Patients with cancer have a high risk of developing cancer-associated thrombosis (CAT). Current guidelines suggest preferential use of low molecular weight heparins (LMWH) in CAT. The real-world data show that compliance with recommended LMWH therapy in cancer patients is low. Many patients discontinue injectable anticoagulants prematurely, in some cases even after a month, despite a high recurrence rate in this population. In recent years an increasing number of cancer patients are treated with direct oral anticoagulants, mainly rivaroxaban. Recent data confirming the safety and efficacy of rivaroxaban are starting to emerge and support the growing trend of using direct oral anticoagulants in cancer patients. If positive results of the recently completed SELECT-D trial are confirmed in the upcoming trials and registries of CALLISTO project, the guidelines for the treatment of CAT will have to be revised in favour of DOAC use in cancer-associated thrombosis.
{"title":"Current evidence of rivaroxaban in cancer-associated thrombosis","authors":"Grzegorz Halena, A. Kulik","doi":"10.5603/AA.2018.0018","DOIUrl":"https://doi.org/10.5603/AA.2018.0018","url":null,"abstract":"Patients with cancer have a high risk of developing cancer-associated thrombosis (CAT). Current guidelines suggest preferential use of low molecular weight heparins (LMWH) in CAT. The real-world data show that compliance with recommended LMWH therapy in cancer patients is low. Many patients discontinue injectable anticoagulants prematurely, in some cases even after a month, despite a high recurrence rate in this population. In recent years an increasing number of cancer patients are treated with direct oral anticoagulants, mainly rivaroxaban. Recent data confirming the safety and efficacy of rivaroxaban are starting to emerge and support the growing trend of using direct oral anticoagulants in cancer patients. If positive results of the recently completed SELECT-D trial are confirmed in the upcoming trials and registries of CALLISTO project, the guidelines for the treatment of CAT will have to be revised in favour of DOAC use in cancer-associated thrombosis.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45233650","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}
Introduction. Phlegmon is a disease which causes purulent inflammation of the subcutaneous tissue, being of unlimited character. This disease does not only affect the external coverings of the body; it may also be transmitted to the internal organs, and lead to their insufficiency. Case report. The study presents the results of the physical therapy applied to phlegmon located in the right shank and foot of a 57-year old patient with type 2 diabetes after an ineffective typical symptomatic treatment. A local hyperbaric oxygen therapy has been used in this treatment which utilizes the therapeutic effect of gases with high oxygen content close to 100%,exceeding the pressure of one atmosphere. Results. After completion of the 4-month therapy complete regression of pain symptoms was achieved assessed accordingly to the VAS scale, as well as the complete healing of wounds, reduction of the inflammatory reaction and skin congestion, thanks to which the amputation of the limb turned out not to be necessary. The thermographic assessment performed after the completion of the treatment confirmed normalization of the previously reduced temperature of tissues in the area of healed wounds. Conclusions. The obtained initial results indicate that the therapy with the use of the local hyperbaric oxygen therapy may constitute a useful adjunctive method for treatment of patients whose wounds are hard to heal, including wounds with inflammatory origin.
{"title":"Evaluation of the healing progress of phlegmon related to type 2 diabetes treated with the local hyperbaric oxygen therapy","authors":"J. Pasek, G. Cieślar, A. Sieroń","doi":"10.5603/AA.2018.0017","DOIUrl":"https://doi.org/10.5603/AA.2018.0017","url":null,"abstract":"Introduction. Phlegmon is a disease which causes purulent inflammation of the subcutaneous tissue, being of unlimited character. This disease does not only affect the external coverings of the body; it may also be transmitted to the internal organs, and lead to their insufficiency. Case report. The study presents the results of the physical therapy applied to phlegmon located in the right shank and foot of a 57-year old patient with type 2 diabetes after an ineffective typical symptomatic treatment. A local hyperbaric oxygen therapy has been used in this treatment which utilizes the therapeutic effect of gases with high oxygen content close to 100%,exceeding the pressure of one atmosphere. Results. After completion of the 4-month therapy complete regression of pain symptoms was achieved assessed accordingly to the VAS scale, as well as the complete healing of wounds, reduction of the inflammatory reaction and skin congestion, thanks to which the amputation of the limb turned out not to be necessary. The thermographic assessment performed after the completion of the treatment confirmed normalization of the previously reduced temperature of tissues in the area of healed wounds. Conclusions. The obtained initial results indicate that the therapy with the use of the local hyperbaric oxygen therapy may constitute a useful adjunctive method for treatment of patients whose wounds are hard to heal, including wounds with inflammatory origin.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48381057","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}
Amro Alsharabi, T. Jakimowicz, P. Hammer, S. Nazarewski
Takayasu Arteritis (TA) is a granulomatous inflammation of unknown aetiology affecting the aorta and its major branches with usual affliction among patients younger than 50 years and rarely among children. We present a 7-years old boy referred for evaluation of hypertension. He had a significant blood pressure difference between right arm, left arm and lower limbs. Computed tomography imaging of thorax and abdomen showed stenosis of left subclavian artery, left renal artery and juxtarenal aorta which was subsequently confirmed on aortogram. He underwent percutaneous endovascular therapy with aorto-renal bifurcation stenting with reduction of blood pressure and gradient. Renal angioplasty with stenting remains a challenging procedure in patients with tight ostial lesion, and juxtarenal aortic involvement in lieu of precise stent placement and avoiding side branch occlusion.
{"title":"Aorto-renal bifurcation stenting in a juvenile non-specific aorto-arteritis: case report","authors":"Amro Alsharabi, T. Jakimowicz, P. Hammer, S. Nazarewski","doi":"10.5603/AA.2018.0004","DOIUrl":"https://doi.org/10.5603/AA.2018.0004","url":null,"abstract":"Takayasu Arteritis (TA) is a granulomatous inflammation of unknown aetiology affecting the aorta and its major branches with usual affliction among patients younger than 50 years and rarely among children. We present a 7-years old boy referred for evaluation of hypertension. He had a significant blood pressure difference between right arm, left arm and lower limbs. Computed tomography imaging of thorax and abdomen showed stenosis of left subclavian artery, left renal artery and juxtarenal aorta which was subsequently confirmed on aortogram. He underwent percutaneous endovascular therapy with aorto-renal bifurcation stenting with reduction of blood pressure and gradient. Renal angioplasty with stenting remains a challenging procedure in patients with tight ostial lesion, and juxtarenal aortic involvement in lieu of precise stent placement and avoiding side branch occlusion.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"24 1","pages":"18-24"},"PeriodicalIF":0.2,"publicationDate":"2018-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45664109","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}
Agata Dżeljilji, J. Chorostowska-Wynimko, D. Szewczyk, Wojciech Popiołek, Artur Kierach, P. Andziak
Alpha-1-antitrypsin is a potent antiprotease playing an important role in maintaining protease-antiprotease balance. It protects the structures of extracellular matrix against destruction by proteolytic enzymes. Loss of elasticity occurs when increased protease activity is accompanied by qualitative impairment or reduced concentrations of antiproteases. Alpha-1-antitrypsin deficiency is a risk factor for obstructive lung disease, including emphysema, liver and kidney disorders and, less often, follicular panniculitis, granulomatosis with polyangiitis (previously Wegener’s granulomatosis). Literature also emphasises the role of AAT in the development of aortic aneurysms, and results of biochemical studies support this theory. Aortic aneurysm is an important clinical problem, unceasingly associated with high mortality. For this reason, it is exceptionally important to identify its risk factors. Studies on the relationship between AAT and development of AAA (abdominal aortic aneurysm) have been conducted since the 1990s. Due to the development in molecular diagnostic techniques, new reports on the topic appeared over the last decade.
{"title":"The role of alpha-1-antitrypsin protein in the pathogenesis of abdominal aortic aneurysm","authors":"Agata Dżeljilji, J. Chorostowska-Wynimko, D. Szewczyk, Wojciech Popiołek, Artur Kierach, P. Andziak","doi":"10.5603/AA.2018.0006","DOIUrl":"https://doi.org/10.5603/AA.2018.0006","url":null,"abstract":"Alpha-1-antitrypsin is a potent antiprotease playing an important role in maintaining protease-antiprotease balance. It protects the structures of extracellular matrix against destruction by proteolytic enzymes. Loss of elasticity occurs when increased protease activity is accompanied by qualitative impairment or reduced concentrations of antiproteases. Alpha-1-antitrypsin deficiency is a risk factor for obstructive lung disease, including emphysema, liver and kidney disorders and, less often, follicular panniculitis, granulomatosis with polyangiitis (previously Wegener’s granulomatosis). Literature also emphasises the role of AAT in the development of aortic aneurysms, and results of biochemical studies support this theory. Aortic aneurysm is an important clinical problem, unceasingly associated with high mortality. For this reason, it is exceptionally important to identify its risk factors. Studies on the relationship between AAT and development of AAA (abdominal aortic aneurysm) have been conducted since the 1990s. Due to the development in molecular diagnostic techniques, new reports on the topic appeared over the last decade.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"24 1","pages":"30-33"},"PeriodicalIF":0.2,"publicationDate":"2018-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48980874","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}
Piotr Kaszczewski, T. Ostrowski, J. Żyłkowski, Z. Gałązka
We report a case of a 55-year-old male who was diagnosed with the adductor canal compression syndrome – a rarely described nontraumatic disorder of the lower limb resulting from the external compression of the superficial femoral artery in the adductor canal, that may present with the symptoms ranging from intermittent exercise-induced claudication up to arterial obstruction and critical limb ischemia.
{"title":"Critical limb ischemia caused by adductor canal compression syndrome — case report with the review of the literature","authors":"Piotr Kaszczewski, T. Ostrowski, J. Żyłkowski, Z. Gałązka","doi":"10.5603/AA.2018.0003","DOIUrl":"https://doi.org/10.5603/AA.2018.0003","url":null,"abstract":"We report a case of a 55-year-old male who was diagnosed with the adductor canal compression syndrome – a rarely described nontraumatic disorder of the lower limb resulting from the external compression of the superficial femoral artery in the adductor canal, that may present with the symptoms ranging from intermittent exercise-induced claudication up to arterial obstruction and critical limb ischemia.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"24 1","pages":"14-17"},"PeriodicalIF":0.2,"publicationDate":"2018-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43520836","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}
S. Sinha, V. Krishna, N. Khanna, Lawrence Rajan, M. Jha, V. Mishra, M. Asif, R. Thakur, Mahmadula Razi
Takayasu Arteritis (TA) is a granulomatous inflammation of unknown aetiology affecting the aorta and its major branches with usual affliction among patients younger than 50 years and rarely among children. We present a 7-years old boy referred for evaluation of hypertension. He had a significant blood pressure difference between right arm, left arm and lower limbs. Computed tomography imaging of thorax and abdomen showed stenosis of left subclavian artery, left renal artery and juxtareanl aorta which was subsequently confirmed on aortogram. He underwent percutaneous endovascular therapy with aorto-renal bifurcation stenting with reduction of blood pressure and gradient. Renal angioplasty with stenting remains a challenging procedure in patients with tight ostial lesion, and juxtarenal aortic involvement in lieu of precise stent placement and avoiding side branch occlusion.
{"title":"Aorto-renal Bifurcation Stenting in a Juvenile Non-specific Aorto-Arteritis: case report","authors":"S. Sinha, V. Krishna, N. Khanna, Lawrence Rajan, M. Jha, V. Mishra, M. Asif, R. Thakur, Mahmadula Razi","doi":"10.5603/AA.2018.0005","DOIUrl":"https://doi.org/10.5603/AA.2018.0005","url":null,"abstract":"Takayasu Arteritis (TA) is a granulomatous inflammation of unknown aetiology affecting the aorta and its major branches with usual affliction among patients younger than 50 years and rarely among children. We present a 7-years old boy referred for evaluation of hypertension. He had a significant blood pressure difference between right arm, left arm and lower limbs. Computed tomography imaging of thorax and abdomen showed stenosis of left subclavian artery, left renal artery and juxtareanl aorta which was subsequently confirmed on aortogram. He underwent percutaneous endovascular therapy with aorto-renal bifurcation stenting with reduction of blood pressure and gradient. Renal angioplasty with stenting remains a challenging procedure in patients with tight ostial lesion, and juxtarenal aortic involvement in lieu of precise stent placement and avoiding side branch occlusion.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"24 1","pages":"25-29"},"PeriodicalIF":0.2,"publicationDate":"2018-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43847749","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}
M. Stanisić, T. Rzepa, Jarosław Nakonieczny, Przemysław Kubaszewski, Maciej Putowski, M. Popek, Athanasios Liougkos
Introduction. It is a common unofficial perception of surgeons performing endovascular operations that patients living in the different social and economic environment assess pain differently during peripheral angioplasty procedures. The objective was to examine the differences in assessing pain experienced during endovascular arterial interventions on lower limbs, by Polish and German patients, and to analyse the psychological determinants of the assumed differences, by referring to mental dispositions such as optimism and satisfaction with own life quality. Material and methods. 101 patients were qualified for endovascular intervention on lower limbs arteries — 51 Germans (M = 67.31; SD = 9.82) and 50 Poles (age M = 67.88; SD = 8.4). 37 women and 64 men were classified as Rutherford category 2–3. Three scales were applied: 1. Life Orientation Test-Revised 2. Satisfaction With Life Scale 3. Pain Appraisal Scale which comprises emoticons showing subsequent degrees of sustained pain and the corresponding Visual Analogue Scale. Results. The patients from Poland graded their life quality lower than the German patients (M = 23.44; SD = 5.977 and M = 25.94; SD = 5.584). The Poles presented a lower level of optimism (M = 15.04; SD = 3.703 vs M = 15.8; SD = 3.516). The Polish patients classified the level of pain during lower limb angioplasty as higher than in German patients (M = 4.22; SD = 2.999 and M = 2.88; SD = 2.215) (p < 0.012). Conclusions. Resistance to pain experienced during endovascular procedures probably depends on the assessment of the patient’s current life situation, determined by satisfaction with own life quality and related optimism. With great caution, it might also be supposed that resistance to pain depends on the life standard typical of a given population
介绍。在进行血管内手术的外科医生中，一种常见的非官方看法是，生活在不同社会和经济环境中的患者在周围血管成形术中对疼痛的评估不同。目的是检查波兰和德国患者在下肢血管内动脉介入治疗期间评估疼痛的差异，并通过参考心理倾向，如乐观和对自己生活质量的满意度，分析假设差异的心理决定因素。材料和方法。101例患者符合下肢动脉血管内介入治疗条件——51例德国人(M = 67.31;SD = 9.82)和50个波兰人(年龄M = 67.88;Sd = 8.4)。37名女性和64名男性被归类为卢瑟福2-3类。采用三种量表:1。人生取向测验生活满意度量表疼痛评估量表，包括显示后续持续疼痛程度的表情符号和相应的视觉模拟量表。结果。波兰患者的生活质量评分低于德国患者(M = 23.44;SD = 5.977, M = 25.94;Sd = 5.584)。波兰人的乐观程度较低(M = 15.04;SD = 3.703 vs M = 15.8;Sd = 3.516)。波兰患者在下肢血管成形术中疼痛程度高于德国患者(M = 4.22;SD = 2.999, M = 2.88;SD = 2.215) (p < 0.012)。结论。在血管内手术过程中对疼痛的抵抗可能取决于对患者当前生活状况的评估，由对自身生活质量的满意度和相关的乐观情绪决定。谨慎起见，我们也可以假设，对疼痛的抵抗力取决于特定人群的典型生活标准
{"title":"Cultural and psychological determinants of pain assessment during lower limb angioplasty","authors":"M. Stanisić, T. Rzepa, Jarosław Nakonieczny, Przemysław Kubaszewski, Maciej Putowski, M. Popek, Athanasios Liougkos","doi":"10.5603/AA.2018.0002","DOIUrl":"https://doi.org/10.5603/AA.2018.0002","url":null,"abstract":"Introduction. It is a common unofficial perception of surgeons performing endovascular operations that patients living in the different social and economic environment assess pain differently during peripheral angioplasty procedures. The objective was to examine the differences in assessing pain experienced during endovascular arterial interventions on lower limbs, by Polish and German patients, and to analyse the psychological determinants of the assumed differences, by referring to mental dispositions such as optimism and satisfaction with own life quality. Material and methods. 101 patients were qualified for endovascular intervention on lower limbs arteries — 51 Germans (M = 67.31; SD = 9.82) and 50 Poles (age M = 67.88; SD = 8.4). 37 women and 64 men were classified as Rutherford category 2–3. Three scales were applied: 1. Life Orientation Test-Revised 2. Satisfaction With Life Scale 3. Pain Appraisal Scale which comprises emoticons showing subsequent degrees of sustained pain and the corresponding Visual Analogue Scale. Results. The patients from Poland graded their life quality lower than the German patients (M = 23.44; SD = 5.977 and M = 25.94; SD = 5.584). The Poles presented a lower level of optimism (M = 15.04; SD = 3.703 vs M = 15.8; SD = 3.516). The Polish patients classified the level of pain during lower limb angioplasty as higher than in German patients (M = 4.22; SD = 2.999 and M = 2.88; SD = 2.215) (p < 0.012). Conclusions. Resistance to pain experienced during endovascular procedures probably depends on the assessment of the patient’s current life situation, determined by satisfaction with own life quality and related optimism. With great caution, it might also be supposed that resistance to pain depends on the life standard typical of a given population","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"24 1","pages":"9-13"},"PeriodicalIF":0.2,"publicationDate":"2018-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46070154","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}
F. Fitouri, S. Sahli, Y. Houas, N. Sassi, M. Hamzaoui
The traumatic asphyxia or Perthes syndrome is uncommon. It is a clinical syndrome associating an ecchymotic mask consisting of cervicofacial cyanosis, petechiae and subconjunctival hemorrhage to neurological and ocu¬lar symptoms. The authors report a pediatric case of 8-year-old boy who was a highway accident victim. He presented a cervicofacial cyanosis, petechiae and immediate massive bilateral sub-conjunctival hemorrhage. The attitude was limited to a clinical monitoring. The decline is twelve months.
{"title":"Perthes syndrome: a pediatric case","authors":"F. Fitouri, S. Sahli, Y. Houas, N. Sassi, M. Hamzaoui","doi":"10.5603/AA.2017.0017","DOIUrl":"https://doi.org/10.5603/AA.2017.0017","url":null,"abstract":"The traumatic asphyxia or Perthes syndrome is uncommon. It is a clinical syndrome associating an ecchymotic mask consisting of cervicofacial cyanosis, petechiae and subconjunctival hemorrhage to neurological and ocu¬lar symptoms. The authors report a pediatric case of 8-year-old boy who was a highway accident victim. He presented a cervicofacial cyanosis, petechiae and immediate massive bilateral sub-conjunctival hemorrhage. The attitude was limited to a clinical monitoring. The decline is twelve months.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"23 1","pages":"163-164"},"PeriodicalIF":0.2,"publicationDate":"2017-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44219099","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}
S. Sinha, M. Jha, V. Mishra, Mahmadula Razi, A. Mahrotra, M. Asif, Nasar Abdali, V. Chaturvedi, L. Rekwal
The transradial access for diagnostic and therapeutic purpose is becoming increasingly popular, mainly because of its lack of complications. Radial artery pseudoaneurysm (RAP) is an extremely rare complication, so many of its clinical features are unknown and treatment is not systematic. Therapeutic options are conservative management, ultrasound-guided compression, thrombin injection and surgical intervention. Here, we report a 43-year old female who underwent transradial percutaneous angioplasty of left anterior descending artery. During cannulation of her radial artery, multiple puncture attempts were done. Upon removal of the transra¬dial compression band (TR Band), forearm ecchymosis and small hematoma were noted with mild pain. Tight compression bandage was applied but on the following day, she had complaints of increasing right forearm pain and tenderness. Physical evaluation revealed increased swelling of the right forearm and an ultrasound of the right forearm demonstrated a RAP of the right radial artery measuring up to 3.9x1.9 cm with 3.4 mm neck. Tight compression bandage was further prolonged following ultrasound compression with vascular probe which failed to alleviate her complaints. Following failure of conservative therapy and in lieu of her symptoms, surgical exploration, clot removal and successful repair was done.
{"title":"Radial artery pseudoaneurysm (RAP) following transradial intervention — an extremely rare complication successfully managed by surgery: case report","authors":"S. Sinha, M. Jha, V. Mishra, Mahmadula Razi, A. Mahrotra, M. Asif, Nasar Abdali, V. Chaturvedi, L. Rekwal","doi":"10.5603/AA.2017.0018","DOIUrl":"https://doi.org/10.5603/AA.2017.0018","url":null,"abstract":"The transradial access for diagnostic and therapeutic purpose is becoming increasingly popular, mainly because of its lack of complications. Radial artery pseudoaneurysm (RAP) is an extremely rare complication, so many of its clinical features are unknown and treatment is not systematic. Therapeutic options are conservative management, ultrasound-guided compression, thrombin injection and surgical intervention. Here, we report a 43-year old female who underwent transradial percutaneous angioplasty of left anterior descending artery. During cannulation of her radial artery, multiple puncture attempts were done. Upon removal of the transra¬dial compression band (TR Band), forearm ecchymosis and small hematoma were noted with mild pain. Tight compression bandage was applied but on the following day, she had complaints of increasing right forearm pain and tenderness. Physical evaluation revealed increased swelling of the right forearm and an ultrasound of the right forearm demonstrated a RAP of the right radial artery measuring up to 3.9x1.9 cm with 3.4 mm neck. Tight compression bandage was further prolonged following ultrasound compression with vascular probe which failed to alleviate her complaints. Following failure of conservative therapy and in lieu of her symptoms, surgical exploration, clot removal and successful repair was done.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"23 1","pages":"165-169"},"PeriodicalIF":0.2,"publicationDate":"2017-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44529138","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}
Michał Macech, T. Jakimowicz, P. Hammer, T. Grochowiecki, S. Nazarewski
The aim of the study is to describe an endovascular manoeuvre that can help in the cannulation and stenting of difficult renal arteries in endovascular thoracoabdominal aortic aneurysm exclusion (EVAR) with a branched stent graft. Routinely, dedicated branch and target vessels are cannulated in antegrade fashion through a transaxillary approach. If renal arteries are steep, tortuous, and unfavourable, cannulation failure can preclude a successful endovascular procedure. In that situation, the guidewire slips off the artery. However, another guidewire and balloon can be introduced to the target vessel through femoral access. Expansion of an additional percutaneous transluminal angioplasty (PTA) balloon in the target vessel grabs the guidewire or catheter cannulated in typical fashion and prevents it from slipping off. At this point, a stiffer wire can be introduced, and the covered stent easily bridges the target vessel. The rest of the procedure is continued typically. Expansion of an additionally introduced balloon allows the surgeon to grab the guidewire in the renal artery, thus excluding an aneurysm during EVAR. Our early experience shows that this method is effective and durable.
{"title":"Balloon-grab technique to bridge steep renal artery during endovascular thoracoabdominal aortic aneurysm repair: technical note","authors":"Michał Macech, T. Jakimowicz, P. Hammer, T. Grochowiecki, S. Nazarewski","doi":"10.5603/AA.2017.0016","DOIUrl":"https://doi.org/10.5603/AA.2017.0016","url":null,"abstract":"The aim of the study is to describe an endovascular manoeuvre that can help in the cannulation and stenting of difficult renal arteries in endovascular thoracoabdominal aortic aneurysm exclusion (EVAR) with a branched stent graft. Routinely, dedicated branch and target vessels are cannulated in antegrade fashion through a transaxillary approach. If renal arteries are steep, tortuous, and unfavourable, cannulation failure can preclude a successful endovascular procedure. In that situation, the guidewire slips off the artery. However, another guidewire and balloon can be introduced to the target vessel through femoral access. Expansion of an additional percutaneous transluminal angioplasty (PTA) balloon in the target vessel grabs the guidewire or catheter cannulated in typical fashion and prevents it from slipping off. At this point, a stiffer wire can be introduced, and the covered stent easily bridges the target vessel. The rest of the procedure is continued typically. Expansion of an additionally introduced balloon allows the surgeon to grab the guidewire in the renal artery, thus excluding an aneurysm during EVAR. Our early experience shows that this method is effective and durable.","PeriodicalId":41754,"journal":{"name":"Acta Angiologica","volume":"23 1","pages":"159-162"},"PeriodicalIF":0.2,"publicationDate":"2017-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45682926","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}
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