A Rare and Dangerous Combination of COVID-19, Lemierre Syndrome, and Carotid Pseudoaneurysm: A Case Report.

Lemierre syndrome is a rare complication of oropharyngeal infection that causes septic thrombophlebitis in the internal jugular vein. Since the onset of the COVID-19 pandemic, this condition has been dangerously overlooked and poses an even greater threat when complicated by vascular pathologies. A case is presented where the patient required emergency endovascular exclusion of a right internal carotid artery pseudoaneurysm due to Lemierre syndrome.

Challenging Endovascular Treatment of Coral Reef Aorta and a Literature Review.

Coral reef aorta is a rare type of atherosclerotic disease that causes severe calcification in the abdominal aorta. We present a case of coral reef aorta with hemodynamically significant symptomatic aortic stenosis causing intermittent claudication and bilateral cyanosis of the toes. Despite the challenging anatomy for endovascular treatment, the patient underwent successful transfemoral endovascular stent-graft placement.

Combined AFX2 with thoracic stent graft: A different endovascular approach of an abdominal aorta aneurysm.

The AFX2 endovascular repair system is a unibody, bifurcated stent graft that can be used in an abdominal aortic aneurysm associated with anatomical challenges, especially if it is combined with different aortic cuffs. The use of an AFX2 main body combined with a thoracic stent graft as a proximal aortic cuff was selected to treat a 77-year-old male patient with abdominal aortic aneurysm. The AFX2 endograft combined with a proximal thoracic aortic cuff plays a safe and effective role in treating complex infrarenal abdominal aortic aneurysm that may otherwise be technically more challenging with the open technique and inaccessible with the traditional endovascular technique.

Long-term outcomes of the Endurant endograft in patients undergoing endovascular abdominal aortic aneurysm repair.

Objective/background: To investigate the long-term outcomes after endovascular aneurysm repair (EVAR) in a real-world setting using the Endurant endograft (EG).

Methods: 184 EVAR candidates treated with the Endurant family EGs in a single vascular center were prospectively enrolled from January 2009 to December 2016. Kaplan-Meir estimates of long-term standardized primary and secondary outcome measures were performed.

Ruptured true aneurysm of the superficial femoral artery leading to Behçet disease diagnosis.

Femoral artery aneurysms are rare, and aneurysms of the superficial femoral artery (SFA) are even rarer, with ruptured true aneurysms of the SFA the rarest. In the present report, we have described the case of a young patient whose SFA had clinical findings suggestive of an aneurysm rupture, which resulted in the diagnosis of Behçet disease, in accordance with the clinical features of the disease. The patient underwent standard treatment, with aneurysmectomy and interposition of a synthetic graft.

Open surgical repair of abdominal aortic aneurysm and horseshoe kidney: A strange relationship.

Introduction And Importance: The horseshoe kidney (HK) is the most common fusion defect of the kidneys. Τhe simultaneous presence of HK and abdominal aortic aneurysm (ΑΑΑ) is rare and comprises a technical challenge for the vascular surgeon due to variation of renal arteries and the renal isthmus overlying the AAA sac.

Case Presentation: We present the first case in Nicosia General Hospital of Cyprus of an infrarenal AAA with a HK (Crawford Type I), which was successfully treated using an open surgical approach.

Lessons Learned from Open Surgical Conversion after Failed Previous EVAR.

Background: Delayed open conversion (OpC) after endovascular aortic aneurysm repair (EVAR) is becoming increasingly common worldwide. We reviewed our experience to characterize the perioperative spectrum of OpC repairs.

Materials And Methods: A retrospective analysis of a prospectively maintained institutional database to identify patients who underwent late OpC after failed EVAR was performed.

Correlation of Baseline Plasma and Inguinal Connective Tissue Metalloproteinases and Their Inhibitors With Late High-Pressure Endoleak After Endovascular Aneurysm Repair: Long-term Results.

To investigate whether plasma and connective tissue matrix metalloproteinases (MMP) and their inhibitors (TIMP) may predict late high-pressure endoleak after endovascular aneurysm repair (EVAR). Samples of inguinal fascia and blood were collected in 72 consecutive patients (mean age 73.1 years; 68 men) undergoing primary EVAR with the Endurant stent-graft.

Giant Splenic Aneurysm with Arteriovenous (A-V) Shunt, Portal Hypertension, and Ascites.

BACKGROUND Splenic aneurysms are rare, asymptomatic, and usually derive from previous surgical interventions. Endovascular repair is the best option, but when A-V shunt is present, open repair might be more suitable. CASE REPORT A 43-year-old man presented to the Internal Medicine Department of AHEPA University Hospital with symptoms of fever and ascites.

A case report of thrombosed varicosities of pubic collateral veins: Ideal treatment strategy and contribution of era imaging technologies in diagnosis.

Collateral circulation is an alternative path occurring in case of venous or artery obstruction. This path may usually develop after primary recanalization. In our case, a 62-year-old woman presented to our Emergency Department complaining about a suprapubic swelling with a cyanotic discoloration of the overlying skin for the past 10 days for which she had been previously prescribed antibiotics.

Percutaneous Endovascular Recanalization of a Thrombosed Aortic Graft Limb with Stent Placement.

Common practice in recanalization of a thrombosed prosthetic graft limb in an aortoiliac bypass focuses on balloon-catheter thrombectomy and angiographic exploration followed either by open surgical revision or endovascular management. This report describes the technique of percutaneous endovascular recanalization of an early thrombosed aortic graft limb with stent placement and subsequent restoration of patency and adequate limb perfusion, which remains patent after one year. Percutaneous intervention with stent placement and angioplasty for early graft limb recanalization avoids femoral incisions, and complications or morbidity associated with open surgery, while permitting rapid mobilization of the patient.

Antiplatelet treatment and prothrombotic diathesis following endovascular abdominal aortic aneurysm repair.

Prothrombotic diathesis expressed by elevated levels of coagulation-specific biomarkers has been reported in patients with abdominal aortic aneurysm (AAA) and after AAA endovascular repair (EVAR). This study investigates the effect of antiplatelet agents (APLs) on the prothrombotic diathesis in the post-EVAR period. Forty elective EVAR patients had thrombin-antithrombin complex, d-dimer, fibrinopeptide A, and high-sensitivity C-reactive protein measured before, at 24 hours, 1 month, and 6 months after EVAR.

A computational study of the factors influencing pressure in arteriovenous fistulae venous aneurysms.

Purpose: To investigate the factors influencing the hydrostatic pressure exerted within the venous aneurysms (VA) of an arteriovenous fistula (AVF).

Methods: Ideal models of a side-to-end brachial-cephalic AVF were computationally constructed and typical values for the length and the local diameters were considered for both the artery and vein sections of the models. Three VA configurations were reconstructed (spherical, fusiform and curved) and hydrostatic pressure was assessed with respect to different degrees of the outflow vein stenosis, ranging from 25% to 95%, and VA maximum diameters, using validated, commercially available software.

Technical advances with newer aortic endografts provide additional support to withhold the early endovascular repair of small abdominal aortic aneurysms until it is really needed.

The idea of early endovascular aortic repair (EVAR) of "small" abdominal aortic aneurysms (AAAs) has gained attention over "watchful waiting," mostly due to the concern for losing the anatomic suitability for endovascular repair over time. Generally, small AAAs have longer, smaller, less angulated necks, and less tortuous iliac arteries than larger ones. Though the borderline anatomic characteristics were assumed to be contraindications for older generation endografts, the modifications of modern devices seem promising to overcome those limitations, in order to treat the small AAAs when reaching the 5.

An uncommon clinical presentation of acute limb ischemia: underscoring the role of perigenicular collaterals.

We present a case of atypical acute limb ischemia in a non-diabetic patient, with ankle-brachial pressure index of 0.6 and rest pain localized exclusively over the gastrocnemius muscle, sparing the foot. This uncommon presentation was attributed to an impaired perigenicular collateral network.

Aneurysm sac shrinkage after endovascular treatment of the aorta: beyond sac pressure and endoleaks.

The isolation of the aneurysm sac from systemic pressure and its consequent shrinkage are considered criteria of success after endovascular repair (EVAR). However, the process of shrinkage does not solely depend on the intrasac pressure, the predictive role of which remains ambiguous. This brief review summarizes the additional pathophysiological mechanisms that regulate the biomechanical properties of the aneurysm wall and may interfere with the process of aneurysm sac shrinkage.

Application of bioengineering modalities in vascular research: evaluating the clinical gain.

Using knowledge gained from bioengineering studies, current vascular research focuses on the delineation of the natural history and risk assessment of clinical vascular entities with significant morbidity and mortality, making the development of new, more accurate predictive criteria a great challenge. Additionally, conclusions derived from computational simulation studies have enabled the improvement and modification of many biotechnology products that are used routinely in the treatment of vascular diseases. This review highlights the promising role of the bioengineering applications in the vascular field.

An overview of the hemodynamic aspects of the blood flow in the venous outflow tract of the arteriovenous fistula.

Upper limb vein aneurysms complicate all types of autogenous arteriovenous fistulae (AVF) and comprise false aneurysms secondary to venipuncture trauma as well as true aneurysms, characterized by dilatation of native veins. The dilatation of a normal vein and the development of a true aneurysm are strongly influenced by local hemodynamic factors affecting the flow in the drainage venous system and are also the target of operative interventions. This review article focuses on the description of these hemodynamic aspects which all physicians involved in the management of dialysis patients should be aware of.

Modification of the trap door technique to treat venous aneurysms in arteriovenous fistulae.

We present a modification of the "trap door" technique to treat true venous aneurysms which complicate vascular access arteriovenous fistula. The technique provides wide exposure of the aneurysm, facilitating aneurysmoraphy and permitting the exploitation of any adequate venous length for autologous reconstruction of the venous outflow. Furthermore, by precluding the proximity of the newly-reconstructed venous segments to the incised skin, their level of compromise from tissue scarring or infection is prevented.

Early results of the Endurant endograft system in patients with friendly and hostile infrarenal abdominal aortic aneurysm anatomy.

Objective: To evaluate and compare the outcome after endovascular abdominal aortic aneurysm repair (EVAR) with the newly released Endurant endograft system in patients with different aortoiliac anatomic characteristics.

Methods: We conducted a prospective observational study assigning patients with infrarenal abdominal aortic aneurysm (AAA) treated with the Endurant endoprosthesis from February 2009 to March 2010. Two groups were studied, according to the presence of a friendly (group I [GI] = 43) or hostile (group II [GII] = 34) infrarenal aortoiliac anatomy.

Expanding current EVAR indications to include small abdominal aortic aneurysms: a glimpse of the future.

The traditional criterion of maximum transverse diameter is not sufficient to differentiate the small abdominal aortic aneurysms (AAAs) that are either prone to rupture or prone to enlarge rapidly. Wall stress may be a more reliable indicator with respect to these tasks. We review the importance of geometric features in rupture- or growth-predictive models and stress the need for further evaluation and validation of geometric indices.

Composite PTFE-transposed superficial femoral vein for lower limb arteriovenous access.

Purpose: We report our experience in creating a composite loop of transposed superficial femoral vein (tSFV) and polytetrafluoroethylene (PTFE) synthetic graft for lower limb access. The indication for surgery was exhaustion of access sites in both upper limbs.

Methods: Surgery was performed on 3 male patients.