1/70. Inferior vena cava hypoplasia with intrahepatic venous continuation: sonographic, angiographic and MR features including MR angiography.In cases of inborn or acquired obstacles on the inferior vena cava (IVC), the derived blood flow usually goes through collaterals in the azygos or the hemiazygos venous systems. Exceptionally, a collateral pathway through the portal system or through an anastomosis in between hepatic veins, shunting the IVC interruption, is encountered. In the present paper, the authors describe the fortuitous discovery of a IVC hypoplasia in its retrohepatic segment. MR venography, correlated with fluoroscopic angiography, clearly depicted an intrahepatic collateral circulation consisting of a double aneurysmal communication between an inferior right hepatic vein and the main right hepatic vein.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
2/70. Pacing lead adhesions after long-term ventricular pacing via the coronary sinus.Left ventricular pacing via the coronary sinus is being increasingly used. There is little data to guide possible lead extractions that might be required in the future. Significant adhesions to the coronary veins were found 12 years after placing a pacing lead in the posterolateral coronary vein in a man with double inlet left ventricle and severe subpulmonary stenosis who had undergone a Fontan operation. The appearances suggest that percutaneous extraction from the proximal coronary sinus may be feasible but that difficulty may be encountered if the lead tip is placed into the distal coronary veins.- - - - - - - - - - ranking = 8.9250003268814keywords = coronary (Clic here for more details about this article) |
3/70. Acute vasospastic attack after extradural block in a patient with Raynaud's disease.Implications: Raynaud's disease is an episodic and debilitating disease of the circulation to the fingers and toes. This case report describes an acute exacerbation of Raynaud's disease in a patient undergoing surgery with epidural anesthesia. This potentially hazardous complication has not been previously reported.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
4/70. Dramatic worsening of vascular calcifications after kidney transplantation in spite of early parathyroidectomy.vascular calcification is a common feature in chronic dialysis patients, but their clinical significance is debated and the role of kidney transplantation (TP) in the natural history of their development has received scanty attention. We will describe a case of dramatic worsening of vascular calcifications during TP in a young patient in spite of early and successful parathyroidectomy (PTX), and will discuss other causes which might be putatively linked to vascular damage during the time of TP. A 37-year-old man on regular dialytic treatment (RDT) for 11 years, received his first cadaveric transplantation in January 1993. He underwent PTX 6 months after TP because of the lack of decreasing in parathyroid hormone values despite normal graft function. Although PTX was effective, a dramatic worsening was evident in large as well as in medium and small-sized arteries during the following three years of TP. In February 1997, few months after starting dialysis again because of the recurrence of his primary membranoproliferative glomerulonephritis (MPGN), the patient experienced myocardial infarction followed by aorto-coronary bypass (right coronary artery and anterior descending coronary artery) and leg "claudicatio". Though a role for parathyroid hormone in vascular disease has been commonly accepted, the case here reported clearly shows that blunting parathyroid gland activity may be unable to avoid the worsening of a process of vascular disease during the time of TP. Many other factors--linked to the time of TP--may be involved in vascular diseases, such as nephrotic syndrome, dyslipidemia, hypertension and drugs. In the case of our patient, a clear cut risk factor for his progressive atherosclerosis can be designated hyperlipidema and other disturbancies secondary to a nephrotic syndrome due to relapse of MPGN, together with persistent hypertension. This is the first case report in the English literature which clearly demonstrates that TP may add fuel to the fire of vascular disease also in young people and even in the absence of parathyroid hyperactivity, perhaps on the basis of a favorable genetic background. Furthermore, the history of our patient demonstrates that vascular calcifcation heralds major cardiovascular diseases.- - - - - - - - - - ranking = 2.9750001089605keywords = coronary (Clic here for more details about this article) |
5/70. Vascular reconstruction of a vertebral artery loop causing cervical radiculopathy and vertebrobasilar insufficiency. Case report.The authors present the case of a 62-year-old man with a 4-month history of progressive left-sided C-5 radiculopathy and dizziness. neuroimaging studies revealed a looped vertebral artery (VA) that had migrated into the widened left C4-5 intervertebral foramen. The patient underwent vascular reconstruction of the VA loop, in which there was minimal manipulation of the C-5 nerve root, via a left-sided anterolateral approach after a balloon occlusion test. Postoperatively the patient's symptoms improved immediately, and there were no signs of recurrence within the 2-year follow-up period. This excellent outcome supports the belief that a proper surgical reconstruction of the compressive, tortuous VA should be the therapeutic option of choice, which carries a lower risk of the nerve root injury and improves the hemodynamics in the posterior circulation.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
6/70. Vasospastic dystrophy of the hand. Case report.The author reports a patient with a history of left arm pain and wasting of the hand who had absent radial and ulnar pulses. sympathectomy restored the arterial circulation to the hand with nearly complete return of function.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
7/70. Cilio-retinal arterial circulation in central retinal vein occlusion.The hypothesis that an occlusion of the central retinal artery is an essential prerequisite for haemorrhage formation after central retinal vein obstruction has been investigated by examining the fundus changes in patients with a cilio-retinal arterial circulation; the findings are at variance with the 'combined occlusion hypothesis'. Comparisons were made between the pathological features in two retinal capillary beds with independent sources of arterial supply--namely, the central retinal and cilio-retinal arteries--but with an obstructed venous drainage channel common to both--namely, the central retinal vein. The importance of intraluminal pressure changes (as distinct from perfusion changes) in the causation of haemorrhages and oedema after venous occlusion is stressed, and the role of arterial disease in the pathogenesis of venous occlusions is distinguished from its role in determining the sequelae of such occlusions.- - - - - - - - - - ranking = 5keywords = circulation (Clic here for more details about this article) |
8/70. Vascular involvement in Behcet's disease. Two case reports.Arterial involvement is rare in Behcet's disease but can be at the forefront of the clinical picture and cause life-threatening complications. case reports: A 36-year-old man had Behcet's disease with an aortographically documented aneurysm of the abdominal aorta as the inaugural manifestation. He had oral and genital ulcers. Funduscopy showed periphlebitis. In a 38-year-old man with an 8-year history of Behcet's disease, pulmonary and coronary artery aneurysms developed, as well as intracardiac and venous thromboses. DISCUSSION: Arterial involvement occurs in 3-5% of patients with Behcet's disease and usually manifests as multiple spindle-shaped aneurysms. Intracardiac thrombosis and cardiac aneurysm are exceedingly rare. Our patient had an extremely unusual presentation given the low rate of occurrence of arterial lesions in Behcet's disease. CONCLUSION: Arterial involvement in Behcet's disease raises treatment challenges because the lesions tend to recur and can cause life-threatening complications.- - - - - - - - - - ranking = 0.99166670298682keywords = coronary (Clic here for more details about this article) |
9/70. Successful treatment of acute vascular insufficiency in a hand by intra-arterial fibrinolysin, heparin, and reserpine. Case report.A patient is presented who presumably had multiple drugs injected intra-arterially in the right hand. Clinical signs and angiographic evidence of severe vascular insufficiency were well demonstrated. Therapy with fibrinolysin, reserpine, and heparin was followed by a return of normal circulation.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
10/70. Congenital fibromuscular dysplasia involving multivessels in an infant with fatal outcome.We report the unusual case of a 2-month-old boy with systemic fibromuscular dysplasia (FMD). He presented with congenital renovascular hypertension due to stenosis of the right renal artery, and later developed renal infarction on the contralateral side resulting in renal failure. The boy subsequently died of intracranial haemorrhage at the age of 14 months. During the course, hemiconvulsion caused by a moyamoya disease-like vascular lesion was noted. Stenotic lesions of both the abdominal aorta and its branches were also revealed by angiography. Post-mortem examination confirmed that the coronary, splenic and mesenteric arteries were also affected and their histological findings were compatible with FMD. To our knowledge, this is the first congenital case of FMD demonstrating a rapidly progressive course resulting in a fatal outcome. In this case, multivessels in both intracranial and extracranial arteries were involved. CONCLUSION: Our case suggests that the nature of fibromuscular dysplasia is congenital in origin and its aetiology, at least in some cases, is a systemic abnormality of vascular development.- - - - - - - - - - ranking = 0.99166670298682keywords = coronary (Clic here for more details about this article) |
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