1/53. basilar artery occlusion due to spontaneous basilar artery dissection in a child.basilar artery occlusion (BAO) causing brainstem infarction occurred in a 7-year-old boy without any basic disorders. A diagnosis of BAO due to basilar artery dissection (BAD) was suspected at angiography, and this was confirmed by gadolinium-enhanced magnetic resonance imaging (MRI). These investigations clearly showed all the typical diagnostic signs such as a pseudolumen, double lumen and intimal flap, and a pseudolumen in resolution. The spontaneous healing of the dissection was clearly demonstrated during 10 months of follow-up. We stress that BAD can occur in young children and that combined diagnosis with gadolinium-enhanced MRI and angiography is conclusive for diagnosis of dissecting aneurysms. Wider use of these combined diagnostic methods will allow the detection of less severe basilar artery dissection, thus extending the spectrum of presentation and prognosis.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/53. A single-stage operation for bicuspid aortic valve, annulo-aortic ectasia, hypoplastic aortic arch, and coarctation of the aorta: A case report.The patient was an 18-year-old man who had been diagnosed as having a bicuspid aortic valve and dilatation of the ascending aorta six years previously. As he grew up, aneurysmal change of the ascending aorta and hypertension in the upper body gradually progressed. Preoperative evaluation showed annulo-aortic ectasia and the following congenital abnormalities: bicuspid aortic valve, hypoplastic aortic arch, and coarctation of the aorta. Composite graft replacement and extended total aortic arch replacement were carried out.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
3/53. Giant unruptured aneurysm of the thoracic aorta--a case report.An asymptomatic 88-year-old woman underwent a screening medical examination. The chest x-ray film showed a large mediastinal mass with calcification. Both chest computed tomography and nuclear magnetic resonance imaging revealed an unruptured aortic aneurysm, predominantly affecting the ascending aorta and the proximal part of the aortic arch. Its maximum diameter was 10.5 cm. An ascending aortic aneurysm more than 10 cm in diameter is very rare. She died of acute pulmonary embolism unrelated to the aneurysm, and autopsy indicated that the etiology of the aneurysm was atherosclerotic degeneration. Retrospectively, the natural progression of the aneurysm was able to be followed on a series of chest x-ray films obtained over 18 years.- - - - - - - - - - ranking = 9keywords = aneurysm (Clic here for more details about this article) |
4/53. Evolution toward dissection of an intramural hematoma of the ascending aorta.Intramural hematoma of the aorta is a condition increasingly observed in clinical practice. uncertainty exists whether such lesions represent a different pathology or simply the precursors of classic dissecting aneurysm. The patient was a 76-year-old woman with intramural hematoma of the ascending aorta. Clinical course, progression of the lesion to type A aortic dissection, and surgical treatment are described. Although natural history of intramural hematoma of the ascending aorta is not clearly elucidated, the case presented confirms that the evolution toward intimal flap formation is possible and that we cannot foresee the stabilization of these lesions. We stress that intramural hematoma of the ascending aorta has to be managed as an aortic type A dissection and that aggressive treatment is advisable.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
5/53. Delayed onset of ascending paralysis after thoracic aortic stent graft deployment.Delayed spinal cord ischemia after thoracic aortic aneurysm repair is an infrequent but devastating complication. The use of stent grafts to exclude aortic aneurysms is thought to decrease the incidence of the neurologic deficit because there is no period of significant aortic occlusion. We report a case of paraplegia that progressed to quadriplegia occurring 48 hours after the apparently successful deployment of a thoracic aortic stent graft.- - - - - - - - - - ranking = 2keywords = aneurysm (Clic here for more details about this article) |
6/53. Aggressive aneurysmal bone cyst of the proximal humerus. A case report.The case of an 11-year-old girl with a rapidly expanding, massive lesion in the right proximal humerus is reported. After biopsy, surgical treatment of the aneurysmal bone cyst consisted of aggressive intralesional resection with autogenous tibial strut grafting for reconstruction. After followup of 17 years with no recurrence of disease, there is excellent graft incorporation and remodeling and excellent function of the shoulder.- - - - - - - - - - ranking = 5keywords = aneurysm (Clic here for more details about this article) |
7/53. Endotension: an explanation for continued AAA growth after successful endoluminal repair.PURPOSE: To present and analyze several cases that illustrate persistent sac pressurization following endovascular abdominal aortic aneurysm (AAA) repair. methods AND RESULTS: Four patients with successful endovascular AAA exclusion presented in follow-up with an expanding aneurysm. Two had initial sac diameter decrease, but by 18 and 24 months, respectively, the AAA had enlarged and become pulsatile. There was no endoleak evident, but the proximal attachment stents had mig rated distally in both cases. One patient developed endoleak with aneurysm expansion at 6 months; contained rupture occurred at 12 months. The last case had slowly evolving aneurysm expansion over 36 months but no endoleak. All endografts were removed and successfully replaced with conventional grafts. Intrasac thrombus was implicated as the means of pressure transmission that precipitated AAA expansion in these cases. CONCLUSIONS: Excluded AAAs can increase in size owing to persistent or recurrent pressurization (endotension) of the sac even when there is no evidence of endoleak. One proposed mechanism is pressure transmission via thrombus that lines the attachment site. Endotension may also represent an indiscernible, very low flow endoleak that allows blood to clot at the source of leakage.- - - - - - - - - - ranking = 4keywords = aneurysm (Clic here for more details about this article) |
8/53. Ruptured sinus of a Valsalva aneurysm associated with autosomal-dominant polycystic kidney disease in an elderly patient: report of a case.We report herein the case of a 71-year-old woman with autosomal-dominant polycystic kidney disease (ADPKD), who was referred to our hospital for investigation of facial edema. echocardiography demonstrated a large aneurysm arising from the non-coronary sinus of valsalva, with a left to right shunt and jets of blood passing from the aneurysm toward the septal leaflet of the tricuspid valve. Surgical treatment was successfully carried out by resecting the aneurysmal wall and performing a patch closure of the orifice. It is well known that ADPKD predisposes patients to cardiovascular disease, and this case report serves to demonstrate that when a patient with ADPKD presents with progressive heart failure, the possibility of a ruptured sinus of a Valsalva aneurysm must be considered.- - - - - - - - - - ranking = 8keywords = aneurysm (Clic here for more details about this article) |
9/53. Abdominal aortic aneurysm rupture following endoluminal graft deployment: report of a predictable event.PURPOSE: To describe the predictability of an abdominal aortic aneurysm (AAA) rupture secondary to a type II endoleak following stent-graft exclusion. methods AND RESULTS: An 81-year-old man with an enlarging AAA underwent endovascular repair using an AneuRx aortic stent-graft, but a type II endoleak fed by an accessory renal artery was detected at postprocedural computed tomography (CT). Surveillance CT scans at 6 and 16 months showed an increase in the aneurysm diameter and endoleak volume, but the patient refused advised treatment to close the leak. He suffered a fatal aneurysm rupture 24 months after endografting. Retrospective analysis of CT data documented progressive aneurysm enlargement that correctly predicted the rupture. CONCLUSIONS: Type II endoleaks can lead to aneurysm rupture. Three-dimensional (3D) spiral CT angiography offers an opportunity to track endoleak volume and the effect of exposure to systemic pressure on the aneurysm sac.- - - - - - - - - - ranking = 10keywords = aneurysm (Clic here for more details about this article) |
10/53. Evolution of left ventricular involvement in arrhythmogenic right ventricular cardiomyopathy.Left ventricular (LV) involvement in arrhythmogenic right ventricular cardiomyopathy (ARVC) is fairly well known, but the evolution of LV involvement during long-term follow-up has not been well documented. We describe such evolution in a patient followed for 9 years. Evolution was confirmed by a progressive perfusion defect of the LV wall in myocardial scintigrams and by the development of LV asynergy with ventricular aneurysm formation in left ventriculograms. As the right ventricle progressively enlarged, we concluded that ARVC is a diffuse and progressive myocardial disease that affects both ventricles.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
| | Next -> |