1/81. Angioplasic surgery for renal artery aneurysm in pediatric hypertension.Aneurysmectomy and renal angioplasty were performed on a 14-year-old Japanese male and the blood pressure was within normal values 3 years after this surgery. Measurement of renal blood flow was facilitated by using 133Xe washout technique. This incidence is the eighth such case to be reported from japan.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/81. Carotid ligation for carotid aneurysms.Thirty patients with subarachnoid haemorrhage due to rupture of a carotid aneurysm were treated by ligation of the common carotid artery. Two patients died as a result of the procedure, two patients developed persisting hemisphere deficit. Eight of the ten patients who developed cerebral ischemia after the operation were operated within ten days after the bleeding. At present out aim is to guide the patient safely through the first ten days after his haemorrhage and perform ligation at the end of the second week. After a follow up period of 1-8 years recurrent haemorrhage did not occur. Common carotid ligation, preferably with control of carotid artery end pressure, cerebral blood-flow and EEG is considered to be a valuable method to treat ruptured intracranial carotid aneurysm.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/81. Fusiform vertebral artery aneurysms as a cause of dissecting aneurysms. Report of two autopsy cases and a review of the literature.Two autopsy cases of angiographically determined fusiform aneurysms of the vertebral arteries (VAs) are reported and the appropriate literature is reviewed to investigate the pathological characteristics of both fusiform and dissecting VA aneurysms and the pathogenesis of dissecting aneurysms. One patient had suffered a subarachnoid hemorrhage (SAH) due to dissection of a previously documented incidental fusiform aneurysm. The other patient had harbored incidental fusiform aneurysms coexistent with a ruptured aneurysm of the posterior inferior cerebellar artery. The location and pathological features of the aneurysms were similar in the two cases. The aneurysms in both cases displayed intimal thickening, disruption of the internal elastic lamina, and degeneration of the media. A mural hemorrhage and patchy calcification were also found in the case that included SAH. Based on their pathological investigation of these two cases and a review of reported cases, the authors propose that incidental fusiform aneurysms in the VAs are characterized by weakness in the internal elastic lamina and, therefore, have the potential to become dissecting aneurysms, resulting in a fatal prognosis. This suggests that long-term control of blood pressure is mandatory in patients with incidental fusiform aneurysms in the VAs.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/81. systemic vasculitis and aneurysm formation in the wiskott-aldrich syndrome.A 24 year old male who suffered from the wiskott-aldrich syndrome developed intra-abdominal bleeding on two occasions. Radiological investigations showed aneurysmal dilatation of branches of the hepatic and superior mesenteric arteries. The second abdominal bleed necessitated laparotomy and the bleeding was localised to the kidneys. Right nephrectomy was performed and histological examination showed a necrotising vasculitis, mainly involving medium and small sized renal blood vessels. steroids, immunosuppressive treatment, and control of blood pressure resulted in resolution of the vasculitic process and prevented further haemorrhage. Vasculitis and aneurysm formation are rarely described complications of wiskott-aldrich syndrome and may account for the life threatening haemorrhage which occurs in this condition.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/81. Sinoatrial nodal artery aneurysm with right ventricular outflow tract compression: report of a case.We described a 16-year-old boy with sinoatrial nodal (SAN) artery aneurysm that drained into right atrium and compressed right ventricular outflow tract. The patient was clinically asymptomatic. Hemodynamic study revealed a 15 mm Hg peak systolic pressure gradient at right ventricular outflow tract. The fistula was successfully excised without sequalae. Cathet. Cardiovasc. Intervent. 51:328-331, 2000.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/81. A case of renovascular hypertension due to bilateral renal artery microaneurysm who succeeded in baby delivery.We report the case of a young pregnant woman with bilateral renovascular hypertension due to renal microaneurysms from an unknown cause, who had a successful delivery. pregnancy did not affect the disease activity even in the postpartum period. Her blood pressure was maintained within the normal range by administration of labetalol. Although the angiographic appearance of the symmetrical aneurysms in both renal artery beds from the interlobular to arcuate artery levels suggested polyarteritis nodosa of multiple microaneurysms in the bilateral interlobular arteries, the clinical features suggested other causes of renovascular hypertension, such as fibromuscular dysplasia and/or congenital microaneurysms. We were thus unable to reach a definitive diagnosis.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/81. Renovascular hypertension associated with neurofibromatosis: two cases and review of the literature.The authors report two cases of renovascular hypertension associated with neurofibromatosis. A 19-year-old woman was admitted to our hospital with a complaint of abdominal pain and blood pressure of 180/120 mmHg. Examination revealed cafe-au-lait spots over her chest and extremities. Peripheral plasma renin activity (PRA) under basal conditions was 2.8 ng/ml/h and increased to 12.6 ng/ml/h after administration of 50 mg captopril. plasma and urinary catecholamines were normal. Selective renal angiography showed left aneurysmal dilatation of the segmentary branch and right renal artery stenosis with multiple aneurysmal affecting different branches. blood pressure was controlled by multiple drugs, including beta-blockers and angiotensin-converting enzyme inhibitor. Another patient, a 20-year-old woman, was admitted because of severe arterial hypertension, numerous cafe-au-lait spots, scoliosis, and mass over the right arm. PRA from the right renal vein was extremely elevated, and selective angiography demonstrated bilateral renal artery stenosis. Aortorenal bypass was performed successfully.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
8/81. Anesthetic management of patients with Takayasu's arteritis: a case series and review.Takayasu's arteritis is a rare, chronic progressive panendarteritis involving the aorta and its main branches. anesthesia for patients with Takayasu's arteritis is complicated by their severe uncontrolled hypertension, end-organ dysfunction resulting from hypertension, stenosis of major blood vessels affecting regional circulation, and difficulties encountered in monitoring arterial blood pressure. Takayasu's arteritis is an uncommon disease and previous descriptions of the anesthetic management of patients with this disease have been limited to isolated case reports in the anesthetic literature, mostly in women undergoing cesarean delivery. We present our experience in this series of eight patients for various emergency and elective surgical procedures and review their perioperative problems and management. Implications: This case series describes the anesthetic problems and management of patients with pulseless disease.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/81. Endovascular repair of an innominate artery true aneurysm.PURPOSE: To describe endovascular repair of a large aneurysm of the innominate artery in a patient with episodes of transient cerebral ischemia. CASE REPORT: A 44-year-old man with a history of transient hemiparesis and aphasia demonstrated a large mass in the upper right hemithorax on chest radiography. Systolic brachial pressure in the right arm was 100 mm Hg versus 130 mm Hg in the left. Imaging disclosed a large 12-mm-diameter aneurysm involving the brachiocephalic trunk 1 cm above its origin and the first portion of the right subclavian artery, which was occluded after the dilated segment. The aneurysm was treated with a tapered endograft made from polyester graft attached to a Palmaz stent inserted via a carotid artery arteriotomy. The distal end of the graft was anastomosed to the common carotid artery. Completion angiography showed exclusion of the aneurysm, which has been confirmed by imaging at 21 months. After 2 years, the patient is free from neurological symptoms and has a strong carotid pulse; no arm claudication developed. CONCLUSIONS: Endovascular correction of innominate artery aneurysms is feasible whenever there is an adequate proximal neck for attachment. In these cases, thoracotomy may be avoided.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/81. 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.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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