Cases reported "Ischemia"

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1/280. An unusual vascular graft infection by aspergillus--a case report and literature review.

    Vascular graft infection due to aspergillus is a rare event. Only 11 previous case reports have been documented. All of these infections were in the aortic position, and infrainguinal arterial prosthetic graft involvement has been uncommon. The usual clinical presentation was back pain. fever and systemic complaints were usually present. An unusual case that began with bilateral groin pain is reported and a review of the clinical presentation and the management of the other cases described in the literature is presented.
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ranking = 1
keywords = back pain, back
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2/280. Limb-threatening lower extremity ischemia successfully treated with intra-arterial infusion--case reports.

    The authors present two patients with acute arterial vasospasm of the lower extremities causing marked ischemia. One patient had a history of Raynaud's disease, the second had been taking Cafergot for migraine headaches. Both patients's were given a test dose of intra-arterial tolazoline (50 mg). The patient with Raynaud's disease demonstrated marked improvement diffusely and was successfully treated with overnight infusion of papaverine. The second patient, taking Cafergot, demonstrated no angiographic response to tolazoline. It was speculated that the arteries of this patient were thrombosed. The patient was successfully treated with urokinase and remained free of pain at the 15-month follow-up.
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ranking = 0.3595608086741
keywords = headache
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3/280. Superior and inferior limb ischaemia in giant cell arteritis: angiography follow-up.

    giant cell arteritis most often affects the superficial temporal artery. Arterial territories such as the facial, carotid, myometrial and upper and lower limb arteries may be affected. In this paper we describe the case of a 52-year-old patient with upper and lower limb ischaemia who presented with grade III ischaemia in the left lower limb. giant cell arteritis was diagnosed as responsible for the symptoms. After treatment with corticoids, an angiographic improvement was evidence after 2-year period. The low number of reported cases, the diverse symptoms and varied course make diagnosis of GCA difficult. Therefore, GCA must be taken into consideration in the ischaemia of inferior and superior limbs whether isolated or simultaneous.
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ranking = 7.00512633723
keywords = upper
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4/280. Subacute ischaemic proctitis: a rare condition requiring extensive rectal surgery.

    Subacute ischaemic proctitis is a rare condition. We describe the case of a 60-year-old male patient who developed, after aortic aneurysm repair, a transient ischaemic colitis that totally healed without sequelae. He eventually developed symptoms of severe proctitis. Investigations identified a stenosis of the mid rectum, while the upper rectum was inflammatory. On angiogram, there was a poor blood flow through the Riolan's arcade and a stenosis of the proximal aorto-graft anastomosis. diagnosis of subacute ischaemic proctitis due to poor blood supply through the internal iliac arteries was made. Anti-inflammatory drugs and dilations were inefficient. A subtotal proctectomy with low colorectal anastomosis was required. On pathological specimen, the lesions were strongly suggestive of an ischaemic process. The patient had an excellent recovery and was asymptomatic 8 months after the operation.
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ranking = 3.502563168615
keywords = upper
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5/280. Acute upper limb ischemia: a complication of coronary artery bypass grafting.

    We present the case of a patient with acute upper limb ischemia after radial artery harvest for coronary artery bypass grafting. This occurred despite adequate preoperative and intraoperative assessment with the Allen test, hand-held Doppler and radial artery backbleeding. A successful outcome was achieved by performing brachioradial bypass grafting using reversed cephalic vein.
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ranking = 17.635713213459
keywords = upper, back
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6/280. Near infrared spectroscopy and transcranial Doppler in monohemispheric stroke.

    We simultaneously performed near infrared spectroscopy (NIRS) and transcranial Doppler (TCD) to evaluate the effects of hypercapnia as well as of scalp ischemia on the blood flow at two different depth levels within the brain and of the scalp vessels. A decrease in the backscattered light intensity, meaning an increment of blood volume, was detected at the end of hypercapnia in all healthy subjects. This decrement was partly masked by ischemia in the cutaneous vessels. In 2 patients with a monohemispheric lesion in the middle cerebral artery (MCA) territory, an increase in NIRS response was found in the healthy hemisphere, while in the stroke side the CO2-induced changes were negligible. TCD data showed a similar increment of blood flow velocity to the hypercapnia in both hemispheres, with no differences between the affected and normal side in 1 patient, whereas in the second one, no increment was observed on the affected side, probably due to internal carotid artery stenosis. The two methods nicely integrate: TCD mainly tests subcortical changes in the MCA flow, while NIRS is exquisitely sensitive to cortical arterioles and capillary blood flow modifications.
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ranking = 0.12289737038423
keywords = back
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7/280. Surgical treatment of vascular lesions of the spinal cord.

    Paravertebral block and resection of upper thoracic sympathetic ganglions were performed on cases in which vascular disturbance of the spinal cord was considered partly responsible. Block was performed in 14 cases and clinical improvement was seen in 10 cases out of them while resection was considered effective in 2 out of 3 cases. The evoked EMG of patients was assumed recovery of a part of synaptic function in the ischemic cord after the block. On the other hand, the skin temperature of the lower extremity did not show considerable change and this supports the view that the restoration of clinical picture was not due to the improvement of the periphral circulation of extremities. From these observations, it would be well presumed that favorable effect of sympathectomy consists partly in the improvement of vascular disturbance of the spinal cord.
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ranking = 3.502563168615
keywords = upper
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8/280. Pringle's maneuver lasting 322 min.

    Up to now, the reported limit of 'continuous' Pringle's maneuver during hepatectomy has not exceeded 127 min. Here we used 'intermittent' clamping to increase the cumulative time of safe ischemia. A 49 year-old man who had undergone jejunal resection because of leiomyosarcoma was referred with 18 hepatic metastases. Using 'intermittent' Pringle's maneuver, enucleation of the entire tumor was performed. The cumulative ischemic time of the liver was 322 min, but post-operative serum level total bilirubin remained normal. The patient was discharged on day 24 without any complications, remaining well for up to 5 months after surgery. The present case shows that the safe upper limit of cumulative hepatic ischemia can be extended to 322 min.
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ranking = 3.502563168615
keywords = upper
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9/280. ergotamine-induced intermittent claudication.

    We report about a female patient with intermittent claudication caused by ergotamine. She used ergotamine as a treatment for migraine headaches for more than 4 years. The claudication began 7 month before admission. Colour Doppler sonography and angiography showed severe stenosis of the left external iliac and superficial femoral artery. The patient was treated with phenprocoumon for one year after withdrawal of ergotamine. After that the superficial femoral stenosis disappeared completely, but the external iliac stenosis was still present and was consequently successfully treated by atherectomy. The histology showed a fibrosis of the intima and a hypertrophy of the media.
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ranking = 0.3595608086741
keywords = headache
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10/280. Type I acute aortic dissection accompanied by ischemic enterocolitis due to blood flow insufficiency in the superior mesenteric artery.

    We report a case of acute type I aortic dissection with ischemic enterocolitis due to blood flow insufficiency in the superior mesenteric artery. The patient was a 52-year-old man who visited the hospital with major complaints of sudden low back pain and melena. Mesenteric ischemia was suspected, and angiography revealed type I aortic dissection with accompanying blood flow insufficiency in the superior mesenteric artery. Because catheterization during angiography improved the blood flow disorder and prevented intestinal necrosis, it was possible to replace the ascending aorta with a prosthetic graft. Arterial pulsation in the mesentery was recovered by the operation and the patient's life was saved without bowel resection. This case demonstrates that prompt surgical or percutaneous relief of ischemia in major organs is important to save lives in the cases of acute aortic dissection with ischemic complications.
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ranking = 1
keywords = back pain, back
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