robotic-assisted-laparoscopic-splenic-artery-aneurysm-resection

Robotic Assisted Laparoscopic Splenic Artery Aneurysm Resection

Splenic artery aneurysms (SAA) are the most common visceral aneurysm and&#160;may develop significant risk for rupture and life-threatening complications ...

Houston Methodist Hospital

Large-bore aspiration thrombectomy is emerging as a promising alternative for thrombus removal in acute pulmonary embolism (PE). In this article, we report a successful case with the newly approved AlphaVac F18 device in a 76-year-old patient presenting with an intermediate- to high-risk acute PE. Preoperative imaging demonstrated bilateral PE with a modified miller index of 30 and an right ventricle-to-left ventricle ratio of 2.1. Mechanical thrombectomy was performed under local anesthesia with mild sedation. The pulmonary artery pressures decreased from 85/27 to 46/13 immediately after thrombectomy. The postoperative course was notable for marked symptom improvement and repeat imaging showed a 63% decrease in clot burden with a decrease in right ventricle-to-left ventricle ratio to 1.3.

Successful mechanical thrombectomy of an intermediate-high risk acute pulmonary embolism using the Alpha Vac aspiration catheter.

Pulmonary arteriovenous malformations create continuous shunting of unoxygenated blood through the lungs into the systemic circulation. These malformations are asymptomatic if small, but cause serious symptoms as they grow in size. Treatment primarily consists of endovascular embolization; lobectomy is preserved for recurring or endovascularly untreatable cases. We describe a case of a 24-year-old man who was first treated with coil embolization 10 years previously, with complete symptom resolution. However, more recently he noted recurrent exercise intolerance, with shortness of breath and hypoxemia. After repeat re-embolization, a computed tomography scan noted some persistent flow. Given the patient's young age, we considered resection as a definite therapy. The patient underwent an uncomplicated robot-assisted right lower lobectomy. Afterward, his symptoms resolved completely. In selected cases, robotic lobectomy for pulmonary arteriovenous malformation is feasible and safe.

Article	Year
Successful mechanical thrombectomy of an intermediate-high risk acute pulmonary embolism using the Alpha Vac aspiration catheter. Journal of vascular surgery cases and innovative techniques\| PubMed ID: 39188693	2024
Robotic right lower lobectomy for a persistent large pulmonary arteriovenous malformation following repeated coil embolization. Journal of vascular surgery cases and innovative techniques\| PubMed ID: 39314857	2024

Jacob B. Watson

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