1/114. Vascular reconstruction utilizing artery from an amputated extremity: A case report.Although infrainguinal arterial reconstruction is best performed with autologous tissue, reconstruction with vein in an infected field has been associated with vein graft disruption and hemorrhage. H.P., a 61-year-old man with peripheral vascular disease, was initially seen with an infected prosthetic right femoral-tibioperoneal artery bypass graft. Because of the presence of purulent drainage from the proximal and distal anastomotic regions and his comorbidities, a right through-knee guillotine amputation was performed, followed by graft excision and groin debridement. Right hip and thigh perfusion was preserved via arterial reconstruction by using a segment of endarterectomized popliteal artery, harvested from the amputated extremity. Arterial reconstruction with autologous tissue from an amputated extremity allowed us to balance our patient's overall risks with life and tissue preservation. This technique may be applied in the settings of lower extremity ischemia, trauma, or malignancy requiring concomitant arterial or venous reconstruction.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/114. may-thurner syndrome in an adolescent: persistence despite operative management.We describe a patient with may-thurner syndrome who underwent operative transection and transposition of the right common iliac artery without direct venous repair, because preoperative and intraoperative intravascular ultrasound scans were negative for "spurs" in the left common iliac vein. When symptoms and signs persisted, a postoperative magnetic resonance venogram (MRV) showed severe stenosis in the left common iliac vein. Progressive, but incomplete, clinical improvement occurred with conservative management.- - - - - - - - - - ranking = 0.16666666666667keywords = artery (Clic here for more details about this article) |
3/114. Peripheral arterial involvement in neurofibromatosis type 1--a case report.Neurofibromatosis is a dominantly inherited, progressive, generalized dysplasia of mesodermal and neuroectodermal tissues. Vascular lesions associated with neurofibromatosis type 1 (NF-1) are mainly characterized by stenosis, occlusion, aneurysm, pseudoaneurysm, and rupture or fistula formation of small, medium, and large-sized arteries. The authors hereby present a rare case of NF-1 with bilateral aneurysms and large pseudoaneurysms of the femoral and popliteal arteries and occlusion of the left superficial femoral artery.- - - - - - - - - - ranking = 0.16666666666667keywords = artery (Clic here for more details about this article) |
4/114. Peripheral vascular disease in Behcet's syndrome.We describe a patient with Behcet's syndrome who had peripheral vascular disease involving the left subclavian artery for which angioplasty with stent placement was performed and reangioplasty done for in-stent restenosis. She presented with recurrence one year after stent placement; angiography revealed diffuse disease of the axillary and radial arteries with mild to moderate restenosis at the site of stent placement.- - - - - - - - - - ranking = 0.16666666666667keywords = artery (Clic here for more details about this article) |
5/114. Peripheral arterial embolization: Doppler ultrasound scan diagnosis.Use of intraoperative monitoring with transcranial Doppler scanning during carotid endarterectomy has enabled identification of embolus signals in the ultrasound spectrum. Extension of this technique to preoperative screening has enabled identification of actively embolizing lesions and correlation with neurologic deficits. We report embolus signals in the peripheral circulation before operation, which aided diagnosis and decision to operate. The patient had been transferred from another institution after multiple revascularization procedures, including posterior tibial artery thrombectomy. angiography performed on arrival at our institution confirmed an open bypass graft, although a small indentation was noted at the site of the previous posterior tibial artery thrombectomy. Runoff was intact to the plantar arch where there was attenuation of that vessel and occlusion of most digital branches. Duplex monitoring revealed no embolic signals in the graft or in the posterior tibial artery proximal to the previous arteriotomy. Distal to this site, embolic signals were detected. At the time of operation, a large platelet thrombus was identified at the site of the previous arteriotomy, and platelet thrombus was obtained from the plantar artery. It is concluded that doppler ultrasound scanning enables detection of peripheral embolization and the identification and location of lesions with such embolic activity. Diagnostic accuracy may be improved when there is clinical suspicion of embolization, enabling better patient selection for surgical procedures. This report provides the first clinicopathologic characterization of the emboli detected.- - - - - - - - - - ranking = 0.67652392512956keywords = artery, carotid (Clic here for more details about this article) |
6/114. Functional entrapment of the popliteal artery.A case of functional entrapment missed at the initial angiogram is presented. The imaging of popliteal artery entrapment syndrome and functional entrapment is discussed. The importance of appropriate imaging is emphasized. The classification of popliteal artery entrapment syndrome is discussed and it is proposed that functional entrapment is added to the existing classification in the interest of consistent reporting.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
7/114. popliteal artery entrapment syndrome: diagnosis and management, with report of three cases.popliteal artery entrapment syndrome is an important albeit infrequent cause of serious disability among young adults and athletes with anomalous anatomic relationships between the popliteal artery and surrounding musculotendinous structures. We report our experience with 3 patients, in whom we used duplex ultrasonography, computed tomography, digital subtraction angiography, and conventional arteriography to diagnose popliteal artery entrapment and to grade the severity of dynamic circulatory insufficiency and arterial damage. We used a posterior surgical approach to give the best view of the anatomic structures compressing the popliteal artery. In 2 patients, in whom compression had not yet damaged the arterial wall, operative decompression of the artery by resection of the aberrant muscle was sufficient. In the 3rd patient, operative reconstruction of an occluded segment with autologous vein graft was necessary, in addition to decompression of the vessel and resection of aberrant muscle. The result in each case was complete recovery, with absence of symptoms and with patency verified by Doppler examination. We conclude that clinicians who encounter young patients with progressive lowerlimb arterial insufficiency should be aware of the possibility of popliteal artery entrapment. early diagnosis through a combined approach (careful physical examination and history-taking, duplex ultrasonography, computerized tomography, and angiography) is necessary for exact diagnosis. The treatment of choice is the surgical creation of normal anatomy within the popliteal fossa.- - - - - - - - - - ranking = 1.6666666666667keywords = artery (Clic here for more details about this article) |
8/114. cyclosporine A-associated fatal central nervous system angiopathy in a bone marrow transplant recipient: an autopsy case.We report here the case of a 32-year-old woman who suffered from a unique angiopathy in the central nervous system (CNS). She died of multiple infarcts in the brain stem and cerebellum during treatment with cyclosporine A after bone marrow transplantation for refractory anemia with excess of blasts. The autopsy findings showed segmental narrowing of the basilar artery, in which circumferential dissection of the internal elastic lamina had occurred. The distal portion of the basilar artery was obstructed by upward dislocation of the dissected intima. Similar angiopathy was also observed at multiple sites along the basilar artery branches. These findings suggest endothelial damage, including vasoconstriction and dissection of the CNS arteries.- - - - - - - - - - ranking = 0.5keywords = artery (Clic here for more details about this article) |
9/114. Three elderly patients with lower esophageal cancer successfully treated by transhiatal esophagectomy assisted by mediastinoscopy.mediastinoscopy-assisted transhiatal esophagectomy recently has been applied in patients with intrathoracic esophageal cancer. Elderly patients with esophageal cancer experience several types of complications and often cannot undergo standard transthoracic esophagectomy. In this study, three elderly patients with preoperative complications underwent mediastinoscopy-assisted transhiatal esophagectomy for esophageal cancer located in the lower part of the esophagus. Patient 1 was an 80-year-old man with alcoholic liver cirrhosis. Patient 2 was a 78-year-old man with bronchial asthma. Patient 3 was an 81-year-old-man with diabetes mellitus and an atherosclerotic obstruction of the lower extremities. In these patients, mediastinoscopy-assisted transhiatal esophagectomy concomitant with reconstruction by means of a gastric tube was performed. Lymph node dissections of the middle and lower mediastinum and of the abdomen, including the regions surrounding the left gastric and celiac arteries, were performed. postoperative complications developed only in patient 1; minor leakage of the esophagogastrostomy and high bilirubinemia were observed. Metastasis was detected in the lymph nodes surrounding the celiac artery in patient 1 and surrounding the left gastric artery in patients 2 and 3. Patient 2 died of pneumonia 18 months later, but the other patients have been well, without recurrence of the cancer after surgery. In conclusion, mediastinoscopy-assisted transhiatal esophagectomy has some benefits for elderly esophageal cancer patients who experience preoperative complications.- - - - - - - - - - ranking = 0.33333333333333keywords = artery (Clic here for more details about this article) |
10/114. Treatment of pulmonary artery compression due to fibrous mediastinitis with endovascular stent placement.We present the case of a 32-year-old woman with high-grade right pulmonary artery stenosis secondary to fibrous mediastinitis. The patient was managed with balloon angioplasty and stent placement. Only 15 cases of this nature have been reported in the literature, and this is one of the first to be managed with endovascular stent placement.- - - - - - - - - - ranking = 0.83333333333333keywords = artery (Clic here for more details about this article) |
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