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

Tirofiban rescue in acute carotid stent thrombosis despite a standard antiplatelet regimen - A case report

WOS: 000231873100014Fifty minutes following implantation of a right internal carotid artery stent, left lower extremity paresis developed in a patient despite use of heparin, clopidogrel and aspirin. Immediate angiograms revealed partially thrombosed carotid stent, then tirofiban (a glycoprotein IIb-IIIa receptor inhibitor) was administered intraarterially into the stent. After 15 minutes, complete resolution of the thrombus was detected on repeat angiography. The patient had recovered completely at 30-day follow-up

Embolisation of both fistulae through the same carotid artery tear in a patient with bilateral traumatic caroticocavernous fistulae

WOS: 000220298500012PubMed ID: 14758451Endovascular treatment of traumatic caroticocavernous fistulae (CCF) may present technical difficulties with specific angiographic dilemmas. We report endovascular techniques used in a patient with bilateral post-traumatic CCF, high-flow on one side, and slow-flow on the other. Complete closure of both was achieved through the same carotid artery tear. To our knowledge, transarterial venous coil embolisation of a low-flow fistula through a contralateral carotid artery tear, with transarterial detachable balloon embolisation of the ipsilateral high-flow fistula has not been described previously

Chimney technique for solitary pelvic kidney

PubMed: 32888009The combination of solitary pelvic kidney and abdominal aortic aneurysm is extremely rare. In this report, we present chimney graft implantation in a patient with solitary pelvic kidney. A 63-year-old man had the diagnosis of infrarenal abdominal aortic aneurysm made incidentally. Preoperative computed tomography illustrated a fusiform abdominal aortic aneurysm accompanying a solitary ectopic kidney in the pelvis with aberrant renal artery. A bifurcated endograft was implanted, and a covered stent graft was placed into the renal artery by use of the chimney technique. Good patency of the chimney graft was documented with early postoperative and first month scans. To the best of our knowledge, this is the first report of the chimney technique used in a solitary pelvic kidney. © The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved

Chimney technique for a solitary pelvic kidney

The combination of a solitary pelvic kidney and an abdominal aortic aneurysm is extremely rare. We demonstrate a chimney graft implant in a patient with a solitary pelvic kidney. A 63-year-old man was diagnosed with an abdominal aortic aneurysm found incidentally. Preoperative computed tomography illustrated a fusiform abdominal aortic aneurysm accompanying a solitary ectopic kidney in the pelvis with an aberrant renal artery. A bifurcated endograft was implanted, and a covered stent graft was placed into the renal artery using the chimney technique. Good patency of the chimney graft was documented with early postoperative and first month scans. To the best of our knowledge, this is the first report of the chimney technique used for a solitary pelvic kidney. © The Author 2023. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved

Endovascular Management of Vascular Injury during Transsphenoidal Surgery

WOS: 000345479500016PubMed ID: 23472732Vascular injury is an unusual and serious complication of transsphenoidal surgery. We aimed to define the role of angiography and endovascular treatment in patients with vascular injuries occurring during transsphenoidal surgery. During the last ten-year period, we retrospectively evaluated nine patients with vascular injury after transsphenoidal surgery. Eight patients were symptomatic due to vascular injury, while one had only suspicion of vascular injury during surgery. Four patients presented with epistaxis, two with subarachnoid hemorrhage, one with exophthalmos, and one with hemiparesia. Emergency angiography revealed a pseudoaneurysm in four patients, contrast extravasation in two, vessel dissection in one, vessel wall irregularity in one, and arteriovenous fistula in one. All patients but one were treated successfully with parent artery occlusion, with one covered stent implantation, one stent-assisted coiling method, while one patient was managed conservatively. One patient died due to complications related to the primary insult without rebleeding. Vascular injuries suspected intra or postoperatively must be investigated rapidly after transsphenoidal surgery. Endovascular treatment with parent artery occlusion is feasible with acceptable morbidity and mortality rates in the treatment of vascular injuries occurring in transsphenoidal surgery