1/121. External iliac artery occlusion in posterior spinal surgery.STUDY DESIGN: Report of a case of external iliac artery occlusion occurring as a rare complication of lumbar posterior spinal surgery. OBJECTIVE: To clarify the cause of this rare complication and recommend methods for preventing its recurrence. SUMMARY OF BACKGROUND DATA: Several cases of central retinal artery occlusion after posterior spinal surgery have been reported, but there has been no reported case of external iliac artery occlusion after posterior spinal surgery. methods: A 65-year-old woman who had a 32-year history of systemic lupus erythematosus underwent posterior decompression and spinal fusion for degenerative scoliosis. She was supported on a Hall frame during the operation. Three hours after surgery, paralysis and sensory impairment of the left leg and cyanosis of the toes of the left foot were noted. The popliteal, dorsalis pedis, and posterior tibial pulses were not palpable. Angiography showed complete occlusion of the external iliac artery, and emergency removal of the thrombus was performed. RESULTS: One year later, neurologic symptoms were absent, and the leg vessels were normal. CONCLUSIONS: Prolonged direct pressure on the inguinal region during posterior spinal surgery on a Hall frame may cause external iliac artery occlusion. Early recognition and adequate treatment can prevent serious sequelae.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/121. Unusual complications in an inflammatory abdominal aortic aneurysm.An unusual case of an inflammatory abdominal aortic aneurysm (IAAA) associated with coronary aneurysms and pathological fracture of the adjacent lumbar vertebrae. The associated coronary lesions in cases of IAAA are usually occlusions. In the present case, it was concluded that a possible cause of the coronary aneurysm was coronary arteritis and the etiology of the pathological fracture of the lumbar vertebrae was occlusion of the lumbar penetrating arteries due to vasculitis resulting in aseptic necrosis. Inflammatory AAA can be associated with aneurysms in addition to occlusive disease in systemic arteries. The preoperative evaluation of systemic arterial lesions and the function of systemic organs is essential.- - - - - - - - - - ranking = 0.18524339315405keywords = fracture (Clic here for more details about this article) |
3/121. pulmonary artery compression by a giant aortocoronary vein graft aneurysm.Late failure of saphenous vein aortocoronary bypass grafts is predominantly due to vein graft atherosclerotic disease. Rarely, saphenous vein aortocoronary bypass grafts undergo aneurysmal degeneration. We report a case of a giant true aneurysm of a saphenous vein aortocoronary bypass graft producing right heart failure from main pulmonary artery compression.- - - - - - - - - - ranking = 5keywords = compression (Clic here for more details about this article) |
4/121. Hepatic ischemia as a complication after correction of post-traumatic gibbus at the thoracolumbar junction.STUDY DESIGN: This is a case report of hepatic ischemia secondary to celiac trunk stenosis as a complication after correction of a preoperative 30 degrees gibbus at the thoracolumbar junction. OBJECTIVES: A high index of suspicion is needed to make a timely diagnosis of hepatic ischemia in any setting. After spinal reconstruction involving lengthening, symptoms suggestive of an acute abdomen accompanied by markedly elevated liver enzymes should be evaluated with an angiogram to check for celiac trunk stenosis. SUMMARY OF BACKGROUND DATA: review of the literature showed no reported cases of hepatic ischemia or descriptions of the status of celiac trunk stenosis after spinal surgery. Even in more commonly associated settings, diagnosis of both phenomena is often delayed, with possible morbid consequences. methods: A case is presented of a patient who underwent gibbus correction and re-establishment of lost anterior intervertebral distance at the thoracolumbar junction. After surgery, ischemic hepatitis, a perforated gallbladder, and splenic infarction developed secondary to celiac trunk stenosis-a result of cephalad displacement of the celiac trunk and compression of the artery by the diaphragmatic ligament. RESULTS: An emergent exploratory laparotomy with cholecystectomy was performed followed by an angiogram, which demonstrated stenosis of the celiac trunk. After release of the arcuate ligament, the patient's condition improved rapidly, and he made a complete recovery. CONCLUSIONS: The consequences of a delay in diagnosis of hepatic ischemia can be disastrous. An awareness of the possibility of this complication after spinal lengthening should facilitate a timely angiogram and operative intervention.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
5/121. celiac artery compression syndrome.celiac artery compression syndrome occurs when the median arcuate ligament of the diaphragm causes extrinsic compression of the celiac trunk. We report a case of a 65-year-old woman who presented with a three-month history of postprandial abdominal pain, nausea and some emesis, without weight loss. There was a bruit in the upper mid-epigastrium and the lateral aortic arteriography revealed a significant stenosis of the celiac artery. At operation, the celiac axis was found to be severely compressed anteriorly by fibers forming the inferior margin of the arcuate ligament of the diaphragm. The ligament was cut and a vein by-pass from the supraceliac aorta to the distal celiac artery was performed. The patient remains well and free of symptoms two and a half years since operation.In this report we discuss the indications and the therapeutic options of this syndrome as well as a review of the literature is being given.- - - - - - - - - - ranking = 6keywords = compression (Clic here for more details about this article) |
6/121. popliteal artery entrapment syndrome: diagnosis and management, with report of three cases.popliteal artery entrapment syndrome is an important albeit infrequent cause of serious disability among young adults and athletes with anomalous anatomic relationships between the popliteal artery and surrounding musculotendinous structures. We report our experience with 3 patients, in whom we used duplex ultrasonography, computed tomography, digital subtraction angiography, and conventional arteriography to diagnose popliteal artery entrapment and to grade the severity of dynamic circulatory insufficiency and arterial damage. We used a posterior surgical approach to give the best view of the anatomic structures compressing the popliteal artery. In 2 patients, in whom compression had not yet damaged the arterial wall, operative decompression of the artery by resection of the aberrant muscle was sufficient. In the 3rd patient, operative reconstruction of an occluded segment with autologous vein graft was necessary, in addition to decompression of the vessel and resection of aberrant muscle. The result in each case was complete recovery, with absence of symptoms and with patency verified by Doppler examination. We conclude that clinicians who encounter young patients with progressive lowerlimb arterial insufficiency should be aware of the possibility of popliteal artery entrapment. early diagnosis through a combined approach (careful physical examination and history-taking, duplex ultrasonography, computerized tomography, and angiography) is necessary for exact diagnosis. The treatment of choice is the surgical creation of normal anatomy within the popliteal fossa.- - - - - - - - - - ranking = 3keywords = compression (Clic here for more details about this article) |
7/121. Laparoscopic release of celiac artery compression syndrome facilitated by laparoscopic ultrasound scanning to confirm restoration of flow.A 43-year-old woman presented with symptomatic mesenteric ischemia caused by median arcuate ligament compression of her celiac artery. magnetic resonance angiography clearly demonstrated stenosis of the proximal celiac artery. She underwent laparoscopic decompression by division of the ligament and excision of the celiac plexus. Laparoscopic Doppler ultrasound scanning demonstrated markedly improved flow in the artery. She was discharged in 15 hours and reported complete resolution of her symptoms at the 3-month postoperative visit. laparoscopy provides a less invasive but equally effective method for decompressing the celiac artery as well as assessing adequacy of flow after its release.- - - - - - - - - - ranking = 6keywords = compression (Clic here for more details about this article) |
8/121. Cystic adventitial disease of the popliteal artery: elongation into the media of the popliteal artery and communication with the knee joint capsule: report of a case.Cystic disease of the popliteal artery is a rare disorder in which most cases involve the formation of an adventitial cyst that disturbs the popliteal artery blood flow. We present herein the case of a patient presenting with popliteal artery occlusion due to compression by a cyst which formed at the media of the popliteal artery. The onset occurred during a baseball game in which he played catcher. Preoperative magnetic resonance imaging demonstrated a communication of the cyst with the adjacent knee joint. This unusual case could provide important clues to help identify the pathogenesis of this disease.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
9/121. Acute dissecting aneurysm of the ascending thoracic aorta causing obstruction and thrombosis of the right pulmonary artery.We present the case of a 69-year-old man with a history of hypertension and a recent pelvic fracture who presented with acute chest pain, shortness of breath, and severe hypotension. The history of recent pelvic fracture and the clinical manifestations, including the sudden onset of acute respiratory distress, hypotension, and hypoxemia, indicated pulmonary embolism; however, at surgery the patient was found to have an acute dissection of the ascending aorta with obstruction and thrombosis of the right pulmonary artery. This case emphasizes the need to consider such a diagnosis in patients who have unilateral absence of perfusion to the right lung.- - - - - - - - - - ranking = 0.18524339315405keywords = fracture (Clic here for more details about this article) |
10/121. A lateral mass fracture of C1 associated with left vertebral artery and mid-basilar artery occlusion.Extreme acceleration and deceleration forces as well as axial loading are exerted at the occipito-cervical junction of drivers involved in high-velocity motor vehicle accidents, especially with fastened seatbelts. Injury at this level, usually lethal, can go unrecognized despite modern emergency management of the unconscious patient. A precise neurologic and radiographic workup of damage to this area is often not possible or overlooked in the initial phase of such severe trauma. We describe a patient with multiple injuries who sustained a left vertebral artery occlusion associated with a left-sided lateral mass fracture of C1 and a basilar artery occlusion resulting in a locked-in syndrome after an automobile accident.- - - - - - - - - - ranking = 0.46310848288513keywords = fracture (Clic here for more details about this article) |
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