1/290. 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.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
2/290. 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.- - - - - - - - - - ranking = 0.6keywords = lower (Clic here for more details about this article) |
3/290. 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.- - - - - - - - - - ranking = 0.2keywords = lower (Clic here for more details about this article) |
4/290. Acute ischemia of the lower limb. An unusual complication of Paget's disease of bone.Paget's disease of bone (osteitis deformans) is one of the most common skeletal diseases, characterised by bone distortion and the loss of interior structure. Asymptomatic evolution is usual, so diagnosis is likely to be made only when complications of the disease appear. This paper describes such a diagnosis made in a patient with acute lower limb ischemia caused by the compression of the superficial femoral artery between the adductor muscles and an exostosis of the femur.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
5/290. hyperhomocysteinemia, aortic thrombus, and peripheral arterial emboli--a case report.A young Native American woman presented with ischemia of the left lower limb resulting from embolic occlusion of the left common iliac artery and left femoral artery. The source of her emboli was aortic thrombus. The only underlying abnormality responsible for her hypercoagulability appeared to be hyperhomocysteinemia.- - - - - - - - - - ranking = 0.2keywords = lower (Clic here for more details about this article) |
6/290. An unusual peripheral vascular response to dopamine in a neonate.We report a case of a neonate who developed hypotension immediately after birth, and needed dopamine infusion to sustain his blood pressure and tissue perfusion. He developed cyanosis of his extremity immediately after dopamine was started via peripheral line and improved spontaneously after dopamine was stopped. This happened repeatedly at various sites and at lower concentrations of dopamine. Subsequently, dopamine was replaced by dobutamine and the patient did well. We conclude that some neonates can show heightened alpha-adrenergic response to dopamine and this can lead to ischemic vascular events. dopamine infusion in neonates should be started at a low-dose via central line.- - - - - - - - - - ranking = 0.2keywords = lower (Clic here for more details about this article) |
7/290. Embolization of a spinal arteriovenous malformation: correlation between motor evoked potentials and angiographic findings: technical case report.OBJECTIVE AND IMPORTANCE: endovascular procedures for the treatment of spinal arteriovenous malformations place the spinal cord at risk of ischemia. This report illustrates the usefulness of motor evoked potentials (MEPs) in detecting functional changes within the spinal cord motor pathways during embolization of a spinal arteriovenous malformation under general anesthesia. CLINICAL PRESENTATION: A 28-year-old man presented with a history of progressive lower extremity numbness and weakness followed by bladder dysfunction. magnetic resonance imaging and angiography disclosed a T11-T12 spinal arteriovenous malformation. INTERVENTION: During the endovascular procedure, before injection of particles, the disappearance of MEPs from the tibialis anterior muscle led to prompt angiographic reevaluation, which disclosed the arrest of spinal blood flow secondary to radiculomedullary artery occlusion by the catheter. Embolization and catheter withdrawal were followed by temporary recovery of spinal blood flow and MEPs. A second arrest of spinal cord blood flow, caused by severe vasospasm of the feeding radiculomedullary artery, was documented by a control angiogram, and its functional relevance was revealed by a second disappearance of MEPs. The therapeutic effect of papaverine infusion and induced moderate hypertension was confirmed angiographically by complete reopacification of the anterior spinal artery and confirmed neurophysiologically by the complete recovery of MEPs. At the end of the procedure, no additional neurological deficits were noted. CONCLUSION: During spinal cord embolization, MEPs may play a critical role in early detection of spinal cord dysfunction by aiding in the prevention of damage to the spinal cord as well as by predicting the clinical outcome.- - - - - - - - - - ranking = 0.2keywords = lower (Clic here for more details about this article) |
8/290. Arterial occlusion and thrombus aspiration after total knee arthroplasty.Arterial occlusion after total knee arthroplasty is an uncommon complication. In the literature only a few cases have been reported, and non consensus exists on the optimal management for this condition. The authors report two patients with popliteal artery thrombosis in the early postoperative period. Both patients were treated with percutaneous thrombus aspiration, a technique that has not been reported previously for this indication. In both patients complete restoration of arterial perfusion and limb salvage was achieved, although ischemic necrosis of the anterior compartment muscles of the lower leg could not be prevented.- - - - - - - - - - ranking = 0.2keywords = lower (Clic here for more details about this article) |
9/290. Isolated infarction of the cecum: CT findings in two patients.Colonic ischemia isolated to the cecum is a rare entity. The authors evaluated two patients who underwent computed tomography (CT) because appendicitis was suspected at clinical examination. CT findings were suggestive of isolated cecal ischemia or infarction. Surgical-histopathologic findings helped confirm the presumptive CT diagnoses. Isolated cecal infarction should be included in the differential diagnosis of acute right lower quadrant pain.- - - - - - - - - - ranking = 0.2keywords = lower (Clic here for more details about this article) |
10/290. Internal mammary artery perfusing Leriche's syndrome in association with significant coronary arteriosclerosis: four case reports and review of literature.Four cases of collateral perfusion of a lower extremity by way of an internal mammary artery in the presence of Leriche's syndrome are described. Angiographic documentation preceding coronary artery bypass grafting prevented an acutely ischemic leg in two of the cases.- - - - - - - - - - ranking = 0.2keywords = lower (Clic here for more details about this article) |
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