scholarly journals Massive Scrotal Hematoma due to Ruptured Anastomotic Pseudoaneurysm in a Patient with Aortobifemoral Bypass Surgery: CTA Evaluation

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Magdalini Smarda ◽  
Dimitrios Fagkrezos ◽  
Ilias Dodos ◽  
Anastasios Potouridis ◽  
Dimitrios Staramos ◽  
...  
Keyword(s):  
Bypass Surgery ◽  
Inguinal Region ◽  
Synthetic Graft ◽  
Aortobifemoral Bypass ◽  
Ultrasound Evaluation ◽  
Anastomotic Pseudoaneurysm ◽  
Pulsatile Mass ◽  
Left Limb ◽  
Scrotal Hematoma ◽  
Artery Disease

A 74-year-old male patient was presented with scrotal swelling and a pulsatile mass of the left femoro-inguinal region. His medical history included hypertension, coronary artery disease, respiratory failure, and an aortobifemoral bypass surgery performed 7 years ago. Ultrasound evaluation revealed a massive scrotal hematoma. Computed tomography angiography (CTA) was conducted, confirming the aortobifemoral graft existence and revealing bilateral anastomotic pseudoaneurysms with the left one being ruptured, resulting in extension of the hematoma to the left femoro-inguinal region and the scrotum. An emergency surgery was performed, where proximal control of the left limb of the synthetic graft as well as distal control of the iliac vessels were accomplished. After the control of the hemorrhage, an iliofemoral bypass with a Polytetrafluoroethylene (PTFE) 6 mm synthetic graft was placed. Unfortunately, the patient passed away during the first postoperative day due to myocardial infarction.

Endoluminal Graft Exclusion of a Proximal Para-Anastomotic Pseudoaneurysm following Aortobifemoral Bypass

1997 ◽  
Vol 4 (1) ◽  
pp. 88-94 ◽  
Author(s):  
Rodney A. White ◽  
Carlos E. Donayre ◽  
Irwin Walot ◽  
Eric Wilson ◽  
George Jackson ◽  
...  
Keyword(s):  
Medical Condition ◽  
Ct Scanning ◽  
Abdominal Ultrasound ◽  
Spiral Ct ◽  
Aortobifemoral Bypass ◽  
Anastomotic Pseudoaneurysm ◽  
Left Limb ◽  
Work Up ◽  
Abdominal Ultrasound Examination

Purpose: To describe a case of endoluminal graft exclusion of a proximal para-anastomotic pseudoaneurysm that occurred 17 years following aortobifemoral bypass for occlusive disease. Methods and Results: The lesion was found on abdominal ultrasound examination as part of a work-up for acute abdominal pain and upper gastrointestinal bleeding in a 67-year-old male. A 5-cm saccular pseudoaneurysm was confirmed by preintervention aortography and spiral computed tomography (CT) scanning. Because of the patient's acute symptoms and high-risk medical condition (cardiomyopathy), he was deemed a candidate for endoluminal bypass. At the time of intervention, intravascular ultrasound (IVUS) interrogation identified a 3.5-cm-long separation of the existing aortic graft from the proximal aortic stump with a large pseudoaneurysm. The lesion was isolated and repaired by placement of an aortic-to-right iliac endoluminal bypass, ligation of the left limb of the aortofemoral graft, and femorofemoral bypass to restore blood flow to the lower extremities. Spiral CT scans at 48 hours and 3 months following the procedure confirmed complete isolation of the lesion. Conclusions: This case illustrates the feasibility of endografting for repair of aortic para-anastomotic pseudoaneurysms, and it also highlights the potential role of IVUS imaging in endoluminal graft deployment.

scholarly journals Surgical treatment of patients with critical ischemia of lower limbs originating from aortoiliac lesions and concomitant coronary artery disease

2015 ◽  
Vol 17 (1) ◽  
pp. 73
Author(s):  
A. N. Vachev ◽  
V. V. Sukhorukov ◽  
Ye. A. Surkova ◽  
A. D. Gureev ◽  
A. V. Krugomov ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Surgical Treatment ◽  
Bypass Surgery ◽  
Lower Limbs ◽  
Hybrid Procedures ◽  
Aortobifemoral Bypass ◽  
Critical Ischemia ◽  
Artery Disease ◽  
Concomitant Coronary Artery Disease

The study focuses on the outcomes of surgical treatment of 236 patients with critical ischemia of lower limbs originating from aortoiliac lesions and concomitant coronary artery disease. All patients first underwent vascular surgery, with 158 of them having aortobifemoral bypass surgery and 78 - hybrid vascular procedures on the aortoiliac segment: open surgical revascularization of femoral arteries and angioplasty and stenting of iliac arteries. Critical limb ischemia was successfully treated in all patients. One patient died after aortobifemoral bypass surgery; no fatal outcomes were registered after hybrid procedures.

Endoluminal Graft Exclusion of a Proximal Para-Anastomotic Pseudoaneurysm Following Aortobifemoral Bypass

1997 ◽  
Vol 4 (1) ◽  
pp. 88-94 ◽  
Author(s):  
Rodney A. White ◽  
Carlos E. Donayre ◽  
Irwin Walot ◽  
Eric Wilson ◽  
George Jackson ◽  
...  
Keyword(s):  
Aortobifemoral Bypass ◽  
Anastomotic Pseudoaneurysm

Coronary Artery Disease and Endothelial Dysfunction: Novel Diagnostic and Therapeutic Approaches

2020 ◽  
Vol 27 (7) ◽  
pp. 1052-1080 ◽  
Author(s):  
Evangelos Oikonomou ◽  
Gerasimos Siasos ◽  
Vasiliki Tsigkou ◽  
Evanthia Bletsa ◽  
Maria-Evi Panoilia ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Stable Coronary Artery Disease ◽  
Therapeutic Interventions ◽  
Therapeutic Approaches ◽  
Cardiovascular Prognosis ◽  
Ultrasound Evaluation ◽  
Artery Disease

Coronary artery disease is the leading cause of morbidity and mortality worldwide. The most common pathophysiologic substrate is atherosclerosis which is an inflammatory procedure that starts at childhood and develops throughout life. Endothelial dysfunction is associated with the initiation and progression of atherosclerosis and is characterized by the impaired production of nitric oxide. In general, endothelial dysfunction is linked to poor cardiovascular prognosis and different methods, both invasive and non-invasive, have been developed for its evaluation. Ultrasound evaluation of flow mediated dilatation of the branchial artery is the most commonly used method to assessed endothelial function while intracoronary administration of vasoactive agents may be also be used to test directly endothelial properties of the coronary vasculature. Endothelial dysfunction has also been the subject of therapeutic interventions. This review article summarizes the knowledge about evaluation of endothelial function in acute coronary syndromes and stable coronary artery disease and demonstrates the current therapeutic approaches against endothelial dysfunction.

Prospective Analysis after Coronary-artery Bypass Grafting: Platelet GP IIIa Polymorphism (HPA-1b /PlA2) Is a Risk Factor for Bypass Occlusion, Myocardial Infarction, and Death

2000 ◽  
Vol 83 (03) ◽  
pp. 404-407 ◽  
Author(s):  
Michael Klein ◽  
Hans Dauben ◽  
Christiane Moser ◽  
Emmeran Gams ◽  
Rüdiger Scharf ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Odds Ratio ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Hereditary Risk ◽  
Artery Disease

SummaryRecently, we have demonstrated that human platelet antigen 1b (HPA-1b or PlA2) is a hereditary risk factor for platelet thrombogenicity leading to premature myocardial infarction in preexisting coronary artery disease. However, HPA-1b does not represent a risk factor for coronary artery disease itself. The aim of our present study was to evaluate the role of HPA-1b on the outcome in patients after coronaryartery bypass surgery. We prospectively determined the HPA-1 genotype in 261 consecutive patients prior to saphenous-vein coronaryartery bypass grafting. The patients were followed for one year. Among patients with bypass occlusion, myocardial infarction, or death more than 30 days after surgery, the prevalence of HPA-1b was significantly higher than among patients without postoperative complications (60 percent, 6/10, vs. 24 percent, 58/241, p <0.05, odds ratio 4.7). Using a stepwise logistic regression analysis with the variables HPA1b, age, sex, body mass index, smoking (pack-years), hypertension, diabetes, cholesterol and triglyceride concentration, only HPA-1b had a significant association with bypass occlusion, myocardial infarction, or death after bypass surgery (p = 0.019, odds ratio 4.7). This study shows that HPA-1b is a hereditary risk factor for bypass occlusion, myocardial infarction, or death in patients after coronary-artery bypass surgery.

scholarly journals Guideline-Oriented Therapy of Lower Extremity Peripheral Artery Disease (PAD) – Current Data and Perspectives

2019 ◽  
Vol 191 (04) ◽  
pp. 311-322 ◽  
Author(s):  
Jonas Kersting ◽  
Lars Kamper ◽  
Marco Das ◽  
Patrick Haage
Keyword(s):  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Bypass Surgery ◽  
Interdisciplinary Approach ◽  
Current Data ◽  
Arterial System ◽  
Peripheral Artery ◽  
Vascular Surgeon ◽  
Technical Developments ◽  
Artery Disease

Background Because of the demographic change, lower extremity peripheral artery disease (PAD) is becoming increasingly relevant with respect to health economics. PAD patients often suffer from multiple diseases. Consequently, therapy is commonly complex and requires an interdisciplinary approach. Because of rapid technical developments, interventional endovascular therapy regimens play an increasingly important role. Method Review and literature search on the basis of the current German S3 guidelines on the therapy of PAD as well as international guidelines. In terms of state-of-the-art therapies, relevant current studies were considered. Results Knowledge of existing guidelines and recommendations as well as new therapeutic approaches is essential for the adequate therapy of PAD patients. A close cooperation between the interventional radiologist and the vascular surgeon is the key to success. In addition to established conservative approaches and invasive bypass surgery, the endovascular approach has been a mainstay in the TASC A and B environment for years. It has recently shown promising results in advanced PAD conditions, such as TASC C and D. An endovascular-first strategy is defined in most guidelines. Conclusion A primarily endovascular-first strategy has become the standard in the majority of even complex lesions of the lower extremity arterial system. Regarding the crural segment, a decrease in mortality compared to bypass surgery has been demonstrated. Further evidence can be expected from ongoing randomized multicenter trials. Key Points:  Citation Format

Sign in / Sign up

Export Citation Format

Share Document