1/9. Unusual pregnancy-related vascular emergency.Although rare, aneurysms are well-known pregnancy-related vascular diseases. They are influenced by hormonal, mechanical, and genetic factors and may be associated with high incidence of maternal and fetal mortality. We present a case of a pregnancy-related common iliac aneurysm, ruptured 5 days after delivery. The source of bleeding was recognized during the second emergency laparotomy for hemoperitoneum and retroperitoneal hematoma. The treatment consisted of excision and substitution of the common iliac artery (totally involved) by an autologous saphenous vein graft. The outcome for the patient was good. We underline that the only way to avoid a fatal event is to know and to think about this rare but very important complication that may occur during pregnancy or shortly after delivery.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/9. Laparoscopic exclusion of a splenic artery aneurysm--a case report.splenic artery aneurysm is a rare but serious vascular disease. The mortality risk is 36% when one is ruptured. Surgical therapy has traditionally consisted in resection through a laparotomy. The authors' experience of a case of laparoscopic exclusion of a splenic artery aneurysm is reported. This surgical approach is simple, safe, and minimally invasive. This procedure should increase the indication for surgical treatment of a splenic artery aneurysm.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
3/9. pregnancy and subarachnoid hemorrhage: a case report.Cerebrovascular diseases are rare in pregnancy and mostly caused by rupture of an arterial aneurysm. We present the case of a pregnant woman at 36 weeks of gestation who had a subarachnoid hemorrhage resulting from rupture of an unknown aneurysm, and who underwent a cesarean section and an endovascular treatment to embolize the aneurysm.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
4/9. Intracranial atypical fibromuscular dysplasia with ruptured aneurysm--case report.A 53-year-old woman was admitted with severe subarachnoid hemorrhage due to rupture of an aneurysm associated with atypical intracranial fibromuscular dysplasia (FMD). Angiography demonstrated the aneurysm and very irregular form of the left internal carotid artery (ICA), the right ICA, and right proximal middle cerebral artery (MCA). Other arteries showed signs of atherosclerosis. The aneurysm was treated by embolization, but she subsequently died of shock of unknown cause. Detailed examination of serial angiograms detected enlargement of the aneurysm and progression of the irregular appearance of the ICA. FMD is a non-inflammatory and non-atheromatous arteriopathy that commonly affects the cervical ICA and sometimes the intracranial ICA. The association with saccular aneurysm is widely known and the prevalence of incidental aneurysms is higher than that in the general population. The common "string of beads" finding is easily distinguished from other vascular diseases, but non-specific findings such as "tubular stenosis" and "diverticular-like outpouching" are harder to differentiate. FMD is associated with various complications and appropriate periodic follow-up examination is required. Detailed analysis of serial angiograms may facilitate diagnosis of this condition.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
5/9. Sudden, unexpected death due to splenic artery aneurysm rupture.splenic artery aneurysms are an uncommon form of vascular disease that have a significant potential for rupture, resulting in life-threatening intraperitoneal hemorrhage. We describe the case of a 33-year-old man who died suddenly and unexpectedly due to the rupture of a splenic artery aneurysm. At medicolegal autopsy, 3000 mL of fluid blood were recovered from the peritoneal cavity. The source of bleeding was a sack-like aneurysm of the splenic artery, measuring 2 cm in diameter. Histologic examination of the splenic artery aneurysm revealed fibromuscular dysplasia. No atherosclerotic lesions or any inflammatory changes were apparent within the wall of the splenic artery. Portal hypertension and pancreatitis, previously described as important factors promoting splenic artery aneurysm formation, were excluded by autopsy and histology. From the forensic pathologist's viewpoint, this rare case underlines the importance of splenic artery aneurysm rupture as a relevant differential diagnosis of intraperitoneal hemorrhage and sudden death, respectively, since such cases may be misinterpreted as a result of blunt-force trauma.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
6/9. Unruptured aneurysms associated with ischaemic cerebrovascular diseases. Surgical indication.Out of 3435 patients with ischaemic cerebrovascular disease 2540 cases were investigated using cerebral angiography. In 127 of them (5%) aneurysms were found, but without clinical evidence of subarachnoid haemorrhage (SAH). 45 cases were operated upon and 82 were treated conservatively. Five of these 82 cases (6%) suffered from SAH 3 months to 10 years (mean interval 5.6 years) after the angiographic diagnosis. Four of these 5 patients with SAH died. Among the 45 surgical cases follow-up was uneventful in 29 (64%). The other 16 cases postoperatively showed neurological deterioration (36%), which was transient in 6 but with only minor improvement in 10. Of these 10 cases 2 died from cerebral infarction related to intra-operative temporary vascular occlusion respectively myocardial infarction. Thus surgical mortality was 4% and permanent morbidity 18%. Causes of postoperative neurological deterioration were partly related to general arteriosclerotic changes and special fragility of the ischaemic brain, and partly to operative technique (excessive brain retraction, damage to cortical veins, occlusion of major vessels or damage to perforators, temporary artery occlusion). Apparently in cases with ischaemic cerebrovascular diseases operative procedures, which in other cases as a rule are well tolerated, may produce harmful effects. Therefore, in these cases, the indication for operative treatment of so far silent aneurysms should be restricted to patients who are in good general condition with longer life expectancy as far as the vascular disease is concerned, and without major neurological deficit. Furthermore, the operative technique should be especially gentle and atraumatic.- - - - - - - - - - ranking = 7keywords = vascular disease (Clic here for more details about this article) |
7/9. Rupture of dissecting aneurysm in a china Airlines co-pilot.A 46-year-old male co-pilot of china Airlines developed shortness of breath during landing on a flight from tokyo to Taipei on May 17, 1994. He was found dead shortly after landing. He was well and had passed his semi-annual health examination with no history of cardiovascular disease or hereditary disease. A dissecting aneurysm of DeBakey type I and cardiac tamponade with 200 ml blood inside the pericardial cavity during autopsy was noted. The right and left coronary arteries showed atherosclerotic changes with the lumen narrowing down to 30% in the anterior descending branch. Focal myocardial infarction with a healing scar, atheroma and arteriosclerosis of the small arteries including the kidney were observed. Nonspecific changes of the chest X-Ray and EKG with hyperlipoproteinemia suggests that a more advanced technique is required to carefully examine the heart condition during regular physical checkups to prevent sudden illness that might contribute to mass disaster.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
8/9. stroke: anatomy of a catastrophic event.subarachnoid hemorrhage (SAH) resulting from the rupture of a cerebral aneurysm represents one major cause of stroke. SAH may be followed by a spontaneous severe contraction of major cerebral arteries, a condition referred to as cerebral vasospasm. Vasospasm may result in brain ischemia or actual tissue death. This constrictive vascular state is devastating, remains largely untreatable, and is a major cause of morbidity and mortality in SAH patients. Approximately 30,000 Americans are affected by this condition each year. The overall death rates are 25%, and significant neurological complications occur in 50% of individuals who survive the initial bleed. This report highlights some of the important aspects of this vascular disease.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
9/9. Segmental mediolytic arteritis [correction of arteries]: a case report with review of the literature.Segmental mediolytic arteritis is a very rare vascular disease which causes sudden intraabdominal hemorrhage. The disease is characterized by degeneration of the arterial media, followed by aneurysmal dilatation and rupture of the involved artery. Up to now, only 13 cases have been reported, and this unique disease is not fully recognized among general pathologists and physicians. Here, we present a case of segmental mediolytic arteritis involving the propria hepatic artery, which resulted in intraabdominal hemorrhage, and consequently hypovolemic circulatory disturbance. Histologically, the rupture focus showed degeneration and desquamation of the intima and media with fibrin-like material covering the exposed adventitia. Inflammatory infiltrates were only noted in the rupture focus as a secondary reactive change. Other than the rupture focus, there were two foci showing similar findings. This disease has rarely been reported and is seldom recognized as a cause of arterial rupture. In cases of sudden intraabdominal hemorrhage, segmental mediolytic arteritis should be considered as a possible cause in addition to atherosclerotic and mycotic aneurysm, traumatic injury and vasculitis syndromes.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |