Superficial Femoral Artery Rupture "Bailed Out" Using Novel Design of Supera Stent.

Peripheral artery disease is a condition that occurs due to narrowing or occlusion of arterial lumen usually secondary to atherosclerosis. Endovascular treatments are minimally invasive procedures that have become popular for recanalization of such calcified/sclerosed arteries. However, heavily calcified arteries make these procedures challenging and are more prone to complications like balloon rupture and bleeding. Herein, we report a novel case of rupture of superficial femoral artery and its management using self-expanding Supera stent.

CT chest analysis of 2019 novel coronavirus pneumonia: An Indian perspective.

CONTEXT: Since its outbreak, the COVID-19 pneumonia pandemic is rapidly spreading across India; although computed tomography of chest (CT chest) is not recommended as a screening tool, there is a rapid surge in the CT chest performed in suspected cases. We should be aware of the imaging features among the Indian population. AIM: To analyze the CT chest features in Indian COVID-19 patients. SETTINGS AND DESIGN: Retrospective study. SUBJECTS AND METHODS: CT chest of 31 polymerase chain reaction (PCR) verified patients of COVID-19 was assessed for ground-glass opacities (GGO), consolidations, bronchiectasis, pleural effusions, vascular enlargement, crazy paving, and reverse halo sign. STATISTICAL ANALYSIS USED: The data was analyzed in Microsoft Excel 2019. RESULTS: Only one patient showed a normal scan. Multilobar involvements with parenchymal abnormalities were seen in all the patients with bilateral involvement in 74.1%. 42.5% of the lung parenchymal abnormalities were pure GGOs, while 41.6% had GGOs mixed with consolidation. Peripheral and posterior lung field involvement was seen in 70.5% and 65.5%, respectively; 56.8% had well-defined margins. Pure GGOs were seen in all six patients, who underwent CT in the first 2 days of onset of symptoms. Seventeen patients scanned between 3 and 6 days of the illness showed GGOs mixed with consolidation and pure consolidations 76%. Vascular enlargement, crazy paving, and reverse halo sign were seen in 70%, 53%, and 35% of the patients, respectively. Patients scanned after 1 week of symptoms showed traction bronchiectasis along with GGOs and or consolidations. CONCLUSIONS: COVID-19 pneumonia showed multifocal predominantly subpleural basal posteriorly located GGOs and/or consolidations which were predominantly well defined. "Crazy paving" was prevailing in the intermediate stage while early traction bronchiectasis among the patients presented later in the course of illness.

Laparoscopic management of celiac artery compression syndrome: A case report.

INTRODUCTION: Celiac artery compression syndrome is a rare disorder found mainly in young females. It many a times goes undiagnosed as the symptoms are non-specific and varied. PRESENTATION OF THE CASE: We present a case of celiac artery compression syndrome in a young female where laparoscopic median arcuate ligament release with celiac ganglionectomy was effective in relieving the symptoms. DISCUSSION: Commonly they may present with abdominal pain, vomiting and diarrhea but there is absence of significant clinical signs. High level of suspicion and the right imaging techniques like the lateral aortogram, helps us to clinch the diagnosis. CONCLUSION: Laparoscopic release of celiac artery compression is a safe and effective method to treat this uncommon disease.

Unmasking the culprit: MAPCA masquerading as RV failure in post surgical correction of TOF.

Pulmonary regurgitation and right ventricular dilatation are major determinants of long-term follow up of surgically corrected tetralogy of Fallot. Occasionally, there are undiagnosed associated anomalies, which can exaggerate pulmonary regurgitation. The present report describes long-term effect of major aorto pulmonary collateral on right ventricular volume also a result of successful intervention. .

Percutaneous retrieval of misplaced intravascular foreign objects with the Dormia basket: an effective solution.

PURPOSE: We report our experience of the retrieval of intravascular foreign body objects by the percutaneous use of the Gemini Dormia basket. METHODS: Over a period of 2 years we attempted the percutaneous removal of intravascular foreign bodies in 26 patients. Twenty-six foreign bodies were removed: 8 intravascular stents, 4 embolization coils, 9 guidewires, 1 pacemaker lead, and 4 catheter fragments. The percutaneous retrieval was achieved with a combination of guide catheters and the Gemini Dormia basket. RESULTS: Percutaneous retrieval was successful in 25 of 26 patients (96.2%). It was possible to remove all the intravascular foreign bodies with a combination of guide catheters and the Dormia basket. No complication occurred during the procedure, and no long-term complications were registered during the follow-up period, which ranged from 6 months to 32 months (mean 22.4 months overall). CONCLUSION: Percutaneous retrieval is an effective and safe technique that should be the first choice for removal of an intravascular foreign body.

Treatment of acute lower gastrointestinal hemorrhage by superselective transcatheter embolization.

AIM: To evaluate the technical feasibility, success of hemostasis and complications of transcatheter embolization in the treatment of acute lower gastrointestinal (GI) bleeding. METHODS: Retrospective review of 63 patients with acute lower GI bleed who had undergone transcatheter selective embolization of mesenteric arteries over a two-year period. Embolization was carried out only if the arteria recta leading to the bleed could be successfully catheterized (n=52). The lesions treated were located in the jejunum (n=13), ileum and ileo-cecal region (n=9), appendicular region (n=2) and colon (n=28). Embolization was performed with only polyvinyl alcohol particles (PVA) (250-500 microns) in 23 patients, only microcoils in 16 patients and both PVA particles and microcoils in 13 patients. Twenty-eight patients were evaluated for objective evidence of ischemia by colonoscopy (n=21) and/or histologic evidence in the surgical specimen (n=7); 23 patients were followed up clinically. RESULTS: Immediate hemostasis was achieved in 61 of 63 patients; of the remaining 2 patients, one underwent surgery whereas the other died during the procedure. Recurrent bleeding occurred in 9 patients - 6 were managed surgically and 3 medically. Endoscopic evaluation showed mucosal ischemia in 7 patients but they remained asymptomatic on follow up. Embolization was the sole modality of treatment in 41 patients (78.9%). CONCLUSION: Transcatheter superselective embolization is an effective and safe modality of treatment for acute lower GI bleeding.

Transjugular liver biopsy--experience in fifty patients.

OBJECTIVE: We evaluated the safety, adequacy, clinical impact and cost of transjugular liver biopsies performed at our institution. METHODS: Eighty-four biopsies performed in 50 consecutive patients with coagulopathy (INR >1.4; n=20), thrombocytopenia (platelet count <75,000/cmm; n=17), ascites (n=10), or coagulopathy and thrombocytopenia (n=3) from April 1999 to July 2002 were analyzed. Biopsy was performed under local anesthesia with fluoroscopic guidance, using the Quick Core biopsy needle. RESULTS: Ninety-two needle passes were made to obtain 84 samples. Biopsy was technically unsuccessful in two patients because of hepatic vein ostial block; however, the procedure established the diagnosis of blockage of hepatic vein ostia in these patients. Biopsy specimen was adequate for histological examination in 45 patients. The median number of biopsies performed with 18- and 19-gauge needles was 14 and 8, respectively. The biopsy provided diagnostic information in 23 of 50 (46%) patients, and helped in staging or providing prognostic information in 37 (74%) patients. There were no major complications. Minor complications included transient hepatic vein-to-portal vein fistula in 2, transient hepatic vein-biliary fistula in one, local hematoma in 5, and post-procedure fever in 5 patients. The approximate cost of the needle and accessories was Rs. 2000 per patient. CONCLUSIONS: Transjugular liver biopsy was safe, provided adequate tissue in 90% of patients, and helped frequently in diagnosis and in staging or prognostication of disease.