ABSTRACT
Purpose The aim of this paper is to report our experience of type II endoleak treatment after endovascular aneurysm repair with intra-arterial injection of the embolizing liquid material, Onyx liquid embolic system. Methods From 2005 to 2012, we performed a retrospective review of 600 patients, who underwent endovascular repair of an abdominal aortic aneurysm. During this period, 18 patients were treated with Onyx for type II endoleaks. Principal findings The source of the endoleak was the internal iliac artery in seven cases, inferior mesenteric artery in seven cases and lumbar arteries in four cases. Immediate technical success was achieved in all patients and no endoleak from the treated vessel recurred. During a mean follow-up of 19 months, no major morbidity or mortality occurred, and one-year survival was 100%. Conclusions Treatment of type II endoleaks with Onyx is safe and effective over a significant time period.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Dimethyl Sulfoxide/administration & dosage , Embolization, Therapeutic/methods , Endoleak/therapy , Endovascular Procedures/adverse effects , Iliac Artery , Lumbar Vertebrae/blood supply , Mesenteric Artery, Inferior , Polyvinyls/administration & dosage , Tantalum/administration & dosage , Aged , Aged, 80 and over , Angiography, Digital Subtraction , Computed Tomography Angiography , Dimethyl Sulfoxide/adverse effects , Drug Combinations , Embolization, Therapeutic/adverse effects , Endoleak/diagnostic imaging , Endoleak/etiology , Female , Humans , Iliac Artery/diagnostic imaging , Injections, Intra-Arterial , Male , Mesenteric Artery, Inferior/diagnostic imaging , Polyvinyls/adverse effects , Retrospective Studies , Tantalum/adverse effects , Time Factors , Treatment OutcomeABSTRACT
Access for endovascular treatment of the superficial femoral artery (SFA) is usually gained through an antegrade approach from the ipsilateral common femoral artery (CFA), or by crossing over from the contralateral CFA. In this technical note, an alternative method, based on retrograde access of the ipsilateral iliac artery (IA), and conversion into an antegrade approach to the SFA, is described. Successful reverse ipsilateral catheterisation was obtained in 15/16 patients. Calcification of the CFA and IA required a crossover approach in one case. There were no complications related to the technique, except for moderate bleeding in relation to the deployment of a closure device.
ABSTRACT
OBJECTIVE: To report a case of a refractory post-thrombotic chronic venous ulcer managed with an off-label treatment. METHOD: We present the case of an 82-year-old woman with a previous medical history of severe hypertension and a deep vein thrombosis three years before. A refractory giant chronic venous ulcer in her left leg was treated with Bosentan. RESULTS: The appearance of the ulcer improved in the first 45 days, worsened after an unintended stop of the treatment and was almost resolved after 90 days of treatment. Ulcer-associated pain improved very quickly and so, in only one week, opioid treatment was stopped. Bosentan treatment was well tolerated, with only mild and manageable side effects. CONCLUSION: Treatment with Bosentan has been successful in the treatment of this case of refractory chronic venous ulcer.