Subintimal angioplasty of lower limb arterial occlusion carries a relatively higher risk of vessel perforation compared to transluminal angioplasty. Vessel perforation is a potentially life threatening complication which requires prompt recognition and management. They are usually managed by endovascular techniques such as low-pressure balloon tamponade, covered stents, and coil embolization of the ruptured artery. We describe a technique of treating vessel perforation following balloon angioplasty. Patient developed a large perforation of the proximal superficial femoral artery (SFA) after balloon inflation during subintimal angioplasty of complete SFA occlusion. Following failure of balloon tamponade in sealing the perforation, we successfully treated it by deploying an embolization coil at the site of perforation through the vessel wall followed by balloon tamponade. Our technique could be a useful relatively inexpensive alternative treatment option in the management of vessel perforation compared to covered stents.
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http://dx.doi.org/10.4103/0971-3026.190422 | DOI Listing |
Health Sci Rep
January 2025
Department of Cardiology Saiseikai Yokohama City Eastern Hospital Kanagawa Japan.
Background And Aims: When dealing with severely calcified lesions in endovascular therapy (EVT) for lower extremity artery disease (LEAD), navigating through severely calcified chronic total occlusion (CTO) using hard-tip guidewires can be challenging. To address this issue, we employed a novel highly intensive penetration (HIP) technique. This technique involves modifying the tail of a 0.
View Article and Find Full Text PDFJ Atheroscler Thromb
January 2025
Department of Neurology, National Cerebral and Cardiovascular Center.
Aim: Branch atheromatous disease (BAD), characterized by the occlusion of perforating branches near the orifice of a parent artery, often develops early neurological deterioration because the mechanisms underlying BAD remain unclear. Abnormal wall shear stress (WSS) is strongly associated with endothelial dysfunction and plaque growth or rupture. Therefore, we hypothesized that computational fluid dynamics (CFD) modeling could detect differences in WSS between BAD and small-vessel occlusion (SVO), both of which result from perforating artery occlusion/stenosis.
View Article and Find Full Text PDFWorld Neurosurg
January 2025
Department of Neurological Surgery, St. John's Neuroscience Institute, Tulsa, OK. Electronic address:
Middle cerebral artery (MCA) aneurysms remain excellent candidates for microsurgical treatment, despite proliferation of new endovascular tools. Nonetheless, patients desire less invasive options for permanent, durable treatment of their aneurysms; this is particularly the case for those presenting without subarachnoid hemorrhage, and those with multiple aneurysms that may require several surgical approaches. Keyhole craniotomies, when properly utilized in well-selected patients, allow for minimally invasive treatment of both ruptured and unruptured cerebral aneurysms, including those harboring bilateral aneurysms which may be treated from a single approach.
View Article and Find Full Text PDFJ Clin Med
January 2025
My Houston Surgeons, 9230 Katy Freeway, Suite 600, Houston, TX 77055, USA.
Removal of the rib and adjacent cartilage is a common step for exposure of the recipient chest vessels in free-flap breast reconstructions. However, this adds both short- and long-term morbidity to the procedure. We describe our experience in avoiding rib removal in microvascular breast reconstruction.
View Article and Find Full Text PDFMedicina (Kaunas)
December 2024
Department of Dermatology, International University of Health and Welfare Narita Hospital, Chiba 286-8520, Japan.
Acquired reactive perforating dermatosis (ARPD) is characterized by its onset after the age of 18 years, umbilicated papules or nodules with a central keratotic plug, and the presence of necrotic collagen tissue within an epithelial crater. ARPD is strongly associated with systemic diseases such as diabetes mellitus (DM) and chronic renal failure, which may contribute to ARPD through factors including microcirculatory disturbances and the deposition of metabolic byproducts, including advanced glycation end-products and calcium. Here, we report a case of ARPD that improved following DM treatment and catheter-based interventions for peripheral artery disease (PAD).
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