Vargas M Cecilia,  Crido Silvina,  Quintero Karina,  Alonso Jose,  Rizzi Ana,  Pibernous J,  Lipsich Jose,  Moguillanky Slvia

Final Pr. ID: Poster #: CR-018

Aortic dissection in children is often associated with congenital heart disease (bicuspid aortic valve or aortic coarctation), collagenopathies or serious injuries. It rarely arises as a differential diagnosis in the presence of thoracic or abdominal pain in an apparently healthy child. Early diagnosis and treatment is crucial to their survival.
Our purpose is describe the clinical and images characteristics that allowed to diagnose . Read More

Authors:  Vargas M Cecilia , Crido Silvina , Quintero Karina , Alonso Jose , Rizzi Ana , Pibernous J , Lipsich Jose , Moguillanky Slvia

Keywords:  aortic dissection, stent-grafts, imaging, Chronic hypertension

Tulin-silver Sheryl,  Padua Horacio,  Yu Richard,  Chow Jeanne

Final Pr. ID: Poster #: EDU-073

The purpose of this educational exhibit is to review radiography, fluoroscopy, computed tomography (CT), and ultrasound (US) imaging appearance of commonly placed genitourinary catheters. The imaging findings associated with appropriately positioned catheters as well as misplaced and displaced catheters are described. Read More

Authors:  Tulin-silver Sheryl , Padua Horacio , Yu Richard , Chow Jeanne

Keywords:  Nephrostomy, Nephroureterostomy, Malecot, Foley catheter, Double-J stent

Dubois Josée,  Thomas-chausse Frederic,  Ghali Rafik,  Soulez Gilles

Final Pr. ID: Poster #: CR-042

Congenital portosystemic shunt is a rare vascular malformation that leads to severe complications. Two types are described: extrahepatic and intrahepatic. Extrahepatic shunt is represented by a direct communication of the portal trunk, or one of its branches of origin, to the inferior vena cava, or one of its branches.

We present two cases of extrahepatic shunt treated with stent-graft placement.

Case 1: Two y.o. male with cutaneous telangiectasias and liver calcifications on abdominal ultrasound. An extrahepatic portosystemic shunt was detected on color Doppler examination.

MR and catheter angiography revealed a large fistula between the main portal vein and the suprarenal inferior vena cava. The fistula was closed by deploying a balloon expandable stent-graft in the retrohepatic inferior vena cava. Five years later, the liver function was normalized and no complication was observed.

Case 2: Thirteen y.o. male referred for three hepatic lesions and an extrahepatic portosystemic shunt.

MR and angiography revealed a large fistula between the left portal vein and the inferior vena cava. It was closed by deploying a custom self-expandable stent-graft (Zenith, Cook Medical, Bloomington, IN) in the inferior vena cava. At five years follow-up, the patient is asymptomatic with a resolution of the liver lesions. Read More

Authors:  Dubois Josée , Thomas-chausse Frederic , Ghali Rafik , Soulez Gilles

Keywords:  Stent, Portosystemic shunt, Liver, Embolization, Children

Smitthimedhin Anilawan,  Silvestro Elizabeth,  Shellikeri Sphoorti,  Whitaker Jayme,  Cahill Anne Marie

Final Pr. ID: Paper #: 141

The renal artery ostial anatomy, balloon profile, and stent deployment are all challenges of complex procedural RAS planning in children. In such cases there is an increased risk of renal artery rupture secondary to angioplasty requiring placement of a covered stent. This study aims to establish the feasibility of simulating renovascular stent deployment in three 3D printed pediatric patient-specific RAS endovascular phantoms. Read More

Authors:  Smitthimedhin Anilawan , Silvestro Elizabeth , Shellikeri Sphoorti , Whitaker Jayme , Cahill Anne Marie

Keywords:  3D Printing, Stent, Simulation

Risch Mary,  Desai Sudhen

Final Pr. ID: Poster #: EDU-012

Abdominal aortic injuries are rare in the pediatric population and typically occur from motor vehicle crashes or other blunt trauma, and are associated with significant morbidity and mortality. Due to their infrequent nature, guidelines for treating these patients are not as well established and generally are treated on a case-by-case basis.

In this case report, a previously healthy 9-year-old female presented to the emergency department with suspected abdominal aortic injury from a lap belt after a head on motor vehicle collision and was subsequently diagnosed with a contained abdominal aortic rupture at the L2 level with associated lumbar spinal fractures. In this patient, there was partial indication to place the stent to stabilize the aorta in preparation for the spinal surgery, as well as to treat the primary aortic injury.

After multidisciplinary discussion, the aortic irregularity was successfully treated with the Gore Viabahn VBX® (10mm x 39mm, able to size up to 13mm) stent and there was no post-intervention evidence of ongoing aortic leaking. At three months, the patient remained in stable condition without evidence of mesenteric or exertional ischemia.

Endovascular stents are now standard of care in the repair of post-traumatic adult vascular injuries. Unfortunately, long term follow-up data for endovascular stent grafts in children is lacking, and this patient will likely require stent graft dilation as the remainder of her aorta increases in diameter. In addition, stent grafts are not designed for pediatric use, so extra consideration needs to be given to the size and profile of the stent as to not cause deployment injury, and to be aware of the relative shortening of the stent following dilation as the aorta increases in diameter.

This report reviews a case of a traumatic contained abdominal aortic rupture with an associated spinal fracture requiring surgery at the same level, with further need for bowel repair and hemicolectomy. An endovascular stent graft was determined to be optimal for immediate stabilization of the aorta and to allow subsequent spinal and laparoscopic abdominal surgeries that followed Read More

Authors:  Risch Mary , Desai Sudhen

Keywords:  Contained Aortic Rupture, Pediatric, Stent Graft