Conservative Surgical Management of Late Carotid Patch Infection in a Patient with Subsequent Stenting for Restenosis

2021 ◽  
pp. 153857442110433
Author(s):  
Álvaro Torres-Blanco ◽  
Mario Altable-García ◽  
Manuel Miralles-Hernández
Keyword(s):  
Surgical Management ◽  
Clinical Manifestations ◽  
Duplex Ultrasound ◽  
Carotid Stenting ◽  
Sinus Tract ◽  
Surrounding Tissue ◽  
Patch Removal ◽  
History Of ◽  
Dacron Patch

Carotid patch infection is a rare but dreaded complication after endarterectomy. About 160 cases can be found in literature, but presentation in a patient with post-endarterectomy stenting has not been reported. Most frequent clinical manifestations include the occurrence of a sinus, a pseudoaneurysm, or neck swelling, but in severe cases it may present anastomosis dehiscence with hematoma or hemorrhage. Usually, patch removal and reconstruction is recommended, but there is not a standard protocol for management. Conservative surgical management with patch preservation has only been reported in a minority of cases. We report a patient with a history of carotid endarterectomy and subsequent carotid stenting 21 months later because of >80% restenosis. He presented a sinus in the scar 81 months after the former intervention. The patient underwent surgery, and during the procedure, a detachment of a small segment of the Dacron patch from the surrounding tissue was found. The sinus tract was resected, and after verifying the integrity of the patch, it was irrigated with rifampicin and preserved in situ. S. epidermidis was isolated from tissue cultures. Twenty-four months later, the patient remains asymptomatic and duplex ultrasound shows no signs of infection. Conservative surgical approach can be a valid option for treatment and may be considered in selected patients with limited infection.

Surgical management of extracranial carotid artery aneurysms

VASA ◽  
2016 ◽  
Vol 45 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Jan Paweł Skóra ◽  
Jacek Kurcz ◽  
Krzysztof Korta ◽  
Przemysław Szyber ◽  
Tadeusz Andrzej Dorobisz ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Surgical Management ◽  
Minor Stroke ◽  
Stroke Rate ◽  
Extracranial Carotid Artery ◽  
Long Term Follow Up ◽  
End To End ◽  
Dacron Patch ◽  
Major Stroke

Abstract. Background: We present the methods and results of the surgical management of extracranial carotid artery aneurysms (ECCA). Postoperative complications including early and late neurological events were analysed. Correlation between reconstruction techniques and morphology of ECCA was assessed in this retrospective study. Patients and methods: In total, 32 reconstructions of ECCA were performed in 31 symptomatic patients with a mean age of 59.2 (range 33 - 84) years. The causes of ECCA were divided among atherosclerosis (n = 25; 78.1 %), previous carotid endarterectomy with Dacron patch (n = 4; 12.5 %), iatrogenic injury (n = 2; 6.3 %) and infection (n = 1; 3.1 %). In 23 cases, intervention consisted of carotid bypass. Aneurysmectomy with end-to-end suture was performed in 4 cases. Aneurysmal resection with patching was done in 2 cases and aneurysmorrhaphy without patching in another 2 cases. In 1 case, ligature of the internal carotid artery (ICA) was required. Results: Technical success defined as the preservation of ICA patency was achieved in 31 cases (96.9 %). There was one perioperative death due to major stroke (3.1 %). Two cases of minor stroke occurred in the 30-day observation period (6.3 %). Three patients had a transient hypoglossal nerve palsy that subsided spontaneously (9.4 %). At a mean long-term follow-up of 68 months, there were no major or minor ipsilateral strokes or surgery-related deaths reported. In all 30 surviving patients (96.9 %), long-term clinical outcomes were free from ipsilateral neurological symptoms. Conclusions: Open surgery is a relatively safe method in the therapy of ECCA. Surgical repair of ECCAs can be associated with an acceptable major stroke rate and moderate minor stroke rate. Complication-free long-term outcomes can be achieved in as many as 96.9 % of patients. Aneurysmectomy with end-to-end anastomosis or bypass surgery can be implemented during open repair of ECCA.

Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Sara Abolghasemi ◽  
Mohammad Alizadeh ◽  
Ali Hashemi ◽  
Shabnam Tehrani
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
Urinary Frequency ◽  
Serological Tests ◽  
Duration Of Symptoms ◽  
Two Samples ◽  
History Of ◽  
Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

Surgical management of choke through oesophagotomy in a buffalo: A case report

2017 ◽  
Vol 12 (3) ◽  
Author(s):  
Devasee Borakhatariya ◽  
A. B. Gadara
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Thoracic Inlet ◽  
Cervical Oesophagus ◽  
Foreign Objects ◽  
History Of ◽  
Oesophageal Obstruction ◽  
Large Animals

Oesophageal disorders are relatively uncommon in large animals. Oesophageal obstruction is the most frequently encountered clinical presentation in bovine and it may be intraluminal or extra luminal (Haven, 1990). Intraluminal obstruction or “choke” is the most common abnormality that usually occurs when foreign objects, large feedstuff, medicated boluses, trichobezoars, or oesophageal granuloma lodge in the lumen of the oesophagus. Oesophageal obstructions in bovine commonly occur at the pharynx, the cranial aspect of the cervical oesophagus, the thoracic inlet, or the base of the heart (Choudhary et al., 2010). Diagnosis of such problem depends on the history of eating particular foodstuff and clinical signs as bloat, tenesmus, retching, and salivation

Occurrence of seromucinous borderline tumours in the peritoneal lesions after bilateral salpingo-oophorectomy

2020 ◽  
Vol 13 (12) ◽  
pp. e234692
Author(s):  
Taihei Yamada ◽  
Satoko Eguchi ◽  
Ikuko Yokoo ◽  
Takahide Arimoto
Keyword(s):  
Malignant Transformation ◽  
Surgical Management ◽  
Previous History ◽  
Cancer Antigen ◽  
History Of

A 65-year-old woman with a previous history of bilateral salpingo-oophorectomy had peritoneal cysts, increasing in size over 15 years and an increasing cancer antigen 19–9 (CA 19–9) level. The size of the cysts eventually reached 86 mm and 70 mm. As malignant transformation of endometriosis was suspected, we performed peritoneal cystectomy and hysterectomy. Histopathology revealed seromucinous borderline tumours (SMBTs) derived from endometriosis. One month after surgery, her CA 19-9 level had decreased. It is rare for SMBT to occur after bilateral salpingo-oophorectomy; surgical management is the best treatment at present.

scholarly journals North polar trough formation due to in-situ erosion as a source of young ice in mid-latitudinal mantles on Mars

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
J. Alexis P. Rodriguez ◽  
Kenneth L. Tanaka ◽  
Ali M. Bramson ◽  
Gregory J. Leonard ◽  
Victor R. Baker ◽  
...  
Keyword(s):  
Katabatic Wind ◽  
Spiral Pattern ◽  
Near Surface ◽  
Valuable Source ◽  
History Of ◽  
North Polar ◽  
Human Exploration ◽  
Erosional Event

AbstractThe clockwise spiral of troughs marking the Martian north polar plateau forms one of the planet’s youngest megastructures. One popular hypothesis posits that the spiral pattern resulted as troughs underwent poleward migration. Here, we show that the troughs are extensively segmented into enclosed depressions (or cells). Many cell interiors display concentric layers that connect pole- and equator-facing slopes, demonstrating in-situ trough erosion. The segmentation patterns indicate a history of gradual trough growth transversely to katabatic wind directions, whereby increases in trough intersections generated their spiral arrangement. The erosional event recorded in the truncated strata and trough segmentation may have supplied up to ~25% of the volume of the mid-latitude icy mantles. Topographically subtle undulations transition into troughs and have distributions that mimic and extend the troughs’ spiraling pattern, indicating that they probably represent buried trough sections. The retention of the spiral pattern in surface and subsurface troughs is consistent with the megastructure’s stabilization before its partial burial. A previously suggested warm paleoclimatic spike indicates that the erosion could have occurred as recently as ~50 Ka. Hence, if the removed ice was redeposited to form the mid-latitude mantles, they could provide a valuable source of near-surface, clean ice for future human exploration.

scholarly journals Development of a Field Deployable Firebrand Flux and Condition Measurement System

2020 ◽  
Author(s):  
Simone Zen ◽  
Jan C. Thomas ◽  
Eric V. Mueller ◽  
Bhisham Dhurandher ◽  
Michael Gallagher ◽  
...  
Keyword(s):  
Imaging Techniques ◽  
Time History ◽  
Infrared Camera ◽  
Thermal Conditions ◽  
Particle Characterization ◽  
Fire Dynamics ◽  
Rate Of Spread ◽  
New Instrument ◽  
History Of

AbstractA new instrument to quantify firebrand dynamics during fires with particular focus on those associated with the Wildland-Urban Interface (WUI) has been developed. During WUI fires, firebrands can ignite spot fires, which can rapidly increase the rate of spread (ROS) of the fire, provide a mechanism by which the fire can pass over firebreaks and are the leading cause of structure ignitions. Despite this key role in driving wildfire dynamics and hazards, difficulties in collecting firebrands in the field and preserving their physical condition (e.g. dimensions and temperature) have limited the development of knowledge of firebrand dynamics. In this work we present a new, field-deployable diagnostic tool, an emberometer, designed to provide measurement of firebrand fluxes and information on both the geometry and the thermal conditions of firebrands immediately before deposition by combining a visual and infrared camera. A series of laboratory experiments were conducted to calibrate and validate the developed imaging techniques. The emberometer was then deployed in the field to explore firebrand fluxes and particle conditions for a range of fire intensities in natural pine forest environments. In addition to firebrand particle characterization, field observations with the emberometer enabled detailed time history of deposition (i.e. firebrand flux) relative to concurrent in situ fire behaviour observations. We highlight that deposition was characterised by intense, short duration “showers” that can be reasonably associated to spikes in the average fire line intensity. The results presented illustrate the potential use of an emberometer in studying firebrand and spot fire dynamics.

The physiopathology of spontaneous hemorrhagic stroke: a systematic review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Alcivan Batista de Morais Filho ◽  
Thiago Luis de Holanda Rego ◽  
Letícia de Lima Mendonça ◽  
Sulyanne Saraiva de Almeida ◽  
Mariana Lima da Nóbrega ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Natural History ◽  
Hemorrhagic Stroke ◽  
Recent Literature ◽  
Clinical Manifestations ◽  
The Road ◽  
History Of

Abstract Hemorrhagic stroke (HS) is a major cause of death and disability worldwide, despite being less common, it presents more aggressively and leads to more severe sequelae than ischemic stroke. There are two types of HS: Intracerebral Hemorrhage (ICH) and Subarachnoid Hemorrhage (SAH), differing not only in the site of bleeding, but also in the mechanisms responsible for acute and subacute symptoms. This is a systematic review of databases in search of works of the last five years relating to the comprehension of both kinds of HS. Sixty two articles composed the direct findings of the recent literature and were further characterized to construct the pathophysiology in the order of events. The road to the understanding of the spontaneous HS pathophysiology is far from complete. Our findings show specific and individual results relating to the natural history of the disease of ICH and SAH, presenting common and different risk factors, distinct and similar clinical manifestations at onset or later days to weeks, and possible complications for both.

scholarly journals In Situ exploration of the giant planets

2021 ◽  
Author(s):  
O. Mousis ◽  
D. H. Atkinson ◽  
R. Ambrosi ◽  
S. Atreya ◽  
D. Banfield ◽  
...  
Keyword(s):  
Solar System ◽  
Giant Planets ◽  
Atmospheric Composition ◽  
Formation History ◽  
History Of ◽  
Composition Structure ◽  
Galileo Probe ◽  
Probe Measurements

AbstractRemote sensing observations suffer significant limitations when used to study the bulk atmospheric composition of the giant planets of our Solar System. This impacts our knowledge of the formation of these planets and the physics of their atmospheres. A remarkable example of the superiority of in situ probe measurements was illustrated by the exploration of Jupiter, where key measurements such as the determination of the noble gases’ abundances and the precise measurement of the helium mixing ratio were only made available through in situ measurements by the Galileo probe. Here we describe the main scientific goals to be addressed by the future in situ exploration of Saturn, Uranus, and Neptune, placing the Galileo probe exploration of Jupiter in a broader context. An atmospheric entry probe targeting the 10-bar level would yield insight into two broad themes: i) the formation history of the giant planets and that of the Solar System, and ii) the processes at play in planetary atmospheres. The probe would descend under parachute to measure composition, structure, and dynamics, with data returned to Earth using a Carrier Relay Spacecraft as a relay station. An atmospheric probe could represent a significant ESA contribution to a future NASA New Frontiers or flagship mission to be launched toward Saturn, Uranus, and/or Neptune.

scholarly journals Gaia DR1 completeness within 250 pc & star formation history of the Solar neighbourhood

2017 ◽  
Vol 12 (S330) ◽  
pp. 148-151 ◽  
Author(s):  
Edouard J. Bernard
Keyword(s):  
Star Formation ◽  
Star Formation History ◽  
Solar Neighbourhood ◽  
The Sun ◽  
Thick Disc ◽  
Formation History ◽  
Magnitude Diagram ◽  
History Of

AbstractWe took advantage of the Gaia DR1 to combine TGAS parallaxes with Tycho-2 and APASS photometry to calculate the star formation history (SFH) of the solar neighbourhood within 250 pc using the colour-magnitude diagram fitting technique. We present the determination of the completeness within this volume, and compare the resulting SFH with that calculated from the Hipparcos catalogue within 80 pc of the Sun. We also show how this technique will be applied out to ~5 kpc thanks to the next Gaia data releases, which will allow us to quantify the SFH of the thin disc, thick disc and halo in situ, rather than extrapolating based on the stars from these components that are today in the solar neighbourhood.

scholarly journals The merger-driven evolution of massive early-type galaxies

2020 ◽  
Vol 15 (S359) ◽  
pp. 62-66
Author(s):  
Carlo Cannarozzo ◽  
Carlo Nipoti ◽  
Alessandro Sonnenfeld ◽  
Alexie Leauthaud ◽  
Song Huang ◽  
...  
Keyword(s):  
Mass Velocity ◽  
Selection Criteria ◽  
Velocity Dispersion ◽  
Ex Situ ◽  
Scaling Relations ◽  
Early Type ◽  
History Of ◽  
Kinematic Properties ◽  
Shed Light

AbstractThe evolution of the structural and kinematic properties of early-type galaxies (ETGs), their scaling relations, as well as their stellar metallicity and age contain precious information on the assembly history of these systems. We present results on the evolution of the stellar mass-velocity dispersion relation of ETGs, focusing in particular on the effects of some selection criteria used to define ETGs. We also try to shed light on the role that in-situ and ex-situ stellar populations have in massive ETGs, providing a possible explanation of the observed metallicity distributions.

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