38 year old pregnant female presents with acute LLE DVT diag | Figure 1

38 year old pregnant female presents with acute LLE DVT diagnosed by MRI.

Due to the extreme pain, risk of PE and for prevention of post-thrombotic syndrome, she was treated with balloon venoplasty, AngioJet thrombectomy and overnight catheter directed lytics infusion. A self expanding stent was then deployed across the narrowing. Repeat venoplasty was performed within the stent. IVUS post intervention demonstrates that at the IVC bifurcation, the right common iliac artery (red arrowhead) no longer compresses the open left common iliac vein (yellow arrowhead). (Courtesy Feraz N Rahman MD)

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Endovascular abdominal aortic aneurysm repair involves aneurysm exclusion with an endoluminal aortic stent-graft introduced remotely, usually through the femoral artery. An endovascular graft extends from the infrarenal aorta to both common iliac arteries, preserving the flow to the internal iliac arteries. CIA, Common iliac artery; IIA, internal iliac artery; IN, infrarenal aortic neck; LK, left kidney; RK, right kidney; SA, suprarenal aorta. Source: Ferri’s Clinical Advisor 2019. ISBN: 9780323530422. Copyright ©2019 Elsevier, Inc.

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  1. Wide-open aortic regurgitation
  2. Anti-hypertensive medication The patient was administered Esmolol and Nicardipine. IR consulted and recommended dissection flap fenestration and true lumen aortic and branch-vessel stenting. Bilateral femoral access was obtained. Intravascular ultrasound (IVUS) revealed thrombus in the bilateral common femoral, external iliac, and common iliac arteries. Mechanical thrombectomy performed. Post-procedure patient underwent successful aortic repair, bilateral femoral cutdowns with SFA thromboembolectomy, patch angioplasty, and bilateral 4-compartment fasciotomies. Patient discharged on day 28 to rehab.

75 y.o. Male pt with left lower limb claudication. PTA and stenting of left common Iliac artery performed.

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