Cases reported "Aneurysm"

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1/31. Aneurysmal portosystemic venous shunt: a case report.

    A case of an aneurysmal portosystemic venous shunt detected by colour Doppler ultrasound (CDUS) is presented. A young female patient complained of postprandial fatigue and had paroxysmal tachycardia. A direct vascular communication between right portal vein and right hepatic vein was found at CDUS and confirmed by direct portal angiogram. Using detachable coils a complete occlusion of the intrahepatic shunt was obtained. Reports from the literature regarding portovenous aneurysms are reviewed.
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2/31. Ventricular septal aneurysm: a complication of myocardial infarction.

    We report the case of a ventricular septal aneurysm in a patient with a previous inferior myocardial infarction. Two-dimensional echocardiography demonstrated a cystic cavity in the muscular septum with a small communication into the left ventricle. No evidence of left-to-right shunt was detected with Doppler echocardiography or during left ventriculography.
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3/31. Aneurysms of the lateral spinal artery: report of two cases.

    OBJECTIVE AND IMPORTANCE: The goal of this report was to describe aneurysms arising from the lateral spinal artery. The locations of aneurysms contributing to subarachnoid hemorrhage (SAH) have been well characterized and are primarily in the circle of willis or at the bifurcation points of the internal carotid artery or the vertebrobasilar system. Although the spinal arteries are also in direct communication with the subarachnoid space, aneurysms of these arteries that lead to SAH are rare. To date, only aneurysms of the anterior and posterior spinal arteries have been described. In this communication, we report two patients with aneurysms of the lateral spinal artery who presented with SAH. CLINICAL PRESENTATION: review of our neurointerventional database from 1997 to the present revealed two patients with lateral spinal artery aneurysms. The medical records, as well as the operative and radiological findings, were reviewed for both patients. In both cases, the lateral spinal arteries were involved as collateral pathways for occlusive vertebral lesions, suggesting hemodynamic stress as a cause. INTERVENTION: Endovascular treatment was attempted in both cases and was successful in one; open surgery, with aneurysm resection, was performed in the other case. We review the vascular anatomic features of the spinal cord as they relate to the lateral spinal artery, as well as treatment options for lateral spinal artery aneurysms. CONCLUSION: Lateral spinal artery aneurysms are a rare cause of SAH. Both endovascular and surgical treatment options are available.
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4/31. Congenital aneurysm of the left main coronary artery with fistulous communication to the right atrium and coronary 'steal' phenomenon.

    We describe a unique case of a left coronary arteriovenous fistula arising from an extremely short and aneurysmal left main coronary artery and selectively affecting the blood flow in the circumflex coronary artery. The relevant diagnostic contributions of two-dimensional echocardiography, colour flow Doppler, cardiolite stress testing and coronary angiography are discussed. The haemodynamic features of this anomaly are reviewed.
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5/31. Intrahepatic portal vein aneurysm: three-dimensional power Doppler demonstration in four cases.

    We describe four cases of portal vein aneurysm that were studied with ultrasonography, color Doppler, computed tomography, and magnetic resonance imaging as well as three-dimensional power Doppler. Three-dimensional ultrasonography showed the portal aneurysm and its relationship to its portal branches in all patients and showed the portosystemic communication in three. In all cases, computed tomography or magnetic resonance imaging confirmed the three-dimensional ultrasonographic findings.
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6/31. Cirsoid aneurysm after hysterectomy.

    Cirsoid aneurysm, an uncommon abnormal either congenital or acquired arteriovenous communication, is described. As massive life-threatening bleeding can be a consequence, diagnosis is very important. Earlier, angiography was the only imaging method available for visualizing vascular lesions and recent developments in imaging techniques have made diagnostic imaging of cirsoid aneurysms possible using ultrasonography, color flow mapping, magnetic resonance imaging and magnetic resonance angiography. In this report, a patient with intrapelvic cirsoid aneurysm posthysterectomy who died 8 h after she had been kicked in the abdomen is described and the results obtained by various imaging techniques are discussed.
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7/31. False aneurysm of the brachial artery complicating closed fracture of the humerus. A case report.

    A 66-year-old, obese, mentally retarded man sustained a closed spiral fracture of the humerus accompanied by development of a large false aneurysm arising from a small rent in the distal third of the brachial artery. Because of the patient's body habitus, mental deficiency, and paucity of objective physical findings, the arterial injury was not suspected until expensive pressure necrosis necessitated shoulder disarticulation as a lifesaving measure. Although false aneurysms are known to complicate penetrating trauma and various surgical procedures using metallic implants, the lesion has not been previously reported with closed long bone fractures. The authors wish to alert others to occurrence of the occult arterial injury in association with a relatively common extremity fracture. The need to exercise special awareness and suspicion of subtle injuries in patients whose age, mental status, or associated trauma render communication of symptoms impossible, cannot be overemphasized.
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8/31. Intrahepatic aneurysmal portohepatic venous shunt: embolization with a tissue adhesive solution.

    PURPOSE: To report the endovascular treatment of an intrahepatic portosystemic venous shunt (IPSVS) using a tissue adhesive solution. CASE REPORT: A 40-year-old woman without diagnosed liver disease presented for evaluation of vague abdominal pains. A latent portosystemic encephalopathy was diagnosed only during hospitalization, when ultrasound examination disclosed a venous-venous right hepatic communication. The patient was treated with selective percutaneous embolization using a tissue adhesive after blocking the lesion's venous inflow and outflow tracts. The result was excellent, and the patient recovered completely in a few days. After 5 months, the patient is asymptomatic and event-free. CONCLUSIONS: Large IPSVS may be successfully treated percutaneously using a tissue adhesive solution, avoiding a more invasive procedure.
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9/31. Partial thrombosis of an idiopathic azygos vein aneurysm.

    Aneurysms of the azygos vein are often asymptomatic, detected on a chest radiograph simulating paratracheal mass. When the aneurysm is totally thrombosed, it is impossible to distinguish it from another cause of mediastinal mass. A case is presented in which partial thrombosis of the aneurysm and communication with the superior vena cava led to a diagnosis on angiography and CT.
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10/31. Osler-Weber-Rendu disease--unexpected complication following excision of splenic aneurysm--a case report.

    Osler-Weber-Rendu disease is an autosomal dominant disease, sometimes known as hereditary hemorrhagic telangiectasia (HHT) with a family history. It is a rare disease and there are no records of families with inheritance lineage in Riyadh. We experienced an anesthetic management of a 28-yr-old woman with Osler-Weber-Rendu disease. She was diagnosed to have splenic aneurysm and was scheduled for excision of splenic aneurysm. A chest X-ray revealed pulmonary arterio-venous malformation all over the lungs. The anesthesia and surgery went deliberately smooth with selective period of intensive care admission. In the intermediate post operative period, however, she was diagnosed as having pleural effusion. A chest drain was inserted as an emergency, but the patient developed tension pneumothorax, which necessitated resuscitation and readmission to intensive care Unit. lung atelactasis was diagnosed. Attendance by qualified surgical night staff, communication, vigilance and consultations are as important as the proper management of such rare cases.
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