Acute Limb Ischemia due to a Fractured Superficial Femoral Artery Stent

Peripheral Vascular Disease (PVD) is a rapidly growing and recognized disease of the peripheral circulation. Its presentation can vary between asymptomatic state, exercise limiting limb pain, limb loss and even death. Advances have been achieved in the treatment of PVD specially in the field of interventional cardiovascular medicine. Different devices and techniques are used in the treatment of peripheral atherosclerotic disease, which has lowered the need for bypass surgery. Although invasive peripheral intervention has a low rate of complications, there are still well recognized acute and chronic complications that an operator should be aware of. We present an interesting case of acute limb ischemia due to Superficial Femoral Artery (SFA) stent fracture

A rare case of paradoxical left sided endocarditis through patent foramen ovale.

A 36 -year old woman IV drug abuser admitted with Right-Sided Infective Endocarditis (RSIE) as demonstrated by transthoracic echocardiogram. Patient was admitted 8 weeks later with recurrence of symptoms, moreover signs of systemic embolization were noted. Transthoracic and Transesophageal Echocardiograms revealed tricuspid valve vegetation, severe tricuspid regurgitation, left atrial mass, Patent Foramen Ovale (PFO), severely dilated right atrium and prominent Chiari\u27s network. Systemic embolization included brain and Left iliacus abscesses. Patent Foramen ovale is the proposed mechanism leading to extensive systemic embolization in the present case

A rare case of paradoxical left sided endocarditis through patent foramen ovale

A 36 -year old woman IV drug abuser admitted with Right-Sided Infective Endocarditis (RSIE) as demonstrated by transthoracic echocardiogram. Patient was admitted 8 weeks later with recurrence of symptoms, moreover signs of systemic embolization were noted. Transthoracic and Transesophageal Echocardiograms revealed tricuspid valve vegetation, severe tricuspid regurgitation, left atrial mass, Patent Foramen Ovale (PFO), severely dilated right atrium and prominent Chiari's network. Systemic embolization included brain and Left iliacus abscesses. Patent Foramen ovale is the proposed mechanism leading to extensive systemic embolization in the present case

Retrograde Pedal Access For Revascularization Of Infrapopliteal Arterial Occlusive Disease In Critical Limb Ischemia (CLI) Patients As A Primary Approach

Introduction: We are presenting three cases (out of similar several cases) where tibio-pedal approach was performed as an initial primary approach for limb salvage in patients with CLI secondary to Infra-popliteal (IP) disease. We consider this approach to be a necessary evolution in endovascular intervention. Discussion: Retrograde pedal access is safe, feasible with high technical success rate and a relatively low procedural complication rate, with low 30 days mortality and low rate of major adverse cardiac events. Freedom from major adverse limb events and limb salvage are both high at 1 year follow up. It allows quick therapy and short procedure time with less observation time in the hospital. A retrograde approach utilizing pedal access improves the crossing success of lesions as well as facilitates the use of some atherectomy devices to remove large plaque burden and modify the compliance of severely calcified infra-popliteal vessels. Using the retrograde approach will minimize the classic complications of the antegrade femoral approach. Conclusion: Retrograde tibio-pedal arterial access, as an initial primary approach for endovascular intervention in CLI patients confined to IP vessels, is an effective, safe, and feasible approach with a high technical success rate and a relatively low procedural complication rate