1/48. Acute arterial occlusion associated with total knee arthroplasty.Acute arterial occlusion is a rare but limb-threatening complication in total knee arthroplasty. Most of the previously reported cases of this complication required surgical intervention. This report illustrates an unusual case of this complication that was managed conservatively with an acceptable outcome. The case is also indicative of the etiology and the optimal prevention of this complication. In a patient with advanced arteriosclerosis, as indicated by vascular calcification around the knee or in the abdomen, knee arthroplasty should be performed without a tourniquet, and intra-operative manipulation should be done cautiously because of the potential for intimal disruption.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
2/48. Severe diffuse atherosclerotic lesions of right gastroepiploic artery graft.The incidence of arteriosclerosis of the right gastroepiploic artery (RGEA) has not been widely known. We experienced one patient in whom the RGEA had severe diffuse atherosclerotic lesions and luminal narrowing, and was therefore determined to be unsuitable as a coronary bypass conduit at operation.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
3/48. Geriatric ureteropelvic junction obstruction: the possible role of an arteriosclerotic lower pole branch of renal artery: report of two cases.An 83-year-old woman presented with left flank pain and high grade fever. After left ureteral catheterization and intensive chemotherapy with hemoperfusion, surgical exploration revealed the lower pole branches of the renal vessels were obstructing the ureteropelvic junction (UPJ), and dissection of the vessels released the obstruction. An 82-year-old man presented with right flank pain. angiography demonstrated UPJ obstruction caused by the lower pole branch of the renal artery. Arterial dissection with dismembered pyeloplasty resulted in improvement of obstruction. In both cases, the patients had a long history of hypertension with mild to severe arteriosclerosis. Arteriosclerosis associated with fixation of the UPJ, may be one of the important factors leading to progressive hydronephrosis in geriatric patients.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
4/48. Nephropathy subsequent to hyperlipidemia.The relationship between lipid abnormalities and the pathogenesis of renal disease is still unclear. Although most patients with primary hyperlipidemia do not develop renal function impairment, experimental and clinical data indicate a possible damaging effect of a disturbed lipid metabolism on the kidney. We report the case history of a patient with hyperlipidemia and mild nephropathy in which an accidentally removed kidney showed intrarenal arteriosclerosis which occured before the development of other cardiovascular risk factors, indicating that primary dyslipidemia induced nephroangiosclerosis.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
5/48. Management of amputation-stump breakdown.Seven cases of above-knee amputation stump breakdown following surgery for arteriosclerosis obliterans were successfully treated with Travase ointment. (bacillus subtilis proteinase). rehabilitation was facilitated because secondary closure of the previously infected necrotic wounds could be more rapidly undertaken.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
6/48. Fatal lipid embolism following intraarterial angiography at an early stage of arteriosclerosis.Intraarterial angiography was performed on a patient with peripheral arterial occlusive disease (Fontaine IIb). No relevant risk factors were known, and a previous angiography had been undertaken without incident. After administration of contrast medium, the patient complained of acute pain in the lower abdomen and both legs, and a sudden rise in blood pressure was observed. The patient subsequently lost consciousness and died within 1.5 h. Postmortem examination showed that death was due to peripheral atheromatous microembolism of lipids, and not cholesterol as is usual in these cases. The differential diagnosis is discussed and a review of the literature is presented.- - - - - - - - - - ranking = 4keywords = arteriosclerosis (Clic here for more details about this article) |
7/48. Different roles of arteriosclerosis in the rupture of intracranial dissecting aneurysms.AIMS: Although intracranial dissecting aneurysm (IDA) is a newly described variant of the brain aneurysms that affects mainly the vertebrobasilar arterial system, its pathogenesis remains obscure. We aimed to clarify the role of arteriosclerosis in the pathogenesis of IDA based on histopathological findings in seven autopsy cases of IDA. methods AND RESULTS: All cases exhibited systemic hypertension or left ventricular hypertrophy. Macroscopically, all cases exhibited subarachnoid haemorrhage. Two types of dissection were recognized in the vertebral artery. Six of seven IDA cases showed a widespread disruption of the entire thickness of the arterial wall with the formation of a dilated pseudoaneurysm, which consisted of thin adventitia (arterial wall disruption type). Medial disruption of the arterial wall and subadventitial dissecting haemorrhage were also found, resulting in the formation of a false lumen and stenosis of the 'true' lumen of the artery. However, these lesions were connected to the site of rupture of the entire arterial wall. Within 1 day after onset of IDA, the autopsy cases showed formation of fibrin thrombus, marked leucocyte infiltration and necrosis of the arterial wall at the site of the lesion. Cases that survived more than 1 week showed smooth muscle cell proliferation, macrophage accumulation and lymphocytic infiltration in the lesions. These cases showed no atherosclerotic plaque, but non-atherosclerotic fibrocellular intima. The thickness of intima and media was significantly less in the vertebral artery of IDA patients than that of non-IDA patients with systemic hypertension. On the other hand, the remaining case showed severe atherosclerosis with haemorrhage into the lipid core without connection to the arterial lumen (intra-atheromatous plaque haemorrhage type). However, unusual arterioles and neovascularization of the intra-and peri-arterial walls were observed. CONCLUSIONS: Our results suggest that disruption of the entire arterial wall may be a critical event in the development of IDA and result in the medial disruption and subadventitial haemorrhage. Non-atheromatous intima might function as a protective factor in arterial wall disruption. On the other hand, atherosclerosis may predispose to intra-atheromatous plaque haemorrhage type of IDA through intramural haemorrhage originating from the newly formed vessels.- - - - - - - - - - ranking = 5keywords = arteriosclerosis (Clic here for more details about this article) |
8/48. Occlusion of the left common iliac artery and consecutive thromboembolism of the left popliteal artery following anterior lumbar interbody fusion.We report on a case of occlusion of the left common iliac artery due to arteriosclerosis and consecutive thrombotic occlusion of the left popliteal artery in a 52-year-old man following anterior retroperitoneal interbody fusion of L4--S1. Initial symptoms included leg pain and numbness of the lateral shank, which were thought to be a result of lumbar nerve root irritation from surgery. diagnosis was not made until 13 days after surgery, when motor deficits were observed. angiography showed occlusion of the left common iliac artery and thromboembolism of the left popliteal artery. After thromboendarterectomy of the common iliac artery and thrombectomy of the popliteal artery, motor deficits of the left foot were resolved whereas symptoms of pain and sensory deficits continued. spine surgeons should be aware of this rare complication in cases of postoperative leg pain or of neurologic deficits in the lower extremity after anterior lumbar interbody fusions.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
9/48. Extracranial angiographic findings in giant cell (temporal) arteritis.Angiograms of 10 patients with giant cell arteritis who had large-artery and aortic abnormalities were reviewed. The affected arteries had multiple stenotic areas, and occlusions were relatively common, usually located at the end of tapered stenotic segments. Bridging collateral arteries usually refilled the distal portion of the occluded artery. The laterations were seen most frequently in the subclavian, axillary, and brachial arters, and the arteriographic lesions reflected the clinical findings. Such arteriographic abnormalities are suggestive of giant cell arteritis in a patient over the age of 50. The differential diagnosis includes Takayasu's disease, arteriosclerosis, thoracic outlet syndrome, and ergotism.- - - - - - - - - - ranking = 1keywords = arteriosclerosis (Clic here for more details about this article) |
10/48. Aneurysms of the superficial femoral artery: a report of two cases and review of the literature.True "arteriosclerotic" aneurysms of the superficial femoral artery, not associated with generalized dilatation of the common femoral or popliteal artery, are relatively rare. We report our experience with two isolated superficial femoral artery aneurysms and review the previous literature. An 88-year-old woman was first seen with thrombosis of a superficial femoral aneurysm and limb-threatening ischemia and had eventual limb loss as a result of occlusion of distal run-off vessels despite surgical revascularization. A 93-year-old man came to us with rupture and was treated with an interposition graft, which resulted in limb salvage. review of 17 "arteriosclerotic" superficial femoral artery aneurysms in 14 patients whose cases were reported in the literature revealed a complication at presentation in 65%, rupture in 35%, thrombosis in 18%, and distal emboli in 12%. However, limb salvage was 94% and there were no perioperative deaths. Abdominal aortic aneurysms were discovered in 40%. Males (75%) were more common than females, and the average age was 77 years (range 61 to 93). Isolated superficial femoral artery aneurysms are rare and occur at an older average age than do other peripheral aneurysms, but their incidence is anticipated to increase with this growing segment of our population. In the absence of evidence of syphilitic, other infectious, immunologic, inflammatory, or connective-tissue disorders, these and other aneurysms are considered arteriosclerotic in origin, despite the absence of diffuse arteriosclerosis in many cases and controversy regarding the role of arteriosclerosis in their cause.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 2keywords = arteriosclerosis (Clic here for more details about this article) |
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