Aneurysm involving distal fibular artery in a patient with Behcet's disease.
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ABSTRACT:
SUBMITTER: Higashi Y
PROVIDER: S-EPMC7649475 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
Publications
Aneurysm involving distal fibular artery in a patient with Behçet's disease.
Higashi Yukihito Y Mikami Shinsuke S Maruhashi Tatsuya T
European heart journal. Case reports 20200918 5
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Project description:BackgroundBehçet's syndrome (BS) is a multisystemic vasculitis of unknown aetiology. Coronary involvement is extremely uncommon in BS, with a reported prevalence of 0.5%. The mortality of cardiovascular manifestation in BS is 20%, while there are still considerable challenges in the management of these patients.Case summaryWe report the case of a 30-year-old young man with a 12-year history of BS complicated by left anterior descending coronary (LAD) aneurysms, stenosis, and recurrent myocardial infarction. Percutaneous coronary intervention treated the stenosis and aneurysms of the LAD, but the coronary angiography clearly revealed an acute stent thrombosis after 7 months. This unusual coronary complication of BS treated successfully is presented.DiscussionOur case demonstrated the feasibility of covered stent, immunosuppressive therapy, and escalated antithrombotic regimen in the treatment of BS patients with coronary artery aneurysm (CAA). We also demonstrated that drug-eluting stents may aggravate aneurysmal dilatation of the CAA under inefficient immunosuppressive therapy.
| S-EPMC6939788 | biostudies-literature
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| S-EPMC9898725 | biostudies-literature
Project description:PurposeThis prospective study aimed to assess the prognosis of claudication after endovascular aneurysm repair (EVAR) involving hypogastric artery (HGA) embolization.MethodsPatients who were scheduled to undergo EVAR involving bilateral or unilateral HGA embolization (BHE or UHE, respectively) between May 2017 and January 2019 were included in this study. Patients underwent the walk test preoperatively, one week postoperatively, and monthly thereafter for six months. The presence of claudication and the maximum walking distance (MWD) were recorded. A near-infrared spectroscopy monitor was placed on the buttocks, and the recovery time (RT) was determined. A walking impairment questionnaire (WIQ) was completed to determine subjective symptoms.ResultsOf the 13 patients who completed the protocol, 12 experienced claudication in the 6-min walk test. The MWD was significantly lower at one week postoperatively than preoperatively. The claudication prevalence was significantly higher at five and six months postoperatively after BHE than after UHE. BHE was associated with longer RTs and lower WIQ scores than UHE.ConclusionsWe noted a trend in adverse effects on the gluteal circulation and subjective symptoms ameliorating within six months postoperatively, with more effects being associated with BHE than with UHE. These findings should be used to make decisions concerning management strategies for HGA reconstruction.
| S-EPMC9592672 | biostudies-literature
Project description:BackgroundAneurysms of the lower basilar artery (BA) are rare, accounting for <1% of all intracranial aneurysms. This location has been described as "No man's land" since it poses a potential challenge for microsurgery. Recently, endovascular treatment has become an alternative option; however, there are some disadvantages regarding the obliteration rate, patency of the parent, and perforating arteries.Case descriptionWe present the case of a 69-year-old female with an incidentally found lower BA aneurysm. The imaging examinations revealed a wide-neck aneurysm size of 8.5 mm arising just distal to the vertebrobasilar junction, with involvement of the left anterior inferior cerebellar artery (AICA). After a discussion with the patient, she opted to undergo the surgical treatment. We described the detailed steps of our surgical techniques in performing a combined transpetrosal-transtentorial approach. First, the occipital artery (OA) was harvested. Then, the posterior transpetrosal (retrolabyrinthine) and a far-lateral suboccipital approach were conducted with tentorial sectioning to expose the aneurysm. After AICA was confirmed to arise from the aneurysm sac, the OAAICA bypass was established to ensure AICA patency, followed by complete aneurysm clipping. The approach provided both the presigmoid and retrosigmoid corridors for bypass and clipping procedures, respectively. The patient tolerated the procedure well. Postoperative imaging examinations showed complete aneurysm obliteration and bypass patency without complications. She was discharged without neurological deficits (modified Rankin Scale 0).ConclusionThe combined transpetrosal approach is safe and effective for revascularization and clipping procedure for a lower BA aneurysm.
| S-EPMC11618824 | biostudies-literature
Project description:Coronary artery aneurysm in adults is associated with connective tissue disorders, including Marfan syndrome. Coronary artery aneurysms are at risk for thrombosis, which obstructs coronary flow and thus results in myocardial infarction. We present a case of coronary artery aneurysm thrombosis in a patient with Marfan syndrome who presented with acute coronary syndrome.
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Project description: Not available
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| S-EPMC10642247 | biostudies-literature
Project description:BackgroundBehcet's disease (BD) is an inflammatory disorder of unknown cause that is characterized by recurrent oral aphthous ulcers, genital ulcers, uveitis, and skin lesions. Local vasculitis can cause damage to the visceral system, but it is rare in kidney patients, especially those with IgA nephropathy (IgAN). In China, a small number of related cases have been reported. Here we present a case of co-occurrence of BD and IgAN.Case presentationAn 18-year-old female who presented with a history of recurrent oral ulcers was found ten years ago. Four years later, the patient presented with reddish nodules on the skin of both lower limbs and then presented with vulvar ulcers. This patient was clinically diagnosed with Behcet's disease after left calf skin biopsy and presented severe proteinuria and hematuria during this period. IgAN was diagnosed after percutaneous renal biopsy. The patient was treated with hormonal, anti-inflammatory, immunomodulatory, kidney protective, and protein-lowering urine agents. After 3 years of follow-up, the patient reappears oral ulcers, reddish nodules on the skin of both lower limbs and renal dysfunction.ConclusionsBD is less common in China and is clinically prone to missed diagnosis and misdiagnosis. BD with IgAN is rarer. We should regularly pay attention to the routine urine and renal function of BD patients for early detection and treatment and to prevent further progression of the disease.
| S-EPMC11411838 | biostudies-literature
Project description:Pulmonary artery (PA) aneurysm is a rare condition, frequently associated with pulmonary hypertension. However, the evolution and treatment of this pathology is still not clear. We report a case of a 45-year-old female patient with giant PA aneurysm associated with rheumatic mitral stenosis and severe pulmonary arterial hypertension. The patient had undergone balloon mitral valvotomy around 7 years back; aneurysm was first identified 3 years back during routine follow-up. The PA aneurysm size, however, had remained almost unchanged with associated severe pulmonary regurgitation. Surgical correction was advised but denied by the patient. To our knowledge, this is the first case report of such a large PA aneurysm in association with rheumatic heart disease. Although medical therapy for pulmonary hypertension was started, surgical correction of the aneurysm was advised in order to prevent the future complications.
| S-EPMC4268619 | biostudies-literature
Project description:BackgroundA lateral approach with open reduction and internal fixation with a plate is a very effective technique for the majority of distal fibular fractures. However, this open approach for ankle fixation may be complicated by wound dehiscence and infection, especially in high-risk patients. An alternative to plating is an intramedullary implant, which allows maintenance of length, alignment, and rotation and which allows for decreased soft tissue dissection. While there has been clinical data suggesting favorable short-term outcomes with these implants, there is no current biomechanical literature investigating this technology in this particular fracture pattern. This study sought to biomechanically compare an emerging technology with an established method of fixation for distal fibular fractures that traditionally require an extensive exposure.MethodsTen matched cadaveric pairs from the proximal tibia to the foot were prepared to simulate an Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 44C2 ankle fracture and randomized to fixation with a distal fibular locking plate or intramedullary fibular rod. A constant 700-N axial load was applied, and all specimens underwent testing for external rotation stiffness, external rotation cyclic loading, and torque to failure. The syndesmotic diastasis, stiffness, torque to failure, angle at failure, and mode of failure were obtained from each specimen.ResultsThere was no significant difference in syndesmotic diastasis during cyclic loading or at maximal external rotation between the rod and plate groups. Post-cycle external rotation stiffness across the syndesmosis was significantly higher for the locking plate than the fibular rod. There was no significant difference between the rod and plate in torque at failure or external rotation angle. The majority of specimens had failure at the syndesmotic screw.ConclusionsIn the present cadaveric study of an AO/OTA 44C2 ankle fracture, a modern fibular rod demonstrated less external rotation stiffness while maintaining the syndesmotic diastasis to within acceptable tolerances and having similar failure characteristics.
| S-EPMC5024498 | biostudies-literature