1/79. Pseudoaneurysm following successful excimer laser coronary angioplasty of a restenotic left internal mammary artery graft ostial lesion.Although significant left internal mammary artery graft ostial stenosis is extremely rare, the clinical importance can be profound. In this report we describe a case in which a restenotic left internal mammary artery graft ostial lesion was successfully opened with excimer laser coronary angioplasty. A resulting pseudoaneurysm spontaneously closed after conservative therapy.- - - - - - - - - - ranking = 1keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
2/79. A large coronary artery saphenous vein bypass graft aneurysm with a fistula: case report and review of the literature.We describe a patient who developed a large aneurysm of saphenous vein graft to the right coronary artery with a fistulous communication to the right atrium. The presence of a fistulous communication of a saphenous vein graft aneurysm after coronary bypass surgery to one of the heart chambers is extremely rare. The diagnosis was made by coronary angiography and confirmed by CT and MRI. At surgery the aneurysm was ligated and excised. The fistula to the right atrium was closed. Repeat coronary artery bypass surgery with aortic valve replacement was performed at the same time without complications. Cathet. Cardiovasc. Intervent. 48:214-216, 1999.- - - - - - - - - - ranking = 1.0374849528383keywords = aneurysm (Clic here for more details about this article) |
3/79. Surgical management of arteriosclerotic coronary artery aneurysm.A 60-year-old man suffered antero-septal myocardial infarction at the age of 56. coronary angiography demonstrated total occlusion of the left anterior descending artery and a large saccular aneurysm of the right coronary artery. Diffuse coronary ectasia was also shown in the right coronary artery adjacent to the aneurysm. Despite anticoagulant therapy, the aneurysm formed a thrombus and developed coronary artery stenosis distal to the aneurysm. ligation of the aneurysm and in situ gastroepiploic artery grafting were performed. Sudden heart failure was developed during skin closure. As this condition was considered to be graft hypoperfusion, supplemental saphenous vein grafting was placed. ligation is a simple, reliable technique to prevent future complications for a large saccular right coronary artery aneurysm, however, gastroepiploic artery might be an inappropriate bypass conduit for the ligated coronary artery with diffuse ectasia.- - - - - - - - - - ranking = 1.4821213611975keywords = aneurysm (Clic here for more details about this article) |
4/79. Giant aneurysm of saphenous vein graft to coronary artery compressing the right atrium.Aneurysm of reverse aortocoronary saphenous vein graft is a known complication of coronary artery bypass grafting. In this report we present a case of a 60-year-old man who presented 12 years after coronary artery bypass grafting with a giant graft aneurysm of the reverse aortocoronary saphenous vein graft to the right coronary artery, compressing the right atrium. Spiral computed tomography was used to identify the aneurysm measuring 7 x 6 x 7 cm. We also reviewed the English-language literature and found reports of 50 patients with similar aneurysms of which 30 (61%) were identified as true aneurysms and 17 (33%) were identified as pseudoaneurysms. Three patients could not be identified into either group. We reviewed the presenting symptoms, diagnostic tools, and treatment options for this rare entity. An understanding of the pathophysiology of reverse aortocoronary saphenous vein graft aneurysm is important to prevent the possibility of aneurysm rupture, embolization, myocardial infarction, or death.- - - - - - - - - - ranking = 1.8892728167185keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
5/79. Results of saphenous vein graft stent implantation: single center results from use of oversized balloon catheters.The results and complications of a single-center experience of stent implantation in old saphenous vein grafts (SVGs) need to be defined. The authors studied their initial consecutive 92 patients (125 stents, 1.4 stents/per patient) with a mean age of 67 /-9 years. The patients' mean saphenous vein graft (SVG) age was 10 /-4 years, and the mean left ventricular ejection fraction was 46% /-15. Patient population included unstable angina (65%), stable angina (10%), myocardial infarction (21%), and silent ischemia (4%). The authors implanted 122 Palmaz-Schatz/biliary and three Gianturco-Roubin stents. They aimed at a balloon-artery ratio of 1.1/1.0. Procedural success, defined as stent deployment with <50% stenosis without death/Q-wave myocardial infarction/coronary artery bypass grafting (MI/CABG) was 95%. The mean luminal diameter (MLD) increased from 0.6 /-0.5 to 3.3 /-0.8 mm (p<0.001) and mean SVG stenosis diameter was decreased from 80% /-14 to -10% /-11 (p<0.001). Angiographic SVG lesions exhibited thrombus (17%), ulceration (38%), and plaque rupture (28%). Sixty-two patients were treated with warfarin and aspirin and 30 with ticlid and aspirin. Complications included death in three patients (3.3%) who sustained subacute stent thrombosis, and two of three had Q-wave MI. Distal embolization occurred in seven patients (8%); six of seven sustained a non Q-wave acute myocardial infarction (AMI); and one of seven a Q-wave MI. Eight (9%) patients had major groin hematoma, two had pseudoaneurysm (2.2%), one had arteriovenous (A-V) fistula (1.1%), two had vascular surgery (2.2%), nine had blood transfusion (9.8%), and three had stent migration (3.3%). Single-center experience with stents in SVGs indicates a highly successful procedural and angiographic immediate result. However, it was complicated by significant risk of non Q-wave MI due to distal coronary embolization which may affect prognosis.- - - - - - - - - - ranking = 0.407151455521keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
6/79. Pseudoaneurysm formation in surgically treated Behcet's syndrome--a case report.Behcet's syndrome is a multisystem disorder with unknown etiology. Clinically it is mostly seen as a systemic vasculitis; almost 30% of the patients have vascular involvements, and most of these are venous thrombosis and arterial aneurysms. Obstructions of the femoral and tibial arteries have also been reported in the literature. The authors present here a patient with Behcet's syndrome who had pseudoaneurysms on both femoral arteries after aortobifemoral bypass surgery.- - - - - - - - - - ranking = 1.1482121361198keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
7/79. Unsuccessful long-term outcome after treatment of a vein graft false aneurysm with a polytetrafluoethylene-coated Jostent.We describe a case in which a stented ulcerated plaque in an old vein graft ruptured to a huge false aneurysm. By the use of a PTFE-coated Jostent, the false aneurysm could be percutaneously closed. However, 6 months later, a new false aneurysm, probably due to focal perforation of the covered Jostent, developed.- - - - - - - - - - ranking = 1.0374849528383keywords = aneurysm (Clic here for more details about this article) |
8/79. Aneurysmal degeneration and late rupture of an aortorenal vein graft: case report, review of the literature, and implications for conduit selection.The saphenous vein is among the most commonly used conduits for renal artery revascularization in adults. Vein grafts are more durable in the renal artery bed than in coronary and peripheral beds, and mechanisms of potential graft failure vary. Coronary vein grafts often fail because of atherosclerotic degeneration, whereas lower extremity grafts fail because of intimal hyperplasia or progression of underlying disease. In contrast, renal vein grafts may dilate over time but seldom fail. This may relate to the distinct hemodynamic environment of the renal bed with low-resistance, high-velocity blood flow. However, frank aneurysmal degeneration of renal vein grafts is rare with only a single report of rupture in the literature. We report an additional case of rupture of a late graft aneurysm and review the literature and our own experience with renal revascularization to underscore the rarity of this serious complication. The saphenous vein for aortorenal bypass grafting continues to be a favorable conduit for renal revascularization. Long-term duplex ultrasound scanning follow-up is recommended to survey the reconstructed artery and perhaps more important, to evaluate progression of subclinical disease in the contralateral renal artery.- - - - - - - - - - ranking = 0.2964242722395keywords = aneurysm (Clic here for more details about this article) |
9/79. Aneurysm expansion and retroperitoneal hematoma after thrombolysis for stent-graft limb occlusion caused by distal endograft migration.PURPOSE: To describe a complication of thrombolytic therapy used to treat graft limb occlusion precipitated by distal migration and kinking of an abdominal aortic stent-graft. CASE REPORT: A 5.5-cm abdominal aortic aneurysm (AAA) in a 66-year-old woman was treated with Vanguard bifurcated stent-graft. At the 1-year follow-up, she complained of left leg claudication. Computed tomography (CT) showed a 36% reduction in maximum AAA diameter, but the stent-graft had migrated distally approximately 5 mm, and the left graft limb was occluded. Thrombolysis was initiated, but after approximately 8 hours, abdominal pain began. Emergent CT scanning revealed rapid aneurysm expansion and a retroperitoneal hematoma. Thrombolytic treatment was stopped; transfusions and thrombogenic drugs were given to restore hemodynamic stability. The aneurysm began to decrease in size. The occluded graft limb had been reopened by the lytic therapy, uncovering a stenosis in the native artery distal to the graft limb. Stent placement restored outflow. The retroperitoneal hematoma resolved over time, and the aneurysm sac shrank to its prelytic diameter. The patient is well with a functioning endograft 18 months after the occlusion (30 months after stent-grafting). CONCLUSIONS: Caution must be taken when using thrombolysis in patients with endovascular aortic grafts because unexpected bleeding complications might arise. thrombectomy, femorofemoral bypass, or stent or stent-graft extensions might be safer alternatives for treating occluded stent-graft limbs.- - - - - - - - - - ranking = 0.592848544479keywords = aneurysm (Clic here for more details about this article) |
10/79. Successful management of aortoiliac aneurysms with a quadrifurcated prosthesis.Aortoiliac aneurysms constitute one of the main challenges facing vascular surgeons worldwide. We report for the first time the successful reconstruction of the aorta and iliac arteries with a quadrifurcated prosthesis, in a 72-year-old man with an infrarenal abdominal aortic aneurysm, and aneurysms of the iliac arteries involving both iliac bifurcations. The aortoiliac reconstruction was performed with a quadrifurcated knitted Dacron graft, revascularising both internal and external iliac arteries. In our opinion, the use of such a graft is recommended in aortoiliac revascularisations whenever it is advisable for the preservation of flow to internal iliac arteries.- - - - - - - - - - ranking = 1.0374849528383keywords = aneurysm (Clic here for more details about this article) |
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