11/290. Insidious symptomatology and misleading physical findings in popliteal artery entrapment syndrome. A case report.A patient presented with an ischemic right forefoot. She suffered rest pain but had relief on walking and on flexing her leg. Popliteal and pedal pulses were palpable. The underlying condition was popliteal artery entrapment. Compression of the popliteal artery occurred with extension of the knee and additional contraction of the gastrocnemius muscles only and was released with flexion. Distal embolizations into all three lower leg arteries had caused acute ischemia. As the emboli had travelled through both tibial vessels very distally pedal pulses were found to be normal. Treatment was operatively by resection of a tiny lateral portion of the medial gastrocnemic tendon which crossed the artery dorsally as the vessel pierced the tendon.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
12/290. Aorto-iliac steal syndrome. A rare case of renal hypoperfusion.In aorto-iliac occlusive disease a diversion of blood flow from visceral arteries to lower limbs rarely occurs. This condition is known as aorto-iliac steal syndrome. This report is about the case of a male patient affected by chronic atherosclerotic occlusion of the aorta associated with an aorto-iliac steal supported by an anomalous vessel coming from the left renal artery to the homolateral external iliac artery to the detriment of the renal blood flow. Renal sequential scintiscan (RSS) at rest and after stress test was employed to assess renal blood flow and excretory functions before and after an aorto-bifemoral bypass. Surgical revascularization permitted reversal of the steal phenomenon and the improvement of left renal blood flow.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
13/290. Femorofemoral bypass, even in pregnancy--a case report.A 29-year-old pregnant woman sustained blunt, left lower abdominal trauma, with hip and pelvic fractures, and progressive dissection of an intimal flap in the left iliac artery, which manifested two days later as profound ischemia of the left leg. The patient underwent distal thromboembolectomy, fasciotomies and revascularization of the leg by femorofemoral polytetrafluoroethylene bypass. The patient recovered completely and gave normal birth three months later to a healthy child. Four years after the operation she gave uneventful birth to another child. Various considerations pertinent to this complex traumatic-vascular-gestational state are discussed.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
14/290. prothrombin gene 20210 G-->A and factor v Arg 506 to Gln mutation in a patient with Buerger's disease--a case report.thromboangiitis obliterans, or Buerger's disease, is a segmental occlusive inflammatory disorder of the arteries and veins most commonly affecting the lower extremities of young male cigarette smokers. The etiopathogenesis of the thromboangiitis obliterans is still obscure. The authors have identified heterozygosity for the recently described prothrombin gene 20210 G-->A variation and factor v Arg 506 to Gln (factor v Leiden) mutation in a patient with Buerger's disease. Both mutations confer a high risk of thrombosis. This coincidental observation may serve as further evidence that a thrombotic mechanism is involved in Buerger's disease.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
15/290. Chronic ergot toxicity: A rare cause of lower extremity ischemia.Chronic ergot toxicity is a rare cause of lower extremity ischemia. The cornerstone of therapy in ergot toxicity is to discontinue the use of caffeine, cigarettes, and all ergot-containing medications. Although multiple different therapies have been recommended for acute toxicity, no specific treatment is uniformly recommended in chronic toxicity. We present a case of long-term ergot use for migraine headaches in a woman who had severe chronic lower extremity claudication. This case demonstrates the unique features associated with the diagnosis and management of chronic ergot toxicity. We recommend a conservative approach consisting of observation, antiplatelet agents, and the discontinuance of ergots. If symptoms progress to rest pain or gangrene, surgical treatment should be considered.- - - - - - - - - - ranking = 6keywords = lower (Clic here for more details about this article) |
16/290. Recurrent peripheral arterial embolism from pulmonary cancer. Case report and review of the literature.Peripheral arterial embolism arising from a malignant tumour is an infrequent manifestation of neoplastic disease and also a rare cause of acute arterial occlusion. A case of recurrent arterial embolism of the lower extremities due to a primary lung cancer is reported and the literature on this topic is reviewed.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
17/290. Transmural necrosis of the esophagus secondary to acute aortic dissection.A case of transmural ischemic necrosis of the esophagus secondary to aortic dissection is presented. A 66-year-old woman with acute type A aortic dissection underwent total arch replacement with a technique of deep hypothermic arrest and retrograde cerebral perfusion. Postoperatively she had hematemesis, and endoscopic examination revealed circumferential mucosal necrosis and desquamation of the lower esophagus. She died of multiple organ failure on postoperative day 74. autopsy demonstrated transmural necrosis of the esophagus secondary to ischemia. ischemia of the esophagus secondary to aortic dissection is extremely rare.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
18/290. Salvage of an ischaemic lower limb and a free flap with an arterial Y-graft. Case report.A defect of the lower limb was treated with a scapular free flap. An end-to-side anastomosis was made to the posterior tibial artery, which was the single perfusing artery of the foot. When it thrombosed, the problem was solved successfully with an arterial Y-graft.- - - - - - - - - - ranking = 5keywords = lower (Clic here for more details about this article) |
19/290. Percutaneous balloon fenestration in a case of traumatic abdominal aortic dissection with lower extremity ischemia.A 38-year-old man was involved in a traffic accident and experienced a heavy blow to the abdomen. He had traumatic abdominal aortic dissection with right lower extremity ischemia. He underwent percutaneous balloon fenestration, which is safe and minimally invasive, for relief of right lower extremity ischemia. He has been working for 2 years without any signs of vascular compromise. Percutaneous balloon fenestration is one of the few treatments for traumatic abdominal aortic dissection.- - - - - - - - - - ranking = 6keywords = lower (Clic here for more details about this article) |
20/290. Combined minimaly invasive surgery for coronary bypass and abdominal aortic occlusion.association of extracorporal assisted coronary bypass with peripheral vascular surgery is already commonplace in the therapeutic arsenal. This case report presents a combined cardiac and vascular surgery in a high risk patient, with unstable angina following myocardial infarction and critical ischemia of a single lower limb. Synchronous minimally invasive direct coronary bypass graft and extra-anatomic aorto-profundal bypass in one single sitting were performed. The procedure was successful at 6 months follow up. We believe that this type of synchronous procedure, minimising surgical aggression, could be effective in selected high risk patients.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
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