1/167. Transplant kidney protection during aortic aneurysm surgery.PURPOSE: Renal allografts are sensitive to ischemic insult. During aortic cross clamping prevention of ischemic damage to a kidney below an aneurysm is vital. Many maneuvers have been reported. We describe a simple technique of protecting the transplant kidney from ischemic damage during aortic surgery. MATERIALS AND methods: During vascular cross clamping a sterile ice slush was placed around the kidney for surface cooling, obviating the need for some of the complicated procedures previously reported. RESULTS: After removal of the ice slush and clamps, urine production resumed and creatinine levels remained unchanged. CONCLUSIONS: External cooling with ice slush provides adequate renal protection during aortic cross clamping and requires no special expertise or equipment.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/167. Subacute ischaemic proctitis: a rare condition requiring extensive rectal surgery.Subacute ischaemic proctitis is a rare condition. We describe the case of a 60-year-old male patient who developed, after aortic aneurysm repair, a transient ischaemic colitis that totally healed without sequelae. He eventually developed symptoms of severe proctitis. Investigations identified a stenosis of the mid rectum, while the upper rectum was inflammatory. On angiogram, there was a poor blood flow through the Riolan's arcade and a stenosis of the proximal aorto-graft anastomosis. diagnosis of subacute ischaemic proctitis due to poor blood supply through the internal iliac arteries was made. Anti-inflammatory drugs and dilations were inefficient. A subtotal proctectomy with low colorectal anastomosis was required. On pathological specimen, the lesions were strongly suggestive of an ischaemic process. The patient had an excellent recovery and was asymptomatic 8 months after the operation.- - - - - - - - - - ranking = 0.2keywords = aneurysm (Clic here for more details about this article) |
3/167. Mucoid degeneration of the brachial artery: case report and a review of literature.Cystic adventitial disease (CAD) is a rare cause of intermittent claudication, occurring in approximately 1:1200 claudicants or 1:1000 of those undergoing arteriography. It is most often described in the popliteal artery and is characterised by a mucinous cyst located in the adventitia of the artery, the contents of which resemble those of a ganglion. The origins of adventitial cysts are unknown, but connections to adjacent synovial spaces have been identified, suggesting that the cyst is a variant of a ganglion. In this report, we discuss a rare case of severe mucoid degeneration of the intima and media in a 67-year-old Saudi male patient. The patient presented with a saccular aneurysm of his right "mid-arm" brachial artery and critical ischemia of his right hand from distal embolisation.- - - - - - - - - - ranking = 0.2keywords = aneurysm (Clic here for more details about this article) |
4/167. Treatment of popliteal artery aneurysms with uncovered Wallstents.We report two patients with acutely thrombosed popliteal artery aneurysms that were successfully treated with a combination of thrombolytic therapy and placement of noncovered Wallstents.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
5/167. Idiopathic nodular glomerulosclerosis.Idiopathic nodular glomerulosclerosis is an unusual entity with light microscopic and ultrastructural features similar to those of nodular diabetic glomerulosclerosis but without evidence of abnormal glucose metabolism. We report 2 patients whose renal biopsies showed nodular glomerulosclerosis with afferent and efferent arteriolosclerosis, glomerular basement membrane thickening, focal mesangiolysis and capillary microaneurysm formation, and who had no evidence of abnormal glucose metabolism or other features of diabetes mellitus. review of the literature shows that, of the 27 reported cases of idiopathic nodular glomerulosclerosis (not including the 2 cases reported herein), 11 showed evidence of abnormal glucose metabolism or were frankly diabetic. Of the remaining 16 cases with normal serum blood glucose measurements, 3 had diabetic retinopathy and 1 had a delayed insulin response curve. The cause and pathogenesis of the glomerular nodules are discussed, and it is suggested that arteriolar stenosis and glomerular ischemia may be involved in the development these lesions.- - - - - - - - - - ranking = 0.2keywords = aneurysm (Clic here for more details about this article) |
6/167. ulnar artery aneurysm with digital ischemia.The case of a young male patient with a thrombosed distal ulnar artery aneurysm and digital emboli is presented. The hypothenar hammer syndrome is reviewed, with particular attention to clinical presentation, differential diagnosis and the non-invasive and invasive diagnostic evaluation. Surgical and thrombolytic therapeutic options are reviewed with reference to the available literature.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
7/167. 'Shared spinal cord' scenario: paraplegia following abdominal aortic surgery under combined general and epidural anaesthesia.Serious neurological complications of abdominal aortic vascular surgery are rare but devastating for all involved. When epidural blockade is part of the anaesthetic technique such complications may be attributed to needles, catheters or drugs. We present a patient who developed paraplegia following an elective abdominal aortic aneurysm repair. Continuous epidural blockade was part of the anaesthetic technique and postoperative analgesia. In this case the spinal cord damage was explained by ischaemia caused by the aortic surgery. This event has made us aware of a rare complication associated with abdominal aortic surgery and highlighted safety aspects of epidural anaesthesia in such patients.- - - - - - - - - - ranking = 0.2keywords = aneurysm (Clic here for more details about this article) |
8/167. hyperbaric oxygenation treatment of acute paraplegia after resection of a thoracoabdominal aortic aneurysm.Acute spinal cord ischemic injury after resection of thoracoabdominal aneurysm remains a relatively common and potentially devastating complication. The complete resolution of postoperative paraplegia after resection of a type II thoracoabdominal aneurysm, after treatment with hyperbaric oxygenation, is reported.- - - - - - - - - - ranking = 1.2keywords = aneurysm (Clic here for more details about this article) |
9/167. 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 = 0.4keywords = aneurysm (Clic here for more details about this article) |
10/167. Gastrointestinal complications of aortic bypass surgery.Gastrointestinal bleeding following abdominal aortic bypass surgery is not uncommon, as approximately 20% of patients with abdominal aortic aneurysms have peptic ulcer disease. We have recently seen three patients who presented with gastrointestinal bleeding secondary to the complications of their surgery. The cause of the bleeding was aortoduodenal fistula, graft erosion into the sigmoid colon and ischaemic colitis respectively. The correct diagnosis was only considered in one patient, although in retrospect it should have been suggested in all three. Our experiences with these complications and their clinical and radiological presentation form the basis for this paper.- - - - - - - - - - ranking = 0.2keywords = aneurysm (Clic here for more details about this article) |
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