Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
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To evaluate whether contrast-enhanced 3-dimensional (3D) magnetic resonance angiography (MRA) can substitute for transaxillary or transbrachial catheter access when angiography via the transfemoral route is not possible. ⋯ When transfemoral catheter angiography of the aortoiliac and lower extremities is not feasible, contrast-enhanced 3D MRA is suitable for determining and planning therapy and can be used instead of angiography via the transaxillary or transbrachial routes.
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To present a method of predicting spinal cord ischemia before deployment of an endograft in the thoracoabdominal aorta. ⋯ An occlusion test to detect spinal cord ischemia before deployment of an endograft could be useful in lowering the risk of paraplegia associated with endovascular treatment of thoracoabdominal aneurysm.
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To describe the importance of accurate diagnosis and successful emergent endovascular repair of intimal injury to the renal artery from sudden deceleration. ⋯ A 22-year-old man was evaluated after jumping head first out of a fourth floor window. Gross hematuria was detected at the initial assessment. Contrast-enhanced computed tomography (CT) revealed diminished uptake in the right kidney. Arteriographic examination of the renal artery demonstrated 2 areas of intimal disruption, which a team of physicians decided to treat with angioplasty and stent placement owing to the associated intracranial injuries. Two balloon-expandable stents were successfully deployed to exclude the intimal defects. Once the associated injuries were also addressed, the patient made an uneventful recovery. CONCLUSIONS; Management of blunt traumatic injuries to the renal vasculature involves timely assessment to maximize preservation of renal function. In the setting of multiple concomitant injuries, recent experience supports the consideration of endoluminal intervention for traumatic renal artery dissections.
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To report the endovascular exclusion of an abdominal aortic aneurysm (AAA) in a patient with a horseshoe kidney and an isthmus mass with preservation of accessory renal vessels. ⋯ The presence of accessory renal arteries in AAA patients with horseshoe kidneys should not automatically exclude them from consideration for endovascular repair. Creative stent-graft arrangements can be a treatment option.
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To present a rare case of chronic total occlusion of the infrarenal aorta treated with a self-expanding endoluminal stent implanted without preliminary dilation. ⋯ Primary stenting may be considered a viable alternative to conventional surgery in selected patients with total infrarenal aortic occlusion.