Successful Hybrid Management of Extensive Thromboembolism of the Innominate Trunk, Right Subclavian Artery, Bilateral Common Carotid Artery, and Pulmonary Embolism

Chisci, Emiliano; Ercolini, Leonardo; Romano, Eugenio; Troisi, Nicola; Michelagnoli, Stefano

doi:10.1016/j.avsg.2013.12.035

Cited by 5 publications

(8 citation statements)

References 15 publications

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“…Reports of AEO-BCA themselves are very rare, 3,4) and, concerning AEO-BCA treated by EVT, there is only one report by Chisci et al 3) In this report, complete recanalization and a favorable outcome were achieved in a patient who presented with symptoms of not only limb, but also cerebral ischemia due to multiple embolism of the right BCA, left CCA, and left SCA by simultaneous surgical exposure of the bilateral carotid arteries and right brachial artery by three vascular surgeons, followed by serial thrombectomy using FCs. Therapeutic options for AEO-BCA are internal and surgical, but internal treatment is associated Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, in our patient, distal embolism occurred due to fragmentation of the thrombus immediately after the passage of the CGW near the giant thrombus in the BCA. However, on a review of the video of the procedure, the exposure of the right CCA and right SCA for distal protection, that is, the retrograde approach using FCs from incisions at the bifurcation of the right carotid artery and right brachial artery employed by Chisci et al, 3) is necessary. However, even by this procedure, protection of the right VA is impossible.…”

Section: Discussionmentioning

confidence: 99%

“…1,2) However, the revascularization technique for acute embolic occlusion of BCA (AEO-BCA) has not been established, and reports of endovascular thrombectomy (EVT) are very rare. 3) We recently performed EVT with direct surgery in a patient with AEO-BCA by cooperation between a cardiovascular surgeon and a cardiologist and could remove the thrombus despite the occurrence of distal thrombosis. Since this case is rich in implications about EVT for AEO-BCA, it is reported with a review of the literature.…”

Section: Introductionmentioning

confidence: 99%

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A Case of Acute Embolic Occlusion of the Brachiocephalic Artery Recanalized with Endovascular Thrombectomy

Okamoto

Imai

Hamanaka

et al. 2017

JNET

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Objective: Endovascular treatment of a patient with acute embolism of the brachiocephalic artery (BCA) is reported. Case Presentations:A 70-year-old woman presenting with weakness of the right upper extremity was transferred to our hospital due to acute embolism of the BCA. After the right brachial artery was secured by direct cardiovascular surgery, a balloon guidewire was inserted through the femoral artery and advanced near the thrombus in the BCA, and the balloon at its tip was inflated in the right internal carotid artery. Immediately after this, the thrombus in the BCA migrated to the right common carotid artery and right subclavian artery. The two vessels could be recanalized by endovascular treatment via a guide catheter and via the right brachial artery, respectively. Conclusion:In endovascular treatment for acute embolization of the BCA, the methods for thrombus retrieval and distal protection have not been established, and the concurrent direct surgery and cooperation by a cardiologist are indispensable.Keywords▶ cardiogenic embolism, embolic occlusion of brachiocephalic artery, endovascular thrombectomy, balloon-guide catheter, fogarty catheter

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Case of Acute Embolic Occlusion of the Brachiocephalic Artery Recanalized with Endovascular Thrombectomy

Okamoto

Imai

Hamanaka

et al. 2017

JNET

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“…[3][4][5][6][7][8] The prognosis was unfavorable, and eight of nine patients died. Chisci et al 4) performed hybrid therapy, consisting of direct surgery and endovascular treatment, for acute occlusion of bilateral of the ICA. Collateral via PcomA was not evident in the present case, which may have been also involved.…”

Section: Discussionmentioning

confidence: 99%

A Case of Acute Simultaneous Bilateral Internal Carotid Artery Occlusion Treated by Thrombectomy

Ota

Matsubara

Takahashi

et al. 2018

JNET

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Objective: We report a patient who underwent thrombectomy for acute bilateral internal carotid artery occlusion (ICAO).Case Presentation: A 76-year-old female presented consciousness disturbance. Although warfarin had been administered after prosthetic replacement, it was discontinued due to gastrointestinal hemorrhage. MRI showed bilateral ICAO and right-dominant ischemic changes involving the bilateral hemispheres. Radiological findings indicated acute occlusion of the right internal carotid artery (ICA), and chronic occlusion of the left ICA was primarily considered; however, revascularization was conducted with considering the possibility of bilateral occlusion. Thrombectomy was performed and recanalization of the bilateral ICAs was achieved. However, ischemia progressed, leading to extensive cerebral infarction. Conclusion:Thrombectomy for bilateral ICAO was performed although the outcome was unfavorable. Acute bilateral ICAO contains poor prognosis although it is indispensable to appropriately diagnose, evaluate, and select therapeutic strategy. A proper management for bilateral ICAO awaits further investigation.

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“…But it appears as an increase in the wall thickness. Chisci et al 6 stated that surgical procedure was required to treat identified blood vessel clots. The stiffness of the wall is influenced by calcifications, tumours and congenital vascular malformations, huge amounts of collagen, fragmentation or break of elastic tissues.…”

Section: Introductionmentioning

confidence: 99%

An insight into elasticity analysis of common carotid artery using ultrasonography

Raj

Rahman

Anand

2016

Proc Inst Mech Eng H

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Elastance is a distinguished marker in diagnosing various arterial diseases as studies have reported carotid artery-related diseases linked with stiffness index (β) values greater than 5. This study was to estimate elasticity of common carotid artery by measuring the diameter during systolic and diastolic phases using pixel tracing of successive frames and blood pressure. The B-mode ultrasonography video containing arterial wall motion was captured and fragmented into image frames. Each pixel on the greyscale image was converted into RGB intensity values. The diameter of the artery as well as the thickness of the wall was measured by tracing the pixel displacements from successive frames during arterial pulsation. The study was conducted on 19 subjects aged 25-40 years. The systolic and diastolic carotid artery lumen diameters and carotid intima-media thickness were calculated as 7.1 ± 0.7, 6.3 ± 0.6 and 0.5 ± 0.05 mm (mean ± standard deviation), respectively. The mean stiffness index (β), Peterson's modulus and Young's modulus of elasticity were 5.2 ± 1.1, 69 ± 15 kPa and 453 ± 99 kPa, respectively. The pixel displacements in tunica intima, tunica media and tunica adventitia were not homogeneous, due to varied macro-constituents such as endothelial tissues, smooth muscle cells, elastin lamina, fibrous tissue and micro-constituents such as collagen, fibroblast and elastin. We found that women have smaller arteries, and the stiffness increased during the systolic phase.

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Successful Hybrid Management of Extensive Thromboembolism of the Innominate Trunk, Right Subclavian Artery, Bilateral Common Carotid Artery, and Pulmonary Embolism

Cited by 5 publications

References 15 publications

A Case of Acute Embolic Occlusion of the Brachiocephalic Artery Recanalized with Endovascular Thrombectomy

A Case of Acute Embolic Occlusion of the Brachiocephalic Artery Recanalized with Endovascular Thrombectomy

A Case of Acute Simultaneous Bilateral Internal Carotid Artery Occlusion Treated by Thrombectomy

An insight into elasticity analysis of common carotid artery using ultrasonography

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