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  1. Article ; Online: Venous Hypertension from a Percutaneous EndoAVF Exacerbated by Surgical Ligation.

    Ali, Ahmed / Varma, Rakesh K / Almehmi, Ammar

    Journal of vascular and interventional radiology : JVIR

    2024  

    Language English
    Publishing date 2024-03-27
    Publishing country United States
    Document type Letter
    ZDB-ID 1137756-2
    ISSN 1535-7732 ; 1051-0443
    ISSN (online) 1535-7732
    ISSN 1051-0443
    DOI 10.1016/j.jvir.2024.03.026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3720: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Fatal superior vena cava rupture complicating dialysis catheter exchange.

    Ali, Ahmed E / Al-Balas, Alian / Benson, Paul V / Almehmi, Ammar

    The journal of vascular access

    2024  , Page(s) 11297298231219288

    Abstract: Central vein stenosis (CVS) is a common and challenging complication in hemodialysis patients with chronic central venous catheters (CVCs). CVS often remains asymptomatic and is discovered incidentally during follow-up imaging. CVS symptoms include arm ... ...

    Abstract Central vein stenosis (CVS) is a common and challenging complication in hemodialysis patients with chronic central venous catheters (CVCs). CVS often remains asymptomatic and is discovered incidentally during follow-up imaging. CVS symptoms include arm swelling, venous hypertension, impaired dialysis flow rates, and development of collateral veins. However, these symptoms can be nonspecific and overlap with other conditions, making the diagnosis challenging. Timely recognition and appropriate intervention are crucial to prevent complications and optimize patient outcomes. Diagnostic tools commonly used include duplex ultrasonography and venography to assess the degree and location of stenosis. Management strategies for CVS encompass a multidisciplinary approach involving nephrologists, interventional radiologists, and vascular surgeons. Initial conservative measures may include anticoagulation therapy, along with pharmacological interventions such as antiplatelet agents and thrombolytics. The endovascular approach is the first line for managing CVS by using balloon angioplasty either alone or in combination with stent placement, but CVS typically recurs frequently, requiring repeated interventions with an increased risk of complications. Additionally, alternative vascular access options such as arteriovenous fistulas or grafts may be considered. In this report, we describe a case of a 25-year-old woman who presented with an extensive history of multiple dialysis access failure for left internal jugular vein central venous tunneled catheter exchange. The procedure was complicated by a fatal superior vena cava rupture likely related to the dislodgment of the guidewire causing perforation into the pericardium space with subsequent cardiopulmonary collapse. The post-mortem autopsy showed severe organized stenosis of SVC and transmural defect above the SVC/atrial junction.
    Language English
    Publishing date 2024-01-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2252820-9
    ISSN 1724-6032 ; 1129-7298
    ISSN (online) 1724-6032
    ISSN 1129-7298
    DOI 10.1177/11297298231219288
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6414: Show issues Location:
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  3. Article: Catheter-based therapy for traumatic pseudoaneurysm of the anterior tibial artery.

    Ali, Ahmed E / Haggag, Akram / Almehmi, Ammar

    Radiology case reports

    2023  Volume 19, Issue 3, Page(s) 1060–1063

    Abstract: Tibial artery pseudoaneurysms often result from penetrating or blunt trauma to the lower extremities, or after orthopedic and endovascular interventions. Clinically, these lesions manifest as an expanding pulsatile mass of the affected area accompanied ... ...

    Abstract Tibial artery pseudoaneurysms often result from penetrating or blunt trauma to the lower extremities, or after orthopedic and endovascular interventions. Clinically, these lesions manifest as an expanding pulsatile mass of the affected area accompanied with pain and erythema. Despite the rare occurrence, traumatic tibial pseudoaneurysms can be associated with significant morbidity including local discomfort, rupture, and lower limb ischemia. Duplex ultrasound is considered the gold standard for diagnosis. Treatment options include surgical repair, ultrasound-guided compression or thrombin injection, and endovascular repair. In this report, we describe a 42-year-old male who presented to our center with pulsatile swelling over the mid-lateral aspect of the left leg. The diagnosis of a large anterior tibial artery pseudoaneurysm was made on clinical basis and was confirmed with computed tomography angiography. The lesion was treated endovascularly with a covered stent graft. In conclusion, this case highlights the role of endovascular therapy as a surgery-sparing and minimally invasive approach in managing traumatic peripheral arterial pseudoaneurysms with excellent clinical outcomes.
    Language English
    Publishing date 2023-12-28
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2406300-9
    ISSN 1930-0433
    ISSN 1930-0433
    DOI 10.1016/j.radcr.2023.12.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Pickering syndrome in a patient with a single kidney: role of renal artery stenting.

    Malas, Amer / Ali, Ahmed E / Al-Balas, Alian / Almehmi, Ammar

    Radiology case reports

    2023  Volume 18, Issue 8, Page(s) 2618–2620

    Abstract: Renal artery stenosis (RAS) is associated with hypertension and high mortality rates. With its prevalence and associated risk of death, it is important to screen for patients displaying symptoms of RAS. RAS has a wide spectrum of clinical manifestations ... ...

    Abstract Renal artery stenosis (RAS) is associated with hypertension and high mortality rates. With its prevalence and associated risk of death, it is important to screen for patients displaying symptoms of RAS. RAS has a wide spectrum of clinical manifestations and is usually resistant to medical therapy. Of these clinical manifestations is Pickering syndrome which is characterized by bilateral renal arterial occlusion inflow lesions, flash pulmonary edema, acute kidney injury, and hypertensive emergencies in the setting of a preserved left ventricle function. Stenting techniques have been used extensively to treat symptomatic renal artery stenosis with excellent primary patency rate, however have failed to demonstrate a long-term benefit over the optimal medical management alone in randomized trials. However, accumulating evidence suggests that stenting is justified in specific patient subgroups that have severe occlusive renal artery stenoses with significant clinical sequelae, including flash pulmonary edema, acute ischemic kidney injury, and uncontrolled hypertension. In this report we discuss the case of a 32-year-old male who presented to our center with recurrent flash pulmonary edema and hypertensive emergency and was found to have RAS, which responded well to renal artery stenting. In conclusion, correcting the renal arterial inflow stenosis is beneficial and warranted in selective clinical scenarios.
    Language English
    Publishing date 2023-05-26
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2406300-9
    ISSN 1930-0433
    ISSN 1930-0433
    DOI 10.1016/j.radcr.2023.04.063
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Chest wall arteriovenous graft for dialysis: A case report.

    Hakim, Ahmad / McFarland, Graeme / Almehmi, Ammar

    Radiology case reports

    2022  Volume 17, Issue 5, Page(s) 1598–1600

    Abstract: Upper extremity access sites are the preferred access sites for hemodialysis. With the improvement of the survival in dialysis population, most patients outlive the dialysis access lifespan. As such, some patients exhaust the vascular access options of ... ...

    Abstract Upper extremity access sites are the preferred access sites for hemodialysis. With the improvement of the survival in dialysis population, most patients outlive the dialysis access lifespan. As such, some patients exhaust the vascular access options of the upper extremities, which necessitates the search for new access sites. While lower extremity grafts and hemodialysis reliable outflow devices are potential alternatives, these access sites are plagued with recurrent lesions at the venous anastomosis and subsequent thrombosis leading to poor access survival. Within this framework, the axillary-based dialysis access was developed to address these challenges. In this report, we describe a 70-year-old woman who exhausted her upper extremity access sites and eventually underwent a chest wall arteriovenous graft (AVG) that connected the right axillary artery to the right axillary vein. This chest wall AVG remained functional without any intervention for more than 3 years. In conclusion, chest wall AVG access can be a viable option for hemodialysis patients who have exhausted the access sites of the upper extremities, while potentially minimizing complications seen in other methods of vascular access.
    Language English
    Publishing date 2022-03-14
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2406300-9
    ISSN 1930-0433
    ISSN 1930-0433
    DOI 10.1016/j.radcr.2022.02.045
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Complications of Percutaneous Peritoneal Dialysis Catheter.

    Oza-Gajera, Bharvi P / Abdel-Aal, Ahmed K / Almehmi, Ammar

    Seminars in interventional radiology

    2022  Volume 39, Issue 1, Page(s) 40–46

    Abstract: A functional peritoneal dialysis (PD) catheter is the cornerstone for the success of renal replacement therapy. This success is largely dependent on adhering to best practices during catheter insertion, which starts with a comprehensive preoperative ... ...

    Abstract A functional peritoneal dialysis (PD) catheter is the cornerstone for the success of renal replacement therapy. This success is largely dependent on adhering to best practices during catheter insertion, which starts with a comprehensive preoperative evaluation that helps in determining the catheter configuration type and both entry and exit sites. Additionally, following the best practice guidelines during PD catheter insertion minimizes undesirable complications and provides a durable functional access for dialysis. However, adverse complications are still encountered despite abiding with these clinical guidelines. These complications are categorized into mechanical and infectious groups. The description and management of these adverse events are discussed in detail in this article with particular attention to the technical pitfalls that can occur during catheter insertion. Avoiding these pitfalls can minimize PD catheter complications and potentially improve clinical outcomes.
    Language English
    Publishing date 2022-02-18
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 848341-3
    ISSN 1098-8963 ; 0739-9529
    ISSN (online) 1098-8963
    ISSN 0739-9529
    DOI 10.1055/s-0041-1741484
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Se 916: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    ab Jg. 2022: Lesesaal (EG)

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  7. Article: Transhepatic Tunneled Catheter Using Left Hepatic Vein: The Last Resort for Dialysis.

    Abaza, Masa / Almehmi, Sloan E / Almehmi, Ammar

    Clinical medicine insights. Case reports

    2021  Volume 14, Page(s) 11795476211066354

    Abstract: Vascular access is the Achilles tendon of hemodialysis and is considered the lifeline for patients with end stage renal disease. Arteriovenous fistulas and grafts are the preferred traditional access for performing dialysis therapy. However, some ... ...

    Abstract Vascular access is the Achilles tendon of hemodialysis and is considered the lifeline for patients with end stage renal disease. Arteriovenous fistulas and grafts are the preferred traditional access for performing dialysis therapy. However, some patients exhaust the traditional routes of dialysis vascular access for different reasons. In search for alternatives, other unusual vascular routes have been explored, such as transhepatic and translumbar approaches, as the last resort to preserve life in this unfortunate population. Here, we present the unusual case of a 66-year-old female who ran out of the traditional vascular access options and became catheter dependent via the right femoral vein. However, due to recurrent femoral catheter infections, extensive skin calciphylactic lesions and her body habitus, other routes were explored and the decision was to use the transhepatic approach. Traditionally, the right and middle hepatic veins are used to insert these catheters. However, the use of the left hepatic vein was not reported in the literature. Hence, in order to avoid the skin lesions seen in our patient, the dialysis catheter was inserted using the left hepatic vein. Overall, this case highlights the challenges of securing a reliable vascular access to perform dialysis therapy and brings attention to other vascular dialysis routes in certain clinical scenarios.
    Language English
    Publishing date 2021-12-21
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2580498-4
    ISSN 1179-5476
    ISSN 1179-5476
    DOI 10.1177/11795476211066354
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Skin Rash in a Stage 4 CKD Patient Treated for Hyperkalemia.

    Boge, Hanna / Almehmi, Sloan / Almehmi, Ammar

    Kidney360

    2021  Volume 2, Issue 1, Page(s) 176–177

    MeSH term(s) Exanthema/drug therapy ; Humans ; Hyperkalemia/diagnosis ; Potassium/therapeutic use ; Renal Insufficiency, Chronic/complications
    Chemical Substances Potassium (RWP5GA015D)
    Language English
    Publishing date 2021-01-28
    Publishing country United States
    Document type Journal Article
    ISSN 2641-7650
    ISSN (online) 2641-7650
    DOI 10.34067/KID.0003992020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Endovascular embolization for managing a massive shoulder arteriovenous malformation.

    Abaza, Masa / Abdel-Aal, Ahmed K / Almehmi, Ammar

    Radiology case reports

    2021  Volume 16, Issue 12, Page(s) 3965–3968

    Abstract: Arteriovenous malformations (AVMs) are congenital high flow pathologic linkages between arteries and veins of different sizes that may occur in any part of the body. The clinical presentation is largely dependent on the size and location of AVMs and can ... ...

    Abstract Arteriovenous malformations (AVMs) are congenital high flow pathologic linkages between arteries and veins of different sizes that may occur in any part of the body. The clinical presentation is largely dependent on the size and location of AVMs and can range from an asymptomatic birthmark to congestive heart failure in extreme cases. In this report, we describe a 20-year-old male who presented with a large AVM of the right shoulder that resulted in significant cosmetic and physical impairment and treated with several sessions of endovascular embolization with good clinical outcomes. This case highlights the complexity of diagnosing and managing these AVMs. Most of these anomalies require a multi-disciplinary approach that integrates both trans-catheter and surgical interventions with trans-arterial lesion embolization being the cornerstone of the treatment.
    Language English
    Publishing date 2021-10-20
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2406300-9
    ISSN 1930-0433
    ISSN 1930-0433
    DOI 10.1016/j.radcr.2021.09.024
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  10. Article: Inferior epigastric artery injury after percutaneous imaging-guided peritoneal dialysis catheter placement.

    Dryer, Emily A / Abaza, Masa / Almehmi, Ammar

    Radiology case reports

    2021  Volume 17, Issue 2, Page(s) 332–335

    Abstract: Inferior epigastric artery (IEA) injury is a rare clinical entity that is usually associated with abdominal wall procedures and injuries though can also be spontaneous, particularly in individuals with coagulopathy. Of all described mechanisms of injury, ...

    Abstract Inferior epigastric artery (IEA) injury is a rare clinical entity that is usually associated with abdominal wall procedures and injuries though can also be spontaneous, particularly in individuals with coagulopathy. Of all described mechanisms of injury, percutaneous peritoneal dialysis (PD) catheter insertion is a rarely encountered, particularly in instances where insertion is performed under imaging guidance. While this injury is self-limited, it can be associated with hemodynamic instability and acute blood loss anemia, which can be fatal if left untreated. Computed tomographic (CT) angiography is the diagnostic method of choice. Transcatheter arterial embolization is an effective treatment modality with a high success rate. Here, we describe a 41-year-old female who underwent percutaneous PD catheter insertion that, despite intraprocedural imaging guidance, was complicated by large hemoperitoneum and clinical instability. Prompt identification of IEA injury followed by immediate intervention with coil embolization led to a successful outcome for this patient in the setting of a life-threatening uncommon complication of such procedure. The details of the diagnostic evaluation and management are outlined.
    Language English
    Publishing date 2021-11-27
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2406300-9
    ISSN 1930-0433
    ISSN 1930-0433
    DOI 10.1016/j.radcr.2021.10.055
    Database MEDical Literature Analysis and Retrieval System OnLINE

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