11/169. A case of intestinal obstruction following stent graft placement for an abdominal aortic aneurysm.A 76-year-old male was admitted to hospital complaining of severe abdominal pain, constipation, nausea and vomiting. The patient had undergone stent graft placement of an abdominal aortic aneurysm (AAA) at another hospital 13 months prior to admission. An X-ray, computed tomography scan and barium-enema examination revealed partial obstruction of the duodenum. Stent graft placement has been reported to be a useful procedure for AAA. However, as mass effects associated with AAA cannot be excluded, several symptoms may remain postoperatively.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
12/169. Acute rupture of an aortic false aneurysm treated with a stent-graft.PURPOSE: To report the use of an aortic endograft to treat a ruptured false aneurysm at the anastomosis of an aortofemoral bypass graft. methods AND RESULTS: A 68-year-old man with a 30-year-old aorto-right femoral bypass and multiple comorbidities was admitted to the hospital complaining of acute abdominal pain. Imaging identified a 60-mm ruptured aortic false aneurysm with associated retroperitoneal hematoma, a 9-cm right femoral false aneurysm, and a calcified 23-mm left common iliac aneurysm. Two slightly overlapping Vanguard straight stent-grafts were implanted in the aorta and left common iliac artery in an emergency procedure owing to the patient's high surgical risk. The anastomotic false aneurysm and the bypass were excluded. A left-to-right femorofemoral bypass was performed to re-establish flow to the right femoral artery with ligation of the external iliac artery. The patient recovered uneventfully. He remained well with a successful repair until his death of a myocardial infarction 6 months after the procedure. CONCLUSIONS: Endovascular grafting can be used successfully for the urgent treatment of aortic false aneurysm rupture.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
13/169. Surgical repair of type B aortic dissection complicated by early postoperative lung vein and artery thrombosis.A 24-year old man with marfan syndrome previously operated for abdominal aortic aneurysm and type A dissection sustained a type B dissection. He underwent graft replacement of the descending and upper abdominal aorta, complicated by infarction of the left upper lobe and lobectomy was carried out. The postoperative course was uneventful. The mechanism for this rare complication is discussed.- - - - - - - - - - ranking = 0.015166319452393keywords = upper (Clic here for more details about this article) |
14/169. Aortic stent grafting and side-branch embolization in an expanding chronic type B dissection.OBJECTIVE: This is a report of endovascular treatment of a case of type B thoracoabdominal aortic dissection in a patient with progressive dyspnea, dorsolumbar pain, and expanding aortic diameter over a 1-year period. methods: Pretreatment imaging evaluation showed that the false lumen supplied only the celiac trunk. Endovascular treatment combined (1) embolization of the first segment of the celiac trunk to avoid distal back-flow into the false lumen and (2) stent grafting to occlude the initial entry tear. RESULTS: The treatment resulted in technical and clinical success. The patient remains asymptomatic 12 months after treatment. CONCLUSION: Stent grafting offers an interesting therapeutic alternative to exclude the initial entry tear in aortic dissection and may be combined with other endovascular procedures.- - - - - - - - - - ranking = 0.18616862262627keywords = back (Clic here for more details about this article) |
15/169. Acute dissection of the abdominal aorta.A 64-year-old man presented with sudden lower abdominal pain and diffuse lumbago. He was diagnosed as having primary dissection of the abdominal aorta. Entry closure and aneurysmal wall plication was performed, and the subsequent course was satisfactory. Surgical intervention is recommended for patients with abdominal aortic dissection in the infrarenal segment, where the extent of dissection is limited and access is comparatively easy. Enhanced computed tomography is useful both in diagnosis and follow-up of this aortic disease.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
16/169. Aortoduodenal fistula after endovascular stent-graft of an abdominal aortic aneurysm.Despite satisfying short- and middle-term effectiveness and feasibility, endovascular stent-grafting for abdominal aortic aneurysm is still under evaluation. We report a case of an aortoduodenal fistula after the use of this technique. Enlargement of the upper aneurysmal neck was followed by caudal migration of the major portion of the stent-graft, which resulted in kinking of the device in the aneurysmal sac. Ulcerations were found on adjacent portions of both the aneurysmal sac and the adjacent duodenum. Only the textile portion of the prosthetic contralateral limb separated the aortic lumen from the corresponding duodenal lumen. Early detection of complications after stent-grafting is essential to allow successful treatment, either surgical or endoluminal.- - - - - - - - - - ranking = 0.0075831597261967keywords = upper (Clic here for more details about this article) |
17/169. A patient with fever and an abdominal aortic aneurysm.A 55-year-old man with an abdominal aortic aneurysm presented with fever and abdominal pain 3 weeks after an episode of salmonella gastroenteritis. His symptoms persisted despite antimicrobial therapy. Two abdominal computed tomography (CT) scans showed no evidence of aortitis. His abdominal pain worsened and further investigation including a third CT scan demonstrated a leaking aortic aneurysm. The wall of the aorta was shown to contain Gram-negative bacilli. This case illustrates the difficulty in diagnosing bacterial aortitis.- - - - - - - - - - ranking = 2keywords = abdominal pain (Clic here for more details about this article) |
18/169. Purulent pericarditis due to group B streptococcus and mycotic aneurysm of the ascending aorta: case report.A 61-year-old female, with a history of uterine and cervical cancer treated with radical hysterectomy and 2 years of postoperative chemotherapy, presented to the emergency department with dyspnea on exertion. Computed tomography of the chest revealed a large pericardial effusion and a sacciform aneurysm of the ascending aorta. The patient subsequently underwent emergency pericardiocentesis with drainage of approximately 330 ml of a bloody and turbid effusion. Cultures from the effusion yielded group B streptococcus. multiple organ failure and disseminated intravascular coagulation syndrome occurred in the acute phase, but gradually improved with continuous antibiotic therapy. On the 194th hospital day, in situ reconstruction of the ascending aorta was successfully performed using a synthetic graft. Although rarely reported, both purulent bacterial pericarditis and mycotic aneurysm can be life-threatening.- - - - - - - - - - ranking = 0.00398891966759keywords = chest (Clic here for more details about this article) |
19/169. A subclavian artery aneurysm associated with aortitis syndrome.We performed surgery on a 61-year-old woman who had increasingly severe right shoulder pain and paresthesia in her right upper extremity as a result of a large right subclavian artery aneurysm. She had suffered from aortitis syndrome for 10 years for which she was treated with steroids and had multiple arterial lesions, including bilateral subclavian artery aneurysms, abdominal aortic aneurysm and obstruction of bilateral superficial femoral arteries. The right subclavian artery aneurysm measured 4 cm in diameter and rupture appeared imminent, prompting surgical therapy. Via the supraclavicular incision approach and additional partial sternotomy, the aneurysm was excluded and the brachiocephalic to right axillar arterial bypass was set up using an extended polytetrafluoroethylene graft. The patient recovered without complications and a subclavian artery aneurysm demonstrated by computed tomography was thrombosed 1 month after surgery. In conclusion, we recommend the exclusion technique to treat subclavian artery aneurysms in cases in which aneurysmectomy is likely to injure adjacent veins and nerves.- - - - - - - - - - ranking = 0.0075831597261967keywords = upper (Clic here for more details about this article) |
20/169. Multiple mycotic arch-thoraco-abdominal aortic aneurysms: a successful case of in situ graft replacement.Mycotic aortic aneurysms are an uncommon yet still life-threatening pathology. We report on a 67-year-old male who had a persistent fever and back pain. Contrast enhanced computed tomography (CT) showed multiple aortic aneurysms located in the aortic arch, the descending thoracic aorta and the supraceliac abdominal aorta. After 2 months of antibiotic therapy, a staged operation was carried out with 2-week interval, which includes a graft replacement of aortic arch with elephant trunk technique and a graft replacement of thoraco-abdominal aorta with omental transfer. The postoperative course was uneventful. This case seems to be quite rare in terms of multiplicity and location of mycotic aneurysms. Surgical strategy for this pathology is discussed.- - - - - - - - - - ranking = 2.7765399369899keywords = back pain, back (Clic here for more details about this article) |
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