Welcome to the Library of Vascupedia. Use our filters on the left side of the page to quickly find the content of your interest. You may select an area of interest and the respective indication or the media type.
Dr. Mallios (Vascular Surgeon, Paris) demonstrates in a complex live case the percutaneous creation of an arteriovenous fistula with the Ellipsys system (Avenu Medical) and discusses with the experts all relevant steps of the procedure.
Dr. Franco summarizes all important information about hemodynamics after open surgical and percutaneous AVF creation. Especially, as regards the latter, he explains why pAVF leads the physicians to think out of the box and re-define all aspects about maturation, high-flow and steal phenomenon.
Dr. Hebibi (nephrologist, Paris, FR) demonstrates her real-world experience with the percutaneous arteriovenous fistulae. She presents recorded videos from the cannulation of the fistulae and discusses important technical aspects, which are important for every nephrologist.
63 y.o. patient treated in the emergency setting for ruptured AAA
Endovascular repair planned despite proximal hostile anatomy and left iliac aneurysm with thrombus.
procedure details:
-bilateral percutaneous access
-bifurcated endurant endograft implant (left hypogastric embolization)
-partial left renal artery coverage @ control angio (intentional aggressive deployment)
-renal stenting
-type Ia endoleak after renal stenting, persistent after re-ballooning
-endoleak correction with endoanchors
Case presentation:
41 years old female patient presenting with swelling of both limbs, diffuse aching, heaviness and tiring of both extremities since 5 years from a previous deep vein thrombosis on both limbs. At the time of presentation, the patient showed severe dermatoliposclerosis on the right extremity and ulceration at the level of the left internal malleolus. The patient had no other risk factors except Factor V Leiden mutation.
This is a complex case of a 74-year-old female with an acute onset of rest pain of the right limb. Previous Rx: primary stenting of both renal arteries, endovascular repair of both CIA in CERAB technique and fem-pop 1 bypass right limb.
During her current readmission, the CT-scan revealed a high-flow AV fistula of the right CFA, an abdominal aortic aneurysm (4.7 cm), an occluded stent in the right renal artery as well as an occluded fem-pop bypass. What would you do in this case?
This live case demonstrates two different techniques of retrograde recanalization: through collaterals of the CTO and through a retrograde tibial puncture. Moreover, you will see tips and tricks about the snaring of the wire and the further steps of such a procedure. Finally, the intervention was performed with CO2 angiography due to the chronic kidney disease of this patient suffering from chronic limb-threatening ischemia (CLTI).
Preloaded custom-made fEVAR (Cook) in a 63 y.o. male with pararenal abdominal aortic aneurysm 55 mm. This video shows all the procedural steps and the CT scan at 1 month.
- Chronic ischaemic heart disease with left ventricular apex aneurysm
- Left mild intermittent claudication 500 mt (Left common iliac artery chronic occlusion)
- COPD
- Chronic celiac artery occlusion
We used Begraft 10x37 in SMA, 8x27 for left renal and 7x18 in right renal.
We are delighted to offer to our Vascupedians the opportunity to watch again the first live case of pAVF creation in the most important vascular access meeting in the world: CiDA. In this completely unedited video Dr Mallios creates a percutaneous AVF with the Ellipsys Vascular Access System (Avenu Medical Juan Capistrano CA USA) between the proximal radial artery and the deep communicating vein at the level of proximal forearm.
We report a case of pararenal pseudoaneurysm endovascular correction with triple chimney technique and the following gutter embolization procedure
Key points:
-Previous fEVAR attempt (failed because of extremely tortuous accesses)
-Emergency procedure during the night
-Bilateral percutaneous femoral access
-Double axillary puncture on both sides
-Challenging endograft advancement on through and through guidewire
-Triple ChEVAR (SMA, RRA, LRA)
-Subsequent gutter embolization
Bilateral common iliac aneurysm endovascular repair with an iliac branched device in a 63 years old patient. This video demonstrates the procedural steps and the CT scan at 3 years of surveillance.
Notice: Intentional cross-leg because of short lowest renal to hypogastric distance.
Total endovascular treatment of a huge visceral artery aneurysm (proper hepatic) with covered stent deployment.
-Flexor 6 Fr delivered into common hepatic artery
-Bentley BeGraft 8*37 mm positioned over Rosen guidewire and balloon inflated
-Patency of gastroduodenal artery and both efferent branches @ final angio
-Complete aneurysm exclusion with collateral's patency at control CT Scan
The postischemic compartment syndrome of lower extremity could lead to devastating complications, particularly after a successful revascularization procedure.
The following presentation summarises the pathophysiology, diagnostic and treatment options for this entity.
This video demonstrates step by step the technique of percutaneous axillary artery access for the endovascular repair of complex aortic aneurysms. The technique includes the ultrasound-based identification of the vessels and the nerve, the introduction of the closure system, the performance of the intervention and the angiographic control after closing the puncture site.
This case presents important intraoperative steps of the endovascular treatment of non-thrombotic iliac vein lesion (May Thurner) as well as the key features of the VICI stent (Boston Scientific).
We report two cases of tibial vessel pseudoaneurysms. Due to the endovascular failure and their location, these lesions may require surgical intervention and removal. The presentation, the diagnostic evaluation, and the surgical management of the pseudaneurysms are discussed.
This video summarizes in 3 minutes all important steps to perform an isolated antegrade aortomesenteric bypass. The patient had a chronic occlusion of the superior mesenteric artery and underwent a primary stenting of a high-grade stenosis of the celiac trunk (CT). The endovascular recanalization of the SMA at that time was not feasible. The CT-stent occluded 8 months postimplantation with a complete thrombosis of the hepatic artery as well. The splenic artery arose from the aorta directly.
Dr. Bisdas (Vascular Surgeon, Muenster, Germany) explains step by step the deployment of a branched endograft for the endovascular treatment of thoracoabdominal aortic aneurysms. Check out important technical issues about the positioning of the anterior markers, the right recognition of the markers for each branch and the importance of the J tip for a precise and successful implantation of the branched endograft.
In this case report, we present a special freestyle technique treating a gigantic ascending aortic aneurysm, replacing the aortic root and ascending aorta with a porcine bioprosthesis.
