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1/39. Primary cardiac malignant fibrous histiocytoma in the right ventricular infundibulum treated with a cavo-pulmonary shunt and coronary embolization.

    A 51-year-old woman presented with progressive right ventricular infundibular wall thickening and outflow obstruction. She had had an aorto-coronary bypass for left main coronary artery disease 1 year after radiation therapy for left mammary cancer. Enhanced computed tomography showed a mass in the right ventricular free wall with no connection to the mediastinum; the tumor extended into the main pulmonary artery, but there was no other evidence of a primary or metastatic tumor. A biopsy specimen was obtained and based on the microscopic and immuno-histochemical findings (vimentin and Kp-1 positive) the diagnosis was primary cardiac malignant fibrous histiocytoma, which is very rare. A cavo-pulmonary artery connection lessened her symptoms, but embolization of the coronary artery to try and to reduce the mass had minimal effect. Four months after the tumor was diagnosed she died of extended pulmonary artery obstruction.
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ranking = 1
keywords = cancer
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2/39. Primary sarcoma of the aorta.

    A 70-year-old man had an obstruction of the aortic bifurcation by a primary aortic sarcoma. The tumor was not fibrosarcomatous, as are the majority of primary aortic tumors. To our knowledge, this is the third occurrence of this type of primary aortic malignant neoplasm to be reported in the literature. A possible endotheliomatous origin is suggested.
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ranking = 0.18179013428177
keywords = neoplasm
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3/39. Trousseau's syndrome treated with long-term subcutaneous lepirudin (case report and review of the literature).

    We report here a case of recurrent venous and arterial thromboembolism, Trousseau's syndrome, in a cancer patient who developed heparin-induced thrombocytopenia. She was treated with lepirudin and after establishing the patient-specific half-life for subcutaneous lepirudin, she was successfully maintained on this therapy for more than eight months.To our knowledge this case represents the longest reported use of subcutaneous lepirudin.
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ranking = 1
keywords = cancer
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4/39. Case report: Hepatic arterial occlusion following infusion catheter placement: recanalization using the Palmaz stent.

    We report two cases in which hepatic arterial occlusion developed soon after percutaneous catheter placement for hepatic arterial infusion chemotherapy in malignant hepatic neoplasms. A replaced hepatic artery and a proper hepatic artery, respectively, became occluded in these cases. In both, because the tip of a side-holed catheter for arterial infusion was fixed in place, we performed recanalization without removing the indwelling catheter. Despite the presence of the catheter, a stent could be inserted into the occluded portion of the hepatic artery. Recanalization of the hepatic artery was achieved with stent placement, and continuation of hepatic arterial infusion became possible.
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ranking = 0.18179013428177
keywords = neoplasm
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5/39. Presentation and revascularization outcomes in patients with radiation-induced renal artery stenosis.

    This study analyzed the initial presentation and revascularization outcomes of patients with radiation-induced renal artery stenosis, a rare complication of therapeutic irradiation. Of 11 patients with renal artery stenosis after irradiation, 7 patients fulfilled the following criteria: normotension before irradiation, radiation dose greater than 25 grays delivered to the renal arteries, associated perirenal radiation-induced lesions, and absence of arterial disease outside the radiation field. The median age at irradiation was 30 years, and the median local irradiation dose was 40 grays. The median time from irradiation to referral was 13 years. All patients were hypertensive at referral, with a median blood pressure (BP) of 171/102 mm Hg and median treatment score of two. The median glomerular filtration rate was 67 mL/min. Two patients had bilateral stenoses and 1 patient had stenosis affecting a single kidney. Stenoses were proximal in 6 patients and truncal in 1 patient, and all had the appearance of atherosclerotic stenosis. Percutaneous transluminal renal artery angioplasty (PTRA) was successful in 5 patients, but required multiple insufflations. PTRA failed in 1 patient, who subsequently underwent an aortorenal bypass. After a median follow-up of 36 months, 2 patients had died of noncardiovascular causes and 4 patients remained hypertensive, with a median BP of 136/85 mm Hg and median treatment score of two. No restenosis occurred, but aneurysms developed at the site of angioplasty in 1 patient. If hypertension occurs even decades after irradiation, a radiation-induced renal artery stenosis should be sought in patients who have undergone abdominal irradiation.
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ranking = 6949.3206206839
keywords = radiation-induced
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6/39. Arterial occlusive events during chemotherapy for germ cell cancer.

    During four courses of chemotherapy for a disseminated testicular seminoma a 30-year-old man developed three arterial occlusive events and one silent myocardial infarction. The events occurred approximately 10 days after the start of each chemotherapy course. During chemotherapy suggested pathogenetic factors were monitored without observing any significant abnormality. After completion of chemotherapy the patient remained in a complete remission and free of new thromboembolic events. A review of possible pathogenetic factors is given.
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ranking = 4
keywords = cancer
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7/39. Occlusion of the left superficial femoral artery during hepatic arterial infusion of chemotherapy for liver metastases from colon cancer 18 months after the implantation of a port system: a case report.

    We report a case of complication of a catheter port system. A 67-year-old male who had undergone left hemicolorectomy and partial hepatectomy for liver metastases from colon cancer underwent hepatic arterial infusion (HAI) of chemotherapy by a percutaneously implanted catheter port system to prevent recurrence. Eighteen months after the implantation of a port system he complained of intermittent claudication. Intravenous digital subtraction angiography (IV-DSA) showed occlusion of the left superficial femoral artery. The catheter was removed and a femoro-popliteal bypass with an artificial graft was constructed. Thrombus was found around the indwelling catheter at the insertion site. After the operation his complaint disappeared and has been alive without recurrence for 6 years.
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ranking = 5
keywords = cancer
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8/39. Pulmonary arterial occlusive disease following chemotherapy and bone marrow transplantation for leukaemia.

    Cancer treatment is not known to cause obstructive lesions in the pulmonary artery. We report the case of an 8-year-old girl in whom apparent primary pulmonary hypertension developed shortly after chemotherapy and bone marrow transplantation for myelomonocytic leukaemia (LAME 91 protocol). Cardiac catheterisation showed, at baseline, severe precapillary pulmonary hypertension (mean pulmonary arterial pressure 49 mm Hg) with an increase in pulmonary vascular resistance (23.3 U/m(2)). Prostacyclin infusion demonstrated a 49% reduction and diltiazem infusion a 30% reduction in pulmonary vascular resistance without significant modification of systemic vascular resistance or cardiac output. Significant improvement in functional status was obtained with oral diltiazem. Follow-up cardiac catheterisation 3 months later showed a maintained haemodynamic improvement. CONCLUSION: pulmonary arterial occlusive disease should be added to the list of complications likely to occur after cancer chemotherapy. In addition, our report demonstrates that the pulmonary vasodilator response of vasodilating agents should be tested in such patients.
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ranking = 1
keywords = cancer
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9/39. pulmonary artery stenting for recurrent lung cancer after left pneumonectomy.

    We present a case of a patient with stenosis of the pulmonary artery which was successfully treated by implantation of a vascular endoprosthesis. A 50-year-old man underwent left pneumonectomy for lung cancer. Eleven months later, a computed tomographic scan revealed a soft tissue mass in the mediastinum and there was severe stenosis of the remaining right main pulmonary artery. A self-expandable vascular endoprosthesis was implanted in the stenotic portion. We used percutaneous cardiopulmonary support (PCPS) during the procedure. We recommend the technique of pulmonary artery stenting using PCPS as efficacious and safe.
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ranking = 5
keywords = cancer
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10/39. radiation-induced arteriopathy. A report of two cases.

    radiation is a rare cause of occlusive arterial disease. It can manifest with a variety of symptoms. The pathophysiology of radiation-induced arterial injury has not been clearly elucidated. Surgically correctable cases pose a technical challenge and there appears to be high incidence of late graft infection in areas of irradiated tissue. Two case reports and a brief review of the literature are presented.
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ranking = 992.76008866912
keywords = radiation-induced
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