A case of successful surgical treatment of patient with rare vascular anomaly – hypoplasia of infrarenal abdominal aorta

2020 ◽  
Vol 28 (4) ◽  
pp. 506-513
Author(s):  
Alexander F. Kharazov ◽  
V. A. Kul'bak ◽  
Naida Minatullaevna Basirova
Keyword(s):  
Surgical Treatment ◽  
Arterial Pressure ◽  
Arterial Hypertension ◽  
Abdominal Aorta ◽  
Clinical Manifestations ◽  
Vascular Anomaly ◽  
The Body ◽  
Lower Limbs ◽  
Critical Ischemia ◽  
Infrarenal Abdominal Aorta

Aim. To demonstrate a case of treatment of a patient with a rare vascular anomaly hypoplasia of infrarenal abdominal aorta. On a clinical example of female patient U., 41 years of age, with critical ischemia of the lower limbs and diagnosis hypoplasia of the abdominal aorta made on the basis of the clinical and instrumental data, the manifestations, diagnostics and potentials of the successful surgical treatment of the given pathology were demonstrated. Conclusion. Clinical manifestations of hypoplasia of the aorta depend on localization of the lesion and involvement of renal arteries. The commonest clinical sign is arterial hypertension and symptoms associated with the elevated arterial pressure. Hypoplasia of the aorta may also be manifested by hypertrophy of the upper limbs in combination with poor development of muscles of the lower limbs. More aged individuals present with arterial insufficiency leading to clinically significant ischemia of the lower limbs. Thus, in the case described, the patient already had ischemic trophic ulcers of the lower limbs. Without treatment, secondary arterial hypertension and cardiac failure may lead a patient to early death. Today, irrespective of the etiology, the only effective method of treatment of this disease is surgery. In case of our patient, resection of the hypoplastic segment of the aorta and its prosthetics were performed. This permitted to restore circulation in the lower parts of the body and further led to complete healing of trophic ulcers of the shin and to normalization of the systemic arterial pressure.

scholarly journals Pharmacological therapy in critically ill patients with peripheral and concomitant arteriopathy

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 166-173
Author(s):  
Nicola Troisi ◽  
Antonio Trani ◽  
Pierluigi Antonino Cappiello
Keyword(s):  
Peripheral Arterial Disease ◽  
Clinical Manifestations ◽  
Arterial Disease ◽  
Risk Profile ◽  
Pharmacological Therapy ◽  
Lower Limbs ◽  
Limb Amputation ◽  
Critical Ischemia ◽  
Good Safety Profile ◽  
Peripheral Arterial

Peripheral arterial disease is one of the most frequent clinical manifestations of atherosclerotic disease. The clinical picture of critical ischemia of the lower limbs is often burdened by high mortality and the risk of limb amputation. The direct and indirect prostanoids, and in particular iloprost and cilostazol, are effective in the medical treatment of peripheral arterial disease. We describe here five clinical cases in which iloprost and cilostazol have been successfully administered in arterial patients with various concomitant cardiovascular diseases, highlighting a good safety profile in relation to the cardiocascular risk profile (Cardiology).

Surgical Treatment of Occlusion of the Infrarenal Abdominal Aorta

1987 ◽  
Vol 138 (3) ◽  
pp. 687-687
Author(s):  
P. Ketonan ◽  
P.-T. Harjola ◽  
K. Ala-Kulju ◽  
T. Mattila ◽  
R. Luosto ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Abdominal Aorta ◽  
Infrarenal Abdominal Aorta

Lipoedema – a growing problem in Spain

Phlebologie ◽  
2021 ◽  
Author(s):  
Isabel Forner-Cordero ◽  
Angeles Forner-Cordero
Keyword(s):  
Social Networks ◽  
Chronic Disease ◽  
Surgical Treatment ◽  
Self Care ◽  
Fat Deposition ◽  
Psychological Support ◽  
The Body ◽  
Lower Limbs ◽  
Compression Garments ◽  
Physical Therapies

AbstractLipoedema is a chronic disease frequent in women, that causes an abnormal fat deposition in their lower limbs, with a remarkable disproportion between the upper and lower part of the body, easy bruising and pain. Despite the lack of pathognomonic tests for lipoedema, more and more patients in social networks are claiming they suffer from it, giving the disease more visibility but allowing a lot of fake information about lipoedema. Information for self-care and realistic expectations are important. Depending on the severity, the treatment includes: physical therapies, compression garments, exercise, diet, psychological support and surgical treatment.

scholarly journals PROGRESS IN SURGICAL TREATMENT OF CHRONIC LOWER LIMB ISCHEMIA

2018 ◽  
Vol 25 (6) ◽  
pp. 14-18
Author(s):  
O. A. Alukhanyan ◽  
X. G. Маrtyrosya ◽  
I. V. Poluektova ◽  
V. A. Avakimyan
Keyword(s):  
Surgical Treatment ◽  
Pain Syndrome ◽  
Limb Ischemia ◽  
Lower Limbs ◽  
Chronic Ischemia ◽  
Critical Ischemia ◽  
Surgical Interventions ◽  
Bypass Patency ◽  
Thrombotic Complications ◽  
Male Patients

Aim. The study was conducted to expand the variety of ways for surgical treatment of chronic ischemia of lower limbs complicated by the involvement of the femoropopliteal and pedidial arterial segment. Materials and methods. The experience of surgical interventions in 43 male patients aged 52-75 suffering from chronic ischemia of lower limbs complicated by the atherosclerotic involvement of the femoropopliteal and pedidial segment has been summarized. According to the classification by A.V. Pokrovskiy, ischemia of the 3rd stage has been determined in 24 patients (55,8%), while ischemia of the 4th stage complicated by necrosis of the toes (critical ischemia) has been determined in other 19 patients (44,2%). All examined patients have undergone the reconstructive interventions using the prepared lateral subcutaneous vein of the upper extremity as a shunt.Results. During the first day after the operation, the regression of pain syndrome as well as the warming of the lower extremity was indicated in 93% of patients. In 8-12 days after the reconstructive operation, the patients have undergone the 15 necrectomy or toe amputation. In the nearest postoperative period (less than 6 months) no thrombotic complications in the reconstructed segment have been determined. Within the observation period from 6 months to 5 years the bypass patency has been preserved in 71% of patients; ischemia of the 2nd B type has been revealed in all patients with the preserved bypass patency by the clinical examination.Conclusion. Despite the “forced” character of usage of the prepared V. cephalica due to the absence of “traditional” venous shunts as well as the labor intensity of the method, it allows to expand the variety of ways for surgical treatment of patients suffering from chronic ischemia of lower limbs of the 3rd-4th stages complicated by occlusive involvements of the femoropopliteal and pedidial segment.

scholarly journals Our experience with pediatric surgical treatment of fibular hemimelia

2020 ◽  
Vol 26 (4) ◽  
pp. 527-531
Author(s):  
A.M. Dzhuraev ◽  
◽  
B.U. Kholmatov ◽  
Kh.M. Karimov ◽  
A.R. Khashimov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Manifestations ◽  
Treatment Method ◽  
Lower Limbs ◽  
Pediatric Orthopedics ◽  
Effective Treatment Option ◽  
Postoperative Rehabilitation ◽  
Fibular Hemimelia ◽  
Ankle Joints ◽  
Choice Of Treatment

Introduction Fibular hemimelia is a rare congenital malformation of lower limbs with associated deformities of the knee and ankle joints. There is no consensus among the authors regarding the choice of treatment method, appropriate timing of surgery, strategy and postoperative rehabilitation. Objective To explore clinical manifestations of the deformities and review outcomes of pediatric surgical treatment of fibular hemimelia. Material and methods Surgical treatment was performed for 11 children with fibular hemimelia at the Department of Pediatric Orthopedics, RSSPMCTO RUz between 2014 and 2019. Clinical and instrumentation studies were produced for all patients. Results Outcomes of surgical treatment were evaluated using functional characteristics with 7 rated as good and 4 as fair. Conclusion External fixation offers an effective treatment option in the pediatric surgical management of fibular hemimelia.

scholarly journals Surgical treatment of patients with critical ischemia of lower limbs originating from aortoiliac lesions and concomitant coronary artery disease

2015 ◽  
Vol 17 (1) ◽  
pp. 73
Author(s):  
A. N. Vachev ◽  
V. V. Sukhorukov ◽  
Ye. A. Surkova ◽  
A. D. Gureev ◽  
A. V. Krugomov ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Surgical Treatment ◽  
Bypass Surgery ◽  
Lower Limbs ◽  
Hybrid Procedures ◽  
Aortobifemoral Bypass ◽  
Critical Ischemia ◽  
Artery Disease ◽  
Concomitant Coronary Artery Disease

The study focuses on the outcomes of surgical treatment of 236 patients with critical ischemia of lower limbs originating from aortoiliac lesions and concomitant coronary artery disease. All patients first underwent vascular surgery, with 158 of them having aortobifemoral bypass surgery and 78 - hybrid vascular procedures on the aortoiliac segment: open surgical revascularization of femoral arteries and angioplasty and stenting of iliac arteries. Critical limb ischemia was successfully treated in all patients. One patient died after aortobifemoral bypass surgery; no fatal outcomes were registered after hybrid procedures.

scholarly journals COMPLICATIONS OF SURGICAL TREATMENT OF LUMBAR STENOSIS IN THE EARLY POSTOPERATIVE PERIOD

2018 ◽  
Vol 17 (3) ◽  
pp. 185-187
Author(s):  
Igor Vadimovich Basankin ◽  
Vladimir Alexeevich Porkhanov ◽  
Asker Alievich Afaunov ◽  
Alexander Veniaminovich Kuzmenko ◽  
Vladimir Konstantinovich Shapovalov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Intraoperative Complications ◽  
Clinical Manifestations ◽  
Early Postoperative Period ◽  
Lower Limbs ◽  
Wound Complications ◽  
Lumbar Stenosis ◽  
Results Of Treatment ◽  
Acute Radiculopathy

ABSTRACT Objective: To analyze the structure of degenerative lumbar stenosis surgical treatment complications and to analyze their effect on the results and indications for revision operations. Methods: Between 2009 and 2013, 513 patients with lumbar stenosis of degenerative etiology were surgically treated. There were 205 men, 308 women, aged 23 to 74 years. The main clinical manifestations were persistent compression radiculopathy, chronic pain in the back and lower limbs, and difficulty walking. The intensity of the pain was assessed by the VAS. At the time of hospitalization, VAS was 55-90 points. Results: Of the 513 operated patients, 65 (12.67%) had complications in the early postoperative period (up to three months after the operation); intraoperative complications occurred in 26 (5.1%) patients; intraoperative dura mater injury occurred in 24 (4.67%); pulmonary embolism (PE) occurred in 2 (0.39%) patients; 39 patients had early postoperative complications; acute radiculopathy occurred in 22 patients (4.28%); and 17 patients (3.31%) had surgical wound complications. Conclusions: Liquorrhea, postoperative hematomas and acute radiculopathy had no negative effect on the results of treatment in any of the cases. In the early postoperative period, 4 (0.77%) deaths were recorded intraoperatively and in 2 (0.39%) cases, intraoperative PE occurred. Two cases (0.39%) resulted in sepsis and multiple organ failure. In eight (1.55%) patients, the results of the treatment were unsatisfactory: in 4 (0.77%) cases due to death, and in a further 4 (0.77%) due to elimination of the system by the spinal column as a result of suppuration. Level of Evidence IV; Therapeutic studies - Investing the results of treatment.

scholarly journals SURGICAL TREATMENT OF L5-SPONDYLOLISTHESIS VERTEBRAE IN CHILDREN. BENEFITS OF POSTERIOR APPROACH

2014 ◽  
Vol 2 (3) ◽  
pp. 24-33 ◽  
Author(s):  
Sergei Valentinovich Vissarionov ◽  
Vladislav Valerievich Murashko ◽  
Sergei Mikhailovich Belyanchikov ◽  
Dmitriy Nikolaevich Kokushin ◽  
Irina Yurievna Solokhina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Neurological Deficit ◽  
Posterior Approach ◽  
Clinical Manifestations ◽  
The Body ◽  
Segmental Instability ◽  
Body Balance ◽  
Vertebral Canal ◽  
Grade 3 ◽  
Full Reduction

Objective to develop current options of surgical treatment of L5-spondylolisthesis in children. Materials and methods: 48 patients were observed and underwent surgical treatment at age of 10-17 years. In 9 patients spondylolisthesis of L5 was grade 2, in 14 - grade 3, in 12 - grade 4. 9 patients had spondyloptosis of the body of L5-vertebra. The article presents different options of surgical treatment of spondylolisthesis in children depending on the degree of vertebrae body shift and the main clinical manifestations. During surgery the anatomy of the vertebral canal and the normal interposition in the pathological segment were reconstructed. It resulted in normalization of the body balance and regression of neurological symptoms. Results: in spondylolisthesis grade 2 and 3 full reduction was achieved. In patients with grade 4 spondylolisthesis deformity was reduced to grade 2-3. Pain and radicular syndromes regressed in 2-3 days after surgery. In patients with monoparesis and contractures regression of neurological deficit took 1-1,5 months. Conclusions: The method of surgical treatment in patients with spondylolisthesis of L5 vertebrae depends on the degree of vertebrae shifting presence of segmental instability and neurological sighns.

scholarly journals Impact of Muscular Arteries State on the Results of Surgical Treatment of Lower Limb Obliterating Atherosclerosis

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
Sergey V Sander
Keyword(s):  
Blood Flow ◽  
Surgical Treatment ◽  
Arterial Hypertension ◽  
Reactive Hyperemia ◽  
Lower Limbs ◽  
Arterial Stenosis ◽  
Arterial Reconstruction ◽  
Local Blood Flow ◽  
Presumptive Treatment ◽  
Limb Preservation

The failure of surgical treatment of obliterating atherosclerosis of the lower extremities may be associated with underestimation of changes in local hemodynamics, particularly in arterial hypertension.The objective of the research was to study the state of small muscular arteries in patients with arterial hypertension and its impact on the course of obliterating atherosclerosis and the results of surgical treatment.Materials and methods. There were examined 281 patients with obliterating atherosclerosis and 32 patients with arterial hypertension. Patients with obliterating atherosclerosis received presumptive treatment: an intravenous infusion of 4.2 g of L-arginine, forceful intra-arterial injection of 20-80 ml of infusate (heparin, pentoxifylline, procaine), femoral and gluteal nerve block.         Results. Among hypertensive patients without obliterating atherosclerosis 13 persons had paraesthesia, feeling of coldness in the feet, platypodia, hypomyotonia, slow (63.7±1.3 sec) reactive hyperemia, arterial stenosis (40-45%), and low-amplitude or nonpulsative local blood flow. Among 97 patients with stable course of obliterating atherosclerosis 49 (50.5%) persons were diagnosed with uncomplicated arterial hypertension. Most of patients (80.3%) had single level occlusions of the iliac-femoral or femoral-popliteal segment. Presumptive treatment was effective in 87.1% of cases, reactive hyperemia was rapid (26.2±0.4 sec), local blood flow was pulsative. Arterial reconstruction with limb preservation for more than 1 year was performed in 12 (12.4%) cases. Among 184 patients with progressive course of obliterating atherosclerosis 162 (88.0%) persons were diagnosed with complicated arterial hypertension. Most of patients (83.7%) had multilevel lesions with diffuse stenosis or occlusions of the tibial arteries. Presumptive treatment was effective in 9.5% cases, reactive hyperemia was slow (106.3±2.7 sec), local blood flow was nonpulsative. Within 2 months 83 patients underwent above-knee amputation. Arterial reconstruction with limb preservation for more than 1 year was performed in 17 cases. Patients with arterial hypertension and obliterating atherosclerosis developed sclerosis of muscular arteries, intimal hyperplasia.Conclusions. Arterial hypertension causes lesions of small muscular arteries of the lower limbs. Hypertensive arteriopathy initiates the ascending development of obliterating atherosclerosis, causes hypertensive foot syndrome and unsatisfactory results of arterial reconstructions.

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