1/18. Preoperative evaluation of a patient for abdominal aortic aneurysm repair.Coexistent cardiovascular disease is common in patients presenting for repair of aortic aneurysms. However, preoperative cardiac evaluation prior to abdominal aortic aneurysm (AAA) surgery remains contentious with significant variations in practice between countries, institutions and individual anesthetists. The following case report raises some everyday issues confronting clinical anesthetists.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/18. Regression of inflammatory abdominal aortic aneurysm after endoluminal treatment with bare-metal Wallstent endoprostheses.Bare-metal Wallstent endoprostheses were used to treat a 60-year-old man who had an inflammatory abdominal aortic aneurysm, as confirmed by clinical and computed tomographic findings. The patient had concomitant coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, and severe iliofemoral disease. Because of high surgical risk due to coexisting disease (including severe peripheral vascular disease), the patient was not a candidate for current endovascular methods or surgical repair. Therefore, we used the novel endovascular approach described. Serial, spiral, computed tomographic scans during a 2-year follow-up period revealed a reduction in the maximal diameter of the abdominal aortic aneurysm from 44 mm to 36 mm. Stabilization of thrombus and regression of the periaortitis were also noted. To our knowledge, this is the 1st reported case of endoluminal therapy with an uncovered stent for an inflammatory abdominal aortic aneurysm. Bare-metal Wallstent exclusion of inflammatory abdominal aortic aneurysms presents a treatment option for patients who are at high risk for surgery and cannot be treated with covered stent-grafts due to severe disease of the iliofemoral vessels.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
3/18. Giant coronary aneurysms with multiple vascular aneurysms: a rare manifestation of hyperhomocysteinemia.hyperhomocysteinemia is associated with accelerated atherosclerosis, which leads to an increased incidence of premature vascular disease. Although multiple vascular aneurysms have been linked to hyperhomocysteinemia, coronary artery aneurysms have not. We report a case of giant coronary artery aneurysm associated with multiple peripheral vascular aneurysms in a patient with hyperhomocysteinemia.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
4/18. Successful renal transplantation after endovascular bifurcated stent graft repair of an abdominal aortic aneurysm.Renal transplantation after repair of aortoiliac aneurysms with traditional prosthetic vascular grafts has been shown to be effective. Vascular surgery continues to rapidly evolve, most notably with the advancement of endovascular repair of abdominal aortic aneurysms. Controlled trials continue to support the trend toward the use of endovascular bifurcated aortic stent grafts. For this we describe the first renal transplant in a patient with an endovascular bifurcated aortoiliac stent graft. No intraoperative difficulties were encountered. At 1-year follow-up, the transplanted kidney is functioning well with a normal serum creatinine level of 1.3 mg/dl, and the patient has no worsening of peripheral vascular disease. We recommend that the presence of an endovascular aortic graft not be a contraindication to renal transplantation.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
5/18. Severe potential consequences of delayed diagnosis in patients with hip claudication.delayed diagnosis in patients with hip claudication can lead to severe consequences. We report on patients with ischaemic hip claudication which had primarily been attributed to coxarthrosis. One patient went through a variety of treatments including hip arthroplasty. The second patient had a life-threatening abdominal aortic aneurysm (AAA) which remained undiagnosed. Orthopaedic surgeons should maintain a high degree of suspicion for vascular disease. Moreover, we strongly advocate that all men over 60 years old who seek medical advice for whatever reason should be screened once for AAA by ultrasonography.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
6/18. Marfan's syndrome presenting with abdominal aortic aneurysm: a case for vigilance.We present the case of a 16-year old student with Marfan's syndrome and abdominal aortic aneurysm who presented with a diagnostic conundrum. He presented with a three months history of progressive painful left upper abdominal mass and back pain. It became severe in the last two weeks before presentation and was associated with constipation. This mass was thought to be of splenic origin but the initial ultrasound suggested a pancreatic pseudocyst. review of his previous hospital record revealed that he had been treated for severe myopia which started at infancy. Another opthalmic review at our centre revealed bilateral ectopia lentis. He had no cardiac signs and no family history of cardiovascular diseases. He is the 6th of 8 siblings, all the family members are alive and healthy except one sibling who died at 7 months. The diagnosis of abdominal aortic aneurysm was only made at laparotomy and confirmed by on-table aortogram. He had excision of the aneurysmal sac and replacement with on-lay dacron tube graft. He died on the 4th post-operative day. A diagnosis of abdominal aortic aneurysm was not made at initial presentation because of the rarity of this condition in our environment and incompetence of the ultrasonographer. aortic aneurysm in Marfan's syndrome is commonly found in the thoracic part of the aorta, however in this case, it is abdominal. A high index of suspicion is necessary to avoid missing this pathology, therefore the need for vigilance.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
7/18. role of wrapping in concomitant intra-abdominal aneurysm and colorectal carcinoma. Report of three cases.The therapeutic measure against concomitant intraabdominal aneurysm and colorectal carcinoma is still a dilemma. Here we report the clinical courses of three cases of colorectal carcinoma coincidental with moderate-sized abdominal aortic or iliac artery aneurysm in those who underwent operations during a recent three-year period. Resection of malignant lesion and wrapping of aneurysm were carried out in all three patients simultaneously. carcinoma was staged by Dukes classification as A in one patient and B in two patients. All tolerated surgery well without any signs of complications. Two-year or three-year follow-up shows that they have continued to do well, with no further symptoms of abdominal aortic aneurysm, peripheral vascular disease, or recurrence of colorectal carcinoma. We conclude that, if the aneurysm is not about to rupture and the carcinoma is in an advanced stage, then the carcinoma should be resected, associated with interim aneurysmal wrapping. However, both lesions need to be resected eventually for long-term survival.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
8/18. Aortoenteric fistula to the sigmoid colon-case report.Aortoenteric fistula is defined as a communication between the aorta and any adjacent segment of the bowel. It may be primary or secondary. The former occurs de novo in patients with intestinal or vascular diseases, whereas secondary aortoenteric fistula is a rare and dreadful complication of aortic reconstruction with vascular prosthesis. We report a case of a 62-year-old man who presented to the emergency department with acute rectal bleeding. The patient had previous aortoiliac surgery with the utilization of an aorto-bifemoral vascular graft. Diagnosis of secondary aortoenteric fistula was made between the aortoiliac graft and sigmoid colon. After exploratory laparotomy, Hartmann's procedure, excision of the graft, oversewing of the aortic stump, and axilobifemoral bypass were successfully performed. This study reports a rare type of secondary aortoenteric fistula to the left colon, and it describes an unusual and successful surgical treatment.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
9/18. Persistent sciatic artery in a patient with extracranial internal carotid artery aneurysm and infrarenal abdominal aortic aneurysm. A case report.A rare case of a persistent sciatic artery (PSA) in a patient with aneurysms of the internal carotid artery and abdominal aorta is presented. A 70-year-old man was referred with intermittent claudication of the right lower extremity. angiography and computed tomography demonstrated that this symptom was due to occlusion of the PSA. On preoperative examinations, aneurysms of the extracranial internal carotid artery and abdominal aorta were incidentally discovered, and then surgically treated prior to the management of PSA. Systemic examinations must be performed in patients with PSA in order to scrutinize associated anomalies or vascular disease.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
10/18. Abdominal aortic aneurysm infected by yersinia pseudotuberculosis.Infected aneurysms caused by Yersinia are very uncommon and are principally due to yersinia enterocolitica. We describe the first case of an infected aneurysm caused by yersinia pseudotuberculosis in an elderly patient with a history of atherosclerotic cardiovascular disease.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
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