Scrub typhus with complications of acute myocarditis and cardiac tamponade in metropolitan areas: two case reports / 고신대학교의과대학학술지

Scrub typhus is known as one of the most common seasonal infections in endemic rural areas, but life-threatening cardiac complications in cases of scrub typhus are very infrequent. In addition, scrub typhus infection has been rarely reported among workers assembling pallets using manufactured wood in metropolitan areas. Herein, we present two cases involving myocarditis and cardiac tamponade as complications of scrub typhus. One patient died and the other patient survived. These cases indicate that scrub typhus infection could be an environmental hazard in metropolitan areas, especially in locations with poor hygiene, and highlight the need for timely diagnosis and proper management of severe scrub typhus infections. Therefore, we present these two informative fatal cases of scrub typhus infection presenting with myocarditis and cardiac tamponade as an environmental hazard in metropolitan areas.

Stent Graft Implantation and Superselective Embolization with Liquid Embolic Agent, Onyx for Iatrogenic Common Iliac Artery Pseudoaneurysm and Persistant Endoleak

A 68-year-old male patient with a history of femoro-femoral bypass following unsuccessful intervention for chronic total iliac occlusion was found to have a saccular pseudoaneurysm of the right common iliac artery (CIA) due to interventional device-related injuries associated with the past endovascular intervention. An iatrogenic pseudoaneurysm in the CIA is generally asymptomatic, but it has a high risk of rupture, regardless of its size or symptoms. Endovascular therapy may be the best treatment option; however, ineffective sealing with a stent graft may lead to a type I endoleak. Under such conditions, use of the liquid embolic agent, Onyx, as a bailout solution for the type 1 endoleak is promising.

Treatment of Femoropopliteal Artery In-stent Restenosis

Femoropopliteal (FP) artery-in stent restenosis (ISR) is a daunting management problem that we continue to face. FP artery-ISR rates after primary stent implantation are relatively high. Although repeat FP artery-ISR and the need for additional interventions remain all too common, little consensus exists regarding the best treatment algorithm. In this article, we review the limitations of the currently used devices for the endovascular treatment of FP artery-ISR and discuss which strategies are the most effective and safe.

Treatment of Femoropopliteal Artery In-stent Restenosis

Femoropopliteal (FP) artery-in stent restenosis (ISR) is a daunting management problem that we continue to face. FP artery-ISR rates after primary stent implantation are relatively high. Although repeat FP artery-ISR and the need for additional interventions remain all too common, little consensus exists regarding the best treatment algorithm. In this article, we review the limitations of the currently used devices for the endovascular treatment of FP artery-ISR and discuss which strategies are the most effective and safe.

Aorto-Uni-Iliac Stent Grafting and Femoro-Femoral Bypass in a Patient with a Failed and Catastrophic Endovascular Aortic Aneurysm Repair

A 78-year-old man presented at Eulji University Hospital due to an abdominal aortic aneurysm with maximum diameter of 52 mm, which had been increased from 45 mm over 6 months. He underwent embolization of the left internal iliac artery with vascular plug, prior to endovascular abdominal aortic repair with a bifurcated stent graft system. Unfortunately, the inserted vascular plug was maldeployed and protruded into left external iliac artery, and caused acute limb ischemia. Because revascularization of the occluded segment was failed, emergent hybrid approach with aorto-uni-iliac stent grafting and femoro-femoral bypass was done, successfully.