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 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.

1522: Utility of Preoperative 3-D Reconstruction of Pelvic Vasculature using Multi-Detector Spiral CT Scanning in Treatment Planning for Robotic Prostatectomy

2005 ◽  
Vol 173 (4S) ◽  
pp. 412-412
Author(s):  
Ashutosh Tewari ◽  
Assaad El-Hakim ◽  
Peter N. Schlegel ◽  
Mani Menon ◽  
Deirdre M. Coll
Keyword(s):  
Treatment Planning ◽  
Ct Scanning ◽  
Spiral Ct ◽  
Robotic Prostatectomy

The role of computed tomography perfusion in the diagnosis of brain ischaemic stroke

2008 ◽  
Vol 149 (23) ◽  
pp. 1059-1065 ◽  
Author(s):  
Szabolcs Halász ◽  
Tamás Puskás
Keyword(s):  
Computed Tomography ◽  
Ischaemic Stroke ◽  
Spiral Ct ◽  
Computed Tomography Perfusion

A többszeletes spirál-CT-berendezések széles körű alkalmazása és a perfúziós szoftverek bevezetése lehetővé tette az agyi véráramlás CT-vizsgálatát. Cél és módszerek: A szerzők ismertetik az agyi perfúziós CT-vizsgálatok elvét, technikáját, amelyet az elmúlt másfél évben 96 betegükön végzett vizsgálatuk tapasztalataival egészítenek ki. A folyamatos technikai fejlődés eredményeként a közeljövőben lehetővé válik a teljes agy perfúziós CT-vizsgálata. Következtetések: Az agy perfúziós CT-vizsgálata gyors, viszonylag olcsó és a stroke kórismézésében pontos diagnózist eredményez.

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

Commedia dell'arte Actresses and the Performance of Lovesickness

2009 ◽  
Vol 10 (2) ◽  
pp. 26-37
Author(s):  
Clarissa Hanora Hurley
Keyword(s):  
Medical Condition ◽  
Commedia Dell'arte ◽  
Cultural Attitudes ◽  
Gender Based

In the late sixteenth and early seventeenth centuries there was a conjunction of interest in erotomania as a “real” medical condition and the representation of that condition in literature and on the popular stage. This period corresponds with the rise of the professional actress of the commedia dell’arte. This paper explores some instances of pazzia (madness) scenes in the scenarios of Flaminio Scala and contemporary accounts of commedia performances with a view to better understanding the role of the professional theatre and professional actress in shaping and reflecting cultural attitudes towards gender-based erotic “distraction”.

scholarly journals Rhinocerotidae from the early Miocene of the Negev (Israel) and implications for the dispersal of early Neogene rhinoceroses

2021 ◽  
pp. 1-12
Author(s):  
Luca Pandolfi ◽  
Ran Calvo ◽  
Ari Grossman ◽  
Rivka Rabinovich
Keyword(s):  
Southeast Asia ◽  
South Asian ◽  
North Africa ◽  
Range Expansion ◽  
New Records ◽  
Ct Scanning ◽  
Early Miocene ◽  
Early Neogene ◽  
Postcranial Remains

Abstract A revision of the rhinocerotid material from the Negev (Israel), dating back to the early Miocene (MN3 in the European Mammal Biochronology), highlights the presence of Brachypotherium and a taxon close to Gaindatherium in the Levantine corridor. A juvenile mandible, investigated using CT scanning, displays morphologically distinct characters consistent with Brachypotherium cf. B. snowi rather than with other Eurasian representatives of this genus. Some postcranial remains from the Negev, such as a humerus, display features that distinguish it among Miocene taxa. We attribute these postcrania to cf. Gaindatherium sp., a taxon never recorded outside the Siwaliks until now. This taxon dispersed into the Levantine region during the late early Miocene, following a pattern similar to other South Asian taxa. Brachypotherium cf. B. snowi probably occurred in the Levantine region and then in North Africa during the early Miocene because its remains are known from slightly younger localities such as Moghara (Egypt) and Jebel Zelten (Libya). The occurrence cf. Gaindatherium sp. represents a previously unrecorded range expansion out of Southeast Asia. These new records demonstrate the paleogeographic importance of the Levantine region showcasing the complex role of the Levantine corridor in intercontinental dispersals between Asia and Europe as well as Eurasia and Africa.

scholarly journals General practitioner use of D-dimer in suspected venous thromboembolism: historical cohort study in one geographical region in the Netherlands

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026846 ◽  
Author(s):  
Angel M R Schols ◽  
Eline Meijs ◽  
Geert-Jan Dinant ◽  
Henri E J H Stoffers ◽  
Mariëlle M E Krekels ◽  
...  
Keyword(s):  
Cohort Study ◽  
General Practitioner ◽  
Clinical Assessment ◽  
Geographical Region ◽  
Historical Cohort ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up ◽  
D Dimer

ObjectivesTo investigate how many general practitioner (GP)-referred venous thromboembolic events (VTEs) are diagnosed during 1 year in one geographical region and to investigate the (urgent) referral pathway of VTE diagnoses, including the role of laboratory D-dimer testing.DesignHistorical cohort study.SettingGP patients of 47 general practices in a demarcated geographical region of 161 503 inhabitants in the Netherlands.ParticipantsWe analysed all 895 primary care patients in whom either the GP determined a D-dimer value or who had a diagnostic work-up for suspected VTE in a non-academic hospital during 2015.Primary and secondary outcome measuresThe primary outcomes of this study were the total number of VTEs per year and the diagnostic pathways—including the role of GP determined D-dimer testing—of patients urgently referred to secondary care for suspected VTE. Additionally, we explored the use of an age-adjusted D-dimer cut-off.ResultsThe annual VTE incidence was 0.9 per 1000 inhabitants. GPs annually ordered 5.1 D-dimer tests per 1000 inhabitants. Of 470 urgently GP-referred patients, 31.3% had a VTE. Of those urgently referred based on clinical assessment only (without D-dimer testing), 73.8% (96/130) had a VTE; based on clinical assessment and laboratory D-dimer testing yielded 15.0% (51/340) VTE. Applying age-adjusted D-dimer cut-offs to all patients aged 50 years or older resulted in a reduction of positive D-dimer results from 97.9% to 79.4%, without missing any VTE.ConclusionsAlthough D-dimer testing contributes to the diagnostic work-up of VTE, GPs have a high detection rate for VTE in patients who they urgently refer to secondary care based on clinical assessment only.

Questions in the Role of Chest CT Scanning in TB Outbreak Investigation

CHEST Journal ◽  
2010 ◽  
Vol 138 (6) ◽  
pp. 1522-1523 ◽  
Author(s):  
Sourin Bhuniya ◽  
Pampa De
Keyword(s):  
Ct Scanning ◽  
Chest Ct ◽  
Outbreak Investigation

Incidence of silent hemorrhage and delayed deterioration after stereotactic brain biopsy

1998 ◽  
Vol 89 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Abhaya V. Kulkarni ◽  
Abhijit Guha ◽  
Andres Lozano ◽  
Mark Bernstein
Keyword(s):  
Ct Scan ◽  
Neurological Deficit ◽  
Stereotactic Biopsy ◽  
Brain Biopsy ◽  
Ct Scanning ◽  
Ct Scans ◽  
Stereotactic Brain Biopsy ◽  
Content Type ◽  
Fine Print

Object. Many neurosurgeons routinely obtain computerized tomography (CT) scans to rule out hemorrhage in patients after stereotactic procedures. In the present prospective study, the authors investigated the rate of silent hemorrhage and delayed deterioration after stereotactic biopsy sampling and the role of postbiopsy CT scanning. Methods. A subset of patients (the last 102 of approximately 800 patients) who underwent stereotactic brain biopsies at the Toronto Hospital prospectively underwent routine postoperative CT scanning within hours of the biopsy procedure. Their medical charts and CT scans were then reviewed. A postoperative CT scan was obtained in 102 patients (aged 17–87 years) who underwent stereotactic biopsy between June 1994 and September 1996. Sixty-one patients (59.8%) exhibited hemorrhages, mostly intracerebral (54.9%), on the immediate postoperative scan. Only six of these patients were clinically suspected to have suffered a hemorrhage based on immediate postoperative neurological deficit; in the remaining 55 (53.9%) of 102 patients, the hemorrhage was clinically silent and unsuspected. Among the clinically silent intracerebral hemorrhages, 22 measured less than 5 mm, 20 between 5 and 10 mm, five between 10 and 30 mm, and four between 30 and 40 mm. Of the 55 patients with clinically silent hemorrhages, only three demonstrated a delayed neurological deficit (one case of seizure and two cases of progressive loss of consciousness) and these all occurred within the first 2 postoperative days. Of the neurologically well patients in whom no hemorrhage was demonstrated on initial postoperative CT scan, none experienced delayed deterioration. Conclusions. Clinically silent hemorrhage after stereotactic biopsy is very common. However, the authors did not find that knowledge of its existence ultimately affected individual patient management or outcome. The authors, therefore, suggest that the most important role of postoperative CT scanning is to screen for those neurologically well patients with no hemorrhage. These patients could safely be discharged on the same day they underwent biopsy.

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