scholarly journals Vertebral Metastasis Treated by Vertebroplasty, a Cause of Respiratory Failure: Case Report and Literature Review

2021 ◽  
pp. 279-283
Author(s):  
Mathieu Chevallier ◽  
Chloé Chevallier-Lugon ◽  
Alex Friedlaender ◽  
Alfredo Addeo
Keyword(s):  
Spinal Fractures ◽  
Safe Procedure ◽  
Vertebral Metastasis ◽  
Minimally Invasive Surgical Procedure ◽  
Venous Circulation ◽  
Minimally Invasive Surgical ◽  
Life Threatening ◽  
Frequent Site ◽  
The Right ◽  
Substantial Morbidity

Bone is a frequent site of metastases in advanced cancers including lung, breast, prostate, kidney, or myeloma. Lesions are commonly located on the spine. Neoplastic invasion of the vertebral body can result in painful vertebral fractures, leading to disability and substantial morbidity. Percutaneous vertebroplasty is a minimally invasive surgical procedure used to treat spinal fractures due to osteolytic tumors. It could result in pain reduction or resolution in 80–90% of patients with fractures, and it improves stability. Although considered safe, vertebroplasty has been associated over the years with life-threatening complications. We have reported the case of a 55-year-old patient with lung adenocarcinoma, who underwent vertebroplasty for a pathological neoplastic fracture of L2. The procedure was complicated by a leak of cement into the systemic venous circulation, characterized by an 11-cm filament in the right heart chambers and multiple pulmonary emboli. To our knowledge, only one similar case was previously reported, involving an intracardiac cement filament longer than 10 cm. The data are scant, hence the importance of collecting and reporting possible complications about what is perceived as a rather safe procedure. The case highlights the need for a robust postprocedure imaging plan to detect complications, which can impact patients’ morbidity and survival.

Uniportal thoracoscopic right anterior basal (S8) segmentectomy using unidirectional dissection

2021 ◽  
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedure ◽  
Lower Lobe ◽  
Lung Parenchyma ◽  
Surgical Instruments ◽  
Thoracoscopic Approach ◽  
Minimally Invasive Surgical Procedure ◽  
Small Incision ◽  
Minimally Invasive Surgical ◽  
The Right

Anterior basal (S8) segmentectomy is one of the most challenging procedures among the uncommon pulmonary segmentectomies because the surgeon has to identify dominant pulmonary vein branches located deep in the lung parenchyma. Moreover, with the uniportal thoracoscopic approach, the angulation of inserted surgical instruments via a single small incision is extremely limited, which causes technical difficulties. However, adoption of a suitable procedure such as unidirectional dissection enables us to perform this type of minimally invasive surgical procedure. We describe the successful results of a patient undergoing uniportal thoracoscopic S8 segmentectomy of the right lower lobe and explain the nuances of performing it.

A surgical technique for a terminal intracranial hypertension model in pigs

2012 ◽  
Vol 46 (3) ◽  
pp. 258-260 ◽  
Author(s):  
M Janda ◽  
J Bajorat ◽  
O Simanski ◽  
G Nöldge-Schomburg ◽  
R Hofmockel ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Intracranial Hypertension ◽  
Cerebral Metabolism ◽  
Balloon Catheter ◽  
Brain Perfusion ◽  
Minimally Invasive Surgical ◽  
Left Lateral Ventricle ◽  
Right Cerebral Hemisphere ◽  
Life Threatening ◽  
The Right

The life-threatening effects of intracranial hypertension on brain perfusion and cerebral metabolism are the subject of current research in different animal models. The purpose of this study was to describe an efficient, reliable and inexpensive surgical method for temporary elevation of intracranial pressure (ICP) in acutely instrumented pigs in a research setting. Therefore, a balloon catheter was inserted into the left lateral ventricle and an ICP sensor was placed in the parenchyma of the right cerebral hemisphere. Ten acutely instrumented pigs were studied while under deep terminal general anaesthesia. The step-by-step inflation of the intraventricular balloon allows one to achieve the desired ICP up to 46 mmHg and maintain it at this level. ICP values ranged from a median of 2 (1–2) mmHg to 43 (29–45) mmHg. To the authors’ knowledge, this is the first detailed description of a minimally invasive surgical technique for temporary ICP elevation in pigs via stepwise inflation of an intraventricular balloon.

May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

Clinical Case: Complications after Endovascular Treatment of Intracranial Aneurysm in a Patient after Subarachnoid Hemorrhage

2020 ◽  
Vol 8 (1) ◽  
pp. 9-15
Author(s):  
Petrov Nikolay ◽  
◽  
Marinova R. ◽  
Odiseeva Ev.
Keyword(s):  
Intracranial Aneurysm ◽  
Endovascular Treatment ◽  
Clinical Case ◽  
Endovascular Coiling ◽  
Published Data ◽  
Military Medical Academy ◽  
Life Threatening ◽  
Arachnoid Hemorrhage ◽  
The Right ◽  
Brain Artery

Abstract: Intracranial aneurysm is one of the most common neurovascular complications. During the recent years the accepted treatment of enraptured cranial aneurysm is noninvasive endovascular coiling. This technique is modern but it is not without complications which can be serious and life-threatening. A clinical case of a patient admitted to the ICU of Military Medical Academy - Sofia with sub arachnoid hemorrhage is described. After a positive clinical course, the check-up magnetic resonance showed intracranial aneurism of the right carotid artery. The patient underwent angiographic endovascular treatment. Vasospasm of the middle and right brain artery and thrombosis were detected during the procedure. Attempt of thromboaspiration was made without success. This article reviews published data on broad-spectrum researches concerning complications of endovascular coiling of intracranial aneurysms and the ways to prevent and reduce them.

The management of Hemorrhoidal Disease by Dearterialization and Mucopexy.

2020 ◽  
Vol 15 ◽  
Author(s):  
Veronica De Simone ◽  
Francesco Litta ◽  
Angelo Parello ◽  
Paola Campennì ◽  
Raffaele Orefice ◽  
...  
Keyword(s):  
Postoperative Management ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Doppler Probe ◽  
Minimally Invasive Surgical ◽  
Bowel Movements ◽  
Excessive Strain ◽  
Life Threatening ◽  
Hemorrhoidal Prolapse ◽  
The Impact

: Several minimally invasive surgical procedures have been recently developed to treat hemorrhoids without any excision. About 25 years ago, a non-excisional procedure providing doppler-guided ligation of the hemorrhoidal arteries has been proposed - named “hemorrhoidal dearterialization”. The original technique has been modified over the years, and indications were expanded. In particular, a plication of the redundant and prolapsing mucosa/submucosa of the rectum (named “mucopexy”) has been introduced to treat hemorrhoidal prolapse, without excision of the hemorrhoidal piles. At present, the THD® Doppler procedure is one of the most used techniques to treat hemorrhoids. Aim of this technique is to realize a target dearterialization, using a Doppler probe with the final purpose to reduce the arterial overflow to the hemorrhoidal piles. In case of associated hemorrhoidal prolapse, a mucopexy is performed together with Doppler-guided dearterialization. The entity and circumferential extension of the hemorrhoidal prolapse guides the mucopexy, which can be considered tailored to a single patient; the dearterialization should be considered mandatory. Advantages of this surgical technique are the absence of serious and life-threatening postoperative events, chronic complications, and limited recurrence risks. The impact of the procedure on the anorectal physiology is negligible. However, a careful postoperative management is mandatory to avoid complications and to guarantee an improved long-term outcome. Therefore, regular physiologic bowel movements, excessive strain at the defecation and strong physical activity are advisable.

Single center experience with ultrasound guided axillary vein port placement

2021 ◽  
pp. 112972982110080
Author(s):  
Patrick Tivnan ◽  
Micaela Nannery ◽  
Yan Epelboym ◽  
Rajendran Vilvendhan
Keyword(s):  
Demographic Data ◽  
Axillary Vein ◽  
Safe Procedure ◽  
Ultrasound Guided ◽  
Port Placement ◽  
Chi Square ◽  
Vein Thrombosis ◽  
Single Center Experience ◽  
Procedural Complications ◽  
The Right

Purpose: To retrospectively review a single institution experience of ultrasound guided axillary vein port placement. Methods: In this retrospective study, a patient list was generated after searching our internal database from 1/1/2012 to 10/1/2018. Patients who had undergone axillary vein port placement were included. Chart review was performed to confirm approach, laterality and to gather demographic data, clinical indications, technical outcomes, and complications. Descriptive statistics were used to analyze this cohort. Chi-square statistics were used to compare outcomes by laterality. Results: Three hundred seven patients (51% female) with an average age of 58 years were included. The port was placed via the right axillary vein in 85% (261/307), predominantly for the indication of chemotherapy access (296/307). Technical success was achieved in all 307 cases. Peri procedural complications occurred in 1% (4/307) of cases and included port malpositioning requiring replacement and a case of port pocket hematoma. Post procedural complications including deep vein thrombosis and port malfunction occurred in 17% (52/307) of cases and port removal as a result of complication occurred in 9% (29/307) of cases. Conclusions: Ultrasound guided placement of an axillary port is a safe procedure to perform and demonstrates good clinical outcomes.

scholarly journals Peritoneal well-differentiated papillary mesothelioma associated with infertility in a 37-year-old woman

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098668
Author(s):  
Bo Pang ◽  
Cong Hu ◽  
Qian Liu ◽  
Jinyu Yu ◽  
Zhentong Wei ◽  
...  
Keyword(s):  
Benign Tumors ◽  
Free Fluid ◽  
Adenomatoid Tumor ◽  
Cancer Antigen 125 ◽  
Immunohistochemical Markers ◽  
Serum Ca125 ◽  
Life Threatening ◽  
Well Differentiated ◽  
The Right

Well-differentiated papillary mesothelioma (WDPM) is an uncommon mesothelial tumor. The lesions may be single or multiple and usually behave in a benign or indolent fashion, sometimes persisting for many years. In the present case, a 37-year-old woman had experienced primary infertility for 12 years, and a diagnostic laparoscopy was performed. Approximately 200 mL of dark red, free fluid in the pelvis and more than 10 yellow-white nodules on the surface of the right round ligament, sacrum ligament, right fallopian tube, and both sides of the uterus were found. A lesionectomy was performed and immunohistochemical markers indicated WDPM with adenomatoid tumor. The patient was monitored by computed tomography and serum CA125 (cancer antigen 125) levels for 49 months with no recurrence. WDPM and adenomatoid tumor are both benign tumors of mesothelial origin. Because of the lack of effective radical treatment, regular follow-up is sufficient. However, the effects of estrogen and progesterone on WDPM and adenomatoid tumors during ovulation or pregnancy remains unclear. Although WDPM is not life threatening, a strategy to fulfill the fertility requirements of women with this condition is a new challenge for infertility doctors.

Ab interno 180-degree trabeculectomy with a dual blade in a patient with refractory primary congenital glaucoma

2021 ◽  
pp. 112067212110104
Author(s):  
Mehmet Talay Koylu ◽  
Fatih Mehmet Mutlu ◽  
Alper Can Yilmaz
Keyword(s):  
Intraocular Pressure ◽  
Female Patient ◽  
Congenital Glaucoma ◽  
Safe Procedure ◽  
Primary Congenital Glaucoma ◽  
History Of ◽  
Kahook Dual Blade ◽  
The Right ◽  
Ab Interno

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.

Stent Graft Placement in the Top-Down Direction for Treating Traumatic Intra-Abdominal Suprahepatic Inferior Vena Cava Rupture: A Case Report

2021 ◽  
pp. 152660282110250
Author(s):  
Yun Chul Park ◽  
Hyoung Ook Kim ◽  
Nam Yeol Yim ◽  
Byung Chan Lee ◽  
Chan Park ◽  
...  
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Stent Graft ◽  
Inferior Vena ◽  
Vena Cava ◽  
Endovascular Management ◽  
Top Down ◽  
Life Threatening ◽  
The Right ◽  
Suprahepatic Inferior Vena Cava

Purpose The treatment of suprahepatic inferior vena cava (IVC) ruptures results in high mortality rates due to difficulty in performing the surgical procedure. Here, we present a case of successful endovascular management of a life-threatening suprahepatic IVC rupture with top-down placement of a stent graft. Case Report A 33-year-old woman was involved in a traffic accident and presented to our emergency department due to unstable hemodynamics after blunt abdominal wall trauma. Computed tomography (CT) revealed massive extravasation of contrast agent from the suprahepatic IVC, which suggested traumatic suprahepatic IVC rupture. To seal the IVC, to salvage major hepatic veins, and to prevent migration of the stent graft into the right side of the heart after placement, an aortic cuff with a proximal hook was introduced in a top-down direction via the right internal jugular vein. After closure of the injured IVC, the patient’s hemodynamics improved, and additional laparotomy was performed. After 3 months of trauma care, the patient recovered and was discharged. Follow-up CT after 58 months showed a patent stent graft within the IVC. Conclusion Endovascular management with top-down placement of a stent graft is a viable option for emergent damage control in patients with life-threatening hemorrhage from IVC rupture.

Primary cutaneous nocardiosis of the head and neck in an immunocompetent patient

2021 ◽  
Vol 14 (5) ◽  
pp. e241217
Author(s):  
Claudio Tirso Acevedo ◽  
Frank Imkamp ◽  
Ewerton Marques Maggio ◽  
Silvio Daniel Brugger
Keyword(s):  
Head And Neck ◽  
Skin Lesions ◽  
Immunocompetent Patient ◽  
Rrna Gene ◽  
Gene Sequence Analysis ◽  
Rare Manifestation ◽  
Life Threatening ◽  
Amoxicillin Clavulanic Acid ◽  
Disseminated Nocardiosis ◽  
The Right

Nocardiosis is known to be an opportunistic infection most commonly affecting immunocompromised patients that can lead to life-threatening conditions. Primary cutaneous disease remains a rare manifestation and unlike pulmonary or disseminated nocardiosis, it usually affects immunocompetent individuals. We present a case of a primary cutaneous nocardiosis of the head and neck after an insect bite in a healthy 50-year-old woman who had recently travelled from Greece. She presented with a painful right-sided swelling of her face and neck and an ulcerated plaque over the right temple. Biopsy of the plaque revealed inflammation with abscess formation indicating underlying infection. Culture from the biopsy showed growth of Nocardia spp and 16S rRNA gene sequence analysis identified Nocardia brasiliensis. The patient was treated with trimethoprim/sulfamethoxazole and subsequently switched to amoxicillin/clavulanic acid due to a drug eruption. Antibiotic therapy was continued for a total of 3 months with complete resolution of the skin lesions.

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