Endovascular treatment has rapidly progressed due to the improvements of the equipment and endovascular devices. Continual refinement of the technology and techniques associated with endovascular treatment has led interventionists to perform more complicated endovascular treatment. However, the numerous complications of endovascular treatment are now well recognized and described in the literature. This article reviews various complications of three main endovascular treatments: balloon angioplasty, stent or stent-graft placement, and catheter-directed thrombolysis.
Angioplasty, Balloon ; Stents

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No abstract available.

A 76-years old man with a ruptured abdominal aortic aneurysm underwent an emergency abdominal aortic replacement with artificial graft. The patient developed abdominal compartment syndrome at the day of the operation and he received secondary decompression operation the next day. At 45 hours after the second operation the patient was returned to operation room to close the abdominal fascia, and sigmoid colon necrosis was found so we performed sigmoid colectomy with colostomy. After 22 days from the last operation, the abdominal wound was closed completely and the patient was discharged at the 42nd postoperative day with a colostomy state. We report here on this complex case together with a review of the recent articles.
Aged ; Aortic Aneurysm, Abdominal* ; Colectomy ; Colon* ; Colon, Sigmoid ; Colostomy ; Compartment Syndromes ; Decompression ; Emergencies ; Fascia ; Humans ; Intra-Abdominal Hypertension* ; Ischemia* ; Necrosis ; Transplants ; Wounds and Injuries

Isolated aneurysm of the common iliac artery that is secondary to medial degeneration (MD) is a very rare clinical entity. MD is an important histological abnormality that is commonly seen in the annuloaortic ectasia with Marfan syndrome. This abnormality is also observed in congenital aortic disease, atherosclerosis, and aging. This aortic disease develops as the consequences of disruption of the medial elastic layers in association with loss of vascular smooth muscle cells and the accumulation of proteoglycans. An iliac aneurysm greater than 3 cm in diameter should be treated. The treatment options include open surgical replacement with prosthetic graft or endovascular stent grafting. We experienced one case of the isolated common iliac artery aneurysm in a 60 year-old female patient. Her chief complaint was a pulsatile painful mass in the left lower quadrant of the abdomen that she had suffered with for 5 days. She was treated by performing aorto-left external iliac artery bypass with a Dacron graft (10 mm in diameter). The result was excellent. We report here on a case of a isolated common iliac artery aneurysm that was caused by MD, and we include a review of the relevant literature.
Abdomen ; Aging ; Aneurysm* ; Aortic Diseases ; Atherosclerosis ; Blood Vessel Prosthesis ; Dilatation, Pathologic ; Female ; Humans ; Iliac Aneurysm ; Iliac Artery* ; Marfan Syndrome ; Middle Aged ; Muscle, Smooth, Vascular ; Polyethylene Terephthalates ; Proteoglycans ; Transplants

An aberrant right subclavian artery is the most common arch anomaly, and it occurs in approximately 1.0% of the population. It is caused by obliteration of the right fourth aortic arch during the early embryologic development. Aberrant right subclavian artery originates from a diverticulum; this was originally described by Kommerell. Aneurysms arising in an aberrant subclavian artery are rare, but they constitute a potentially lethal condition that can be treated successfully when this is appropriately identified. The presence of an aneurysm of the artery or Kommerell's diverticulum at its aortic origin is more likely to produce symptoms from the esophageal compression. Virtually all these patients have a superior mediastinal mass that may be asymptomatic, but such patients usually have symptoms of dysphagia, chest pain, or shortness of breath. The presence of an aneurysm of an anomalous subclavian artery is an indication for surgical resection. Resection of the aneurysm may be approached through either a right or left thoracotomy. We present here a case of an aberrant origin of the right subclavian artery together with a review of the literature.
Aneurysm* ; Aorta, Thoracic ; Arteries ; Chest Pain ; Deglutition Disorders ; Diverticulum ; Dyspnea ; Humans ; Subclavian Artery* ; Thoracotomy

Marfan syndrome is an inherited autosomal dominant disorder of the connective tissues, and the afflicted patients present with abnormalities of the skeletal, ocular, and cardiovascular system. The progressive dilatation of the proximal aorta leading to dissection and rupture is the typical feature and this can be a lethal complication of this disease. The incidence of Marfan syndrome is estimated to be 1 in 10,000 in most racial and ethnic groups. We experienced two cases of aortic aneurysm in Marfan syndrome. The first case was 32-year-old woman. She was admitted because of sudden onset of a painful abdominal mass for 2 days. Aortic aneurysm was diagnosed by CT and an echocardiogram showed severe mitral regurgitation (area ratio: 13/15). She underwent successful abdominal aortic aneurysm (AAA) repair and was discharged on postoperative 14th day; she was then prepared for open cardiac surgery for mitral valve replacement. The second case was 19- year-old woman. She was admitted with a known abdominal aortic aneurysm that she'd had for 1.5 years. She also underwent abdominal aortic aneurysm (AAA) repair that was technically successful, but she died on postoperative 10th day due to sudden cardiac arrest.
Adult ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Cardiovascular System ; Connective Tissue ; Death, Sudden, Cardiac ; Dilatation ; Ethnic Groups ; Female ; Humans ; Incidence ; Marfan Syndrome* ; Mitral Valve ; Mitral Valve Insufficiency ; Rupture ; Thoracic Surgery

Surgery for the inflammatory abdominal aortic aneurysm (IAAA) is a technically challenging procedure and it's associated with increased morbidity and mortality. Injuries of the vena cava, the duodenum, the left ureter and the renal vein are common in an operation for IAAA. Herein, we report 2 cases of ligation of the left renal vein during repair of the IAAA. Cases: The 1st case was a 75- year-old male patient, who had an abrupt onset of abdominal pain and a pulsatile abdominal mass. An 8.5 cm sized IAAA and left hydronephrosis were detected via CT angiogram. During the operation, the left renal vein was mobilized and then divided to gain access to the aneuysmal neck. We couldn't reconstruct the divided left renal vein. On the follow-up CT scan, the left renal vein drained into the left paravertebral plexus, and no renal congestion was demonstrated. The 2nd patient was a 72-year-old male who experienced sudden abdominal pain and a growing pulsatile mass on the abdomen. A huge IAAA 10.5 cm in diameter was detected in CT scan. During the repair of IAAA, the left renal vein was divided and ligated to expose the neck of the aneurysm. The divided left renal vein was anastomosed to the splenic vein in an end-to-side fashion instead of performing direct reconstruction. On follow-up CT scan, neither left renal congestion nor significant increment of the portal venous flow was noted. The two patients were doing well at the 15th and 10th postoperative month, respectively.
Abdomen ; Abdominal Pain ; Aged ; Aneurysm ; Aortic Aneurysm, Abdominal* ; Duodenum ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Humans ; Hydronephrosis ; Ligation* ; Male ; Mortality ; Neck ; Renal Veins* ; Splenic Vein ; Tomography, X-Ray Computed ; Ureter

Central venous stenosis or occlusion is a serious complication in end-stage renal disease patients undergoing maintenance hemodialysis. It is mostly secondary to trauma caused by temporary or permanent hemodialysis catheter placement. Venous hypertension may cause pain, edema of the ipsilateral arm and increased venous pressure prevents acceptable flow rates during dialysis. Venous bypass to the internal jugular vein, the external jugular vein, or axillary vein to saphenous vein bypass have been described as alternative options of surgical management. Our patients underwent internal jugular vein bypass. We think it is an effective and low risk surgical option.
Arm ; Axillary Vein ; Catheters ; Constriction, Pathologic ; Dialysis ; Edema ; Humans ; Hypertension ; Jugular Veins ; Kidney Failure, Chronic ; Renal Dialysis* ; Saphenous Vein ; Veins* ; Venous Pressure

PURPOSE: Peripheral artery disease (PAD) is thought one of the most serious complications caused by atherosclerosis, and the principal cause of death and disability in persons age 50 years or older. But, there is very little information on the prevalence of PAD in diabetic patients and relationship between risk factors and PAD in Korea. Thus, the authors conducted this study to find the risk factors for PAD in diabetic patients and help to improve patients' health. METHOD: A total of 149 Korean NIDDM patients were enrolled. All subject's systolic blood pressures in arm and ankle were measured with a Doppler ultrasonic instrument, from which ankle-brachial pressure index (ABPI) was derived. We also examined clinical and biochemical parameters in all patients. RESULT: Systolic pressure, total cholesterol, TG, LDL were higher and albumin were lower in diabetic patients with PAD than in diabetic patients without PAD (p value < 0.01). Logistic regression analysis showed that hypoalbuminemia and hypertriglyceridemia were independent risk factor of PAD. CONCLUSION: In the light of these results, it seems reasonable to suggest that hypoalbuminemia and hypertriglyceridemia in diabetic patients may play a role in the pathogenesis of PAD.
Ankle ; Arm ; Arteries ; Atherosclerosis ; Blood Pressure ; Cause of Death ; Cholesterol ; Diabetes Mellitus, Type 2 ; Humans ; Hypertriglyceridemia ; Hypoalbuminemia ; Korea ; Logistic Models ; Peripheral Arterial Disease* ; Prevalence ; Risk Factors* ; Ultrasonics