Cases reported "Embolism"

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11/102. Fatal diffuse atheromatous embolization following endovascular grafting for an abdominal aortic aneurysm: report of a case.

    A 78-year-old woman with an abdominal aortic aneurysm, 57 mm in diameter, was admitted to our hospital for endovascular grafting. Preoperative computed tomography and angiography showed friable mural thrombus in the suprarenal and infrarenal aorta, and a diagnosis of shaggy aorta was made. Postoperatively, the patient suffered cerebral infarction, and disseminated intravascular coagulopathy with multiple organ failure developed, resulting in early death on the third day after surgery. An autopsy revealed diffuse atheromatous embolization into the celiac, superior mesenteric, bilateral renal, bilateral hypogastric (trash buttock), and peripheral arteries. This case report serves to demonstrate that an abdominal aortic aneurysm with a shaggy aorta in the proximal neck is a contraindication to endovascular grafting, and that predicting the possibility of diffuse atheromatous embolization by detecting a shaggy aorta is the best way to prevent this catastrophic complication.
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12/102. calcium embolism of the coronary arteries after percutaneous mitral balloon valvuloplasty.

    Two cases of rare, catastrophic calcium emboli to the coronary arteries immediately after percutaneous mitral balloon valvuloplasty are presented. Preoperative echocardiographic findings may identify patients at risk for this complication. These cases should increase the awareness of calcium emboli and lead to consideration of urgent coronary angiography for patients with signs or symptoms of acute coronary occlusion after valvuloplasty.
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13/102. Bullet embolization to the heart. Report of a case and review of the literature on indications for removal of intracardiac foreign bodies.

    The hospital course of a young man with a bullet migration through the venous system to the right ventricle is reviewed. The intraoperative management of foreign bodies to the heart using x-ray image intensifier is employed.
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14/102. hematuria caused by atheromatous embolism: report of a case diagnosed intravitam.

    Gross, painless hematuria as the only symptom in a 53-year-old male diabetic necessitated partial nephrectomy and was then found to have been caused by atheromatous embolism associated with recent infarction of the renal parenchyma. This case appears to be the first one reported in which the diagnosis of renal atheromatous embolization had been established intravitam. A similar episode of hematuria occurred a year postoperatively and another renal infarction, likely caused by atheromatous embolization, was demonstrable with tomographic and angiographic techniques.
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15/102. Cruciate paralysis or man-in-the-barrel syndrome? Report of a case of brachial diplegia.

    A patient who developed isolated brachial diplegia following cardiac surgery is described. The underlying cerebral lesion could not be localized using magnetic resonance imaging (MRI). evoked potentials disclosed normal findings, while pathological latencies were seen on cortical magnetic stimulation. Their marked improvement over the following year was accompanied by almost complete clinical recovery. The preserved arm reflexes, together with the observed slow firing motor units in electromyography argued against bilateral lesions of the brachial plexus. We attribute the observed diplegia to a medullary lesion at the level of the pyramidal decussation, presumably caused by an intraoperative embolic occlusion of the anterior spinal artery. Cruciate paralysis and man-in-barrel-syndrome (MIBS) both are terms used to describe brachial diplegia; cruciate paralysis when caused by medullary lesions, MIBS when caused either by supratentorial or by medullary lesions. Exclusive use of the term MIBS for bilateral frontal lobe lesions, as in the original description, would provide more clarity in terminology.
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16/102. Early experience using the Wallgraft in the management of distal microembolism from common iliac artery patholology.

    blue toe syndrome commonly occurs as a result of aneurysmal or atherosclerotic disease in the iliac arteries. Surgery, angioplasty, or intraarterial stent placement are the most common treatment options but the optimal management has not been defined. Here we report managing distal microembolization from iliac artery atherosclerosis associated with aneurysmal dilation with the Wallgraft Endoprosthesis, a self-expanding metallic stent covered with Dacron. Three common iliac arteries in two patients were treated using this device. A 79-year-old male presented with unilateral symptoms and an 83-year-old female with bilateral disease. Arteriography demonstrated complex plaque at the aortic bifurcation associated with aneurysmal dilation of the distal common iliac artery in both patients. This complex disease was successfully covered using the Wallgraft Endoprosthesis. Postoperatively the patients received aspirin, their toe lesions healed, and neither has had a recurrence after 16 months. Covered stents offer the theoretic advantage of completely excluding the diseased segment, preventing the escape of thrombus or plaque debris, and covering aneurysmal dilation in the artery.
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17/102. Silent embolism of a large pedunculated left atrial thrombus.

    patients with a left atrial thrombus are considered as being at high risk for thromboembolic events. Although embolization may be asymptomatic, embolic events related to large thrombi are usually clinically manifest and tend to be associated with a worse prognosis. We describe the very unusual case of a patient with atrial fibrillation in whom two-dimensional echocardiography revealed a large, pedunculated, highly mobile left atrial thrombus attached by a thin stalk to the interatrial septum. Because of the high risk of embolism the patient was submitted to urgent surgery. At surgery, only the stalk was found. No mass was visualized at intraoperative transesophageal echocardiography. The patient had an uneventful postoperative course without signs of embolism. Computed tomography of the brain did not reveal any cerebral infarction.
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18/102. Intraoperative diagnosis of an unsuspected left atrial myxoma by transesophageal echocardiography.

    IMPLICATIONS: The authors report the intraoperative diagnosis using transesophageal echocardiography (TEE) of an unsuspected myxoma in a patient admitted for an acute occlusion of the aorta, resulting in emergency excision of the atrial tumor. This observation illustrates the usefulness of intraoperative TEE examination to identify life-threatening pathology.
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19/102. Complications of albendazole treatment in hydatid disease of lung.

    We present rupture of lung hydatid cyst in a patient with multiple organ involvement during albendazole treatment. The patient was first provided mechanical ventilation than residue cavity and the other intact cyst was treated surgically. We concluded that albendazole should be used in postoperative period in patients with hydatid disease of the lung to prevent recurrent disease.
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20/102. Arterial embolism caused by a ruptured hydatid cyst in the heart: report of a case.

    Cardiac hydatid cysts are extremely rare and, although patients may remain asymptomatic for many years or have only minor nonspecific symptoms, they are associated with life-threatening complications. We report the case of a 32-year-old woman with an acute arterial embolism caused by a ruptured hydatid cyst in the heart. An emergency operation revealed that the embolism originated from the left cardiac chamber caused by a cyst in the left ventricle. There were also three cystic lesions in the right lung. The patient underwent surgery to remove the hydatid cysts from the right lung on the 13th day after the first operation. Her postoperative course was uneventful and she was discharged from hospital on the 27th day after admission.
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