1/6. Ruptured distal aortic arch aneurysm associated with arteriosclerosis obliterans.A 73-year-old man with a ruptured distal aortic arch aneurysm into the pericardial space, mediastinum and right pleural space is described. The patient underwent a successful total aortic arch replacement using deep hypothermia, systemic circulatory arrest and selective cerebral perfusion. extracorporeal circulation was established with right axillar arterial perfusion due to arteriosclerosis obliterans (ASO). Presentation and management are discussed.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
2/6. Regional extra-corporeal circulation to protect transplanted kidney and pancreas from ischemia during vascular reconstruction.The development of severe aorto-ilio-femoral atherosclerotic disease in a patient with a previous double transplantation, kidney and pancreas, is a major surgical challenge. The transplanted organs have to be protected from extensive ischemia during the vascular reconstructive procedure and achieve optimal revascularization. The surgical management of a complex case where regional extra-corporeal circulation was used to protect transplanted pancreas and kidney during aorto-bifemoral vascular grafting in a 39 yr old diabetic patient is described.Regional femoro-femoral extra-corporeal circulation with an oxygenator is a safe technique that allows time for the proximal revascularization, minimizes the warm organ ischemia time and results in preservation of organ function.- - - - - - - - - - ranking = 6keywords = circulation (Clic here for more details about this article) |
3/6. Acute carotid obliteration: a new vascular manifestation in poems syndrome.The case of a 65-year-old woman with polyneuropathy, organomegaly, skin changes and monoclonal gammopathy of IgG-lambda type is described. This patient developed an acute carotid obliteration during oral anticoagulation and despite absence of vascular risk factors. Macroangiopathy has been described as a rare systemic manifestation of poems syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal spike and skin changes), affecting the coronary and lower limbs arteries. To our knowledge, this is the second case of poems syndrome with a cerebrovascular manifestation.- - - - - - - - - - ranking = 0.29130292309529keywords = coronary (Clic here for more details about this article) |
4/6. Risk-factor profile in severe, generalized, obliterating vascular disease.A 74-year-old woman had a history over 25 years of endarterectomy of both renal arteries, iliac venous thrombosis, pulmonary embolism, left internal carotid artery endarterectomy, coronary angioplasty, aortocoronary bypass grafting, occlusion of the right axillary artery, lower-limb claudication due to common iliac artery aneurysm, external iliac artery stenosis, multiple femoral artery stenoses, bifurcational stent grafting, occlusion of the left brachial artery and the right external iliac artery, and stroke. Assessment of the risk-factor profile revealed an absence of classic risk factors but the presence of the factor v Leiden mutation, the methylenetetrahydrofolate reductase AI298C mutation, the HFE C282Y mutation, plasminogen activator inhibitor-1 gene mutation, the -455 G/A fibrinogen gene polymorphism, the epsilon3/epsilon4 apolipoprotein E -675 4G gene polymorphism, and hyperhomocysteinemia. This case shows that severe, generalized, occlusive vascular disease may be due to the combination of various genetic risk factors for atherosclerosis and venous thromboembolism.- - - - - - - - - - ranking = 0.58260584619059keywords = coronary (Clic here for more details about this article) |
5/6. Multiple arterial occlusions in a hemophilic patient.Development of cerebral and coronary arterial occlusion in a hemophilic patient with widespread obliterative arteriosclerosis is described. This observation indicates that even a profound life-long coagulation defect does not afford protection against cerebrovascular and coronary occlusion and raises further questions regarding the rationale of anticoagulant therapy in the management of arteriosclerotic obliterative disease.- - - - - - - - - - ranking = 0.58260584619059keywords = coronary (Clic here for more details about this article) |
6/6. Prosthetic vascular graft infection--defect covering with delayed vertical rectus abdominis muscular flap (VRAM) and rectus femoris flap.Prosthetic vascular graft infection is associated with high rates of morbidity and mortality. When infections lead to an open exposure of vascular prosthesis special techniques may be necessary to cover tissue defects in regions with often very poor circulation/perfusion conditions. Even when there are large tissue defects associated with vascular prosthetic graft infections and exposure of prosthesis local cure can be achieved after radical debridement and defect coverage through transposition of myocutaneous flaps. The cases of two patients with open exposure of prosthesis in the groin who had been successfully treated by delayed vertical rectus abdominis muscular flap (VRAM) or rectus femoris rotation are presented. The contralateral VRAM myocutaneous flap is an excellent alternative if local measures fail to close large groin defects with exposed prosthesis. In addition the delayed flap rotation offers a greater safety in conditioning the vascularity of the flap.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |