ABSTRACT
Four patients suffering from concomitant descending thoracic pathology and abdominal aortic aneurysms were treated with endovascular stent-grafts simultaneously. Graft deployment was successful and uneventful in all patients. Paraplegia was not observed. One patient developed an abdominal type Ib endoleak at 12 months which was repaired endovascularly. One patient died from multiorgan failure 3 days after the deployment of the grafts. After 18, 36 and 42 months follow up all the other patients are well without any graft related complication. Simultaneous endovascular repair for coexisting descending thoracic and abdominal aortic pathologies might be an acceptable alternative to open surgery or hybrid operations, at least for the high risk patients.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Aortic Aneurysm, Thoracic/surgery , Aortic Dissection/surgery , Blood Vessel Prosthesis Implantation , Aged , Aged, 80 and over , Aortic Dissection/complications , Aortic Dissection/diagnostic imaging , Aortic Aneurysm, Abdominal/complications , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Aneurysm, Thoracic/complications , Aortic Aneurysm, Thoracic/diagnostic imaging , Aortography/methods , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis Implantation/mortality , Humans , Male , Middle Aged , Multiple Organ Failure/etiology , Multiple Organ Failure/mortality , Prosthesis Failure , Stents , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
We describe a case of a voluminous infected aneurysm of the popliteal artery, with Listeria monocytogenes (LM) associated with rupture, in a 72-year old man. After radical resection of the aneurysm a reconstruction was not necessary, because of the sufficient blood supply, due to the pre-existent good development of collateral circulation. The patient was discharged on the 12th postoperative day with primary healing of the wound and viable leg. Adequate antibiotic treatment was continued for 4 weeks. In the following 18 months the serial clinical examinations, laboratory tests and ultrasound scans have shown no evidence of reinfection.
Subject(s)
Aneurysm, Infected , Aneurysm, Ruptured , Listeria monocytogenes , Listeriosis , Popliteal Artery , Aged , Aneurysm, Infected/diagnosis , Aneurysm, Infected/microbiology , Aneurysm, Infected/surgery , Aneurysm, Ruptured/diagnosis , Aneurysm, Ruptured/microbiology , Aneurysm, Ruptured/surgery , Humans , Listeriosis/complications , Listeriosis/diagnosis , MaleABSTRACT
We report the preoperative diagnosis and surgical treatment of an abdominal aortic aneurysm (AAA) in association with a horseshoe kidney (HSK) in a 70-year-old man. Through a median laparotomy a vascular tube graft was successfully used for repair the AAA. The extensive parenchymal isthmus overlying the aneurysm remained intact.
Subject(s)
Angiography, Digital Subtraction , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortography , Blood Vessel Prosthesis Implantation , Kidney/abnormalities , Tomography, X-Ray Computed , Aged , Aortic Aneurysm, Abdominal/surgery , Follow-Up Studies , Humans , Kidney/blood supply , Kidney/diagnostic imaging , MaleABSTRACT
We report a case of an arteriovenous fistula (AVF) following osteosynthetic treatment of a fracture of the lower limb 13 years ago. A stent-graft technique had been used to close a high flow traumatic AVF between the popliteal artery and the popliteal vein. The failure to properly evaluate traumatic AVF may sometimes lead to remarkable delay in diagnosis with devastating consequences including edema, ischaemia, ulceration and high output heart failure. Endovascular treatment of these lesions is promising but long-term follow-up will be required to determine the durable patency and the onset of potential complications.
Subject(s)
Arteriovenous Fistula/surgery , Fracture Fixation, Internal , Popliteal Artery/surgery , Postoperative Complications , Aged , Arteriovenous Fistula/diagnostic imaging , Arteriovenous Fistula/etiology , Follow-Up Studies , Humans , Male , Popliteal Artery/diagnostic imaging , Popliteal Artery/injuries , Stents , Ultrasonography , Vascular PatencyABSTRACT
Exertional disruption of axillary anastomosis is a well documented, although rare, complication of axillo-femoral grafts. Comprehension of causative mechanisms is of great importance, so that precautions can be taken against it. Here, a case of an early disruption of proximal anastomosis of an axillofemoral graft is reported. Use of crutches was incriminated as the responsible mechanism.
Subject(s)
Anastomosis, Surgical , Aortic Diseases/surgery , Axillary Artery/surgery , Blood Vessel Prosthesis Implantation , Femoral Artery/surgery , Polytetrafluoroethylene , Surgical Wound Dehiscence/surgery , Humans , Male , Middle Aged , ReoperationABSTRACT
Despite the proven reliability of polyethylene terephthlate (PET) grafts, structural defects resulting in graft rupture and false aneurysm formation have been sporadically described. Two cases of late, non anastomotic, false aneurysms of PET femoropopliteal grafts, are reported. The diagnosis is readily apparent on clinical examination and imaging studies, which display an aneurysm along the course of the graft, remote from the anastomosis. The extent of the repair depends on the extent of the degenerative process.