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Leopoldo Marine, MD, Rishi Gupta, MD, Heather L. Gornik, MD, Vikram S

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Presentation on theme: "Leopoldo Marine, MD, Rishi Gupta, MD, Heather L. Gornik, MD, Vikram S"— Presentation transcript:

1 Glue embolus complicating the endovascular treatment of a patient with Loeys-Dietz syndrome 
Leopoldo Marine, MD, Rishi Gupta, MD, Heather L. Gornik, MD, Vikram S. Kashyap, MD  Journal of Vascular Surgery  Volume 52, Issue 5, Pages (November 2010) DOI: /j.jvs Copyright © 2010 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Computed tomography angiography reveals a new 2.6-cm proximal left subclavian artery (LSA) pseudaneurysm (short arrow) and a new 1.4-cm distal left internal carotid artery (ICA) dilation at the bottom of a complete coil (long arrow) in a patient with LDS. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Marker catheter angiography via the left subclavian artery (A) documents a large pseudoaneurysm (B) with the vertebral (C), internal mammary arteries (D), and thyrocervical trunk (E) in close proximity. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Embolization and stent graft therapy of the LSA pseudoaneurysm using a combined brachial and femoral approach. Multiple coils have been already placed into the vertebral artery in this staged procedure. The brachial glide catheter (left) is used to select a thyrocervical branch for embolization. The femoral angled catheter (bottom) allows contrast injections and eventual guidewire and stent graft placement. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Completion imaging after stent graft deployment showing an excluded left subclavian artery (LSA) pseudoaneurysm with no evidence of antegrade flow into the aneurysm, or endoleak from LSA branches. The coil and glue mass in the LSA pseudoaneurysm is seen. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

6 Fig 5 Glue embolus to the mid-brachial artery complicating this endovascular case. Late images (not shown) revealed a patent distal brachial artery allowing a brachial-to-brachial reversed vein bypass. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

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