Cases reported "Aneurysm, False"

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1/20. Awake use of a new laryngeal mask prototype in a non-fasted patient requiring urgent peripheral vascular surgery.

    This case illustrates that a new prototype laryngeal mask with high seal pressures can be placed in the awake patient with minimal cardiorespiratory changes and that it facilitates passage of a nasogastric tube.
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2/20. Seat belt aorta: endovascular management with a stent-graft.

    PURPOSE: To report the endovascular treatment of a relatively uncommon type of deceleration injury to the abdominal aorta. CASE REPORT: A 21-year-old backseat passenger was wearing a single lap belt without shoulder harness when the car was involved in a collision. He sustained a transverse (Chance) fracture of the third lumbar vertebra and a circumferential dissection of the infrarenal abdominal aorta with pseudoaneurysm. As an interim measure while a stent-graft was obtained, a Wallstent was deployed to tack down the dissection and prevent distal embolization. Thirty-six hours later, an AneuRx endograft was successfully implanted inside the Wallstent to seal the pseudoaneurysm. The patient's recovery was uneventful, and the endograft remains secure and the pseudoaneurysm excluded at 10 months after the accident. CONCLUSIONS: Endovascular repair of "seat belt aorta" is a minimally invasive, straightforward method of management for this type of aortic injury. The potential for infection in a contaminated peritoneal cavity and the long-term outcome of this treatment have not been determined.
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3/20. Unusual form of cardiac rupture: sealed subacute left ventricular free wall rupture, evolving to intramyocardial dissecting hematoma and to pseudoaneurysm formation--a case report and review of the literature.

    This report describes an unusual course of rupture of the left ventricular free wall, complicating acute myocardial infarction. Spontaneous sealing of the rupture site enabled close echocardiographic follow-up, during which we monitored the development of intramyocardial dissecting hematoma and, finally, development of a full tear in the left ventricular free wall, leading to the formation of a pseudoaneurysm. The pathophysiology, management, and diagnostic criteria of these processes are being revised.
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4/20. subclavian artery pseudoaneurysm successful exclusion with a covered self-expanding stent.

    Subclavian pseudoaneurysms are rare clinical entities occurring most commonly after iatrogenic injury to the subclavian artery. The management of subclavian pseudoaneurysms remains a challenge because of their non-compressibility and close proximity to vital intra-thoracic structures. Until recently, the treatment of choice was surgical intervention. In this case report, an iatrogenic subclavian pseudoaneurysm was successfully managed using a covered, self-expanding stent after an uncovered stent was unsuccessful in sealing the pseudoaneurysm.
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5/20. Rapid evolution from coronary dissection to pseudoaneurysm after stent implantation: a glimpse at the pathogenesis using intravascular ultrasound.

    Coronary dissection during angioplasty can evolve into pseudoaneurysm. Stenting should prevent this complication. We present a case of coronary pseudoaneurysm after dissection that developed despite stent implantation. Intravascular ultrasound demonstrated no sealing of the false lumen due to undersizing and non-apposition to the wall by the stent.
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6/20. thrombin injection for failed stent graft repair of perforated atherosclerotic aortic ulcer.

    We used direct thrombin injection to occlude a pseudoaneurysm that formed from a contained rupture of a penetrating atherosclerotic ulcer at the junction of the thoracic and abdominal aorta after we failed to seal the perforation with an endovascular stent graft. The principles of thrombin injection and the technical modifications specific for use in a false aneurysm of aortic origin are described. An evolving role for thrombin in endovascular therapy is suggested.
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7/20. Use of multiple stents to seal off an epicardial pseudoaneurysm.

    A 69-year-old male patient had triple-vessel coronary artery bypass graft (CABG) surgery. Three months later, an echocardiogram revealed a 6 x 6 cm cardiac mass. A computed tomography scan of the chest showed a 6 cm mass with contrast enhancement. cardiac catheterization revealed a pseudoaneurysm of the saphenous vein graft to a circumflex marginal branch at the distal anastomosis site. The aneurysm neck was completely sealed off using 3 stents, leaving a patent saphenous vein graft and good distal run-off.
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8/20. False aortic aneurysm at site of previous coarctation repair: the role of cardiovascular magnetic resonance.

    We describe a 37-year-old who presented with hemoptysis. Twenty-one years previously he had undergone Dacron patch aortoplasty for coarctation. Initial investigations failed to reveal the cause of the hemoptysis. Cardiovascular magnetic resonance (CMR) demonstrated an aneurysm at the site of the repair. He underwent successful repair of the aneurysm with a Gelseal interpositional graft.
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9/20. Large pseudoaneurysm after left main trunk stenting sealed by polytetrafluorethylene-covered stent.

    Left main trunk (LMT) aneurysm is very rare and the management remains uncertain. We describe a patient who developed a pseudoaneurysm from coronary perforation during stent implantation in LMT and was then treated with polytetrafluorethylene (PTFE)-covered stent graft. PTFE-covered stent is considered to be a valid strategy for LMT aneurysms.
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10/20. Minimally invasive intervention for acute bleeding from a pseudoaneurysm after revision hip arthroplasty.

    After multiple revisions of her right hip arthroplasty, an 83-year-old woman developed deep infection with a chronic draining sinus. In August 2002 severe acute bleeding occurred through this fistula. angiography revealed a pseudoaneurysm of the right external iliac artery. Because of the multiple pathologies affecting this ASA grade IV patient, conventional surgical treatment was considered to be contra-indicated, and a stent was placed percutaneously under fluoroscopic control to seal the vascular laceration. No haematoma and no further bleeding was observed on the control CT-scan or at angiography. However the patient died with terminal renal failure forty days later. The case reported shows a rare complication of total hip arthroplasty. The method used in this case to seal the leakage, using a covered stent, is uncommon but effective in cases where conventional surgery is contra-indicated.
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