scholarly journals Left brachiocephalic vein aneurysm: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Harushi Ueno ◽  
Mari Yazawa ◽  
Hideki Tsubouchi ◽  
Keita Nakanishi ◽  
Tomoshi Sugiyama ◽  
...  
Keyword(s):  
Median Sternotomy ◽  
Anterior Mediastinum ◽  
Aneurysm Rupture ◽  
Brachiocephalic Vein ◽  
Preoperative Imaging ◽  
Venous Aneurysm ◽  
Pulmonary Infarction ◽  
Left Brachiocephalic Vein ◽  
Working Space ◽  
Aneurysm Wall

Abstract Background Aneurysm of the left brachiocephalic vein is a very rare clinical disease and only 40 cases have been reported so far. Case presentation The patient was a 61-year-old woman with no related medical history. She underwent CT to investigate the cause of a cough and a mass was noted in the anterior mediastinum. Dynamic computed tomography with contrast medium injected into the left basilic vein demonstrated the venous aneurysm with blood flow to the left brachiocephalic vein. The patient had no symptoms, but because of the risk of pulmonary infarction and aneurysm rupture, the aneurysm was surgically resected. A median sternotomy was a reasonable approach because of the fragility of the venous aneurysm wall with little working space in the anterior mediastinum. Conclusions We diagnosed an aneurysm of the left brachiocephalic vein on preoperative imaging and excised it through a median sternotomy. The venous wall was thin and fragile in some areas and so this approach was appropriate in view of the possibility of intraoperative injury.

scholarly journals Angioplasty for the treatment of left brachiocephalic vein aneurysm: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Long Gui ◽  
Hongbo Xu ◽  
Chengdong Ning ◽  
Niuliu Huang ◽  
Yu Pan
Keyword(s):  
Case Reports ◽  
Treatment Method ◽  
Anterior Mediastinum ◽  
Postoperative Recovery ◽  
Aneurysm Rupture ◽  
Brachiocephalic Vein ◽  
Left Brachiocephalic Vein ◽  
Contrast Enhanced Ct ◽  
Type Size ◽  
Venous Angioplasty

Abstract Background Brachiocephalic vein aneurysm is a rare vascular malformation, which is often reported in case reports. At present it has attracted much attention due to the serious complications, such as vein aneurysm rupture, pulmonary embolism, venous thrombosis, etc. We report a case of left brachiocephalic vein aneurysm with compression symptoms. Case presentation a 52-year-old male who was admitted to our hospital with irritating cough for more than 1 month. Chest contrast-enhanced CT showed a localized expansion of 5.2 cm in diameter of the left brachiocephalic vein in the anterior mediastinum. The patient received venous angioplasty with brachiocephalic vein aneurysm resection, and the postoperative recovery was well. Conclusion Surgical operation is an effecive treatment method for brachiocephalic vein aneurysm, but it is still necessary to choose the appropriate way according to the type, size, location, lesion scope and complications of the vein aneurysm.

scholarly journals 322 THORACOSCOPIC RETROSTERNAL GASTRIC CONDUIT RESECTION IN THE SUPINE POSITION FOR GASTRIC TUBE CANCER

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Kazumasa Horie ◽  
Taro Oshikiri ◽  
Manabu Horikawa ◽  
Yu Kitamura ◽  
Gosuke Takiguchi ◽  
...  
Keyword(s):  
Supine Position ◽  
Gastric Tube ◽  
Postoperative Bleeding ◽  
Median Sternotomy ◽  
Gastric Conduit ◽  
Brachiocephalic Vein ◽  
R0 Resection ◽  
Left Brachiocephalic Vein ◽  
First Case ◽  
The Right

Abstract   Recent advances in treatment for esophageal cancer have improved prognosis after esophagectomy, but they have led to an increased incidence of gastric conduit cancer. In most gastric conduit cancer patients who underwent retrosternal reconstruction, median sternotomy is performed, which is associated with a risk of postoperative bleeding and osteomyelitis; pain often negatively affects respiration. To avoid these problems, we developed thoracoscopic retrosternal gastric conduit resection in the supine position (TRGR-S) as new procedure. Methods We performed the first case of TRGR-S for a 75-year-old male with retrosternal gastric conduit cancer. He was placed in the supine position. Four ports were placed in the left chest wall. The gastric conduit was separated from the epicardium, sternum, and left brachiocephalic vein. Due to adhesions between the gastric tube and the right pleura, combined resection of the right pleura was performed. Next, pediculated jejunal reconstruction via the presternal route was performed. Results Because there were few adhesions in the left thoracic cavity, this approach provided safety and a good surgical view, and it was easy to recognize the landmark including epicardium, sternum, and left brachiocephalic vein leading to appropriate resection of the tissue. Furthermore, there were few restrictions on the operative angle for the forceps and operability was quite ergonomic. Moreover, the lungs can be noninvasively contracted via an artificial pneumothorax. The pathological diagnosis was signet ring cell carcinoma (pT1b, pN0, M0, pStage I), indicating R0 resection. There were no post-operative complications. Conclusion This approach does not require sternotomy, so it has less risk of postoperative bleeding and osteomyelitis. Due to fewer adhesions, this approach is safe and provides a good surgical view. TRGR-S is a safe, ergonomic, and reliable procedure for resection of retrosternal gastric conduit cancer. Video This is the video of the operation ‘TRGR-S’, which is the new procedure for the gastric conduit cancer. https://www.dropbox.com/s/2whnekgp73hw1lz/video%20for%20ISDE2020.mov?dl=0.

scholarly journals Angioplasty for the Treatment of Left Brachiocephalic Vein Tumor: A Case Report

2020 ◽  
Author(s):  
Long Gui ◽  
Hongbo Xu ◽  
Chengdong Ning ◽  
Niuliu Huang ◽  
Yu Pan
Keyword(s):  
Case Reports ◽  
Tumor Resection ◽  
Treatment Method ◽  
Anterior Mediastinum ◽  
Postoperative Recovery ◽  
Brachiocephalic Vein ◽  
Left Brachiocephalic Vein ◽  
Contrast Enhanced Ct ◽  
Type Size ◽  
Venous Angioplasty

Abstract Background: Brachiocephalic vein tumor is a rare vascular malformation, which is often reported in case reports. At present it has attracted much attention due to the serious complications, such as vein tumor rupture, pulmonary embolism, venous thrombosis, etc. We report a case of left brachiocephalic vein tumor with compression symptoms.Case presentation: a 52-year-old male who was admitted to our hospital with irritating cough for more than one month. Chest contrast-enhanced CT showed a localized expansion of 5.2cm in diameter of the left brachiocephalic vein in the anterior mediastinum. The patient received venous angioplasty with brachiocephalic vein tumor resection, and the postoperative recovery was well.Conclusion: Surgical operation is an effecive treatment method for brachiocephalic vein tumor, but it is still necessary to choose the appropriate way according to the type, size, location, lesion scope and complications of the vein tumor.

Chest case of the day. Obstruction of the left brachiocephalic vein.

1992 ◽  
Vol 158 (6) ◽  
pp. 1358-1359 ◽  
Author(s):  
J A Worrell ◽  
F E Caroll ◽  
D M O'Donnell
Keyword(s):  
Brachiocephalic Vein ◽  
Left Brachiocephalic Vein

scholarly journals High-Resolution Vessel Wall Magnetic Resonance Imaging of Small Unruptured Intracranial Aneurysms

2021 ◽  
Vol 10 (2) ◽  
pp. 225
Author(s):  
Łukasz Zwarzany ◽  
Ernest Tyburski ◽  
Wojciech Poncyljusz
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Aneurysm Rupture ◽  
Resonance Imaging ◽  
Aneurysm Wall ◽  
Conventional Risk Factors

Background: We decided to investigate whether aneurysm wall enhancement (AWE) on high-resolution vessel wall magnetic resonance imaging (HR VW-MRI) coexists with the conventional risk factors for aneurysm rupture. Methods: We performed HR VW-MRI in 46 patients with 64 unruptured small intracranial aneurysms. Patient demographics and clinical characteristics were recorded. The PHASES score was calculated for each aneurysm. Results: Of the 64 aneurysms, 15 (23.4%) showed wall enhancement on post-contrast HR VW-MRI. Aneurysms with wall enhancement had significantly larger size (p = 0.001), higher dome-to-neck ratio (p = 0.024), and a more irregular shape (p = 0.003) than aneurysms without wall enhancement. The proportion of aneurysms with wall enhancement was significantly higher in older patients (p = 0.011), and those with a history of prior aneurysmal SAH. The mean PHASES score was significantly higher in aneurysms with wall enhancement (p < 0.000). The multivariate logistic regression analysis revealed that aneurysm irregularity and the PHASES score are independently associated with the presence of AWE. Conclusions: Aneurysm wall enhancement on HR VW-MRI coexists with the conventional risk factors for aneurysm rupture.

scholarly journals Morphological variables associated with ruptured basilar tip aneurysms

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jian Zhang ◽  
Anil Can ◽  
Pui Man Rosalind Lai ◽  
Srinivasan Mukundan ◽  
Victor M. Castro ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Multivariable Analysis ◽  
Aneurysm Rupture ◽  
Size Ratio ◽  
Width Ratio ◽  
Maximum Height ◽  
Morphological Parameters ◽  
Flow Angle ◽  
Aneurysm Wall ◽  
Fisher Grade

AbstractMorphological factors of intracranial aneurysms and the surrounding vasculature could affect aneurysm rupture risk in a location specific manner. Our goal was to identify image-based morphological parameters that correlated with ruptured basilar tip aneurysms. Three-dimensional morphological parameters obtained from CT-angiography (CTA) or digital subtraction angiography (DSA) from 200 patients with basilar tip aneurysms diagnosed at the Brigham and Women’s Hospital and Massachusetts General Hospital between 1990 and 2016 were evaluated. We examined aneurysm wall irregularity, the presence of daughter domes, hypoplastic, aplastic or fetal PCoAs, vertebral dominance, maximum height, perpendicular height, width, neck diameter, aspect and size ratio, height/width ratio, and diameters and angles of surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine statistical significance. In multivariable analysis, presence of a daughter dome, aspect ratio, and larger flow angle were significantly associated with rupture status. We also introduced two new variables, diameter size ratio and parent-daughter angle ratio, which were both significantly inversely associated with ruptured basilar tip aneurysms. Notably, multivariable analyses also showed that larger diameter size ratio was associated with higher Hunt-Hess score while smaller flow angle was associated with higher Fisher grade. These easily measurable parameters, including a new parameter that is unlikely to be affected by the formation of the aneurysm, could aid in screening strategies in high-risk patients with basilar tip aneurysms. One should note, however, that the changes in parameters related to aneurysm morphology may be secondary to aneurysm rupture rather than causal.

Robotic Resection of a Left Brachiocephalic Vein Aneurysm Mimicking Thymoma

2020 ◽  
Vol 63 ◽  
pp. 461.e1-461.e5
Author(s):  
Madalina Grigoroiu ◽  
Alessio Mariolo ◽  
Walid Abid ◽  
Cedric Foussier ◽  
Nina Weber ◽  
...  
Keyword(s):  
Brachiocephalic Vein ◽  
Left Brachiocephalic Vein ◽  
Robotic Resection

Abstract 147: Role of Nicotine in the Development of Intracranial Aneurysm Rupture

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Yoshinobu Kamio ◽  
Hajime Furukawa ◽  
Kimihiko Yokosuka ◽  
Masaaki Korai ◽  
Kazuha Mitsui ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Tobacco Smoke ◽  
Intracranial Aneurysms ◽  
Aneurysm Rupture ◽  
Alpha7 Nicotinic Acetylcholine Receptor ◽  
Acetate Salt ◽  
Nicotine Receptors ◽  
Aneurysm Wall ◽  
Salt Hypertension

Background: Nicotine is one of main chemicals of tobacco smoke and promotes atherosclerosis and stroke. Tobacco smoke is considered an independent risk factor for intracranial aneurysm formation, growth, and rupture. There are mainly 5 subtypes of nicotine receptors. Roles of alpha7 nicotinic acetylcholine receptor (α7nAChR) in inflammation and vascular remodeling are diverse and context-dependent. Notably, endothelial α7nAChR is considered to mediate nicotine-induced inflammation. Activation of endothelial α7nAChR by nicotine may promote aneurysm rupture by increasing the aneurysm wall inflammation. Using a mouse model of intracranial aneurysm, we examined effects of nicotine in aneurysm rupture. Moreover we investigated potential roles of α7nAChR stimulation by nicotine in the pathophysiology of intracranial aneurysms. Methods: Intracranial aneurysms were induced by a combination of elastase injection into the cerebrospinal fluid and deoxycorticosteron acetate-salt (DOCA-salt) hypertension in male mice. Mice were treated with (1) nicotine (5 mg/kg/day, n=25); (2) saline sc (n=22) for three weeks after aneurysm induction. To investigate the effect of α7nAChR, mice were treated with (1) saline sc + saline ip (n=11); (2) saline sc + α7nAChR antagonist (Methyllycaconitine, MLA 5mg/kg/day) ip (n=13); (3) nicotine (5 mg/kg/day, sc, 28 days) + saline ip (n=18); (4) nicotine sc + MLA ip (n=18). Results: Nicotine alone significantly increased aneurysmal rupture compared with saline treatment (89% vs 46%, p=0.009). While α7nAChR antagonist did not affect the incidence of aneurysm or rupture rates, the α7nAChR antagonist significantly reduced the deleterious effect of nicotine as indicated by the reduction of the rupture rates (41% vs 100%: nicotine sc + MLA ip group vs nicotine sc + saline ip group, p=0.027). Conclusion: Our data indicate the promotion of aneurysm rupture by nicotine may be mediated by its stimulation of alpha7nAChR.

Sign in / Sign up

Export Citation Format

Share Document