1/110. rectum and sigmoid colon necrosis due to cholesterol embolization after implantation of an aortic stent-graft.Endovascular treatment of abdominal aortic aneurysms (AAAs) with stent-grafts is increasingly performed. Recent studies have shown that stent-graft placement for AAA is technically feasible and can effectively exclude aneurysms from the circulation. However, complications related to the procedure, such as graft thrombosis, migration of the prosthesis, peripheral embolization, and leaks with incomplete exclusion of the aneurysmal sac, have been reported. We report a case of rectum and sigmoid colon necrosis with fatal outcome due to cholesterol embolization after implantation of a stent-graft for an infrarenal AAA.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
2/110. Profound ECG abnormalities during emergency cesarean section in a patient with pre-eclampsia.A case of severe ECG abnormalities occurring during pre-eclampsia is presented. Although these electrocardiographic changes were indicative of severe alterations of coronary flow, neither structural nor functional abnormalities could be documented during subsequent diagnostic workup. The pathogenetic pathways potentially involved in this case including coronary spasms are briefly discussed.- - - - - - - - - - ranking = 2.7059049166366keywords = coronary (Clic here for more details about this article) |
3/110. Spontaneous dissection of three major coronary arteries subsequent to cystic medial necrosis.This case report describes the devastating consequences of spontaneous coronary dissection in a 36-year-old female patient. Surgical revascularization was attempted, but diffuse myocardial infarction developed. The patient was bridged to heart transplantation but died secondary to multiple organ failure. To our knowledge, this is the only reported case of spontaneous dissection of the three main coronary arteries due to severe cystic medial necrosis.- - - - - - - - - - ranking = 8.1177147499098keywords = coronary (Clic here for more details about this article) |
4/110. Massive noninflammatory periportal liver necrosis following concentrated acetic acid ingestion.In a fatal occurrence of massive liver necrosis following ingestion of concentrated (90%) acetic acid, the patient showed evidence of hemolysis, disseminated intravascular coagulation, and liver dysfunction at only 45 minutes after exposure. With refractory to vigorous supportive care, the patient s condition deteriorated until death occurred 39 hours after ingestion, despite some improvement of coagulopathy. autopsy revealed corrosive injuries in the upper gastrointestinal tract and massive hepatic necrosis in a periportal distribution without significant inflammation. A direct effect of the noxious agent on hepatocytes involving the portal circulation is suggested.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
5/110. Hypotensive hemorrhagic necrosis in basal ganglia and brainstem.Hypotensive hemorrhagic necrosis of the basal ganglia and brainstem has only occasionally been described. Three such cases are reported. Cardiac arrest had occurred in all cases, and it took at least 1 hour to restore adequate circulation. The patients remained comatose for 2 days to 2 weeks until death. Persistent hypotension causing ischemia in the distribution of deep perforating arteries is considered to have been the key underlying mechanism. hemorrhage is thought to have been caused by extravasation of red blood cells through damaged blood vessels.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
6/110. Diffuse hepatic intravascular carcinomatous embolization resulting in fatal liver failure: a clinicopathologic study of 4 cases.The authors report four cases in which patients died of acute or fulminant hepatic failure resulting from massive intravascular metastatic carcinomatous embolization, a rarely reported manifestation of metastatic disease. neoplasms were high grade carcinomas. Tumor emboli were present within portal branches ranging 0.12-2.9 mm in diameter and were free floating or attached to the vascular wall, with or without varying degrees of superimposed organization. In one case, intravascular tumor necrosis was prominent and appeared as granular casts with superimposed dystrophic calcification and/or entrapped foamy histiocytes. There were associated geographical areas of parenchymal (4 cases) and tumor (1 case) ischemic necrosis with a multifocal and regional topographic distribution. An associated predominant pattern of intrasinusoidal tumor infiltration (with or without fibrosis) was present in 3 cases, whereas the fourth case had underlying micronodular cirrhosis, providing ancillary evidence for preexisting altered intrahepatic microcirculation. The literature on fatal hepatic failure resulting from neoplasia is reviewed with a reassessment of its pathobiological significance.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
7/110. Spontaneous coronary artery dissection associated with cocaine use: a case report and brief review.Isolated, spontaneous dissection of the coronary arteries in the absence of trauma is an unusual but well-documented occurrence. Fewer than 50 cases have been reported in males in the English language literature, and only one case, nonfatal, was associated with cocaine use. We present the second overall and the first fatal case of cocaine-associated spontaneous coronary artery dissection and a brief review of the literature on coronary dissection and the cardiovascular effects of cocaine use. The mechanism of cocaine's toxicity on the heart and vasculature is complex, multifactorial, and predominantly related to cocaine's adrenergic properties. The increased arterial blood pressure from cocaine's inotropic and chronotropic effects combined with its direct vasoconstrictive effect leads to increased shear forces on the coronary endothelium. This elevated stress may be responsible for the formation of an intimal tear and the subsequent dissection of the coronary artery. If the dissected portion of the arterial wall is displaced enough to significantly occlude the true lumen, infarction can result. In light of this possibility, coronary artery dissection must be considered in young patients presenting with symptoms of cardiac ischemia and a history of cocaine use.- - - - - - - - - - ranking = 13.529524583183keywords = coronary (Clic here for more details about this article) |
8/110. Sloughing of the scrotal skin and impotence subsequent to bilateral hypogastric artery embolization for endovascular aortoiliac aneurysm repair.Sloughing of the scrotal skin is an extremely rare event due to pelvic ischemia. We report herein one case of scrotal skin sloughing and impotence after bilateral hypogastric artery embolization for endoluminal aortoiliac aneurysm repair. Postoperative penile plethysmography demonstrated a 75% reduction in the penile brachial index, suggesting that pelvic ischemia is the main culprit for this complication. The devastating morbidity in our patient underscores the importance of maintaining pelvic collateral circulation when planning for endovascular aortoiliac aneurysm repair.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
9/110. Aortic wall alterations after use of gelatin-resorcinol-formalin glue.We report the case of a patient who underwent reoperation 8 years after aortic valve replacement because of aneurysmal dilatation of the aortic root. During the initial intervention, gelatin-resorcinol-formalin glue had been applied on the outside of the aortic root. Perioperative examination revealed a necrotic appearance of the right coronary sinus, with contained ruptures at two different sites. Histologic analysis showed major destruction of the aortic root media, leading to vascular wall thinning and rupture. The use of gelatin-resorcinolformalin glue may expose patients to major alterations of the aortic wall.- - - - - - - - - - ranking = 1.3529524583183keywords = coronary (Clic here for more details about this article) |
10/110. Necrosis in leg ulcers. Probable role of fluocinolone acetonide.Necrosis in chronic leg ulcers developed in all of the four patients who were treated topically with a fluocinolone acetonide-neomycin sulfate ointment. This was probably due to the vasoconstrictive properties of the steroid. A warning against the topical use of potent steroids in skin diseases with impaired circulation seems to be justified.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
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