Persistent Sciatic Artery Aneurysm Presenting with Limb-Threatening Ischemia: A Case Report and Review
- Wed, 3/3/10 - 6:22pm
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Abstract
Persistent sciatic artery (PSA) is a rare congenital vascular anomaly that occurs when the sciatic artery fails to regress during fetal development. This failure to regress is often associated with superficial femoral artery (SFA) hypoplasia and the PSA then becomes the dominant arterial inflow to the lower limb. PSA is prone to several complications due to its anatomical course that exposes it to repeated trauma, with the most common complication being aneurysm formation. Here we describe the case of a 64-year-old female patient who presented with acute right low
Giant Splenic Artery Aneurysm
- Fri, 9/5/08 - 3:36pm
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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
A Quick Fix: Graft Rescue for Iatrogenic Pseudoaneurysm
- Fri, 9/5/08 - 3:36pm
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Introduction
Pseudo-aneurysm formation after vascular reconstruction is a rarely encountered problem in the treatment of peripheral arterial disease (PAD). It has most commonly been described in the vascular surgical literature as a delayed complication of lower extremity bypass surgery, and the usual mode of repair has been surgical. Recent advances in minimally invasive therapy for this clinical entity have centered on ultrasound-guided compression and thrombin injection to obliterate the cavity and restore vascular integrity. With the advent of stent-supported angioplasty, endovascu
Traumatic Ulnar Artery Aneurysm and the Hypothenar Hammer Syndrome
- Fri, 9/5/08 - 3:36pm
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Introduction
Hypothenar hammer syndrome (HHS) is a rare clinical entity with a symptom complex attributable to an ulnar artery aneurysm. These aneurysms are uncommon and have been linked with traumatic injuries to the hand. Although most commonly seen in workers who use the hypothenar eminence of their hands repetitively as a hammer, both acute penetrating and blunt traumas have been documented as sources of ulnar artery aneurysms. In this case report, we present a patient who presented with digital ischemia from a subsequently diagnosed ulnar artery aneurysm the day after moving large
Power-Pulse Spray and Angiojet Thrombectomy in Massive Inferior Vena Cava and Bilateral Lower Extremity Deep Venous Thrombosis
- Fri, 9/5/08 - 3:36pm
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Introduction
Venous thromboembolism (VTE) encompasses both pulmonary embolism (PE) and deep venous thrombosis (DVT) and is a grossly underdiagnosed disease spectrum associated with high mortality and morbidity. It is surprising that despite the vast advances in the interventional field, no significant changes have occurred on a wide scale in the approach to this entity over the last half century, with the mainstay of treatment remaining heparin and chronic warfarin therapy.
We present a 52-year-old man with massive bilateral DVT extending into the inferior vena cava (IVC) who under
Delayed Presentation of a Post-Traumatic Subclavian Pseudoaneurysm
- Fri, 9/5/08 - 3:36pm
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Introduction
In patients with polytrauma, injuries are treated after they are prioritized based on their severity. Some injuries, if managed conservatively, may result in delayed complications. We present a patient with a fractured clavicle who presented with a related complication 2 months later. The management of the case is also discussed.
Case Study
A 40-year-old male was brought to the emergency services department with multiple injuries sustained during a fall from a two-wheeler while under the influence of alcohol.
His sensorium was initally obtunde
Simultaneous Unilateral Aorto-Ostial Renal Artery Stenting with Kissing Balloon Technique and TriActiv Distal Protection Devices
- Fri, 9/5/08 - 3:36pm
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Introduction
Distal protection devices are being utilized with increasing frequency in percutaneous treatment of atherosclerotic renal vascular disease. Early interventions utilized either a distal balloon occlusive device or filter wire to prevent particulate embolization from causing post-procedural decline in renal function. We describe a case in which a new protection device, the TriActiv system, was used to treat tandem aorto-ostial lesions of a solitary kidney with a dual arterial supply.
Case Study
A 73-year-old woman presented with a history of refractory hyperten
Reversal of Refractory Hypertension due to the Goldblatt Kidney Phenomena from a Descending Aortic Dissection Using a Stent and
- Fri, 9/5/08 - 3:36pm
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- 2800 reads
Introduction
Medical therapy for acute type B aortic dissections primarily involves reduction of aortic shear force by decreasing blood pressure. Rarely, if a dissection plane extends directly into a renal artery, the hypertension may be difficult to control and prevent optimal management of the dissection. We describe a case report of a patient who responded to percutaneous intervention of a dissection flap in a renal artery. Additionally, an off-label, FDA-approved filter device was utilized to prevent further progression of renal insufficiency.
Case Presentation
An 80-
Witnessed Rupture of a Sinus of Valsalva Aneurysm into the Right Ventricle Presenting as Cardiogenic Shock
- Fri, 9/5/08 - 3:36pm
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Introduction
The sinuses of Valsalva are three small dilatations or cavity-like structures in the aortic wall above the attachments of the aortic cusps. They are known as the right coronary, left coronary and non-coronary sinuses, as defined by the associated coronary artery. First described in the early 1800’s by Thurnam (in a post-mortem description) and Hope, sinus of Valsalva aneurysms (SVA) are extremely rare, with an incidence of less than 0.15%.1–4 Most develop in the right coronary and non-coronary sinuses, predominantly rupturing into the right atrium or ventric
Renal Sub-capsular Hemorrhage: Unique Imaging Findings and Role of Interventional Management
- Fri, 9/5/08 - 3:36pm
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Introduction
Distal renal artery perforation during renal arterial stenting with a guidewire is an uncommon but potentially fatal complication.1 Although guidewire perforation leading to subcapsular or perirenal hematoma may be successfully managed conservatively or by embolotherapy, surgical intervention is occasionally required.2,3 Spontaneous renal subcapsular hemorrhage (SRSCH) can occur in patients with an underlying renal mass or in those with a bleeding diathesis or on anticoagulant medication.
Case Report
Case 1.
A 65-year-old woman with di
