scholarly journals Endovascular management of giant visceral artery aneurysms

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marcello Andrea Tipaldi ◽  
Miltiadis Krokidis ◽  
Gianluigi Orgera ◽  
Matteo Pignatelli ◽  
Edoardo Ronconi ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Clinical Success ◽  
Splenic Abscess ◽  
Visceral Artery ◽  
Complete Relief ◽  
Endovascular Management ◽  
Visceral Artery Aneurysms ◽  
Long Term Follow Up

AbstractEndovascular management of small visceral artery aneurysms is an established treatment with satisfactory outcomes. However, when size exceeds 5 cm visceral aneurysms are considered as “giant” (giant visceral artery aneurysms or GVAAs) and management is significantly more complex. Between August 2007 and June 2019 eleven cases of GVAAs that were endovascularly treated were retrospectively reviewed and included in this single center study. Mean size was 80 mm (± 26.3 mm) x 46 mm (+ \-11.8 mm). Nine of the lesions were true aneurysms, and two were pseudoaneurysms. In 8 patients, the lesion was causing compression symptoms in the surrounding organs, one patient developed a contained rupture while 2 patients were completely asymptomatic. However, all patients were hemodynamically stable at the time of treatment. Technical success was defined as immediate complete exclusion of the aneurysmal sac, and clinical success as complete relief from clinical symptoms. Follow-up was performed with CT angiography, ultrasound and clinical examination. Mean follow-up was 45 months (range 6–84). Technical and clinical success were both 91%. Complications were one lack of control of contained rupture that was subsequently operated, one case of self-limiting non-target spleen embolization and one case of splenic abscess. Three patients died, one due to the contained rupture 15 days after procedure, the other two for other causes and occurred during the long-term follow-up. This series suggests that endovascular treatment of giant visceral artery aneurysms and pseudoaneuryms is a valid minimally invasive solution with very satisfactory immediate and long-term outcomes unless the aneurysm is already ruptured. A variety of endovascular tools may be required for successful treatment.

Endovascular Exclusion of Visceral Artery Aneurysms with Stent-Grafts: Technique and Long-Term Follow-up

2007 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Michele Rossi ◽  
Alberto Rebonato ◽  
Laura Greco ◽  
Michele Citone ◽  
Vincenzo David
Keyword(s):  
Visceral Artery ◽  
Stent Grafts ◽  
Visceral Artery Aneurysms ◽  
Long Term Follow Up

Tubercular Abscess of the Spleen in a Child: Conservative Management and Long-Term Follow-Up

2017 ◽  
Vol 13 (04) ◽  
pp. 316-318
Author(s):  
Vijai Williams ◽  
Sarvanan Chandrasekaran ◽  
Keerthivasan Seetharaman ◽  
Kushaljit Sodhi ◽  
Devi Dayal
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Splenic Abscess ◽  
Complete Healing ◽  
Rare Occurrence ◽  
Line Probe Assay ◽  
Rare Manifestation ◽  
Long Term Follow Up ◽  
Probe Assay

AbstractIsolated involvement of the spleen is a rare manifestation of childhood tuberculosis. The rare occurrence and presence of nonspecific clinical features often pose diagnostic challenges even in countries where tuberculosis is endemic. Splenectomy is often performed for establishing the diagnosis or achieving a cure in combination with antitubercular therapy (ATT). In this report, we describe a boy who presented with nonspecific symptoms and was detected to have a well-defined lesion in the spleen on ultrasonography. The diagnosis of tubercular splenic abscess was made after line probe assay for the detection of Mycobacterium tuberculosis and cytomorphology of the aspirated material. The tubercular abscess showed complete healing after 9 months of four-drug ATT.

Vestibular migraine: Long-term follow-up of clinical symptoms and vestibulo-cochlear findings

Neurology ◽  
2012 ◽  
Vol 79 (15) ◽  
pp. 1607-1614 ◽  
Author(s):  
A. Radtke ◽  
M. von Brevern ◽  
H. Neuhauser ◽  
T. Hottenrott ◽  
T. Lempert
Keyword(s):  
Clinical Symptoms ◽  
Vestibular Migraine ◽  
Long Term Follow Up

Analysis of Outcomes of Endovascular Embolisation: A Cross-Sectional Multicenter Study on 46 Visceral Artery Pseudoaneurysms

2021 ◽  
Author(s):  
Mohammad Koriem Mahmoud Omar ◽  
Moustafa H. M. Othman ◽  
Robert A. Morgan ◽  
Abdelkarem Hasan Abdallah ◽  
Hany M. A. Seif ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Visceral Artery ◽  
Endovascular Management ◽  
Cross Sectional ◽  
Technical Success Rate ◽  
Endovascular Embolisation ◽  
Visceral Artery Aneurysms ◽  
Perioperative Complication

Abstract Purpose Visceral artery aneurysms are subdivided into true aneurysms and pseudoaneurysms. Visceral artery pseudoaneurysms (VAPAs) are uncommon in clinical practice but may have serious clinical outcomes up to death. Endovascular management is a safe effective alternative option to traditional surgical procedures. This study assesses the outcome of different embolic materials and techniques used in the endovascular management of visceral artery pseudoaneurysms. Materials and methods This is a multicentric prospective analysis of endovascular embolisation of 46 VAPAs with a mean pseudoaneurysm size of 13 ± 11.35 mm. Management using coils only was done in 28/46 patients (60.87%), NBCA glue only in 16/46 patients (34.78%), combined coils and NBCA glue in 1/46 patient (2.17%), and Amplatzer plugs only in 1 patient (2.17%). The management techniques were sac packing in 9/46 patients (19.57%), inflow occlusion in 28/46 patients (60.87%) and trapping in 9/46 patients (19.57%). Results The overall clinical success rate was 93.48%, the overall perioperative complication rate was 15.22% and 30-day mortality was zero. For the coil subgroup (n = 28), the clinical success was 92.86%, while the subgroup of NBCA glue (n = 16) showed clinical success of 93.75%. There was no significant statistical difference between clinical success among coil, and NBCA glue subgroups (P > 0.05). The technical success rate was 100%. Effectiveness of the procedures during the follow-up was 97.83%. Target lesion re-intervention rate was 2.17%. Conclusion Transarterial embolisation can provide high technical and clinical success rates with low perioperative complication and re-intervention rates, as well as satisfactory procedure effectiveness in the management of VAPAs.

scholarly journals Long-term follow-up of abandoned transvenous defibrillator leads: a nationwide cohort study

EP Europace ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. 1097-1102
Author(s):  
Anders Fyhn Elgaard ◽  
Jens Brock Johansen ◽  
Jens Cosedis Nielsen ◽  
Christian Gerdes ◽  
Sam Riahi ◽  
...  
Keyword(s):  
Clinical Success ◽  
Extraction Procedure ◽  
Clinical Success Rate ◽  
High Volume ◽  
Lead Extraction ◽  
Related Data ◽  
Major Complications ◽  
Long Term Follow Up

Abstract Aims  Commonly, a dysfunctional defibrillator lead is abandoned and a new lead is implanted. Long-term follow-up data on abandoned leads are sparse. We aimed to investigate the incidence and reasons for extraction of abandoned defibrillator leads in a nationwide cohort and to describe extraction procedure-related complications. Methods and results  All abandoned transvenous defibrillator leads were identified in the Danish Pacemaker and ICD Register from 1991 to 2019. The event-free survival of abandoned defibrillator leads was studied, and medical records of patients with interventions on abandoned defibrillator leads were audited for procedure-related data. We identified 740 abandoned defibrillator leads. Meantime from implantation to abandonment was 7.2 ± 3.8 years with mean patient age at abandonment of 66.5 ± 13.7 years. During a mean follow-up after abandonment of 4.4 ± 3.1 years, 65 (8.8%) abandoned defibrillator leads were extracted. Most frequent reason for extraction was infection (pocket and systemic) in 41 (63%) patients. Procedural outcome after lead extraction was clinical success in 63 (97%) patients. Minor complications occurred in 3 (5%) patients, and major complications in 1 (2%) patient. No patient died from complication to the procedure during 30-day follow-up after extraction. Conclusion  More than 90% of abandoned defibrillator leads do not need to be extracted during long-term follow-up. The most common indication for extraction is infection. Abandoned defibrillator leads can be extracted with high clinical success rate and low risk of major complications at high-volume centres.

Treatment of visceral artery aneurysms: Retrospective study of 35 cases

VASA ◽  
2007 ◽  
Vol 36 (3) ◽  
pp. 191-198 ◽  
Author(s):  
Popov ◽  
Boskovic ◽  
Sagic ◽  
Radevic ◽  
Ilijevski ◽  
...  
Keyword(s):  
Celiac Trunk ◽  
Visceral Artery ◽  
Mortality And Morbidity ◽  
Active Approach ◽  
Abdominal Aortic ◽  
Visceral Artery Aneurysms ◽  
Long Term Follow Up ◽  
Life Threatening ◽  
Age Range

Background: Visceral artery aneurysms (VAA) represent a rare clinical entity with possible life-threatening complications. The presentation, diagnosis and management vary accordingly to the artery involved and the underlying pathology. Patients and methods: During a 25-year period (1980–2005), 35 patients (25 males + 10 females, age range 36–73 years-median 59.2 years) with VAA were treated at two tertiary vascular surgery centers in Belgrade. All data were retrospectively collected from the patient’s records. Results: On presentation, 19/35 patients were symptomatic, and 3/35 had ruptured VAA. Surgery was performed in 28 cases; most commonly involved arteries were splenic (11), hepatic (5), celiac trunk (5), superior mesenteric (3), inferior mesenteric (3) and gastroduodenal (1). Fatal rupture occurred in two patients. In 5 patients abdominal aortic aneurysm was associated with VAA, and in 4 patients multiple aneurysms of the involved artery were noted. Successful embolization was performed in 3 patients. Overall, four patients were treated medically. In the surgically treated patients, perioperative mortality and morbidity were 11% (3/28) and 40% (10/25) respectively. Of 25 patients included in the long-term follow up, six died. Conclusion: Since VAA have considerable tendency to rupture, an active approach is necessary. Based on our experience, surgical treatment could be recommended for any VAA patient with symptoms. In addition, we believe that the choice of the therapeutic procedure should be made on an individual basis.

LONG TERM RESULTS OF MATCHED HEMIRESECTION INTERPOSITION ARTHROPLASTY FOR DRUJ ARTHRITIS IN RHEUMATOID PATIENTS

Hand Surgery ◽  
2011 ◽  
Vol 16 (02) ◽  
pp. 119-125 ◽  
Author(s):  
Syed Kamran Ahmed ◽  
Jason Pui Yin Cheung ◽  
Boris Kwok-Keung Fung ◽  
Wing-Yuk Ip
Keyword(s):  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
Long Term Results ◽  
Complete Relief ◽  
Average Increase ◽  
Interposition Arthroplasty ◽  
Long Term Follow Up ◽  
Motion Assessment

Introduction: The distal radioulnar joint (DRUJ) is commonly affected in rheumatoid arthritis and is associated with significant functional morbidity. The aim of our study is to review our results with matched hemi-resection interposition arthroplasty in patients with DRUJ arthritis. Methods: This was a retrospective study of 39 patients with 51 wrists that were treated at Queen Mary Hospital in Hong Kong from 1989 to 2007. All patients underwent matched hemi-resection interposition arthroplasty and dorsal wrist synovectomy. Long arm hinged elbow brace was used for three weeks followed by intensive rehabilitation up to twelve weeks. The indicators of outcome included range of motion assessment, pain, wrist stiffness, grip of strength and need for revision assessed during follow-up. Statistical analysis was performed with student t-test. Results: The average age of patients was 50.5 years (25 to 77 years) and there was a 35:4 female to male ratio. The average follow up was 4.5 years ranging from 1 to 18 years. Associated extensor tendon ruptures were found in 31.4% patients. The average increase in supination was from 73 degrees preoperatively to 81 degrees at long term follow up (p = 0.10 at 1 year and 0.13 at long term follow-up). The average increase in pronation was from 68 degrees preoperatively to 74 degrees on long term follow up (p = 0.57 at 1 year and 0.02 at long term follow-up). There was evidence of painless, relatively stiff but functional wrist in 37.25% of patients. There was an increase in grip strength from an average of 6.1 kilogram force preoperatively to an average of 11.5 kilogram force at follow-up (p = 0.004 at 1 year and 0.15 at long term follow-up). Complete relief of ulnar sided pain was seen in 43 wrists (84%), partial relief was seen in 7 wrists (13.7%) and no relief was found in one wrist (1.9%). Conclusions: DRUJ arthroplasty is a rewarding procedure and most of the patients obtain pain free movement.

scholarly journals Is Longstanding Congenital Muscular Torticollis Provoking Pelvic Malalignment Syndrome?

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 735
Author(s):  
Jun-il Park ◽  
Joo-Hyun Kee ◽  
Ja Young Choi ◽  
Shin-seung Yang
Keyword(s):  
Clinical Symptoms ◽  
Limited Range ◽  
Neck Mass ◽  
Congenital Muscular Torticollis ◽  
Limited Range Of Motion ◽  
Chi Squared ◽  
Long Term Follow Up ◽  
Muscular Torticollis

It has been reported that congenital muscular torticollis (CMT) may result in secondary scoliosis over long-term follow-ups. However, there are few reports on whether CMT causes pelvic malalignment syndrome (PMS). This study aimed to investigate the relationship between CMT and PMS and to determine the factors associated with the development of PMS in children with longstanding CMT. Medical records of 130 children with CMT who had long-term follow-up were reviewed retrospectively. The chi-squared test and logistic regression analysis were used to determine which initial clinical parameters contributed to the development of PMS. Among 130 children with CMT, 51 (39.2%) developed PMS with or without compensatory scoliosis during long-term follow-up, indicating a high prevalence of PMS in children with a CMT history. Initial clinical symptoms such as a limited range of motion of the neck or the presence of a neck mass could not predict the development of PMS. Even if the clinical symptoms are mild, long-term follow-up of children with CMT is essential to screen for PMS.

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