Volume 5 - Issue 4 - July/August 2008
Editor's Corner »
Retrievable IVC Filters: Advance or Gimmick?
The article by Arko et al1 served as the foundation for this editorial. The paper describes a first-in-man clinical experience (10 patients) with a new retrievable vena cava filter (VCF). The design of the Crux IVCF appears unique and quite interesting. Instead of the more standard conical, strut-and-hook designs we have all seen many times in the past, this new device features a symmetrical double-loop helical construct. It is meant to be self-centering within the lumen of the vena cava and provide “consistent clot trapping over the entire inferior vena cava (IVC) circumference
Original Contribution »
Early Clinical Experience with a Novel, Self-Centering, Bi-Directional Vena Cava Filter
Introduction
Pulmonary emboli (PE) are estimated to be the third leading cause of cardiovascular death in the United States. Over 600,000 cases are reported in the US annually, causing an estimated 120,000 to 150,000 deaths per year. Emboli most commonly arise from pre-existing deep venous thromboses (DVT). While anticoagulation remains the gold standard of care for both DVT and PE, many patients are contraindicated for anticoagulation1 and up to one-third of PE occurs in patients already on anticoagulant therapy.
Caval interruption by placement of an inferior vena cava
Clinical Decision Making »
Endovascular Treatment of a Long-Segment Iliac Artery Occlusion with a Stent Extending up to the Hip Joint
Aortofemoral bypass graft surgery is the treatment of choice for severe symptomatic aortoiliac occlusive disease.1 An endovascular procedure may be preferred in patients who are at high risk for a major surgery under general anesthesia. We describe such a situation that required the deployment of a stent with its distal end extending up to the hip joint line in order to achieve optimal positioning. For this purpose, a special stent with adequate axial flexibility and tensile strength was chosen to prevent kinking during joint movement.
Case Report
A 60-year-old man p
Case Study »
Unusual Life-Threatening Complications of a Ruptured Infrarenal Aortic Aneurysm in a Young Adult
Case Report
A 34-year-old man presented with a ruptured infrarenal abdominal aortic aneurysm (AAA) (Figure 1). He reported no previous symptoms or illness. His father died at the age of 46 years from a drug overdose. His mother died of AIDS at the age of 44 years. The patient underwent emergency repair of the AAA with a Dacron tube graft and had a smooth postoperative recovery. However, he was readmitted 18 months later with severe abdominal pains. A computed tomography (CT) scan and magnetic resonance angiogram of the aorta indicated a false aneurysm of the distal aortic suture line
Case Study »
Autotransplant and Renal Artery Aneurysm Repair in a Patient with a Congenital Solitary Kidney
Case Report. A 44-year-old, normotensive woman with a 28-pack year history of smoking and a congenital solitary kidney was referred for a right renal artery aneurysm (RAA) seen on magnetic resonance imaging (MRI). The MRI was done as part of a work up for back pain 2 years previously. The patient subsequently had a computed tomography (CT) angiogram where a 2-cm aneurysm was seen in the right renal artery at the hilum of the kidney, with 5 of 7 branches of the renal artery arising from the aneurysm, excluding endovascular repair. The patient initially opted for watchful observation.
Case Study and Review »
Giant Splenic Artery Aneurysm
Introduction
Splenic artery aneurysm (SAA) is an infrequent occurrence, but it is important to evaluate the size and the location of the aneurysm to prevent life-threatening complications. SAA is more common in women than in men. Pregnancy is a major risk factor for rupture. The patient presented here had a very poor general condition, with acute pancreatitis and other severe comorbid conditions. There was a high risk of SAA rupture, owing to the huge size. Angioembolization of SAA was performed successfully with metallic coils. Endovascular procedures are currently the first choice of
