Martin Rabellino

Clinical follow‐up in endovascular treatment for TASC C‐D lesions in femoro‐popliteal segment

To demonstrate the technical success and clinical follow‐up after endovascular treatment of femoropopliteal segment TASC II C and D lesions.

Middle aortic syndrome percutaneous treatment with a balloon-expandable covered stent.

![Figure][1] A 46-year-old female patient was admitted with signs of lower limb ischemia. Her examination demonstrated a nonpalpable distal pulse. Computed tomography angiography revealed an anomalous origin of both renal arteries (A, B) and severe aortic narrowing between the renal arteries

Endovascular Management of a Spontaneous Dissecting Aneurysm of the Superior Mesenteric Artery: Case Report and Discussion of Treatment Options

Spontaneous dissection of the superior mesenteric artery represents a rare cause of abdominal angina. Conservative or more aggressive treatments such as surgery or endovascular therapy depend on the symptoms. We present a case report of acute mesenteric ischemia due to spontaneous dissection of the superior mesenteric artery successfully treated by endovascular stent placement. In the discussion we review the different alternatives of treatment presented in the literature.

Stent-Assisted Coil Embolization of a Wide-Neck Aneurysm of a Persistent Primitive Hypoglossal Artery

Persistent primitive hypoglossal artery (PPHA) represents the second most common carotid-vertebrobasilar anastomosis. The association of PPHA with intracranial aneurysms is not unusual. Treatment of aneurysms located on the PPHA itself is challenging due to the increased risk of ischemic complications secondary to the hypoglossal artery often being the sole contributor of flow to the posterior circulation. We report a case of a wide-neck aneurysm in a PPHA successfully treated using a stent-assisted coil embolization technique.

Oclusión de una fístula arteriovenosa pulmonar con el tapón vascular Amplatzer

Las malformaciones arteriovenosas pulmonares son anomalias poco frecuentes del pulmon, que entranan un riesgo considerable de complicaciones graves como la tromboembolia cerebral, el absceso cerebral y la hemorragia pulmonar. La embolizacion con coils o con balones desprendibles es el tratamiento de eleccion. Sin embargo, estos pueden migrar y producir embolia paradojica, especialmente en las malformaciones con comunicaciones arteriovenosas grandes. Presentamos un caso en el que utilizamos un nuevo dispositivo de oclusion vascular (Tapon Vascular Amplatzer) para ocluir una fistula arteriovenosa pulmonar en un paciente con sindrome de Rendu-Osler-Weber.

Bifurcated Endograft in Aortoiliac Type C and D Lesions: Long-Term Results

PURPOSE To report long-term outcome when using a bifurcated aortic endograft for treatment of aortoiliac occlusive disease (AIOD) in Trans Atlantic Inter Society Consensus (TASC) classification C and D patients. MATERIALS AND METHODS Between May 2001 and May 2009, 14 patients (11 men, 3 women) with aortoiliac TASC C and D type lesions and a mean age of 59 years ± 10 (range 41-73 years) were treated using a bifurcated aortic endograft. Although these patients were young, all were considered at high surgical risk. Patients were followed up clinically and by computed tomography (CT) every 3 months for 1 year and yearly thereafter. RESULTS Endoprosthesis placement was performed in all patients with a technical success rate of 100%. There were no amputations or deaths at 30 days after the procedure. The mean follow-up was 62 months (range 11-96 months). One patient was lost during follow-up at 11 months, and another patient died of a nonrelated cause after 49 months. A single limb occlusion of the prosthesis was seen in two patients at 2 months and 7 months; both were successfully treated by intraarterial fibrinolysis. At a mean follow-up of 62 months, primary patency was 85.7%, and secondary patency was 100%. CONCLUSIONS This series shows promising long-term results following the use of a bifurcated aortic endograft for treatment of AIOD TASC C and D type lesions. Bifurcated aortic endograft is a good minimally invasive alternative to open surgery in high surgical risk patients.

Is endovascular revascularisation worthwhile in diabetic patients with critical limb ischemia who also have end-stage renal disease?

To present the outcomes of endovascular treatment of diabetics patients with critical limb ischemia who have end-stage renal disease. Limb-salvage was achieved in 58.6% of the limbs during a mean follow-up period of 12.4 months. No major amputations were required on patients with rest pain or with grade 1 lesions.

Stent-Assisted Coil Embolization of a Mycotic Renal Artery Aneurysm by Use of a Self-Expanding Neurointerventional Stent

Mycotic aneurysms are uncommon, especially those located in visceral arteries. We present a case of a patient with two visceral mycotic aneurysms due to bacterial endocarditis, one located in right upper pole renal artery and the second in the splenic artery. Both aneurysms were treated as endovascular embolization using microcoils. In the aneurysm located at the renal artery, the technique of stent-assisted coils embolization was preferred to avoid coils migration due to its wide neck. The stent used was the Solitaire AB, which was designed for the treatment of intracranial aneurysms and was used recently in acute stroke as a mechanical thrombectomy device. Complete embolization of the aneurysm was achieved, preserving all the arterial branches without nephrogram defects in the final angiogram.

Endovascular Treatment Is a Hope for Patient With Buerger’s Disease and Foot Ulcer Case Report

Scarce information exists regarding the usefulness of the endovascular approach in patients with thromboangiitis obliterans and critical ischemia. A 41-old-man diagnosed with Buerger’s disease had rest pain and a severe ulceration on the big toe. He had been scheduled for a big toe amputation. Typical findings of Buerger’s disease were found in the angiogram including below-the-knee involvement and corkscrew collateral arteries. Stenoses of the posterior tibial artery were angioplastied and the plantar artery was recanalized and angioplastied. Healing was achieved and the patient remains asymptomatic 21 months after the procedure. The outcome achieved in this case and recent series should encourage doctors dealing with this problem to attempt limb salvage by means of the endovascular approach.

Endovascular treatment of the nutcracker syndrome: Report of two cases

Abstract The nutcracker syndrome (NS) is a rare condition characterized by the entrapment of the left renal vein (LRV) between the superior mesenteric artery (SMA) and the aorta. Clinically, it presents with flank pain, hematuria, and symptoms of pelvic venous congestion. Several surgical techniques have been described including left renal vein (LRV) transposition, autotransplantation, LRV bypass, superior mesenteric artery (SMA) transposition, gonadocaval bypass and nephrectomy. More recently, endovascular stenting of the renal vein has been proposed. We present two patients with NS who were successfully managed endovascularly, providing satisfactory mid-term clinical and imaging results.