| Vascular graft infection due to aspergillus is a rare event. Only 11 previous case reports have been documented. All of these infections were in the aortic position, and infrainguinal arterial prosthetic graft involvement has been uncommon. The usual clinical presentation was back pain. fever and systemic complaints were usually present. An unusual case that began with bilateral groin pain is reported and a review of the clinical presentation and the management of the other cases described in the literature is presented. ( info) |
2/651. Spontaneous recanalization of postoperative severe graft stenosis. What is the cause and prognosis of the "string sign" in the internal thoracic artery? A 68-year-old female with unstable angina was treated surgically. She was referred to the surgical ward by cardiologists because of a diagnosis of unstable angina with three vessel disease. On a coronary angiogram (CAG), 90% stenoses were found in the left anterior descending coronary artery (LAD), circumflex (CX), and right coronary artery (RCA). She received elective coronary artery bypass grafting (CABG), in which the left internal thoracic artery (LITA) was anastomosed to the LAD and reversed saphenous vein grafts (SVG) were made to segment 12 of the CX, and segment 4PD of the RCA, respectively. The postoperative course was uneventful, but postoperative early graftgraphy revealed distal narrowing of the LITA graft as the so-called "string sign". However, one year post surgery, the LITA string sign was not found and its patency had markedly improved on the second graftgram. It is reported that the LITA "string sign" might cause late graft occlusion. However, this LITA graft evidently enlarged the size and increased the flow of the artery in proportion to myocardial blood demand. To our knowledge, it has not been reported that an in situ LITA string sign on postoperative early graftgram has disappeared in the late phase. We hypothesize that the LITA string sign might be caused by several different factors such as flow competition, spasm, and/or technical problems. In any event, the LITA string sign does not cause graft occlusion in the late postoperative period in every case. ( info) |
3/651. Stenting of a stenotic radial artery coronary graft: a new therapeutic scenario in coronary artery disease. With the increasing application of arterial coronary revascularization, a number of patients may develop arterial graft obstructive disease. In addition, the predominantly muscular structure of the radial artery wall may predispose radial artery coronary grafts to spasm. For the first time, we describe a case of stenting of a stenotic free radial artery graft and discuss the technical and pathophysiological aspects of the procedure. ( info) |
4/651. Pancreatic graft survival after arterial thrombosis in simultaneous renal-pancreatic transplantation. Vascular thrombosis following pancreas transplantation is one of the main causes of early graft loss. Successful thrombectomy after pancreatic graft thrombosis has not been reported yet. A patient with arterial graft thrombosis in whom the graft survived after thrombectomy is described. Different varieties of pancreatic graft thrombosis are discussed. ( info) |
5/651. 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. ( info) |
6/651. Intracoronary stent placement in thrombus containing vein graft lesions. Intracoronary stents are traditionally considered to be contraindicated in presence of thrombus. However recent advances in stent deployment technique have reduced the risk of stent thrombosis. We report the placement of a stent in a thrombus laden saphenous vein graft to the posterior descending artery. Three months later the stent site was patent with severe stenosis with thrombus in another graft which was also stented. Intracoronary stents should be considered in patients with complex lesion even in presence of intraluminal thrombus. ( info) |
7/651. thrombosis of an aortobifemoral bypass graft after total hip arthroplasty. Arterial complications after total hip arthroplasty are relatively rare but potentially limb or life threatening. We report a case of an arterial thrombosis occurring in a patient with an aortobifemoral bypass graft after primary total hip arthroplasty. ( info) |
8/651. Functional assessment of internal mammary artery bypass grafts: case reports and review of the literature. The utility of intra-arterial Doppler flow in assessing internal mammary artery (IMA) bypass grafts has infrequently been reported. Two patients are described in which Doppler evaluation of the IMA graft provided valuable diagnostic information prior to intervention. Also provided is a review of the available literature concerning evaluation of pathology in IMA grafts. ( info) |
9/651. Use of stents to treat kinks causing obstruction in a left internal mammary artery graft. Left internal mammary arteries (LIMA) are used routinely as grafts to the left anterior descending coronary artery (LAD) in selected patients undergoing coronary artery bypass graft (CABG) surgery because of better long-term patency rates. pathology other than fibrointimal hyperplasia, accelerated atherosclerosis, or thrombus can sometimes cause obstructive lesions in such grafts. This report illustrates a kink in a LIMA graft to the LAD causing an obstructive lesion shortly after surgery and describes the subsequent management of this lesion with intracoronary stents. ( info) |
10/651. Revascularization of a thrombosed, previously stented aorto-renal graft using combined directional atherectomy and AngioJet thrombectomy. We report an interesting case with bilateral PTFE aorto-renal grafts of which one graft underwent balloon angioplasty and stenting for proximal stenosis. Combined debulking by AngioJet thrombectomy and Simpsons directional atherectomy was performed within the stent following reocclusion of the graft 9 months later. ( info) |