1/48. Abdominal pulsatile tumor after endovascular abdominal aortic aneurysm repair.A 70 years old patient was successfully treated for infrarenal aortic aneurysm by an endovascular bifurcated prosthesis. Three months later, because of dysuria, he underwent urological examination revealing an abdominal pulsatile tumor. Thereafter, the patient was sent to our emergency ward with suspected symptomatical endoleak. Radiological screening by computer tomography and magnetic resonance angiography showed good post-operative results without endoleak. Patient was treated with antispasmodic medication and is doing well today. Because endovascular repair of aortic aneurysm, in contrast to an open approach, does not eliminate the aneurysm itself, post-operative abdominal palpation can be ambiguous. magnetic resonance angiography--without the need of nephrotoxic contrast medium--compares favourably to CT and provides excellent pictures with less artefacts for post-operative screening of endoleak. If reperfusion can be excluded, pulsation is due to the transmission of the blood-pressure wave to the thrombosed aneurysm.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/48. Transient dysfunction of the freestyle stentless xenograft.After replacement of a bicuspid aortic valve with a Freestyle stentless xenograft, right coronary leaflet dysfunction and an elevated pressure gradient developed. Attempts to match the right and left ostia of the prosthesis, which were located at an angle of less than 120 degrees, to the native right and left ostia, which were located at 180 degrees, may have resulted in the leaflet distension. This is a suggestive finding about its implantation technique.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/48. Late spontaneous extrusion of a texturized silicone gel mammary implant.A case report of late spontaneous extrusion of a 250-cm(3), round, texturized silicone gel mammary implant, 14 months after implantation, is presented. The irregular surface of the implant, the location of the implant pocket, and the absence of the fibrous capsule were responsible for alterations in the skin thickness. In addition, the pressure exerted by the implant against the skin provides for stasis with venous thrombosis at the inferior portion of the breast. The continuous manipulation of the breast over a thin skin with vascular alterations led to the skin perforation with implant extrusion.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/48. Symptomatic calcific stenosis of a Toronto stentless porcine valve.We describe the calcific structural failure of a Toronto stentless porcine valve (TSPV) which had been used to replace a calcified bicuspid aortic valve in a 46-year-old man. Against expectations, left ventricular hypertrophy persisted and the transvalvular pressure gradient rose to 125 mmHg by 6 years with the patient becoming symptomatic and requiring redo surgery. On removal the TSPV showed atypical calcification of the leaflet hinges and wall. To our knowledge this is the first case reported and it may have implications for long term durability and future surgery using this prosthesis.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/48. Endotension: an explanation for continued AAA growth after successful endoluminal repair.PURPOSE: To present and analyze several cases that illustrate persistent sac pressurization following endovascular abdominal aortic aneurysm (AAA) repair. methods AND RESULTS: Four patients with successful endovascular AAA exclusion presented in follow-up with an expanding aneurysm. Two had initial sac diameter decrease, but by 18 and 24 months, respectively, the AAA had enlarged and become pulsatile. There was no endoleak evident, but the proximal attachment stents had mig rated distally in both cases. One patient developed endoleak with aneurysm expansion at 6 months; contained rupture occurred at 12 months. The last case had slowly evolving aneurysm expansion over 36 months but no endoleak. All endografts were removed and successfully replaced with conventional grafts. Intrasac thrombus was implicated as the means of pressure transmission that precipitated AAA expansion in these cases. CONCLUSIONS: Excluded AAAs can increase in size owing to persistent or recurrent pressurization (endotension) of the sac even when there is no evidence of endoleak. One proposed mechanism is pressure transmission via thrombus that lines the attachment site. Endotension may also represent an indiscernible, very low flow endoleak that allows blood to clot at the source of leakage.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
6/48. When is an aortic valve prosthesis too small? The need for dobutamine stress echocardiography.We describe a patient who had undergone aortic valve replacement with a small prosthesis 10 years previously and who presented with exertional breathlessness. The resting transaortic pressure gradient was only 30 mmHg but increased to 165 mmHg on dobutamine stress. Conventional resting echocardiography may fail to demonstrate abnormal prosthetic aortic valve function; in the presence of symptoms, dobutamine stress echocardiography should be considered.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/48. Stent recanalization of chronic portal vein occlusion in a child.An 8-year-old boy with a 21/2 year history of portal hypertension and repeated bleedings from esophageal varices, was referred for treatment. The 3.5-cm-long occlusion of the portal vein was passed and the channel created was stabilized with a balloon-expandable stent; a portosystemic stent-shunt was also created. The portosystemic shunt closed spontaneously within 1 month, while the recanalized segment of the portal vein remained open. The pressure gradient between the intrahepatic and extrahepatic portal vein branches dropped from 17 mmHg to 0 mmHg. The pressure in the portal vein dropped from 30 mmHg to 17 mmHg and the bleedings stopped. The next dilation of the stent was performed 12 months later due to an increased pressure gradient; the gastroesophageal varices disappeared completely. Further dilation of the stent was planned after 2, 4, and 6 years.- - - - - - - - - - ranking = 3keywords = pressure (Clic here for more details about this article) |
8/48. Malfunction of a unipolar pacemaker system following development of marked subcutaneous emphysema.Failure of a unipolar pacemaker system due to subcutaneous emphysema is a rare but potentially life-threatening complication after implantation. We report on a pacemaker dysfunction observed three days after implantation in a 91-year-old patient following development of marked subcutaneous emphysema. Function was immediately restored following application of pressure bandages and the condition resolved within a few days.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/48. Motility disturbance due to true Tenon cyst in a child with a Baerveldt glaucoma drainage implant.Epithelial ingrowth of the bleb cavity, a true Tenon cyst, is a rare complication of a glaucoma drainage implant. Previous cases have been associated with persistent bleb leak, and most have occurred in eyes with prior extraocular surgery. We describe a case of a true Tenon cyst causing strabismus and an elevated intraocular pressure that was successfully treated by surgical revision.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/48. vitrectomy to remove a posteriorly dislocated endocapsular tension ring.We treated a patient who had a posteriorly dislocated endocapsular ring associated with decreased vision and intravitreal cortical remnants. The ring was removed by uneventful pars plana vitrectomy. By the last examination, best corrected visual acuity had improved to 6/12 and intraocular pressure had stabilized to within normal limits. A posteriorly dislocated endocapsular ring is a rare complication of cataract surgery. Its removal by pars plana vitrectomy under direct observation is effective and safe.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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