Dataset Information

The conundrum of endovascular common femoral artery treatment: a case report of lithoplasty as a viable solution.

ABSTRACT:

Background

Highly calcific stenosis located in common femoral artery (CFA) represents a difficult target for endovascular treatment due to the possible need for stent implantation in that area.

Case summary

A 63-year-old man with history of coronary artery disease and previous multiple percutaneous transluminal angioplasties for peripheral artery disease (PAD) was admitted for recent onset left lower limb pain at rest with severe activity restriction (Leriche-Fontaine Class III and Rutherford Class III-IV). The angio-computed tomography scan showed a highly calcific stenosis of left CFA. The patient underwent lithoplasty balloon angioplasty followed by drug-eluting balloon inflation with excellent angiographic result and complete blood flow restoration. No procedural complications occurred.

Discussion

Highly calcified stenosis in PAD represents a huge challenge for endovascular treatment as not all lower extremity arteries are suitable for stenting because of compressive and torsional forces associated with stent fracture and restenosis. Lithoplasty is a new technology allowing effective blood flow restoration while minimizing vessel injury.

SUBMITTER: Trani C

PROVIDER: S-EPMC6764558 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

The conundrum of endovascular common femoral artery treatment: a case report of lithoplasty as a viable solution.

Trani Carlo C Russo Giulio G Aurigemma Cristina C Burzotta Francesco F

European heart journal. Case reports 20190729 3

<h4>Background</h4>Highly calcific stenosis located in common femoral artery (CFA) represents a difficult target for endovascular treatment due to the possible need for stent implantation in that area.<h4>Case summary</h4>A 63-year-old man with history of coronary artery disease and previous multiple percutaneous transluminal angioplasties for peripheral artery disease (PAD) was admitted for recent onset left lower limb pain at rest with severe activity restriction (Leriche-Fontaine Class III an ...[more]

PMID: 31660495

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Project description:BackgroundAfter orthotopic liver transplantation (OLT), complications such as hepatic artery stenosis, thrombosis, and bleeding are possible. Hepatic artery pseudoaneurysms (HAP) are prone to rupture, rupture hemorrhage, and increased mortality risk. Endovascular treatment of HAP may result in recurrence, even after successful embolization with thrombin. Formation of a HAP in the common hepatic artery (CHA) is challenging because the CHA is the only artery in the liver graft after OLT. Therefore, CHA embolization in HAP is not an initial option. We report a case of HAP at the CHA after OLT that was treated with endovascular therapy, resulting in the occlusion of the CHA with coil embolization, achieving a radical cure.Case presentationA 59-year-old man with decompensated hepatitis C virus cirrhosis underwent deceased donor whole-liver transplantation after graft failure of a living donor liver transplantation. After the second transplantation, the patient developed infectious narrow-necked HAP at the CHA associated with postoperative pancreatic fistula. Repeated transcatheter arterial embolization with thrombin and n-butyl-2-cyanoacrylate was unsuccessful, as confirmed by postprocedure angiography, which revealed recanalization and regrowth of the HAP. Eight months after the first transcatheter arterial embolization, the patient presented with a chief complaint of abdominal pain due to an enlarged HAP. Angiography of the superior mesenteric artery (SMA) revealed a collateral bypass around the bile duct from the SMA to the liver graft. Coil embolization of the HAP in the CHA completely occluded the HAP without complications. More than 2 years after coil embolization, the liver graft function test results remained within normal limits without HAP recurrence.ConclusionsHAP at the CHA after liver transplantation can be fatal if ruptured. Because the liver is a highly angiogenic organ, even if initial treatment is not successful, radical treatment to occlude the CHA with HAP is possible if sufficient collateral vessels are developed.

Dataset Information

The conundrum of endovascular common femoral artery treatment: a case report of lithoplasty as a viable solution.

Background

Case summary

Discussion

Publications

The conundrum of endovascular common femoral artery treatment: a case report of lithoplasty as a viable solution.

Similar Datasets

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