Pseudoaneurysm of the cervical internal carotid artery secondary to blunt trauma.

A case of pseudoaneurysm in the extracranial internal carotid artery secondary to blunt trauma is presented to corroborate reports of aneurysmal formation in association with ipsilateral mandibular fracture. Because of the possibility of rupture or the development of neurologic symptomatology due to embolization, pseudoaneurysms of the cervical internal carotid artery should be repaired. We recommend use of the autogenous interposition vein graft to restore arterial continuity.

Heparin-induced thrombocytopenia: a prospective study of 142 patients.

In a prospective study of 142 patients receiving intravenous heparin of bovine lung origin, thrombocytopenia developed in nine (6%) patients. In the group of 70 patients with a history of prior heparin therapy, seven (10%) had thrombocytopenia. By contrast, only 2 (3%) of 72 patients with no history of previous heparin treatment had thrombocytopenia, a statistically insignificant difference (p less than 0.

Efficacy of low-dose streptokinase in acute arterial occlusion and graft thrombosis.

In a review of 35 patients undergoing local thrombolysis using selective infusion of low-dose streptokinase, the overall success rate was 43%. Streptokinase appears to be most effective in occlusion of native arteries, in high-flow segments, and in autogenous saphenous vein grafts. Local streptokinase was least effective in occluded prosthetic grafts in the femoropopliteal segment (19% success).

Total occlusion of the intracervical internal carotid artery secondary to vasculitis.

A case of total occlusion of the cervical internal carotid artery secondary to vasculitis is presented. Although vasculitis rarely causes total occlusion of the internal carotid artery, it directly contributed to a left hemispheric stroke in our patient. In the absence of the usual etiologic factors for internal carotid artery occlusion, vasculitis should be considered.

Carotid cavernous fistula following Fogarty catheter thrombectomy.

A patient had carotid cavernous fistula following Fogarty catheter thrombectomy. The patient was successfully treated by percutaneous detachable balloon closure of the fistula. Intraoperative angiography may be helpful in detecting unsuspected injuries of the intracranial carotid artery following thrombectomy.

Changing treatment of pediatric splenic trauma.

A review of splenic injuries at Cincinnati Children's Hospital Medical Center from July 1978 to June 1980 revealed this form of injury in 29 patients. Treatment without surgery was successful in 21 patients. Seven patients required operation.

Complete dislocations of the knee with popliteal vascular injury.

Complete dislocation of the knee is rare, but is frequently associated with popliteal artery disruption. Prompt recognition and early revascularization are paramount for a successful and functional result. Arteriography is recommended in all cases of complete dislocation of the knee.