scholarly journals Case of persistent sciatic artery in a dialysis patient with critical limb ischemia

2022 ◽  
Vol 10 ◽  
pp. 2050313X2110685
Author(s):  
Yasuhito Nakamura ◽  
Yoshitaka Kumada ◽  
Akihiro Mori ◽  
Norikazu Kawai ◽  
Narihiro Ishida

Persistent sciatic artery is a rare congenital malformation (incidence rate, 0.03%–0.06%). We report the case of a 72-year-old male patient with persistent sciatic artery suffering from pain at rest and an ulcer on the left first toe. Angiography findings showed 90% stenosis in the distal persistent sciatic artery. Endovascular therapy was considered difficult because of a long stenotic lesion from the persistent sciatic artery to the popliteal artery and extremely high calcification of the whole body. Because of poor blood flow to the lower leg, vascular prosthesis would have increased the risk of thrombotic occlusion. Therefore, below-knee femoropopliteal bypass using the great saphenous vein graft was performed, which led to the healing of the ulcer on the left first toe. Contrast-enhanced computed tomography of the lower limbs was performed to confirm that the bypass blood flow was good. The patient was discharged on postoperative day 5.

2017 ◽  
Vol 07 (01) ◽  
pp. e13-e16
Author(s):  
Makiko Kirino ◽  
Masayuki Ochiai ◽  
Masako Ichiyama ◽  
Hirosuke Inoue ◽  
Takeshi Kusuda ◽  
...  

Neonatal thromboembolism occurs with various predispositions and triggers. Early diagnosis of the thrombosis is challenging and essential for the therapeutic interventions. We herein report two newborns who presented with transient hemi-lower limb ischemia due to (1) arterial thrombosis or (2) a persistent sciatic artery (PSA). The patient with arterial thrombosis showed elevations of fibrin degradation product and D-dimer and received antithrombin and heparin intravenously. The patient with PSA was immediately assessed by a contrast-enhanced computed tomography because of a transient ischemic episode with no evidence of hypercoagulability. Newborns suspected of having arterial thrombosis may need urgent surgical intervention along with thrombolytic and anticoagulant therapy to prevent organ ischemia and amputation of extremities. Conversely, some PSA cases have reportedly been treated conservatively. This vascular anomaly was previously reported as a cause of lower limb ischemia only in a newborn. PSA is a critical differential diagnosis of neonatal arterial thrombosis that needs urgent therapeutic intervention.


2020 ◽  
Vol 13 ◽  
pp. 117954762091273
Author(s):  
Mimari Kanazawa ◽  
Takeshi Sugaya ◽  
Fumiaki Takahashi ◽  
Kazuhiro Takenaka ◽  
Kouhei Tsuchida ◽  
...  

A patient was diagnosed with ulcerative colitis (UC) in 2010. In March 2015, she had abdominal pain, diarrhea, bloody stool, and UC has relapsed. In June 2015, pain and sensory disturbance of both lower limbs appeared. Blood flow at the distal femoral artery was not confirmed with magnetic resonance angiography, and it was diagnosed as bilateral acute inferior limb ischemia. Arterial thrombolectomy with Fogarty’s balloon catheter was performed and blood flow was improved. The severity of UC was moderate with Mayo score 8. Thrombosis is considered to be a complication with a high incidence in inflammatory bowel disease. Reports of arterial thrombosis are very rare. It is important to evaluate the risk of bleeding and thrombosis in active or severe cases in UC and need to do thrombotic prophylactic treatment simultaneously with UC treatment.


Author(s):  
Andrzej Szopa ◽  
Małgorzata Domagalska-Szopa ◽  
Andrzej Siwiec ◽  
Ilona Kwiecień-Czerwieniec

This study investigated the effectiveness of whole-body vibration (WBV) training incorporated into a conventional physiotherapy (PT) program (WBV-assisted training) in improving blood flow in the lower limbs and range of motion in the lower limb joints of children with myelomeningocele (MMC). A total of 31 children with MMC (7–15 years old) underwent a 6 weeks treatment program consisting of 2 weeks of conventional PT followed by 4 weeks of WBV-assisted training. The assessment comprised two parts: evaluation of lower limb joint range of motion and Doppler ultrasonography of the superficial femoral, popliteal, and anterior tibial arteries and was performed three times for each of the participants (at baseline, after 10 sessions of PT but before WBV-assisted training, and after 20 sessions of WBV-assisted training). Our results showed that WBV-assisted training significantly improved lower limb circulation in patients with MMC, increasing velocity and reducing resistivity in all tested arteries. Moreover, WBV-assisted training alleviated lower-extremity contractures, especially of the knee. Thus, WBV-assisted training is effective as an adjunctive rehabilitation program for improving functional mobility in children with MMC.


VASA ◽  
2010 ◽  
Vol 39 (3) ◽  
pp. 265-267 ◽  
Author(s):  
Moulakakis ◽  
Maras ◽  
Bountouris ◽  
Pomoni ◽  
Georgakis ◽  
...  

Thrombosis of an abdominal aortic aneurysm is a rare devastating complication with an estimated mortality rate of 50%. Simultaneous acute pain, pallor and coldness of the lower limbs, mottling from the level of iliac crests or umbilicus, paraplegia and absence of femoral pulses are all manifestations of a sudden and acute interruption of blood flow through the aneurysmatic aorta. We report a case of an occlusion of an abdominal aortic aneurysm during hospitalization which was not manifested with symptoms of limb ischemia. In this case we feature the rare and unusually “silent” presentation of the event.


2004 ◽  
Vol 97 (2) ◽  
pp. 627-634 ◽  
Author(s):  
Timothy A. Bauer ◽  
Eric P. Brass ◽  
Mark Nehler ◽  
Thomas J. Barstow ◽  
William R. Hiatt

Slowed pulmonary O2 uptake (V̇o2) kinetics in peripheral arterial disease (PAD) have been attributed to impaired limb blood flow and/or peripheral muscle metabolic abnormalities. Although PAD results from atherosclerotic occlusive disease in the arteries to the lower extremities, systemic abnormalities affecting whole body O2 delivery or vascular function in PAD could also partially explain the exercise impairment. To date, the effects of these systemic abnormalities have not been evaluated. To test the hypothesis that the slowed pulmonary V̇o2 kinetics in PAD reflects local and not systemic abnormalities, V̇o2 kinetics were evaluated after the onset of constant-load exercise of the upper and lower limbs in PAD patients and healthy controls (Con). Ten PAD patients and 10 Con without significant cardiopulmonary dysfunction performed multiple transitions from rest to moderate-intensity arm ergometry and treadmill exercise to assess their V̇o2 kinetic responses. Reactive hyperemic (RH) blood flow was assessed in the arms and legs as a measure of endothelial function. Compared with Con, PAD V̇o2 kinetic phase 2 time constants were prolonged during treadmill exercise (PAD 34.3 ± 9.2 s vs. Con 19.6 ± 3.5 s; P < 0.01) but not arm exercise (PAD 38.5 ± 7.5 s vs. Con 32.5 ± 9.0 s; P > 0.05). RH blood flow was significantly reduced in the legs (PAD 20.7 ± 8.3 vs. Con 46.1 ± 17.1 ml·100 ml−1·min−1; P < 0.01) and arms of PAD subjects (PAD 34.0 ± 8.6 vs. Con 50.8 ± 12.2 ml·100 ml−1·min−1; P < 0.01) compared with Con, but RH limb flow was not correlated with arm or treadmill V̇o2 kinetic responses in either group. In summary, slowed pulmonary V̇o2 kinetics in PAD patients occur only with exercise of the lower limbs affected by the arterial occlusive disease process and are not slowed with exercise of the unaffected upper extremities compared with controls. Furthermore, the slowed pulmonaryV̇o2 kinetics of the lower extremity could not be explained by any abnormalities in resting cardiac or pulmonary function and were not related to the magnitude of reduction in limb vascular reactivity.


2021 ◽  
Vol 10 (18) ◽  
pp. 4273
Author(s):  
Małgorzata Domagalska-Szopa ◽  
Andrzej Szopa ◽  
Andrzej Siwiec ◽  
Ilona Kwiecień-Czerwieniec ◽  
Lutz Schreiber ◽  
...  

The objective of the present study was to determine the effectiveness of a three-week Whole-Body Vibration (WBV) training on the vascular blood flow of the lower limbs in children with myelomeningocele. The secondary goal was to evaluate the effect of WBV on the ROM of lower limb joints in this population. A total of 30 children with MMC (7–16 years old) were enrolled in the study. Children were randomly allocated to two groups of equal numbers, using an envelope code. The experimental group underwent a 3-week WBV training, while the control group received a 3-week conventional physiotherapy (PT) program. The examination consisted of two parts: (1) Doppler USG examination of the lower limb vascular blood flow; (2) evaluation of ROM. The results obtained revealed three main findings. First, WBV training effectively improved blood flow by increasing flow velocities in all tested arteries, while the impact of the PT program was limited to a single parameter. Second, WBV training effectively improved vascular resistance in arteries of the lower legs, while the PT program did not achieve any significant differences. Third, both types of treatment intervention significantly improved ROM in all joints of the lower limbs in MMC participants.


2022 ◽  
Vol 8 ◽  
Author(s):  
Qilong Wang ◽  
Zhihua Cheng ◽  
Liang Tang ◽  
Qi Wang ◽  
Ping Zhang ◽  
...  

Herein, we report the case of a 59-year-old man with intermittent claudication of ~100 m, who complained of resting pain in his lower right extremity. A pelvic, contrast-enhanced, computed tomography scan showed the presence of cystic density in the lower segment of the right common femoral artery. Faced with the risk of acute limb ischemia, we navigated a challenging diagnostic procedure to choose an appropriate treatment for him. Additionally, we performed a pathological investigation of the excised common femoral artery following the excision bypass. On postoperative day 5, the patient was discharged from the hospital. During the 2-year follow-up, no new cysts were discovered, and the patient had favorable prognosis.


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