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1/325. Simultaneous operation for minimally invasive direct coronary artery bypass and abdominal aortic aneurysm repair.

    Simultaneous minimally invasive direct coronary artery bypass and abdominal aortic aneurysm repair were conducted in a 66-year-old man uneventful, requiring no transfusion. Surgery required 9 hours and 2 minutes. The tracheal tube was extubated in the operating room. Postoperative bleeding was 215 ml. The postoperative course was very smooth, with the patient able to walk on postoperative day 1. Postoperative coronary arteriogram and aortogram showed favorable results and the patient was discharged on day 23 after surgery.
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keywords = artery
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2/325. Chronic aortic dissection: stenting of aortic true lumen obliteration with late dynamic variations of both lumens.

    Percutaneous endovascular techniques were used to treat an arteriovenous fistula (AVF) associated with pancreatic transplantation. A pancreatic transplant superior mesenteric artery-to-superior mesenteric-vein AVF was successfully embolized while flow to the pancreas transplant was preserved. The embolization was aided by the use of Guglielmi detachable coils and a detachable balloon. No complications were encountered. At 23 months follow-up, the patient is doing well with no recurrence.
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keywords = artery
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3/325. Fatal late multiple emboli after endovascular treatment of abdominal aortic aneurysm. Case report.

    BACKGROUND: The short term experience of endovascular treatment of abdominal aortic aneurysms (AAA) seems promising but long term randomised data are lacking. Consequently, cases treated by endovascular procedures need to be closely followed for potential risks and benefits. CASE REPORT: A 70 year-old mildly hypertensive male without previous or present arteriosclerotic, pulmonary, or urological manifestations was subjected to endovascular treatment after his mass-screening diagnosed abdominal aortic aneurysm had expanded to above 5 cm in diameter, the aneurysm having been found by CT-scanning and arteriography to be endovascularly treatable. A Vanguard bifurcated aortic stent graft was implanted under epidural/spinal anaesthesia and covered by cephalosporine and heparin (8000 IE) protection. Apart from treatment of a groin haematoma and stenosis of the left superficial femoral artery, the postoperative period presented no problems. A few days before the monthly follow-up visit, the patient developed uraemia, gangrene of one foot and dyspnoea. blood glucose and LDH was elevated. Deterioration led to death a month and a half after stent implantation. autopsy showed extraordinary large, extensive soft, brown vegetations in the lower part of the thoracic aorta above the properly infrarenally-placed stent. Microscopic examination revealed multiple microemboli in the liver, spleen, pancreas, intestines, testes, and especially the kidneys. DISCUSSION: Early death from microemboli after aortic stent implantation has been reported. However, the present case developed fatal multiple microemboli so late that they could not have originated from the excluded mural thrombus. The sudden death of an otherwise healthy man of extensive microemboli is difficult to explain. The stent application may have altered the proximal flow and wall movements disposing to microemboli in the case of vegetations.
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keywords = artery
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4/325. Two-stage operation for multiple aneurysms of the thoracic aorta, abdominal aorta, and left common iliac artery in an octogenarian.

    Multiple aortic aneurysms are well described in the surgical literature. However, there are many problems related to surgical treatment of elderly patients with such aneurysms. This report presents the case, an octogenarian with multiple aortic aneurysms that were successfully treated by graft replacement. An 82-year-old man with a descending aortic aneurysm was referred to our institution for surgery. In addition to the previously diagnosed aneurysm, computed tomography and aortography showed an abdominal aortic aneurysm and a left common iliac aneurysm. Since the patient was an elderly man with chronic obstructive pulmonary disease, a two-stage operation was performed. The abdominal aortic aneurysm and left common iliac aneurysm were resected first due to the risk of thromboembolism from the abdominal aortic aneurysm during surgery involving replacement of the descending aorta under femoro-femoral (F-F) bypass. Fifty-two days after the first operation, a second operation was performed to repair the descending aortic aneurysm. The postoperative course was uneventful. angiography after the operation showed satisfactory replacement of the multiple aortic aneurysms. The patient was discharged 25 days after the second operation.
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5/325. Cavernous aneurysm rupture with balloon occlusion of a direct carotid cavernous fistula: postmortem examination.

    We present a unique case of a patient with a symptomatic carotid cavernous fistula treated successfully with balloon embolization. Her subsequent death from other disease processes allowed direct visualization of the balloon occlusion in situ at postmortem examination.
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ranking = 0.10852734031843
keywords = carotid
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6/325. saphenous vein graft ectasia: an unusual late complication of coronary artery bypass surgery. A case report.

    Aneurysms and ectasias of saphenous vein grafts are infrequent complications of coronary artery bypass surgery. They usually present as an expanding asymptomatic mediastinal mass on chest x-ray film or computed tomography scan. Though rare, they must be excluded from the differential diagnosis of mediastinal masses to avoid potentially dangerous needle biopsy. The authors describe ectasia of a saphenous vein graft in a 62-year-old man 14 years after coronary artery bypass surgery. The relevant literature is also discussed.
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ranking = 1.2
keywords = artery
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7/325. coronary artery bypass grafting in a case with severe aortic atheromatosis associated with abdominal aortic aneurysm.

    A 69-year-old man with coronary artery disease associated with abdominal aortic aneurysm underwent a one-stage operation utilizing a low-flow cardiopulmonary bypass. Ordinary cardiopulmonary bypass was abandoned as a result of severe atheromatous finding in the entire aorta. However, coronary artery bypass grafting without cardiopulmonary bypass was hazardous as a result of heart enlargement and deteriorating function. Therefore, the abdominal aortic aneurysm was first replaced with a bifurcated graft. coronary artery bypass grafting with two arterial grafts was then performed successfully on the beating heart with the support of a low-flow cardiopulmonary bypass connected to the bifurcated graft.
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ranking = 1.5374372792588
keywords = artery, artery disease
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8/325. Endovascular stent-grafting via the aortic arch for distal arch aneurysm: An alternative of endovascular stent-grafting in a complicated case.

    A 67-year-old man with severe discomfort was diagnosed with a rupture of the thoraco-abdominal aneurysm, a distal arch aneurysm and triple coronary artery disease. After emergency surgery for a thoracoabdominal aneurysm, a scheduled surgery for coronary artery bypass grafting and endoluminal stent-grafting for the distal arch aneurysm was performed simultaneously. A stent-graft was introduced into the descending aorta via a small incision on the arch aorta. Open endovascular stent-grafting via the arch aorta is an alternative for repairing a distal arch aneurysm with coronary artery bypass grafting.
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ranking = 0.73743727925885
keywords = artery, artery disease
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9/325. Abdominal aortic aneurysmectomy with left-sided inferior vena cava and transplanted kidney.

    Aortic aneurysmectomy was performed in a 43-year-old man with left-sided inferior vena cava (It-IVC) after renal transplantation 10 years before. In the admission examination chronic rejection was found histopathologically. For renal protection, a temporary heparin-coated shunt tube was used to maintain continuous blood flow to the transplanted kidney. The shunt was placed between the left brachial artery and the right external iliac artery, because there was no segment healthy enough for cannulation of the shunt tube and the It-IVC crossed over the aorta above the aneurysm. Aortic aneurysmectomy was performed without complications and perioperative renal function was satisfactorily maintained without progression of the chronic rejection.
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ranking = 0.4
keywords = artery
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10/325. Isolated hypogastric artery aneurysms.

    iliac artery aneurysms are rare in the absence of concomitant abdominal aortic aneurysm (AAA), and isolated internal iliac (hypogastric) aneurysms in particular are extremely rare. From 1986 to 1997 we repaired 572 aortic and/or iliac artery aneurysms in 440 patients. Among these there were only seven hypogastric aneurysms and three of these occurred in the absence of, or remote to, AAA. Hypogastric aneurysms are difficult to diagnose, and large aneurysms are associated with significant morbidity and mortality due to compression of adjacent structures and a high rate of rupture. They pose technical challenges in repair because of their location deep in the pelvis and because it is difficult to gain distal control of the hypogastric artery and its branches. However, the technique of obliterative endoaneurysmorrhaphy has made repair of these aneurysms safe and straightforward. Moreover, this method, unlike percutaneous endovascular techniques, eliminates the compressive mass that is often associated with significant symptomatology. We report three isolated hypogastric aneurysms repaired over an 11-year period, illustrating the technique of proximal ligation and obliterative endoaneurysmorrhaphy, and review the literature on the topic.
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ranking = 1.4
keywords = artery
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