1/50. Autosomal dominant polycystic kidney disease associated with familial sensorineural deafness.Autosomal dominant polycystic kidney disease (ADPKD) is characterized by both renal and non-renal disorders. Extrarenal involvement includes noncystic manifestations such as cardiovascular abnormalities, colonic diverticula and intracranial aneurysms. Familial sensorineural hearing loss (SNHL) has been included in the definition of Alport's syndrome. However, other types of nephropathy have been occasionally associated with hereditary deafness. The association of ADPKD with hereditary SNHL has not been previously documented. We report a family with ADPKD associated with bilateral sensorineural deafness in a pedigree of four affected members in four generations.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/50. anesthesia for ruptured cerebral aneurysm surgery associated with chronic renal failure.The management of patients with chronic renal failure (CRF) undergoing cerebral aneurysm surgery has been documented on only a few occasions. We report a 58-year-old man with CRF and subarachnoid hemorrhage (SAH) due to aneurysm rupture. We describe the patient's perioperative anesthetic management, discussing the current methods for maintaining an appropriate cerebral perfusion pressure and for preventing rehemorrhage from the aneurysm. We suggest that heparin-aided hemodialysis be avoided in these cases.- - - - - - - - - - ranking = 7keywords = aneurysm (Clic here for more details about this article) |
3/50. Endovascular treatment of arteriovenous fistulas complicating percutaneous renal biopsy in three paediatric cases.DESIGN: We evaluated the incidence and history of arteriovenous fistula (AVF) after kidney biopsy and assessed the use of superselective embolization for treatment. OBSERVATIONS: During the last 10 years, 896 kidney biopsies (age range of the patients: 1 month-18.6 years) have been performed in our institution under real-time ultrasonographic guidance with a 14 gauge cutting biopsy needle, and 32 of the patients had renal allografts (3.4%). We observed three cases of AVF (two in allograft kidneys, one in a native kidney) among all biopsies (0.34%), and the incidence of developing AVF after renal allograft biopsy was 6.3%. All three patients with AVF were symptomatic, and intravascular therapy was indicated. INTERVENTIONS: An angiographic study combined with endovascular treatment of the intrarenal AVF and pseudoaneurysm was performed in all three patients. Embolization was performed with bucrylate and lipiodol in two patients and with micro-coils in one. After successful embolization, all three patients became asymptomatic (in two renal bleeding stopped, in one patient with severe uncontrollable hypertension blood pressure returned to normal limits). No complications were observed secondary to the embolization procedure. CONCLUSION: The technique of superselective embolization using a coaxial catheter is an effective and safe method in the treatment of post-biopsy AVFs and pseudoaneurysm.- - - - - - - - - - ranking = 14.560992684163keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
4/50. Atypical Fabry's disease presenting with cholesterol crystal embolization.We describe a 65-year-old man who presented with pulmonary hemorrhage and progressive renal insufficiency three months after resection surgery for an abdominal aortic aneurysm. Intensive treatment with corticosteroids and hemodialysis were not effective, and the patient died. Postmortem examination of the kidneys revealed widespread cholesterol clefts within the renal arterioles and a number of lamellar inclusion bodies were observed by electron microscopy. The diagnosis of Fabry's disease was made by the absence of plasma alpha-galactosidase A activity. This was a very rare case of subclinical Fabry's disease coexistent with cholesterol crystal embolization, mimicking pulmonary-renal syndrome.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
5/50. Retinal arterial macroaneurysm in a young patient with chronic renal failure.PURPOSE: To report the youngest case of retinal arterial macroaneurysm. METHOD: Case Report. RESULTS: Clinical examination and fundus fluoroscein angiography revealed retinal arterial macroaneurysm in a 23-year-old patient with chronic renal failure. CONCLUSIONS: Acquired macroaneurysm may develop even in a very young patient, especially with chronic renal failure.- - - - - - - - - - ranking = 7keywords = aneurysm (Clic here for more details about this article) |
6/50. Transverse cervical artery pseudoaneurysm: a rare complication of internal jugular vein cannulation.Internal jugular vein cannulation has become the preferred approach for temporary hemodialysis catheter placement following reports of an increased incidence of subclavian vein stenosis due to subclavian vein catheterization. Internal jugular vein catheterization is associated with a high rate of successful catheter placement. However, significant complications such as internal carotid artery (ICA) puncture, pneumothorax, vessel erosion, thrombosis, airway obstruction and infection can occur. The most common complication is ICA puncture. More recently a few cases of thyrocervical trunk pseudoaneurysm and fistula following internal jugular vein and subclavian vein catheterization attempts have been reported. patients with renal failure who are on hemodialysis may have to undergo multiple catheter placements and vascular access interventions. This, along with their comorbid conditions, increases the risk of such complications. Here we report a patient on hemodialysis who developed transverse cervical artery pseudoaneurysm following an attempted right internal jugular vein catheterization. We report this case because of its rarity, to raise awareness of such a complication and to discuss different treatment options, in particular endovascular coil occlusion. A review of relevant literature is also presented.- - - - - - - - - - ranking = 43.682978052489keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
7/50. Abdominal aortic aneurysm resection following cholecystectomy and heart transplantation. Case report.The case of a patient who underwent heart transplantation and cholecystectomy in 1993 and admitted for resection of abdominal aortic aneurysm in May 1997, is reported. About 25 minutes after unclamping the abdominal aorta the patient s blood pressure fell suddenly to 70/40 mmHg. In spite of vigorous fluid administration and infusion of dopamine and Adrenaline the hemodynamic pattern returned to normal only 15 minutes later. The authors discuss the possible explanations of this behaviour (mesenteric traction syndrome, hypovolemia) and conclude that heart transplant patients are particularly affected by hypotension. Of paramount importance remains therefore the correct evaluation of adequate filling pressures which should be maintained slightly above normal range.- - - - - - - - - - ranking = 5keywords = aneurysm (Clic here for more details about this article) |
8/50. Case report: endovascular repair of a thoracic aortic aneurysm (saccular type) with a stent-graft.We describe the repair of a descending thoracic aortic aneurysm (saccular type, maximal size 85 mm) with an endovascular stent-graft in a 69-year-old man with chronic renal failure. The graft consisted of a self-expanding Z-stent covered with a woven polyester graft. An angiogram obtained intraoperatively showed complete thrombosis of the aneurysm. One month after the procedure, a contrast-enhanced computed tomographic (CT) scan showed thrombosis of the aneurysmal sac. A follow-up CT scan obtained 18 months after operation confirmed that the aneurysm had disappeared.- - - - - - - - - - ranking = 8keywords = aneurysm (Clic here for more details about this article) |
9/50. Successful renal transplantation after endovascular bifurcated stent graft repair of an abdominal aortic aneurysm.Renal transplantation after repair of aortoiliac aneurysms with traditional prosthetic vascular grafts has been shown to be effective. Vascular surgery continues to rapidly evolve, most notably with the advancement of endovascular repair of abdominal aortic aneurysms. Controlled trials continue to support the trend toward the use of endovascular bifurcated aortic stent grafts. For this we describe the first renal transplant in a patient with an endovascular bifurcated aortoiliac stent graft. No intraoperative difficulties were encountered. At 1-year follow-up, the transplanted kidney is functioning well with a normal serum creatinine level of 1.3 mg/dl, and the patient has no worsening of peripheral vascular disease. We recommend that the presence of an endovascular aortic graft not be a contraindication to renal transplantation.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
10/50. Cardiac arrest after administration of Omnipaque radiocontrast medium during endoluminal repair of abdominal aortic aneurysm.We describe a case of acute cardiovascular collapse in a patient with end-stage renal failure undergoing endoluminal repair of an abdominal aortic aneurysm. The 61-yr-old man suffered cardiac arrest shortly after administration of radiocontrast medium (Omnipaque), during deployment of the endovascular device. He had received the same contrast solution for diagnostic angiography on the previous day. He was successfully resuscitated and recovered completely. The differential diagnosis and management are discussed.- - - - - - - - - - ranking = 5keywords = aneurysm (Clic here for more details about this article) |
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