Aortobronchial fistula after aortic coartactation.
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Biomedical subjects
Publications and source records attributed to Vicente Riambau.
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PURPOSE: To evaluate whether MR angiography (MRA) is a useful tool for the follow-up of aortic aneurysms treated with nitinol endoluminal grafts. MATERIALS AND METHODS: We examined 28 patients treated with nitinol endovascular stents to repair an aortic aneurysm with CT angiography (CTA) and MRA. Eleven patients (group 1) underwent an MRA after a positive CTA for endoleak was observed. Afterwards, 17 patients (group 2) were scheduled for both follow-up examinations. The kind of endoleak that occurred and the maximum aortic diameter were compared. The sensitivity of CTA relative to MRA for detecting endoleaks in group 2 was calculated. Signal-to-noise ratios (SNRs) were measured in the aortoiliac lumen at the arterial phase in, above, and below the endoprostheses. Student's t-test was used to compare aneurysm dimensions and SNR measurements. RESULTS: Three type III leaks were correctly assessed at both examinations; however, CTA was less sensitive (50%) than MRA in depicting type II or unclassified leaks. No differences in aneurismal size were observed between the two examinations or between arterial SNRs observed in or out of the devices. CONCLUSION: MRA can provide all relevant information necessary for the follow-up of patients treated with nitinol endoprostheses, and performs better than CTA in detecting endoleaks.
PURPOSE: To describe an unusual case involving thrombosis in an aortic endograft limb following microwave therapy (MWT) for lumbar pain. CASE REPORT: A 77-year-old man had successful repair of an abdominal aortic aneurysm with a Vanguard endograft. He had been free of complications during the 3-year follow-up. Five days after the 36-month surveillance angiogram, the patient was treated with MWT for chronic left-sided lumbar pain due to vertebral arthrosis. Immediately after this session, the patient presented with acute ischemia in the left lower limb. Computed tomographic angiography showed a thrombosis of the left limb of the endograft. A femorofemoral crossover bypass was performed. No complication was observed in later surveillance. CONCLUSIONS: It may be advisable to avoid MWT and other deep heating therapies in patients with endografts. This caution is applicable to other metallic stents.
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