Post EVAR endovascular revision of late onset stent graft collapse due to Type 1 endoleak in a complicated case with left limb occlusion and solitary kidney

Type 1 endoleak is one of the most frequent complication usually seen at the initial phase of EVAR procedure. B alloon dilatation is mostly used to oversize the proximal or the distal part of the orifice to stabilize the attachment of the graft stent to the aortic wall. Late onset of type 1 endoleak with graft stents may cause severe lumen compression of the stent and aneurysm enlargement which might cause a serious problem especially in a patient whose graft stents left iliac branch is thrombosed and the left leg is supplied by the bypass graft from right CFA. Although operation was advised by the endovascular specialists the procedure was done in our hospital as the patient preferred the endovascular method instead of open surgery

Endoleaks after endovascular aortic aneurysm repair: Definition and treatment [Endovasküler aortik anevrizma tamiri sonrasi görülen kaçaklar (endoleak): Tanim ve tedavi]

Endoleak is a common phenomenon after endovascular aneurysm repair for abdominal or descending thoracic aortic aneurysms. Some types of endoleaks are totally innocuous that they have the potential of spontaneous recovery and therefore do not require intervention. However, some endoleaks might cause aortic rupture. Type 1 and type 3 endoleaks are technical failures of endovascular treatment that should be treated immediately first by endovascular means. Type 2, 4 and 5 endoleaks can be monitored for aneurysm growth with appropriate imaging techniques. Five different type of previously defined endoleaks will be reviewed and their appropriate treatment methodologies will be discussed in this manuscript

Endovascular treatment of thoracic aortic aneurysms [Torasik aort anevrizmalarinda endovasküler tedavi]

The morbidity and mortality rates of conventional surgery for the extensive distal aortic lesions are relatively high. Stent-grafting has been widely used for the diseases of the distal thoracic and abdominal aorta. However, endoleaks, and visceral and spinal cord ischemia due to coverage of critical branches of the distal aorta are major concerns related to this technique. The outcome mostly depends on the proper placement of the proximal part of the graft. Anatomical features of the aneurysmal aorta are the main cause of complications of the stent-grafts

Interventional radiological treatment in complications of pancreatitis

WOS: 000178531200005PubMed ID: 12204404Percutaneous interventional therapy plays an important role in treating complications of acute and chronic pancreatitis. With the development of cross-sectional imaging and advanced interventional techniques, percutaneous drainage has become the preferred treatment for pancreatic fluid collections such as acute collections, pseudocysts and abscesses. Abscess and pancreatic hemorrhage are the most life threatening complications of pancreatitis. Massive hemorrhage is rare but frequently lethal. As a rule, bleeding complications of pancreatitis require prompt diagnosis and an aggressive surgical approach. In unstable patients with a severely bleeding pseudoaneurysm, hemostasis can be obtained by occlusion with mechanical devices. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved

Nitric oxide and oxidative stress in atherosclerotic renovascular hypertension: Effect of endovascular treatment

WOS: 000184102500008PubMed ID: 12847196PURPOSE: Because activation of the renin-angiotensin system leads to an increase in oxidative stress, the authors investigated nitric oxide (NO; nitrite + nitrate), superoxide dismutase (SOD), catalase, and malondialdehyde (MDA) levels and the effect of endovascular treatment on these parameters in patients with atherosclerotic renovascular hypertension. The relationship of NO with blood pressure and renal functional indexes was also investigated. MATERIALS AND METHODS: In this prospective cohort study, serum creatinine, NO, SOD, catalase, plasma MDA, urinary microalbumin, and NO levels, and blood pressure were determined in 21 patients with hypertension and unilateral renal artery stenosis caused by atherosclerosis at entry and after 24 hours, 2 weeks, and 6 weeks of endovascular treatment. RESULTS: MDA concentrations decreased 24 hours after intervention and remained low 2 and 6 weeks later. In addition, serum SOD and NO and urine NO levels were increased significantly 24 hours after endovascular treatment and decreased after 2 and 6 weeks. However, serum catalase levels did not differ after the intervention. Blood pressures decreased after treatment. There were no significant differences in urinary microalbumin levels, estimated glomerular filtration rates, and creatinine levels after endovascular treatment. CONCLUSIONS: Endovascular treatment decreases oxidative stress and may offer new benefits in the treatment of patients with hypertension associated with renal artery stenosis. The decrease in oxidative stress and/or the upregulation of SOD may increase the bioavailability of NO, which in turn may lead to the rapid hypotensive response

Hemodynamic disorders in internal thoracic artery: How often are they associated with subclavian steal via ipsilateral vertebral artery?

WOS: 000072219900002PubMed ID: 9514164The scores based on Doppler sonographic spectral features in 14 vertebral arteries with flow reversal and 10 vertebral arteries with normal antegrade flow were correlated with those of ipsilateral internal thoracic (or internal mammary) and subclavian arteries. The statistical analysis revealed significant correlation between the scores of all ipsilateral arteries. We concluded that color duplex ultrasonographic examination of internal thoracic arteries should be carried out in all patients with flow reversal in vertebral arteries. It is especially important in those who are potential candidates or coronary revascularization using in situ internal thoracic artery graft