Misplaced Arterial Pacemaker Lead.

A 90 year old man presented with an ischaemic stroke and haemorrhagic transformation in the left posterior cerebral artery territory. Chest Xray (A) and a computed tomography angiogram (CTA; B) showed a misplaced pacemaker lead entering the left subclavian artery (LSA, a), anchored in the left ventricular apex through the ascending aorta (b). Lead extraction with covered stent placement in the LSA was proposed, but the patient refused. Bridging therapy with acetylsalicylic acid 100 mg daily was administered for two weeks. With no new cerebral CTA changes, 110 mg of dabigatran twice daily was prescribed. The patient remained well after six months follow up. [...

A bare covered stent

A 60 year old man had undergone cervical radiotherapy and lymphadenectomy for a metastatic epidermoid carcinoma 8 months ago. During follow up, there was persistent tissue necrosis around the carotid bifurcation. To prevent carotid disruption and also maintain cerebral perfusion, two self expandable covered stents (7 × 50 mm and 7 × 25 mm; Viabahn, Gore, Flagstaff, AZ, USA) were placed from the common to the internal carotid arteries. Ten days later, continuous neck bleeding occurred; computed tomography angiography showed good stent coverage surrounded by major tissue disruption and bleeding from the external circuit

Double Check That You Are in the Endograft and Not in Front or Behind It!

No abstract availabl

A Pulsatile Abdominal Mass.

A 66-year-old man presented to the emergency department with a 2-month history of abdominal bloating and worsening constipation. His medical history was notable for untreated hypertension and hyperlipidemia. [...

Vertebral Cement Leak: How Far Will It Go…?

A 73 year old woman underwent posterior spinal arthrodesis for a traumatic T12 vertebral fracture. Owing to osteoporosis, the screw fixation was reinforced by a cement injection. During the procedure, cement leakage along the vertebra was observed (A, arrows). A post-operative thoraco-abdominal computed tomography scan was performed to evaluate the leakage and demonstrated a long continuous venous solidified cement string, extending from T12 to the right atrium via the inferior vena cava (B) with no further emboli. No valve malfunction was observed on echocardiogram. In this asymptomatic patient, lifelong oral anticoagulation was administered to prevent inferior vena cava thrombosis. [...

Onyx® Embolisation.

A 37 year old woman underwent embolisation of a ruptured lumbar artery pseudo-aneurysm with coils and an Onyx® 18 liquid embolic system (Medtronic, Minneapolis, MN, USA) [...

Azygos Vein Mimicking Aortic Dissection.

An asymptomatic 45 year old woman who underwent open surgical correction of a coarctation 25 years ago was under cardiac surveillance. [...