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Case report

Spontaneous Rupture of SFA

This is an 81-Year-old patient presented with a spontaneous rupture of the superficial femoral artery of the left leg and on arrival to hospital he developed DVT in the same leg with pulmonary emboli which makes the anticoagulation policy to be quiet interesting, IVC filter has been deployed and covered stent has been implanted in his ruptured artery with endoleak type 1 B which settled conservatively, I hope you enjoy watching this case and looking forward to all your great comments

Mr. Mohamed Omar Elfarok M.Sc, FRCSEng, FRCSEd, IME

Consultant Vascular Surgeon

Royal College of Surgeons of England Examiner

 

 

 

 

December 17, 2019 9 Comments
Technical note

Recorded webinar – Percutaneous Venous Arterialization

Up to 20% of patients with Critical Limb Ischemia (CLI) are not considered good candidates for endovascular revascularization. If recanalization of a chronic occlusion of a BTK/ BTA artery proves to be impossible owing to the inability to cross an extensive occlusion or in the presence of a “desert foot”, percutaneous venous arterialization has proven to be a bailout strategy for limb salvage. Drs. August Ysa and Marta Lobato, from Vascular Surgery Dpt. Hospital de Cruces, Barakaldo (Spain), present the last update in Percutaneous Venous Arterialization technique and expose a Case in the box.

December 11, 2019 No Comments
Case report

Extreme retrograde metatarsal puncture in a complex CLI case

After an unsuccessful antegrade recanalization attempt of the ATA/DP  due to vessel perforation, an extreme retrograde puncture of the first metatarsal artery was performed. Following a  1.5 mm balloon dilatation, the rendezvous of the wires was obtained using the CART technique. 2 mm DCB balloon angioplasty of the DP, 2.5mm for the distal ATA and 3mm for the proximal ATA were subsequently performed.  The completion angio showed full blushing of the target lesion, and  excellent flow on the forefoot including the plantar arch.

December 3, 2019 No Comments
Basic vascular surgery skills

Knee Disarticulation (Major Amputation)

Unfortunately, sometimes happens that we can not save a leg with our interventions. Here only the amputation remains. In this short film from the series “Basic vascular surgery skills” – you can follow the individual steps for disarticulation in the knee joint as a major amputation of the lower leg.

November 8, 2019 No Comments
Poll 04/10/2019 – 31/10/2019

Choice of antiplatelet therapy around complex revascularisation

A 79-year-old diabetic male patient with no history of coronary disease is referred to you to undergo angioplasty for tissue loss on the tips of the hallux and second toe. He is taking Aspirin 75mg. From preoperative imaging he needs a 20cm SFA occlusion stopping before the adductor hiatus recanalizing as well as multilevel tibial disease which appears to be a combination of short occlusions and stenoses. The dorsal pedal is seen in the foot and is in continuity with the arch. The PT artery appears occluded through it’s whole length.

Technical note

Retrograde recanalisation of the peroneal. Step by step with tips and tricks

The peroneal artery often represents the last arterial supply to the foot. The retrograde puncture of this vessel is often avoided because of its deep location and its small diameter. In this video all the tricks to succeed are presented with a step by step approach and a mix of procedural and fluoroscopical imaging to better understand the procedure

September 13, 2019 No Comments
Review of the literature

VRTD: The use of PTX coated devices in everyday clinical practice following the late mortality signal

Vascupedia Round Table broadcasted on September 2nd through the Vascupedia Live App about the use of PTX coated devices in everyday clinical practice following the late mortality signal

September 6, 2019 No Comments
Poll 05/09/2019 – 30/09/2019

Online education in vascular medicine

Shape your learning experience on Vascupedia

 

Dear colleagues, our mission is to help physicians worldwide to bring their interventions to perfection. Our hope is to indirectly contribute to safety and well-being of patients with vascular diseases.

Over a year ago, we started Vascupedia as a unique online project that we believe fulfills the need for free education in the challenging field of Vascular Medicine. Now it’s time to ask you to help us to become better for you! Are we offering the right information in the right way at the right level? Is there anything missing to support you in your quest to grow your knowledge to treat your patients in the best possible way? Please complete this short survey to make sure we will work on improving the platform to serve YOUR educational needs!

Recorded video case

Retrograde femoropopliteal recanalization through the dorsal pedal artery

This case demonstrates the recanalization of the femoropopliteal artery in a patient with CLTI. The reason for the solely retrograde approach was a Y-graft for AAA having the anastomoses at both common femoral arteries, the above-knee amputation of the contralateral limb and the extent of the disease. Primary stent implantation was performed by using the Pulsar-18 (Biotronik) bare-metal stent, which has a 4Fr profile and a proven efficacy according to the 4EVER trial.

July 14, 2019 No Comments
Recorded video case

TUTORIAL VIDEO: Venous arterialization using conventional “off-the-shelf” devices

Although we favor a more distal location of the AVF to circumvent the need to use covered stent extensions to destroy the valves and avoid bleeding off venous flow via collaterals, sometimes (e.g. due to extreme vessel calcification) it is unavoidable to have to look for a more proximal inflow. The versatility of the VAST maneuver allows to perform a proximal DVA at the origin of the PT artery with conventional off-the-shelf devices.”

JEVT 2019 Apr;26(2):213-218
JEVT 2019 Jun;26(3):427-428

July 7, 2019 1 Comment
Awareness

The power of surgical drawings

This presentation aims to highlight the usefulness of surgical drawing in practice. It sums up experiences, planning and real cases of the past 5 years of practice in vascular surgery. As I got tremendous positive feedback from patients, colleagues, GP’s, relatives and artists, I decided to share this experience with the vascular community.

June 13, 2019 1 Comment
Clinical investigation

The value of peripheral arterial IVUS in decision making

Despite the continuous development of endovascular modalities we still base our therapy in conventional angiographic imaging. IVUS might help us, however, to better understand the characteristics of the disease and guide our treatment. This presentation summarizes the value of peripheral arterial IVUS in our decision making process.

April 17, 2019 1 Comment