Endovascular procedures are increasing in number for the treatment of thoracic aortic diseases (TAD). Retrograde approach through the femoral artery is the preferred vascular access. Despite the improvements in the devices, femoral artery complications still occurs and some times this access is not possible because of the small size of the vessels, obstruction, calcification, dissection or extreme tortuosity. An axillary approach could be an alternative. We present a series of five patients and describe the technique we used in the axillary artery approach to treat TAD. There were two ascending aortas and three descending aortic aneurysms treated. The left axillary artery was used in three patients and the right in two. There were no local or neurological complications. In this preliminary approach, both axillary arteries were a good alternative access for endovascular graft insertion to treat aortic diseases when femoral access was not possible or was suboptimal.
Cardiac stimulation therapy has evolved significantly over the past 30 years. Currently, cardiac implantable electronic devices (CIED) are the mainstream therapy for many potentially lethal heart conditions, such as advanced atrioventricular block or sustained ventricular tachycardia or fibrillation. Despite sometimes being lifesaving, the implant is surgical and therefore carries all the inevitable intrinsic risks. In the process of technology evolution, one of the most important factors is to make it safer for the patient. In the context of CIED implants, complications include accidental puncture of intrathoracic structures. Alternative strategies to intrathoracic subclavian vein puncture include cephalic vein dissection or axillary vein puncture, which can be guided by fluoroscopy, venography or, more recently, ultrasound. In this article, the authors analyse the state of the art of ultrasound-guided axillary vein puncture using evidence from landmark studies in this field.
Horseshoe kidney is a rare congenital anomaly that may cause various technical problems during conventional repairs of abdominal aortic aneurysms. We report the case of a 68-year-old woman with a horseshoe kidney, symptomatic abdominal aortic aneurysm and mild renal failure. The patient underwent endovascular repair using a bifurcated endoprosthesis. The postoperative was uneventful. We describe the diagnosis and the endovascular technique and literature review.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.