aortic syndrome from a solitary PAU to multiple PAUs with IMH extension. Despite an eventual clinical picture of an acute type B aortic dissection, there was a notable absence of a classical dissection flap on any imaging. We recommend that all aortic pathologies should be at least discussed with and preferably managed by vascular surgeons. The absence of a classical dissection flap on imaging is not a contra-indication to emergent treatment with thoracic stent grafting and in select patients is actually the only therapy that will treat this pathology.
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Case Reports
Hybrid endovascular treatment of an aberrant right subclavian artery with Kommerell aneurysm.
Aberrant right subclavian artery is a rare anatomical finding of abnormal embryologic development of the dorsal aorta and right subclavian artery. An associated aortic outpouching, or Kommerell diverticulum, may develop at the origin of the aberrant right subclavian artery. ⋯ Such hybrid techniques offer a decrease in mortality and complication rates. Herein, we describe a successful repair of a symptomatic (dysphagia, weight loss) aberrant right subclavian artery with Kommerell diverticulum using this hybrid open-endovascular approach.
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The 2014 meeting of the International Society for Vascular Surgery (ISVS) was held in Guangzhou, China, in conjunction with the fifth annual Wang Zhong-Gao's Vascular Forum, the eighth annual China Southern Endovascular Congress, and the third annual Straits Vascular Forum. Keynote addresses were given by Professors Christos Liapis, Wang Zhong-Gao, and Wang Shen-Ming. President Liapis presented the first ISVS Lifetime Achievement Award to Professor Wang Zhong-Gao for his multi-decade accomplishments establishing Vascular Surgery as a specialty in China. ⋯ The 2014 ISVS meeting was a success. Partnership of this meeting with host Chinese Vascular Surgery societies was of mutual benefit, bringing vascular surgeons of international reputation to the local area for academic and intellectual exchange and formation of collaborations; integration of the meetings allows easier logistics to facilitate meeting organization and optimization of time for both faculty and attendees. This integrated model may serve as an optimal model for future meetings.
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Abdominal aortic aneurysms can be complicated by some conditions and aortocaval fistula is one of them. Aortocaval fistula is an unusual entity. ⋯ After a long-term untreated fistula, right-sided heart failure, acute renal and hepatic insufficiency, deep vein thrombosis and pulmonary thrombo-embolism can be seen in these patients. Increased venous pressure should be the reason for decreased arterial flow results in renal insufficiency. Emergency intervention in these patients saves the patient's life as well as prevents irreversible organ failure.
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Case Reports
Total endovascular management of ruptured aortocaval fistula: technical challenges and case report.
Primary aortocaval fistula (ACF) is a rare complication of ruptured abdominal aortic aneurysms (rAAA). Endovascular repair for rAAA (REVAR) provides an efficient, elegant and safe option, minimizing the risk of massive bleeding with open repair. ⋯ Here in, we report the first two cases in the English literature of rAAA with ACF successfully managed with simultaneous endovascular stent-grafting of both the aorta and the inferior vena cava.