Main arena

Welcome to the Main Arena of Vascupedia. Here you can share your experience, express your opinion, participate in discussions and expand your knowledge. You can upload your presentation (case report, recorded video cases, lecture) or comment on posts of your colleagues. Your active participation will contribute to the education experience of all vascular specialists and will improve vascular care worldwide.

Live case

Creation of percutaneous arteriovenous fistula in a complex case

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.

December 6, 2018 No Comments
Review of the literature

Surgical versus percutaneous arteriovenous fistula (pAVF): it’s all about hemodynamics

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.

December 6, 2018 No Comments
Technical note

Real world experience: nephrologists’ opinion on pAVFs

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.

December 6, 2018 No Comments
Recorded video case

Use of endoanchors for EVAR sealing in case of ruptured AAA

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

December 2, 2018 No Comments
Case report

Decision making by a complex case of iatrogenically created A-V fistula with concomitant AAA and fem-pop bypass occlusion

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?

November 29, 2018 No Comments
Live case

Two different techniques for retrograde infrainguinal CTO recanalization

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).

November 26, 2018 No Comments
Recorded video case

Preloaded custom-made fEVAR. Step by step procedure

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.

November 21, 2018 No Comments
Live case

CiDA: Percutaneous AV fistula between proximal radial artery and deep communicating vein

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.

November 19, 2018 No Comments
Recorded video case

Emergency triple chimney in a patient with giant symptomatic pararenal pseudoaneurysm and subsequent gutter embolization

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

November 18, 2018 3 Comments
Recorded video case

Step by step bilateral common iliac aneurysm endovascular repair with Gore IBE (iliac branched endograft) and C3 device.

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.

November 14, 2018 No Comments
Recorded video case

Giant proper hepatic aneurysm endovascular treatment with covered stent deployment

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

November 14, 2018 No Comments
Recorded video case

Percutaneous large bore axillary artery access technique for complicated EVAR

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.

November 11, 2018 No Comments
Question to the Vascupedians

Two cases of tibial vessel post-traumatic pseudoaneurysm: still space for surgery ?

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.

November 11, 2018 No Comments

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