Challenging Endovascular Treatment of Coral Reef Aorta and a Literature Review.

Coral reef aorta is a rare type of atherosclerotic disease that causes severe calcification in the abdominal aorta. We present a case of coral reef aorta with hemodynamically significant symptomatic aortic stenosis causing intermittent claudication and bilateral cyanosis of the toes. Despite the challenging anatomy for endovascular treatment, the patient underwent successful transfemoral endovascular stent-graft placement. The endovascular intervention with stents is a viable alternative method and, in many cases, constitutes the first choice for the treatment of coral reef aorta.

Combined AFX2 with thoracic stent graft: A different endovascular approach of an abdominal aorta aneurysm.

The AFX2 endovascular repair system is a unibody, bifurcated stent graft that can be used in an abdominal aortic aneurysm associated with anatomical challenges, especially if it is combined with different aortic cuffs. The use of an AFX2 main body combined with a thoracic stent graft as a proximal aortic cuff was selected to treat a 77-year-old male patient with abdominal aortic aneurysm. The AFX2 endograft combined with a proximal thoracic aortic cuff plays a safe and effective role in treating complex infrarenal abdominal aortic aneurysm that may otherwise be technically more challenging with the open technique and inaccessible with the traditional endovascular technique.

Comparison of MANTA vs ProGlide Vascular Closure Device and 30-Day Outcomes in Transfemoral Transcatheter Aortic Valve Implantation.

BACKGROUND: Vascular complications (VCs) after transfemoral transcatheter aortic valve implantation (TAVI) have an increased mortality risk, and vascular closure device (VCD) use is mandatory. The percutaneous MANTA VCD (Teleflex) is a novel collagen-based technology for closure of large-bore arteriotomies. We compared the MANTA VCD with the suture-based ProGlide VCD (Abbott Vascular). METHODS: A retrospective review was performed on all consecutive patients who underwent transfemoral TAVI in our center from January 1, 2015, to February 28, 2021, and 30-day outcomes were recorded. Major adverse cardiovascular events (MACE) were cardiac death, disabling stroke, and/or major VCs. Access site-related VCs were VCs related to the access site vessel from which the transcatheter valve was introduced and advanced. RESULTS: The MANTA VCD was used in 99 patients and the ProGlide in 224. There was 4.0% MACE in the MANTA group and 4.9% in the ProGlide group (P = .999). Overall VCs were 10.1% vs 7.6%, major VCs were 3.0% vs 2.2%, and minor VCs 7.1% vs 5.4%(P = .753). Access site-related VCs were 5.1% vs 5.8% in the (P = .999), and periprocedural vascular surgical intervention was needed in 6.1% of the MANTA group vs 2.2% of the ProGlide group (P = .099). CONCLUSION: There was no significant difference in MACE, mortality, cardiovascular mortality, VCs, access site-related VCs, periprocedural vascular surgical interventions, bleeding, or transfusion rate between the 2 groups. The MANTA VCD group had more periprocedural vascular surgical interventions which did not reach statistical significance.

Ruptured true aneurysm of the superficial femoral artery leading to Behçet disease diagnosis.

Femoral artery aneurysms are rare, and aneurysms of the superficial femoral artery (SFA) are even rarer, with ruptured true aneurysms of the SFA the rarest. In the present report, we have described the case of a young patient whose SFA had clinical findings suggestive of an aneurysm rupture, which resulted in the diagnosis of Behçet disease, in accordance with the clinical features of the disease. The patient underwent standard treatment, with aneurysmectomy and interposition of a synthetic graft.

Open surgical repair of abdominal aortic aneurysm and horseshoe kidney: A strange relationship.

INTRODUCTION AND IMPORTANCE: The horseshoe kidney (HK) is the most common fusion defect of the kidneys. Τhe simultaneous presence of HK and abdominal aortic aneurysm (ΑΑΑ) is rare and comprises a technical challenge for the vascular surgeon due to variation of renal arteries and the renal isthmus overlying the AAA sac. CASE PRESENTATION: We present the first case in Nicosia General Hospital of Cyprus of an infrarenal AAA with a HK (Crawford Type I), which was successfully treated using an open surgical approach. CLINICAL DISCUSSION: Review the technical challenges associated with the case and a brief reference to the relevant published articles. CONCLUSION: The surgical repair of coexistence of AAA and HK continues to be a difficult technical challenge for the vascular surgeon from the past until today. There is a need to record the few cases and to create detailed specific guidelines to facilitate the surgical approach for the disease.