1/79. Cerebral and renal embolization after lymphography in a patient with non-Hodgkin lymphoma: case report.An unusual case of lipid embolization to brain and kidney after lymphography in a patient with non-Hodgkin lymphoma of the upper anterior mediastinum is reported. Contrast material-enhanced echocardiography demonstrated a right-to-left shunt to the left atrium without evidence of a patent foramen ovale. Echo contrast particles were transiently present within the tumor surrounding the great vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/79. Acute neoplastic arterial embolism after pneumonectomy.Intra-arterial tumour embolism after pneumonectomy is a known but rare complication. It arises because of tumour involvement of pulmonary veins. Usual outcome of this complication is grave when embolism is to a major vessel. If embolism occurs in a peripheral circulation, timely intervention can avoid significant morbidity. We report a case where embolisation occurred in both the femoral arteries. Emergency embolectomy was done successfully avoiding major complication.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/79. Disseminated intravascular meconium in a newborn with meconium peritonitis.A 3-day-old premature infant with meconium peritonitis, periventricular leukomalacia, and pulmonary hypertension died with respiratory insufficiency. An autopsy disclosed intravascular squamous cells in the lungs, brain, liver, pancreas, and kidneys. Numerous pulmonary capillaries and arterioles were occluded by squamous cells, accounting for pulmonary hypertension. brain parenchyma surrounding occluded cerebral vessels showed infarct and gliosis. A mediastinal lymph node filled with squamous cells alluded to the mechanism by which these cells from the peritoneal cavity likely entered the bloodstream--namely, via diaphragmatic pores connecting with lymphatics. Thus, disseminated intravascular meconium rarely may complicate meconium peritonitis and have devastating consequences.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/79. Ultrastructural changes in a case of mucoid degeneration of the brachial artery.An electron microscopic (EM) description of mucoid degeneration of the brachial artery in a 67 year old man is presented. In this case, the affected artery showed mucoid degeneration of the intima and media circumferentially, dissecting and destroying the muscle fibres. Ultrastructurally, mucoid degenerating muscle cells showed numerous large mucin-containing vesicles in the cytoplasm. Cells were widely separated by large accumulation of mucoid material, which appeared to penetrate the extracellular collagen fibre bundles. Most of the nuclei of the smooth muscle cells displayed typical necrotic changes undergoing dissolution or having already broken up into discrete fragments. This case of intimo-medial degeneration (IMMD) suggests that the condition could arise spontaneously anywhere in the inner coats of the arterial system away from the vessels that are close to synovial joints. This is a rare presentation of IMMD of arteries, which has been described mainly in the aorta and its major branches.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/79. Asymptomatic unilateral microembolic retinopathy secondary to percutaneous transluminal coronary angioplasty.BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA) for the treatment of coronary artery disease has increased in frequency as technological advances have made the procedure more effective and cost-efficient. In spite of the number of procedures that have been performed, ocular complications have rarely been reported. CASE REPORT: A case of asymptomatic unilateral microembolic retinopathy one month after PTCA is presented. Embolic events to the retinal circulation and their relationship to invasive cardiac procedures is discussed. CONCLUSIONS: The embolic ocular complications of PTCA is probably underestimated due to the lack of symptoms from the partial occlusion of the larger retinal arteries and the total occlusion of the remote smaller vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/79. Staged thoracic and abdominal aortic aneurysm repair using stent graft technology and surgery in a patient with acute renal failure.A 52-year-old male presented with severe hypertension and acute renal failure. carbon dioxide (CO(2)) angiography identified a saccular thoracic aortic aneurysm, right renal artery stenosis, left renal artery occlusion, an infrarenal aortic aneurysm, celiac artery, and inferior mesenteric artery (IMA) orificial stenoses. Via an anterior retroperitoneal approach, bilateral renal artery thromboendarterectomy, infrarenal aortic aneurysmectomy, and IMA reimplantation were performed. The patient's tortuous iliac arteries were straightened to permit future passage of a thoracic stent graft by mobilizing the aortic bifurcation and anastomosing it to a Dacron graft within 4 cm of the renal vessels. Two weeks later, a stent graft was placed via a femoral incision utilizing CO(2) angiography, successfully excluding the saccular thoracic aneurysm. Recovery from both procedures was quick, with rapid return of renal function, and alleviation of the hypertension. At 8 months follow-up, his renal arteries and aorta are patent.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/79. Peripheral arterial embolization: Doppler ultrasound scan diagnosis.Use of intraoperative monitoring with transcranial Doppler scanning during carotid endarterectomy has enabled identification of embolus signals in the ultrasound spectrum. Extension of this technique to preoperative screening has enabled identification of actively embolizing lesions and correlation with neurologic deficits. We report embolus signals in the peripheral circulation before operation, which aided diagnosis and decision to operate. The patient had been transferred from another institution after multiple revascularization procedures, including posterior tibial artery thrombectomy. Angiography performed on arrival at our institution confirmed an open bypass graft, although a small indentation was noted at the site of the previous posterior tibial artery thrombectomy. Runoff was intact to the plantar arch where there was attenuation of that vessel and occlusion of most digital branches. Duplex monitoring revealed no embolic signals in the graft or in the posterior tibial artery proximal to the previous arteriotomy. Distal to this site, embolic signals were detected. At the time of operation, a large platelet thrombus was identified at the site of the previous arteriotomy, and platelet thrombus was obtained from the plantar artery. It is concluded that doppler ultrasound scanning enables detection of peripheral embolization and the identification and location of lesions with such embolic activity. Diagnostic accuracy may be improved when there is clinical suspicion of embolization, enabling better patient selection for surgical procedures. This report provides the first clinicopathologic characterization of the emboli detected.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/79. 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 = 2keywords = vessel (Clic here for more details about this article) |
9/79. Ocular massage in a case of central retinal artery occlusion the successful treatment of a hitherto undescribed type of embolism.BACKGROUND: The pathogenesis of central retinal artery occlusions (CRAO) varies, depending upon the underlying disease. An embolic origin of an occlusion often occurs. PATIENT AND methods: A 50-year-old man with an occlusion of the left internal carotid artery was examined because of a left central retinal artery occlusion. fluorescein angiography revealed that in no blood vessel could any circulation of blood be demonstrated. The slight vascular filling with dye mainly came from collateral circulation at the disc. RESULTS: Ocular massage was carried out. After a delay of several minutes, the vessels of the fundus became increasingly filled with blood. The patient noticed continuing recovery in the vision of his left eye. During fluorescein angiography, carried out one day later, white embolic clots appeared in the arteries of the papilla, some of them moving with the velocity of the blood flow through the retinal vessels and reaching the periphery of the retina and immediately disappearing. Others moved more slowly. This was seen repeatedly over several minutes. CONCLUSIONS: In this patient we have recorded in a fluorescein angiogram bright boluses visible in the blood of the retinal arteries. We suggest that conglomerations of blood cells can also cause an obstruction of blood flow. The observation of this kind of bright clots (boluses) visible in the blood of the retinal arteries we did not find described in the literature. In such a situation ocular massage is extremely helpful. Therefore, ocular massage should be carried out in every patient with CRAO.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
10/79. Embolized ischemic lesions of toes in an afibrinogenemic patient: possible relevance to in vivo circulating thrombin.Fibrinogen plays a complex role in hemostasis, thrombosis, and vascular disease. Hyperfibrinogenemia is an independent vascular risk factor and dysfibrinogenemia can provoke thrombosis. afibrinogenemia is usually responsible for hemorrhagic diathesis, and unexpected ischemic lesions are intriguing. We report the case of an afibrinogenemic patient, who at the age of 30 developed ischemic lesions of the feet related to severe stenosis of the iliac and hypogastric arteries. The biopsy of the iliac artery lesion showed an intense myointimal hyperplasia. We performed standard hemostatic analysis and analyzed the activation markers of platelets and coagulation factors and the kinetics of thrombin generation in the patient and in normal control plasmas treated or not with reptilase. Occlusive arterial lesions were attributed to a disruptive hematoma penetrating the vascular lumen. Thrombin concentration after calcium addition increase markedly in the afibrinogenemic patient and in defibrinated normal plasma, as compared to untreated normal plasma. Thrombin-antithrombin complexes (T-AT) were markedly enhanced while F1 2 prothrombin fragments stayed in the normal range. These results suggested activation of coagulation and in vivo circulating thrombin. Thrombin activates the platelets that secrete growth factors for smooth muscle cells and generate the intimal hyperplasia. Recurrent hemorrhage within the vessel wall might induce injury and local thrombin generation. Thrombin not trapped by the clot is available for platelet activation and smooth muscle cell migration and proliferation. The absence of a protective fibrin cap on the intima might account for intima vulnerability and embolization. afibrinogenemia appears in this paradoxical situation as a vascular risk factor.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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