Pub Date : 2022-07-01DOI: 10.4103/ijves.ijves_7_22
K. Sivagnanam
Postimplantation syndrome following endovascular aneurysm repair (EVAR) is a known entity which presents within the 1st week of EVAR. The symptoms include fever, leukocytosis, and elevated C-reactive protein. Although the pathogenesis is unknown, it resolves within a 5 days. This case report involves elaborating on delayed onset inflammatory response in the 3rd week following EVAR when the patient developed thrombocytopenia which went as low as 55,000/μL. It resolved gradually with supportive measures and systemic steroids.
{"title":"Systemic inflammatory response and delayed thrombocytopenia following endovascular aneurysm repair for abdominal aortic aneurysm","authors":"K. Sivagnanam","doi":"10.4103/ijves.ijves_7_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_7_22","url":null,"abstract":"Postimplantation syndrome following endovascular aneurysm repair (EVAR) is a known entity which presents within the 1st week of EVAR. The symptoms include fever, leukocytosis, and elevated C-reactive protein. Although the pathogenesis is unknown, it resolves within a 5 days. This case report involves elaborating on delayed onset inflammatory response in the 3rd week following EVAR when the patient developed thrombocytopenia which went as low as 55,000/μL. It resolved gradually with supportive measures and systemic steroids.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47747801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.4103/ijves.ijves_47_22
R. Agarwal, Viswanath Atreyapurapu, Pritee Sharma, Vamsikrishna Yerramsetty, Chainulu Saripalli, K. Reddy, G. Atturu, P. Gupta
Introduction: A surge in the number of patients with acute limb ischemia (ALI) was seen during the first and second waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. This has been ascribed to the hypercoagulable state seen in COVID infections. The aim of this study is to report our experience and outcomes of ALI associated with SARS-CoV-2 infection. Materials and Methods: It was a single-center observational retrospective study from a prospectively maintained database of patients with SARS-CoV-2 infection presenting with ALI between July 2020 and December 2020 with 1-year follow-up. Results: Thirty-nine acutely ischemic limbs were treated in 32 patients including three upper limbs. The mean age of patients was 55.75 (range: 27–80). There were 23 (71.87%) males and 9 (28.12%) females. Majority of the limbs were in Class IIB of ALI, whereas 20.51% had irreversible ischemia. Of the 39 affected limbs in 32 patients, 22 limbs were revascularized, 9 had primary amputation, and 8 were managed conservatively with anticoagulation. The overall limb salvage was 26 out of 39 limbs (66.7%), whereas it was 81.8% for the limbs that had an intervention. The overall mortality was 9.4%. There was no further limb loss or mortality during 1-year follow-up. Interestingly, 15 patients did not have any symptoms suggestive of SARS-CoV-2 infection other than ALI. The severity of COVID infection did not correlate with the severity of ALI. Conclusion: COVID-19 infection can be associated with arterial thrombosis and ALI, which, if treated early with appropriate intervention, can result in a satisfactory limb salvage rate. Prophylactic anticoagulation in COVID-19-infected patients may not prevent arterial thrombosis, and the clinical severity of the COVID-19 infection is not a predictor of arterial thrombosis.
{"title":"COVID-19 and clotting: A wave of acute limb ischemia","authors":"R. Agarwal, Viswanath Atreyapurapu, Pritee Sharma, Vamsikrishna Yerramsetty, Chainulu Saripalli, K. Reddy, G. Atturu, P. Gupta","doi":"10.4103/ijves.ijves_47_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_47_22","url":null,"abstract":"Introduction: A surge in the number of patients with acute limb ischemia (ALI) was seen during the first and second waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. This has been ascribed to the hypercoagulable state seen in COVID infections. The aim of this study is to report our experience and outcomes of ALI associated with SARS-CoV-2 infection. Materials and Methods: It was a single-center observational retrospective study from a prospectively maintained database of patients with SARS-CoV-2 infection presenting with ALI between July 2020 and December 2020 with 1-year follow-up. Results: Thirty-nine acutely ischemic limbs were treated in 32 patients including three upper limbs. The mean age of patients was 55.75 (range: 27–80). There were 23 (71.87%) males and 9 (28.12%) females. Majority of the limbs were in Class IIB of ALI, whereas 20.51% had irreversible ischemia. Of the 39 affected limbs in 32 patients, 22 limbs were revascularized, 9 had primary amputation, and 8 were managed conservatively with anticoagulation. The overall limb salvage was 26 out of 39 limbs (66.7%), whereas it was 81.8% for the limbs that had an intervention. The overall mortality was 9.4%. There was no further limb loss or mortality during 1-year follow-up. Interestingly, 15 patients did not have any symptoms suggestive of SARS-CoV-2 infection other than ALI. The severity of COVID infection did not correlate with the severity of ALI. Conclusion: COVID-19 infection can be associated with arterial thrombosis and ALI, which, if treated early with appropriate intervention, can result in a satisfactory limb salvage rate. Prophylactic anticoagulation in COVID-19-infected patients may not prevent arterial thrombosis, and the clinical severity of the COVID-19 infection is not a predictor of arterial thrombosis.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70769026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.4103/ijves.ijves_135_21
S. Alim, A. Ammar, Mayank Yadav, Syed Rabbani, S. Chawla, A. Shama, M. Haseen
Subclavian artery thrombosis is a relatively rare and unheard complication postmodified radical mastectomy (MRM) surgery and it is still not reported in the literature. We report a case of a 55-year-old female who underwent MRM for Stage II left ductal carcinoma of breast with level 2 lymph node involvement in a private hospital. She developed ischemic pain in the left upper limb on postoperative day 3. She came to JNMCH and was referred to us and initial imaging with computed tomography angiography revealed occlusion from the origin of the subclavian to axillary artery. We discuss the management of the aforementioned condition in our setup and would also discuss the steps needed to avoid the same in the future.
{"title":"Subclavian artery thrombosis post modified radical mastectomy surgery - A rare case report","authors":"S. Alim, A. Ammar, Mayank Yadav, Syed Rabbani, S. Chawla, A. Shama, M. Haseen","doi":"10.4103/ijves.ijves_135_21","DOIUrl":"https://doi.org/10.4103/ijves.ijves_135_21","url":null,"abstract":"Subclavian artery thrombosis is a relatively rare and unheard complication postmodified radical mastectomy (MRM) surgery and it is still not reported in the literature. We report a case of a 55-year-old female who underwent MRM for Stage II left ductal carcinoma of breast with level 2 lymph node involvement in a private hospital. She developed ischemic pain in the left upper limb on postoperative day 3. She came to JNMCH and was referred to us and initial imaging with computed tomography angiography revealed occlusion from the origin of the subclavian to axillary artery. We discuss the management of the aforementioned condition in our setup and would also discuss the steps needed to avoid the same in the future.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44775189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.4103/ijves.ijves_8_22
Animesh Singla, V. Cook, Krishna Kotecha, W. Mohabbat
This article provides a case and reviews the considerations involved in acute endovascular stent for penetrating aortic ulcers (PAU)/intramural hematoma (IMH). This case aims to highlight the decision-making and considerations in the acute endovascular management of a patient presenting with PAU and associated IMH. The literature was reviewed including Google Scholar, PubMed, and Embase. Acute aortic syndrome encompasses a spectrum of aortic disease ranging from aortic dissection to PAU and IMH. Whilst classical aortic dissection has been well studied, the PAU/IMH subset of this population is exceedingly rare. Only a handful of case reports have reported on technical considerations for repair. Despite limited natural history data, growing evidence suggests a more aggressive stance is warranted to prevent progression to rupture and late aortic-related mortality. This pathology poses unique challenges in anatomical and technical considerations of repair.
{"title":"A wolf in wolf's clothing? The complexities of decision involved with acute thoracic endovascular aortic intervention for penetrating aortic ulcer and intramural hematoma","authors":"Animesh Singla, V. Cook, Krishna Kotecha, W. Mohabbat","doi":"10.4103/ijves.ijves_8_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_8_22","url":null,"abstract":"This article provides a case and reviews the considerations involved in acute endovascular stent for penetrating aortic ulcers (PAU)/intramural hematoma (IMH). This case aims to highlight the decision-making and considerations in the acute endovascular management of a patient presenting with PAU and associated IMH. The literature was reviewed including Google Scholar, PubMed, and Embase. Acute aortic syndrome encompasses a spectrum of aortic disease ranging from aortic dissection to PAU and IMH. Whilst classical aortic dissection has been well studied, the PAU/IMH subset of this population is exceedingly rare. Only a handful of case reports have reported on technical considerations for repair. Despite limited natural history data, growing evidence suggests a more aggressive stance is warranted to prevent progression to rupture and late aortic-related mortality. This pathology poses unique challenges in anatomical and technical considerations of repair.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49554749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.4103/ijves.ijves_4_22
Devender Singh, S. Aryala
Vascular injuries due to kite string are uncommon but are associated with significant morbidities and mortality. We report a case of 45 years female sustaining kite string injury to her ankle resulting in neurovascular injuries and total transection of the tendoachilles. The aim of the article is to highlight this rare injury, its mechanism and the importance of awareness which can prevent this to a large extent.
{"title":"Kite string injury: An unusual cause of extensive ankle trauma with vascular injury","authors":"Devender Singh, S. Aryala","doi":"10.4103/ijves.ijves_4_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_4_22","url":null,"abstract":"Vascular injuries due to kite string are uncommon but are associated with significant morbidities and mortality. We report a case of 45 years female sustaining kite string injury to her ankle resulting in neurovascular injuries and total transection of the tendoachilles. The aim of the article is to highlight this rare injury, its mechanism and the importance of awareness which can prevent this to a large extent.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47539012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.4103/ijves.ijves_95_22
S. Rajendran, S. Natarajan
{"title":"Vascular awareness in India: What more needs to be done","authors":"S. Rajendran, S. Natarajan","doi":"10.4103/ijves.ijves_95_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_95_22","url":null,"abstract":"","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48425465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.4103/ijves.ijves_20_22
A. Dabas, Anand Katiyar, Sachin Srivastava, A. Chadha, R. Janardhanapillai, K. Bhat, D. Chadha
Introduction: Diagnostic and therapeutic interventions can lead to iatrogenic vascular injuries (IVIs). The spectrum of IVIs, their management, and outcomes is presented. Materials and Methods: This prospective observational study from January 2016 to December 2020, included all successive IVIs managed by the vascular surgery department. IVI was defined as vascular injury manifesting as hemorrhage/vessel occlusion/and/or retained foreign body in vasculature. Those due to trauma and/or <30 days follow-up were excluded. Reasons for IVI, presentation, vessels involved, and outcomes were analyzed. Results: Thirty-eight IVIs were analyzed. Age ranged from 3 days to 77 years. Sixteen were due to cardiology, seven due to orthopedics, four cases in end-stage kidney patients, 4 cases due to invasive arterial monitoring, and two following cardiac surgery. One case each was following laparoscopy, spine surgery, thrombectomy, endovascular aneurysm repair, and umbilical catheterization. Manifestations were limb ischemia (lower limb-13, upper limb-6), pseudoaneurysms-10, retained foreign body-4 (superior vena cava and/or right atrium-3; external iliac artery-1), hemorrhage-2, arterio-venous fistula-2, and compartment syndrome-1. Common femoral artery (with/without superficial femoral artery) was affected in 13, forearm arteries in 8, popliteal artery and crural arteries in three each, and one case, each of profunda femoris, carotid artery, external iliac artery branch, and thoracic aorta. IVIs were managed by thrombectomy in 13, arterial repair in 11, endovascular procedures in 5, bypass in 4, conservative in 3, and by laparotomy and open retrieval of a balloon in one case each. Four developed surgical site infections, three died, three suffered amputations, three had motor deficits, and two developed acute kidney injury. Conclusion: IVIs have heterogeneous presentation. Both open and endovascular skill sets are required for management. IVIs carry high morbidity and mortality.
{"title":"A single-center 5-year experience of iatrogenic vascular injuries and their outcomes","authors":"A. Dabas, Anand Katiyar, Sachin Srivastava, A. Chadha, R. Janardhanapillai, K. Bhat, D. Chadha","doi":"10.4103/ijves.ijves_20_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_20_22","url":null,"abstract":"Introduction: Diagnostic and therapeutic interventions can lead to iatrogenic vascular injuries (IVIs). The spectrum of IVIs, their management, and outcomes is presented. Materials and Methods: This prospective observational study from January 2016 to December 2020, included all successive IVIs managed by the vascular surgery department. IVI was defined as vascular injury manifesting as hemorrhage/vessel occlusion/and/or retained foreign body in vasculature. Those due to trauma and/or <30 days follow-up were excluded. Reasons for IVI, presentation, vessels involved, and outcomes were analyzed. Results: Thirty-eight IVIs were analyzed. Age ranged from 3 days to 77 years. Sixteen were due to cardiology, seven due to orthopedics, four cases in end-stage kidney patients, 4 cases due to invasive arterial monitoring, and two following cardiac surgery. One case each was following laparoscopy, spine surgery, thrombectomy, endovascular aneurysm repair, and umbilical catheterization. Manifestations were limb ischemia (lower limb-13, upper limb-6), pseudoaneurysms-10, retained foreign body-4 (superior vena cava and/or right atrium-3; external iliac artery-1), hemorrhage-2, arterio-venous fistula-2, and compartment syndrome-1. Common femoral artery (with/without superficial femoral artery) was affected in 13, forearm arteries in 8, popliteal artery and crural arteries in three each, and one case, each of profunda femoris, carotid artery, external iliac artery branch, and thoracic aorta. IVIs were managed by thrombectomy in 13, arterial repair in 11, endovascular procedures in 5, bypass in 4, conservative in 3, and by laparotomy and open retrieval of a balloon in one case each. Four developed surgical site infections, three died, three suffered amputations, three had motor deficits, and two developed acute kidney injury. Conclusion: IVIs have heterogeneous presentation. Both open and endovascular skill sets are required for management. IVIs carry high morbidity and mortality.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45771896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.4103/ijves.ijves_10_22
K. Sivagnanam
This case report highlights our experience in managing two cases of acute lower limb ischemia with simultaneous acute coronary events. One patient was detected with acute ST-elevation myocardial infarction while being evaluated for acute lower limb ischemia and another patient had NSTEMI with acute left ventricular failure and delayed presentation of acute lower limb ischemia. Both had good outcomes.
{"title":"Perioperative management of a double hit - Acute limb ischemia in a patient with acute myocardial infarction","authors":"K. Sivagnanam","doi":"10.4103/ijves.ijves_10_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_10_22","url":null,"abstract":"This case report highlights our experience in managing two cases of acute lower limb ischemia with simultaneous acute coronary events. One patient was detected with acute ST-elevation myocardial infarction while being evaluated for acute lower limb ischemia and another patient had NSTEMI with acute left ventricular failure and delayed presentation of acute lower limb ischemia. Both had good outcomes.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49001664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.4103/ijves.ijves_46_22
M. Ayyappan, J. Sebastian
{"title":"Vein valves – From discovery to repair to bioprosthesis","authors":"M. Ayyappan, J. Sebastian","doi":"10.4103/ijves.ijves_46_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_46_22","url":null,"abstract":"","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45832297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.4103/ijves.ijves_2_22
Neelamjingbha Sun, A. Pandey, Sriram Manchikanti, Shivanesan Pitchai
Renal artery aneurysm is a rare disorder with an incidence of < 1%. We describe a case of fibromuscular dysplasia with right renal artery branch aneurysm, who had uncontrolled renovascular hypertension. The patient was successfully managed with ex vivo repair and reconstruction of the renal artery using reverse saphenous vein graft, followed by autotransplantation of the right kidney. Although surgically demanding, the technique is feasible and yielded good results.
{"title":"Ex vivo Repair of renal artery branch aneurysm in fibromuscular dysplasia","authors":"Neelamjingbha Sun, A. Pandey, Sriram Manchikanti, Shivanesan Pitchai","doi":"10.4103/ijves.ijves_2_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_2_22","url":null,"abstract":"Renal artery aneurysm is a rare disorder with an incidence of < 1%. We describe a case of fibromuscular dysplasia with right renal artery branch aneurysm, who had uncontrolled renovascular hypertension. The patient was successfully managed with ex vivo repair and reconstruction of the renal artery using reverse saphenous vein graft, followed by autotransplantation of the right kidney. Although surgically demanding, the technique is feasible and yielded good results.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46068993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：