1/663. Atrial tamponade causing acute ischemic hepatic injury after cardiac surgery.A patient developed late cardiac tamponade after aortic valve replacement and coronary artery bypass grafting. nausea and dramatic elevations of serum aminotransferases were the initial clinical manifestations of cardiac tamponade. Severe acute ischemic hepatic injury secondary to isolated compression of both atrial cavities by two loculated thrombi was diagnosed.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/663. Superior and inferior limb ischaemia in giant cell arteritis: angiography follow-up.giant cell arteritis most often affects the superficial temporal artery. Arterial territories such as the facial, carotid, myometrial and upper and lower limb arteries may be affected. In this paper we describe the case of a 52-year-old patient with upper and lower limb ischaemia who presented with grade III ischaemia in the left lower limb. giant cell arteritis was diagnosed as responsible for the symptoms. After treatment with corticoids, an angiographic improvement was evidence after 2-year period. The low number of reported cases, the diverse symptoms and varied course make diagnosis of GCA difficult. Therefore, GCA must be taken into consideration in the ischaemia of inferior and superior limbs whether isolated or simultaneous.- - - - - - - - - - ranking = 1.5375572457292keywords = artery, carotid (Clic here for more details about this article) |
3/663. University of Miami Division of Clinical pharmacology Therapeutic Rounds: ischemic renal disease.Ischemic renal disease (IRD) is defined as a significant reduction in glomerular filtration rate and/or loss of renal parenchyma caused by hemodynamically significant renal artery stenosis. IRD is a common and often overlooked clinical entity that presents in the setting of extrarenal arteriosclerotic vascular disease in older individuals with azotemia. IRD is an important cause of chronic renal failure and end-stage renal disease (ESRD), and many patients with a presumed diagnosis of hypertensive nephrosclerosis may actually have undiagnosed ischemic nephropathy as the cause of their ESRD. The primary reason for establishing the diagnosis of IRD is the hope that correction of a renal artery stenosis will lead to improvement of renal function or a delay in progression to ESRD. There are six typical clinical settings in which the clinician could suspect IRD: acute renal failure caused by the treatment of hypertension, especially with angiotensin-converting enzyme inhibitors; progressive azotemia in a patient with known renovascular hypertension; acute pulmonary edema superimposed on poorly controlled hypertension and renal failure; progressive azotemia in an elderly patient with refractory or severe hypertension; progressive azotemia in an elderly patient with evidence of atherosclerotic disease; and unexplained progressive azotemia in an elderly patient. It is important for the clinician to identify IRD, because IRD represents a potentially reversible cause of chronic renal failure in a hypertensive patient.- - - - - - - - - - ranking = 2keywords = artery (Clic here for more details about this article) |
4/663. Acute upper limb ischemia: a complication of coronary artery bypass grafting.We present the case of a patient with acute upper limb ischemia after radial artery harvest for coronary artery bypass grafting. This occurred despite adequate preoperative and intraoperative assessment with the Allen test, hand-held Doppler and radial artery backbleeding. A successful outcome was achieved by performing brachioradial bypass grafting using reversed cephalic vein.- - - - - - - - - - ranking = 7keywords = artery (Clic here for more details about this article) |
5/663. Near infrared spectroscopy and transcranial Doppler in monohemispheric stroke.We simultaneously performed near infrared spectroscopy (NIRS) and transcranial Doppler (TCD) to evaluate the effects of hypercapnia as well as of scalp ischemia on the blood flow at two different depth levels within the brain and of the scalp vessels. A decrease in the backscattered light intensity, meaning an increment of blood volume, was detected at the end of hypercapnia in all healthy subjects. This decrement was partly masked by ischemia in the cutaneous vessels. In 2 patients with a monohemispheric lesion in the middle cerebral artery (MCA) territory, an increase in NIRS response was found in the healthy hemisphere, while in the stroke side the CO2-induced changes were negligible. TCD data showed a similar increment of blood flow velocity to the hypercapnia in both hemispheres, with no differences between the affected and normal side in 1 patient, whereas in the second one, no increment was observed on the affected side, probably due to internal carotid artery stenosis. The two methods nicely integrate: TCD mainly tests subcortical changes in the MCA flow, while NIRS is exquisitely sensitive to cortical arterioles and capillary blood flow modifications.- - - - - - - - - - ranking = 3.0556125469289keywords = artery, carotid, carotid artery (Clic here for more details about this article) |
6/663. Spinal cord vascular injuries following surgery of advanced thoracic neuroblastoma: an unusual catastrophic complication.BACKGROUND: Spinal cord injury is a possible complication associated with removal of thoracic dumbbell neuroblastomas. Our experience with two children whose postsurgical course was complicated by midthoracic spinal cord ischemia is reported there. Permanent paraplegia resulted in both. PROCEDURE AND RESULTS: Preoperative awareness of the origin and distribution of the Adamkiewicz artery (arteria radiculomedullaris magna, ARMM) and of the possible collateral pathways for spinal cord blood supply may be helpful in the planning of operations that involve dissection in the midthoracic posterior mediastinum. Otherwise, a flaccid paraplegia may result. CONCLUSIONS: The syndrome is presumed to be triggered by a spasm, an embolism, or a iatrogenic interruption of the ARMM.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
7/663. Mesenteric ischemia after coronary artery bypass grafting: should local continuous intra-arterial perfusion with papaverine be regarded as a treatment?Mesenteric ischemia after cardiac surgery is rare but dramatic. We present a patient who had acute mesenteric ischemia following low cardiac output after coronary artery bypass grafting. Our patient was successfully treated with continuous intra-arterial perfusion with papaverine. We think that selective angiography must be performed as early as mesenteric ischemia is suspected, to get earlier diagnosis and treatment of an ischemic patient.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
8/663. 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 = 7keywords = artery (Clic here for more details about this article) |
9/663. The hemodynamics of steal syndrome and its treatment.A 61-year-old man developed steal syndrome after creation of a transposed basilic vein arteriovenous fistula (AVF) resulting in rest pain and ischemic ulcers in the fingertips. Our initial surgically created stenosis reduced the diameter by 32% and the area by 56%, and increased the radial artery pressure from 52 to 78 mmHg, with relief of symptoms. Within 3 weeks his symptoms reappeared. Repeat measurements did not explain his return of symptoms. A second area of stenosis was created in the AVF, with a diameter reduction of 75%, and an area reduction of 94%. His symptoms resolved, and his ulcers healed. The hemodynamics of the AVF and the steal syndrome were evaluated by duplex imaging and Doppler pressure assessment. A greater stenosis increased the radial artery pressure from 78 to 140 mmHg while maintaining flow through the AVF. Rather than increasing the degree of stenosis at the first site, we created a second area of stenosis. Hemodynamically, this would be additive to the first without the risk of creating a high-grade stenosis that could thrombose the AVF. Increasing the resistance in the AVF will decrease flow in the AVF and, ultimately, increase flow to the hand.- - - - - - - - - - ranking = 2keywords = artery (Clic here for more details about this article) |
10/663. Acute ischemia of the lower limb. An unusual complication of Paget's disease of bone.Paget's disease of bone (osteitis deformans) is one of the most common skeletal diseases, characterised by bone distortion and the loss of interior structure. Asymptomatic evolution is usual, so diagnosis is likely to be made only when complications of the disease appear. This paper describes such a diagnosis made in a patient with acute lower limb ischemia caused by the compression of the superficial femoral artery between the adductor muscles and an exostosis of the femur.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
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