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Charalampos Seretis,Andreas Tsimpoukis,Andreas Georgiakakis,Panagiotis Kitrou,Eleftheria Panteli,Spyros I. Papadoulas 대한혈관외과학회 2022 Vascular Specialist International Vol.38 No.1
Iatrogenic trauma of the axillary artery by non-vascular surgeons can occur during various general surgical procedures such as resection of soft tissue tumors or axillary lymph node clearance. Prompt recognition, appropriate initial management, and rapid transfer to a tertiary vascular surgery service, if needed, are key steps to ensuring patient safety. Here we present a case of iatrogenic axillary artery injury during the resection of a recurrent soft tissue tumor in a local hospital. The desperate application of a Kocher clamp on the bleeding axillary artery by the operating general surgeons controlled the bleeding but led to further arterial damage. The patient was transferred to our tertiary hospital, where the arterial injury was repaired using a vein interposition graft. Apart from the encountered intraoperative technical challenges, this case highlights the need for broader training of nonvascular specialist surgeons on the core principles of basic vascular surgical techniques and oncovascular surgery.
Treatment of Dialysis Access Steal Syndrome with Concomitant Vascular Access Aneurysms
Spyros I. Papadoulas,Theoni Theodoropoulou,Natasa Kouri,Andreas Tsimpoukis,Panagiotis Kitrou,Evangelos Papachristou,Konstantinos G. Moulakakis,Stavros K. Kakkos 대한혈관외과학회 2022 Vascular Specialist International Vol.38 No.1
Limb ischemia is a known complication of vascular access that may appear early postoperatively or after years. Over the last few decades, various techniques based on different physiological mechanisms have been used for treatment. A standardized treatment does not exist, and must be individualized based on the flow volume, and the type and location of the access. True and false vascular access aneurysms are another common complication of arteriovenous fistulas, which develop because of venous hypertension or repeated needling. Evidence in the literature regarding treatment of patients with steal syndrome and concomitant true arteriovenous aneurysms is scarce. A female with a brachiocephalic fistula complicated by steal syndrome and vascular access aneurysms was treated successfully with tapered graft placement and aneurysm exclusion.