Endovascular stent-graft implantation is an alternative to conventional open surgery for the treatment of aortic aneurysm. Forty-nine consecutive patients with aortic aneurysm (thoracic, n = 17; infrarenal, n = 32) were treated with endovascular stent-graft implantation. Complications occurred in 25 patients (two patients had two complications): endoleak (n = 13), graft thrombosis (n = 5), graft kinking (n = 2), pseudoaneurysm caused by graft infection (n = 1), graft occlusion (n = 1), shower embolism (n = 1), perforation of mural thrombus by means of inadvertent penetration of delivery system (n = 1), colon necrosis (n = 1), aortic dissection (n = 1), and hematoma at the arteriotomy site (n = 1). Imaging findings were analyzed for spiral computed tomography, plain abdominal radiography, transesophageal echocardiography, and digital subtraction angiography. Since some of these complications are fatal, radiologists need to instantly and accurately recognize them. Awareness and understanding of possible complications should help ensure a safe, successful procedure.
Superselective IA-CTA is a useful technique to correctly identify the intratumoral perfusion and to predict tumor response to the intra-arterial chemotherapy of advanced maxillary sinus cancer.
The purpose of this case report is to determine the unique pathogenesis of a "spared flow tract" through a thick mural thrombus of an aortic aneurysm mimicking the penetrating or dissecting tract of an impending or acute rupture of an abdominal aortic aneurysm (AAA) and to discuss its clinical importance. Three blood flow tracts (i.e., spared flow tracts) penetrating to aortic major branches (inferior mesenteric arteries in two and left renal artery in one) through thick mural thrombi of three aortic aneurysms were found on thin section spiral CT scans. Histopathological examination revealed that the tracts were formed by thrombi and partially covered with endothelial cells. In conclusion, spared flow tracts may be pathways continuing to the aortic major branches through thick mural thrombi of aortic aneurysms and are spared from thrombogenesis because of relatively high blood flows. Their pathogenesis is definitely different from penetrating or dissecting tracts within mural thrombi of ruptured AAAs. Spared flow tracts should not be misinterpreted as penetrating or dissecting tracts of impending or acute rupture.
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