1
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Kumar B, Kanakapura K, Ayachit G, Ayachit A. Sequential central retinal artery and posterior ciliary artery occlusion due to ophthalmic artery aneurysm. BMJ Case Rep 2024; 17:e257568. [PMID: 38697685 PMCID: PMC11085753 DOI: 10.1136/bcr-2023-257568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Affiliation(s)
| | | | | | - Apoorva Ayachit
- Vitreoretina, MM Joshi Eye Institute, Hubli, Karnataka, India
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2
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Subramanian P, Paul S, Sharma A, Singhal M. Major aortopulmonary collateral artery aneurysms-A rare cause of airway narrowing. Pediatr Pulmonol 2024; 59:1479-1481. [PMID: 38372442 DOI: 10.1002/ppul.26923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/20/2024]
Affiliation(s)
| | - Shouvik Paul
- Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India
| | - Arun Sharma
- Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India
| | - Manphool Singhal
- Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India
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3
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Jin Y, Zhang HY, Chai DZ. Radial artery aneurysm associated with congenital arteriovenous malformation of upper extremity. J Vasc Surg Venous Lymphat Disord 2024; 12:101718. [PMID: 37977521 DOI: 10.1016/j.jvsv.2023.101718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/24/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Yao Jin
- Department of Vascular Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China
| | - Hua Yi Zhang
- Department of Vascular Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
| | - Dong Zhe Chai
- Department of Vascular Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China
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4
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Çiloğlu U, Velibey Y, Aldağ M, Güvenç TS, Naser A. Multiple aneurysms in the inferior vena cava. Am J Med Sci 2024; 367:e60-e61. [PMID: 38280672 DOI: 10.1016/j.amjms.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 01/20/2024] [Indexed: 01/29/2024]
Affiliation(s)
- Ufuk Çiloğlu
- Department of Cardiovascular Surgery, VM Medical Park Pendik Hospital, Istanbul, Turkey
| | - Yalcin Velibey
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
| | - Mustafa Aldağ
- Department of Cardiovascular Surgery, VM Medical Park Pendik Hospital, Istanbul, Turkey
| | - Tolga Sinan Güvenç
- Department of Cardiology, VM Medical Park Pendik Hospital, Istanbul, Turkey
| | - Abdulrahman Naser
- Department of Cardiology, VM Medical Park Pendik Hospital, Istanbul, Turkey
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5
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Bhatia H, Aswal CSS, Sharma A, Singhal M. Bicarotid trunk coexisting with anomalous right vertebral and aberrant right subclavian artery. Pediatr Pulmonol 2024; 59:1476-1478. [PMID: 38358033 DOI: 10.1002/ppul.26894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/15/2024] [Accepted: 01/22/2024] [Indexed: 02/16/2024]
Affiliation(s)
- Harsimran Bhatia
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Arun Sharma
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manphool Singhal
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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6
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Deyaert P, Goeminne P, Jerjir N. Rare and potentially lethal case of a round lesion in the lung. BMJ Case Rep 2024; 17:e257519. [PMID: 38663900 PMCID: PMC11043702 DOI: 10.1136/bcr-2023-257519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
A pulmonary venous aneurysm (PVA) is extremely rare. A PVA can be either congenital or acquired. Possible symptoms include thoracic pain, dyspnoea, haemoptysis and palpitations but can also occur asymptomatically. Treatment can be conservative or surgical depending on growth and risk of rupture or development of mitral insufficiency, symptoms and thrombus formation. Only a few cases have been described in the literature. A recent case study and a literature review are described below.
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Affiliation(s)
| | | | - Naïm Jerjir
- Radiology, AZ Nikolaas, Sint-Niklaas, Belgium
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7
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Mavuduru RM, Mohd Ziauddin SA, Bora GS, Gorsi U. Renal artery pseudoaneurysm following robot assisted nephron sparing surgery: two case reports. J Med Case Rep 2024; 18:191. [PMID: 38637904 PMCID: PMC11027276 DOI: 10.1186/s13256-024-04510-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Renal artery pseudoaneurysm following partial nephrectomy is a rare entity, the incidence of this entity is more common following penetrating abdominal injuries, percutaneous renal interventions such as percutaneous nephrostomy(PCN) or Percutaneous nephrolithotomy (PCNL). Although rare, renal artery pseudoaneurysm can be life threatening if not managed timely, they usually present within two weeks postoperatively with usual presenting complains being gross haematuria, flank pain and/or anaemia. CASE PRESENTATION We report case of two female patients 34 and 57 year old respectively of South Asian ethnicity, presenting with renal artery pseudoaneurysm following left sided robot assisted nephron sparing surgery for interpolar masses presenting clinically with total, painless, gross haematuria with clots within fifteen days postoperatively and their successful treatment by digital subtraction angiography and coil embolization. CONCLUSION Renal artery aneurysm is a rare fatal complication of minimally invasive nephron sparing surgery however considering the preoperative and intraoperative risk factors for its development and prompt suspicion at the outset can be life saving with coil embolization of the bleeding arterial aneurysm.
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Affiliation(s)
| | | | | | - Ujjwal Gorsi
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
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8
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Harnal R, Shiraev T. Subclavian Vein Aneurysm: An Unusual Cause of Massive Pulmonary Embolism. Eur J Vasc Endovasc Surg 2024; 67:661. [PMID: 38141958 DOI: 10.1016/j.ejvs.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/24/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Affiliation(s)
- Richa Harnal
- Resident, Royal Prince Alfred Hospital, Sydney, Australia.
| | - Timothy Shiraev
- Vascular Surgeon, Royal Prince Alfred Hospital, Sydney, Australia
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9
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Tsuda E. Recurrent events of acute coronary syndrome in young adult patients after Kawasaki disease. Cardiol Young 2024; 34:809-814. [PMID: 37850457 DOI: 10.1017/s1047951123003499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
OBJECTIVE I encountered three adult patients with major coronary artery occlusion after Kawasaki disease in childhood, who had developed again acute coronary syndrome of adults in the peripheral branches, such as the 4th segments, the atrioventricular node artery, and the posterior descending artery, of the right coronary artery. METHODS I reviewed their clinical course and coronary angiograms. RESULTS Their age at onset of acute coronary syndrome ranged from 29 to 33 years. The male patient with a previous anteroseptal myocardial infarction in children had a symptomatic occlusion of the branch of the 4th posterior descending artery at 32 years of age. Acute coronary syndrome occurred in the area of 4th atrioventricular node artery in two female patients. The collateral arteries from the circumflex artery to the 4th atrioventricular node arteries were not clearly injected. It was suspected that they had developed bilateral giant aneurysms after acute Kawasaki disease. Two patients had an acute myocardial infarction due to thrombotic occlusion in a giant aneurysm of the right coronary artery or the left anterior descending artery, and one patient had an asymptomatic coronary occlusion of the right coronary artery and left anterior descending artery in children. CONCLUSION Occlusion of peripheral coronary arteries in adulthood can occur in patients with multi-vessel disease caused by Kawasaki disease. Recurrent events of acute coronary syndrome can occur in adults, although its prevalence may be low. Careful follow-up in adults is also needed in this population.
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Affiliation(s)
- Etsuko Tsuda
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
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10
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Maruyama S, Furusawa H, Endo S, Kumagai T, Mitsumura T, Shimada S, Yamana T, Sakakibara R, Iijima Y, Shibata S, Honda T, Shirai T, Okamoto T, Tateishi T, Tamaoka M, Kinowaki Y, Ishibashi H, Okubo K, Miyazaki Y. Pulmonary Artery Aneurysm in a Patient with Nontuberculous Mycobacteria Infection. Intern Med 2024; 63:989-992. [PMID: 37558481 PMCID: PMC11045386 DOI: 10.2169/internalmedicine.2199-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/05/2023] [Indexed: 08/11/2023] Open
Abstract
Nontuberculous mycobacterial (NTM) infection sometimes leads to the development of pulmonary artery aneurysm (PAA), a rare but life-threatening complication. We herein report a 64-year-old woman with a history of NTM infection who presented with severe hemoptysis. Computed tomography revealed a ruptured PAA, which was treated successfully with pulmonary artery embolization. Subsequent right total pneumonectomy was performed to control infection. This case emphasizes the need to consider PAA in patients with NTM infection who present with hemoptysis. Early detection and appropriate management are critical for preventing this fatal complication.
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Affiliation(s)
- Soichi Maruyama
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
- Department of Respiratory Medicine, Nerima Hikarigaoka Hospital, Japan
| | - Haruhiko Furusawa
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Satoshi Endo
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takashi Kumagai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takahiro Mitsumura
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Sho Shimada
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takashi Yamana
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Rie Sakakibara
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Yuki Iijima
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Sho Shibata
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Takayuki Honda
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tsuyoshi Shirai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tsukasa Okamoto
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Tomoya Tateishi
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Meiyo Tamaoka
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
| | - Yuko Kinowaki
- Department of Comprehensive Pathology, Tokyo Medical and Dental University, Japan
| | - Hironori Ishibashi
- Department of Thoracic Surgery, Tokyo Medical and Dental University, Japan
| | - Kenichi Okubo
- Department of Thoracic Surgery, Tokyo Medical and Dental University, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Japan
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11
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Ueda A, Saito K, Murase H, Kato T, Imafuji H, Morimoto M, Ogawa R, Takahashi H, Matsuo Y, Takiguchi S. Robotic resection for splenic artery aneurysm associated with neurofibromatosis type 1: a case report. J Med Case Rep 2024; 18:104. [PMID: 38481300 PMCID: PMC10938794 DOI: 10.1186/s13256-024-04440-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/07/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Neurofibromatosis type 1 is an autosomal-dominant disease characterized by café-au-lait spots and neurofibromas, as well as various other symptoms in the bones, eyes, and nervous system. Due to its connection with vascular fragility, neurofibromatosis type 1 has been reported to be associated with vascular lesions, such as aneurysms. However, there have been few reports of abdominal visceral aneurysms associated with neurofibromatosis type 1. Furthermore, there have been no reports of robotic treatment of aneurysms associated with neurofibromatosis type 1. In this report, we describe the case of a patient with neurofibromatosis type 1 with a splenic artery aneurysm who was successfully treated with robotic surgery. CASE PRESENTATION This report describes a 41-year-old Asian woman with a history of neurofibromatosis type 1 who was referred to our hospital for evaluation of a 28 mm splenic artery aneurysm observed on abdominal ultrasound. The aneurysm was in the splenic hilum, and transcatheter arterial embolization was attempted; however, this was difficult due to the tortuosity of the splenic artery. Thus, we suggested minimally invasive robotic surgery for treatment and resection of the splenic artery aneurysm with preservation of the spleen. The postoperative course was uneventful, and the patient was discharged on the eighth day after surgery. At 1 year of follow-up, the patient was doing well, with no evidence of recurrence. CONCLUSION We encountered a rare case of splenic artery aneurysm in a patient with neurofibromatosis type 1 who was successfully treated with robotic surgery. There is no consensus on treatment modalities for neurofibromatosis-related aneurysms, and endovascular treatment is considered safe and effective; however, surgery remains an important treatment modality. Especially in patients with stable hemodynamic status, robotic surgery may be considered as definitive treatment. To our knowledge, this is the first successfully treated case of a splenic artery aneurysm in a patient with neurofibromatosis type 1.
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Affiliation(s)
- Akihiko Ueda
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 4678601, Japan
| | - Kenta Saito
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 4678601, Japan.
| | - Hiromichi Murase
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 4678601, Japan
| | - Tomokatsu Kato
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 4678601, Japan
| | - Hiroyuki Imafuji
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 4678601, Japan
| | - Mamoru Morimoto
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 4678601, Japan
| | - Ryo Ogawa
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 4678601, Japan
| | - Hiroki Takahashi
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 4678601, Japan
| | - Yoichi Matsuo
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 4678601, Japan
| | - Shuji Takiguchi
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 4678601, Japan
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12
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Ichimata S, Hata Y, Yoshida K, Tanaka R, Nishida N. Sudden unexpected death of a young adult due to subarachnoid hemorrhage associated with polyarteritis nodosa: Clinicopathological appearance and literature review. Cardiovasc Pathol 2024; 69:107602. [PMID: 38072093 DOI: 10.1016/j.carpath.2023.107602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/21/2023] [Accepted: 12/05/2023] [Indexed: 12/30/2023] Open
Abstract
A 28-year-old male was found dead in his bedroom. There were no anomalies in his birth and medical history, and there was no family history of sudden unexpected death (SUD). Autopsy showed subarachnoid hemorrhage (SAH) with basilar top inflammatory pseudoaneurysm rupture accompanied by fibrinoid necrosis in the aneurysm wall. Active and healed arteritides in small- to medium-sized arteries were identified in the brain, heart, and systemic connective tissue, which was consistent with polyarteritis nodosa (PAN). Furthermore, pneumatosis cystoides intestinalis was observed in the ascending colon. Hepatitis B virus infection and antineutrophil nuclear antibodies were negative. Genetic investigation using whole-exome sequencing showed no mutations among autoinflammatory-related genes, including UBA1, MEFV, and ADA2. SAH due to rupture of a pseudoaneurysm formed by PAN was considered as the cause of death in the present case. Although myocardial ischemia linked to coronary arteritis is a recognized trigger for SUD in PAN, our study showed that rupture of inflammatory pseudoaneurysm in the cerebral artery can also cause SUD in younger subjects with PAN, even if prodromal symptoms are not evident before death.
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Affiliation(s)
- Shojiro Ichimata
- Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yukiko Hata
- Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Koji Yoshida
- Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Ryo Tanaka
- Department of Neurology, Toyama University Hospital, Toyama, Japan
| | - Naoki Nishida
- Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan.
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13
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Roldan CA, Allen K, Ratliff M, Grodin J, Alaiti A, Banerjee S. Infective Endocarditis Complicated With a Large Left Coronary Cusp Aneurysm: A Condition With Undefined Natural History and Treatment. Am J Cardiol 2024; 214:105-108. [PMID: 38160924 DOI: 10.1016/j.amjcard.2023.12.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/19/2023] [Accepted: 12/09/2023] [Indexed: 01/03/2024]
Abstract
The natural history and treatment of an aortic cusp aneurysm with or without rupture because of native aortic valve infective endocarditis (NAV-IE) have not been well defined. This may explain why current guidelines for the management of valvular heart disease do not include this complication as an indication for surgical aortic valve replacement or repair or transcatheter aortic valve replacement (TAVR). We describe herein the first case of a man aged 76 years with multiple co-morbidities with a NAV-IE associated large left coronary cusp aneurysm with subsequent rupture and consequent severe aortic regurgitation and heart failure for which he underwent an off-label successful TAVR. This patient's scenario suggests that a cusp aneurysm because of NAV-IE poses a high risk for subsequent rupture, severe aortic regurgitation, and heart failure. In conclusion, TAVR may be a reasonable alternative to high-risk surgical aortic valve replacement in patients with NAV-IE associated cusp aneurysms with or without but impending rupture.
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Affiliation(s)
- Carlos A Roldan
- Division of Cardiology, Albuquerque New Mexico VA Health Care System, Albuquerque, New Mexico; Division of Cardiology, University of New Mexico School of Medicine, Albuquerque, New Mexico.
| | - Kathleen Allen
- Division of Cardiology, Albuquerque New Mexico VA Health Care System, Albuquerque, New Mexico; Division of Cardiology, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Michelle Ratliff
- Division of Cardiology, Albuquerque New Mexico VA Health Care System, Albuquerque, New Mexico; Division of Cardiology, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Jerrold Grodin
- Division of Cardiology, Dallas Texas VA Health Care System, Dallas, Texas
| | - Amer Alaiti
- Division of Cardiology, Dallas Texas VA Health Care System, Dallas, Texas
| | - Subhash Banerjee
- Division of Cardiology, Dallas Texas VA Health Care System, Dallas, Texas
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14
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Oztunc F, Murt NU, Dedeoglu R, Coskun YI, Madazli R. Prenatal Diagnosis of Ductus Arteriosus Anomalies: A Single-Center Study. Pediatr Cardiol 2024; 45:600-604. [PMID: 38099950 DOI: 10.1007/s00246-023-03359-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/14/2023] [Indexed: 02/24/2024]
Abstract
To evaluate the fetal ductus arteriosus anomalies diagnosed by fetal echocardiography. The perinatal outcomes and associated cardiac and genetic anomalies are also explored. The fetal echocardiography records of 2366 fetuses were evaluated retrospectively. Thirty-seven pregnancies prenatally diagnosed with ductus arteriosus anomalies and evaluated after delivery were enrolled in the study. Perinatal and obstetric outcomes were analyzed. The incidence of ductus arteriosus anomaly in our series was 1.5% (37/2366). The most frequent ductus arteriosus anomaly detected was right-sided ductus arteriosus followed by aneurysm, constriction and bilateral ductus arteriosus with an incidence of 51.3%, 27.1%, 18.9% and 2.7%, respectively. There were 19 fetuses with right-sided ductus arteriosus, of which 15 had tetralogy of Fallot. There were 2 chromosomal anomalies (22q11 microdeletion) in this group. Of the 7 fetuses with ductus arteriosus constriction, 3 (3/7, 42.9%) died in-utero. There were 2 (2/10, 20%) neonatal deaths due to hypoplastic left heart syndrome in the ductus arteriosus aneurysm group. Various types of ductus arteriosus anomalies can be diagnosed prenatally. Perinatal outcomes mostly dependent on the type of the ductus arteriosus anomaly and accompanying cardiac malformations.
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Affiliation(s)
- Funda Oztunc
- Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | | | | | | | - Riza Madazli
- Istanbul University-Cerrahpasa, Istanbul, Turkey
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15
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Khan J, Khan MM, Brohi Z, Mahboob M, Bangash SK. Massive left pulmonary artery aneurysm with a co-existing patent ductus arteriosus in a five-year-old female child: A case report. J PAK MED ASSOC 2024; 74:585-588. [PMID: 38591305 DOI: 10.47391/jpma.9952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Pulmonary Artery Aneur ysm (PAA), whether congenital or acquired, is a rare diagnostic find ing com pare d to aor tic aneur ysms. There have been fe w cases where PA As were documented as a complication of untreated Patent Ductus Ar teriosus (PDA) due to long-standing Pulmonary Arterial H ypertension (PAH). However, it is quite rare for a case of PAA to be reported with co-existing PDA without PAH. This report highlights a case of a five -year-old girl who was presented with palpitations, easy fatigability, fever, c yanos is, and vomiting. A Chest X-ray s howed mo derate cardiomega ly. A PDA of 6 mm was diagnosed on Transthoracic E chocardiog rap hy ( TTE ) and a large cavity con necte d with LPA raised suspicion of a possible LPA aneur ysm. A Chest CT scan confirm ed the diagnosis of a saccular aneurysm, originating from the distal part of the main Left Pulmonary Artery (LPA) just proximal to the point of bifurcation into lobar branches, measuring 7.5x6.5 cm. During surgery, the aneurysm was opened, emptied with suction and closed without resecting the aneur ysmal walls. The patient had an uneventful post-op course and is doing well during regular interval follow up visits.
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Affiliation(s)
- Javeria Khan
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | | | - Zubair Brohi
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Mahwish Mahboob
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
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16
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Lefebvre F, Ross C, Soowamber M, Pagnoux C. Aneurysmal Disease in Patients With Takayasu Arteritis. J Rheumatol 2024; 51:277-284. [PMID: 38101913 DOI: 10.3899/jrheum.2023-0629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Takayasu arteritis (TA) leads to stenotic disease. Aneurysmal lesions are rarer. This study assessed the main characteristics of aneurysmal disease in a Canadian cohort of patients with TA. METHODS This monocentric retrospective study included patients with TA followed at the Mount Sinai Hospital Vasculitis Clinic in Toronto. Diagnosis of TA was based on clinical findings and/or satisfied the 1990 American College of Rheumatology classification criteria. RESULTS Seventy-four patients were included. At any time, aneurysmal disease was found in 23 (31%) patients. Median disease duration was 9.0 (IQR 7.0-19.0) years. Prior hypertension (P = 0.02), fever (P = 0.04), and seizure disorders (P = 0.03) were more common. Limb claudication was less frequent (P = 0.01). Persistent and/or new aneurysms were demonstrated in 22/23 patients at follow-up. Thoracic aorta aneurysm (13/22) was most common, followed by abdominal aorta (8/22), subclavian (7/22), and carotid (6/22) artery disease. Aortic valve regurgitation was more frequent (9/23 vs 3/48; P = 0.001). Twenty-one patients had been treated with glucocorticoids (median 6.1 years [IQR 3.7-8.1]). Methotrexate, azathioprine, and leflunomide were repeatedly used. Infliximab (7/23) was used more often (P = 0.04), whereas tocilizumab was received by only 4 patients with aneurysmal disease (P = 0.01). Patients with aneurysms suffered more frequent relapses (2.0 [IQR 0.0-4.0] vs 1.0 [IQR 0.0-2.0], P = 0.04). CONCLUSION Aneurysmal disease was found in a significant proportion of patients with TA. Given that aneurysms may carry a risk of rupture, and are associated with a higher rate of relapse, this finding should be reported systematically in TA studies.
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Affiliation(s)
- Frédéric Lefebvre
- F. Lefebvre, MD, MSc, Vasculitis Clinic, Division of Rheumatology, Department of Medicine, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, Quebec, and Vasculitis Clinic, Mount Sinai Hospital, Department of Medicine, Division of Rheumatology, University Health Network, University of Toronto, Toronto, Ontario;
| | - Carolyn Ross
- C. Ross, PharmD, MD, Vasculitis Clinic, Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Quebec, and Vasculitis Clinic, Mount Sinai Hospital, Department of Medicine, Division of Rheumatology, University Health Network, University of Toronto, Toronto, Ontario
| | - Medha Soowamber
- M. Soowamber, MD, MSc, C. Pagnoux, MD, MSc, MPH, Vasculitis Clinic, Mount Sinai Hospital, Department of Medicine, Division of Rheumatology, University Health Network, University of Toronto, Toronto, Ontario, Canada
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Matsuura H, Okita A. Multiple pancreaticoduodenal artery aneurysms and retroperitoneal bleeding in a patient with celiac artery compression syndrome. Intern Emerg Med 2024; 19:575-576. [PMID: 37770771 DOI: 10.1007/s11739-023-03424-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/01/2023] [Indexed: 09/30/2023]
Affiliation(s)
- Hiroki Matsuura
- Department of Emergency Medicine, Okayama City Hospital, 3-20-1, Omote-Cho, Kitanagase, Okayama, Okayama, 700-0962, Japan.
- Department of General Internal Medicine, Okayama City Hospital, Okayama, Japan.
| | - Atsushi Okita
- Department of Surgery, Okayama City Hospital, Okayama, Japan
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18
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Damadian BE, Machnicki SC. I saw the sign: He felt a pang and we saw the Yin-Yang (sign). Clin Imaging 2024; 107:110087. [PMID: 38241966 DOI: 10.1016/j.clinimag.2024.110087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/27/2023] [Accepted: 01/10/2024] [Indexed: 01/21/2024]
Abstract
The yin-yang sign, also known as the Pepsi sign, is used to describe the classic appearance of bidirectional blood flow within an aneurysm or pseudoaneurysm sac on color Doppler ultrasound. The corresponding spectral Doppler finding is a "to-and-fro" waveform, caused by inflow to the aneurysm/pseudoaneurysm sac during systole and outflow during diastole. It is important to recognize this sign in order to quickly identify the presence of an aneurysm or pseudoaneurysm and prevent complications such as expansion and rupture.
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Affiliation(s)
- Brianna E Damadian
- Northwell Health/Lenox Hill Hospital, Department of Radiology, 100 East 77th Street, New York, NY 10075, United States of America.
| | - Stephen C Machnicki
- Northwell Health/Lenox Hill Hospital, Department of Radiology, 100 East 77th Street, New York, NY 10075, United States of America
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19
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Charan BD, Thanneru S, Sebastian LJD, Jain S. Reconstructive endovascular treatment of petrous ICA pseudoaneurysm in skull base osteomyelitis: a hidden catastrophe. BMJ Case Rep 2024; 17:e258539. [PMID: 38417939 PMCID: PMC10900339 DOI: 10.1136/bcr-2023-258539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
Skull base osteomyelitis can be more life-threatening in immunocompromised patients and patients with diabetes. Here, we present a case of a petrous internal carotid artery pseudoaneurysm resulting from skull base osteomyelitis in a diabetic male in his 50s. This case report highlights the need to be conscious of the various complications associated with skull base osteomyelitis, be proficient in detecting them and treat them as early as possible for better outcomes. After adequate control of the disease process with medical treatment, immediate management of the aneurysm with balloon angioplasty and stenting was done. Acknowledging the trivial nasal and ear bleed, radiological evaluation is necessary to rule out rare complications like pseudoaneurysms in a diagnosed case of skull base osteomyelitis. In the discussion, we have cited the various treatment methods and similar cases of pseudoaneurysm caused by osteomyelitis. Currently, the patient continues to live a disease and disability-free life.
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20
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Shehzad D, Khan D, Shehzad M, Khan W, Chaudhry H, Oliver T. Gastroduodenal artery aneurysm - an extremely rare but insidious cause of abdominal pain: a case report. Pan Afr Med J 2024; 47:77. [PMID: 38708132 PMCID: PMC11068471 DOI: 10.11604/pamj.2024.47.77.42605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 02/04/2024] [Indexed: 05/07/2024] Open
Abstract
An arterial aneurysm is a localized weakening of the artery wall that results in pathological dilatation. All intra-abdominal artery aneurysms are labeled as visceral artery aneurysms (VAA), apart from the aorto-iliac artery aneurysms. VAA´s are rare, gastroduodenal artery aneurysms (GDAA), constituting 1.5% of visceral artery aneurysms. A woman in her early 80s´ presented with chronic epigastric pain, weight loss, and nausea. Conservative management was unsuccessful. Imaging revealed a GDAA, prompting endovascular coil embolization. Subsequent evaluation confirmed Polyarteritis Nodosa (PAN), treated with rituximab. The report underscores the diagnostic challenges, emphasizing the need for a multidisciplinary approach using imaging and angiography. GDAA's potential life-threatening rupture necessitates prompt intervention, as illustrated in this case. The rare association with PAN, although infrequent, underscores the importance of considering underlying etiologies in multiple visceral aneurysms. Early diagnosis and intervention are pivotal for this uncommon yet potentially lethal condition.
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Affiliation(s)
- Dawood Shehzad
- Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, South Dakota, United States of America
| | - Dawlat Khan
- Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, South Dakota, United States of America
| | - Mustafa Shehzad
- Hackensack University Medical Center, Hackensack, United States of America
| | - Wahab Khan
- Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, South Dakota, United States of America
| | - Hammad Chaudhry
- Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, South Dakota, United States of America
| | - Tony Oliver
- Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, South Dakota, United States of America
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Pochepnia S, Lang IM, Milos RI, Röhrich S, Ba-Ssalamah A, Beer L, Prosch H. Hughes-Stovin syndrome-An important differential diagnosis in patients with suspected chronic thromboembolic pulmonary hypertension : A case report. Wien Klin Wochenschr 2024; 136:118-121. [PMID: 37966526 PMCID: PMC10837237 DOI: 10.1007/s00508-023-02299-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023]
Abstract
Hughes-Stovin syndrome (HSS) is a rare vasculitis of unknown etiology. The disease is characterized by pronounced inflammation and damage to the vessel walls, with subsequent widespread vascular thrombosis and the formation of pulmonary artery aneurysms that can lead to fatal hemoptysis. This disorder can be mistaken for other conditions, such as chronic thromboembolic pulmonary disease (CTEPD) without or with pulmonary hypertension at rest (CTEPH).We report the case of a 20-year-old female with HSS, which was misdiagnosed as CTEPH and subsequently treated with anticoagulants, which led to severe hemoptysis and eventually death of the patient. This case highlights the challenges of diagnosing HSS at early stages of the disease.HSS should be considered in young patients with signs of large vessel vasculitis in combination with thrombotic occlusions of pulmonary arteries, with or without aneurysms of the pulmonary arteries, and particularly, if there are no risk factors for thromboembolic disease.
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Affiliation(s)
- Svitlana Pochepnia
- Vienna General Hospital, Dept. of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria.
| | - Irene M Lang
- Dept. of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Ruxandra Iulia Milos
- Vienna General Hospital, Dept. of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
| | - Sebastian Röhrich
- Vienna General Hospital, Dept. of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
| | - Ahmed Ba-Ssalamah
- Vienna General Hospital, Dept. of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
| | - Lucian Beer
- Vienna General Hospital, Dept. of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
| | - Helmut Prosch
- Vienna General Hospital, Dept. of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
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Kai K, Hamada T, Sakae T, Sato Y, Hiyoshi M, Inomata M, Suzuki Y, Nakamura S, Azuma M, Nanashima A. A case of multifocal sclerosis angiomatoid nodular transformations of the spleen occurring after partial splenic infarction with transcatheter arterial embolization for splenic artery aneurysm. Clin J Gastroenterol 2024; 17:198-203. [PMID: 37831375 DOI: 10.1007/s12328-023-01869-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/20/2023] [Indexed: 10/14/2023]
Abstract
A 48-year-old woman underwent transcatheter arterial embolization (TAE) for a splenic artery aneurysm, which resulted in a partial splenic infarction in the middle lobe. Five years after TAE, a 20-mm diameter mass in the noninfarcted area of the spleen was detected on imaging, which grew to 25 mm in diameter after 6 months. MRI after gadolinium administration showed a 35 × 34 mm mass within the superior pole and 15 × 12 mm mass within the inferior pole. The patient underwent laparoscopic splenectomy and had an uneventful postoperative recovery. No evidence of recurrence was observed during the 2-year follow-up period after surgery. The mass was pathologically confirmed to be sclerosing angiomatoid nodular transformation (SANT) of the spleen. While some studies hypothesize that SANT is a response to vascular injury or trauma, to the best of our knowledge, there have been no previous reports of SANT occurring after procedures directly affecting splenic blood flow. Additionally, multifocal SANTs are reported to be very rare, accounting for only 4.7% of all reported SANTs of the spleen. We highlight a rare course of SANT of the spleen and discuss the possible relationship between blood flow abnormalities and the appearance of SANT.
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Affiliation(s)
- Kengo Kai
- Department of Surgery, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
- Department of Anatomy, Histochemistry and Cell Biology, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Takeomi Hamada
- Department of Surgery, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Tatefumi Sakae
- Department of Radiology, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yuichiro Sato
- Department of Diagnostic Pathology, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Masahide Hiyoshi
- Department of Surgery, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Mayu Inomata
- Department of Surgery, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yasuto Suzuki
- Department of Surgery, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Sawa Nakamura
- Department of Radiology, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Minako Azuma
- Department of Radiology, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Atsushi Nanashima
- Department of Surgery, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
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Brahim O, Mahjoub Y, Boussaid M, Limem H, Aissaoui A. Fibromuscular dysplasia of the coronary arteries: An unusual case of sudden death and review of the literature. J Forensic Leg Med 2024; 102:102633. [PMID: 38241822 DOI: 10.1016/j.jflm.2023.102633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 01/21/2024]
Abstract
Fibromuscular dysplasia of the coronary is an uncommon coronary defect with a range of pathological alterations and unpredictable clinical description that can cause sudden death. We present an autopsy case of sudden cardiac death due to a rupture of a coronary artery aneurysm in a 59-year-old woman. Postmortem autopsy revealed two huge saccular aneurysms located at the right coronary artery, one of which was ruptured leading to a fatal hemopericardium. Histopathological examination revealed coronary artery fibromuscular dysplasia with fibromyxoid dissociation of the media causing saccular aneurysms. The involvement of coronary arteries in fibromuscular dysplasia with aneurysmal features has been rarely reported in the literature and is most likely an underdiagnosed finding. Due to the little number of published studies, the etiology is not fully understood and data on pathogenesis, risk factors, manifestation, disease course, and mortality are still unclear, which is a gap that needs to be filled in order to avoid under-diagnosis of the disease. Our case report aimed to discuss the mechanisms of sudden death attributed to coronary fibromuscular dysplasia.
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Affiliation(s)
- Oumeima Brahim
- Department of Legal Medicine, Taher Sfar Teaching Hospital, 5100, Mahdia, Tunisia; Faculty of Medicine of Monastir, University of Monastir, Tunisia; Laboratory of Technology and Medical Imaging " LR12ES06, Tunisia.
| | - Yosra Mahjoub
- Department of Legal Medicine, Taher Sfar Teaching Hospital, 5100, Mahdia, Tunisia; Faculty of Medicine of Monastir, University of Monastir, Tunisia; Laboratory of Technology and Medical Imaging " LR12ES06, Tunisia.
| | - Marwa Boussaid
- Department of Legal Medicine, Taher Sfar Teaching Hospital, 5100, Mahdia, Tunisia; Faculty of Medicine of Monastir, University of Monastir, Tunisia; Laboratory of Technology and Medical Imaging " LR12ES06, Tunisia.
| | - Hiba Limem
- Department of Legal Medicine, Taher Sfar Teaching Hospital, 5100, Mahdia, Tunisia; Faculty of Medicine of Monastir, University of Monastir, Tunisia; Laboratory of Technology and Medical Imaging " LR12ES06, Tunisia.
| | - Abir Aissaoui
- Department of Legal Medicine, Taher Sfar Teaching Hospital, 5100, Mahdia, Tunisia; Faculty of Medicine of Monastir, University of Monastir, Tunisia; Laboratory of Technology and Medical Imaging " LR12ES06, Tunisia.
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Bonvini S, Spadoni N, Tasselli S. Endovascular repair of an intrathoracic subclavian artery aneurysm with a single-branched thoracic endograft in a hostile anatomy. Vascular 2024; 32:42-47. [PMID: 36120869 DOI: 10.1177/17085381221128058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
OBJECTIVE Subclavian artery aneurysms (SAA) are rare and usually involve the proximal segment of the artery. In this setting traditional surgical treatment or hybrid procedures are associated with significative morbidity rate so that new endovascular solutions are preferred. METHODS Authors report a case of a patient with an intrathoracic left SAA involving the aortic arch's outer curve. Patient's comorbidities contraindicated open surgical treatment while anatomical issues were not favourable to hybrid or standard endovascular solutions. Thus a single-branched custom-made thoracic stent-graft (Castor, MicroPort Medical, Shanghai, China) was implanted. RESULTS Technical success was achieved with no intra-operative complications and technical steps of the procedure are accurately described.A pre-discharge CT scan showed the correct position of the endograft, complete aneurysm exclusion and branch patency. CONCLUSION Single-branched thoracic stentgrafts could be a good option in unfavourable anatomies with supra-aortic vessels disease involving the aortic arch, with good results in terms of morbidity and early outcomes.
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Affiliation(s)
- Stefano Bonvini
- Department of Vascular Surgery, Santa Chiara Hospital, Trento, Italy
| | - Nicola Spadoni
- Department of Vascular Surgery, Santa Chiara Hospital, Trento, Italy
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25
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Suzuki M, Hojo M, Sugiyama H. Idiopathic multiple bronchial artery aneurysms and racemose haemangioma without symptoms. BMJ Case Rep 2024; 17:e258606. [PMID: 38176756 PMCID: PMC10773295 DOI: 10.1136/bcr-2023-258606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Affiliation(s)
- Manabu Suzuki
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Masayuki Hojo
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Haruhito Sugiyama
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
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Wang Y, Li S, Jin M, Xue Y, Wang D, Zhou Q. Surgical treatment for right-side aortic arch concomitant with Kommerell's diverticulum: techniques selection and follow-up results. Eur J Med Res 2024; 29:10. [PMID: 38172972 PMCID: PMC10762982 DOI: 10.1186/s40001-023-01595-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Right-side aortic arch concomitant with Kommerell's diverticulum (KD) is a rare and complex ailment, and there is no consensus on the optimal strategy to deal with this congenital anomaly. We retrospectively analyzed and summary of the cases treated in our center with individual treatment methods for different situations. METHODS Between September 2018 and December 2021, 10 patients experienced surgical therapy at our institution who presented with a Kommerell's diverticulum arising from an aberrant subclavian artery from the right-side aortic arch. Four main surgical techniques were applied to those patients: 1. total arch replacement with frozen elephant trunk implantation (n = 2); 2. hybrid procedure combining open arch repair and endovascular intervention (n = 1); 3. total endovascular repair using thoracic endovascular aortic repair (TEVAR) with or without left subclavian artery (LSCA) revascularization (n = 6); 4. direct repair underwent endoaneurysmorrhaphy. Clinical characteristics and outcomes were collected. RESULTS The mean age of these 10 patients was 56.5 years (range 29-79 years) and only 1 woman. The pathology includes aortic dissection (n = 6) and aneurysm (n = 4). The mean diverticulum size was 41.4 [24.2-56.8] mm. There were no in-hospital deaths, and the median hospital stay was 22 [15-43] days. During the follow-up period (21.4 months, 1-44 months), one died of an unknown cause and one died of esophageal fistula. Two patients underwent second-stage endovascular intervention for distal lesion. And none of the patients had endoleak during the follow-up period. CONCLUSIONS Each of the procedures we have mentioned here has its advantages and disadvantages; individualized treatment should meet the appropriate indications. A single-branched stent graft is feasible and effective in the treatment of aortic disease combined with Kommerell's diverticulum.
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Affiliation(s)
- Yali Wang
- Department of Thoracic and Cardiovascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
- Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China
| | - Shuchun Li
- Department of Thoracic and Cardiovascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
- Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China
| | - Min Jin
- Department of Thoracic and Cardiovascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
- Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China
| | - Yunxing Xue
- Department of Thoracic and Cardiovascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
- Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China
| | - Dongjin Wang
- Department of Thoracic and Cardiovascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
- Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China
| | - Qing Zhou
- Department of Thoracic and Cardiovascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China.
- Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China.
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Govindaraj I, Kuriakose A, Rajendran A. Enlarging aneurysm with paracentral acute middle maculopathy in idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) - a case report. Eur J Ophthalmol 2024; 34:NP70-NP74. [PMID: 37186765 DOI: 10.1177/11206721231174259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome is a rare clinical entity affecting young healthy individuals. Treatment primarily involves pan retinal photocoagulation (PRP) to capillary non perfusion areas. Intravitreal anti-VEGF or steroids are given in the presence of macula edema. Oral steroids do not alter the course of the disease. Arterial occlusions have been reported in IRVAN. METHODS Retrospective case review. RESULT A twenty seven year old male presented to us with mild blurring of vision for one week. His BCVA was OU 20/20. Anterior segment examination was normal. Fundus examination showed bilateral disc aneurysm with OS arterial aneurysm along the inferior arcade. Fundhus fluorescein angiography and OCT angiography were confirmatory of the disc and retinal aneurysm. Capillary non perfusion (CNP) areas were noted in the periphery. Two days later he presented with paracentral scotoma in his left eye which was confirmed by Amsler chart. Fundus, OCT and OCTA were confirmatory of Paracentral Acute Middle Maculopathy (PAMM). The retinal aneurysm had increased in size from 333 micron diameter to 566 micron diameter. Panretinal photocoagulation to the CNP areas was done and intravitreal antiVEGF was given. At 6 months follow up, retinal aneurysm had disappeared. DISCUSSION Our case describes a unique event with sudden increase in size of the aneurysm leading to acute blockage in the deep capillary plexus thus being the first report of PAMM in IRVAN. The patient was treated with PRP and intravitreal anti-VEGF for the enlarging aneurysm which reduced in size within a week.
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van Schaik J, Witt D, Albers L, Wever J, Elzevier H, Hamming J. Pilot Study on Feasibility and Outcome of a Nerve-Preserving Aortoiliac Exposure Technique. Ann Vasc Surg 2024; 98:388-397. [PMID: 37390965 DOI: 10.1016/j.avsg.2023.05.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Dysfunctional ejaculation is a common complication following open aortoiliac aneurysm surgery. It may occur in 49-63% of patients and is caused by iatrogenic damage to the sympathetic lumbar splanchnic nerves and superior hypogastric plexus. A nerve-preserving operative technique based on a unilateral right-sided approach to the abdominal aorta, was implemented in clinical practice. The aim of this pilot study was to establish the safety and feasibility of the technique, and whether a sympathetic pathway and ejaculatory function was preserved. METHODS Patients were asked to fill out questionnaires preoperatively, and 6 weeks, 6 months, and 9 months postoperatively. The International Index of Erectile Function, Cleveland Clinic Incontinence Score (CCIS), Patient assessment of constipation symptoms (Pac-Sym), and International Consultation on Incontinence Questionnaire on male lower urinary tract symptoms were used. Surgeons were asked to complete a technical feasibility questionnaire. RESULTS Twenty-four patients undergoing aortoiliac aneurysm surgery were included. The nerve-sparing phase of the procedure added an average of 5-10 min of operating time and was technically feasible in twenty-two patients. No major complications occurred during nerve-sparing exposure. Fifteen of twenty-four patients were sexually active at some point throughout the study. No postoperative loss of ejaculation was seen in sexually active patients. CCIS, Pac-sym, International Index of Erectile Function, and Incontinence Questionnaire on male lower urinary tract symptoms scores remained similar throughout the study. CONCLUSIONS Nerve-preserving aortoiliac reconstruction surgery is safe and feasible. Ejaculatory function is preserved. Given the low number of patients in the study, further research is needed to provide robust data.
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Affiliation(s)
- Jan van Schaik
- Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
| | - Daniël Witt
- Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - Leonore Albers
- Department of Urology and Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jan Wever
- Department of Surgery, Haga Teaching Hopsital, The Hague, The Netherlands
| | - Henk Elzevier
- Department of Urology and Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jaap Hamming
- Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands
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Kim Y, Loanzon RS, Southerland KW, Long CA, Williams ZF, Mohapatra A. Prosthetic Conduit Use Does Not Adversely Impact Outcomes after Open Repair of Popliteal Artery Aneurysms. Ann Vasc Surg 2024; 98:124-130. [PMID: 37858670 DOI: 10.1016/j.avsg.2023.08.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Single segment, greater saphenous vein (GSV) conduit is considered the optimal bypass conduit among patients undergoing bypass surgery for peripheral artery disease (PAD). While this data has been extrapolated to patients undergoing bypass for popliteal artery aneurysms (PAAs), the pathophysiology of PAA is inherently different when compared to PAD, and the impact of conduit type on long-term outcomes after open repair of PAA remains unclear. METHODS A multicenter database of five regional hospitals was retrospectively reviewed for all patients with PAA undergoing open surgical repair. Data were collected on demographic information, operative details, medications, and postoperative outcomes. Kaplan-Meier curves were used to compare freedom from major adverse limb events (MALE) following GSV versus prosthetic bypass. Cox proportional hazards model was used to identify patient-level characteristics associated with MALE, which was defined as major ipsilateral limb amputation or reintervention for graft patency. RESULTS From 1999 to 2020, a total of 101 patients with PAA underwent open exclusion and bypass surgery. Median follow-up period was 4.2 years (interquartile range, 1.3-7.4 years), and complete data were available for 99 (98.0%) patients. The majority of patients were male (99.0%) and Caucasian (93.9%). Only 11.1% of procedures were emergent, with the remainder (88.9%) being elective. All patients underwent medial exposure with a below-knee popliteal bypass target (100%). Bypass conduits included GSV (69.7%), prosthetic conduit (28.3%), and 2 (2.0%) alternative conduits (one spliced arm vein, one cryopreserved vein). Patients undergoing prosthetic bypass were older (72 vs. 66 years, P = 0.001) and had similar rates of medical comorbidities. Compared with the GSV group, patients with prosthetic conduits were more frequently placed on postoperative anticoagulation (60.7% vs. 23.2%, P < 0.001). Conduit type did not impact postoperative complication rates (P = NS each). MALE rates were low overall (19.2% at 2 years), and similar when stratified by conduit type (log rank P = 0.47). On multivariable analysis, emergent bypass was associated with MALE (hazard ratio [HR] 5.73, 95% confidence interval [CI] 2.07-15.85, P < 0.001). Prosthetic conduit usage (HR 1.00, 95% CI, 0.40-2.51, P = 0.99) and postoperative anticoagulation (HR 1.02, 95% CI 0.42-2.50, P = 0.97) were not associated with MALE. CONCLUSIONS Open repair of PAA is associated with excellent long-term outcomes. Prosthetic bypass is a comparable alternative to autogenous conduit for below-knee popliteal bypass targets, and lack of suitable GSV should not prohibit open surgical repair when indicated.
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Affiliation(s)
- Young Kim
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC.
| | - Roberto S Loanzon
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC
| | - Kevin W Southerland
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC
| | - Chandler A Long
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC
| | - Zachary F Williams
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC
| | - Abhisekh Mohapatra
- Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Giovannico L, Fischetti G, Parigino D, Savino L, Santeramo V, Scrascia G, Di Bari N, Milano AD, Bottio T. Giant Aneurysm of Aortic Arch: When Coughing Can Save A Life. Heart Lung Circ 2024; 33:e1-e2. [PMID: 38160128 DOI: 10.1016/j.hlc.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Lorenzo Giovannico
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Medical School, Bari, Italy.
| | - Giuseppe Fischetti
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Medical School, Bari, Italy
| | - Domenico Parigino
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Medical School, Bari, Italy
| | - Luca Savino
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Medical School, Bari, Italy
| | - Vincenzo Santeramo
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Medical School, Bari, Italy
| | - Giuseppe Scrascia
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Medical School, Bari, Italy
| | - Nicola Di Bari
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Medical School, Bari, Italy
| | - Aldo Domenico Milano
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Medical School, Bari, Italy
| | - Tomaso Bottio
- Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Medical School, Bari, Italy
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Hinze CA, Park DH, Bollmann BA. Pulmonary Artery Aneurysm in Longstanding Idiopathic Pulmonary Arterial Hypertension. Dtsch Arztebl Int 2023; 120:890. [PMID: 38315656 PMCID: PMC10859743 DOI: 10.3238/arztebl.m2022.0404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Affiliation(s)
| | - Da-Hee Park
- Klinik für Pneumologie, Medizinische Hochschule Hannover,
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Liu T, Zhang Y, Liu M, Li Y, Xie M. Coexistence of left ventricular aneurysm and giant pseudoaneurysm following myocardial infarction: the value of multimodality imaging in the clinical workup. Eur Heart J Cardiovasc Imaging 2023; 25:e59. [PMID: 37801644 PMCID: PMC10735287 DOI: 10.1093/ehjci/jead248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023] Open
Affiliation(s)
- Tan Liu
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Ave, Wuhan 430022, China
- Clinical Research Center for Medical Imaging in Hubei Province, 1277# Jiefang Ave, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, 1277# Jiefang Ave, Wuhan 430022, China
| | - Yongxing Zhang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Ave, Wuhan 430022, China
- Clinical Research Center for Medical Imaging in Hubei Province, 1277# Jiefang Ave, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, 1277# Jiefang Ave, Wuhan 430022, China
| | - Manwei Liu
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Ave, Wuhan 430022, China
- Clinical Research Center for Medical Imaging in Hubei Province, 1277# Jiefang Ave, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, 1277# Jiefang Ave, Wuhan 430022, China
| | - Yuman Li
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Ave, Wuhan 430022, China
- Clinical Research Center for Medical Imaging in Hubei Province, 1277# Jiefang Ave, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, 1277# Jiefang Ave, Wuhan 430022, China
| | - Mingxing Xie
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Ave, Wuhan 430022, China
- Clinical Research Center for Medical Imaging in Hubei Province, 1277# Jiefang Ave, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, 1277# Jiefang Ave, Wuhan 430022, China
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Power Foley M, Alawy M, Tubassam M. Acute limb ischaemia due to thrombosed persistent sciatic artery aneurysm presents a surgical challenge in a frail octogenarian. Vascular 2023; 31:1124-1127. [PMID: 35737445 DOI: 10.1177/17085381221111016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Persistent sciatic artery (PSA) is a rare congenital anomaly, whereby the embryonic sciatic artery remains patent with associated degrees of femoral axis hypoplasia. Aneurysmal degeneration and distal ischaemia from thromboembolic complications are common. Revascularisation strategies include embolectomy, bypass or interposition grafting and catheter-directed thrombolysis. METHODS We describe a sedentary 88-year-old woman with right acute limb ischaemia secondary to a thrombosed PSA aneurysm and concurrent occlusive thrombus at the femoral bifurcation. RESULTS The patient presented with a 3-day history of a cold, painful right foot. Examination revealed Rutherford IIb ischaemia. CT-angiography demonstrated no continuity between the hypoplastic superficial femoral and popliteal arteries, complete occlusion of the right PSA distal to the thrombosed aneurysm and occlusive thrombus in the right profunda. As she was too frail for femoral-distal bypass, we restored femoral axis inflow via profunda embolectomy. Her prognosis remained guarded as we deliberately did not reconstruct the PSA. However, she was discharged pain-free and mobilising with aids 2 weeks later. CONCLUSION Limb ischaemia in frail, high-risk patients is an ever-increasing challenge for vascular surgeons and requires complex decision-making, balancing comorbidities against desired outcomes. This case illustrates that a selective approach can be sufficient to maintain function despite complex anatomy.
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Affiliation(s)
- Megan Power Foley
- Department of Vascular Surgery, University College Hospital Galway, Galway, Ireland
| | - Mahmoud Alawy
- Department of Vascular Surgery, University College Hospital Galway, Galway, Ireland
| | - Muhammad Tubassam
- Department of Vascular Surgery, University College Hospital Galway, Galway, Ireland
- National University of Ireland, Galway
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Ritzenthaler T, Gobert F, Balança B, Dailler F. The post-resuscitation VASOGRADE: a more accurate scale to predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. Neurol Sci 2023; 44:4385-4390. [PMID: 37433900 DOI: 10.1007/s10072-023-06945-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/03/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Predicting the occurrence of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage is of interest to adjust the level of care. The VASOGRADE, a simple grading scale using admission World Federation of Neurosurgical Societies (WFNS) grading score and modified Fisher scale (mFS) on first CT scan, could help to select patients at risk of DCI. However, using data after initial resuscitation (initial complication treatment, aneurysm exclusion) may be more relevant. METHODS We calculated a post-resuscitation VASOGRADE (prVG) using WFNS grade and mFS after early brain injury treatment and aneurysm exclusion (or at day 3). Patients were categorized as green, yellow, or red. RESULTS Using our prospective observational registry, 566 patients were included in the study. Two hundred six (36.4%) were classified as green, 208 (36.7%) as yellow, and 152 (26.9%) as red, and DCI was experienced in 22 (10.7%), 67 (32.2%), and 45 (29.6%) cases respectively. Patients classified as yellow had higher risk of developing DCI (OR 3.94, 95% CI 2.35-6.83). Risk was slightly lower in red patients (OR 3.49, 95% CI 2.00-6.24). The AUC for prediction was higher with prVG (0.62, 95% CI 0.58-0.67) than with VASOGRADE (0.56, 95% CI 0.51-0.60) (p < 0.01). CONCLUSION By using simple clinical and radiological scale evaluated at subacute stage, prVG is more accurate to predict the occurrence of DCI.
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Affiliation(s)
- Thomas Ritzenthaler
- Service de Réanimation Neurologique, Hôpital Neurologique, Hospices Civils de Lyon, 59 Boulevard Pinel, 69677, Bron Cedex, France.
| | - Florent Gobert
- Service de Réanimation Neurologique, Hôpital Neurologique, Hospices Civils de Lyon, 59 Boulevard Pinel, 69677, Bron Cedex, France
| | - Baptiste Balança
- Service de Réanimation Neurologique, Hôpital Neurologique, Hospices Civils de Lyon, 59 Boulevard Pinel, 69677, Bron Cedex, France
- Équipe TIGER, U1028, UMR5292, Centre de Recherche en Neurosciences de Lyon, Université de Lyon, 69500, Bron, France
| | - Frederic Dailler
- Service de Réanimation Neurologique, Hôpital Neurologique, Hospices Civils de Lyon, 59 Boulevard Pinel, 69677, Bron Cedex, France
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Negmadjanov U, Vazquez OA, Ross RL, Hamm AD, Buicko JL, Lopez-Viego MA. Portal Hypertension Due to a Traumatic Arteriovenous Fistula in a Patient With a Celiac Artery Aneurysm. Am Surg 2023; 89:6200-6202. [PMID: 35850555 DOI: 10.1177/00031348221111518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article describes a rare case of a traumatic splenic arteriovenous fistula (AVF) causing portal hypertension in a patient presenting with abdominal pain, diarrhea, and melena. A 78-year-old was admitted to the hospital with abdominal pain. The patient's history was notable for prior laparotomy and left nephrectomy for a gunshot wound. Workup demonstrated portal hypertension with a dilated splenic vein with aneurysmal changes and a saccular celiac artery aneurysm. Celiac angiogram demonstrated a communication between celiac and portal circulation. The patient underwent laparotomy with ligation of the splenic artery and resection of the celiac artery aneurysm. In conclusion, splenic AVFs are relatively rare in clinical practice. Once the diagnosis is established, operative intervention is required to avoid complications of portal hypertension. Surgical ligation has been used in this case with a successful outcome.
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Affiliation(s)
- Ulugbek Negmadjanov
- Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Oscar A Vazquez
- Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Reagan L Ross
- Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Aidan D Hamm
- Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Jessica L Buicko
- Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Miguel A Lopez-Viego
- Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
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Hagiwara H, Tomishima K, Jimbo Y, Ushio M, Suzuki A, Fujisawa T, Isayama H. Recurrent pancreatitis caused by previous coiling of a pancreaticoduodenal artery aneurysm in a patient with median arcuate ligament syndrome. Endoscopy 2023; 55:E932-E933. [PMID: 37500091 PMCID: PMC10374398 DOI: 10.1055/a-2113-9880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Affiliation(s)
- Haruka Hagiwara
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ko Tomishima
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yasuhisa Jimbo
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Mako Ushio
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Akinori Suzuki
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Toshio Fujisawa
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hiroyuki Isayama
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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Gauden AJ, Dodd R, Steinberg GK. Combined high-flow bypass and endovascular sacrifice for dysplastic cavernous internal carotid artery aneurysm for recurrent epistaxis. J Clin Neurosci 2023; 118:175. [PMID: 37956500 DOI: 10.1016/j.jocn.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023]
Affiliation(s)
- Andrew J Gauden
- Stanford University School of Medicine, Department of Neurosurgery, California, USA.
| | - Robert Dodd
- Stanford University School of Medicine, Department of Neurosurgery, California, USA
| | - Gary K Steinberg
- Stanford University School of Medicine, Department of Neurosurgery, California, USA
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Kim SH, Lee JH, Baek SH, Lee SU, Yu S, Kim JS. Triquarter Visual Field Defect Due to Internal Carotid Artery Giant Aneurysm. J Neuroophthalmol 2023; 43:e280-e282. [PMID: 36166775 DOI: 10.1097/wno.0000000000001580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Seong-Hwan Kim
- Department of Neurology (S-HK, J-HL, S-HB, S-UL, SY), Korea University Medical Center, Seoul, Republic of Korea; Department of Neurology (S-UL, J-SK), Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neurology (SY), Korea University College of Medicine, Seoul, Republic of Korea; and Department of Neurology (J-SK), Dizziness Center, Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Umeno H, Matsui H, Tokumitsu Y, Shindo Y, Nakajima M, Watanabe Y, Tomochika S, Iida M, Suzuki N, Takeda S, Ioka T, Nagano H. [A Severe Case of Bleeding from Duodenal Invasion Due to Co-Morbid IPMC with Arcuate Ligament Syndrome and IPDA Aneurysm]. Gan To Kagaku Ryoho 2023; 50:1581-1583. [PMID: 38303348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
An 81-year-old man with a history of left hemiplegia due to a cerebral hemorrhage was admitted to a clinic because of tarry stools. Endoscopic findings revealed an ulcerative lesion with hemorrhage in the descending duodenum. The patient was transferred to our hospital for treatment. Because endoscopic hemostasis was impossible, interventional radiology(IVR) hemostasis was performed using coil embolization for the feeding artery. Simultaneously, angiography showed stenosis of the root of the celiac axis due to arch ligament syndrome and an aneurysm of the inferior pancreaticoduodenal artery (IPDA). Due to the risk of rebleeding, subtotal stomach-preserving pancreatoduodenectomy was performed after the patient's overall condition had stabilized. Despite dissecting the arcuate ligament, the hepatic artery flow did not improve. Hence, a direct arterial anastomosis between the middle colic artery and the gastroduodenal artery was performed. Furthermore, due to the proximity of the IPDA aneurysm to the superior mesenteric artery, IVR embolization for the IPDA aneurysm was performed on postoperative day 8, and he was transferred to a rehabilitation hospital on postoperative day 57. The pathological result was invasive intraductal papillary mucinous carcinoma(IPMC). The patient has been an outpatient with no recurrence 12 months postoperatively.
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Affiliation(s)
- Hiroki Umeno
- Dept. of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine
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Poráčová J, Nagy M, Mydlárová Blaščáková M, Konečná M, Sedlák V, Zahatňanská M, Kimáková T, Vašková H, Rybárová V, Majherová M, Uher I. Diabetes mellitus and its influence on the incidence and process of diabetic retinopathy. Cent Eur J Public Health 2023; 31:S4-S9. [PMID: 38272471 DOI: 10.21101/cejph.a7838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 12/04/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVES The main aim of the study was to show the effect of diabetes in relation to the gender of the patients, duration of the disease, and on the incidence of diabetic retinopathy. In this study, we investigated the prevalence of these two diseases, pathological ocular changes and progression of disease occurrence in relation to the duration of the disease with respect to their impact on the quality of vision of the patient. METHODS The prospective observational cross-sectional study included 3,951 patients (1,838 males, 2,113 females) with diabetes mellitus from 7 districts of eastern Slovakia. Patients with diabetes mellitus and diabetic retinopathy were identified by special screening in the number of 2,093 (1,094 females and 999 males). Subjects were divided by sex and by duration of diabetes into 5 groups: patients with diabetes under 5, 10, 15, 20, and over 20 years. We differentiated between proliferative and non-proliferative forms of diabetic retinopathy and monitored changes in visual quality. Manifestations of pathological changes were recorded using special examination methods in the eye clinic. We observed a decrease in vision by two lines, pathological changes on the retina and the occurrence of practical blindness. RESULTS Of the total number of diabetic patients examined, diabetic retinopathy was also present in more than half of the patients. The major form represented in the patients was the non-proliferative form of retinopathy. The obtained results confirmed that the representation of patients with diabetic retinopathy increases with increasing duration of diabetes. Similarly, pathological changes characteristic of this type of late complication of diabetes were also more frequent, such as deterioration of visual acuity, the appearance of aneurysms, hard exudates macular edema, and gradual loss of vision, which can result in practical blindness. CONCLUSION The percentage of people with diabetic retinopathy increases with the duration of diabetes, as well as the increased frequency of pathological late complication of diabetes, including deterioration of visual acuity, the development of aneurysms, hard exudates, macular oedema, and gradual loss of vision, which can result in practical blindness. Early diagnosis of the disease and introduction of appropriate treatment would alleviate the symptoms of the disease in more than half of the patients, so more frequent preventive check-ups with an ophthalmologist should be performed in diabetic patients to avoid detection of the disease in its late stages.
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Affiliation(s)
- Janka Poráčová
- Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Melinda Nagy
- Department of Biology, Faculty of Education, J. Selye University, Komarno, Slovak Republic
| | - Marta Mydlárová Blaščáková
- Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Mária Konečná
- Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Vincent Sedlák
- Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Mária Zahatňanská
- Institute of Pedagogy, Andragogy and Psychology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Tatiana Kimáková
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovak Republic
| | - Hedviga Vašková
- Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Viktória Rybárová
- Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Mária Majherová
- Department of Physics, Mathematics and Technologies, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Ivan Uher
- Institute of Physical Education and Sports, Pavol Jozef Safarik University, Kosice, Slovak Republic
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41
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Mafra J, Pires V, Andrade C, Rodrigues ÂR. Spontaneous rupture of breast pseudoaneurysm: a rare case. BMJ Case Rep 2023; 16:e256962. [PMID: 37993146 PMCID: PMC10668168 DOI: 10.1136/bcr-2023-256962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023] Open
Abstract
Ehlers-Danlos syndrome (EDS) type IV is a hereditary autosomal dominant disease associated with skin and vascular fragility, hyperextensibility and joint hypermobility. Spontaneous arterial rupture is one of its higher-risk features.The authors describe a case of a woman with EDS type IV who presented with a spontaneous breast haematoma associated with a pseudoaneurysm of a branch of the left internal mammary artery. The patient underwent a minimally invasive endovascular approach that was uneventful. However, 6 months later, she presented in the emergency room with a similar episode on the contralateral breast. There were no signs of active bleeding, and she stayed under surveillance. Nine months later, she was asymptomatic.Aneurysms of branches of the internal mammary artery are rare and prone to rupture. Early diagnosis and treatment are imperative, and this case demonstrates that an endovascular approach is a safe treatment option.
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Affiliation(s)
- Joana Mafra
- Department of Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Verena Pires
- Department of Radiology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Cláudia Andrade
- Department of Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Ângela Reis Rodrigues
- Department of Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
- Centro Académico Clínico de Coimbra, Coimbra, Portugal
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42
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Forderer N, Akintürk H, Jux C. Idiopathic enlargement of the right atrium masking left atrial aneurysm in a neonate. Cardiol Young 2023; 33:2446-2448. [PMID: 37492020 DOI: 10.1017/s104795112300255x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
An idiopathic enlargement of the right atrium is an extremely rare cardiac malformation. There are no established guidelines for the management of this disease, especially concerning medical versus surgical therapeutic approach and the timing for an operation. We report in this case about a neonate that first was treated conservatively until the age of 5 month and finally got an operative resection of the aneurysm. After surgery, unexpected complications occurred. A second aneurysm in the left atrium was demasked. Furthermore, a progressive dilatation of both atrial chambers after resection required regular follow-up and ongoing evaluation of treatment.
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Affiliation(s)
- N Forderer
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Pediatric Heart Center, University of Giessen, Giessen, HE, Germany
| | - H Akintürk
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Pediatric Heart Center, University of Giessen, Giessen, HE, Germany
| | - C Jux
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Pediatric Heart Center, University of Giessen, Giessen, HE, Germany
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43
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Ironside N, Chen CJ, Chalhoub RM, Wludyka P, Kellogg RT, Al Kasab S, Ding D, Maier I, Rai A, Jabbour P, Kim JT, Wolfe SQ, Starke RM, Psychogios MN, Shaban A, Arthur AS, Yoshimura S, Grossberg JA, Alawieh A, Fragata I, Polifka AJ, Mascitelli JR, Osbun JW, Matouk C, Levitt MR, Dumont TM, Cuellar-Saenz HH, Williamson R, Romano DG, Crosa RJ, Gory B, Mokin M, Moss M, Limaye K, Kan P, Spiotta AM, Park MS. Risk factors and predictors of intracranial hemorrhage after mechanical thrombectomy in acute ischemic stroke: insights from the Stroke Thrombectomy and Aneurysm Registry (STAR). J Neurointerv Surg 2023; 15:e312-e322. [PMID: 36725360 PMCID: PMC10962911 DOI: 10.1136/jnis-2022-019513] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/02/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Reducing intracranial hemorrhage (ICH) can improve patient outcome in acute ischemic stroke (AIS) intervention. We sought to identify ICH risk factors after AIS thrombectomy. METHODS This is a retrospective review of the Stroke Thrombectomy and Aneurysm Registry (STAR) database. All patients who underwent AIS thrombectomy with available ICH data were included. Multivariable regression models were developed to identify predictors of ICH after thrombectomy. Subgroup analyses were performed stratified by symptom status and European Cooperative Acute Stroke Study (ECASS) grade. RESULTS The study cohort comprised 6860 patients. Any ICH and symptomatic ICH (sICH) occurred in 25% and 7% of patients, respectively. Hemorrhagic infarction 1 (HI1) occurred in 36%, HI2 in 24%, parenchymal hemorrhage 1 (PH1) in 22%, and PH2 in 17% of patients classified by ECASS grade. Intraprocedural complications independently predicted any ICH (OR 3.8083, P<0.0001), PH1 (OR 1.9053, P=0.0195), and PH2 (OR 2.7347, P=0.0004). Race also independently predicted any ICH (black: OR 0.5180, P=0.0017; Hispanic: OR 0.4615, P=0.0148), sICH (non-white: OR 0.4349, P=0.0107), PH1 (non-white: OR 3.1668, P<0.0001), and PH2 (non-white: OR 1.8689, P=0.0176), with white as the reference. Primary mechanical thrombectomy technique also independently predicted ICH. ADAPT (A Direct Aspiration First Pass Technique) was a negative predictor of sICH (OR 0.2501, P<0.0001), with stent retriever as the reference. CONCLUSIONS This study identified ICH risk factors after AIS thrombectomy using real-world data. There was a propensity towards a reduced sICH risk with direct aspiration. Procedural complications and ethnicity were predictors congruent between categories of any ICH, sICH, PH1, and PH2. Further investigation of technique and ethnicity effects on ICH and outcomes after AIS thrombectomy is warranted.
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Affiliation(s)
- Natasha Ironside
- Neurosurgery, University of Virginia, Charlottesville, Virginia, USA
| | - Ching-Jen Chen
- Neurosurgery, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Reda M Chalhoub
- Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Peter Wludyka
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Ryan T Kellogg
- Neurosurgery, University of Virginia, Charlottesville, Virginia, USA
| | - Sami Al Kasab
- Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Dale Ding
- Neurosurgery, University of Louisville, Louisville, Kentucky, USA
| | - Ilko Maier
- Neurology, University Medicine Goettingen, Goettingen, NS, Germany
| | - Ansaar Rai
- Radiology, West Virginia University Hospitals, Morgantown, West Virginia, USA
| | - Pascal Jabbour
- Neurological surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Joon-Tae Kim
- Chonnam National University Hospital, Gwangju, Gwangju, Korea (the Republic of)
| | - Stacey Q Wolfe
- Neurosurgery, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Robert M Starke
- Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Marios-Nikos Psychogios
- Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Amir Shaban
- Neurology, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Adam S Arthur
- Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA
| | - Shinichi Yoshimura
- Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Jonathan A Grossberg
- Neurosurgery and Radiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ali Alawieh
- Neurosurgery, Emory University, Atlanta, Georgia, USA
| | - Isabel Fragata
- Neuroradiology, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Adam J Polifka
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Justin R Mascitelli
- Department of Neurosurgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Joshua W Osbun
- Neurosurgery, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA
| | - Charles Matouk
- Neurosurgery, Yale University, New Haven, Connecticut, USA
| | - Michael R Levitt
- Neurological Surgery, University of Washington School of Medicine, Seattle, Washington, USA
| | - Travis M Dumont
- Department of Surgery, Division of Neurosurgery, University of Arizona/Arizona Health Science Center, Tucson, Arizona, USA
| | | | | | - Daniele G Romano
- Neurordiology, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | | | - Benjamin Gory
- Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, Lorraine, France
| | - Maxim Mokin
- Neurosurgery, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Mark Moss
- Washington Regional Medical Center, Fayetteville, Arkansas, USA
| | | | - Peter Kan
- Neurosurgery, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Alejandro M Spiotta
- Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Min S Park
- Neurosurgery, University of Virginia, Charlottesville, Virginia, USA
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44
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de Mathelin P, Hericher F, Addeo P. Rupture of a Splenic Artery Aneurysm During Pregnancy. J Gastrointest Surg 2023; 27:2694-2695. [PMID: 37256511 DOI: 10.1007/s11605-023-05715-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 06/01/2023]
Affiliation(s)
- Pierre de Mathelin
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle Des Pathologies Digestives, Hépatiques Et de La Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 67098, Strasbourg, France
| | - Florian Hericher
- Département of Anesthesiology, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 67098, Strasbourg, France
| | - Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle Des Pathologies Digestives, Hépatiques Et de La Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 67098, Strasbourg, France.
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45
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Bram R, Atwal G. Transradial flow diversion with an aberrant right subclavian artery. J Neurointerv Surg 2023; 15:1164. [PMID: 36958827 DOI: 10.1136/jnis-2023-020182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023]
Abstract
Transradial access for diagnostic and therapeutic neurointerventional procedures has gained popularity due to a decreased incidence of access site complications and improved patient comfort compared with transfemoral access.1-4 An aberrant right subclavian artery is an aortic arch variant characterized by a right subclavian artery that arises directly from the arch as the most distal great vessel. Transradial access with an aberrant right subclavian artery is anatomically challenging due to the predilection of the catheter system to collapse into the descending aorta. In this (video 1), we describe a step-by-step technique for transradial access in a patient with an aberrant right subclavian artery undergoing endovascular flow diversion for a left superior hypophyseal artery aneurysm. Particular emphasis is placed on the technique for accessing the proximal arch and aortic valve as well as distal catheter navigation while avoiding prolapse into the descending aorta. neurintsurg;15/11/1164/V1F1V1Video 1 .
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Affiliation(s)
- Richard Bram
- Neurosurgery, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Gursant Atwal
- Neurosurgery, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
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46
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Mizuno R, Uesugi A, Yamazaki M. Giant pulmonary artery aneurysm in long-standing chronic thromboembolic pulmonary hypertension. Eur Heart J Cardiovasc Imaging 2023; 24:e298. [PMID: 37643898 DOI: 10.1093/ehjci/jead217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/01/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023] Open
Affiliation(s)
- Reiko Mizuno
- Central Clinical Laboratory, Nara Medical University, 840 Shijo, Kashihara, Nara 634-8522, Japan
| | - Atsushi Uesugi
- Department of General Medicine, Nara Medical University, Kashihara, Japan
| | - Masaharu Yamazaki
- Central Clinical Laboratory, Nara Medical University, 840 Shijo, Kashihara, Nara 634-8522, Japan
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47
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Cook V, Wong K, Yan TD. Recurrent pulmonary emboli with aneurysms: think vasculitis and Hughes Stovin syndrome. Lancet 2023; 402:e12. [PMID: 37865471 DOI: 10.1016/s0140-6736(23)01776-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 08/19/2023] [Indexed: 10/23/2023]
Affiliation(s)
- Victoria Cook
- Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Kirby Wong
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Tristan D Yan
- Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
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48
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Pomatto S, Faggioli G, Pini R, Ficarelli I, Pini A, Angherà C, Rocchi C, Caputo S, Vacirca A, Ruotolo C, Gargiulo M. Limb salvage and survival after urgent surgical treatment of popliteal artery aneurysm. World J Emerg Surg 2023; 18:49. [PMID: 37838652 PMCID: PMC10576300 DOI: 10.1186/s13017-023-00514-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/21/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Popliteal artery aneurysms (PAAs) need urgent treatment in case of acute thrombosis, distal embolization, or rupture. Few data are available in the literature about the treatment results in these scenarios. The aim of the present study was to evaluate an 11-year multicenter experience in the urgent treatment of PAAs. METHODS All symptomatic PAAs surgically treated in two vascular centers between 2010 and 2021 were retrospectively analyzed. In the postoperative period periodical clinical and Duplex-Ultrasound evaluation were performed. The evaluated endpoint was the outcome of urgent PAAs treatment according to their clinical presentation. Statistical analysis was performed by Kaplan-Meier log-rank evaluation and multivariable Cox regression tests. RESULTS Sixty-six PAAs needed an urgent repair. Twelve (18%) patients had a PAA rupture and 54 (82%) had an acute limb ischemia (ALI) due to either distal embolization or acute thrombosis. Patients with ALI underwent bypass surgery in 51 (95%) cases, which was associated with preoperative thrombolysis in 18 (31%) cases. A primary major amputation was performed in 3 (5%) cases. The mean follow-up was 52 ± 21 months with an overall 5-year limb salvage of 83 ± 6%. Limb salvage was influenced only by the number of patent tibial arteries (pTA) [5-years limb salvage 0%, 86 ± 10%, 92 ± 8% and 100% in case of 0, 1, 2 or 3 pTA, respectively (P = .001)]. An independent association of number of pTA and limb loss was found [hazard ratio (HR): 0.14 (95% confidence interval (CI) 0.03-0.6), P = .001]. Overall 5-year survival was 71 ± 7%. Ruptured PAAs were associated with lower 5-year survival compared with the ALI group (48 ± 2% vs. 79 ± 7%, P = .001). The number of pTA (33 ± 20%, 65 ± 10%, 84 ± 10% and 80 ± 10% for 0, 1, 2 and 3 pTA, respectively, P = .001) and the thrombolysis (94 ± 6% vs. 62 ± 10%, P = .03) were associated with higher survival in patients with ALI. There was an independent association of number of pTA and long-term survival [HR 0.15 (95% CI 0.03-0.8), P = .03]. CONCLUSIONS PAA rupture is the cause of urgent PAA treatment in almost one fifth of cases, and it is associated with lower long-term survival. ALI can benefit from thrombolysis, and long-term limb salvage and survival are associated with the number of pTA.
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Affiliation(s)
- Sara Pomatto
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna "Alma Mater Studiorum" - DIMEC, Policlinico S. Orsola, Via Giuseppe Massarenti 9, 40138, Bologna, Italy.
| | - Gianluca Faggioli
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna "Alma Mater Studiorum" - DIMEC, Policlinico S. Orsola, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
- Vascular Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria S. Orsola, Bologna, Italy
| | - Rodolfo Pini
- Vascular Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria S. Orsola, Bologna, Italy
| | - Ilaria Ficarelli
- Division of Vascular Surgery, Cardarelli Hospital, 9 Via A. Cardarelli, 80131, Naples, Italy
| | - Alessia Pini
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna "Alma Mater Studiorum" - DIMEC, Policlinico S. Orsola, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Cecilia Angherà
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna "Alma Mater Studiorum" - DIMEC, Policlinico S. Orsola, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Cristina Rocchi
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna "Alma Mater Studiorum" - DIMEC, Policlinico S. Orsola, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Stefania Caputo
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna "Alma Mater Studiorum" - DIMEC, Policlinico S. Orsola, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Andrea Vacirca
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna "Alma Mater Studiorum" - DIMEC, Policlinico S. Orsola, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
- Vascular Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria S. Orsola, Bologna, Italy
| | - Carlo Ruotolo
- Division of Vascular Surgery, Cardarelli Hospital, 9 Via A. Cardarelli, 80131, Naples, Italy
| | - Mauro Gargiulo
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna "Alma Mater Studiorum" - DIMEC, Policlinico S. Orsola, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
- Vascular Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria S. Orsola, Bologna, Italy
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49
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Nunes C, Sousa J, O'Neill Pedrosa J, Oliveira V, Silva E, Baldaia L, Silva M, Antunes L. An Incidental Finding Of A Persistent Sciatic Artery - Case Report And Literature Review. Port J Card Thorac Vasc Surg 2023; 30:67-70. [PMID: 38499026 DOI: 10.48729/pjctvs.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 08/02/2023] [Indexed: 03/20/2024]
Abstract
Persistent sciatic artery is a rare anatomic variation due to the lack of regression during fetal development, associated sometimes with abnormalities of the iliofemoral arterial axis and predisposing the patients to aneurysm formation and thromboembolism, which can compromise the limb. In our department, we assisted a 59-year-old male with an acute limb ischemia as result of an incidental finding of a thrombosed persistent sciatic artery aneurysm.
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Affiliation(s)
- Celso Nunes
- Trainee in Vascular Surgery Department, at Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Juliana Sousa
- Vascular Surgeon, at Centro Hospitalar e Universitário de Coimbra, Portugal
| | - João O'Neill Pedrosa
- Vascular and Cardiothoracic Theather Nurse, at Hospital da Luz, Lisboa, Portugal
| | - Vânia Oliveira
- Trainee in Vascular Surgery Department, at Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Eduardo Silva
- Trainee in Vascular Surgery Department, at Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Leonor Baldaia
- Trainee in Vascular Surgery Department, at Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Miguel Silva
- Trainee in Vascular Surgery Department, at Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Luís Antunes
- Vascular Surgeon, at Centro Hospitalar e Universitário de Coimbra, Portugal
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50
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Mohanty V, Sharma SK, Deora S. Rare association of aneurysm of anterior mitral leaflet with bicuspid aortic valve. Ann Afr Med 2023; 22:554-556. [PMID: 38358161 PMCID: PMC10775931 DOI: 10.4103/aam.aam_142_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/02/2022] [Accepted: 11/18/2022] [Indexed: 02/16/2024] Open
Abstract
Mitral valve aneurysm is defined as outpouching of the mitral valve which expands in systole and collapse in diastole. It was first reported in 1729 by Morand. Most of the cases have been described in the African population. It is rare in the Indian population. Its chief presentations are congestive heart failure, palpitations, arrhythmia, or in rare cases an embolic phenomenon. It can be diagnosed either by echocardiography or cardiac imaging (magnetic resonance imaging/computed tomography). It can either occur as an isolated defect or with other associated valvular abnormalities. Here, we present a case of a 40-year-old male who was referred for the evaluation of palpitation who on the investigation was found to have a bicuspid aortic valve with severe Aortic Regurgitation (AR) along with aneurysm in the anterior mitral leaflet causing severe mitral regurgitation. This case highlights the importance of keeping a submitral aneurysm as a differential diagnosis for mitral regurgitation and searching for other associated valvular defects which may affect the management and treatment outcomes.
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Affiliation(s)
- Vivek Mohanty
- Department of Cardiology, All India Institute of Medical Science, Jodhpur, Rajasthan, India
| | - Shubham Kumar Sharma
- Department of Cardiology, All India Institute of Medical Science, Jodhpur, Rajasthan, India
| | - Surender Deora
- Department of Cardiology, All India Institute of Medical Science, Jodhpur, Rajasthan, India
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