Yilmaz Onal

Late Type 3b Endoleak with an Endurant Endograft

Endovascular stent grafting with different commercially available stent graft systems is widely applied for the treatment of abdominal aortic aneurysms with high success rates in the current era. Various types of endoleaks are potential complications of the procedure. They usually occur in the early period. In this report, we present type 3b endoleak occurring 14 months after a successful endovascular abdominal aortic aneurysm repair with a Medtronic Endurant stent graft.

Cerebral Protection with a Temporary Ascending Aorta–External Carotid Artery Bypass during Common Carotid Artery Revascularization

Atherosclerosis is a systemic disease, and multiarterial involvement is common. Involvement of all the supra-aortic arteries may occur in the same patient making cerebral revascularization challenging. In this report, we present complete supra-aortic revascularization, that is, revascularization of the bilateral common carotid and subclavian arteries in a 51-year-old male patient with occluded brachiocephalic trunk, left subclavian artery, and proximally stenotic left common carotid artery. A temporary ascending aorta to left external carotid artery bypass provided meticulous cerebral protection with pulsatile cerebral flow in the presence of a proximal arterial clamp; hence, a neurologically uneventful procedure during bilateral common carotid artery revascularization.

Endovascular Thoracoabdominal Replacement after Total Abdominal Aortic Debranching

Marfan syndrome is an inherited connective tissue disorder affecting mainly eyes and skeletal and cardiovascular systems. Cardiovascular involvement may lead to life-threatening aortic pathologies including aneurysms and/or dissections. In this report, the authors present images of a patient with Marfan syndrome with a history of Bentall-De Bono procedure followed by aortic arch and infrarenal aortoiliac replacements who strongly refused conventional open repair and underwent abdominal debranching followed by thoracoabdominal endovascular stent grafting for the treatment of thoracoabdominal aneurysm.

Anatomic Revascularization of the Celiac Trunk and the Superior Mesenteric Artery

Chronic atherosclerotic mesenteric ischemia is a debilitating disorder. It may cause postprandial abdominal pain leading to severe weight loss. Patients are usually emotionally affected with major depression. The disease can be treated with open surgical and endovascular techniques and both methods have individual risks and benefits. In this report, the authors present anatomical revascularization of the superior mesenteric artery and the celiac trunk.

Extracolonic findings of CT colonography: Our experience in 227 cases

Extracolonic findings in CT colonography: Our experience in 227 cases Objective: The aim of our study is to evaluate the frequency and the types of extracolonic findings (ECF) in Computed Tomography Colonography (CTC) performed for screening purposes in an asymptomatic population. Methods: CTC examinations performed for Colo-Rectal Carcinoma (CRC) screening between April 2013 and April 2014 were included in the study. We classified ECF according to CTC reporting and data system (C-RADS). Two radiologists examined images. Patients’ demographic data were documented. The presence and the types of ECF were determined in consensus. Results: We evaluated 227 CTC retrospectively. There were 121 women (mean age 58.9±7.1) and 106 men (mean age 60.7±7.7). In 145 patients, ECF were detected and in 82 patients no ECF were found. The mean age was significantly higher in patients with ECF (p<0.01). The mean ages for clinically significant and insignificant groups were 61.7±8.7 and 57.5±6.8 years, respectively. This difference was statistically significant (p=0.003). There were no statistically significant difference between men and women in terms of ECF (p=0.397). Conclusion: Although ECF are encountered frequently and even more often with increasing age, only limited fraction of them have clinically significant outcomes.

Proximal flow control with a balloon during the treatment of left subclavian artery aneurysmsreply

© 2017 Heart Views | Published by Wolters Kluwer ‐ Medknow 75 We read with a great interest the manuscript entitled, “Successful treatment of giant left subclavian artery pseudoaneurysm abutting the arch of the aorta and descending aorta” by Khan et al.[1] The authors presented treatment of a giant, most probably, mycotic pseudoaneurysm of the intrathoracic left subclavian artery through thoracotomy with an autologous pericardial patch. In addition, they mentioned about other treatment options briefly such as endovascular stent graft implantation[2] and ligation[1] with or without an anatomic/extra-anatomic bypass. It is known that, in patients with proximal left subclavian artery aneurysms, the orifice of the subclavian artery may be very fragile.[1] It may be easily injured leading to catastrophic complications during surgical dissection. A balloon catheter placed prior to the surgery at the orifice of the left subclavian artery ready to be inflated in case of a rupture can be lifesaving. In addition, the balloon may also be used instead of a proximal arterial clamp. Once again, we congratulate the authors for their successful treatment of a challenging left subclavian artery pseudoaneurysm; however, we believe that the operation could have been performed safer if a balloon catheter had been placed to the left subclavian artery orifice prior to the surgery.

Endovascular Stent Grafting for Aortic Arch Aneurysm in Aortoiliac Occlusive Disease following Aortic Arch Debranching and Aortobifemoral Reconstruction

Treatment of thoracic aortic aneurysms constitutes high mortality and morbidity rates despite improvements in surgery, anesthesia, and technology. Endovascular stent grafting may be an alternative therapy with lower risks when compared with conventional techniques. However, sometimes the branches of the aortic arch may require transport to the proximal segments prior to successful thoracic aortic endovascular stent grafting. Atherosclerosis is accounted among the etiology of both aneurysms and occlusive diseases that can coexist in the same patient. In these situations stent grafting may even be more complicated. In this report, we present the treatment of a 92-year-old patient with aortic arch aneurysm and proximal descending aortic aneurysm. For successful thoracic endovascular stent grafting, the patient needed an alternative route other than the native femoral and iliac arteries for the deployment of the stent graft. In addition, debranching of left carotid and subclavian arteries from the aortic arch was also required for successful exclusion of the thoracic aneurysm.

Treatment of Dacron Grafting Dilatation with Endovascular Stent Grafting

Dacron grafts are frequently used during surgical revascularization procedures. Complications including graft thrombosis and infection are well known; however, aneurysm formation is extremely rare. In this report, we describe dilatation of a Dacron graft detected four years after aortobifemoral bypass procedure in a 50-year-old male patient who was treated with endovascular stent grafting.