Editor's Update

VASCULAR DISEASE MANAGEMENT

Editor’s Update*

March 2015, Vol. 12, No. 3

 

CASE REPORT

Upper Limb Salvage with Endovascular Treatment of Acute Axillary Artery Occlusion Secondary to Proximal Humeral Fracture

Tsuyoshi Isawa, Kenji Suzuki, Hideki Abe

From 1Sendai Kousei Hospital, Sendai, Japan, and 2Sanyudo Hospital, Yonezawa, Japan.

 

Abstract

Acute axillary artery occlusion associated with proximal humeral fracture is rare. Traditionally, axillary artery complications associated with humeral fractures are managed with open surgery. However, open vascular repair presents a considerable challenge to even the most skilled surgeons. Endovascular treatment (EVT) offers an alternative to surgical management. We describe the case of an 82-year-old Japanese male with acute upper limb ischemia (AULI) secondary to acute axillary artery occlusion caused by a proximal humeral fracture. He was successfully treated with EVT. Unless there is vessel transection, EVT is feasible and offers a minimally invasive and prompt therapy for AULI, resulting from axillary artery occlusion.

 

CASE REPORT

Percutaneously Inserted AngioVac Suction Thrombectomy for the Treatment of Filter-Related Iliocaval Thrombosis

Faiz D. Francis, MD; Gianvito Salerno, MD; Sabbah D. Butty, MD

From Indiana University, Indianapolis, Indiana.

 

Abstract

In the setting of acute iliocaval thrombosis due to reversible causes, thrombus removal is preferred by many in the management of IVC thrombosis as it is thought likely to minimize the long-term complications of chronic venous insufficiency (CVI) and post thrombotic syndrome (PTS). Systemic therapies for acute iliocaval thrombosis do not rapidly remove thrombus burden. The majority of reports suggest that thrombolytic therapy, delivered locally using catheter directed thrombolysis (CDT; with or without a pulse-spray and/or a pharmacomechanical adjunct), should be administered as soon as possible after the patient becomes symptomatic and ideally within 14 days of onset of symptoms to minimize the risk of  CVI and PTS. When catheter-directed thrombolysis is not a viable or effective option, the treatment options are limited. AngioVac (AngioDynamics, Latham, NY) is a suction thrombectomy device FDA-approved for "Removal of Undesirable Intravascular Material." Limited peer-reviewed data is available on its percutaneous application in the management of iliocaval thrombus. We describe the case of a patient with severe leg swelling and permanent filter-related iliocaval thrombosis who was treated successfully with unassisted percutaneously inserted AngioVac suction thrombectomy.

 

INTERVIEW

Kenneth Rosenfield, MD, Discusses Results of the LEVANT II Trial

Interview by Jennifer Ford

 

INTERVIEW

Andrej Schmidt, MD, Discusses Study Results on Drug-Eluting Balloons in Infrapopliteal Lesions

Interview by Jennifer Ford

 

INTERVIEW

Jeffrey Lawson, MD, Presents Keynote on Bioengineered Vessels at ISET 2015

Interview by Jennifer Ford

 

 

* Articles are subject to change at the editor’s discretion. 

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Editor's Update

VASCULAR DISEASE MANAGEMENT

Editor’s Update*

March 2015, Vol. 12, No. 3

 

CASE REPORT

Upper Limb Salvage with Endovascular Treatment of Acute Axillary Artery Occlusion Secondary to Proximal Humeral Fracture

Tsuyoshi Isawa, Kenji Suzuki, Hideki Abe

From 1Sendai Kousei Hospital, Sendai, Japan, and 2Sanyudo Hospital, Yonezawa, Japan.

 

Abstract

Acute axillary artery occlusion associated with proximal humeral fracture is rare. Traditionally, axillary artery complications associated with humeral fractures are managed with open surgery. However, open vascular repair presents a considerable challenge to even the most skilled surgeons. Endovascular treatment (EVT) offers an alternative to surgical management. We describe the case of an 82-year-old Japanese male with acute upper limb ischemia (AULI) secondary to acute axillary artery occlusion caused by a proximal humeral fracture. He was successfully treated with EVT. Unless there is vessel transection, EVT is feasible and offers a minimally invasive and prompt therapy for AULI, resulting from axillary artery occlusion.

 

CASE REPORT

Percutaneously Inserted AngioVac Suction Thrombectomy for the Treatment of Filter-Related Iliocaval Thrombosis

Faiz D. Francis, MD; Gianvito Salerno, MD; Sabbah D. Butty, MD

From Indiana University, Indianapolis, Indiana.

 

Abstract

In the setting of acute iliocaval thrombosis due to reversible causes, thrombus removal is preferred by many in the management of IVC thrombosis as it is thought likely to minimize the long-term complications of chronic venous insufficiency (CVI) and post thrombotic syndrome (PTS). Systemic therapies for acute iliocaval thrombosis do not rapidly remove thrombus burden. The majority of reports suggest that thrombolytic therapy, delivered locally using catheter directed thrombolysis (CDT; with or without a pulse-spray and/or a pharmacomechanical adjunct), should be administered as soon as possible after the patient becomes symptomatic and ideally within 14 days of onset of symptoms to minimize the risk of  CVI and PTS. When catheter-directed thrombolysis is not a viable or effective option, the treatment options are limited. AngioVac (AngioDynamics, Latham, NY) is a suction thrombectomy device FDA-approved for "Removal of Undesirable Intravascular Material." Limited peer-reviewed data is available on its percutaneous application in the management of iliocaval thrombus. We describe the case of a patient with severe leg swelling and permanent filter-related iliocaval thrombosis who was treated successfully with unassisted percutaneously inserted AngioVac suction thrombectomy.

 

INTERVIEW

Kenneth Rosenfield, MD, Discusses Results of the LEVANT II Trial

Interview by Jennifer Ford

 

INTERVIEW

Andrej Schmidt, MD, Discusses Study Results on Drug-Eluting Balloons in Infrapopliteal Lesions

Interview by Jennifer Ford

 

INTERVIEW

Jeffrey Lawson, MD, Presents Keynote on Bioengineered Vessels at ISET 2015

Interview by Jennifer Ford

 

 

* Articles are subject to change at the editor’s discretion. 

Back to top