Transcatheter embolization of congenital coronary arterial fistulas in adults

1999 ◽  
Vol 9 (4) ◽  
pp. 371-376 ◽  
Author(s):  
Antônio M. Kambara ◽  
Carlos A. C. Pedra ◽  
C,sar A. Esteves ◽  
Manoel N. Cano ◽  
Sérgio L. N. Braga ◽  
...  
Keyword(s):  
Bronchial Artery ◽  
Transcatheter Embolization ◽  
Pulmonary Trunk ◽  
Circumflex Artery ◽  
Catheterization Laboratory ◽  
Transcatheter Occlusion ◽  
Acceptable Alternative ◽  
The Right ◽  
Guiding Catheter

AbstractIn this report, we describe our experience with transcatheter occlusion of congenital coronary arterial fistulas in adults. From November 1992 to November 1996, 5 symptomatic patients, aged from 47 to 70 years, underwent transcatheter occlusion of fistulas using a retrograde arterial approach. All had chest pain or dyspnea on exertion. Detachable balloons were used in 4 patients, and Gianturco coils in 1. Detachable balloons were implanted through a Debrun system, while the coils were implanted through a 5 French right coronary Judkins catheter. Both were passed through an 8 French guiding catheter (Amplatz II). Each patient had a single fistula. The fistulas originated from the right coronary artery in 3 patients, and from the circumflex artery in 2. They drained into the pulmonary trunk in 3 patients, into the right atrium in 1, andinto a bronchial artery in the other. All fistulas were occluded completely in the catheterization laboratory, and the procedures were uncomplicated. At follow up, 3 patients underwent coronary angiography, and there was no evidence of recanalization. Transcatheter embolization in adults of single congenital coronary fistulas with detachable balloons and coils is safe and effective and can be regarded as an acceptable alternative to surgery.

scholarly journals A Case of Congenital Bronchial Pulmonary Arterial Malformation Successfully Treated by Embolization

2018 ◽  
Vol 02 (03) ◽  
pp. 201-204
Author(s):  
Ferdinand Chu ◽  
Ko Sit ◽  
King Kwok
Keyword(s):  
Bronchial Artery ◽  
Effective Means ◽  
Rare Condition ◽  
Embolic Material ◽  
Right Pulmonary Artery ◽  
Pulmonary Arterial ◽  
The Right ◽  
Arterial Malformation ◽  
Right Bronchial Artery

AbstractIdiopathic bronchial pulmonary arterial malformation (BPAM) is a very rare condition. The authors present a case of BPAM in which a right bronchial artery communicates with a main upper lobe branch of the right pulmonary artery. It was successfully treated by embolization in one setting. The patient remained asymptomatic and well during the follow-up period. The authors therefore conclude that if the embolic material/device is carefully chosen, it is a safe and effective means of treating BPAM.

Endovascular Treatment of Multiple Bronchial Artery Aneurysms With Prominent Fistula to Pulmonary Artery in a Patient With Interstitial Lung Disease: A Case Report and Literature Review

2019 ◽  
Vol 53 (6) ◽  
pp. 492-496
Author(s):  
Yuan Li ◽  
Guang-Chao Gu ◽  
Bao Liu ◽  
Jiang Shao ◽  
Yu Chen ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Bronchial Artery ◽  
Pulmonary Arteries ◽  
Artery Aneurysm ◽  
Transcatheter Embolization ◽  
Life Threatening ◽  
Nontarget Embolization ◽  
Feeding Vessels ◽  
The Right

Bronchial artery aneurysm (BAA) is a rare entity. Ruptured BAA can cause life-threatening hemorrhage. It is recommended that treatment should be initiated immediately after diagnosis. We present the case of a 56-year-old female with multiple BAAs and interstitial lung disease. Aortic computed tomography angiography demonstrated that the largest aneurysm at the right hilum was fed by right subclavian artery and right bronchial artery. A fistula between the pulmonary trunk and the aneurysm was also revealed. The patient underwent transcatheter embolization. Coils were placed in the feeding vessels instead of the aneurysms to avoid nontarget embolization of the pulmonary arteries through the fistula. The procedure achieved reduction in aneurysmal blood flow. The patient’s cough resolved at 6-month follow-up.

Abstract 141: A Case of Kawasaki Disease with Re-dilatation of a Coronary Artery Aneurysm after Regression

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Kensuke Oka ◽  
Takaomi Minami ◽  
Tatsuya Anzai ◽  
Sadahiro Furui ◽  
Akiko Yokomizo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Angiography ◽  
Artery Aneurysm ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Ct ◽  
History Of ◽  
The Right

Background: In patients with Kawasaki disease (KD), re-dilatation of coronary artery lesions (CAL) after regression is very rare. Here we report a case of KD with CAL re-dilatation after regression. Case report: A 15-year-old boy was diagnosed with KD at 1 year of age and was treated with intravenous immunoglobulin (IVIG, 400 mg/kg х 5 days). On day 14, echocardiography revealed CAL on the right coronary artery (RCA) and left coronary artery (LCA). Coronary arteriographic findings were as follows: segment 1, 3 mm in diameter; segment 6, 5 mm in diameter. He was prescribed aspirin, ticlopidine, and warfarin for 3 years. When he was 3 years old, coronary angiography showed complete CAL regression. His medications were discontinued and he underwent routine follow-up by echocardiography on which the CAL were not seen. At 14 years of age, coronary CT revealed re-dilatation of the LCA. Coronary angiography showed the same findings: 7 mm in diameter at the bifurcation between the LAD and the left circumflex artery, while the other regions were intact. He restarted aspirin and warfarin. The mechanism of CAL re-dilatation remains unclear; however, it is very important to follow patients carefully and routinely using echocardiography and/or coronary computed tomography, especially in cases with a history of CAL.

scholarly journals Different conduits for the right ventricular outflow tract reconstruction in adults during the Ross procedure

2015 ◽  
Vol 17 (2) ◽  
pp. 23 ◽  
Author(s):  
A. M. Karaskov ◽  
I. I. Demin ◽  
R. M. Sharifulin ◽  
S. I. Zheleznev ◽  
A. V. Bogachev-prokofev ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Multivariable Analysis ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Ross Procedure ◽  
Acceptable Alternative ◽  
The Right ◽  
Pulmonary Homograft

We compared different conduits for the right ventricular outflow tract reconstruction (RVOT) in adults during the Ross procedure. Between 1998 and 2012, 586 consecutive adult patients underwent the Ross procedures. Mean age was 45,514,2 years. The RVOT was reconstructed with a diepoxy-treated xenografts in 372 and with glutaraldehyde-treated in 88 patients. A pulmonary homograft was used in 125 patients. Hospital mortality was 4,9%. Mean follow up was 43,216,9 months. At discharge systolic gradient was 8,1 3,7 mm.Hg for the pulmonary homograft, 11,44,7 mm.Hg for the diepoxytreated and 14,96,1 mm.Hg for the glutaraldehyde-treated xenopericardial conduits. Twenty eight patients underwent reoperation. The 3-year actuarial freedom from conduit explantation for pulmonary homograft was 100%, for diepoxy- and glutaraldehyde-treated xenopericardial conduits 99,20,7% and 84,74,7% respectively. Multivariable analysis identified the type of xenograft and age as independent factors for xenograft dysfunction. Results from this study show that the pulmonary homograft is the most preferred conduit for the RVOT reconstruction during the Ross procedure. The diepoxy-treated xenopericardial conduits are acceptable alternative to the homograft in patients older 45 years.

Transcatheter Embolization Treatment of Coronary Arteriovenous Fistulas

2003 ◽  
Vol 11 (1) ◽  
pp. 63-67
Author(s):  
Ümrah Aydogan
Keyword(s):  
Arteriovenous Fistula ◽  
Surgical Intervention ◽  
Transcatheter Embolization ◽  
Transcatheter Occlusion ◽  
Surgical Ligation ◽  
Arteriovenous Fistulas ◽  
Coronary Arteriovenous Fistula ◽  
Embolization Treatment ◽  
Valve Insufficiency

Transcatheter coronary arteriovenous fistula occlusion was performed in 5 children with a median age of 5.3 years (range, 0.7 to 11 years). Surgical ligation had been carried out previously in one case, but recanalization occurred during follow-up. Dilation of the feeding artery was observed in 4 patients, with an additional aneurysm of the coronary artery in one of these. Occlusion was attempted three times in 1 patient, twice in 2, and once in the other 2. Detachable balloons were used in 2 procedures, and controlled-release coils in 3. Complete occlusion of the fistula was achieved in 4 patients. In the 5th patient, occlusion of one of two fistulas was unsuccessful, and mild to moderate aortic valve insufficiency developed due to catheter manipulation. Our experience indicates that transcatheter occlusion of congenital coronary arteriovenous fistula is at least as successful as surgical intervention. Multiple occlusion procedures can be avoided by selecting the optimal technique in each case.

A novel system for the reconstruction of a coronary artery lumen profile in real time: a preclinical validation

2009 ◽  
Vol 297 (1) ◽  
pp. H485-H492 ◽  
Author(s):  
Ghassan S. Kassab ◽  
Jenny S. Choy ◽  
Mark Svendsen ◽  
Anjan K. Sinha ◽  
Mouhamad Alloosh ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Real Time ◽  
Vessel Diameter ◽  
Circumflex Artery ◽  
Cross Sectional ◽  
Catheterization Laboratory ◽  
Left Circumflex Artery ◽  
The Mean ◽  
The Difference ◽  
The Right

Accurate sizing of vessel diameter is important for understanding the physiology of blood vessels as well as the treatment of coronary and peripheral artery disease. The objective of this study was to validate a novel catheter-based system [the LumenRECON (LR) system] for the real-time reconstruction of lumen cross-sectional area (CSA) along the length of a vessel segment. A total of 22 swine (20 Yorkshire and 2 atherosclerotic Ossabaw swine) were used to evaluate the accuracy, reproducibility, and safety of the system compared with intravascular ultrasound (IVUS). The CSA of the right coronary artery, left anterior descending coronary artery, and left circumflex artery were determined by IVUS and the LR system over a 3- to 4-cm segment in 12 Yorkshire and 2 atherosclerotic Ossabaw swine and 2 postmortem atherosclerotic human hearts. In eight chronic animals, the effect of the LR catheter on the vessel wall was evaluated at 1 day and 2 wk (4 animals each) after the intervention. A Bland-Altman plot of the LR and IVUS data showed a mean difference between the two measurements of 0.055 mm in diameter, which was not statistically significant from zero, indicating a lack of bias in the comparison of the LR system with IVUS. The root mean square error of the two measurements was 10.2% of the mean IVUS diameter. The repeatability of the LR system was assessed using duplicate measurements. The mean of the difference between the two measurements was nearly zero, and the repeatability coefficient was within 4.5% of the mean of the two measurements. No injury or intimal hyperplasia was found acutely or chronically after the use of the LR system. This study establishes the accuracy, reproducibility, and safety of a nonimaging 2.7-Fr catheter for lumen sizing of coronary arteries. The system provides a continuous quantitative axial profile of the mean vessel lumen in real time and may have significant utility in vascular research and clinically in the catheterization laboratory.

CASE REPORT: SURGICAL MANAGEMENT OF LUMBAR COMPRESSION FRACTURE

2019 ◽  
Vol 1 (4) ◽  
Author(s):  
Yustinus Robby Budiman Gondowardojo ◽  
Tjokorda Gde Bagus Mahadewa
Keyword(s):  
Spinal Cord ◽  
Left Lung ◽  
Lumbar Vertebrae ◽  
Compression Fracture ◽  
High Mobility ◽  
Early Mobilization ◽  
Cord Injury ◽  
Cardiothoracic Surgeon ◽  
The Right

The lumbar vertebrae are the most common site for fracture incident because of its high mobility. The spinal cord injury usually happened as a result of a direct traumatic blow to the spine causing fractured and compressed spinal cord. A 38-year-old man presented with lumbar spine’s compression fracture at L2 level. In this patient, decompression laminectomy, stabilization, and fusion were done by posterior approach. The operation was successful, according to the X-Ray and patient’s early mobilization. Pneumothorax of the right lung and pleural effusion of the left lung occurred in this patient, so consultation was made to a cardiothoracic surgeon. Chest tube and WSD insertion were performed to treat the comorbidities. Although the patient had multiple trauma that threat a patient’s life, the management was done quickly, so the problems could be solved thus saving the patient’s life. After two months follow up, the patient could already walk and do daily activities independently.

Upper instrumented vertebra to the right of the lowest instrumented vertebra as a predictor of an increase in the main thoracic curve after selective posterior fusion for the thoracolumbar/lumbar curve in Lenke type 5C adolescent idiopathic scoliosis: multicenter study on the relationship between fusion area and surgical outcome

2019 ◽  
Vol 31 (6) ◽  
pp. 857-864 ◽  
Author(s):  
Hiroki Oba ◽  
Jun Takahashi ◽  
Sho Kobayashi ◽  
Tetsuro Ohba ◽  
Shota Ikegami ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Posterior Fusion ◽  
Main Thoracic ◽  
Lowest Instrumented Vertebra ◽  
Line Tilt ◽  
The Right ◽  
Upper Instrumented Vertebra

OBJECTIVEUnfused main thoracic (MT) curvatures occasionally increase after selective thoracolumbar/lumbar (TL/L) fusion. This study sought to identify the predictors of an unacceptable increase in MT curve (UIMT) after selective posterior fusion (SPF) of the TL/L curve in patients with Lenke type 5C adolescent idiopathic scoliosis (AIS).METHODSForty-eight consecutive patients (44 females and 4 males, mean age 15.7 ± 2.5 years, range 13–24 years) with Lenke type 5C AIS who underwent SPF of the TL/L curve were analyzed. The novel “Shinshu line” (S-line) was defined as a line connecting the centers of the concave-side pedicles of the upper instrumented vertebra (UIV) and lowest instrumented vertebra (LIV) on preoperative radiographs. The authors established an S-line tilt to the right as S-line positive (S-line+, i.e., the UIV being to the right of the LIV) and compared S-line+ and S-line− groups for thoracic apical vertebral translation (T-AVT) and MT Cobb angle preoperatively, early postoperatively, and at final follow-up. The predictors for T-AVT > 20 mm at final follow-up were evaluated as well. T-AVT > 20 mm was defined as a UIMT.RESULTSAmong the 48 consecutively treated patients, 26 were S-line+ and 22 were S-line−. At preoperative, early postoperative, and final follow-up a minimum of 2 years later, the mean T-AVT was 12.8 mm (range −9.3 to 32.8 mm), 19.6 mm (range −13.0 to 41.0 mm), and 22.8 mm (range −1.9 to 68.7 mm) in the S-line+ group, and 10.8 mm (range −5.1 to 27.3 mm), 16.2 mm (range −11.7 to 42.1 mm), and 11.0 mm (range −6.3 to 26.9 mm) in the S-line− group, respectively. T-AVT in S-line+ patients was significantly larger than that in S-line− patients at the final follow-up. Multivariate analysis revealed S-line+ (odds ratio [OR] 23.8, p = 0.003) and preoperative MT Cobb angle (OR 7.9, p = 0.001) to be predictors of a UIMT.CONCLUSIONSS-line+ was defined as the UIV being to the right of the LIV. T-AVT in the S-line+ group was significantly larger than in the S-line− group at the final follow-up. S-line+ status and larger preoperative MT Cobb angle were independent predictors of a UIMT after SPF for the TL/L curve in patients with Lenke type 5C AIS. Surgeons should consider changing the UIV and/or LIV in patients exhibiting S-line+ during preoperative planning to avoid a possible increase in MT curve and revision surgery.

Sign in / Sign up

Export Citation Format

Share Document