1/21. Cutaneous manifestation of left atrial myxoma.A 53-year-old woman had a left hemiplegia with suspicion of cerebral metastases. Thoracic and abdominal computed tomography revealed renal and splenic infarction features and she presented violaceous papulosis on her fingers corresponding to thrombosis of dermal vessels. echocardiography showed a left atrial tumor evoking myxoma. The clinical features of left atrial myxomas are intracardiac obstruction, extracardiac embolism and general symptoms. Cutaneous manifestations are frequently reported and can correspond to cutaneous manifestations of emboli, symptoms related to auto-immune disorders and specific cutaneous findings that suggest atrial myxoma as part of more complex syndromes.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/21. Cerebral air emboli from angiography in a patient with stroke. A case report.A 42-year-old woman with subarachnoid and intracerebral hemorrhage was investigated with diagnostic angiography, disclosing an occlusion of the left internal carotid artery and the middle cerebral artery. CT examination immediately after the angiography revealed a 12-h-old infarct of the left middle cerebral artery territory. There was also gas in the arteries supplying the infarcted part of the brain, but not in other vessels. air had most probably been introduced during the angiography and had consequently been "trapped" in the cortical arteries of the ischemic brain. In the non-ischemic parts of the brain air may have passed through the vessels leaving no trace.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
3/21. Vascular tumors simulating occlusive disease.Two cases of vascular tumors of large vessels with intraluminal growth simulating venous thrombosis and arterial occlusive disease are reported. One was a borderline malignant epithelioid hemangioendothelioma of the femoral vein and the other a malignant epithelioid angiosarcoma of the carotid artery. Immunohistochemical studies permitted to classify the tumors. Treatment consisted in surgical resection. No recurrence and no metastasis are noted at 24 months. uncertainty regarding biological behaviour of vascular tumors and treatment persists.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/21. Use of glycoprotein IIb-IIIa inhibitor for a thromboembolic complication during Guglielmi detachable coil treatment of an acutely ruptured aneurysm.Thrombotic occlusion of the anterior communicating and right anterior cerebral arteries occurred during embolization of an acutely ruptured aneurysm of the anterior communicating artery. Traditional management, including superselective infusion of a fibrinolytic agent, was unsuccessful in reestablishing normal vessel patency. Therefore, an intravenous dose of abciximab was administered. Serial angiography showed that normal vessel patency was reestablished within 10 min. There were no adverse events related to abciximab administration, and the patient recovered from the procedure without neurologic deficit.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
5/21. diagnosis of esophageal carcinoma because of findings on transesophageal echocardiography.A patient in whom transesophageal echocardiography was performed to evaluate a possible source of cerebral embolization. The fact that the probe could not be passed easily beyond 35 cm from the incisors suggested esophageal obstruction or compression. A mass was seen posterior to the left atrium that was heterogenous and contained blood vessels, suggesting a malignancy. There were no complications of the procedure. Esophageal adenocarcinoma was confirmed on biopsy. Transesophageal echocardiography may be diagnostic of paracardiac mediastinal masses, both benign and malignant. Great care must be taken if passage of the probe through the esophagus is met with resistance, to avoid serious complications.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/21. Small aneurysms as a cause of thromboembolic stroke.OBJECTIVE AND IMPORTANCE: A small percentage of patients with intracranial aneurysms present with embolic stroke distal to the site of the aneurysm. thromboembolism typically occurs in large or giant aneurysms where reduction of flow within the aneurysm is thought to increase the possibility of clot formation. Only a few examples are available in the literature of patients with smaller aneurysms who develop embolic infarction distal to the lesion. We have experience with two such patients with an apparent common pathophysiology. CLINICAL PRESENTATION: Patient 1 with a distal left middle cerebral artery infarct was found to have an 18 mm carotid artery bifurcation aneurysm (patient age 49 years). Patient 2 had a 7 mm right middle cerebral artery aneurysm with a small distal embolus (patient age 65 years). At surgery both patients were found to have atherosclerotic disease involving the aneurysm base and parent vessel. In each instance, the aneurysm was opened during temporary vessel occlusion and microendarterectomy was performed. Occlusion of one of the major arterial branches exiting the aneurysm was also present with anterior cerebral artery occlusion in the case of ICA bifurcation lesion and MCA branch occlusion in the case of the MCA aneurysm. Both patients made a good recovery following surgery. CONCLUSION: In small aneurysms with atherosclerotic disease distal thromboembolism may occur. Surgical treatment with microendarterectomy is appropriate to prevent further emboli and potential for subarachnoid hemorrhage. (Fig. 5, Ref. 16.)- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
7/21. Pleuropulmonary blastoma with a large embolic cerebral infarct.We report on a 3-year-old girl who developed a large embolic cerebral infarct 1 day after an uneventful thoracotomy to remove a large pleuropulmonary blastoma. The tumour had encased the heart and great vessels and ruptured into the left hemithorax. Pleuropulmonary blastoma is a rare, but unique, primary thoracic neoplasm in young children and, to our knowledge, the development of a secondary large embolic cerebral infarct is also uncommon and has not been reported in this tumour.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/21. Acute vasogenic edema induced by thrombosis of a giant intracranial aneurysm: a cause of pseudostroke after therapeutic occlusion of the parent vessel.A 16-year-old male adolescent presenting with acute retro-orbital pain underwent emergent internal carotid occlusion for a giant cavernous aneurysm. Three weeks later, the patient complained of headache and right hemiparesis, which suggested an acute stroke. CT and MR imaging revealed vasogenic brain edema without infarct. The symptoms rapidly resolved with steroid therapy. Follow-up CT showed resolution of the edema. The imaging characteristics, clinical implications, and etiology of vasogenic edema occurring after thrombosis of a giant intracranial aneurysm are discussed.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |
9/21. Endovascular management of symptomatic vertebral artery dissection achieved using stent angioplasty and emboli protection device.Extracranial vertebral artery (VA) dissection may lead to significant arterial stenosis, occlusion, or pseudoaneurysm formation with subsequent hemodynamic and embolic infarcts. To prevent thromboembolic complications, anticoagulation with intravenous heparin followed by oral warfarin has been recommended for all patients with acute dissections, regardless of the type of symptoms, unless there are contra-indications. Nevertheless, anticoagulation is not innocuous, may be contra-indicated or may be ineffective to prevent symptoms or dissection progression. Because it is effective and less invasive than other surgical procedures, endovascular treatment of VA dissection has recently attracted interest. We present a case of a traumatic VA dissection, presenting with multiple embolic infarctions that was managed with protected stent-assisted angioplasty. Protected stent-assisted VA angioplasty has not been previously reported and appears to be a safe, effective and immediate method of restoring vessel lumen integrity and should be considered in the therapy of selected cases of VA dissection.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/21. Choice of protection devices in carotid angioplasty. Two case reports.patient selection is of the utmost importance with all endovascular procedures. It is equally important to select the appropriate protection device during carotid angioplasty/stenting (CAS). CAS in two patients was unsuccessful due to the chosen protection device. Occlusion of the external carotid artery while deploying a Parodi Anti-Embolic-System Device (PAEC - ArteriA) resulted in cerebral ischaemia. Conversion to the Angioguard System (Cordis) made carotid angioplasty possible, but was complicated by thrombosis of the filter. In the second case it was impossible to negotiate tortuous vessels with the Angioguard system. Our experience illustrates that both devices have limitations. Choosing the wrong device may have serious consequences.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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