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Levine D, Zhang A, Haikal K, Janda P, Vickers A. Post-traumatic Secondary Complications Resembling Stroke Symptoms Following Axillofemoral Bypass Surgery: A Case Report. Cureus 2024; 16:e65660. [PMID: 39205722 PMCID: PMC11352765 DOI: 10.7759/cureus.65660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
Peripheral artery disease exerts a substantial toll on public health in the United States, straining healthcare resources. In challenging cases, the axillofemoral bypass graft had emerged as a cornerstone in managing this condition. Unforeseen events, such as trauma, can lead to a presentation mimicking stroke and thus exacerbating the complexity of the diagnostic process. Herein, we present the case of a 64-year-old male with complex peripheral artery disease who developed a pseudoaneurysm mimicking stroke symptoms following a traumatic incident post axillofemoral bypass graft surgery. This case underscores the critical importance of employing diverse diagnostic modalities to navigate the complex differential diagnosis of stroke-like symptoms in patients post-surgery.
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Affiliation(s)
- Daniel Levine
- Medical School, Kirk Kerkorian School of Medicine at UNLV (University of Nevada, Las Vegas), Las Vegas, USA
| | - Allen Zhang
- Medical School, Kirk Kerkorian School of Medicine at UNLV (University of Nevada, Las Vegas), Las Vegas, USA
| | - Khalid Haikal
- Neurology, Valley Hospital Medical Center, Las Vegas, USA
| | - Paul Janda
- Neurology, Valley Hospital Medical Center, Las Vegas, USA
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2
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Ogino H, Iida O, Akutsu K, Chiba Y, Hayashi H, Ishibashi-Ueda H, Kaji S, Kato M, Komori K, Matsuda H, Minatoya K, Morisaki H, Ohki T, Saiki Y, Shigematsu K, Shiiya N, Shimizu H, Azuma N, Higami H, Ichihashi S, Iwahashi T, Kamiya K, Katsumata T, Kawaharada N, Kinoshita Y, Matsumoto T, Miyamoto S, Morisaki T, Morota T, Nanto K, Nishibe T, Okada K, Orihashi K, Tazaki J, Toma M, Tsukube T, Uchida K, Ueda T, Usui A, Yamanaka K, Yamauchi H, Yoshioka K, Kimura T, Miyata T, Okita Y, Ono M, Ueda Y. JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection. Circ J 2023; 87:1410-1621. [PMID: 37661428 DOI: 10.1253/circj.cj-22-0794] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Affiliation(s)
- Hitoshi Ogino
- Department of Cardiovascular Surgery, Tokyo Medical University
| | - Osamu Iida
- Cardiovascular Center, Kansai Rosai Hospital
| | - Koichi Akutsu
- Cardiovascular Medicine, Nippon Medical School Hospital
| | - Yoshiro Chiba
- Department of Cardiology, Mito Saiseikai General Hospital
| | | | | | - Shuichiro Kaji
- Department of Cardiovascular Medicine, Kansai Electric Power Hospital
| | - Masaaki Kato
- Department of Cardiovascular Surgery, Morinomiya Hospital
| | - Kimihiro Komori
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine
| | - Hitoshi Matsuda
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Kenji Minatoya
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University
| | | | - Takao Ohki
- Division of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine
| | - Yoshikatsu Saiki
- Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University
| | - Kunihiro Shigematsu
- Department of Vascular Surgery, International University of Health and Welfare Mita Hospital
| | - Norihiko Shiiya
- First Department of Surgery, Hamamatsu University School of Medicine
| | | | - Nobuyoshi Azuma
- Department of Vascular Surgery, Asahikawa Medical University
| | - Hirooki Higami
- Department of Cardiology, Japanese Red Cross Otsu Hospital
| | | | - Toru Iwahashi
- Department of Cardiovascular Surgery, Tokyo Medical University
| | - Kentaro Kamiya
- Department of Cardiovascular Surgery, Tokyo Medical University
| | - Takahiro Katsumata
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine
| | | | - Takuya Matsumoto
- Department of Vascular Surgery, International University of Health and Welfare
| | | | - Takayuki Morisaki
- Department of General Medicine, IMSUT Hospital, the Institute of Medical Science, the University of Tokyo
| | - Tetsuro Morota
- Department of Cardiovascular Surgery, Nippon Medical School Hospital
| | | | - Toshiya Nishibe
- Department of Cardiovascular Surgery, Tokyo Medical University
| | - Kenji Okada
- Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine
| | | | - Junichi Tazaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Masanao Toma
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Takuro Tsukube
- Department of Cardiovascular Surgery, Japanese Red Cross Kobe Hospital
| | - Keiji Uchida
- Cardiovascular Center, Yokohama City University Medical Center
| | - Tatsuo Ueda
- Department of Radiology, Nippon Medical School
| | - Akihiko Usui
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine
| | - Kazuo Yamanaka
- Cardiovascular Center, Nara Prefecture General Medical Center
| | - Haruo Yamauchi
- Department of Cardiac Surgery, The University of Tokyo Hospital
| | | | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | | | - Yutaka Okita
- Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo
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3
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Chandra VM, Norton EL, Khaja MS, Herrera DG, Williams DM, Yang B. Surgical and endovascular repair for type B aortic dissections with mesenteric malperfusion syndrome: A systematic review of in-hospital mortality. JTCVS OPEN 2022; 12:37-50. [PMID: 36590716 PMCID: PMC9801243 DOI: 10.1016/j.xjon.2022.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 07/06/2022] [Accepted: 07/20/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Mesenteric malperfusion is a feared complication of aortic dissection, with high mortality. The purpose of this study was to systematically review in-hospital mortality (IHM) of endovascular and surgical management of acute and chronic Stanford type B aortic dissections (TBAD) complicated by mesenteric malperfusion (MesMP). METHODS A systematic search of English language articles was conducted in relevant databases. Data on patient demographics, procedure details, and survival outcomes were collected. Reports were classified by type of intervention performed. Studies that failed to report patient-level outcomes based on specific intervention performed or IHM were excluded. Retrospective chart review of previously published data from a single institution was also performed to further identify cases of TBAD that were managed endovascularly. The Fisher exact test was performed to determine statistical significance. RESULTS In total, 37 articles were suitable for inclusion in this systematic review, which yielded 149 patients with a median age 55.0 years (interquartile range, 46.5-65 years) and 79% being male. Overall, in-hospital mortality was 12.8% (19/149) and was similar between endovascular and open surgical interventions (13% vs 11%, P = .99). Among endovascular strategies, IHM was greater, although not statistically significant in the thoracic endovascular aortic repair group compared with the fenestration/stenting without thoracic endovascular aortic repair group (24% vs 11%, P = .15). CONCLUSIONS Multiple strategies exist for the management of TBAD with MesMP; however, a majority of cases were managed endovascularly. Despite advances in therapies, mortality remains high at 13%.
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Affiliation(s)
- Vishnu M. Chandra
- Division of Vascular and Interventional Radiology, Department of Radiology & Medical Imaging, University of Virginia Health, Charlottesville, Va
| | - Elizabeth L. Norton
- Division of Cardiothoracic Surgery, Department of Surgery, Emory University, Atlanta, Ga
| | - Minhaj S. Khaja
- Division of Vascular and Interventional Radiology, Department of Radiology & Medical Imaging, University of Virginia Health, Charlottesville, Va
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan, Ann Arbor, Mich
| | - Daniel Giraldo Herrera
- Division of Vascular and Interventional Radiology, Department of Radiology & Medical Imaging, University of Virginia Health, Charlottesville, Va
| | - David M. Williams
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan, Ann Arbor, Mich
| | - Bo Yang
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Mich
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Nomura Y, Nagao K, Hasegawa S, Kawashima M, Tsujimoto T, Izumi S, Matsumori M, Murakami H, Honda T, Mukohara N. Fatal Complications of New-Onset Complicated Type B Aortic Dissection After Endovascular Abdominal Aortic Aneurysm Repair: Report of 2 Cases and Literature Review. Vasc Endovascular Surg 2018; 53:255-258. [PMID: 30572794 DOI: 10.1177/1538574418819540] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
New-onset antegrade Stanford type B aortic dissection (TBAD) after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) is rare. The extension of aortic dissection leads to various symptoms and affects the stent graft. Moreover, various symptoms may arise owing to a stent graft being present. We describe 2 cases of complicated acute TBAD occurring after EVAR, which were ultimately fatal. The case in which rupture occurred could not be treated and the patient died. In another case with bilateral lower extremity malperfusion caused by collapse and occlusion of the endograft, extra-anatomical bypass was performed. Although the collapsed endograft gradually re-expanded, the patient ultimately died because of multiorgan failure. We have reviewed the literature and analyzed the treatment of complicated TBAD after EVAR.
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Affiliation(s)
- Yoshikatsu Nomura
- 1 Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan
| | - Kanetsugu Nagao
- 1 Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan
| | - Shota Hasegawa
- 1 Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan
| | - Motoharu Kawashima
- 1 Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan
| | - Takanori Tsujimoto
- 1 Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan
| | - So Izumi
- 1 Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan
| | - Masamichi Matsumori
- 1 Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan
| | - Hirohisa Murakami
- 1 Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan
| | - Tasuku Honda
- 1 Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan
| | - Nobuhiko Mukohara
- 1 Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan
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Goto Y, Hosoba S, Ogawa S, Kinoshita Y. Collapsed stent graft and severe malperfusion 2 years after endovascular aortic repair. Eur J Cardiothorac Surg 2018; 52:599-600. [PMID: 28605479 DOI: 10.1093/ejcts/ezx195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 03/28/2017] [Indexed: 11/14/2022] Open
Abstract
Late collapsing of a stent graft is an extremely rare event, with one existing report describing this phenomenon. A 65-year-old man with a history of endovascular aortic repair for an abdominal aortic aneurysm presented with paraplegia and bilateral lower limb ischaemia. Contrast-enhanced computed tomography showed a dissection of the descending thoracic aorta and a collapsed stent graft, resulting in bilateral lower limb ischaemia. Subsequent axillo-bifemoral bypass resolved his lower extremity functions. The patient required haemodialysis due to acute kidney failure. The follow-up computed tomography scan demonstrated re-expansion of the collapsed stent graft, and his renal function recovered. The case highlights the rare manifestation of late stent collapse and subsequent re-expansion of the collapsed stent and restoration of visceral and lower extremity perfusions following axillo-bifemoral bypass.
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Affiliation(s)
- Yoshihiro Goto
- Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan
| | - Soh Hosoba
- Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan
| | - Shinji Ogawa
- Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan
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6
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The role of axillofemoral bypass in current vascular surgery practice. Am J Surg 2016; 211:968-71. [DOI: 10.1016/j.amjsurg.2016.02.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 01/31/2016] [Accepted: 02/01/2016] [Indexed: 11/19/2022]
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Tamura K, Nakajima K, Chikazawa G, Hiraoka A, Totsugawa T, Sakaguchi T, Yoshitaka H. Effectiveness of the Use of Near-Infrared Spectroscopy to Treat Acute Type A Aortic Dissection Complicated with Limb Ischemia: Report of a Case. Ann Vasc Dis 2015; 8:249-51. [PMID: 26421076 DOI: 10.3400/avd.cr.15-00020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/11/2015] [Indexed: 11/13/2022] Open
Abstract
We report an effectiveness of the use of near-infrared spectroscopy to evaluate the limb perfusion, which helps to continuously measure the tissue oxygen index of bilateral legs in treating acute type A aortic dissection complicated with limb ischemia. A 62-year-old man underwent total arch replacement for acute type A aortic dissection with limb ischemia. Intraoperative retrograde true lumen perfusion via bilateral femoral arteries during cardiopulmonary bypass improved ischemic condition of bilateral legs before the resection of primary intimal tear, and the use of near-infrared spectroscopy made it possible to assess additional revascularizations to the lower limbs were required or not.
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Affiliation(s)
- Kentaro Tamura
- Department of Cardiovascular Surgery, the Sakakibara Heart Institute of Okayama, Okayama, Okayama, Japan
| | - Kousuke Nakajima
- Department of Cardiovascular Surgery, the Sakakibara Heart Institute of Okayama, Okayama, Okayama, Japan
| | - Genta Chikazawa
- Department of Cardiovascular Surgery, the Sakakibara Heart Institute of Okayama, Okayama, Okayama, Japan
| | - Arudo Hiraoka
- Department of Cardiovascular Surgery, the Sakakibara Heart Institute of Okayama, Okayama, Okayama, Japan
| | - Toshinori Totsugawa
- Department of Cardiovascular Surgery, the Sakakibara Heart Institute of Okayama, Okayama, Okayama, Japan
| | - Taichi Sakaguchi
- Department of Cardiovascular Surgery, the Sakakibara Heart Institute of Okayama, Okayama, Okayama, Japan
| | - Hidenori Yoshitaka
- Department of Cardiovascular Surgery, the Sakakibara Heart Institute of Okayama, Okayama, Okayama, Japan
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8
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Orihashi K. Mesenteric ischemia in acute aortic dissection. Surg Today 2015; 46:509-16. [DOI: 10.1007/s00595-015-1193-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/28/2015] [Indexed: 11/30/2022]
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9
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Almdahl SM. Misuse of the term “subclavian access”. J Thorac Cardiovasc Surg 2014; 148:2438. [DOI: 10.1016/j.jtcvs.2014.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 07/16/2014] [Indexed: 10/24/2022]
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10
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Gargiulo M, Bianchini Massoni C, Gallitto E, Freyrie A, Trimarchi S, Faggioli G, Stella A. Lower limb malperfusion in type B aortic dissection: a systematic review. Ann Cardiothorac Surg 2014; 3:351-67. [PMID: 25133098 DOI: 10.3978/j.issn.2225-319x.2014.07.05] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 07/19/2014] [Indexed: 11/14/2022]
Abstract
BACKGROUND Lower limb malperfusion (LLM) syndrome occurs in up to 40% of complicated type B aortic dissections (TBAD) and in up to 71% of TBAD with malperfusion syndrome. This syndrome is associated with higher 30-day mortality. The aim of this systematic review was to provide clinical and procedural data of patients with LLM syndrome secondary to TBAD. METHODS The PubMed database was systematically searched from January 2000 to June 2014 for English-language publications reporting on demographic data of patients with LLM secondary to TBAD. RESULTS A total of 29 papers were included (10 original articles and 19 case reports), reporting on a total of 138 patients (mean age =58±12 years; male =87%). Lower limb complications developed in acute and chronic TBAD in 134 (97%) and 4 (3%) cases, respectively. LLM presented with acute limb ischemia in 120 (87%) patients. Bilateral clinical presentation occurred in 56% (40/72) of cases. LLM was the only clinically detected malperfusion in 52% of cases (44/84). In 40% (35/84) and 25% (21/84) of cases, LLM was clinically associated with renal and visceral malperfusion, respectively. Radiological imaging showed renal, celiac trunk and superior mesenteric artery involvement in 53% (47/88), 31% (27/88) and 34% (30/88) of cases, respectively. Medical, surgical and endovascular treatments were performed in 22 (16%), 51 (37%) and 65 (47%) patients, respectively. Thirty-day morbidity was 31% (13/42) and 46% (6/13) following surgical and endovascular treatment, respectively. Thirty-day mortality was 14% (5/36) and 8% (2/26) following surgical and endovascular treatment, respectively. CONCLUSIONS LLM syndrome secondary to TBAD usually developed during the acute phase and, in most cases, presented with acute limb ischemia. Bilateral clinical presentation occurred in more than half of cases. Renal and visceral malperfusion were frequently associated with lower limb flow reduction but LLM was the only clinically detected malperfusion in more than half of patients. Surgical fenestration was burdened with significant complication rates and 30-day mortality. Endovascular procedures showed lower mortality but complication rates remained high.
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Affiliation(s)
- Mauro Gargiulo
- Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy ; 2 Vascular Surgery, Department of Cardiovascular Surgery, Thoracic Aortic Research Center, Policlinico San Donato I.R.C.C.S., University of Milan, Italy
| | - Claudio Bianchini Massoni
- Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy ; 2 Vascular Surgery, Department of Cardiovascular Surgery, Thoracic Aortic Research Center, Policlinico San Donato I.R.C.C.S., University of Milan, Italy
| | - Enrico Gallitto
- Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy ; 2 Vascular Surgery, Department of Cardiovascular Surgery, Thoracic Aortic Research Center, Policlinico San Donato I.R.C.C.S., University of Milan, Italy
| | - Antonio Freyrie
- Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy ; 2 Vascular Surgery, Department of Cardiovascular Surgery, Thoracic Aortic Research Center, Policlinico San Donato I.R.C.C.S., University of Milan, Italy
| | - Santi Trimarchi
- Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy ; 2 Vascular Surgery, Department of Cardiovascular Surgery, Thoracic Aortic Research Center, Policlinico San Donato I.R.C.C.S., University of Milan, Italy
| | - Gianluca Faggioli
- Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy ; 2 Vascular Surgery, Department of Cardiovascular Surgery, Thoracic Aortic Research Center, Policlinico San Donato I.R.C.C.S., University of Milan, Italy
| | - Andrea Stella
- 1 Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy ; 2 Vascular Surgery, Department of Cardiovascular Surgery, Thoracic Aortic Research Center, Policlinico San Donato I.R.C.C.S., University of Milan, Italy
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Morishita A, Tomioka H, Katahira S, Hoshino T, Hanzawa K. Delayed visceral and spinal cord malperfusion after axillo-bifemoral bypass for complicated acute type B aortic dissection. Ann Vasc Dis 2014; 7:331-4. [PMID: 25298840 DOI: 10.3400/avd.cr.14-00059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 06/11/2014] [Indexed: 11/13/2022] Open
Abstract
We describe a successfully treated case of acute type B aortic dissection complicated with lower extremity, visceral, and spinal cord malperfusion. To restore perfusion to both lower extremities, we performed an emergency right axillo-bifemoral bypass. Furthermore, we performed total arch replacement, including primary entry closure, because of delayed visceral organ ischemia. Unexpectedly, delayed paraplegia occurred after hospital discharge; however, the patient recovered without any neurologic sequelae after early introduction of hyperbaric oxygen therapy. Because another episode of organ malperfusion in the long term cannot be anticipated, and even though the previous organ malperfusion episode was treated successfully, close observation is mandatory for detecting clinical manifestations in combination with the availability of imaging modalities.
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Affiliation(s)
- Atsushi Morishita
- Department of Cardiovascular Surgery, Numata Neurosurgery Heart-Disease Hospital, Numata, Gunma, Japan
| | - Hideyuki Tomioka
- Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's, Medical University, Tokyo, Japan
| | | | - Takeshi Hoshino
- Department of Anesthesiology, Minami Machida Hospital, Machida, Tokyo, Japan
| | - Kazuhiko Hanzawa
- Department of Thoracic and Cardiovascular Surgery, Niigata University School of Medicine, Niigata, Niigata, Japan
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12
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Qiao A, Yin W, Chu B. Numerical simulation of fluid–structure interaction in bypassed DeBakey III aortic dissection. Comput Methods Biomech Biomed Engin 2014; 18:1173-1180. [DOI: 10.1080/10255842.2014.881806] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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