Occlusion Of Left Common Iliac Artery Research Articles

Endovascular Treatment of Aortic Bifurcation Occlusive Disease 10 Years After Open Surgical Repair of an Infrarenal Abdominal Aortic Aneurysm

A 74 year old man, a moderate smoker treated 10 years previously by open infrarenal abdominal aortic aneurysm tube graft, presented with left leg rest pain. (A) Computed tomography angiography revealed dilatation of the infrarenal aortic segment (31 mm) with a newly developed left common iliac artery occlusion and right common iliac artery sub-occlusion. (B) Two balloon expandable stents (8 × 59 mm; Omnilink Elite [Abbott Vascular, Santa Clara, CA, USA]) were deployed in a kissing stent configuration with good results and no complications. The patient received dual antiplatelet therapy for three months and after this period was asymptomatic.Image 1

Effects of ischemic preconditioning and cilostazol on muscle ischemia-reperfusion injury in rats.

To evaluate effects of ischemic preconditioning and Cilostazol on muscle ischemia-reperfusion injury. Male Wistar rats were submitted to muscle ischemic and reperfusion injury (4h of the left common iliac artery occlusion followed by 1h of reperfusion). Five experimental groups were constituted: Control group (n=4); Ischemia-Reperfusion (IR, n=5); Ischemic preconditioning group (IP, n=6); Ischemia-Reperfusion group treated with cilostazol (IRCi, n=6) and Ischemic preconditioning group treated with cilostazol (IPCi, n=6). At the end, left gracile muscle was removed and embedded in paraffin. Histopathology, neutrophil infiltration, myocyte necrosis and edema were analyzed. When compared with the control group, IR group showed increased neutrophil infiltration, severe necrosis and edema. There was significant difference between myocytes necrosis of IR group and IP group. There was no difference between the histopathological changes between IP, IRCi and IPCi groups. The model of IR caused severe muscle injury in the rat hind limb and ischemic preconditioning has a protective effect, reducing myocyte necrosis, however, treatment with cilostazol and also the association between cilostazol and preconditioning has no protective effect on the skeletal muscle subjected to ischemia and reperfusion injury.

Successful recanalization of a left common iliac artery chronic total occlusion adjacent to an ectopic renal artery at the aortoiliac bifurcation

Ectopic kidneys are rare and usually present incidental findings during invasive or non-invasive angiography. Their parenchyma is not more susceptible to disease and symptoms occur mainly due to alteration of the anatomic relations. The main renal artery of the ectopic kidney derives invariably from the aorta; however, accessory renal arteries may originate from almost any arterial branch adjacent to the ectopic kidney. Knowledge of the common anatomic variations is important during complex peripheral interventions. We present the case of a 46-year-old male with symptoms of claudication secondary to left common iliac artery occlusion. He was diagnosed as occlusion of the left common iliac artery at the aortoiliac bifurcation in close proximity to the ectopic renal artery by peripheral angiography, and percutaneous intervention of the left common iliac artery was successful. Percutaneous intervention led to resolution of the patient's symptoms of claudication as well as preservation of the ectopic renal artery. In such cases, renal ectopy and aberrant arteries should be promptly recognized in order to avoid vascular or renal complications.

Endovascular Repair for Left Common Iliac Artery Occlusion Following Blunt Trauma Without Associated Bony Injury: Image in Vascular Surgery

Common iliac artery injury (CIAI), commonly associated with pelvic fractures may present with a potentially fatal combination of haemorrhage and limb ischaemia. We report a case of isolated CIAI from blunt trauma without bony injury treated successfully using endovascular repair.

Fatal Cardiac Perforation after Percutaneous Treatment in Iliac Artery Occlusion

IntroductionA 68-year-old male smoker was admitted to the hospitalwith a history of bilateral severe lower limb arterial dis-ease. He had claudication due to infrainguinal disease,mainly related to a left common iliac artery occlusion, asrevealed by arteriography (Fig. 1A–C). The patient wastreated with percutaneous transluminal angioplasty (PTA)(Fig. 1D) and stenting (Fig. 1E) through the left brachialartery using a metallic guide wire and a 6F long hydro-philic polytetrafluoroethylene-coated sheath.During the intervention, the radiologist used fluoroscopyto aid placement, but only for visualizing the occluded iliacartery without following the entire route taken by the guidewire. Therefore, he did not notice the erroneous pathwaytaken by the guide wire through the ascending aorta andreaching the cardiac chambers. In a second attempt, afterpulling the guide wire back, the radiologist correctlyredirected it, entering into the descending aorta andreaching the left common iliac artery, where the stent wassuccessfully placed, resulting in revascularization of theleft lower limb (Fig. 1F).Two hours after the intervention, the patient was foundlifeless in his hospital bed; all resuscitation efforts wereunsuccessful.ResultsGross Autopsy FindingsA complete postmortem examination was performed3 days after death. External examination was unremarkableexcept for the puncture site of the PTA in the left arm.The internal examination revealed cardiac tamponade(Fig. 2A); however, a definitive transmural myocardialdefect was not identified. There was evidence of hemor-rhagic infiltration beginning in the epicardium andcontinuing throughout the myocardium at the distal part ofthe left ventricle (Fig. 2B).At the aortic root, a small area of hemorrhagic infiltra-tion in contact with the fibrous pericardium was found.A correctly positioned stent was found in the left com-mon iliac artery. Other significant findings included mul-tiorgan vascular congestion and cerebral and pulmonaryedema.Histological StudiesHistological studies were performed with formalin-fixed,paraffin-embedded tissue sectioned at 4 lm and stainedwith hematoxylin and eosin. The examination of the heart,performed by making seven consecutive myocardial sec-tions, revealed hemorrhagic dissection of myocardial tissueat the level of the left ventricle, consistent with cardiacrupture. The transmural myocardial defect was found; thedefect was compatible with a lesion that could have been

Monitored anesthesia care with remifentanil for femoro-femoral bypass graft patients

Monitored anesthesia care with remifentanil for femoro-femoral bypass graft patients