Wewnątrznaczyniowe zamknięcie pękniętego tętniaka przeszczepu z odwróconej żyły odpiszczelowej w poddanej zabiegowi naprawczemu przetoce tętniczo-żylnej — kwestie techniczne

A 49-year-old diabetic woman who had end stage renal disease associated with membranous glomerulonephritis, was undergoing dialysis through a left brachiocephalic arteriovenous fistula. After sometime, fistula became infected and stopped functioning. It was closed and arterial segment was resected and repaired with reverse saphenous vein graft. After 6 months interval, she presented with painful, expansile swelling with intermittent bleeding. Arteriogram showed ruptured aneurysm of reverse saphenous vein graft with a proximal venous stenosis. It was successfully closed with 6 × 60 mm Fluency Plus self-expanding vascular stent graft (Bard, Tempe, AZ) with resolution of her symptoms.Kobieta w wieku 49 lat, chora na cukrzycę, w schyłkowym stadium niewydolności nerek związanej z błoniastym zapaleniem kłębuszków nerkowych, była dializowana z dostępu przez przetokę tętniczo-żylną ramienno-odpromieniową po lewej stronie. Po pewnym czasie przetoka przestała działać z powodu zakażenia. Przetokę zamknięto, a segment tętniczy wycięto i zastąpiono przeszczepem z odwróconej żyły odpiszczelowej. Po 6 miesiącach chora zgłosiła się z powodu bólu, znacznego obrzęku i okresowego krwawienia. Arteriogram ukazał pęknięty tętniak przeszczepu z żyły odpiszczelowej ze zwężeniem żyły w odcinku proksymalnym. Pęknięcie zamknięto za pomocą samorozprężalnego stentu naczyniowego Fluency Plus 6 × 60 mm (Bard, Tempe, AZ), co spowodowało ustąpienie objawów

Zakończona powodzeniem przezskórna interwencja wieńcowa z zastosowaniem techniki Szabo w przypadku zmian aortalno-ostialnych z przewlekłym całkowitym zamknięciem prawej tętnicy wieńcowej

Percutaneous coronary intervention (PCI) in aorto-ostial lesions with chronic total occlusion is one of the most challenging scenarios, because geographic miss may lead to a higher rate of immediate and late adverse events when comparing with non-ostial lesions. Here we report a case, where aorto-ostial chronic total occlusion of right coronary artery in a 39-year-old male was successfully recanalised and perfectly stented using the Szabo technique

Pierwotna przezskórma interwencja wieńcowa za pomocą cewnika diagnostycznego typu Tiger w przypadku nietypowego odejścia gałęzi pnia lewej tętnicy wieńcowej

The use of smaller catheters for diagnostic and intervention purpose is becoming increasingly popular due to the shift towards transradial catheterisation. The use of smaller catheters permits smaller arterial punctures, which translates into early mobilisation and discharge, as it may obviate the need for closure devices, lesser contrast volume use, potential nephrotoxicity and decreased morbidity. Here, we report a case, where standard 5 F Tiger diagnostic catheters (Terumo Radifocus Optitorque, Japan) was used for primary percutaneous coronary intervention of left circumflex artery with abnormal take-off of the left main

Radial artery pseudoaneurysm (RAP) following transradial intervention — an extremely rare complication successfully managed by surgery: case report

The transradial access for diagnostic and therapeutic purpose is becoming increasingly popular, mainly because of its lack of complications. Radial artery pseudoaneurysm (RAP) is an extremely rare complication, so many of its clinical features are unknown and treatment is not systematic. Therapeutic options are conservative management, ultrasound-guided compression, thrombin injection and surgical intervention. Here, we report a 43-year old female who underwent transradial percutaneous angioplasty of left anterior descending artery. During cannulation of her radial artery, multiple puncture attempts were done. Upon removal of the transra¬dial compression band (TR Band), forearm ecchymosis and small hematoma were noted with mild pain. Tight compression bandage was applied but on the following day, she had complaints of increasing right forearm pain and tenderness. Physical evaluation revealed increased swelling of the right forearm and an ultrasound of the right forearm demonstrated a RAP of the right radial artery measuring up to 3.9x1.9 cm with 3.4 mm neck. Tight compression bandage was further prolonged following ultrasound compression with vascular probe which failed to alleviate her complaints. Following failure of conservative therapy and in lieu of her symptoms, surgical exploration, clot removal and successful repair was done