Fady F. Haddad

• Doctor of Medicine
• Head Division of Vascular & Endovascular Surgery at American University of Beirut

Isolated superior mesenteric artery dissection (ISMAD) is a rare pathology with multifactorial etiology. The aim of this article is to provide a narrative review of the latest literature about ISMAD. Case reports, series, and recent meta-analyses were included. This review is introduced with a brief case report of a rare etiology of ISMAD, followed...

Objectives The current treatment of acute lower limb ischemia (ALLI) includes open surgical and percutaneous pharmaco-mechanical thromboembolectomy (TE). We hereby report our results with open surgical TE over a 10-year period and compare our outcomes using routine fluoroscopic assisted TE (FATE) with blind and selective on demand fluoroscopic-assi...

Background: A postoperative chest x-ray (CXR) remains part of some hospital protocols following tunneled hemodialysis catheter placement despite the use of operative imaging-guided techniques. The aim is to assess the usefulness of this practice and its impact on clinical outcomes and resource use. Methods: A review of medical records and postopera...

Lower limb amputation following arterial cannulation for VA-ECMO has been described in the literature. Limb ischemia however following venous cannulation is very rare and not quite understood. We present a case of limb ischemia following venous cannulation. A combination of venous congestion, compartment syndrome and subsequent arterial insufficien...

Background/Purpose CoA remains one of the most common congenital heart diseases and is associated with significant morbidity and mortality and if untreated. We aim to evaluate the safety, feasibility, and outcomes of endovascular stenting of Coarctation of the aorta (CoA) in a developing country with limited resources and compare it to available be...

This chapter discusses some techniques and tricks that are helpful for all vascular surgeons and interventionalists.

Background Lower extremity amputation (LEA) is a major surgical procedure with a high risk of significant morbidity and mortality. The objective of this study was to describe mortality and functionality outcomes following this procedure in a developing country. Methods This is a retrospective study of all patients undergoing LEA for non-traumatic...

Background: Traumatic arteriovenous fistula (TAVF) is an uncommon vascular entity that arises in various locations, often from penetrating injuries, with a wide spectrum of signs and symptoms. This case report highlights the importance of suspecting multiple TAVFs after a single gunshot wound, especially if it involves pellets. It also sheds light...

Diabetic Foot Infection (DFI) is a challenging complication of diabetes mellitus with a high burden in the Middle East where there is a marked increase in diabetes prevalence and complications. Early detection of DFI and the infectious organisms could result in the early initiation of appropriate antibiotic therapy and improved outcomes. DFI microb...

Background: Vascular infections are rare and challenging conditions with significant deaths and morbidity. Their management necessitates a multi-disciplinary approach and substantial human and financial resources. The management selected may be influenced by the available resources in low- and middle-income countries (LMICs), where such resources m...

Introduction Endovenous laser ablation (EVLA) has become the gold standard for the treatment of saphenous vein reflux. We report the long-term clinical and ultrasound results of EVLA. Methods This study is a retrospective review of patients who underwent EVLA of saphenous vein over four years. Clinical results were assessed using venous clinical s...

Transcatheter treatment is becoming the mainstay treatment for structural heart diseases (SHD) in prohibitive surgical risk patients. Recently with the encouraging results, it is being offered to regular risk patients. Peripheral vascular complications (VCs) are still inherent to these procedures due to the nature of this atherosclerotic high-risk...

Introduction: Carotid endarterectomy (CEA) is the most commonly used invasive procedure for treatment of carotid stenosis. Different methods are used to close the arteriotomy including primary closure and patch repair with a graft. Prosthetic patch infection is a rare but serious complication of patch closure, and we will present a unique case of...

We report the case of a 10-year-old girl with Takayasu arteritis who developed acute onset wrist drop diagnosed with a large right axillary artery aneurysm compressing the surrounding structures. Our case is unique because it describes a rare presentation of Takayasu arteritis (axillary aneurysm) in a child that was treated successfully in an uncon...

Compartment syndrome results from the combination of increased interstitial tissue pressure and the noncompliant nature of the fascia and osseous structures that make up a fascial compartment, causing microvascular compromise and subsequent muscle and nerve ischemia. Nerve conduction can be negatively affected after 2 h of ischemia; however, if com...

Background: Shifting from a short-term catheter to a long-term one is done either by removing the old catheter and placing a new long-term one via fresh new puncture site, or by replacing the old catheter with a long-term one over a guidewire. Aim: We aimed to describe our technique in changing a temporary line to a long-term catheter (LTC) over...

Bypass stenosis angioplasty is performed as a noninvasive first-line therapy in patients with failing bypass due to a stenosis identified by surveillance ultrasonography. This chapter describes indications, essential steps, variations, and complications of this procedure. It provides a detailed template operative note for the procedure.

Endovascular abdominal aortic aneurysm repair (EVAR) with the Cook Zenith or Zenith Flex Endograft is performed for symptomatic or asymptomatic aortic aneurysm greater than 5.5 cm in men and 5 cm in women with suitable anatomy.

Valvular heart disease frequently occurs as a consequence of premature atherosclerosis in individuals with familial hypercholesterolemia (FH). Studies have primarily focused on aortic valve calcification in heterozygous FH, but there is paucity of data on the incidence of valvular disease in homozygous FH. We performed echocardiographic studies in...

At some institutions, lower extremity ultrasound (LEUS) is performed routinely to screen for deep venous thrombosis (DVT) prior to sequential compression device (SCD) application. We set out to evaluate whether screening for DVT with LEUS is warranted prior to SCD application in critically ill adults with contraindications to anticoagulation. A tot...

A fistula formation between the esophagus and an aberrant right subclavian artery is a rare but fatal complication that has been mostly described in the setting of prolonged nasogastric intubation and foreign body erosion. We report a case of a young morbidly obese patient who underwent sleeve gastrectomy that was complicated by a postoperative lea...

Intima-media thickness (IMT) is a well-described marker of cardiovascular disease. In this study we aim to determine whether low-density lipoprotein (LDL) levels and disease-related mutation status can predict IMT in patients with severe familial hypercholesterolemia (FH) referred for or on LDL apheresis. Genetic screening, lipid profile testing, a...

: In-stent restenosis in a renal artery (RA) of a solitary functioning kidney is a serious complication of RA stenting. Drug-eluting balloons (DEB) have emerged as a novel way to manage restenosis. In this paper, the authors reported the first use of a DEB in the treatment of severe in-stent restenosis and thrombosis of a drug-eluting stent deploye...

Kidney injury and renal pseudoaneurysm after blunt abdominal trauma can lead to renal loss and potentially life-threatening bleed. Recent advances in endovascular interventions (embolization) can prevent potentially challenging surgical situations. We are presenting herein a case of life-threatening renal injury with renal artery pseudoaneurysm and...

Popliteal artery entrapment syndrome (PAES) is a relatively rare condition, which occurs predominantly in active young adults who lack atherogenic risk factors. It has been rarely reported in patients under the age of 18 years. The most common presentation in the early stages is intermittent claudication; however, in the later stages of undiagnosed...

1. If target lesion or plan is unclear from the preoperative duplex, we favor prepping and draping the patient from the start umbilicus to toes bilaterally in preparation for potential cut-down or open repair. 2. Get access from the contralateral leg if possible (refer to alternative below). 3. Advance angiographic catheter into aorta and perform a...

Infrarenal abdominal aortic aneurysm (AAA) >5.5 cm (nonruptured) in men 5.0 cm in women, enlarging AAA >4.0 cm (grown >5 mm in 6 months), Common Iliac artery Aneurysm. Anatomic exclusions: Neck: Infrarenal neck length <15 mm. Diameter >32 or <18 mm. Neck angulation >60° relative to aneurysm long axis. Neck angulation >45° relative to suprarenal aor...

Familial hypercholesterolemia (FH) is an inherited disease characterized by the deposition of LDL in tissues causing premature atherosclerosis. Many genes are implicated in FH resulting in a large variability in the phenotype. DNA sequencing of the LDLR gene was done for forty patients clinically diagnosed with homozygous FH and forty family member...

A 65-year-old obese woman with chronic kidney disease presented with acute deterioration requiring hemodialysis. A right internal jugular tunneled hemodialysis catheter was placed, with a chest X-ray (CXR) confirming tip position at the right atrium. On day 10 post-insertion, she was referred from her dialysis center because of bleeding from the tu...

High-output cardiac failure secondary to a surgically constructed arteriovenous fistula (AVF) is a rare entity that is usually under-diagnosed in the dialysis population. We herein present a case of a 35-year-old female who was diagnosed with high-output cardiac failure secondary to an AVF and later managed with surgical division of the fistula. Ri...

Aneurysm formation at the site of prior aortic coarctation patch repair is well documented. Migration of the patch though to the infrarenal aorta, as in this case, with subsequent aortitis and pseudoaneurysm formation has not been described. A 16 y old boy who was operated at the age of 10 for his aortic coarctation, presented with sepsis and abdom...

Cephalic vein aneurysms are rare malformations that may develop in any part of the vascular system, and their history, presentation, and management vary depending on their site. The etiology of venous aneurysms remains unclear, although several theories have been elaborated. Venous aneurysms are unusual vascular malformations that occur equally bet...

Les anévrismes de la veine céphalique sont des malformations rares qui peuvent se développer en n'importe quel endroit du système vasculaire, et leur histoire, leur présentation, et leur traitement varient selon leur emplacement. L'étiologie des anévrismes veineux demeure peu claire, bien que plusieurs théories aient été élaborées. Les anévrismes v...

To assess the intermediate-term outcomes following fenestrated grafting for juxtarenal aneurysms. A prospective trial was conducted on patients with short proximal necks, who were considered to be high-risk for open repair and unacceptable for conventional endovascular repair. Devices were designed from reconstructed CT data. Follow-up studies incl...

Thoracic aortic aneurysm affecting the arch and proximal descending thoracic aorta requires 2-stage repairs that include proximal elephant trunk graft placement and completion of thoracic or thoracoabdominal repair. The application of endovascular grafting to complete the proximal procedure avoids a thoracotomy and may improve the morbidity and mor...

This prospective study was designed to assess the technical success and outcome after patients with thoracic aortic pathology at high risk for conventional therapy were treated with the Zenith TX1 and TX2 endovascular graft. Between 2001 and 2004, patients at high risk for conventional surgical therapy presenting with chronic aortic dissections, th...

Fenestrated endovascular aneurysm repair uses the visceral aortic segment, in the setting of a suboptimal proximal neck, for sealing and fixation. This technique requires the placement of visceral stents and might be hampered by the deleterious effects of such interventions. This study was performed to define outcomes related to renal events. Conse...

Traumatic alimentary tract (AT) perforations in children secondary to instrumentation, though rare, can occur at any age, especially in neonates and young infants. Awareness of such a possibility is essential for prompt management to be initiated. Over a 10-year period (1986-1995), eight pediatric patients with AT perforations secondary to instrume...

A retrospective study of 46 patients who received bupivacaine local injections after hemorrhoidectomy were compared to a matching group of 46 patients of similar age and sex distribution who underwent the same operation. Pain medications requirement on the same day of operation and on subsequent days were measured and found to be the same in both g...

Over a 10-year-period extending from January 1976 to September 1986, 800 peripheral vascular injuries were surgically treated at the American University of Beirut Medical Centre. Of these, 150 were operated on because of injury to the femoral vessels. Bullets were the commonest wounding agents (60% of cases). Thirty-seven patients had a femoral art...