Filter by keywords:



Filtering documents. Please wait...

1/19. Operative and endovascular management of extracranial vertebral artery aneurysm in ehlers-danlos syndrome:a clinical dilemma--case report and literature review.

    The most prevalent lesion of the vertebral artery is an atheromatous plaque located at its origin from the subclavian artery. A case of successful management of a symptomatic vertebral artery aneurysm due to ehlers-danlos syndrome is reported. The patient had asymptomatic posterior intracerebral artery dissection on the contralateral side. A common carotid artery to V-3 segment bypass using reversed saphenous vein graft was carried out. Avulsion of the V-2 segment occurred peroperatively and endovascular coil embolization of the vertebral artery aneurysm was performed. Endovascular equipment and training must be in the armamentarium of vascular surgeons as more complex cases are being treated, which demands new approaches for ultimate clinical success. This unique case outlines what might unexpectedly occur. Endovascular intervention as an adjuvant procedure provides a satisfactory outcome in what could have been a catastrophe.
- - - - - - - - - -
ranking = 1
keywords = outline
(Clic here for more details about this article)

2/19. Circulation of the spinal cord: an important consideration for thoracic surgeons.

    The spinal cord has significant thoracic arterial watershed areas rendering it vulnerable to intraoperative ischemic damage, clearly mandating a need for postoperative neurologic monitoring. Mechanisms of hypoperfusion include aortic cross-clamping, rib retraction, intercostal artery interruption, and costovertebral junction bleeding. We report cases of primary lung cancer resection, resection of pulmonary metastasis adherent to the thoracic aorta, resection of cartilaginous tumor with chest wall invasion, and esophagomyotomy for achalasia-all complicated by postoperative paraplegia. We review spinal cord circulation, describe mechanisms and patterns of neurologic dysfunction of susceptible watershed areas, and outline roles of preoperative spinal angiography and intraoperative evoked potentials.
- - - - - - - - - -
ranking = 1
keywords = outline
(Clic here for more details about this article)

3/19. Common peroneal nerve injury during varicose vein operation.

    Common peroneal nerve (CPN) injury produces considerable and serious disability. The nerve is most frequently damaged as a result of trauma (sharp or blunt, traction, fracture, laceration, and avulsion). Less often iatrogenic injury is the cause of damage (application of tight plaster, retraction injury, division during operation). Even rarer is the complete or partial division of CPN during varicose vein operations. In the UK, on average 34 patients every year begin legal action against their medical attendants in connection with the treatment of varicose veins, on a background of an estimated 100,000 procedures performed. Nerve damage is the most frequent of all major complications that result in legal action; it is cited in 15% of cases. The commonest nerve injury, accounting for about half the cases, is to the common peroneal nerve just before or, as it crosses the neck of the fibula. We present three examples in two cases, which outline the risk of CPN injury, the spectrum of clinical presentation and the problems produced by a failure to recognise the deficit immediately. Regional anatomy, consequences of nerve damage and management options is discussed.
- - - - - - - - - -
ranking = 1
keywords = outline
(Clic here for more details about this article)

4/19. Intrapelvic migration of the trial femoral head during total hip arthroplasty: is retrieval necessary? A report of four cases.

    When testing intra-operative range of motion during a total hip arthroplasty procedure with trial components, there is potential for the femoral head to dissociate from the trial neck. We report the dissociation of the trial femoral head with migration of the head into the pelvis while checking for anterior stability of the total hip arthroplasty construct. Options for retrieval of the head are outlined.
- - - - - - - - - -
ranking = 1
keywords = outline
(Clic here for more details about this article)

5/19. Interruption of critical aortoiliac collateral circulation during nonvascular operations: a cause of acute limb-threatening ischemia.

    In patients with aortoiliac occlusive disease interruption of critical collaterals during another nonvascular or cardiac operation may threaten limb viability. This occurred in four patients whose limb-threatening ischemia was precipitated by radical cystectomy with bilateral hypogastric artery ligation, left colon resection, or coronary artery revascularizations by means of the internal mammary artery. Important collateral pathways, the interruption of which may account for this phenomenon, are detailed, and approaches are outlined for prevention and management of acute ischemia in this setting.
- - - - - - - - - -
ranking = 1
keywords = outline
(Clic here for more details about this article)

6/19. life-threatening complications during anaesthesia in a patient with a ventriculo-atrial shunt and pulmonary hypertension.

    A 6-year-old patient with hydrocephalus who underwent revision of a ventriculo-atrial shunt is described. Anaesthesia was complicated by the occurrence of systemic hypertension and arterial hypoxaemia. The patient was subsequently found to have pulmonary hypertension secondary to recurrent pulmonary thromboembolism. The pathophysiological mechanisms for the patient's deterioration are discussed and the anaesthetic management of children with pulmonary hypertension is outlined. It is concluded that patients with a ventriculo-atrial shunt who present for surgery should be screened carefully for the presence of pulmonary hypertension.
- - - - - - - - - -
ranking = 1
keywords = outline
(Clic here for more details about this article)

7/19. aorta-vena cava fistula.

    In 1831 James Syme described the unusual occurrence of an aortocaval fistula in a 22-year-old man with luetic aortitis. This initial report was followed by illustration of this phenomenon in Rokitanski's Book of Pathologic anatomy in 1841 and by Ryle's delineation of an aortocaval fistula on a pathologic specimen placed in Guy's Hospital Museum in 1892. The first series of aortocaval fistulas, cited by Rudolf Matas in 1909, consisted of a collection of 20 cases gathered by Boinet 10 years earlier. Several later reports, including those by Reid in 1925 and by Lehman in 1938, failed to add any additional cases. It was not until 1955 that Boffi presented an additional six patients who had this disorder, none of whom survived. Since that time, more than 100 cases of spontaneous aortocaval fistulas have been documented. This increasing experience has resulted in improved understanding and surgical treatment of these large-vessel arteriovenous communications. Nevertheless, lack of awareness and failure of recognition of this problem continue to impede its successful management. In this review we present two additional illustrative cases, summarize the clinical and pathophysiologic features of aortocaval fistulas, and outline present approaches to treatment.
- - - - - - - - - -
ranking = 1
keywords = outline
(Clic here for more details about this article)

8/19. Carotid artery vasospasm complicating extensive skull base surgery: cause, prevention, and management.

    Arterial spasm is rarely encountered in the uncomplicated cervical lymphadenectomy. Intense, often dramatic, vasospasm of the internal carotid artery, however, is not infrequently observed in the removal of skull-base lesions. This myogenic reaction is independent of autonomic innervation, occurs more frequently in younger patients, and appears to be due mainly to longitudinal arterial traction and prolonged arterial contact with fresh blood. A case of severe internal carotid artery spasm, which led to a fatal stroke in a young woman who underwent removal of a large glomus jugulare tumor, is presented to emphasize not only the lethal potential of carotid spasm, but intraoperative changes in the character of the artery which suggest the need for immediate spasmolysis. Perioperative guidelines for the prevention and treatment of arterial spasm--including topical and systemic pharmacotherapy and refined surgical techniques--are outlined on the basis of our subsequent experience.
- - - - - - - - - -
ranking = 1
keywords = outline
(Clic here for more details about this article)

9/19. Left atrial tumor embolization during pulmonary resection: review of literature and report of two cases.

    In the past 10 years, 2 patients were seen with metastatic sarcoma to the lower lobe of the lung and extension into the left atrium. In both patients, an attempt to squeeze the intracardiac portion of the tumor into the lung at the time of lobectomy ended in near-catastrophic complications: In the first patient, a saddle embolus occluded both femoral arteries, and in the other, obstruction of the mitral valve orifice and cardiac arrest occurred. This approach is mentioned only to condemn it. Our recommended approach is outlined to prevent this technical mistake in the future.
- - - - - - - - - -
ranking = 1
keywords = outline
(Clic here for more details about this article)

10/19. Adriamycin cardiomyopathy. fatal outcome of general anaesthesia in a child with adriamycin cardiomyopathy.

    The death under general anaesthesia of a child with Adriamycin cardiomyopathy is reported. The acute, subacute and chronic cardiotoxic effects of Adriamycin are discussed and the risk factors for chronic Adriamycin cardiomyopathy presented, with particular reference to cumulative dosage of Adriamycin. The insidious onset of impairment of cardiac function is stressed and suggestions for anaesthetic management outlined.
- - - - - - - - - -
ranking = 1
keywords = outline
(Clic here for more details about this article)
| Next ->


Leave a message about 'Intraoperative Complications'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.