No abstract

CorrespondenceA 75 year old man was referred to our clinic with acute right leg ischemia that developed after interventional angiography was performed for treating left femoral artery pseudoaneurysm. Three months earlier, he had undergone coronary angiography via the left femoral artery, following which he suffered from left groin pain and swelling. Contrast computed tomography revealed a pseudoaneurysm of the left femoral artery, extending to the iliac artery, and bilateral peripheral arterial occlusive lesions (Figure 1). Angiography was repeated at our clinic via the left groin just below the pseudoaneurysm. There was an occlusion of the common iliac artery due to arterial dissection (Figure 2). After diagnostic angiography, a "cross-over" vascular sheath was inserted into the right common iliac artery. Then, the distal part of the right iliac artery was catheterized, a 0.035-inch guidewire was inserted, and an 8 x 60 mm self-expandable stent was mounted into the left external artery. In control angiography, the right external iliac artery and distal fl ow were visualized (Figure 3). Just after percutaneous intervention, the left femoral artery pseudoaneurysm was repaired via groin incision, and femoropopliteal bypass was performed with an 8 mm polytetrafl uoroethylene graft at the same side. As a result, the iatrogenic pseudoaneurysm of the left iliac artery and dissection of the right iliac artery were both repaired with hybrid approach.

Infective endocarditis is an acute or a subacute inflammatory infection of the endocardium caused by bacterial, viral or fungal microorganisms. Despite significant improvements in the diagnosis and treatment, it is still associated with a poor prognosis and a high mortality rate. Viridans streptococci are one of the most common causative microorganisms of bacterial endocarditis. Streptococcus mutans, a member of this group and is usually associated with dental carries. Although it is expected to be more frequently associated with endocarditis, has only rarely been reported. This is most likely to be due to some identification problems. We herein report a case of infective endocarditis due to Streptococcus mutans following tooth extraction with no history of heart disease.

Background: In the present study, it was aimed to compare the stent grafts and bare-metal stents in terms of post-procedural patency, clinical recovery and complications in the subjects with symptomatic aorto-iliac arterial disease. Methods: A total of 79 subjects with symptomatic aorto-iliac arterial disease treated with endovascular methods were included in the present study. Forty three subjects received self-expendable bare metal stent (ev3 Protégé stent system, Endovascular Inc., Plymouth, Minnesota, USA) and 36 subjects received PTFE-covered stent graft (Fluency Plus Stent Graft, Bard Peripheral Vascular, Tempe, Arizona). The subjects were compared after and at Months 1, 6, and 12 following the procedure in terms of Rutherford's classification, ankle-arm index (AAI), patency rates, and complications. Results: The subjects receiving bare metal stent and stent graft for aorto-iliac arterial disease were followed for averagely 15 months. For the subjects receiving bare metal stent, primary patency rates at months 1, 6, and 12 were 98%, 81%, and 70%, respectively, while secondary patency rate at month 12 was found to be 84%. For the group of stent graft, primary patency rates were found as 97%, 97%, and 92%, respectively and secondary patency rate at month 12 was found to be 94%. Stent grafts were applied at the same time in 2 patients who had metal bare metal because the rupture occurred during the procedure. In the comparison between two groups, the group of stent graft was found to be statistically superior to the other in terms of patency, clinical and post-procedural complications. Conclusion: In conclusion, it was found that the stent grafts were superior to the bare metal stents in terms of patency and complication rates in the subjects with symptomatic aortoiliac disease.