Clinical Case: Complications after Endovascular Treatment of Intracranial Aneurysm in a Patient after Subarachnoid Hemorrhage

2020 ◽  
Vol 8 (1) ◽  
pp. 9-15
Author(s):  
Petrov Nikolay ◽  
◽  
Marinova R. ◽  
Odiseeva Ev.
Keyword(s):  
Intracranial Aneurysm ◽  
Endovascular Treatment ◽  
Clinical Case ◽  
Endovascular Coiling ◽  
Published Data ◽  
Military Medical Academy ◽  
Life Threatening ◽  
Arachnoid Hemorrhage ◽  
The Right ◽  
Brain Artery

Abstract: Intracranial aneurysm is one of the most common neurovascular complications. During the recent years the accepted treatment of enraptured cranial aneurysm is noninvasive endovascular coiling. This technique is modern but it is not without complications which can be serious and life-threatening. A clinical case of a patient admitted to the ICU of Military Medical Academy - Sofia with sub arachnoid hemorrhage is described. After a positive clinical course, the check-up magnetic resonance showed intracranial aneurism of the right carotid artery. The patient underwent angiographic endovascular treatment. Vasospasm of the middle and right brain artery and thrombosis were detected during the procedure. Attempt of thromboaspiration was made without success. This article reviews published data on broad-spectrum researches concerning complications of endovascular coiling of intracranial aneurysms and the ways to prevent and reduce them.

Intracranial aneurysm following radiation therapy for medulloblastoma

1997 ◽  
Vol 38 (1) ◽  
pp. 37-42 ◽  
Author(s):  
F. K. Jensen ◽  
A. Wagner
Keyword(s):  
Radiation Therapy ◽  
Intracranial Aneurysm ◽  
Intracranial Aneurysms ◽  
Distal Part ◽  
Anterior Cerebral Artery ◽  
Craniospinal Radiation ◽  
Threatening Condition ◽  
Life Threatening ◽  
Radiation Induced ◽  
The Right

Radiation-induced intracranial aneurysm formation is a rare but life-threatening condition with a high mortality rate secondary to rupture of the aneurysm. Further-more, this condition can mimic tumour recurrence. Only 10 months after craniospinal radiation therapy for medulloblastoma, a 9-year-old boy developed a subarachnoid haemorrhage secondary to a ruptured saccular aneurysm arising from the distal part of the right anterior cerebral artery. The development of intracranial aneurysms and rupture following radiation damage of the arteries has been reported previously, but in no case as soon as 10 months after radiation therapy. It is important to diagnose these aneurysms as they can be successfully treated.

scholarly journals Clinical case of asymptomatic perforation of right ventricle during permanent pacemaker implantation

2019 ◽  
Vol 23 (4) ◽  
pp. 91
Author(s):  
A. N. Verevetinov ◽  
E. S. Tarasyuk ◽  
I. E. Dorovskih ◽  
J. V. Vakhnenko ◽  
V. N. Nikitin ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Conflict Of Interest ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Pacemaker Implantation ◽  
Myocardial Damage ◽  
Left Hand ◽  
Heart Failure Progression ◽  
Life Threatening ◽  
The Right

<p>The present paper discusses one of the serious complications of electrocardiostimulator implantation: electrode perforation of the right ventricle wall, a condition that can occur in both the early and late postoperative periods. The latter occurs less frequently, and the patient may be asymptomatic; this results in an adverse effect on the patient’s quality of life and disease prognosis. Knowledge about the symptoms of late perforation and algorithms to examine patients suspected to have this complication contributes to timely surgical intervention as well as prevention of heart failure progression and fatal outcomes. This paper describes a clinical case of right ventricular perforation 1.5 years after electrocardiostimulator implantation, wherein, despite the absence of pronounced clinical symptoms, the patient was successfully diagnosed with pacemaker testing, Holter diagnostics, echocardiography and computed tomography of thoracic organs. Myocardial damage was accompanied by small left-hand bone-diaphragm hydrotorax and hydropericardium. The risk factors of perforation in the present case were low body weight and age. In the course of the surgical operation performed with the exact observance of the chosen technique, the integrity of the myocardium of the right ventricle and the function of the electrocardiostimulator were restored. Thus, the life-threatening consequences of the described complication were prevented.</p><p>Received 12 September 2019. Revised 20 December 2019. Accepted 23 December 2019.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

scholarly journals A clinical case of staged endovascular treatment of a patient with coronary heart disease and multiple lesions of peripheral arteries

2021 ◽  
Vol 8 (1) ◽  
pp. 5-11
Author(s):  
M. A. Chernyavsky ◽  
Yu. A. Kudaev ◽  
N. N. Zherdev ◽  
R. S. Shumakher
Keyword(s):  
Endovascular Treatment ◽  
Clinical Case ◽  
Myocardial Revascularization ◽  
Perioperative Period ◽  
Left Internal Carotid Artery ◽  
Iliac Arteries ◽  
Multi Stage ◽  
Clinically Significant ◽  
Artery Disease ◽  
The Right

A clinical case of successful treatment of a patient with atherosclerotic peripheral artery disease and clinically significant lesion of the coronary and carotid arteries. Patients underwent multi-stage surgical treatment. The first stage performed endovascular treatment the left internal carotid artery, the second — myocardial revascularization, the third — endovascular treatment of the left iliac arteries, the fourth — rotational atherectomy with stenting of the right superficial femoral artery. There were no complications in the perioperative period. The technique of operations is described, explanations are given for the chosen treatment strategy. The conclusion is drawn about the advantage of endovascular techniques in the treatment of patients with multifocal atherosclerosis.

scholarly journals Heart transplantation in a patient with primary malignant tumor

2019 ◽  
Vol 21 (1) ◽  
pp. 77-81
Author(s):  
E. E. Kliver ◽  
I. S. Murashov ◽  
A. M. Volkov ◽  
E. N. Kliver ◽  
D. V. Doronin
Keyword(s):  
Ventricular Tachycardia ◽  
Right Ventricle ◽  
Clinical Case ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
Apical Region ◽  
Rf Ablation ◽  
Life Threatening ◽  
Electrophysiological Examination ◽  
The Right

The article looks at a clinical case of a 31-year-old female with signs of paroxysmal ventricular tachycardia and Morgagni–Adams–Stokes syndrome. In April 2014, electrophysiological examination revealed a source of ventricular tachycardia localized in the apices of the right and left ventricles of the patient. The sources were then subjected to RF ablation followed by cardioverter-defibrillator implantation. Subsequent antiarrhythmic therapy failed to improve her state. In September 2016 the patient was re-examined and underwent RF ablation of the apical region of the right ventricle. Later on, taking into account continuously recurrent life-threatening cardiac rhythm disorders, as well as unpromising strategies for further conservative treatment, she was put on the waiting list and then underwent orthotopic cardiac transplantation. Histological examination and immunohistochemistry assay showed leiomyosarcoma in the source of ventricular tachycardia previously found in the apex of the right ventricle. This clinical case demonstrates a diversity of clinical manifestations of primary malignant tumors of the heart that pose a challenge for intravital diagnostics and interpretation of a clinical picture.

May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

Combined Extended High Spinal Anesthesia and Endotracheal Narcosis: a Clinical Case

2019 ◽  
Vol 4 (2) ◽  
pp. 152-154
Author(s):  
A. B. Yakushevsky ◽  
A. N. Plekhanov ◽  
A. B. Ayusheev
Keyword(s):  
Abdominal Surgery ◽  
Spinal Anesthesia ◽  
Postoperative Period ◽  
Initial Dose ◽  
Clinical Case ◽  
Central Hemodynamics ◽  
Narcotic Analgesics ◽  
Spinal Catheter ◽  
The Right ◽  
Endotracheal Anesthesia

Background. In recent years, various methods of combined anesthesia during abdominal surgery have been introduced into clinical practice.Aim. To demonstrate the possibilities of a combination of high prolonged spinal anesthesia and endotracheal anesthesia during abdominal surgery.Materials and methods. A clinical case of combined use of high prolonged spinal anesthesia and endotracheal anesthesia in a 48-year-old patient with a tumor in the right half of the ascending part of the right half of the colon is presented.Results. The patient received a puncture of the spinal space at a standard point and was installed a spinal catheter in the cranial direction for 3 cm. An isobaric solution of marcaine in the initial dose of 20 mg was injected into the catheter. The regulation of the development of the block was regulated by the inclination of the head end of the table by 60°. After that endotracheal anesthesia was performed on the basis of fentanyl and propofol. This combination allowed to expand the scope of surgical intervention, provided adequate pain relief intraoperatively and in the postoperative period, without the use of narcotic analgesics. With the appearance of signs of recovery of pain sensitivity, intraoperatively or in the postoperative period, re-introduction of the anesthetic into the spinal catheter was performed in half of the initial dose with liquor barbotage. In the early postoperative period, the patient was on strict bed rest with a head end of the bed raised at 30–45°. The method provides complete segmental blockade and muscle relaxation in the area of operation, stability of central hemodynamics during surgery and in the postoperative period.Conclusion. This type of anesthesia is more easily tolerated by patients, accompanied by early awakening and extubation, characterized by stability of central hemodynamics, reduced risk of complications, the possibility of prolonging anesthesia with lower doses of narcotic analgesics in the intraoperative period, providing high-quality anesthesia in the postoperative period without resorting to the use of narcotic analgesics.

It is better an approximate answer to the right question than the exact answer to the wrong question : the case of the psychometric analysis of the ASQ:SE

2020 ◽  
Author(s):  
Luis Anunciacao ◽  
janet squires ◽  
J. Landeira-Fernandez
Keyword(s):  
Internal Structure ◽  
Statistical Methods ◽  
Principal Component ◽  
Psychological Theory ◽  
Published Data ◽  
Multivariate Statistical ◽  
Exact Answer ◽  
Wide Range ◽  
Ages And Stages Questionnaire ◽  
The Right

One of the main activities in psychometrics is to analyze the internal structure of a test. Multivariate statistical methods, including Exploratory Factor analysis (EFA) and Principal Component Analysis (PCA) are frequently used to do this, but the growth of Network Analysis (NA) places this method as a promising candidate. The results obtained by these methods are of valuable interest, as they not only produce evidence to explore if the test is measuring its intended construct, but also to deal with the substantive theory that motivated the test development. However, these different statistical methods come up with different answers, providing the basis for different analytical and theoretical strategies when one needs to choose a solution. In this study, we took advantage of a large volume of published data (n = 22,331) obtained by the Ages and Stages Questionnaire Social-Emotional (ASQ:SE), and formed a subset of 500 children to present and discuss alternative psychometric solutions to its internal structure, and also to its subjacent theory. The analyses were based on a polychoric matrix, the number of factors to retain followed several well-known rules of thumb, and a wide range of exploratory methods was fitted to the data, including EFA, PCA, and NA. The statistical outcomes were divergent, varying from 1 to 6 domains, allowing a flexible interpretation of the results. We argue that the use of statistical methods in the absence of a well-grounded psychological theory has limited applications, despite its appeal. All data and codes are available at https://osf.io/z6gwv/.

A systematic review and meta-analysis on endovascular treatment as an attractive alternative for acute superior mesenteric venous thrombosis

Vascular ◽  
2021 ◽  
pp. 170853812199127
Author(s):  
Lixin Wang ◽  
Enci Wang ◽  
Fei Liu ◽  
Wei Zhang ◽  
Xiaolong Shu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Venous Thrombosis ◽  
Endovascular Treatment ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Published Data ◽  
Mesenteric Venous Thrombosis ◽  
Surgery Group

Objective This systematic review and meta-analysis evaluated the published data on the efficacy and safety of therapies for superior mesenteric venous thrombosis (SMVT), aiming to provide a reference and set of recommendations for clinical treatment. Methods Relevant databases were searched for studies published from 2000 to June 2020 on SMVT treated with conservative treatment, surgical treatment, or endovascular approach. Different treatment types were grouped for analysis and comparison, and odds ratios with corresponding 95% confidence intervals were calculated. The outcomes were pooled using meta-analytic methods and presented by forest plots. Results Eighteen articles, including eight on SMVT patients treated with endovascular therapies, were enrolled. The treatment effectiveness was compared between different groups according to the change of symptoms, the occurrence of complications, and mortality as well. The conservative treatment group had better efficacy compared to the surgery group (89.0% vs. 78.6%, P <0.05), and the one-year survival rate was also higher (94.4% vs. 80.0%, P >0.05), but without statistical significance. As for endovascular treatment, the effectiveness was significantly higher than the surgery group (94.8% vs. 75.2%, P <0.05), and the conservative treatment group as well (93.3% vs. 86.3%, P >0.05), which still requires further research for the lack of statistical significance. Conclusions Present findings indicate that anticoagulation, as conservative treatment should be the preferred clinical option in the clinic for SMVT, due to its better curative effect compared to other treatment options, including lower mortality, fewer complications, and better prognosis. Moreover, endovascular treatment is a feasible and promising approach that is worth in-depth research, for it is less invasive than surgery and has relatively better effectiveness, thus can provide an alternative option for SMVT treatment and may be considered as a reliable method in clinical.

scholarly journals Vertebral Metastasis Treated by Vertebroplasty, a Cause of Respiratory Failure: Case Report and Literature Review

2021 ◽  
pp. 279-283
Author(s):  
Mathieu Chevallier ◽  
Chloé Chevallier-Lugon ◽  
Alex Friedlaender ◽  
Alfredo Addeo
Keyword(s):  
Spinal Fractures ◽  
Safe Procedure ◽  
Vertebral Metastasis ◽  
Minimally Invasive Surgical Procedure ◽  
Venous Circulation ◽  
Minimally Invasive Surgical ◽  
Life Threatening ◽  
Frequent Site ◽  
The Right ◽  
Substantial Morbidity

Bone is a frequent site of metastases in advanced cancers including lung, breast, prostate, kidney, or myeloma. Lesions are commonly located on the spine. Neoplastic invasion of the vertebral body can result in painful vertebral fractures, leading to disability and substantial morbidity. Percutaneous vertebroplasty is a minimally invasive surgical procedure used to treat spinal fractures due to osteolytic tumors. It could result in pain reduction or resolution in 80–90% of patients with fractures, and it improves stability. Although considered safe, vertebroplasty has been associated over the years with life-threatening complications. We have reported the case of a 55-year-old patient with lung adenocarcinoma, who underwent vertebroplasty for a pathological neoplastic fracture of L2. The procedure was complicated by a leak of cement into the systemic venous circulation, characterized by an 11-cm filament in the right heart chambers and multiple pulmonary emboli. To our knowledge, only one similar case was previously reported, involving an intracardiac cement filament longer than 10 cm. The data are scant, hence the importance of collecting and reporting possible complications about what is perceived as a rather safe procedure. The case highlights the need for a robust postprocedure imaging plan to detect complications, which can impact patients’ morbidity and survival.

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