A traumatic pseudoaneurysm of the suprarenal abdominal aorta was diagnosed in a 58-year-old man 32 years after he received a gunshot wound to the abdomen. Epigastric pain and obstructive jaundice were the presenting symptoms. Repair was performed by intraluminal polytetrafluoroethylene patch aortoplasty with resolution of the biliary obstruction. The literature on traumatic abdominal aortic pseudoaneurysm is reviewed and reveals that this report is the first to describe biliary obstruction caused by such a lesion.
Renal artery compression by fibromuscular bands containing sympathetic nerves and ganglia was encountered in 3 of 75 patients with renovascular hypertension. The hypertension was successfully managed by resection of the bands. The absence of mortality and morbidity dictates that the "stenotic" area of the renal artery be explored, especially in children and adults with minimal angiographic evidence of visceral atherosclerosis, before proceeding with a bypass graft to the renal artery.
venography showed compression of the left renal vein outflow by the right iliac artery with a significant gradient. We performed a novel operation in which we transected the left iliac vein and reconstructed it anterior to the left iliac artery to relieve the point of compression. Results: At 6 months of follow-up, the patient's hematuria and left lower quadrant pain had resolved. Surveillance magnetic resonance angiography of the bypass revealed a patent left iliac vein and renal vein with no signs of compression. Conclusions: This is a unique case of nutcracker syndrome occurring in a pelvic kidney. We used a novel surgical technique to reconstruct the iliac vein in a manner that relieved the obstruction. In medium-term follow-up, the reconstruction remains patent and the patient remains symptom-free.
Conclusions:We report a new classification using unenhanced CT that is accurate and reliable for assessment of access vessels for percutaneous ELD deployment. The classification is defined relative to the delivery sheath, applicable to any ELD implant and can facilitate inter-center and inter-device studies related to transfemoral endovascular access. Table. Iliac-Femoral-Aortic Classification (IFAC)
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