A 75-year old man presented with signs and symptoms of acute abdomen and a clinical picture of hypovolemic shock. An emergency CT scan revealed a ruptured para-anastomotic left common iliac artery aneurysm. The patient had undergone an elective abdominal aortic aneurysm repair operation and placement of an aortoiliac bifurcated graft 10 years before. Para-anastomotic aneurysms had developed in all 3 (aortic and the 2 iliac) anastomosis. As the patient was highrisk, a combined endovascular/surgical approach was undertaken. The patient was discharged 4 days later.This article discusses the applicability of endovascular procedures in emergency settings to high-risk patients.
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http://dx.doi.org/10.2174/1874192400903010143 | DOI Listing |
Cureus
September 2024
Department of Medical Specialties, College of Medicine, Majmaah University, Majmaah, SAU.
Tentorial dural arteriovenous fistulas (DAVFs) are rare but highly dangerous vascular anomalies, constituting a small percentage of all intracranial DAVFs. Despite their infrequency, these lesions display aggressive characteristics, frequently leading to hemorrhage or neurological deficits due to their retrograde drainage into leptomeningeal veins, thus classifying them as Borden type III lesions. This case presents a middle-aged man who suffered cerebellar and subarachnoid hemorrhages resulting from a medial tentorial DAVF.
View Article and Find Full Text PDFCureus
August 2024
Department of Cardiology, Heart Hospital, Fondazione Toscana Gabriele Monasterio, Massa, ITA.
Aortoiliac occlusive disease (AIOD) is a specific form of peripheral artery disease (PAD) that affects the infrarenal aorta and iliac arteries. Patients with PAD commonly suffer from intermittent claudication (IC), a condition characterized by cramping pain during or after exercise that is relieved by rest. The first-line therapy for IC involves medical management, foot care, and structured exercise programs while revascularization therapy, which can be endovascular, surgical, or a combination of both, is generally reserved for patients with claudication who do not respond adequately to initial therapies.
View Article and Find Full Text PDFWorld Neurosurg
September 2024
Department of Neurosurgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Neurovascular Disorders, Amsterdam Neurosciences, Amsterdam, the Netherlands.
Background: Neurofilament light chain (NfL), a biomarker reflecting neuro-axonal damage, may be useful in improving clinical outcome prediction after aneurysmal subarachnoid hemorrhage (aSAH). We explore the robust and additional value of NfL to neurologic and radiologic grading scales in predicting poor outcome after aSAH.
Methods: In this prospective cohort study conducted in a single tertiary center, blood samples were collected of aSAH patients within 24 hours after ictus and before endovascular/surgical intervention.
Cureus
March 2024
Pharmacology and Therapeutics, Lake Erie College of Osteopathic Medicine, Elmira, USA.
Vertebrobasilar insufficiency (VBI) is a significant medical condition that results from a lack of adequate blood flow to the posterior circulation of the brain. The first-line treatment involves the use of antiplatelet therapy, but in cases where patients are not responsive to drug therapy, surgical management is the next viable option. In the past, open endarterectomy was the preferred surgical approach for treating critical VBI patients.
View Article and Find Full Text PDFJ Neurotrauma
August 2024
Department of Neurosurgery, University of Maryland, Baltimore, Maryland, USA.
In previous studies, the incidence of traumatic intracranial aneurysms (TICAs) after civilian gunshot wound to the head (cGSWH) was ∼3%. Given the use of delayed vessel imaging, we hypothesize that a significant fraction of TICAs is missed on initial non-contrasted scans. This study was designed to characterize acute TICAs using admission computed tomographic angiography (aCTA) in cGSWH.
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