An Extremely Rare Disconnection of the External Iliac Artery and Novel Collateral Remodeling in an Endometrial Stromal Sarcoma Woman

2021 ◽  
Author(s):  
Shixuan Wang ◽  
Ting Zhou ◽  
Nan Yu ◽  
Ronghua Liu
Keyword(s):  
Iliac Artery ◽  
Lower Limb ◽  
External Iliac Artery ◽  
Endometrial Stromal Sarcoma ◽  
Lessons Learned ◽  
Lower Limbs ◽  
Arterial Blood Flow ◽  
Stromal Sarcoma ◽  
Arterial Blood ◽  
Left Lower Limb

Abstract Background: Injury to the external iliac artery (EIA) can have serious consequences and can be extremely challenging for surgeons. Here, we report a patient with bizarre disconnection of the external iliac artery during a laparoscopic operation.Case presentation: On May 27, 2020, during a laparoscopic pelvic lymphadenectomy operation to treat endometrial stromal sarcoma, we encountered an unusual anatomy: abnormal disconnection of the left external iliac artery in a 26-year-old female patient. The proximal and distal ends of the left external iliac artery demonstrated old narrowing without active bleeding, and the distance between the two disconnected ends was more than 3 cm. The scenario was surprising to the entire staff in the operating theater. After a comprehensive assessment of skin temperature, arterial pulsation and arterial blood flow, a multidisciplinary team (MDT) determined that collateral circulation of the left lower limb had been established and could meet the blood supply of the lower limbs, which was also confirmed three times by computed tomography angiography (CTA) and Doppler ultrasound of the blood vessels in the abdomen and lower limbs. Eleven months after the operation, the patient had no obvious abnormality, and the daily activities of the left lower limb were not affected. Follow-up after treatment for the patient is still in progress.Conclusions: We describe the details of the whole case of disconnection of the external iliac artery. We hope to summarize the experience and lessons learned through this case and a relevant literature review to improve the safety and orderliness of our future clinical work.

scholarly journals A Case of an Extremely Rare Disconnection of the External Iliac Artery and Novel Collateral Remodeling

2021 ◽  
Author(s):  
Shixuan Wang ◽  
Ting Zhou ◽  
Nan Yu ◽  
Ronghua Liu
Keyword(s):  
Iliac Artery ◽  
Lower Limb ◽  
Relevant Literature ◽  
External Iliac Artery ◽  
Pelvic Lymphadenectomy ◽  
Lessons Learned ◽  
Lower Limbs ◽  
Arterial Blood Flow ◽  
Arterial Blood ◽  
Left Lower Limb

Abstract Background: Injury to the external iliac artery (EIA) can have serious consequences and can be extremely challenging for surgeons. Here, we report a patient with bizarre disconnection of the external iliac artery during a laparoscopic operation.Case presentation: On May 27, 2020, during a laparoscopic pelvic lymphadenectomy operation to treat endometrial stromal sarcoma, we encountered an unusual anatomy: abnormal disconnection of the left external iliac artery in a 26-year-old female patient. The proximal and distal ends of the left external iliac artery demonstrated old narrowing without active bleeding, and the distance between the two disconnected ends was more than 3 cm. The scenario was surprising to the entire staff in the operating theater. After a comprehensive assessment of skin temperature, arterial pulsation and arterial blood flow, a multidisciplinary team (MDT) determined that collateral circulation of the left lower limb had been established and could meet the blood supply of the lower limbs, which was also confirmed three times by computed tomography angiography (CTA) and Doppler ultrasound of the blood vessels in the abdomen and lower limbs. Eleven months after the operation, the patient had no obvious abnormality, and the daily activities of the left lower limb were not affected. Follow-up after treatment for the patient is still in progress.Conclusions: We describe the details of the whole case of disconnection of the external iliac artery. We hope to summarize the experience and lessons learned through this case and a relevant literature review to improve the safety and orderliness of our future clinical work.

scholarly journals Acute Ischemia of Lower Limbs Caused by Thrombosis of Persistent Sciatic Artery: Case Report

2020 ◽  
Vol 13 ◽  
pp. 117954762095119
Author(s):  
Hailong Luo ◽  
Jian Fu ◽  
Bo Tang
Keyword(s):  
Case Report ◽  
Endovascular Treatment ◽  
Iliac Artery ◽  
Lower Limb ◽  
External Iliac Artery ◽  
Lower Limbs ◽  
Acute Ischemia ◽  
Case Presentation ◽  
Persistent Sciatic Artery ◽  
Left Lower Limb

Background: Hypoplasia of the external iliac artery with persistent sciatic artery (PSA) is rare. Patients with this condition seek medical treatment mainly due to the formation of persistent sciatic aneurysm or aneurysm complicated with distal ischemia. Case presentation: In the present study, we report a case of a patient with thrombosis of PSA without aneurysm in the left lower limb that underwent endovascular treatment. Conclusion: Thrombosis of PSA may be associated with sedentary or other unhealthy lifestyles. Endovascular treatment of sciatic arterial diseases could be performed through the brachial artery approach, especially for those with hypoplasia of bilateral iliofemoral arteries.

scholarly journals Lower limb vascular dysfunction in cyclists

2013 ◽  
Vol 12 (2) ◽  
pp. 139-150 ◽  
Author(s):  
Thiago Ayala Melo Di Alencar ◽  
Karinna Ferreira de Sousa Matias ◽  
Bruno do Couto Aguiar
Keyword(s):  
Blood Flow ◽  
Iliac Artery ◽  
Lower Limb ◽  
Vascular Dysfunction ◽  
External Iliac Artery ◽  
Signs And Symptoms ◽  
Musculoskeletal Injuries ◽  
Lower Limbs ◽  
Medical Team ◽  
Vascular Insufficiency

Sports-related vascular insufficiency affecting the lower limbs is uncommon, and early signs and symptoms can be confused with musculoskeletal injuries. This is also the case among professional cyclists, who are always at the threshold between endurance and excess training. The aim of this review was to analyze the occurrence of vascular disorders in the lower limbs of cyclists and to discuss possible etiologies. Eighty-five texts, including papers and books, published from 1950 to 2012, were used. According to the literature reviewed, some cyclists receive a late diagnosis of vascular dysfunction due to a lack of familiarity of the medical team with this type of dysfunction. Data revealed that a reduced blood flow in the external iliac artery, especially on the left, is much more common than in the femoral and popliteal arteries, and that vascular impairment is responsible for the occurrence of early fatigue and reduced performance in cycling.

scholarly journals The use of the drug Wessel Duet F in the complex treatment of lesions of the lower extremities in patients with type II diabetes

1999 ◽  
Vol 45 (3) ◽  
pp. 14-18
Author(s):  
A. Yu. Tokmakova ◽  
T. M. Milenkaya ◽  
L. D. Chirkova ◽  
M. I. Arbuzova ◽  
M. B. Antsiferov
Keyword(s):  
Type 2 Diabetes ◽  
Lipid Metabolism ◽  
Lower Limb ◽  
Total Cholesterol Level ◽  
Blood Rheology ◽  
Lower Limbs ◽  
Arterial Blood Flow ◽  
Arterial Blood ◽  
Peripheral Arterial

A comprehensive approach to treatment of ischemic involvement of the lower limbs in patients with type 2 diabetes is proposed. Diabetics often develop obliterating atherosclerosis of the lower limb arteries; the risk of amputation of feet and shins, involving invalidism and death, is rather high. The authors assessed the effect of Vessel Due F (Alfa Wasserman, Italy) on lipid metabolism, blood rheology, and peripheral hemodynamics in 30 patients with type 2 diabetes complicated by the ischemic form of diabetic foot. The course of therapy lasted for 12 weeks. Lipid metabolism notably improved (total cholesterol level decreased), normocoagulation and normalization of peripheral arterial blood flow were attained in the majority of patients, as shown by dopplerography. Therefore, the drug is effective in the treatment of ischemic form of the lower limb involvement in patients with type 2 diabetes.

scholarly journals Neurologic melioidosis presented as encephalomyelitis and subdural collection in two male labourers in India

2015 ◽  
Vol 9 (11) ◽  
pp. 1289-1293 ◽  
Author(s):  
Kavitha Saravu ◽  
Rajagopal Kadavigere ◽  
Ananthakrishna Barkur Shastry ◽  
Rohit Pai ◽  
Chiranjay Mukhopadhyay
Keyword(s):  
Lower Limb ◽  
Corticosteroid Treatment ◽  
Conus Medullaris ◽  
Subdural Empyema ◽  
Lower Limbs ◽  
High Dose ◽  
Limb Weakness ◽  
Subdural Collection ◽  
Lower Limb Weakness ◽  
Left Lower Limb

Two distinct and potentially deceitful cases of neurologic melioidosis are reported. Case 1: A 39-year-old alcoholic and uncontrolled diabetic male presented with cough, fever, and left focal seizures with secondary generalization. An magnetic resonance imaging (MRI) brain scan revealed a small peripherally enhancing subdural collection along the interhemispheric fissure suggestive of minimal subdural empyema. Blood culture grew Burkholderia pseudomallei. Patient was diagnosed with disseminated bacteraemic melioidosis with subdural empyema. He was successfully treated with ceftazidime-cotrimoxazole-doxycycline. Case 2: A 45-year-old male presented with left lower limb weakness, difficulty in passing urine and stool, and back pain radiating to lower limbs. Neurological examination revealed flaccid left lower limb with absent deep tendon reflexes and plantar reflex. Spinal MRI showed T2 hyperintensity from D9 to L1 suggestive of demyelination. Patient was treated with high dose methylprednisolone. By day 3 of steroid treatment, lower limb weakness progressed. Subsequent MRI showed extensive cord hyperintensity on T2 weighted sequence extending from C5 to conus medullaris consistent with demyelination. Cerebrospinal fluid (CSF) culture grew B. pseudomallei, and the patient was given meropenem-cotrimoxazole. After three weeks of parenteral treatment, the lower limbs remained paralyzed. Patient was discharged on oral cotrimoxazole-doxycycline. Conclusions: Melioidosis should be considered as a differential in focal suppurative central nervous system (CNS) lesions, meningoencephalitis, or encephalomyelitis in endemic areas. CNS infections must be ruled out prior to steroid administration. The role of corticosteroids in demyelinating CNS melioidosis has been refuted. This is a rare documentation of effect of unintentional corticosteroid treatment in melioidosis.

A RARE CASE OF MAY- THURNER SYNDROME

2021 ◽  
pp. 17-19
Author(s):  
B. Santhi ◽  
Manigandan Manigandan ◽  
Nishok Nishok
Keyword(s):  
Iliac Artery ◽  
Lower Limb ◽  
Rare Case ◽  
Common Iliac Artery ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Middle Aged ◽  
Unique Case ◽  
Left Common Iliac Vein ◽  
Left Lower Limb

May-Thurner syndrome (MTS) is a venous outow obstruction disorder characterized by compression of the left common iliac vein by an overriding right common iliac artery. MTS primarily affects young to middle-aged women, although many patients remain entirely asymptomatic.We report a unique case of a 25 -year-old male who presented with MTS-related multiple varicosities in left lower limb.

scholarly journals A Rare Cause of May-Thurner Syndrome Postarterial Intervention

2019 ◽  
Vol 03 (03) ◽  
pp. 180-184 ◽  
Author(s):  
Hiok Yang Chan ◽  
Edward Tieng Chek Choke ◽  
Tjun Yip Tang ◽  
Chandramohan Sivanathan ◽  
Chua Ming Er Jasmine ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Iliac Artery ◽  
Lower Limb ◽  
Unusual Case ◽  
Anatomical Variation ◽  
Iliac Vein ◽  
Team Approach ◽  
Left Lower Limb ◽  
Iliac Vein Compression

AbstractMay-Thurner syndrome (MTS) is rare condition thought to occur due to an anatomical variation. In MTS, there is left iliac vein compression by the right iliac artery and lumbar spine resulting in left lower limb deep venous thrombosis. The authors report a rare cause of MTS postarterial intervention. They describe the unusual case of an Asian man who presented with acute left lower limb deep venous thrombosis 5 days following left common iliac artery angioplasty and stent insertion. Computed tomographic (CT) venogram demonstrated the left iliac vein compression by the left iliac artery stent. Successful recanalization of the thrombosed iliac vein was achieved with a combination of pulse spray thrombolysis and rheolytic mechanical thrombectomy, followed by angioplasty and stent placement in the iliac vein. There was rapid and complete resolution of symptoms. This report illustrates the use of complementary imaging modalities and a multidisciplinary team approach to achieve a successful technical and clinical outcome following an unusual case of MTS postarterial intervention and the subsequent successful endovascular management.

Iliac Venous Obstruction: Surgical Reconstruction

2000 ◽  
Vol 15 (3-4) ◽  
pp. 144-148
Author(s):  
F. Mercier ◽  
F. Cormier ◽  
J. M. Fichelle ◽  
F. Duarte ◽  
J. M. Cormier
Keyword(s):  
Iliac Artery ◽  
Lower Limb ◽  
Iliac Vein ◽  
Lower Limbs ◽  
Surgical Reconstruction ◽  
Invasive Technique ◽  
Venous Obstruction ◽  
Long Term Outcome ◽  
First Choice

Aim: To review the investigation and treatment of iliac vein obstruction. Method: A review of current literature in the field of management of iliac venous obstruction has been conducted. Synthesis: Iliac venous obstruction results in chronic or acute symptoms in the lower limb presenting as pain, swelling, oedema and discomfort of the lower limb. Intrinsic or extrinsic obstruction of the iliac veins may be the cause. Cockett syndrome is the classic aetiology for chronic intermittent or fixed left inferior limb venous obstruction. Other causes include tumours, vascular grafts or lymph node compression and retroperitoneal fibrosis. Duplex ultrasound imaging is now the first-choice investigation. CT scanning is useful where external vein compression is suspected. Phlebography is used when an endovascular procedure is to be done. The surgical treatment of Cockett syndrome described by Cormier is transposition of the common right iliac artery in the left internal iliac artery. This is being replaced by endovascular balloon venoplasty completed by stenting of the left iliac vein. We reviewed the experience of surgical correction of Cockett syndrome with Cormier's technique in 70 patients operated on between 1976 and 1990; 55 patients had a follow-up of 12-177 months. Anatomical and functional results were perfect for all patients except when endoluminal synechiae or iliac venous thrombosis were associated with postural compression. In this case a 50% success rate was achieved. The endovascular revolution offers a less invasive technique for treatment of chronic iliac venous obstruction. Follow-up is short at present in the few publications found in the literature. Conclusions: Iliac vein obstruction results in symptoms of swelling in the lower limbs. These may be managed conservatively. Where there is an indication for venous reconstruction, investigation by duplex ultrasonography is the first step. Endovascular procedures including stenting offer significant benefit. The long-term outcome of these interventions has yet to be established.

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