scholarly journals The perplexing postsurgical complication of carotid-jugular fistula: A bitter experience

2022 ◽  
Vol 13 ◽  
pp. 2
Author(s):  
Md. Rokibul Islam ◽  
Ayub Ansari ◽  
Asifur Rahman ◽  
S. M. G. Saklayen ◽  
Nur Muhammad ◽  
...  
Keyword(s):  
Open Surgery ◽  
Treatment Options ◽  
Vascular Injuries ◽  
Case Description ◽  
Neck Injuries ◽  
Arteriovenous Fistulae ◽  
Arteriovenous Fistulas ◽  
Carotid Artery Injuries ◽  
Postsurgical Complication ◽  
Prompt Action

Background: Vascular injuries occur in approximately 25% of all penetrating neck traumas, with carotid artery injuries being particularly lethal. Penetrating neck injuries are potentially fatal. Vascular injuries occur in approximately 25% of cases, which can lead to the formation of arteriovenous fistulas. Case Description: The authors present a case of delayed open surgery to repair a carotid-jugular fistula that resulted in an unprecedented complication, as well as a brief review of the condition’s diagnosis and treatment options. Conclusion: This case report suggests us that, penetrating neck injuries should be thoroughly evaluated for arteriovenous fistulae. To avoid complications, common carotid-jugular fistulas must be treated as soon as possible. Postoperative complications can be effectively managed with prompt action.

scholarly journals DURAL ARTERIOVENOUS MALFORMATIONS – CASE REPORT AND REVIEW OF THE LITERATURE

2015 ◽  
Vol 14 (3) ◽  
pp. 160-165
Author(s):  
Daniela Rosu ◽  
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Gold Standard ◽  
Arteriovenous Malformations ◽  
Open Surgery ◽  
Treatment Options ◽  
Review Of The Literature ◽  
Arteriovenous Fistulas ◽  
Comatose State ◽  
Dural Arteriovenous Fistulas

The gold standard in dural arteriovenous fistulas (DAVF) evaluation is complete angiography. Treatment options include: conservative management, open surgery, endovascular therapy, stereotactic radiosurgery or multimodality therapy. The goal of microsurgical intervention is DAVF obliteration or selective CVD disconnection. We present a 59 years old male who was brought to the Emergency Department of the National Institute of Neurology and Neurovascular Diseases in a comatose state (GCS- 5p).

Endovascular Solutions for Iliac and Lower Extremity Junctional Injuries

2017 ◽  
Vol 1 (1) ◽  
pp. 22-27
Author(s):  
Edwin R Faulconer ◽  
Rachel M Russo ◽  
Anders J Davidson ◽  
Meryl A Simon ◽  
Erik S DeSoucy ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Open Surgery ◽  
Management Strategies ◽  
Balloon Occlusion ◽  
Vascular Injuries ◽  
Endovascular Management ◽  
Review Of The Literature ◽  
Junctional Zone ◽  
Endovascular Interventions ◽  
Direct Pressure

Hemorrhage is the second leading cause of death in trauma and non-compressible torso hemorrhage is the leading cause of preventable death within this population. Vascular injuries to the pelvis and lower extremity junctional zone may be difficult to control with direct pressure and complex to approach with open surgery. Endovascular interventions such as balloon occlusion, stenting and embolization are potential alternatives or adjuncts to traditional open surgery in patients with blunt or penetrating vascular injuries to the pelvis. This review of the literature will outline contemporary endovascular management strategies for iliac and junctional zone injuries.

Advances in Surgical Approaches to Dural Fistulas

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S32-S41 ◽  
Author(s):  
Patrick P. Youssef ◽  
Albert Jess Schuette ◽  
C. Michael Cawley ◽  
Daniel L. Barrow
Keyword(s):  
Treatment Options ◽  
Venous Drainage ◽  
Venous Hypertension ◽  
Surgical Approaches ◽  
Dural Sinus ◽  
Intraoperative Angiography ◽  
Indocyanine Green Videoangiography ◽  
Arteriovenous Fistulas ◽  
The Past ◽  
Dural Arteriovenous Fistulas

Abstract Dural arteriovenous fistulas are abnormal connections of dural arteries to dural veins or venous sinuses originating from within the dural leaflets. They are usually located near or within the wall of a dural venous sinus that is frequently obstructed or stenosed. The dural fistula sac is contained within the dural leaflets, and drainage can be via a dural sinus or retrograde through cortical veins (leptomeningeal drainage). Dural arteriovenous fistulas can occur at any dural sinus but are found most frequently at the cavernous or transverse sinus. Leptomeningeal venous drainage can lead to venous hypertension and intracranial hemorrhage. The various treatment options include transarterial and transvenous embolization, stereotactic radiosurgery, and open surgery. Although many of the advances in dural arteriovenous fistula treatment have occurred in the endovascular arena, open microsurgical advances in the past decade have primarily been in the tools available to the surgeon. Improvements in microsurgical and skull base approaches have allowed surgeons to approach and obliterate fistulas with little or no retraction of the brain. Image-guided systems have also allowed better localization and more efficient approaches. A better understanding of the need to simply obliterate the venous drainage at the site of the fistula has eliminated the riskier resections of the past. Finally, the use of intraoperative angiography or indocyanine green videoangiography confirms the complete disconnection of fistula while the patient is still on the operating room table, preventing reoperation for residual fistulas.

Laryngospasm

2001 ◽  
Vol 2 (3-4) ◽  
pp. 23-25 ◽  
Keyword(s):  
Pulmonary Oedema ◽  
Treatment Options ◽  
Physiological Processes ◽  
Airway Emergency ◽  
Anaesthetic Care ◽  
Prompt Action

Laryngospam is a relatively common airway emergency. Mevorach [1996] cites Olsson and Hallen [1984] who found a mean incidence of 8.6/1000 in adults and 27.6/ 1000 in children. From these figures it can be assumed that most post anaesthetic care nurses at some time in their career will encounter it. Prompt action is required, and knowledge of the physiological processes involved along with an appreciation of the treatment options available. This article will aim to discuss laryngospasm and will examine briefly the phenomenon of post laryngospasm induced pulmonary oedema.

Novel treatment for glance necrosis due to priapism; presentation and review of literature

2021 ◽  
pp. 039156032110382
Author(s):  
Abbas Soleimani ◽  
Mohammad Javad Nazarpour ◽  
Hamed Akhavizadegan
Keyword(s):  
Treatment Outcome ◽  
Normal Saline ◽  
Open Surgery ◽  
Necrotic Area ◽  
Case Description ◽  
Review Of Literature ◽  
Novel Treatment ◽  
Heparinized Saline ◽  
Appropriate Treatment

Introduction: Glans necrosis in association with priapism is very rare and its appropriate treatment is not known. There is a secondary cause in most cases. Case description: We treated a 65-year-old man with priapism and glans necrosis using a closed shunt (Winter), continuous penile irrigation with normal saline, and heparin for 48 h and waited for the necrotic area to resolve spontaneously. The treatment outcome was much better compared to previous cases in whom open surgery, irrigation with pure normal saline, and/or resection of the necrotic area were performed. Conclusion: In cases with priapism and glans ischemia, we recommend treating the condition with continuous covernose irrigation with heparinized saline and avoiding open surgery.

scholarly journals Nongalenic arteriovenous fistulas: history of treatment and technology

2006 ◽  
Vol 20 (6) ◽  
pp. 1-8 ◽  
Author(s):  
Kristen Upchurch ◽  
Lei Feng ◽  
Gary R. Duckwiler ◽  
John G. Frazee ◽  
Neil A. Martin ◽  
...  
Keyword(s):  
Open Surgery ◽  
Interventional Neuroradiology ◽  
Endovascular Embolization ◽  
High Flow ◽  
Vascular Lesions ◽  
Arteriovenous Fistulas ◽  
The Past ◽  
Technological Developments ◽  
History Of ◽  
Endovascular Technology

✓ Nongalenic cerebral arteriovenous fistulas (AVFs) are uncommon, high-flow vascular lesions first treated by Walter Dandy and his colleagues by using open surgery with ligation of the feeding artery. Due to advances in endovascular technology over the past four decades that make possible the control of high flow in AVFs, treatment has evolved from the sole option of surgery to include the alternative or adjunct option of endovascular embolization. The authors of this review discuss the history of nongalenic AVF treatment, including techniques of both surgery and interventional neuroradiology and the technological developments underlying them.

scholarly journals Clinical analysis of adrenal lesions larger than 5 cm in diameter (an analysis of 251 cases)

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Zongzong Zhang ◽  
Lina Wang ◽  
Jing Chen ◽  
Xiunan Li ◽  
Dikuan Liu ◽  
...  
Keyword(s):  
Open Surgery ◽  
Malignant Tumors ◽  
Treatment Options ◽  
Clinical Analysis ◽  
Metastatic Carcinoma ◽  
Postoperative Recovery ◽  
Adrenal Cortical Carcinoma ◽  
Adrenal Tumors ◽  
Tumor Diameter ◽  
Adrenal Metastases

Abstract Background To describe the pathological distribution, imaging manifestations, and surgical managements and prognosis of large adrenal tumors (LATs) ≥ 5 cm Methods A total of 251 patients with LATs were analyzed on the basis of pathological or clinical diagnosis. Regarding surgery, open adrenalectomy was performed on 89 patients, and laparoscopic adrenalectomy was performed on 89 patients. Thirty-two patients with bilateral tumors were analyzed in terms of clinical characteristics. The survival rate was determined for 43 patients with adrenal metastases and 29 patients with primary adrenal malignancies. The CT characteristics including tumor diameter, shape, edge, heterogeneity, necrosis, calcification, pre-contrast attenuation, and contrast attenuation were analyzed for 117 patients. Results The majority of LATs were still benign, but they had a higher probability to be malignant. Benign LATs made up 68.13% of all cases, mainly adrenal cysts (19.52%), pheochromocytoma (18.73%), benign adenoma (16.73%), and myelolipoma (7.17%). Malignant LATs accounted for 28.69% of cases, mainly including adrenocortical carcinoma (8.76%) and metastases (17.13%). Laparoscopic surgery was found to involve less trauma than open surgery. It was also safer and postoperative recovery was faster, but it had drawbacks and could not completely replace open surgery. CT features had obvious specificity for the diagnosis of benign and malignant tumors. For example, benign adenomas had a smaller pre-contrast (< 10 Hu) whereas malignant adrenal tumors had, on the contrary, higher attenuation. Regarding adrenal malignant carcinoma, adrenal primary malignant tumors showed a better prognosis than adrenal metastases (mean survival of 19.17 months vs 9.49 months). Primary adrenal cortical carcinoma without metastasis had a better prognosis than primary adrenal cortical carcinoma metastasis (mean survival of 23.71 months vs 12.75 months), and adrenal solitary metastasis had a better prognosis than general multiple metastatic carcinoma (mean survival of 14.95 months vs 5.17 months). Conclusion LATs were more likely to be benign; however, they still had a high probability of being a malignant tumor. Understanding the clinicopathological characteristics of LATs can facilitate selection of more effective clinical treatment options.

scholarly journals Multimodal treatment strategies for complex pediatric cerebral arteriovenous fistulas: contemporary case series at Barrow Neurological Institute

2015 ◽  
Vol 15 (6) ◽  
pp. 615-624 ◽  
Author(s):  
Hasan A. Zaidi ◽  
M. Yashar S. Kalani ◽  
Robert F. Spetzler ◽  
Cameron G. McDougall ◽  
Felipe C. Albuquerque
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Clinical Outcomes ◽  
Endovascular Therapy ◽  
Open Surgery ◽  
Treatment Strategies ◽  
Preoperative Imaging ◽  
Arteriovenous Fistulas ◽  
Surgeon Experience

OBJECT Pediatric cerebral arteriovenous fistulas (AVFs) are rare but potentially lethal vascular lesions. Management strategies for these lesions have undergone considerable evolution in the last decade with the advent of new endovascular, surgical, and radiosurgical technologies. This study sought to review current treatment strategies and long-term clinical outcomes at a high-volume cerebrovascular institute. METHODS A retrospective chart review was performed on patients with a diagnosis of cerebral AVF from 1999 to 2012. Patients with carotid-cavernous fistulas, vein of Galen malformations, and age > 18 years were excluded from final analysis. Medical history, surgical and nonsurgical treatment, and clinical outcomes were documented. Pre- and postoperative angiograms were analyzed to assess for obliteration of the fistula. RESULTS Seventeen patients with pial AVFs (29.4%), dural AVFs (64.7%), or mixed pial/dural AVFs (5.9%) were identified. The majority of lesions were paramedian (70.6%) and supratentorial (76.5%). The study population had a mean age of 6.4 years, with a slight male predominance (52.9%), and the most common presenting symptoms were seizures (23.5%), headaches (17.6%), congestive heart failure (11.7%), and enlarging head circumference (11.7%). Among patients who underwent intervention (n = 16), 56.3% were treated with endovascular therapy alone, 6.3% were treated with open surgery alone, and 37.5% required a multimodal approach. Overall, 93.8% of the treated patients received endovascular treatment, 43.8% received open surgery, and 12.5% received radiosurgery. Endovascular embolysates included Onyx (n = 5), N-butyl cyanoacrylate (NBCA; n = 4), or coil embolization (n = 7) with or without balloon assistance (n = 2). Complete angiographic obliteration was achieved in 87.5% at the last follow-up evaluation (mean follow-up 3.1 years). One infant with incomplete AVF obliteration died of congestive heart failure, and 1 patient with complete obliteration died of acute sinus thrombosis, with an overall complication rate of 18.8%. CONCLUSIONS Pediatric cerebral AVFs are challenging neurosurgical lesions. Although advancements in endovascular therapy in the last decade have greatly changed the natural course of this disease, a multidisciplinary approach remains necessary for a large subset of patients. Surgeon experience with a thorough analysis of preoperative imaging is paramount to achieving acceptable clinical outcomes.

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