Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.433
Filtrar
1.
Medicine (Baltimore) ; 100(1): e24215, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429814

RESUMO

RATIONALE: Traumatic arteriovenous fistulas (AVFs) of the pelvis are uncommon and present with a variety of clinical manifestations; their detection may be difficult. An endovascular approach is usually the first choice of treatment, because surgical intervention is complicated due to the location of the lesions. PATIENT CONCERNS: A 68-year-old man was admitted with severe pelvic pain following a fall. DIAGNOSIS: A pelvic bone fracture (Young and Burgess Classification, lateral compression type II) was revealed on pelvic computed tomography (CT), while a pelvic sidewall hematoma, unaccompanied by any vascular injury, was detected on multidetector CT. INTERVENTIONS: Pelvic angiography revealed an AVF between the internal iliac artery and vein, which was undetected by MDCT. The AVF was successfully treated using transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA). OUTCOMES: The patient recovered well and was discharged 4 weeks later. No complications were noted at the 8-month follow-up. LESSONS: AVF may occur as a complication of blunt pelvic bone fracture. A high index of suspicion, angiography, and prompt diagnosis resulted in the successful management of our patient who presented with risk factors. Furthermore, TAE using NBCA enables a minimally invasive and effective treatment of traumatic pelvic AVF.


Assuntos
Fístula Arteriovenosa/terapia , Embucrilato/uso terapêutico , Fraturas Ósseas/complicações , Ossos Pélvicos/lesões , Acidentes por Quedas , Idoso , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Angiografia por Tomografia Computadorizada , Embolização Terapêutica , Embucrilato/administração & dosagem , Fraturas Ósseas/diagnóstico por imagem , Humanos , Artéria Ilíaca , Veia Ilíaca , Masculino , Procedimentos Cirúrgicos Vasculares
3.
Vasc Endovascular Surg ; 54(7): 638-642, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32662320

RESUMO

Aortocaval fistula is uncommon and often associated with a ruptured iliac or abdominal aortic aneurysm. It has a high mortality secondary to the aneurysmal rupture but also to a high output heart failure. Open surgery has been the standard; however, endovascular management has emerged with lower mortality. We present a patient with a ruptured iliac aneurysm and an inferior vena cava fistula successfully treated with an endograft with embolization of the right hypogastric artery. The patient arrested on induction and was resuscitated with aortic balloon inflation. Endovascular therapy can be safely used in the management of iliac/aortocaval fistula.


Assuntos
Aneurisma Roto/cirurgia , Aorta , Fístula Arteriovenosa/terapia , Implante de Prótese Vascular , Embolização Terapêutica , Procedimentos Endovasculares , Aneurisma Ilíaco/cirurgia , Veia Cava Inferior , Idoso de 80 Anos ou mais , Aneurisma Roto/complicações , Aneurisma Roto/diagnóstico por imagem , Aorta/diagnóstico por imagem , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Humanos , Aneurisma Ilíaco/complicações , Aneurisma Ilíaco/diagnóstico por imagem , Masculino , Resultado do Tratamento , Veia Cava Inferior/diagnóstico por imagem
5.
Ann Vasc Surg ; 69: 133-140, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32561239

RESUMO

BACKGROUND: The objective of this study is to report an 18-year single-center experience in the surgical and endovascular treatment of arterial complications due to self-injection in drug abuser patients. METHODS: This retrospective single-center study was conducted analyzing a prospectively collected database including all endovascular or surgical procedures performed from January 2007 to December 2019 for any arterial complication due to self-injection in drug abuser patient. Collected data were patient demographic and comorbidity, site and type of arterial lesion (pseudoaneurysm [PA], arteriovenous fistula [AVF]), signs of systemic or local infection, and procedural data (endovascular/surgical treatment). End points were rate of postoperative complications, reintervention rate, limb salvage, and patients' early and long-term survival. RESULTS: In 11 patients (median age 36 years, range 27-47; male 73%), 13 arterial lesions were treated: 10 (77%) PA, 2 (15%) PA associated with AVF, and 1 (8%) isolated AVF. Arterial lesion involved common femoral artery in 5 (38%), superficial femoral artery in 4 (31%), profunda femoral artery in 1 (8%), brachial artery in 2 (15%), and subclavian artery in 1 (8%). Signs of infections were present in 9 of the 13 cases (69%). The treatment was surgical in 11 (85%) cases: 7 interposition graft (6 great saphenous vein, 1 arterial cryopreserved homograft), 2 direct reconstruction, 1 patch plasty with pericardium bovine patch, and 1 arterial ligation. Endovascular treatment was performed in 2 cases: 1 noninfected PA of the superficial femoral artery, and 1 55-mm PA of the postvertebral segment of the right subclavian artery with clinical sign of hemodynamic instability. At 1 month, postoperative complication rate was 8% (one lower limb claudication after superficial femoral artery ligation). Reintervention rate was 8% (interposition graft rupture for repeated self-injections). Limb salvage and patient survival were both 100%. Median follow-up was 5 years (range 1 month to 11.3 years); surgical group: median 8.2 years (range 2 months to 11.3 years); endovascular group: median 3.5 months (range 1-6). During follow-up, neither complications nor reinterventions occurred, and limb salvage was 100% for both groups. At 2, 4, and 6 years, overall estimated patient survival was 91%, 81%, and 81%, respectively, with no procedure-related death. CONCLUSIONS: After surgical or endovascular management of arterial lesions due to self-injection in drug abuser patients, complications occur mainly in the postoperative period. During follow-up, the surgical procedures have low rate of complications, reinterventions, and procedure-related mortality, whereas for the endovascular treatment the mid-term outcomes remain unknown.


Assuntos
Falso Aneurisma/terapia , Fístula Arteriovenosa/terapia , Implante de Prótese Vascular , Usuários de Drogas , Procedimentos Endovasculares , Abuso de Substâncias por Via Intravenosa/complicações , Lesões do Sistema Vascular/terapia , Adulto , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/mortalidade , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/mortalidade , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/mortalidade , Bases de Dados Factuais , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/mortalidade , Feminino , Humanos , Itália , Ligadura , Salvamento de Membro , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/terapia , Retratamento , Estudos Retrospectivos , Fatores de Risco , Abuso de Substâncias por Via Intravenosa/mortalidade , Fatores de Tempo , Resultado do Tratamento , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/etiologia , Lesões do Sistema Vascular/mortalidade
6.
Ann Vasc Surg ; 68: 571.e15-571.e20, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32422292

RESUMO

It is essential to establish cardiopulmonary bypass by percutaneous insertion of a large-bore catheter via both the femoral vein and internal jugular vein (IJV) for minimally invasive cardiac surgery (MICS). Complications associated with IJV catheterization during MICS have been reported in the literature; however, vascular injury of the subclavian artery (SCA) is rare. We herein present a rare case in which an iatrogenic arteriovenous fistula (AVF) between the right SCA and IJV after MICS was successfully treated by endovascular coil embolization. A 61-year-old man who had undergone mitral valve repair by MICS 10 months before presentation was referred because of pulsatile cervical bruit and tinnitus. Radiographic examination revealed a right SCA pseudoaneurysm associated with an AVF located between the right common carotid artery and vertebral artery. The AVF was completely occluded with detachable coils using a double-catheter technique to avoid coil migration into the IJV. This technique has been used to treat high-flow or complex AVFs, including pulmonary and renal AVFs. As shown in the present case, it is also useful to treat an iatrogenic AVF between the SCA and IJV.


Assuntos
Falso Aneurisma/terapia , Fístula Arteriovenosa/terapia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Embolização Terapêutica/instrumentação , Doença Iatrogênica , Veias Jugulares/lesões , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Artéria Subclávia/lesões , Lesões do Sistema Vascular/terapia , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Humanos , Veias Jugulares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/cirurgia , Artéria Subclávia/diagnóstico por imagem , Resultado do Tratamento , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/etiologia
7.
Vasc Endovascular Surg ; 54(6): 519-524, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32372691

RESUMO

Iliac artery aneurysms can rarely present with rupture into adjacent iliac vein resulting in arteriovenous fistula leading to acute cardiac failure or multi-organ failure. End-organ damage can be reversed with timely diagnosis and intervention. Endovascular therapy is an attractive option to treat this pathology besides allowing for a quick recovery and mitigating the risk of mortality associated with open surgical treatment options. We report treatment of this pathology with Endovascular repair with preservation of ipsilateral hypogastric artery flow using an iliac branch graft device. The postoperative course was complicated by type 3 endoleak due to the separation of components between iliac branch graft and aortic stent graft with resultant recurrence of the fistula. Additional endovascular techniques, including placement of a venous stent and stent grafts to bridge the components, was used to treat the endoleak. We present this report due to the unique nature of the recurrent arteriovenous fistula, technical complexity, and resultant multi-organ dysfunction.


Assuntos
Aneurisma Roto/cirurgia , Fístula Arteriovenosa/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Aneurisma Ilíaco/cirurgia , Artéria Ilíaca/cirurgia , Veia Ilíaca/cirurgia , Insuficiência de Múltiplos Órgãos/etiologia , Aneurisma Roto/diagnóstico por imagem , Aneurisma Roto/etiologia , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Prótese Vascular , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/instrumentação , Endoleak/etiologia , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Humanos , Aneurisma Ilíaco/complicações , Aneurisma Ilíaco/diagnóstico por imagem , Artéria Ilíaca/diagnóstico por imagem , Veia Ilíaca/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/diagnóstico , Recidiva , Stents , Resultado do Tratamento
8.
Vasc Endovascular Surg ; 54(5): 449-454, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32372719

RESUMO

BACKGROUND: Renal artery-inferior vena cava (IVC) fistula is usually caused by penetrating injury to the back. However, it is a very rarely reported entity with only 20 cases reported in the literature. They may present acutely with hemodynamic instability or chronically as congestive heart failure. A thorough examination and adequate imaging are required to avoid missing such injuries. CASE PRESENTATION: A 28-year-old gentleman presented after sustaining stab injury to the back. The stab had penetrated the renal artery and IVC, leading to arteriovenous fistula. He was managed surgically, as he went into hemorrhagic shock, with a successful outcome. The case is also unique as an accessory renal artery was also involved in the fistula. CONCLUSION: Early identification and management of renal artery-IVC fistula is important to ensure a successful outcome. Such fistulas can be managed by either endovascular approach or surgical approach. The decision of approach depends on the level of expertise available and hemodynamic status of the patient.


Assuntos
Fístula Arteriovenosa/cirurgia , Artéria Renal/cirurgia , Lesões do Sistema Vascular/cirurgia , Veia Cava Inferior/cirurgia , Ferimentos Perfurantes/complicações , Adulto , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/fisiopatologia , Hemodinâmica , Humanos , Masculino , Artéria Renal/diagnóstico por imagem , Artéria Renal/lesões , Artéria Renal/fisiopatologia , Choque Hemorrágico/etiologia , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/etiologia , Lesões do Sistema Vascular/fisiopatologia , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/lesões , Veia Cava Inferior/fisiopatologia
9.
Oncology ; 98(8): 558-565, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32422633

RESUMO

BACKGROUND AND AIMS: Conventional transcatheter arterial chemoembolization (C-TACE) and drug-eluting bead (DEB)-based TACE are current treatments for hepatocellular carcinoma (HCC). We compared the therapeutic efficacies and adverse events of these methods in a single-center retrospective cohort study. METHODS: We enrolled 174 patients treated between January 2010 and October 2016; 98 and 76 underwent C-TACE and DEB-TACE, respectively, with 76 and 22 of the former group and 49 and 27 of the latter group classified as Child-Pugh class A and B, respectively. Therapeutic outcomes, progression-free survival (PFS), and adverse events were evaluated. RESULTS: The PFS rates in the C-TACE and DEB-TACE groups were 8.1 and 6.1 months, respectively (p = 0.79). The response and disease control rates were 64 and 71% in C-TACE patients and 69 and 78% in DEB-TACE patients, respectively (p = 0.25). Postprocedural pain, vomiting, and fever were more frequent following C-TACE than DEB-TACE (p < 0.001). In contrast, the incidences of bilomas and arterio-portal shunts were significantly higher following DEB-TACE (p < 0.001); the incident rates of arterio-portal shunt formation were 8.1 and 48.7% in patients undergoing C-TACE and DEB-TACE, respectively. Child-Pugh class A was significantly associated with arterio-portal shunt formation after DEB-TACE on multivariate analysis. CONCLUSIONS: There were no significant differences in the therapeutic efficacies of C-TACE and DEB-TACE. However, the frequency of arterio-portal shunt formation was significantly higher in HCC patients with Child-Pugh class A undergoing DEB-TACE. Our findings imply that C-TACE should be selected for HCC patients with Child-Pugh class A and DEB-TACE should be chosen for those with Child-Pugh class B.


Assuntos
Fístula Arteriovenosa/etiologia , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/efeitos adversos , Quimioembolização Terapêutica/métodos , Sistemas de Liberação de Medicamentos/efeitos adversos , Sistemas de Liberação de Medicamentos/métodos , Neoplasias Hepáticas/terapia , Idoso , Idoso de 80 Anos ou mais , Antibióticos Antineoplásicos/administração & dosagem , Cateterismo/métodos , Epirubicina/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Estudos Retrospectivos
11.
J Vasc Interv Radiol ; 31(5): 728-736, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32229078

RESUMO

PURPOSE: To analyze the clinical course and treatment outcomes of patients with iatrogenic arterioportal fistula (APF) caused by radiofrequency (RF) ablation of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Among the 1,620 hepatocellular carcinoma patients treated by RF ablation between January 2012 and August 2017, 99 who developed APF after RF ablation were included in this retrospective study. Depending on the extent of portal vein enhancement on arterial phase images, APF was classified as massive or nonmassive. The patients' clinical course was investigated and statistically evaluated by univariable and multivariable analyses. RESULTS: Thrombocytopenia (odds ratio [OR] = 3.939; 95% confidence interval [CI], 1.141-13.598) was the only risk factor for developing massive APF. Eleven patients underwent embolotherapy (technical success rate, 90.9%) and no patients experienced serious adverse events within 30 days of the procedure. Patients with massive APF (66.7%) had a significantly higher chance of a Child-Pugh score increase than did the patients with nonmassive APF (13.6%) (P < .001). Massive APF had a significantly lower chance of natural regression than did nonmassive APF (P < .001). Child-Pugh B (OR = 17.739; 95% confidence interval, 2.361-133.279) and massive APF without treatment (OR = 11.061; 95% confidence interval, 1.257-97.341) were independent risk factors for liver failure that led to death of liver transplant within 1 year after RF ablation. CONCLUSIONS: Massive APF caused by RF ablation is mostly irreversible and significantly worsens patients' outcomes, but may be effectively treated with embolotherapy.


Assuntos
Fístula Arteriovenosa/terapia , Carcinoma Hepatocelular/cirurgia , Embolização Terapêutica , Doença Iatrogênica , Neoplasias Hepáticas/cirurgia , Veia Porta , Ablação por Radiofrequência/efeitos adversos , Idoso , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/patologia , Embolização Terapêutica/efeitos adversos , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Veia Porta/diagnóstico por imagem , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
12.
Vasc Endovascular Surg ; 54(5): 441-444, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32292134

RESUMO

This article describes a deep femoral arteriovenous fistula (AVF) diagnosed over a decade after a small caliber gunshot injury to the groin. The fistula persisted following 2 previous attempts at endovascular exclusion and was referred to our institution for further care. We describe the successful exclusion of the AVF via a combination of endovascular techniques. Postoperatively, obliteration was noted to be durable for 4 additional years of follow-up.


Assuntos
Fístula Arteriovenosa/terapia , Embolização Terapêutica , Procedimentos Endovasculares , Artéria Femoral/lesões , Veia Femoral/lesões , Lesões do Sistema Vascular/terapia , Ferimentos por Arma de Fogo/complicações , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/fisiopatologia , Circulação Colateral , Embolização Terapêutica/instrumentação , Procedimentos Endovasculares/instrumentação , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/fisiopatologia , Veia Femoral/diagnóstico por imagem , Veia Femoral/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional , Stents , Resultado do Tratamento , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/etiologia , Lesões do Sistema Vascular/fisiopatologia
13.
Rev Cardiovasc Med ; 21(1): 119-122, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32259910

RESUMO

Arteriovenous fistula (AVF) is a rare complication of the abdominal aortic aneurysm (AAA) with complex clinical features. However, AVF and AAA usually cause no symptoms except when they rupture. This case study demonstrated that ultrasonography was a rapid and non-invasive method for the initial assessment of AAA and AVF. A 65-year-old man was admitted to the intensive care unit with hepatic and renal dysfunction. Physical examination revealed an abdominal vascular murmur and bilateral toe discoloration. Ultrasonic examination revealed an AAA and right common iliac artery aneurysm with an AVF located between the right common iliac artery and inferior vena cava. A computed tomography scan confirmed the sonographic findings. We propose that ultrasound should be used more commonly as part of the initial evaluation of the potential and established vascular diseases.


Assuntos
Aneurisma da Aorta Abdominal/diagnóstico por imagem , Ruptura Aórtica/etiologia , Fístula Arteriovenosa/diagnóstico por imagem , Síndrome Hepatorrenal/etiologia , Aneurisma Ilíaco/diagnóstico por imagem , Artéria Ilíaca/diagnóstico por imagem , Falência Hepática/etiologia , Insuficiência Renal/etiologia , Ultrassonografia Doppler em Cores , Veia Cava Inferior/diagnóstico por imagem , Idoso , Aneurisma da Aorta Abdominal/complicações , Ruptura Aórtica/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Angiografia por Tomografia Computadorizada , Progressão da Doença , Evolução Fatal , Síndrome Hepatorrenal/diagnóstico por imagem , Humanos , Aneurisma Ilíaco/complicações , Falência Hepática/diagnóstico , Masculino , Flebografia , Valor Preditivo dos Testes , Insuficiência Renal/diagnóstico
14.
J Craniofac Surg ; 31(4): e360-e362, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32176004

RESUMO

Traumatic pulsating masses are difficult to make a definitive diagnosis due to anatomic variation of malformed vessels and rarely clinical incidence. It is essentially to recognizing the anatomy of such vessels, otherwise it may lead to an improperly treatment or serious complication. Digital subtraction angiogram (DSA) has a distinct advantage in both diagnosis and treatment of this subject. Here the authors report a case of venous malformation in the supraclavicular fossa with an underlying arteriovenous fistula following nonoperative management of a clavicle fracture in an adult, and discuss how to rule out potential differential diagnoses and get minimally invasive treatment with DSA.


Assuntos
Angiografia Digital , Adulto , Fístula Arteriovenosa/etiologia , Clavícula , Feminino , Fraturas Ósseas/complicações , Humanos
16.
J Pak Med Assoc ; 70(Suppl 1)(2): S83-S88, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31981342

RESUMO

Technological progress has changed the landscape of surgical practice. Minimally invasive surgery (MIS) and percutaneous interventions (PC) are constantly replacing open procedures. This reduces hospital stay and allows quicker recovery. The application of MIS should follow the good medical practice dictum by Hippocrates i.e. "First do no harm". To remain abreast with new procedures, the medical personnel are required to update and enhance their knowledge and skill. To ensure safety, the innovations are rigorously tested and tried. The learning curve of MIS is shortened by simulator training and proctorship. Credentialing processes are in place to enhance safe delivery of care. Despite of all these measures MIS and PCI are associated with adverse effects. The purpose of this article is to overview the iatrogenic trauma associated with MIS and PCI in major surgical subspecialties.


Assuntos
Doença Iatrogênica , Complicações Intraoperatórias/etiologia , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Complicações Pós-Operatórias/etiologia , Ferimentos e Lesões/etiologia , Fístula Arteriovenosa/etiologia , Valvuloplastia com Balão/efeitos adversos , Cateterismo Cardíaco/efeitos adversos , Anuloplastia da Valva Cardíaca/efeitos adversos , Ablação por Cateter/efeitos adversos , Cateterismo Venoso Central/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Nefrolitotomia Percutânea/efeitos adversos , Nefrostomia Percutânea/efeitos adversos , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Ortopédicos/efeitos adversos , Intervenção Coronária Percutânea/efeitos adversos , Pneumoperitônio Artificial/efeitos adversos , Pneumotórax/etiologia , Embolia Pulmonar/etiologia , Substituição da Valva Aórtica Transcateter/efeitos adversos , Lesões do Sistema Vascular/etiologia
17.
Ann Vasc Surg ; 62: 499.e15-499.e20, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31536794

RESUMO

Deep venous thrombosis rarely occurs in conjunction with other vascular anomalies, and is therefore an understudied area. Although arteriovenous fistulae (AVFs) most commonly arise from congenital defects or as a result of trauma, some reports suggest that they may form in association with thrombosis of cerebral veins. In this report, we present a case of acquired pelvic and lower extremity AVFs following left common iliac vein thrombosis. The special feature of this case is that the patient received a series of treatments of which recanalization resulted in best clinical outcome. As a result of long-term follow-up (5 years), this case allows for a better understanding of the natural progression of this rare disease.


Assuntos
Fístula Arteriovenosa/terapia , Implante de Prótese Vascular , Embolização Terapêutica , Procedimentos Endovasculares , Veia Ilíaca , Extremidade Inferior/irrigação sanguínea , Pelve/irrigação sanguínea , Trombose Venosa/complicações , Anticoagulantes/uso terapêutico , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Procedimentos Endovasculares/instrumentação , Feminino , Humanos , Veia Ilíaca/diagnóstico por imagem , Veia Ilíaca/fisiopatologia , Pessoa de Meia-Idade , Recidiva , Stents , Resultado do Tratamento , Pressão Venosa , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/tratamento farmacológico , Trombose Venosa/fisiopatologia
18.
Ann Vasc Surg ; 64: 410.e1-410.e6, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31639478

RESUMO

An 80-year-old woman developed a recurrent chronic limb-threatening ischemia of the right lower limb after a popliteal artery (PA) recanalization with retrograde puncture of the peroneal artery (PR). The angiography showed the PA restenosis and an arteriovenous fistula (AVF) at the previous peroneal retrograde access site. After the PA angioplasty, the AVF was identified through selective contrast injections in multiple projections. A coronary balloon-expandable covered stent was deployed at the AVF site with complete resolution of the AVF. The final angiography demonstrated the patency of PA and PR with complete resolution of the AVF. The patient was discharged without complications, with regression of rest pain. The foot lesion healed within 2 months.


Assuntos
Fístula Arteriovenosa/terapia , Procedimentos Endovasculares/instrumentação , Isquemia/terapia , Doença Arterial Periférica/terapia , Artéria Poplítea , Stents , Lesões do Sistema Vascular/terapia , Idoso de 80 Anos ou mais , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/fisiopatologia , Procedimentos Endovasculares/efeitos adversos , Feminino , Humanos , Isquemia/diagnóstico por imagem , Isquemia/etiologia , Isquemia/fisiopatologia , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/fisiopatologia , Artéria Poplítea/diagnóstico por imagem , Desenho de Prótese , Punções , Recidiva , Resultado do Tratamento , Grau de Desobstrução Vascular , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/etiologia , Lesões do Sistema Vascular/fisiopatologia
19.
Ann Vasc Surg ; 65: 283.e7-283.e11, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31678543

RESUMO

Aortocaval fistulas following endovascular repair of ruptured abdominal aortic aneurysms (rAAA) are rare. We herein describe repair using an Amplatzer Septal Occluder in a 68-year-old male who presented to the emergency department 6 months after ruptured endovascular aneurysm repair (rEVAR) with right heart failure. With the assistance of diagnostic angiography and intravascular ultrasound, the patient was found to have a 1.2 cm diameter aortocaval fistula and a type-II endoleak. His aortocaval fistula was successfully closed using an Amplatzer septal occluder device after failure of attempted closure with an Amplatzer plug and coiling of the aneurysm sac. His symptoms of heart failure improved, and he was discharged to an acute rehabilitation unit. Follow-up at 3 months demonstrated continued improvement in heart failure symptoms, and a small persistent type II endoleak. Aortocaval fistulae are a potentially fatal complication of rAAA. We discuss the sequelae and treatment strategies of aortocaval fistulas following rEVAR including the use of the Amplatzer Septal Occluder.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/cirurgia , Fístula Arteriovenosa/terapia , Implante de Prótese Vascular/instrumentação , Procedimentos Endovasculares/instrumentação , Dispositivo para Oclusão Septal , Veia Cava Inferior , Idoso , Aneurisma da Aorta Abdominal/complicações , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Ruptura Aórtica/complicações , Ruptura Aórtica/diagnóstico por imagem , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Endoleak/etiologia , Insuficiência Cardíaca/etiologia , Humanos , Masculino , Desenho de Prótese , Resultado do Tratamento , Veia Cava Inferior/diagnóstico por imagem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA