OBJECTIVE: This study aimed to assess the effectiveness, feasibility, and security of the Perclose ProGlide device that was used to remove the femoral venous cannulas for the transcatheter closure of atrial septal defect (ASD). METHODS: A total of 145 cases were analyzed retrospectively, who performed transcatheter closure of ASD in our center from March 2019 to March 2021. Based on whether the Perclose ProGlide device was placed or not in the femoral vein, 48 patients were assigned to the Perclose group and 97 ones to the non-Perclose group. The data of general characteristics, femoral venous cannulas, and related puncture complications were compared between the two groups. RESULTS: The data of general characteristics or femoral venous cannulas were not significantly different between the two groups, but the procedure duration of removing venous cannulas was shorter in the Perclose group (0.5 min [0.35, 0.70] vs. 5 min [3.6, 7.4], P < 0.001). The puncture procedure-related blood lose was not significantly different between the two groups (Hemoglobin reduction value: 0.10 [−0.47, 0.30] g/dL vs. 0.10 [−0.50, 0.30] g/dL, P = 0.905). In addition, other complications caused by the removal of venous cannulas, length of stay in the ward, puncture infection, reintervention, and so on were not significantly different between the groups. CONCLUSIONS: The Perclose ProGlide device could simplify the removal of femoral venous cannulas for ASD transcatheter closure by decreasing procedure duration and time in bed. The efficiency, feasibility, and safety of Perclose ProGlide devices, which were used to remove venous cannulas, are good enough for their clinical application.

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OBJECTIVE: Blunt thoracic aortic injury is the second most common cause of death in trauma patients. Traumatic aortic injury is an emergency that patients will face death soonly, even there is no enough time to transport the patient to the hospital. In our center, all patients were treated with thoracic endovascular aortic repair (TEVAR). We retrospectively analyze the therapeutic effects of TEVAR of blunt traumatic aortic injury (BTAI) to get some inspiration for the follow-up treatment and provide valuable guidance. METHODS: We retrospectively reviewed our institutional database to identify all patients treated with TEVAR for traumatic lesions of the aortic isthmus. We have identified 22 patients since 2017. Patients' charts were analyzed for preoperative characteristics and intraoperative variables. RESULTS: Forty-six patients were included. The median age was 56 years (23–79 years). Sixteen patients were male (73%). Most of them were graded III/IV of aortic injury. All patients were undergone endovascular treatment successfully. Six of 22 patients, showing no chest pain before admission, were presented with classic type B aortic dissection. Moreover, one patient was presented with thoracoabdominal dissection. Emergency surgery (<24 h) was performed in seven patients (32%) who experienced life-threatening injury resulting in hemorrhagic shock and hematoma formation in the mediastinum. All patients were discharged smoothly with no residual symptoms. CONCLUSIONS: Endovascular treatment of traumatic aortic dissection reduces the mortality rate of these patients who cannot tolerate traditional open surgery. According to our experience, patients who presented with simple pseudoaneurysm in enhanced computed tomography were more stable. Therefore, a postponed operation could be recommended after symptomatically hypotensive management. However, emergency surgery was necessary if patients presented with obviously mediastinal hematoma, especially progressive pleural effusion, which could result in hematoma rupture and death.

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OBJECTIVE: The objective of this study was performed to demonstrate the feasibility and effectiveness of a custom-manufactured stent graft (CMSG) with directional multibranches for the treatment of a complex thoracoabdominal aortic aneurysm (TAAA) patient. METHODS: A 73-year-old man presented with Crawford Type V TAAA was treated with a CMSG with four down-going directional branches including two proximal directional branches for the celiac artery and superior mesenteric artery and two distal side directional branches for the bilateral renal arteries. RESULTS: Postoperative course was unremarkable and 6-month follow-up demonstrated sac regression, absence of endoleaks, and all of the visceral branches remained patent. CONCLUSIONS: Total endovascular repair using CMSG with directional multibranches is a suitable alternative in higher risk patients with TAAA who are not suited for open surgery. Longer follow-up is needed to confirm the preliminary results.

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BACKGROUND: Several factors are at the root of the aneurysm. This disease is characterized by the loss of parallelism of the abdominal aorta, which widens to a breaking point. This anomaly is silent, and it is discovered by accident during the diagnosis of another patient. High blood pressure is often associated with the aneurysm. The age factor is directly linked to other factors that are often poorly understood. SUBJECTS AND METHODS: This study proposes the analysis of these factors by artificial intelligence techniques, in particular fuzzy analysis. This mode of reasoning compensates for the uncertainties inherent in the process. A fuzzy system is established, allowing factors recorded from 100 diagnosed patients to be entered as input variables to the system to read the predicted aortic diameter. RESULTS: The result at the output of the system will be as precise as possible, because, it is calculated from the aggregation of all the variables. This study compensates for imprecision and uncertainty by considering blood pressure as an imprecise and therefore fuzzy variable CONCLUSIONS: The result at the output of the system will be as precise as possible, because it is calculated from the aggregation of all the variables. In the absence of a systematic screening program, this system can be a tool to help prevent this disease.

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Management of chronic arteriovenous fistula (AVF) thrombosis is challenging. In this case report, we described successful endovascular treatment for a thrombosed AVF with extensive stenosis. A 50-year-old woman presented with diminishing blood flow of her forearm AVF. Diagnostic angiogram showed a long segment of cephalic vein outflow stenosis, occlusion of one accessory cephalic vein branch, and proximal stenosis of the cephalic vein. After angioplasty, the occluded fistula was recanalized without any significant residual stenosis. The AVF had been functional at 6-month follow-up.

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An 81-year-old male presented to our emergency department for abdominal pain and distension. The patient had previously undergone endovascular aortic repair (EVAR) procedure 9 years ago for infrarenal abdominal aortic aneurysm with regular follow-up in postoperative. Three years ago, computed tomography angiography (CT) revealed Type Ib endoleak with right common iliac artery expansion and Type II endoleak from inferior mesenteric artery (IMA). Then, the patient was successfully treated by relining the iliac stent-graft to cover the common iliac expansion and coil embolism to occlude IMA through the Riolan's arch using endovascular technique. Recently, the following up CTA displayed a new Type IIIa endoleak, which the left iliac limb was disconnected with the main body graft. The patient was ultimately successful to treat by implanting stent-grafts using endovascular therapy. This case emphasizes the necessity of follow-up examination for lifelong stent-grafts surveillance. We debated the current late-related complication of EVAR and stent-graft migration treatment choices.

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