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Hypertension, Acute Stent Thrombosis, and Paraplegia 6  Months after Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury in a 22-Year-Old Patient
Thoracic endovascular aortic repair (TEVAR) is a less invasive option for managing traumatic injuries of the descending aorta in polytraumatized patients. Concerns arise when treating young patients with TEVAR. A 22-year-old male was admitted to the emergency department following a high-impact road traffic collision. Whole-body computed tomography (CT) scan documented multiple injuries, including rupture of descending thoracic aorta just below the isthmus. There was no evidence of paraplegia or stroke.
Source: Annals of Vascular Surgery - September 8, 2017 Category: Surgery Authors: Ombretta Martinelli, Federico Faccenna, Alban Malaj, Jihad Jabbour, Salvatore Venosi, Roberto Gattuso, Bruno Gossetti, Luigi Irace Tags: Case Report Source Type: research

Acute facial necrosis due to an extensive carotid thrombosis
The face is richly vascularized by arteries which develop multiple anastomoses between their terminal branches, and most these arteries originate from the external carotid artery.1 Facial necrosis due to an extensive carotid thrombosis was never described in the literature. We observed the case of a 62 years old man who presented an extensive facial necrosis due to carotid thrombosis. Angio-CT confirmed the diagnosis and the patient died following a massive stroke with cerebral engagement. His only risk factor was a massive tobacco addiction (40 pack-years).
Source: Annals of Vascular Surgery - May 4, 2017 Category: Surgery Authors: Mohamed Zoulati, Tarik Bakkali, Nabil Aghoutane, Youssef Lyazidi, Hassan Chtata, Mustapha Taberkant Source Type: research

The Influence of Collagen Impregnation of a Knitted Dacron Patch Used in Carotid Endarterectomy
In selected populations, carotid endarterectomy (CEA) reduces long-term stroke risk. Studies have shown increased risk of restenosis with use of a collagen-impregnated Dacron patch compared to a PTFE patch. There is concern that collagen-impregnation may initiate thrombosis or promote restenosis due to platelet activation. We performed a retrospective analysis of our CEA experience with routine patching using knitted Dacron patches with (Hemashield) and without (Sauvage) collagen-impregnation.
Source: Annals of Vascular Surgery - September 21, 2016 Category: Surgery Authors: Daisy Chou, Allan Tulloch, David Cossman, J. Louis Cohen, Rajeev Rao, Galinos Barmparas, James Mirocha, Willis Wagner Source Type: research

The Influence of Collagen Impregnation of a Knitted Dacron Patch Routinely Used in Carotid Endarterectomy
In selected populations, carotid endarterectomy (CEA) reduces long-term stroke risk. Studies have shown increased risk of restenosis with use of a collagen-impregnated Dacron patch compared to a PTFE patch. There is concern that collagen-impregnation may initiate thrombosis or increase restenosis due to platelet activation. We performed a retrospective analysis of our CEA experience with routine patching using knitted Dacron patches with (Hemashield) and without (Sauvage) collagen-impregnation.
Source: Annals of Vascular Surgery - June 30, 2016 Category: Surgery Authors: Daisy Chou, Allan Tulloch, David Cossman, J. Louis Cohen, Rajeev Rao, James Mirocha, Willis Wagner Source Type: research

Stroke from an External Carotid: Lesion Pattern and Mechanisms
Traditionally, patients with symptomatic external carotid stenosis present with neck or face pain, retinal ischaemic symptoms or jaw claudication. and rarely as ipsilateral cerebrovascular events. In this present case, our patient suffered a stroke from a paradoxical embolism from the external carotid, without involvement of the internal carotid artery. A plaque ulceration of the external carotid’s origin was the cause of this cerebral emboli. Duplex ultrasound showed a pathological left external carotid, with a floating thrombus in the internal carotid.
Source: Annals of Vascular Surgery - January 20, 2016 Category: Surgery Authors: Kagan Nicolas, Lathelyse Hubert, Leclere Franck Marie, Marchand Etienne, Martinez Robert Source Type: research

Inadvertent Arterial Placement of Central Venous Catheters: Diagnostic and Therapeutic Strategies
Central venous catheterization (CVC) is among the most ubiquitous medical procedures. Inadvertent arterial placement of the catheter presents a challenging dilemma to the interventionalist. Treatment options include: removal and manual compression, off-label use of percutaneous closure devices and/or stent grafts, and open surgical removal. Potential sequelae include bleeding, thrombosis, stroke, limb ischemia, neurologic deficit, and death. Our aim is to evaluate the use of open and endovascular techniques for the management of iatrogenic carotid, subclavian, and brachiocephalic arterial injuries related to inadvertent ar...
Source: Annals of Vascular Surgery - August 6, 2015 Category: Surgery Authors: Dustin Y. Yoon, Suman Annambhotla, Scott A. Resnick, Mark K. Eskandari, Heron E. Rodriguez Source Type: research

Case report: Intraluminal thrombus attached to the lesser curvature of the aortic arch and cerebral ischemic stroke after its surgical removal
Some cases of thrombi at the ascending and descending aorta have been reported, but there are only a few reports of intraluminal aortic arch thrombi. Most intraluminal thrombi are associated with atherosclerotic lesions at the aortic wall. Here we report a case of an intraluminal thrombus attached to the lesser curvature of the aortic arch. The thrombus was successfully and completely excised, and the pathological study suggested no obvious atherosclerotic changes in the aortic wall. Two months after surgical removal of the thrombus, the patient suffered a severe cerebral ischemic stroke caused by a newly formed thromboemb...
Source: Annals of Vascular Surgery - March 11, 2015 Category: Surgery Authors: Qiang Fu, Liang Zhang, Bo Wei, Xinjin Luo, Yuetang Wang, Diancai Zhao, Yang Sun, Cuntao Yu Source Type: research

Intraluminal Thrombus Attached to the Lesser Curvature of the Aortic Arch and Cerebral Ischemic Stroke after Its Surgical Removal
Some cases of thrombi at the ascending and descending aorta have been reported, but there are only a few reports of intraluminal aortic arch thrombi. Most intraluminal thrombi are associated with atherosclerotic lesions at the aortic wall. Here, we report a case of an intraluminal thrombus attached to the lesser curvature of the aortic arch. The thrombus was successfully and completely excised, and the pathologic study suggested no obvious atherosclerotic changes in the aortic wall. Two months after surgical removal of the thrombus, the patient suffered a severe cerebral ischemic stroke caused by a newly formed thromboembo...
Source: Annals of Vascular Surgery - March 11, 2015 Category: Surgery Authors: Qiang Fu, Liang Zhang, Bo Wei, Xinjin Luo, Yuetang Wang, Diancai Zhao, Yang Sun, Cuntao Yu Tags: Case Report Source Type: research

CT Perfusion Imaging in the Selection of Acute Stroke Patients to Undergo Emergent Carotid Endarterectomy
Severe acute stroke patients with critical carotid stenosis or occlusion without intracranial thrombus typically do not undergo emergent carotid thromboendarterectomy (CEA) because of the risk of reperfusion-related intracranial hemorrhage. Past studies have not consistently demonstrated benefit of early operative intervention. Cerebral computed tomography (CT), cervical and cerebral CT angiography (CTA), and cerebral CT perfusion (CTP) imaging may identify a subset of acute stroke patients without intracranial thrombus who may benefit from emergent CEA.
Source: Annals of Vascular Surgery - September 3, 2014 Category: Surgery Authors: Thomas G. Devlin, Sachin V. Phade, R. Kent Hutson, Mark W. Fugate, G. Ralston Major, Gregory W. Albers, Abdelazim A. Sirelkhatim, Biggya L. Sapkota, Steven D. Quartfordt, Blaise W. Baxter Source Type: research

Computed Tomography Perfusion Imaging in the Selection of Acute Stroke Patients to Undergo Emergent Carotid Endarterectomy
Severe acute stroke patients with critical carotid stenosis or occlusion without intracranial thrombus typically do not undergo emergent carotid thromboendarterectomy (CEA) because of the risk of reperfusion-related intracranial hemorrhage. Past studies have not consistently demonstrated benefit of early operative intervention. Cerebral computed tomography (CT), cervical and cerebral CT angiography (CTA), and cerebral CT perfusion (CTP) imaging may identify a subset of acute stroke patients without intracranial thrombus who may benefit from emergent CEA.
Source: Annals of Vascular Surgery - September 3, 2014 Category: Surgery Authors: Thomas G. Devlin, Sachin V. Phade, Rodney K. Hutson, Mark W. Fugate, Grant R. Major, Gregory W. Albers, Abdelazim A. Sirelkhatim, Biggya L. Sapkota, Steven D. Quartfordt, Blaise W. Baxter Tags: Case Report Source Type: research

Minimal Thoracotomy Thoracic Bifemoral Bypass in the Endovascular Era
Conclusions: Mini-TBF bypass provides another alternative to successfully revascularize Trans-Atlantic Inter-Society Consensus II type D lesions in patients with prior abdominal revascularization, pelvic anatomy with a critical IMA, or calcification/thrombus of the infrarenal/juxtarenal aorta precludes control.
Source: Annals of Vascular Surgery - April 3, 2014 Category: Surgery Authors: Amy E. Reppert, Omid Jazaeri, Ashok Babu, Joshua I. Greenberg, Erica Deluka, Mark R. Nehler, Thomas B. Reece Tags: Clinical Research Source Type: research

Subclavian Stump Syndrome Causing a Posterior Circulation Stroke after Thoracic Endovascular Aneurysm Repair (TEVAR) with Adjunctive Carotid to Subclavian Bypass and Endovascular Embolization of the Left Subclavian Artery
Conclusions: Consideration should be given to ligating the subclavian artery immediately proximal to the vertebral artery origin when performing adjunctive carotid subclavian bypass during TEVAR. If this is not done, surveillance computed tomography scans should monitor for the development of propagating thrombus in the subclavian stump.
Source: Annals of Vascular Surgery - February 6, 2014 Category: Surgery Authors: Ritesh Patel, Carl Muthu, Kwat Huat Goh Tags: Case Report Abstracts Source Type: research

Aortoiliac Occlusive Disease Presenting as Sudden Onset Paraplegia
Thromboembolism and atherosclerotic stenosis both can cause arterial occlusion. Aortoiliac occlusive disease involving bifurcation of the aortoiliac artery induces symptoms of ischemia such as claudication and pain of buttocks and thighs, decreased bilateral femoral pulses, and impotence. Here, we describe a 58-year-old woman with a past history of atrial fibrillation and lacuna stroke with minimal right side weakness. She presented to our emergency department with sudden onset bilateral pain in the legs and paraplegia. A comprehensive examination revealed paresthesia and decreasing bilateral distal pulses. Computed tomogr...
Source: Annals of Vascular Surgery - February 6, 2014 Category: Surgery Authors: Chien-Hung Lai, Cheng-Hsien Wang, Shih-Yun Wu, Hong-Mo Shih Tags: Case Report Abstracts Source Type: research

Finding a Needle in the Common Carotid Artery 3 Years after Ingestion
A woman presented with an ischemic stroke involving the right middle cerebral artery. Investigations revealed a foreign body in the cervical area. It was identified as a metal needle, perforating the posterior pharyngeal wall and migrating into the right common carotid artery (CCA). Three years previously, this patient had complained of odynophagia, brought on by needle ingestion. Three days before her stroke, she had hematemesis, caused by migration of the needle into the CCA. The stroke was caused by migration of the thrombus. This type of event is rarely encountered in Europe. Early recognition could avoid dangerous vascular complications.
Source: Annals of Vascular Surgery - January 21, 2014 Category: Surgery Authors: Marie Gaudin, Geoffroy Couchet, Caroline Carrieres, Jean-Pierre Ribal, Eugenio Rosset Tags: Case Report Abstracts Source Type: research

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