We report a case of carcinoma of the hypopharynx and cervical esophagus in a patient with an aberrant right subclavian artery. Barium esophagograhy, endoscopy, and computed tomography showed a resectable tumor in the hypopharynx and cervical esophagus, coexistent with an aberrant right ...
PubMed
Although the aberrant right subclavian artery is the most common abnormality in aortic arch development, it is unusual to encounter this abnormality when repairing acute aortic dissection. We report a case of Stanford type A acute aortic dissection involving an aberrant right subclavian ...
Although an aberrant right subclavian artery is the most common abnormality of aortic arch development, it is an unusual entity to encounter during repair of thoracic aortic aneurysms. A case of an aberrant right subclavian artery requiring reattachment during repair of an ...
We report a case of massive hemothorax due to inadvertent puncture of an aberrant right subclavian artery during central venous access. Iatrogenic laceration at the origin of the right internal thoracic artery was successfully treated with coil embolization of the internal thoracic artery ...
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On diagnosis of Stanford type A acute aortic dissection with an aberrant right subclavian artery, emergency operation was performed. Aortic arch replacement was undertaken with additional 'elephant trunk' procedure to cover the entry site and decrease the blood flow through the false lumen. We consider this technique will become one of ...
Aberrant right subclavian artery aneurysms are rare but demonstrate a propensity toward rupture; thus, early elective repair is mandated. Novel endovascular modalities are available to offer less-invasive treatment for a patient population with increasing comorbidities. We report a case of a 65-year-old woman with an ...
PubMed Central
The combination of right cervical aortic arch, aberrant retroesophageal left subclavian artery originating from a Kommerell's diverticulum, and a ligamentum arteriosum, constitutes a rare form of vascular ring. Two patients aged 21 days and 54 years, who were diagnosed by multislice 3-dimensional computed tomography and magnetic ...
The purpose of this study was to evaluate the utility of 16-slice multidetector computed tomographic (MDCT) angiography for identifying anatomic features of aberrant subclavian arteries. Seventeen patients with aberrant subclavian arteries were assessed by MDCT angiography. ...
A right-sided aortic arch with an aberrant left subclavian artery is a rare anatomical variation. We report a case treated with carotid artery stenting (CAS) for a patient with a right-sided aortic arch with an aberrant left subclavian artery. A ...
An unusual variety of aortic coarctation is described in which the left common carotid, left subclavian, and aberrant right subclavian arteries arose distal to the coarcted segment. The literature relating to unusual coarctation is briefly reviewed.Images
Surgical treatment of the combination of aneurysms of an aberrant right subclavian artery, distal aortic arch, and descending thoracic aorta requires control of structures in both the right and the left hemithorax. We report a 2-stage surgical approach. The 1st stage, performed through a median sternotomy, consists of an elephant trunk ...
Aberrant right subclavian artery (ARSA) is asymptomatic in most cases. This variant anatomy can cause dysphagia in elderly patients. Impaction of foreign body in the esophagus is rarely the presenting symptom of ARSA. We present an eighty four years old patient who first presented with esophageal foreign body impaction and was ...
A 4-month-old boy was referred for persistent respiratory symptoms despite having undergone division of the ligamentum arteriosus for the diagnosis of a right aortic arch with an aberrant left subclavian artery. A computed tomography scan demonstrated symmetric arch vessels around the trachea at the thoracic inlet, with the left common ...
A 62-year-old man was incidentally diagnosed with a completely asymptomatic aberrant right subclavian artery (ARSA) aneurysm with a maximum diameter of 4.5 cm. This condition presents a postrupture mortality rate of 50% and the morbidity-mortality rates reported in the literature with traditional open repair procedures are of 25%. In ...
We report the case of a 6 year old girl with Turner Syndrome and Aberrant Right Subclavian�Artery with an incidental finding of PAPVR on contrast-enhanced, high-pitch, 128-slice, electrocardiographic-gated dual source CT. There is value of using high-pitch DSCT in pediatric patients for diagnostic images with minimal radiation exposure. PMID:21376695
A case of double superior venae cavae (Bvc) associated with bilateral azygos veins (Baz), aberrant subclavian artery (Sa) and other rare variations is recorded in a two-year-old Chinese girl with an unknown cause of death. A review of the literature since...
National Technical Information Service (NTIS)
An aberrant right subclavian artery (ARSA) arising from a left-sided aortic arch is the fourth most common aortic arch anomaly. Aneurysmal dilatation of the ARSA requires treatment because of the associated risk of rupture. We present a case where supra-aortic bypass of the arch vessels was performed to facilitate exclusion of the ...
Aberrant right subclavian artery (ARSA) aneurysms are rare but carry a high risk of rupture and require early elective treatment. The present report describes a 60-year-old man with an asymptomatic ARSA aneurysm for whom surgical treatment would have been associated with a high degree of risk. The ARSA aneurysm was occluded with use of ...
We herein report a case showing the simultaneous occurrence of an aberrant right subclavian artery (ARSA) and accessory lobe of the liver in a 75-year-old female cadaver. In the thorax, the left aortic arch branched into the right common carotid artery, left common carotid artery, left ...
?Two children were sent to the catheterization laboratory for transcatheter closure of patent ductus arteriosus (PDA). During the intervention, cineangiogram revealed associated aberrant right subclavian artery (ARSA). Both patients had left-sided aortic arch. The first patient was sent to surgery after one unsuccessful attempt to ...
... and timing of maximum contrast visualized in the aorta was determined by fluoroscopy. Two subsequent iohexol boluses ... the dorsal aortas fuse to become the descending aorta. The first two pairs of aorti...
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A 69-year-old man with right aortic arch was diagnosed as having left lung cancer (cT2aN1M0, cStage IIA) and an aneurysm of an aberrant left subclavian artery. The aneurysm measured 36 mm in diameter and was located 1 cm peripheral from the origin in the area known as "Kommerell's diverticulu Left carotid ...
A complete vascular ring composed of right aortic arch, aberrant left subclavian artery with Kommerell's diverticulum, and left ligamentum arteriosum was diagnosed by barium esophagography, echocardiography, angiography, and multidetector computed tomography of chest in an 18-day-old male neonate who presented with remarkable ...
The internal thoracic artery (ITA) is considered to be the optimal conduit for surgical coronary artery revascularization. Variations in ITA anatomy are relatively common and may impact surgical results. The ITA usually arises from the intrascalenic (first) part of the subclavian artery (SCA) and, occasionally, ...
A novel approach to the management of aortic arch aneurysm with an aberrant right subclavian artery (ARSA) is described. Construction of a Dacron graft with side arms adapted to the patient's arch anatomy allows for antegrade cerebral perfusion during circulatory arrest and revascularisation of the arch vessels. A long elephant-trunk ...
This case report describes the endovascular repair of a right-sided descending thoracic aortic aneurysm associated with a right aortic arch and an aberrant left subclavian artery. A 76-year-old male with multiple comorbidities was incidentally found to have a right-sided descending thoracic aortic aneurysm with a maximum diameter of ...
We report a case of left sided aortic arch with three branches - a bi-carotid trunk, left subclavian, artery and right subclavian artery. The anomalous right subclavian artery presented a retroesophageal course. A right non-recurrent laryngeal nerve was noticed. The ...
Traumatic rupture of the aorta in the rare setting of the aberrant right subclavian artery (ARSA) requires special consideration to prevent the occurrence of a devastating posterior cerebral circulation stroke. We present three cases managed by using an endovascular approach, with a discussion of important preoperative and operative ...
We describe the "double-vessel" sign and its relevance for the diagnosis of carotid and vertebral arterial anatomical variations in a series of four patients with stroke. In these four patients, two arteries could be seen at the expected location of the common carotid artery (CCA), leading to the diagnosis of anatomical variations ...
Four cases of subclavian artery occlusion occurring 5 to 17 years after irradiation for breast carcinoma are presented. Although arterial insufficiency is a rarely reported sequel of radiotherapy, it may be the cause of pain and disability in the upper extremity in a postmastectomy patient. Particular attention should be paid ...
Left subclavian artery occlusion developed in a patient 42 years after a left radical mastectomy and radiotherapy. The vascular supply was successfully reconstructed by a graft from the right subclavian artery to the left brachial artery. Clinical and experimental evidence has demonstrated that ...
A rare anatomic variant of the right vertebral artery is reported as an incidental finding in a 78-year-old female patient. The vessel originated from the aortic arch distal to the origin of the left subclavian artery and presented an unusual retroesophageal course, thus was named "vertebral arteria lusoria". As multi-detector row ...
Vascular injuries from penetrating trauma to the base of the neck are accompanied by significant morbidity and potential mortality. These injuries require several diagnostic adjuncts in order to facilitate early diagnosis and appropriate treatment. Herein reported is the case of a patient who sustained penetrating injury to the thoracic inlet but had a fortuitous anomaly that prevented vascular ...
The aberrant right subclavian artery (ARSA) aneurysm is rare; however, the risk of rupture and thromboembolism is high, with a postrupture mortality rate of 50%. In this report, we have described two cases of this anomaly. In the first case, a 62-year-old male patient presented with a symptomatic aneurysm of ARSA (maximum diameter of 4 ...
A rare morphology of an aberrant innominate artery (IA) is reported here, together with additional arterial variation encountered in the respective specimen. The IA originated in the aortic arch on the left side of the trachea, coursed on that side of the trachea to reach the left thyroid lobe, turned in at a right angle to pass ...
... the thoracic aorta distal to the subclavian artery, the brachiocephalic ... mm Hg). The aorta was then tied distal to the brachiocephalic artery, the ...
DTIC Science & Technology
Objective. To evaluate the efficacy of subclavian stenosis percutaneous transfemoral angioplasty (PTA)-treatment in patients with intermittent or complete subclavian steal syndrome (SSS), and coronary-subclavian steal syndrome (C-SSS) after left internal mammary artery-interventricular anterior ...
When we can't realize the reimplantation because of technical difficulties, special cases are presented during transposition from the subclavian artery to the primitive carotid artery. In these cases, between primitive carotid artery and the subclavian artery and also the ...
Subclavian artery pseudoaneurysms are rare; and cases involving subclavian artery pseudoaneurysms presenting with compression on trachea leading to breathing difficulty are exceptional. We present a case report of huge subclavian artery pseudoaneurysm presenting with ...
Subclavian artery injuries after central venous catheter placement constitute a rare but potentially fatal complication. In this case series, the authors describe several endovascular treatment options in the management of iatrogenic subclavian arterial injuries resulting from inadvertent ...
A variety of cardiac defects, encompassing truncus arteriosus, tetralogy of Fallot, pulmonary atresia with ventricular septal defect and interrupted aortic arch, are generally summarised as conotruncal malformations. Patients with these cardiac defects were frequently found to have a common microdeletion on chromosome 22, the so-called monosomy 22q11.2. The aim of our study was to determine ...
Arteria lusoria, an aberrant or anomalous right subclavian artery, is the most common anomaly of the aortic arch. It may be associated with other congenital anomalies of the heart and great vessels-including, rarely, truncus bicaroticus (a common trunk of both common carotid arteries), and, even more rarely, ...
Arteria lusoria, an aberrant or anomalous right subclavian artery, is the most common anomaly of the aortic arch. It may be associated with other congenital anomalies of the heart and great vessels�including, rarely, truncus bicaroticus (a common trunk of both common carotid arteries), and, even more rarely, ...
Endovascular treatment options have evolved in many ways and become an important alternative for open surgical repairs in various vascular territories. Herein, we present a case of an 18-year-old man with complex injury to the left subclavian artery and vein caused by a gunshot 4 months ago. After the gunshot, a high-flow fistula between the left ...
Various malformations of the aortic arch and great vessels have been reported in the literature, which reflects the complexity of their embryologic development. Most of them are of incidental finding and remain asymptomatic but can be responsible for respiratory or digestive symptoms and be associated with congenital cardiac diseases. We report the case of a patient presenting a right ...
Partial steal has been regarded as a classic ultrasound appearance of subclavian steal syndrome. We report a case with the vertebral artery origin stenosis and intact subclavian artery, which showed the similar partial steal ultrasound features. The following computerized tomography angiography confirmed the ...
Coarctation of the aorta was repaired surgically in a 4 month old boy using the anomalous right subclavian artery as a flap. The role of the anomalous artery in providing collateral flow to the descending aorta should be determined so that injudicious clamping is avoided.Images
Right interrupted aortic arch and descending aorta is exceedingly rare and most likely cause respiratory presentation, since patent ductus arteriosus (PDA) courses over the right mainstem bronchus. We report a case of successful neonatal biventricular repair of a right interrupted aortic arch (type B), with an aberrant right subclavian ...
Subclavian artery stenosis or occlusion may be a cause of myocardial ischemia in patients treated using an internal mammary artery graft. Subclavian stenosis may cause myocardial ischemia during arm exercise by a coronary-subclavian steal phenomenon, with flow inversion in the graft from the ...
Foreign body aspiration is frequently encountered in young children, in the majority of cases it will not lead to an adverse outcome. However, in case of coin battery ingestion more serious adverse outcomes, including death, have been reported. We present a case with fatal outcome due to exsanguination, of a 2-year-old child with an aberrant right ...
This is a retrospective evaluation of the incidence of aberrant subclavian arteries (ASAs) and diverticula of Kommerell, as well as the occurrence and significance of associated aneurysms. Thoracic aortograms obtained during a 12.5-year period were reviewed, seeking the presence of aberrant right and left ...
Spontaneous subclavian artery dissections are rare, with very few cases described in the literature. We report an unusual case of a 62-year-old female who presented with ischemia of the left arm secondary to spontaneous dissection of the first part of the left subclavian artery. We describe the imaging findings on ...
The subclavian steal syndrome is characterized by a subclavian artery stenosis located proximal to the origin of the vertebral artery. In this case, the subclavian artery steals reverse-flow blood from the vertebrobasilar artery circulation to supply ...
We report a case of traumatic right subclavian artery pseudoaneurysm, which failed initial treatment by endovascular covered stent. Subsequent catheter angiogram demonstrated filling of the pseudoaneurysm from retrograde flow of the right vertebral artery with outflow through the internal mammary artery. With ...
An infant under follow-up evaluation since the fetal stage was detected to have subclavian steal syndrome (SSS) associated with heterotaxy syndrome and atrioventricular septal defect. Such a complex association has not been reported previously. Congenital SSS occurs as a result of a subclavian artery originating from the main pulmonary ...
A 43-year-old man with progressive right common carotid, subclavian artery, and brachiocephalic artery stenoses due to aortitis syndrome is presented. The patient's right common carotid artery had been treated by percutaneous transluminal angioplasty (PTA) four times previously, but it was finally ...
IntroductionSurgical treatment of symptomatic occlusive lesions of the proximal subclavian artery is infrequently necessary. Carotid subclavian bypass has gained popularity and is now considered standard treatment when stenting is not possible. Exposure of the subclavian artery and bypass ...
This study is the first report of the branching pattern of the four major branches of the subclavian artery in German Shepherd dogs. A total 116 subclavian artery casts made of silicon under mean arterial pressure were analysed. The casts were classified according to their branching order and ...
We present two cases of acute subclavian and/or axillary arterial occlusion after transaxillary catheterization with an implantable port for hepatic arterial infusion chemotherapy. They were successfully treated with thrombolytic therapy using intraarterial administration of urokinase without removal of the infusion catheter system. We ...
Pulmonary atresia and ventricular septal defect associated with major aortopulmonary collaterals (MAPCAs) is a rare, complex, and heterogeneous congenital cardiac anomaly. The majority of untreated patients present with severe congestive heart failure and respiratory distress in the first decade of life. We describe a 15-year-old cyanotic boy, both of whose pulmonary arteries ...
The variations in the aortic arch and its branches are of surgical interest. Many anomalies of the aortic arch and great vessels are uncovered as serendipitous findings on imaging studies, in the anatomy laboratory, or at surgery. A 56-year-old woman had an arch angiogram as part of an evaluation for cardiovascular disease. A two-vessel left aortic arch was identified consisting of the ...
Congenital vascular anomalies are rare. The cardiovascular specialist should nevertheless be aware of the more common types of vascular anomalies and understand the implications for patient treatment and the likelihood of associated morbidity. The presentation of congenital arteriovenous malformations can range from asymptomatic or cosmetic lesions, to those causing ischemia, ulceration, ...
Occlusive disease of the aortic arch vessels is relatively rare and often missed initially. Of 41 patients treated surgically for this condition over a 10-year period 38 had arteriosclerotic lesions, 2 had symptoms secondary to vasculitis (Takayasu's arteritis) and 1 had a radiation injury to a subclavian artery. In 22 cases the left ...
A 56-year-old male with a past history of coronary artery bypass graft surgery underwent stent implantation for a severe proximal left subclavian artery stenosis. Recurrent in-stent restenosis (ISR) resulted in the coronary subclavian steal syndrome (CSSS), with angina due to compromised blood flow in the left ...
We report the use of gadolinium-based contrast agent for both diagnostic and interventional subclavian angiography in two azotemic patients, presenting with an asymptomatic, high-grade stenosis of the left subclavian artery, ipsilateral to the site of choice for native fistula creation. Angiographic imaging performed with diluted ...
BackgroundWe describe a modified access technique for the proximal (open) part of single stage hybrid exclusion of aneurysm of the aortic arch.Case presentation3 patients had a bifurcated Dacron graft for the innominate and left subclavian arteries and an additional end-to-side anastomosis of the left common carotid artery on the limb ...
Ebstein's anomaly and absent pulmonary valve syndrome belong to the rarest congenital heart defects. Their association has never been reported so far. We present the unusual case of a fetus at 23 weeks of gestation with Ebstein's anomaly, tetralogy of Fallot, absent pulmonary valve and agenesis of the arterial duct. The main diagnostic features were apical displacement of the ...
Right sided aortic arch is an uncommon congenital anomaly. It can be classified into three types, depending on the left aortic arch's degenerating pattern and the branching pattern of the great vessels. It can be associated with major congenital heart disease, depending on the type of right sided aortic arch. We report a case of an 18-years-old female who has right sided aortic arch with atrial ...
Subclavian artery dissection is a rare complication of cardiac catheterization. The usual reason for entering this vessel is to access the origin of the left internal mammary artery (LIMA) when this has previously been used, or is being considered, as a bypass graft. We report an instance of such dissection occurring long after bypass ...
A patient with concomitant rupture of the thoracic aorta and right subclavian artery at its origin was managed with endovascular stents. Due to the patient's hypovolemic shock, kissing stents in the brachiocephalic artery were undersized, requiring repeat intervention with coils and cement. The technical and judgment aspects of this ...
We report a case of scapulothoracic dissociation with right subclavian artery traumatic injury that was managed by endovascular treatment. Particular features are the use of a flexible self-expandable noncovered stent and simultaneous protection of the right common carotid artery from distal embolization by inflating a balloon ...
Severe complications can and do occur when central venous catheters are inadvertently placed into subclavian arteries. Two cases are discussed that describe how these inadvertent arterial punctures can be closed using the Perclose device (Abbott Laboratories, Redwood City, CA, USA)
... vessels: the left pulmonary artery (LPA), the left aorta (LAo), and the branch of the right aorta (RRAo) distal to the subclavian and carotid branching. ... ...
Subclavian artery pseudoaneurysm and occlusion in young patients are usually post-traumatic. We report the case of a 33-year-old diabetic woman with subclavian artery occlusion and pseudoaneurysm formation caused by pulmonary mucormycosis infection. The patient presented with diabetic ketoacidosis, ...
A patient had an occlusion of the left subclavian artery just proximal to the takeoff of a previously placed subclavian-carotid graft. This caused reversal of flow in the graft and a symptomatic steal of blood via to the intracranial arteries. An axilloaxillary graft restored forward flow. In a second patient, a ...
types of aortic arch syndromes, including: Congenital absence of a branch of the aorta Isolation of the subclavian arteries Vascular rings Symptoms Symptoms vary according...
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In cases in which the subclavian artery is severely tortuous or branches with an extremely angulated origin, stent placement in the vertebrobasilar artery on the approach from the femoral artery is often technically difficult. We report two cases in which a stent placement procedure for the vertebrobasilar ...
Catheterization of vessels with severe tortuosity and atherosclerotic changes may represent a technical challenge and is associated with a higher incidence of vascular complications [Putman CM, Chaloupka JC. Use of large-caliber coronary guiding catheters for neurointerventional applications. AJNR Am J Neuroradiol 1996;17:697-704]. Placement of guiding catheter to the tortuous ...
Background Anatomical variants of the aortic arch and its branching patterns often appear as an incidental finding during routine computed tomography (CT) scanning. These variations can be of relevance when performing angiography or endovascular interventions and may cause symptoms such as dysphagia. Purpose To analyze common anatomical variations found within the arteries ...
Tracheoesophageal fistula and tracheo-arterial fistula are both uncommon but life-threatening complications after a tracheostomy. The most common source of a major hemorrhage is from the tracheo-innominate artery fistula. Most tracheo-arterial fistulas occur within the first 3 weeks after tracheostomy. We describe a very rare case of a ...
Persistent right aortic arch (PRAA) is a congenital vascular ring anomaly common in several dog breeds. In German Pinscher, the disorder is characterized by a left retroesophageal subclavian artery in combination with a ligamentum arteriosum originating at the aberrant left subclavian artery ...
Intraoperative transesophageal echocardiography (TEE) has become an important monitoring device for patients undergoing cardiac or noncardiac surgery. Complications associated with TEE are unusual, but the potential for TEE probe compression of the posterior vascular structures has been reported in pediatric patients. We present here a case of occlusion of the right subclavian ...
In total arch replacement for acute type A aortic dissection, the left subclavian artery anastomosis and the distal anastomosis at the descending aorta are often remarkably difficult because of the deep surgical field. We developed a single-branched stent graft that was constructed by adding a side arm stent-graft to a conventional aortic stent graft. By ...
Thoracic endografting offers many advantages over open repair. However, delivery of the device can be difficult and may necessitate adjunctive procedures. We describe our techniques for preserving perfusion to the left subclavian artery despite endograft coverage to obtain a proximal seal zone. We reviewed our experience with the Talent thoracic stent ...
Translumbar selective coronary arteriography was performed using a preshaped 7 French coronary catheter introduced over the long translumbar needle. The patient had abdominal aortic occlusion, left subclavian artery occlusion, and innominate artery stenosis, which precluded the usual angiographic approaches.
A retroesophageal right subclavian artery, arising from the arch of the aorta as the terminal branch and passing dorsal to the esophagus, was found in five (1.2%) of 428 bodies donated for student dissection at Kumamoto University between 1993 and 2008. The presence of a retroesophageal right subclavian artery has ...
Two cases of subclavian-axillary-brachial artery occlusion following irradiation damage are reported. Both followed radiotherapy for carcinoma of the breast at intervals of 11 and 26 yrs respectively. The results appear to show that large and medium artery sclerosis following irradiation is slowly progressive, leading to ...
Takayasu's arteritis, also known as pulseless disease, is a chronic inflammatory arteritis affecting large vessels, predominantly the aorta and its main branches. Vessel inflammation leads to wall thickening, fibrosis, stenosis, and thrombus formation. Percutaneous removal of arterial thrombus with the use of several devices has been reported, with mixed results. We ...
Occlusion of the left subclavian artery was demonstrated following exposure to two courses of radiation, the patient having received 4,200 rads in 4 weeks 9 years previously, and 4,000 rads in 8 weeks almost 5 years previously. Despite other intercurrent medical conditions, this seems to be a cause-and-effect relationship, since the only segment of ...
We report the results of stenting in 17 patients who underwent treatment for total occlusions in the subclavian arteries between July 1991 and December 1995. Fourteen of the lesions were located in the left side; 15 patients had a subclavian steal syndrome. The indications for treatment were vertebrobasilar insufficiency (n = 7); arm ...
This report describes a rare vascular complication of surgical placement of a marking clip and a possible approach to problem solving. A 55-year-old patient presented with loss of sensation in the fingers and loss of peripheral pulsations in the right arm 4 days after right upper lobectomy for a pT2N1 moderately differentiated adenocarcinoma of the lung. Duplex examination and computed tomography ...
A total of 10 adult, healthy, male chinchilla (Chinchilla lanigera) were used to investigate the vessels originating from aortic arch. Coloured latex was injected into the carotid arteries following conventional anatomical applications in all the chinchillas examined. The brachiocephalic trunk and the left subclavian artery arose from ...
Left subclavian arterioesophageal fistula resulting from chicken bone ingestion is a rare occurrence. The authors report the death of a 42-year-old Thai female with mental retardation who presented to the hospital with severe hematemesis and arrested Death occurred about 24 hours after laparotomy due to hypovolemic shock Postmortem examination revealed a chicken bone embedded ...
We report three cases of symptomatic stenosis of the great vessels or supra-aortic trunks successfully treated surgically with aorto-subclavian and aorto-innominate bypass. Two were performed via manubriotomy and a third case via standard median sternotomy because of concomitant coronary revascularisation. There was complete symptomatic relief on follow-up, and radiological ...
Subclavian steal syndrome is usually an incidental finding and rarely causes vertebrobasilar ischemia. We present a 58-year-old man who, over six months, experienced progressive slowing in both talking and walking. Cervical duplex sonography revealed severe stenosis of the right subclavian artery; fixed retrograde flow was noted in the ...
We report a surgical strategy for repairing an interrupted aortic arch (IAA) with truncus arteriosus (TA) by using a reverse subclavian flap and an aorto-pulmonary (A-P) window technique for preserving the pulmonary artery architecture. A 10-day-old neonate with type B IAA and type I TA with echocardiographic evidence of a significant distance between the ...
A case of the right aortic arch with the left subclavian artery as its last branch was found in an 80-year-old Japanese female cadaver during the 1990 dissection for students. The main findings were as follows. The ascending aorta arose from the left ventricle and ran right and upward to the level of the intervertebral disc between the 2nd and 3rd thoracic ...
We present two rare cases of anomalous vertebral artery (VA) with retroesophageal right subclavian artery. One patient had a right VA arising from the right common carotid artery (CCA), and a left VA originating from the third branch off the aorta. Both VAs ascended anteriorly to the transverse foramen of C5 to C6 ...
Operation was carried out on 143 children (aged from 5 days to 16 years) for tracheobronchial obstruction caused by vascular rings. A double arch of the aorta was found in 50 patients, double arch of the aorta with atresia of the left arch--in 50 patients, right arch of the aorta with ligamentum arteriosum--in 30, left arch of the aorta with an aberrant right ...
A 72-year-old male presented to the emergency department with gait instability and unclear speech. Computed tomography of the brain showed old lacunar infarcts in basal ganglia. Transcranial Doppler (TCD) sonography was normal. Extracranial Duplex sonography showed indirect hemodynamic signs of bilateral subclavian artery stenosis and both vertebral ...
... Levendag. Ischemic heart disease after mantlefield irradiation for Hodgkin's disease in long-term follow-up. Radiother. Oncol 51: ... Valvular dysfunction and carotid, subclavian, and coronary artery disea...
Three case reports are reviewed to illustrate the possibility of treating irradiation-induced lesions of the subclavian-brachial vascular segment (aneurysm and segmental occlusions) 14, 20, and 26 years after radical mastectomy and subsequent radiotherapy. All patients had an extraanatomic vein bypass graft from the carotid to the brachial artery crossing ...
Open surgical rerouting and proximal ligation of one or more supra-aortic vessels prior to endovascular stent-graft placement has become an alternative to major open thoracic surgery in the treatment of complex thoracic aortic disease. Complications owing to failed surgical ligation of the left subclavian artery are rare. In this report, 3 cases of failed ...
A 41-year-old woman, status postmastectomy for breast cancer had an attempted 8-F left subclavian vein chemotherapy port placed in her. She developed severe upper back pain radiating to the left shoulder. A computed tomographic scan and angiography revealed catheter placement in the left subclavian artery and a type B aortic ...
Marfan syndrome is an autosomally inherited disorder affecting the synthesis of connective tissues. Vascular manifestations of Marfan syndrome include aneurysmal dilatation of the aortic root, aortic dissection, and rupture. Peripheral aneurysms are mostly reported in the iliac, femoral, and subclavian arteries. We report a Marfan patient with a ruptured ...
The aim of this study was to examine the changes in leukocyte adhesion and leukocyte-induced contraction in balloon-injured rabbit subclavian artery and to correlate these changes with vessel morphology and expression of adhesion molecules on the injured arteries.Rabbits were anaesthetized and their left subclavian ...
A port catheter system for hepatic artery infusion chemotherapy was implanted percutaneously via the left subclavian artery in 41 patients for treatment of unresectable liver metastases. The catheter tip was inserted into the gastroduodenal artery (GDA), the end hole was occluded with a guidewire fragment, and a ...
Locally or recurrent advanced breast cancers can receive arterial blood supply from various arteries, such as the internal thoracic artery (ITA), the lateral thoracic artery, and the other small arterial branches originating from the subclavian artery. ...
We report the first successful application of nonferromagnetic embolization coils for endovascular exclusion of a mycotic right subclavian artery aneurysm. A 58-year-old woman presented with acute cervical pain and a pulsatile mass in the right supraclavicular fossa under antibiotic medication for subacute infectious endocarditis. Diagnostic work-up ...
Flow-directed pulmonary artery catheters provide important information regarding intravascular volume status, cardiac function and vascular resistance. We describe an unusual complication of pulmonary artery catheterization in which a knot formed at the distal end was torn away from the catheter body and migrated from its original position in the right ...
Central venous catheterization is associated with a large number of complications, such as pneumothorax, hydrothorax, hemothorax, phlebothrombosis, pericardial tamponade, air embolism, aberrant placement and line sepsis. There are many case reports of the extravasation of various central venous catheter fluids, including the intravenous fluids, total parenteral nutrition and ...
A pulse wave is composed of incident and reflected waves. Since the attenuation of the reflected wave changes markedly owing to arterial stiffness, analyzing this wave is useful for evaluating an artery. In our previous study, we proposed an estimation method for the reflected wave. However, because the actual path and reflection point of the reflected ...
NASA Astrophysics Data System (ADS)
Coronary artery fistulas are rare congenital malformations that can originate from anywhere in the coronary artery system and terminate in any of the cardiac chambers, great veins or pulmonary arteries. We illustrate the unique case of a multidetector computed tomography coronary angiography scan of a young man, showing a complex ...
Aneurysms of the splenic artery are the most common splanchnic aneurysms. Aneurysms of a splenic artery with an anomalous origin from the superior mesenteric artery are however rare, with eight previously reported cases. Their indications for treatment are superposable to those of aneurysms affecting an orthotopic ...
Since its approval as an occlusive device in the peripheral vasculature in 2004, the first-generation Amplatzer Vascular Plug (AVP; AGA Medical, Golden Valley, MN, USA) has already become a therapeutic alternative to coil embolization in dedicated cases. Here, we present for the first time, a case of type II endoleak from the left subclavian artery after ...
Takayasu's arteritis is a rare form of aortic vasculitis, typically described in young Asian females. In this article, we report a unique presentation of type V Takayasu's arteritis in a Hispanic male. To the best of our knowledge, this is the first case of Takayasu's arteritis presenting with the triad of angina, amaurosis fugax, and subclavian steal syndrome. On diagnostic ...
Technically uncomplicated percutaneous angioplasty and stent placement of a left subclavian artery stenosis was performed in a 56-year-old man for treatment of subclavian steal syndrome and vertebrobasilar insufficiency. Six days later the patient was readmitted with Staphylococcus aureus bacteremia and stigmata of septic emboli ...
Although primary or metastatic nonbronchogenic tumors infrequently arise in or involve the thoracic outlet, they represent a major surgical challenge because of their tendency to encapsulate outlet structures. Fourteen patients with a histologically proven primary (n = 8) or metastatic (n = 6) nonbronchogenic outlet tumor were treated by an anterior transcervical approach, including an L-shaped ...
A previously non-operated 37-year-old patient presented with esophageal dysphagia for solid food and stridorous breathing. Computed tomography and magnetic resonance showed a 33-mm wide Kommerell's diverticulum. The diverticulum and the obliterated ductus arteriosus arising from it towards the pulmonary artery were resected. The left subclavian ...
Disturbance of the arterial circulation in the ipsilateral upper limb following mastectomy is a rare sequel attributed to adjuvant radiotherapy. A review of the literature revealed 20 such cases, and two more are presented. Different mechanisms of injury leading to arterial occlusion have been proposed. This is a late complication with a considerable time ...
Five seat-belt-related injuries occurring in four adults are reported. One injury involved the common carotid artery, two the internal carotid and two the subclavian arteries. Three of the four injured persons were asymptomatic and one had delayed-onset symptoms; none suffered stroke. There was no operative mortality or morbidity. ...
Endoleak is a frequent complication after endovascular repair of aortic rupture. We describe the case of a female patient with traumatic aortic injury, treated with endograft, who developed a type II endoleak through the left subclavian and vertebral arteries. Both arteries originated independently from the aortic arch, and were ...
Society 1281 #12;is diminished in some people suffering from diabetes or vascular diseases, the arteries branching from the celiac axis, and various branches from the subclavian, brachial, and carotid in the model are beyond the initial branching from the aorta, e.g., the branches from the celiac axis. We have
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A 12-year-old boy with ventricular septal defect and patent ductus arteriosus was presented to the operating room. Upon clamping the patent ductus arteriosus, the femoral arterial pressure curve was lost; however, it returned upon unclamping. Upon further dissection, an interrupted aortic arch was found between the left subclavian ...
Arterial prosthetic graft infection is one of the most challenging issues in vascular surgery. We report a case of an infected descending thoracic aorta endograft, presenting itself several years after placement, with hemoptysis and back pain as referred symptoms. The patient was successfully treated by removing the thoracic aorta and replacing the infected endografts with a ...
Purpose. Subclavian or innominate artery (SIA) stenosis affects up to 5% of patients referred to coronary bypass grafting; it is symptomatic in less than half of these. This study aimed to assess the Doppler ultrasonography (DU) findings in SIA obstruction and patients' follow-up after percutaneous angioplasty (PTA). Methods. The study enrolled ...
Thromboembolic obstruction of the brachiocephalic artery can have significant functional consequences because it threatens arterial circulation to the right upper limb and right cerebrum. A case is presented of a young man who sustained right basal ganglia infarct 2 mo after suffering multiple gunshot wounds to his chest. The severity of his hemiplegia ...
We describe a novel technique for cerebral embolic device placement with inadvertent entrapment and subsequent rescue in the endovascular treatment of innominate artery stenosis. A 62-year-old female presented with symptomatic right-sided subclavian steal syndrome. Single-site access for revascularization of critical innominate artery ...
Congenital heart disease is one of the most common human birth defects, yet many genes and pathways regulating heart development remain unknown. A recent study in humans revealed that mutations in a single Hox gene, HOXA1 (Athabascan Brainstem Dysgenesis Syndrome, Bosley-Salih-Alorainy Syndrome) can cause severe cardiovascular malformations, some of which are lethal without surgical intervention. ...
Traumatic injury to the great vessels may be one of the highly lethal states. In many of these cases, the lesion was confirmed at the aortic isthmus. We report a case of successful surgical treatment of the traumatic pseudoaneurysm of the brachiocephalic artery. Pre-operative 3-dimension computed tomography (CT) showed an aneurysm at the left dorsal of the ...
We describe a successful percutaneous transluminal dilatation (PTD) of an innominate artery stenosis in a 40-year-old patient with aortic arch syndrome. Five years earlier both a left central carotid artery occlusion and an innominate and left subclavian artery stenosis were treated by grafting from the aorta to ...
A subclavian artery dissection (SAD) is usually associated with coexisting aortic disease, and spontaneous SAD is extremely rare. This report presents the case of a spontaneous SAD patient who developed atypical clinical symptoms. A 41-year-old woman presented with bilateral ischemia of her lower limbs. An urgent bilateral femoral thrombo-embolectomy was ...
A balloon-expandable intraluminal graft was percutaneously deployed in the left subclavian artery of a 43-year-old woman. This graft was made of a stainless steel, 30-mm Palmaz balloon-expandable iliac stent completely covered with a thin coat of silicone. The procedure was successful in managing and preventing life-threatening hemorrhage as a large-bore ...
Left internal mammary artery (LIMA) angiography was performed with diagnostic coronary angiography in 130 cases for which the coronary findings made use of the LIMA as a bypass graft a consideration. In 98% of the cases the approach to LIMA angiography was femoral with a 5F LIMA catheter first directed into the proximal subclavian and then advanced over a ...
Purpose: To evaluate the feasibility of endoluminal stent-grafts in the treatment of acute type B aortic dissections.Methods: In five patients with acute aortic type B dissections, sealing of the primary intimal tear with an endoluminal stent-graft was attempted. Indication for treatment was aneurysm formation in two patients and persistent pain in three patients. One of the latter also had an ...
A man with an aberrant right coronary artery and haemodynamically important prolapse of the mitral valve was successfully resuscitated. The aberrant right coronary artery was thought to be a possible cause of the cardiopulmonary arrest in this patient. Both lesions were corrected at a single operation.Images
BACKGROUND: Aneurysms of the subclavian artery (SA) are rare, but they can present with devastating consequences that may lead to loss of the limb. We present a case of symptomatic posttraumatic aneurysm of the left SA in a 67-year-old woman. METHODS: A 67-year-old woman presented to our vascular unit with a history of sudden pain in her left hand, ...
Vascular injuries caused by subclavian central venous catheter (CVC) insertion can be associated with major complications. Such injuries differ in clinical presentation as well as optimal management, which ranges from observation only to surgical or endovascular repair. We report an injury to a branch of the internal mammary artery following an attempt to ...
A 61-year-old diabetic woman was referred for myocardial perfusion single photon emission computed tomographic (SPECT) imaging 4 years after coronary artery bypass grafting to the left anterior descending (LAD) artery using a left internal mammary artery (LIMA) graft. She had 3 months' angina associated with fatigue of her left upper ...
The present report describes a patient who experienced unstable angina late after coronary artery bypass surgery, in which the left internal mammary artery was grafted to the left anterior descending artery. Catheterization revealed the culprit, which was left main stem obstructive disease, a significant proximal left ...
An extensive iatrogenic aortic type B dissection during percutaneous transluminal renal angioplasty (PTRA) for bilateral renal artery stenosis was treated with a covered stent placed in the right renal artery. Control angiography confirmed closure of the entry. Postprocedural CT demonstrated a thick intramural hematoma (IMH) up to the left ...
Endovascular treatment (stenting) has evolved as an effective and safe treatment modality for symptomatic subclavian and innominate artery disease. Most of these patients have comorbid conditions associated with atherosclerotic vascular disease, which is responsible for the access site and increased difficulty of procedure. We report a case of symptomatic ...
Interrupted aortic arch is a rare congenital cardiac defect. There are extremely few cases in adults that are reported in the pertinent medical literature. However, single-stage repair of interrupted aortic arch combined with coronary artery disease has been rarely reported. We describe the management of interrupted aortic arch associated with coronary ...
Anomalous origin of the left coronary artery from the main pulmonary artery is a rare form of congenital heart disease. It carries a very poor prognosis with a mortality rate of more than 85% in the first year of life due to severe left ventricular failure. Surgical repair results in progressive improvement of left ventricular function even in patients ...
A 50-year-old woman with Marfan's syndrome was admitted for an aortic dissection with an intimal flap extending from the sinus of Valsalva to the descending aorta and aortic valve incompetence. Ultrasonography revealed a double lumen in the innominate and right common carotid (RCCA) arteries. The false lumen extended from the aortic arch to the distal RCCA and compressed and ...
We present the case of a 43-year-old patient with sensorineural hearing loss and the finding of an aberrant internal carotid artery in the left tympanic cavity that was causing pulsatile tinnitus. The aberrant vessel was initially invisible on magnetic resonance imaging (MRI) and was confirmed by high-resolution computed tomography and ...
A 59-year-old man with ALS developed dyspnea and was performed tracheostomy in September 1987. The cuff volume of a tracheostomy tube increased gradually in four years of mechanical ventilation. His chest X-ray in December 1992 showed a marked enlargement of the cuff. In March 1993, massive hemorrhage suddenly occurred through the tracheostomy site. This was controlled by hyperinflation of the ...
Results of Doppler sonographic examination of the arteries in the neck are not completely comparable to angiographical findings, because the application of the Doppler probe is not standardised and angiography does not demonstrate the exact vascular morphology. To experimentally correlate the Doppler-findings with morphology, a flow rig was constructed that generated within ...
Central venous lines have become an integral part of patient care, but they are not without complications. Vertebral artery pseudoaneurysm formation is one of the rarer complications of central line placement. Presented is a rare case of two pseudoaneurysms of the vertebral and subclavian artery after an attempted internal jugular vein ...
One hundred and fifty patients with coronary artery disease (CAD), 14 (9.3%) of whom had coexisting peripheral vascular disease, underwent bilateral internal mammary arteriography to study the incidence and extent of atherosclerosis in these vessels. Significant atherosclerosis of the internal mammary arteries (IMAs) was present in three patients (2%), of ...
Ankylosing spondylarthritis and Takayasu aorto-arteritis are two inflammatory diseases with a not yet elucidated pathogenic mechanism. Their association is quite exceptional with only a few cases (14) being published in the literature. We report a new case in a 26-year-old woman whose Takayasu disease led to stenosis of the subclavian artery and the ...
The positive early experiences with TAVI however, revealed that vascular access remains a hindrance to broader application and success of the procedure. This article will review the most common vascular routes used to deliver transcatheter aortic valves, and describe a new technique via the right axillary/subclavian artery approach. PMID:21879288
We present an extremely rare case of extralobar pulmonary sequestration in the right upper thoracic region, with a wide tracheal communication and a right subclavian arterial blood supply. The MRI scan suggested a bronchogenic cyst. Although preoperative color Doppler and angiography were not performed, successful resection was carried out. The histology ...
During the past 2 years, 3 anomalous right subclavian artery aneurysms have been encountered at the St. Louis Heart Institute. The 1st patient, a 72-year-old woman, was found to have an asymptomatic 5-cm-diameter anomalous right subclavian artery aneurysm after surgery for suspected rupture of an abdominal aortic ...
AIM--To assess morphometrically the structural changes, which occur with ageing, along the length of the vertebral artery. METHODS--A series of 36 vessels were removed at necropsy from subjects aged between 9 months and 86 years. Image analysis was used to measure the medial width, the circumference, the intimal: medial area ratio and the adventitial: medial area ratio along ...
Purpose: To evaluate the suitability of transbrachial access for endovascular renal artery interventions. Methods: During 37 consecutive endovascular renal artery interventions, the transbrachial approach was used on nine patients (mean age 63 years; range 41-76 years) for 11 renal artery procedures on native kidneys and one ...
A 49-year-old operated for aortic coartaction patient presented with thoracic and ascending aortic aneurysm. He was asymptomatic. Angio-magnetic resonance nuclear scan and angiography revealed an ascending aortic aneurysm (5.2 cm), bicuspid aortic valve, 6-cm proximal descending aortic pseudoaneurysm at the site of the previous operation with involvement of the left subclavian ...
Gestural motions of the hands and fingers are powerful tools for expressing meanings and concepts, and the nervous system has the capacity to retain multiple long-term motor memories, especially including movements of the hands. We developed many sets of successive movements of both hands, referred to as "digit anatomy," and made students practice the movements which express (1) the aortic arch, ...
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Purpose: To compare the early andlong-term outcomes of subclavian artery angioplasty in patients with aortoarteritis and atherosclerosis. Methods: Sixty-one subclavian artery angioplasties were performed in 55 consecutive patients with aortoarteritis (n= 32) and atherosclerosis (n= 23) between 1986 and 1995. An ...
There are four types of aberrant gallbladder: intrahepatic, left-sided, transverse, and retrodisplaced. Five cases of the first three types are illustrated. In three of the five patients the aberrant gallbladder produced false positive liver scans which were correctly diagnosed by hepatic angiography; in one it causes the hepatic angiogram to be ...
Face transplantation is a novel treatment for the reconstruction of massive facial defects. To date 13 cases have been performed. The technical aspects of a composite lower face transplantation including the tongue, floor of the mouth, and most of the mandible are detailed. The transplantation was performed in August 2009 in an HIV-positive, postoncologic patient. A preparatory surgery for nerve ...
A patient with radiation-induced fibrosarcoma following mastectomy and postoperative radiation for bilateral breast carcinoma is described. Only six such cases have been reported in the literature. In this patient erosion of the axillary artery produced massive hemorrhage, and emergency transthoracic ligation of the subclavian artery ...
Carotid revascularization after cervical irradiation is often made more difficult by decreased vascularity, development of fibrosis, and loss of covering tissue by previous surgery. We present three cases to illustrate alternative approaches to carotid revascularization in these circumstances. One case describes the usual direct approach to carotid endarterectomy. The second describes a saphenous ...
We describe the repair of a root, ascending aortic and arch aneurysm in a 69-year-old man with a bioprosthetic Shelhigh conduit and cylinder, employing continuous bilateral antegrade cerebral perfusion through an anomalous innominate artery with a bovine arch variant anatomy. The origin of both the innominate artery and the left common carotid ...
We report an 8-year-old boy with left vertebral artery dissection featuring cerebellar ataxia in which congenital vertebral artery hypoplasia was suspected as a predisposing factor in the dissection. The patient suddenly suffered from vertigo and vomiting while swimming, and he was brought to our department. The initial brain Computed Tomography (CT) ...
Successful reconstructive surgery with muscle flaps depends on adequate arterial supply and undisturbed venous drainage. Combining such surgery with reconstructive vascular surgery of a large-caliber vein that is responsible for the venous drainage of the flap poses an additional challenge--the repaired vein's susceptibility to thrombosis. Every attempt must be made to prevent ...
A 90-year-old woman with symptomatic degenerative aortic stenosis had a logistic Euroscore greater than 53.29%, indicating a high surgical risk. She was therefore advised to undergo transcatheter aortic valve implantation. Both iliac arteries showed subocclusive calcifications, and the left subclavian artery was narrow and calcified. ...
Purpose: To review immediate and midterm results of primary stenting for innominate and subclavian artery occlusive lesions. Methods: Retrospective data were collected from 48 consecutive symptomatic patients (27 men and 21 women, median age 64 years) having 49 subclavian and innominate artery lesions treated with ...
Aortic rupture has a high mortality rate and can be considered a medical emergency. The standard treatment for aortic rupture is surgical repair. An aortic stent graft for a ruptured descending aorta is considered an effective alternative treatment. However, an aortic stent graft is difficult when the aortic aneurysm is in the aortic arch due to supra-aortic vessels. We report on a patient with a ...
Thoracic outlet syndrome (TOS) results from compression of the neurovascular structures that pass through the thoracic outlet. TOS may be classified as neurogenic TOS (NTOS), venous TOS (VTOS), or arterial TOS (ATOS). NTOS presents with upper-extremity symptoms attributable to compression of the brachial plexus. VTOS, also known as Paget-Schr�etter Syndrome, involves ...
The aim of this study was to demonstrate an assessment of left internal mammary artery (LIMA) patency and anatomy by standard left ventriculography, and to define a proposal for predicting LIMA function according to left ventriculography outcome. A total of 335 patients with an indication of coronary angiography were included. Standard coronary angiography and left ...
Interrupted aortic arch is a rare condition, usually lethal in early infancy without treatment. The only characteristic feature on conventional non-invasive investigation is peripheral pulse inequality, which indicates ductal construction, and therefore may be absent or transient and preterminal. We report the cross-sectional echocardiographic findings in seven patients with aortic arch ...
Isolated popliteal venous entrapment is unusual and often caused by variation or aberrant origins of the gastrocnemius muscle, thickened perivenous fascia or an abnormal vascular bundle. We report a unique case of a fit and well 35-year-old man with popliteal venous entrapment after presenting to the vascular unit with symptomatic varicose veins. The cause of the entrapment ...
BACKGROUND: Alcohol septal ablation (ASA) is a therapeutic catheter-based option and an alternative to surgical myectomy in the treatment of patients with hypertrophic obstructive cardiomyopathy. Although the safety of the ASA procedure has been consistently improved, a temporary transvenous pacemaker is recommended for at least 48h postprocedure, with several drawbacks, including the risk of ...
Anomalous coronary arteries arising from the pulmonary trunk is a rare but potentially fatal condition. We report the clinical presentation, surgical treatment and long-term follow-up of seven surgical cases of anomalous left coronary and one case of anomalous right coronary artery arising from the pulmonary artery. Age ranged from 7 ...
Thoracic endovascular aortic repair (TEVAR) has emerged as a promising therapeutic alternative to conventional open aortic replacement but it requires suitable proximal and distal landing zones for stent-graft anchoring. Many aortic pathologies affect in the immediate proximity of the left subclavian artery (LSA) limiting the proximal landing zone site ...
To describe a technique for the preservation of the left common carotid artery (CCA) in zone 2 endovascular repair of thoracic aortic aneurysm. This technique involves the placement of a guide wire into the left CCA via the right brachial artery before stent graft deployment to enable precise visualization and protection of the left CCA during the whole ...
Introduction:Presented herein is a case in which an aberrant right hepatic artery (RHA) passes anterior to the infundibulum and fundus of the gallbladder and courses to an unusually anterior hepatic entry.Case Report:A 54-year-old female with a history of biliary colic was scheduled for laparoscopic cholecystectomy. Laparoscopic dissection revealed an ...
We here present the case of a rarely seen anomalous origin and retropulmonary course of the left circumflex artery from the proximal right coronary artery. The patient suffered from coronary ischemia due to stenotic lesions both in the aberrant circumflex coronary artery and in the first and second diagonal ...
A 69-year-old male underwent implantation of a cardioverter-defibrillator with cardiac resynchronization therapy (CRT) for symptomatic ventricular tachyarrhythmia (VT) and severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 30 % and dyssynchrony via a left subclavian venous access. Twenty days after the procedure, the patient complained of shortness of ...
First rib fractures occurred in 55 patients. This injury is a harbinger of major trauma with 35 patients suffering a major chest injury, and abdominal and cardiac injuries occurring in 18 and eight patients respectively. The mortality associated with this injury was high (36.3%). Neurologic lesions accounted for the majority of deaths, however, unrecognized abdominal injuries and pulmonary ...
Purpose: To describe the use of custom fenestrated endografts to preserve left subclavian artery (SCA) flow when requiring coverage during endovascular repair of blunt aortic injury (BAI). Case Report: A 39-year-old male involved in a motor vehicle accident sustained injuries including intracranial hemorrhage, BAI, and extremity fractures. Immediate ...
OBJECTIVE: To assess the incidence of ARSA and other strong markers of DS and their correlation in a large population of 2(nd) trimester DS fetuses assessed in a tertiary referral center. METHODS: Presence or absence of ARSA and other major ultrasound markers of DS was assessed in a population of 106 2(nd) trimester DS fetuses referred to our unit for expert assessment and termination of pregnancy ...
Transcranial Doppler (TCD) is well known for its usefulness in diagnosing vasospasm in patients with subarachnoid hemorrhage and vasculopathy in children with sickle cell disease. However there are some lesser known TCD studies. Bubble studies detect right to left shunts. Head rotation studies evaluate for extrinsic compression of the vertebral arteries. CO2 challenge and ...
Of the many clinical entities involving the neck region, one of the most intriguing is thoracic outlet syndrome (TOS). TOS is an array of disorders that involves injury to the neurovascular structures in the cervicobrachial region. A classification system based on etiology, symptoms, clinical presentation, and anatomy is supported by most physicians. The first type of TOS is vascular, involving ...
The re-establishment of blood flow to an ischaemic kidney produced an elevation of blood pressure in the rat. This response did not occur in animals with a pithed spinal cord or in rats with low blood pressure produced by haemorrhage. When the blood pressure was raised in rats with pithed spinal cords, by the intravenous infusion of noradrenaline, the response was restored. Occlusion of the ...
We report a case of percutaneous coronary intervention (PCI) where a 6 French (Fr) guiding catheter could not be advanced through extremely tortuous subclavian and brachiocephalic arteries with a right transradial approach. Downsizing from a 6 Fr to 5 Fr guiding catheter was effective to reach to the coronary cusp, and we successfully performed transradial ...
Transcranial Doppler sonongraphy is a non?invasive, non?ionising, inexpensive, portable and safe technique that uses a pulsed Doppler transducer for assessment of intracerebral blood flow. This article deals with the principles and technique of transcranial Doppler sonography. It gives a brief overview of its use in evaluation of intracranial steno?occlusive disease, subarachnoid haemorrhage, and ...
Tracheobronchial stents are increasingly being used for the management of compromised large airways. Traditionally they have been used to palliate malignant conditions; however, they are now being used more frequently for nonmalignant conditions. The use of Gianturco self-expanding metal stent (William Cook, Bjaeverskov, Denmark) has been challenged for treatment of tracheobroncheomalacia, as ...
