Simone Quaglino

Use of Contrast-Enhanced Ultrasound in Carotid Atherosclerotic Disease: Limits and Perspectives

Contrast-enhanced ultrasound (CEUS) has recently become one of the most versatile and powerful diagnostic tools in vascular surgery. One of the most interesting fields of application of this technique is the study of the carotid atherosclerotic plaque vascularization and its correlation with neurological symptoms (transient ischemic attack, minor stroke, and major stroke) and with the characteristics of the “vulnerable plaque” (surface ulceration, hypoechoic plaques, intraplaque hemorrhage, thinner fibrous cap, and carotid plaque neovascularization at histopathological analysis of the sample after surgical removal). The purpose of this review is to collect all the original studies available in literature (24 studies with 1356 patients enrolled) and to discuss the state of the art, limits, and future perspectives of CEUS analysis. The results of this work confirm the reliability of this imaging study for the detection of plaques with high risk of embolization; however, a shared, user-friendly protocol of imaging analysis is not available yet. The definition of this operative protocol becomes mandatory in order to compare results from different centers and to validate a cerebrovascular risk stratification of the carotid atherosclerotic lesions evaluated with CEUS.

Successful Management with 2 Overlapping Bare Stents for Post–Carotid Endarterectomy Carotid Pseudoaneurysm Secondary to Carotid Shunt

Pseudoaneurysms are a rare complication of carotid endarterectomy. We successfully excluded with 2 overlapping bare stents a distal carotid artery pseudoaneurysm very likely induced by a Pruitt-Inahara shunt 2 months after carotid endarterectomy.

Rupture of giant superficial femoral artery aneurysm in a leukemic patient submitted to chemotherapy.

The superficial femoral artery (SFA) is a relatively rare location for lower limb aneurysmatic disease. In the literature, this disease is described an association between a relatively high growth rate and/or the rupture of aneurysms and chemotherapeutic agents. We report a case of the rupture of a giant SFA aneurysm in a patient during chemotherapy for acute lymphatic leukemia.

Contrast-Enhanced Sonographic Follow-up After Stenting of Visceral Artery Aneurysms

We report 2 cases of exclusion of visceral artery aneurysms. The first was a common hepatic artery aneurysm treated with a multilayer stent; the second was a celiac trunk aneurysm excluded by a covered stent. Computed tomographic angiography was performed at regular intervals after each procedure, together with echo color Doppler imaging and contrast‐enhanced sonography. Computed tomographic angiography and contrast‐enhanced sonography were able to detect endoleaks in both patients and the related inflow vessel; moreover, diameter measurements of the sacs were identical. In our preliminary experience, contrast‐enhanced sonography appeared to be as accurate as computed tomographic angiography after endovascular visceral artery aneurysm exclusion.

Ultrasound surveillance in endoluminal laser treatment for varicose veins

License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Journal of Vascular Diagnostics 2013:1 21–23 Journal of Vascular Diagnostics Dovepress

Bailout Chimney Technique during Endovascular Aneurysm Sealing for Accidental Renal Artery Coverage

1. Andersen PE, Midtgaard A, Brenoe AS, Elle B, Duvnjak S. A new nitinol stent for use in superior vena cava syndrome. Initial clinical experience. J Cardiovasc Surg (Torino) 2015; 56:877–881. 2. Mokry T, Bellemann N, Sommer CM, et al. Retrospective study in 23 patients of the self-expanding sinus-XL stent for treatment of malignant superior vena cava obstruction caused by non-small cell lung cancer. J Vasc Interv Radiol 2015; 26:357–365. 3. Gwon DI, Ko GY, Kim JH, Shin JH, Yoon HK, Sung KB. Malignant superior vena cava syndrome: a comparative cohort study of treatment with covered stents versus uncovered stents. Radiology 2013; 266: 979–987. 4. Dinkel HP, Mettke B, Schmid F, Baumgartner I, Triller J, Do DD. Endovascular treatment of malignant superior vena cava syndrome: is bilateral Wallstent placement superior to unilateral placement? J Endovasc Ther 2003; 10:788–797

Mediastinoscopy-assisted Treatment of an Aberrant Right Subclavian Artery

Aberrant right subclavian artery (ARSA) is a rare congenital anomaly characterized by the origin of the right subclavian artery from the aortic arch distally to the left subclavian artery. We describe the case of a young patient with symptomatic ARSA treated by mediastinoscopy-assisted ligation at its origin and subclavian-carotid transposition.

Open Surgical Treatment of a Severe Case of Obstructive Calcifying Aortic Disease

The obstructive calcifying aortic disease refers to severe calcifications of the descending aorta that obstruct or slow blood flow. Here, we report the case of a 65-year-old woman with recent onset of a very tight intermittent claudication and concomitant severe and uncontrolled hypertension, treated with a bypass graft between the proximal descending thoracic aorta and the supravisceral abdominal aorta.

Pulmonary embolism due to popliteal vein aneurysm during pregnancy induced by in vitro fertilization.

Popliteal vein aneurysms (PVAs) are rare but may cause severe and even fatal complications, such as pulmonary embolism (PE). A woman at the eighth week of pregnancy came to our attention because of a thrombosis of a previously undetected left PVA, diagnosed after a PE episode. Surgery was delayed until after delivery and breastfeeding, during which anticoagulant therapy was established.