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Sample records for artery aneurysm secondary

  1. Aortic aneurysm secondary to umbilical artery catheterization

    International Nuclear Information System (INIS)

    A 14-month-girl presented with an asymptomatic posterior mediastinal mass. She had a history of prematurity, umbilical artery catheterization, and sepsis. The diagnosis of aortic aneurysm was made by dynamic computed tomography. The aneurysm was successfully resected. (orig.)

  2. Vertebral artery aneurysms.

    Directory of Open Access Journals (Sweden)

    Ravi Kumar C

    2000-04-01

    Full Text Available Vertebral artery (VA aneurysms are rare. We present our experience with three cases of VA aneurysms. Two aneurysms were located close to the origin of basilar artery while the third patient had a giant posterior inferior cerebellar artery aneurysm. These aneurysms were operated by the far lateral inferior suboccipital approach with good results.

  3. Mycotic aneurysm of the popliteal artery secondary to Streptococus pneumoniae: a case report and review of the literature

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    Killeen Shane D

    2009-11-01

    Full Text Available Abstract Introduction Cases of true mycotic popliteal artery aneurysm are rare. Presentation is variable but invasive and non-invasive investigations collectively facilitate diagnosis and guide operative procedures. Definitive treatment generally utilizes surgical intervention with excision and reconstruction using autologous vein graft. Prolonged targeted antibiotic therapy is an important adjuvant. Case presentation We describe the clinical presentation, radiological investigations and strategies on the management of a 47-year-old Caucasian Irish man who presented with a mycotic aneurysm of the popliteal artery due to thromboembolisation from Streptococus pneumoniae endocarditis. Conclusion Cases of true mycotic popliteal artery aneurysms are rare. To the best of our knowledge this is the first documented case of a popliteal artery mycotic aneurysm developing secondary to Streptococus pneumoniae highlighting the changing profile of causative microorganisms.

  4. Splanchnic artery aneurysms

    Directory of Open Access Journals (Sweden)

    Davidović Lazar B.

    2006-01-01

    Full Text Available Introduction. Splanchnic artery aneurysms are uncommon but important vascular entity because nearly 25% of all cases present as surgical emergency. Objective. The purpose of our study was to present nine patients operated on at the Institute of cardiovascular diseases, as well as literature review of clinical presentation of the disease. Method. There were three splenic artery aneurysms, two celiac trunk aneurysms, and one aneurysm of the hepatic, superior mesenteric, inferior mesenteric and gastroduodenal artery. All patients were males, mean aged 67.5 years (60-73. In four patients, splanchnic artery aneurysm was discovered accidentally during routine ultrasonographic and angiographic examinations of the abdominal aorta. At that time, arteriovenous fistula was diagnosed in a patient No 1; it was formed after rupture of the splenic artery aneurysm into the splenic vein. Three aneurysms were manifested by abdominal pain and palpable pulsating abdominal mass. Two patients were admitted as urgent cases in the state of hemorrhagic shock and signs of intraabdominal bleeding due to rupture of the splenic and hepatic arteries. In 7 cases, diagnosis was made preoperatively by means of ultrasonography and angiography; in two patients, accurate diagnosis was confirmed during surgery. Results. Proximal and distal ligation of the artery was performed in a patient with rupture of the splenic aneurysm into the splenic vein that caused arteriovenous fistula. Gastroduodenal artery aneurysm was treated by trans-aneurysmatic ligation of its "entering" and "exiting" branches. Aneurysms of distal part of the superior mesenteric and splenic artery were resected without further reconstruction. Partial resection of the aneurysm and endoaneurysmorrhaphy was carried out in one case of celiac trunk aneurysm, and in another, after aneurysm resection, the restoration of blood flow through the hepatic and lienal artery was achieved by Dacron grafts. In a patient with the

  5. Mycotic Aneurysm of the Popliteal Artery Secondary to Enterococcus Endo-carditis : a Case Report.

    Science.gov (United States)

    Yogeswaran, S K; Stabel, P; Avet, J; Daenen, G

    2014-01-01

    A mycotic popliteal aneurysm (MAAP) is a very rare condition [1]. We describe a 87-year-old Caucasian male who presented with a MAAP of the right leg due to an enterococcus mitral valve endocarditis. The aneurysm was excised and a reversed vein graft was interposed between the normal popliteal artery and the posterior tibial artery. A second vein graft was interposed between the first graft and the anterior tibial artery.

  6. TEVAR for Flash Pulmonary Edema Secondary to Thoracic Aortic Aneurysm to Pulmonary Artery Fistula.

    Science.gov (United States)

    Bornak, Arash; Baqai, Atif; Li, Xiaoyi; Rey, Jorge; Tashiro, Jun; Velazquez, Omaida C

    2016-01-01

    Enlarging aneurysms in the thoracic aorta frequently remain asymptomatic. Fistulization of thoracic aortic aneurysms (TAA) to adjacent structures or the presence of a patent ductus arteriosus and TAA may lead to irreversible cardiopulmonary sequelae. This article reports on a large aneurysm of the thoracic aorta with communication to the pulmonary artery causing pulmonary edema and cardiorespiratory failure. The communication was ultimately closed after thoracic endovascular aortic aneurysm repair allowing rapid symptom resolution. Early diagnosis and closure of such communication in the presence of TAA are critical for prevention of permanent cardiopulmonary damage.

  7. [Splenic artery aneurysms].

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    Colović, R; Davidović, L; Bilanović, D; Krivokapić, Z; Grubor, N; Cvetković, S; Radak, V; Marković, M

    2006-01-01

    Although the third most frequent aneurysm in the abdomen, after aneurysms of the aorta and iliac arteries, and most frequent aneurisms of visceral arteries, splenic artery aneurysms are rare, but not very rare. Thanks to the new imaging techniques, first of all ultrasonography, they have been discovered with increasing frequency. We present a series of 9 splenic artery aneurysms. Seven patients were female and two male of average age 49 years (ranging from 28 to 75 years). The majority of afected women were multiparae, with average 3 children (ranging from 1 to 6). One patient had a subacute rupture, and 2 had ruptures into the splenic vein causing portal hypertension. The spleen was enlarged in 7 out of 9 patients. The average size of aneurysms was 3,2 cm (ranging from 2 to 8 cm). The preoperative diagnosis of splenic artery aneurysm was established in 6 patients while in 3 patients aneurism was accidentally found during other operations, during splenectomy in 2, and during the excision of a retroperitoneal tumour in 1 patient. Aneurysmectomy was carried out in 7 patients, while a ligation of the incoming and outcoming wessels was performed in 2 patients with arteriovenous fistula. Splenectomy was performed in 6 patients, while pancreatic tail resection, cholecystectomy and excision of the retroperitoneal tumor were performed in 3 patients. Additional resection of the abdominal aortic aneurysm with reconstruction of aortoiliac segment was performed in 2 patients. There were no mortality and the postoperative recovery was uneventful in all patients. PMID:16989145

  8. Management of splenic artery aneurysm associatedwithextrahepaticportal veinobstruction

    Institute of Scientific and Technical Information of China (English)

    Pramod Kumar Mishra; Sundeep Singh Saluja; Ashok K Sharma; Premanand Pattnaik

    2012-01-01

    BACKGROUND: Splenic artery aneurysms although rare are clinically signiifcant in view of their propensity for spontaneous rupture and life-threatening bleeding. While portal hypertension is an important etiological factor, the majority of reported cases are secondary to cirrhosis of the liver. We report three cases of splenic artery aneurysms associated with extrahepatic portal vein obstruction and discuss their management. METHODS: The records of three patients of splenic artery aneurysm associated with extrahepatic portal vein obstruction managed from 2003 to 2010 were reviewed retrospectively. The clinical presentation, surgical treatment and outcome were analyzed. RESULTS:  The aneurysm was >3 cm in all patients. The clinical symptoms were secondary to extrahepatic portal vein obstruction (hematemesis in two, portal biliopathy in two) while the aneurysm was asymptomatic. Doppler ultrasound demonstrated aneurysms in all patients. A proximal splenorenal shunt was performed in two patients with excision of the aneurysm in one patient and ligation of the aneurysm in another one. The third patient had the splenic vein replaced by collaterals and hence underwent splenectomy with aneurysmectomy. All patients had an uneventful post-operative course. CONCLUSIONS: Splenic artery aneurysms are associated with extrahepatic portal vein obstruction. Surgery is the mainstay of treatment. Although technically dififcult, it can be safely performed in an experienced center with minimal morbidity and good outcome.

  9. [Ruptured aneurysm at the anterior wall of the internal carotid artery in a patient with systemic lupus erythematosus and secondary antiphospholipid syndrome].

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    Chonan, Masashi; Fujimura, Miki; Inoue, Takashi; Tominaga, Teiji

    2011-07-01

    A 60 year-old woman, who had a 45-year history of systemic lupus erythematosus (SLE) and secondary antiphospholipid syndrome, presented with subarachnoid hemorrhage due to a ruptured aneurysm at the anterior wall of the non-branching site of the right internal carotid artery. She underwent radical surgery on the day of onset. In light of the possibility of arterial dissection, we performed extracranial-intracranial bypass prior to careful exploration of the aneurysm. Based on the finding of saccular aneurysm, she ultimately underwent neck clipping of the aneurysm without complication. Postoperative course was uneventful, and she did not suffer from cerebral vasospasm. We recommend early surgical intervention in patients with aneurysmal SAH associated with SLE, while intrinsic pathologies of SLE such as fragile vascular structure and the risk for ischemic complication should be considered.

  10. True aneurysm of brachial artery.

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    Hudorović, Narcis; Lovričević, Ivo; Franjić, Dario Bjorn; Brkić, Petar; Tomas, Davor

    2010-10-01

    True upper extremity peripheral artery aneurysms are a rarely encountered arterial disorder. Following computer-tomography angiographic (CT-a) imaging examination, true saccular aneurysm, originating from the left brachial artery was diagnosed in the 77-year-old female without history of trauma. The aneurysm was resected by surgical intervention, and primary repair of the brachial artery was performed by interposition of a part of great saphenous vein harvested from the left groin and creation of two end-to-end anastomoses between interposition graft and previously resected part of brachial artery. No complication was observed during the follow-up. Surgical intervention for upper extremity aneurysms should be initiated without delay. Factors combined with minimal morbidity associated with repair suggest that surgical repair should be performed routinely for true upper extremity arterial aneurysms. PMID:20865459

  11. Ruptured mycotic aneurysm of the superior mesenteric artery secondary to bacterial endocarditis in a 6-year-old-girl

    International Nuclear Information System (INIS)

    By non-invasive examination we demonstrated as false mycotic aneurysm on a branch of the superior mesenteric artery (SMA). It suddenly ruptured but was managed successfully. The patient had mitral valve disease and probably bacterial endocarditis also. (orig.)

  12. Intraorbital ophthalmic artery aneurysm associated with basilar tip saccular aneurysm

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    Dehdashti, A.R.; Tribolet, N. de [Department of Neurosurgery, HUG, Geneva (Switzerland); Safran, A.B. [Department of Ophthalmology, HUG, Geneva (Switzerland); Martin, J.B.; Ruefenacht, D.A. [Division of Neuroradiology, HUG, Geneva (Switzerland)

    2002-07-01

    We present a rare case of intraorbital ophthalmic artery aneurysm found incidentally, together with a ruptured aneurysm of the tip of the basilar artery. The intraorbital aneurysm was asymptomatic, and no treatment was offered. Angiographic control was recommended to detect any progression. Treatment may be indicated for documented enlargement or significant mass effect of the aneurysm. (orig.)

  13. Intraorbital ophthalmic artery aneurysm associated with basilar tip saccular aneurysm

    International Nuclear Information System (INIS)

    We present a rare case of intraorbital ophthalmic artery aneurysm found incidentally, together with a ruptured aneurysm of the tip of the basilar artery. The intraorbital aneurysm was asymptomatic, and no treatment was offered. Angiographic control was recommended to detect any progression. Treatment may be indicated for documented enlargement or significant mass effect of the aneurysm. (orig.)

  14. Mycotic aneurysm of the popliteal artery secondary to Streptococus pneumoniae: a case report and review of the literature.

    LENUS (Irish Health Repository)

    Killeen, Shane D

    2009-01-01

    Cases of true mycotic popliteal artery aneurysm are rare. Presentation is variable but invasive and non-invasive investigations collectively facilitate diagnosis and guide operative procedures. Definitive treatment generally utilizes surgical intervention with excision and reconstruction using autologous vein graft. Prolonged targeted antibiotic therapy is an important adjuvant.

  15. Pediatric cerebral artery aneurysms

    OpenAIRE

    Koroknay-Pál, PÀivi

    2012-01-01

    Objectives. Intracranial aneurysms in children are rare and population-based long-term follow-up studies are limited. In this study, a large clinical and angiographic long-term follow-up was carried out. The special characteristics of the patients and their aneurysms were assessed together with factors affecting early and long-term morbidity and mortality. Materials and Methods. All pediatric (≀18 years) aneurysm patients treated at the Department of Neurosurgery in Helsinki during 193...

  16. MYCTOIC ANEURYSM OF POPLITEAL ARTERY AND AORTOFEMORAL BYPASS GRAFT

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    A. Sohrabi

    1979-11-01

    Full Text Available Mycotic aneurysm could be divided into three types according to their etiology: septic-embolic, cryptogenic and traumatic type. During the period from 1972 to 1974 two cases of mycotic aneurysms have been seen at the Ohio Valley Medical Center - one following a sub acute bacterial endocarditic and another one was two years following surgery for aortofemoral bypass graft. The clinical course of both patients is discussed. The prognosis of mycotic aneurysm is always fatal without surgical intervention. Mycotic aneurysm is a rare entity which is occasionally reported in the literatures. As far as these case reports go the pathology could be divided into three categories according to their etiology, even though the pathology is essentially the same. 1. The septic-embolic or primary mycotic aneurysm in which the aneurysm is secondary to the sepsis which settles in the wall of the artery and destroys the lamina media and finally developing an aneurysm. This type of mycotic aneurysm is, usually seen in any type of septicemia. 2. The cryptogenic or secondary, mycotic aneurysm in which the sepsis takes place in the pra-existing aneurysm of the arterial wall usually due to arteriosclerosis disease. 3. Traumatic or mixed type mycotic aneurysm in which the sepsis and arterial wall damage takes place at the same time.

  17. Atherosclerotic femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Schroeder, T V

    1996-01-01

    Based on a clinical suspicion of an increase in the proportion of deep femoral aneurysms, we reviewed the case records of patients who underwent reconstructive procedures for femoral aneurysms to investigate if this could be confirmed and explained by selection of patient or modality of diagnosis...

  18. Intracranial Arterial Aneurysms

    OpenAIRE

    J Gordon Millichap

    1988-01-01

    Neurosurgeons from the Universita degli Studi di Roma “La Saspeinza,” Rome, Italy, report a 4-year-old girl with a cerebral saccular aneurysm and analyze 71 cases under 5 years of age in the literature.

  19. Basilar Artery Aneurysm at a Persistent Trigeminal Artery Junction

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    Aguiar, G.B.; Conti, M.L.M.; Veiga, J.C.E.; Jory, M.; Souza, R.B.

    2011-01-01

    Summary The trigeminal artery is an anastomosis between the embryonic precursors of the vertebrobasilar and carotid systems, and may persist into adult life. The association of the persistent primitive trigeminal artery (PTA) with cerebral aneurysm is well documented in the literature and, in general, aneurysms are located in the anterior circulation. We describe a patient who presented with a panencephalic Fisher III subarachnoid hemorrhage due to rupture of an intracranial aneurysm. Digital arteriography showed a saccular aneurysm in the middle third of the basilar artery, adjacent to the junction with a persistent trigeminal artery. She was submitted to endovascular treatment with embolization of the basilar artery aneurysm with coils. Aneurysms at the PTA junction with the basilar artery are rare. This paper describes a case of PTA associated with an aneurysm in the basilar artery at PTA junction and briefly reviews the literature. PMID:22005697

  20. Splenic Artery Aneurysm Presenting as Extrahepatic Portal Vein Obstruction: A Case Report

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    T. P. Elamurugan

    2011-01-01

    Full Text Available Splenic artery aneurysms are the most common visceral aneurysm occuring predominantly in females. They are usually asymptomatic, and the symptomatic presentation includes chronic abdominal pain of varied severity or an acute rupture with hypotension. Splenic artery aneurysm causing extrahepatic portal hypertension is very rare and is due to splenic vein thrombosis that develops secondary to compression by the aneurysm. We report one such rare presentation of splenic artery aneurysms in a pregnant female with the features of EHPVO (variceal bleed, hypersplenism treated by splenectomy along with excision of the aneurysm.

  1. Anterior cerebral artery aneurysm associated with multiple intracranial aneurysms and abdominal aorta aneurysm

    OpenAIRE

    Lee, Yunghwan; Min, Hyung Ki; Yoon, Sang Pil

    2013-01-01

    We found multiple aneurysms in the intracranial arteries and abdominal aorta of an 87-year-old Korean female cadaver, whose cause of death was reported as "cholangiocarcinoma." An abdominal aortic aneurysm was observed in the infrarenal aorta, where the inferior mesenteric artery arose. The intracranial aneurysms were found in the A3 segment of the anterior cerebral artery and at the bifurcation of the middle cerebral artery. This case provides an example of the very rare association of perip...

  2. Two Cases of True Uterine Artery Aneurysms Diagnosed during Pregnancy

    DEFF Research Database (Denmark)

    Schlütter, Jacob Mørup; Johansen, Gry; Helmig, Rikke Bek;

    2016-01-01

    We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the first...... case labor was induced at 37 + 4 weeks of gestation. However, due to sudden fetal distress and maternal abdominal pain, an emergency Caesarean section was performed during labor, and 3 liters of intra-peritoneal blood were encountered upon laparotomy, secondary to a ruptured uterine artery aneurysm....... In the second case, an elective Caesarean section was scheduled at 38 + 3 weeks of gestation, and the delivery and postpartum period were uncomplicated. Albeit a rare condition, a uterine artery aneurysm should be among the differential diagnosis considered in pregnant women who present with pelvic and vaginal...

  3. Electronic database of arterial aneurysms

    Directory of Open Access Journals (Sweden)

    Fabiano Luiz Erzinger

    2014-12-01

    Full Text Available Background:The creation of an electronic database facilitates the storage of information, as well as streamlines the exchange of data, making easier the exchange of knowledge for future research.Objective:To construct an electronic database containing comprehensive and up-to-date clinical and surgical data on the most common arterial aneurysms, to help advance scientific research.Methods:The most important specialist textbooks and articles found in journals and on internet databases were reviewed in order to define the basic structure of the protocol. Data were computerized using the SINPE© system for integrated electronic protocols and tested in a pilot study.Results:The data entered onto the system was first used to create a Master protocol, organized into a structure of top-level directories covering a large proportion of the content on vascular diseases as follows: patient history; physical examination; supplementary tests and examinations; diagnosis; treatment; and clinical course. By selecting items from the Master protocol, Specific protocols were then created for the 22 arterial sites most often involved by aneurysms. The program provides a method for collection of data on patients including clinical characteristics (patient history and physical examination, supplementary tests and examinations, treatments received and follow-up care after treatment. Any information of interest on these patients that is contained in the protocol can then be used to query the database and select data for studies.Conclusions:It proved possible to construct a database of clinical and surgical data on the arterial aneurysms of greatest interest and, by adapting the data to specific software, the database was integrated into the SINPE© system, thereby providing a standardized method for collection of data on these patients and tools for retrieving this information in an organized manner for use in scientific studies.

  4. Delayed postpartum haemorrhage secondary to a ruptured uterine artery pseudo-aneurysm, successfully treated by transarterial embolisation.

    Science.gov (United States)

    Moatti, Zoe; Nisner, Tamar; Saini, Ashish; Karoshi, Mahantesh

    2011-01-01

    A 29-year-old woman (gravida 1, para 1) had an uneventful first pregnancy and a delivery by emergency caesarean section at term. The caesarean section was complicated by a massive obstetric haemorrhage of 5000 ml. After closure, an immediate re-laparotomy was indicated due to heavy vaginal bleeding. The site of bleeding was identified as an extension of the uterine incision, and was sutured. She was stabilised by transfusion of blood and blood products in the intensive therapy unit, and discharged 5 days later. The patient was re-admitted 6 weeks later with brisk, painless vaginal bleeding, passing large clots from a well-contracted uterus. Her haemoglobin decreased from 11.8 to 7.8 g/dl overnight. In view of her history, an urgent CT angiogram was performed, which revealed the presence of a pseudo-aneurysm arising from the left uterine artery. This was successfully occluded by transarterial embolisation, obviating the need for further surgical exploration. PMID:22674937

  5. False iliac artery aneurysm following renal transplantation

    DEFF Research Database (Denmark)

    Levi, N; Sønksen, Jens Otto Reimers; Schroeder, T V;

    1999-01-01

    We report a very rare case of a false iliac artery aneurysm following renal transplantation. The patient was a 51-year-old women who presented with a painful 10 x 10 cm pulsating mass in her left iliac fossa. The patient had received a second cadaveric renal transplantation 5 years previously....... The graft never functioned and transplant nephrectomy was performed 2 weeks later. A CT-scanning showed a 10 x 10 cm large aneurysm arising from the left external iliac artery. At operation a large false aneurysm was identified arising from the original transplant anastomotic site. Due to the extent...

  6. Isolated iliac artery aneurysms with associated hydronephrosis.

    LENUS (Irish Health Repository)

    O'Driscoll, D

    2012-02-03

    An isolated iliac artery aneurysm is where there is aneurysmal dilatation of one or more branches of the iliac system, with no associated dilatation of the aorta. Such aneurysms are rare and comprise 1% of all intra-abdominal aneurysms. The signs and symptoms of such an aneurysm are influenced by its concealed location within the bony pelvis. Awareness of these special characteristics improves the chances of early diagnosis and proper treatment before possible rupture. We present the clinical and radiological features of three such aneurysms. Ultrasound was the first imaging modality to be performed. Ipsilateral hydronephrosis was demonstrated in each case, this lead to imaging the pelvis and the correct diagnosis. We review the clinical and radiological literature and conclude that the pelvis should be imaged in all cases of unexplained hydronephrosis.

  7. Resolution of trigeminal neuralgia by coil embolization of a persistent primitive trigeminal artery aneurysm

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    Ladner, Travis R; Ehtesham, Moneeb; Davis, Brandon J; Khan, Imad S; Ghiassi, Mayshan; Ghiassi, Mahan; Singer, Robert J

    2013-01-01

    The persistent primitive trigeminal artery (PTA) is a rare anastomosis between the carotid artery and basilar artery. While most PTAs are asymptomatic, lateral variants can occasionally compress the trigeminal nerve and precipitate trigeminal neuralgia. Aneurysms of the PTA are exceptionally rare in the literature and have not previously been associated with trigeminal neuralgia. We present the first case of an aneurysm of the PTA causing trigeminal neuralgia. The patient underwent coil embolization of the aneurysm which relieved her symptoms. We propose embolization as a viable therapeutic option for the resolution of trigeminal neuralgia when the condition is secondary to irritation by the high velocity pulsatile flow of an aneurysm. PMID:23625680

  8. Resolution of trigeminal neuralgia by coil embolization of a persistent primitive trigeminal artery aneurysm.

    Science.gov (United States)

    Ladner, Travis R; Ehtesham, Moneeb; Davis, Brandon J; Khan, Imad S; Ghiassi, Mayshan; Ghiassi, Mahan; Singer, Robert J

    2014-04-01

    The persistent primitive trigeminal artery (PTA) is a rare anastomosis between the carotid artery and basilar artery. While most PTAs are asymptomatic, lateral variants can occasionally compress the trigeminal nerve and precipitate trigeminal neuralgia. Aneurysms of the PTA are exceptionally rare in the literature and have not previously been associated with trigeminal neuralgia. We present the first case of an aneurysm of the PTA causing trigeminal neuralgia. The patient underwent coil embolization of the aneurysm which relieved her symptoms. We propose embolization as a viable therapeutic option for the resolution of trigeminal neuralgia when the condition is secondary to irritation by the high velocity pulsatile flow of an aneurysm. PMID:24610143

  9. Pituitary Insufficiency and Hyperprolactinemia Associated with Giant Intra- and Suprasellar Carotid Artery Aneurysm

    OpenAIRE

    Gungor, A.; Gokkaya, N.; Bilen, A.; H. Bilen; Akbas, E. M.; Y. Karadeniz; Eren, S

    2015-01-01

    Pituitary insufficiency secondary to internal carotid artery (ICA) aneurysm is a very rare condition. Its prevalence is reported as 0.17% (Heshmati et al., 2001). We present a case of pituitary insufficiency and hyperprolactinemia secondary to suprasellar giant intracranial aneurysm. A 71-year-old man was admitted to our clinic with symptoms of hypopituitarism, hyperprolactinemia, and visual field defect. His pituitary MRI and cerebral angiography revealed a giant saccular aneurysm filling su...

  10. Symptomatic calcified splenic artery aneurysm: Case report

    Directory of Open Access Journals (Sweden)

    Čolović Radoje

    2010-01-01

    Full Text Available Introduction. Although the third most common aneurysm within the abdomen, after aneurysms of the aorta and iliac arteries, splenic artery aneurysms are rare, but not exceptionally. Owing to new imaging techniques, they have been discovered with increasing frequency. Case Outline. Authors present a 47-year-old woman, multipara, who presented with left upper abdominal pain in whom X-ray showed a calcified ring in the area of distal pancreas. Selective angiography confirmed a splenic artery aneurysm of its proximal part. During an open surgery the aneurysm was excised (aneurismectomy without immediate, early or late complications. The patient became symptom-free. Conclusion. In patients, particularly women, the multiparas who present with epigastric or left upper abdominal pain of unknown aetiology, splenic artery aneurysm has to be taken into account. Further diagnostic procedures such as plain X-ray and selective angiography in suspected cases should be performed. Surgery or other treatment modalities are to be seriously considered in all patients, particularly in those with increased risk of rupture.

  11. Totally thrombosed giant anterior communicating artery aneurysm

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    V R Roopesh Kumar

    2015-01-01

    Full Text Available Giant anterior communicating artery aneurysmsarerare. Apatient presented with visual dysfunction, gait ataxia and urinary incontinence. MRI showed a giant suprasellar mass.At surgery, the lesion was identified as being an aneurysm arising from the anterior communicating artery.The difficulty in preoperative diagnosis and relevant literature are reviewed.

  12. Pulmonary artery aneurysm with patent arterial duct: resection of aneurysm and ductal division.

    Science.gov (United States)

    Tefera, Endale; Teodori, Michael

    2013-10-01

    Congenital or acquired aneurysm of the pulmonary artery (PA) is rare. Although aneurysms are described following surgical treatment of patent ductus arteriosus (PDA), occurrence of this lesion in association with PDA without previous surgery is extremely uncommon. An eight-year-old patient with PDA and aneurysm of the main PA is described in this report. Clinical diagnosis of PDA was made upon presentation. Diagnosis of PA aneurysm was suspected on chest x-ray and was confirmed on transthoracic echocardiography. Successful surgical resection of the aneurysm and division of the duct were performed under cardiopulmonary bypass. The patient did well on follow-up both from clinical and echocardiographic point of view.

  13. Idiopathic aneurysm of pulmonary artery

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    Pacheco, Julio B. Cota; Pimentel, Patricia N.; Knust, Beatriz S., E-mail: jcota@uol.com.br [Clinica de Cardiologia Cota Pacheco, Mogi das Cruzes, SP (Brazil)

    2015-07-15

    Because it is a very rare isolated lesion, we decided to present this case of idiopathic pulmonary artery aneurysm (IPAA) and review the cases published in the literature in order to correlate our clinical and imaging findings, as well as management based on patient data. IPAA was first described in a case of autopsy by Bristowe in 1860 and later in 1947 by Deterling and Claggett, whose prevalence was lower than eight to one hundred thousand. Although the use of diagnostic imaging methods has been applied in a very large population in recent decades, this lesion has been most often described in postmortem examinations. Therefore, it is important to be aware of possible clinical symptoms, at times non-specific, as well as the signs on imaging studies. In this study, therefore, the report of a case of an asymptomatic patient whose diagnosis was done through color Doppler echocardiography in a routine test in 2012, later confirmed by simple chest computed tomography (chest CT) and cardiac catheterization as IPAA and its branches. We discussed the literature available and the possibilities for treatment and the use of color Doppler echocardiography as an initial diagnostic tool for such a rare and intriguing disease. (author)

  14. Idiopathic aneurysm of pulmonary artery

    International Nuclear Information System (INIS)

    Because it is a very rare isolated lesion, we decided to present this case of idiopathic pulmonary artery aneurysm (IPAA) and review the cases published in the literature in order to correlate our clinical and imaging findings, as well as management based on patient data. IPAA was first described in a case of autopsy by Bristowe in 1860 and later in 1947 by Deterling and Claggett, whose prevalence was lower than eight to one hundred thousand. Although the use of diagnostic imaging methods has been applied in a very large population in recent decades, this lesion has been most often described in postmortem examinations. Therefore, it is important to be aware of possible clinical symptoms, at times non-specific, as well as the signs on imaging studies. In this study, therefore, the report of a case of an asymptomatic patient whose diagnosis was done through color Doppler echocardiography in a routine test in 2012, later confirmed by simple chest computed tomography (chest CT) and cardiac catheterization as IPAA and its branches. We discussed the literature available and the possibilities for treatment and the use of color Doppler echocardiography as an initial diagnostic tool for such a rare and intriguing disease. (author)

  15. Lumbar and iliac artery aneurysms in Menkes' disease: endovascular cover stent treatment of the lumbar artery aneurysm

    International Nuclear Information System (INIS)

    We report lumbar and iliac artery aneurysms in a 3-month-old boy with Menkes' disease. The iliac artery aneurysm thrombosed spontaneously, documented by follow-up colour Doppler sonography. The lumbar artery aneurysm was successfully treated using a cover stent. There was no filling of the lumbar artery aneurysm and no stenosis of the cover stent during the 9-month follow-up. (orig.)

  16. Wall shear stress in intracranial aneurysms and adjacent arteries

    Institute of Scientific and Technical Information of China (English)

    Fuyu Wang; Bainan Xu; Zhenghui Sun; Chen Wu; Xiaojun Zhang

    2013-01-01

    Hemodynamic parameters play an important role in aneurysm formation and growth. However, it is difficult to directly observe a rapidly growing de novo aneurysm in a patient. To investigate possible associations between hemodynamic parameters and the formation and growth of intracranial aneurysms, the present study constructed a computational model of a case with an internal carotid artery aneurysm and an anterior communicating artery aneurysm, based on the CT angiography findings of a patient. To simulate the formation of the anterior communicating artery aneurysm and the growth of the internal carotid artery aneurysm, we then constructed a model that virtually removed the anterior communicating artery aneurysm, and a further two models that also progressively decreased the size of the internal carotid artery aneurysm. Computational simulations of the fluid dynamics of the four models were performed under pulsatile flow conditions, and wall shear stress was compared among the different models. In the three aneurysm growth models, increasing size of the aneurysm was associated with an increased area of low wall shear stress, a significant decrease in wall shear stress at the dome of the aneurysm, and a significant change in the wall shear stress of the parent artery. The wall shear stress of the anterior communicating artery remained low, and was significantly lower than the wall shear stress at the bifurcation of the internal carotid artery or the bifurcation of the middle cerebral artery. After formation of the anterior communicating artery aneurysm, the wall shear stress at the dome of the internal carotid artery aneurysm increased significantly, and the wall shear stress in the upstream arteries also changed significantly. These findings indicate that low wall shear stress may be associated with the initiation and growth of aneurysms, and that aneurysm formation and growth may influence hemodynamic parameters in the local and adjacent arteries.

  17. Isolated common femoral artery aneurysm: a case report

    OpenAIRE

    Sharma, Saurabh; Nalachandran, Sanjay

    2009-01-01

    Introduction Isolated aneurysm of common femoral artery is a rare occurrence. They may mimic other common conditions like groin lymph nodes or groin hernia. Case presentation Here we present a case of 61-years-old Chinese gentleman who presented with a right groin lump, which was suspected to be groin hernia but turned out common femoral artery aneurysm. The aneurysm was surgically excised and a prosthetic vascular repair was done. Conclusion Isolated common femoral artery aneurysms are rare ...

  18. Endovascular management of giant middle cerebral artery aneurysms

    OpenAIRE

    Huang, Lei; Cao, Wenjie; Ge, Liang; Lu, Gang; Wan, Jun; Zhang, Lei; Gu, Weijin; Zhang, Xiaolong; Geng, Daoying

    2015-01-01

    Background: This article reported the experience of endovascular treatment in giant middle cerebral artery (MCA) aneurysms with parent artery occlusion or stent-assisted coiling. Material and methods: Eleven consecutive patients with giant MCA aneurysms were included. The aneurysms predominantly involved the M1 segment in two cases, bifurcation in four cases, and M2 in five cases. Four M2 fusiform aneurysms were treated with parent artery sacrifice after balloon occlusion test. The seven unru...

  19. Bronchial Artery Aneurysm Embolization with NBCA

    International Nuclear Information System (INIS)

    We present a case of asymptomatic bronchial artery aneurysm that formed a fistula with part of the pulmonary artery (there was no definite fistula with the pulmonary vein). We were able to catheterize the feeding vessel but could not reach the aneurysm. We therefore injected a mixture of N-butyl-2-cyanoacrylate (NBCA; Histoacryl, B. Braun, Melsungen, Germany) and iodized oil (Lipiodol; Guerbet, Aulnay-sous-Bois, France) from the feeding vessel. The fistula, aneurysm, and feeding vessel were almost totally occluded. After embolization, the patient coughed a little; there were no other definite side effects or complications. One and 3 months later, on chest CT, the aneurysm was almost completely occupied with hyperattenuating NBCA-Lipiodol embolization. NBCA is a liquid embolization material whose time to coagulation after injection can be controlled by diluting it with Lipiodol. It is therefore possible to embolize an aneurysm, feeding vessels, and efferent vessels (in our case, it was a fistula) by using an NBCA-Lipiodol mixture of an appropriate concentration, regardless of whether the catheter can reach the aneurysm or not

  20. Management of Extracranial Carotid Artery Aneurysm

    NARCIS (Netherlands)

    Welleweerd, J. C.; den Ruijter, H. M.; Nelissen, B. G. L.; Bots, M. L.; Kappelle, L. J.; Rinkel, G. J. E.; Moll, F. L.; de Borst, G. J.

    2015-01-01

    Introduction: Aneurysms of the extracranial carotid artery (ECAA) are rare. Several treatments have been developed over the last 20 years, yet the preferred method to treat ECAA remains unknown. This paper is a review of all available literature on the risk of complications and long-term outcome aft

  1. Endovascular treatment of ruptured splenic artery aneurysm

    DEFF Research Database (Denmark)

    Bjerring, Ole Steen

    2008-01-01

    Splenic artery aneurysms (SAA) are traditionally treated surgically, but endovascular techniques are becoming increasingly popular. A 64 year-old male with chest pain and low blood pressure was admitted under suspicion of AMI. A CT scan showed a 56 mm SAA with signs of rupture. The patient...

  2. False iliac artery aneurysm following renal transplantation

    DEFF Research Database (Denmark)

    Levi, N; Sønksen, Jens Otto Reimers; Schroeder, T V;

    1999-01-01

    We report a very rare case of a false iliac artery aneurysm following renal transplantation. The patient was a 51-year-old women who presented with a painful 10 x 10 cm pulsating mass in her left iliac fossa. The patient had received a second cadaveric renal transplantation 5 years previously...

  3. Multilocular True Ulnar Artery Aneurysm in a Pediatric Patient

    OpenAIRE

    Stalder, Mark W.; Sanders, Christopher; Lago, Mary; Hilaire, Hugo St.

    2016-01-01

    Summary: Ulnar artery aneurysms are an exceedingly rare entity in the pediatric population and have no consistent etiologic mechanism. We present the case of a 15-year-old male with a multilocular ulnar artery aneurysm in the setting of no antecedent history of trauma, no identifiable connective tissue disorders, and no other apparent etiological factors. Furthermore, the patient’s arterial palmar arch system was absent. The aneurysm was resected, and arterial reconstruction was successfully ...

  4. Aneurysms of the posterior cerebral artery in children

    International Nuclear Information System (INIS)

    Two cases of aneurysms of the posterior cerebral artery, diagnosed by CT and confirmed angiographically, are reported. In the first case, the aneurysm was discovered fortuitously. The second began with intracerebral haemorrhage. A review of the literature is reported. (orig.)

  5. [Aneurysm of the anterior inferior cerebellar artery: case report].

    Science.gov (United States)

    Adorno, Juan Oscar Alarcón; de Andrade, Guilherme Cabral

    2002-12-01

    The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA) are considered rare, can cause cerebello pontine angle (CPA) syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.

  6. Aneurysm of the superficial femoral artery in an infant

    International Nuclear Information System (INIS)

    An isolated arterial aneurysm in childhood is extremely rare. We report a 1-year-old girl with an aneurysm of the right superficial femoral artery, presenting as an asymptomatic mass of the thigh. The aneurysm involved the whole superficial femoral artery (9 cm in length), and surgical treatment would have required replacement of the affected artery. Conservative treatment was chosen, influenced by the patient's rapid growth at that time. Non-invasive, 3-D contrast-enhanced magnetic resonance angiography (MRA) was useful as an alternative to conventional angiography for detailed evaluation of the femoral arteries, including the aneurysm. (orig.)

  7. From basilar artery dolichoectasia to basilar artery aneurysm: natural history in images.

    Science.gov (United States)

    Zis, Panagiotis; Fragkis, Stylianos; Lykouri, Maria; Bageris, Ioannis; Kolovos, Georgios; Angelidakis, Panagiotis; Tavernarakis, Antonios

    2015-05-01

    Dolichoectasia is a medical term used to describe elongated and dilated vessels that follow a tortuous and windy course with frequent loops and curves. We are presenting the natural history in images of a normal basilar artery becoming dolichoectatic, followed by the formation of an aneurysm, over a period of many years, in 60-year-old Caucasian man with a long history of secondary progressive multiple sclerosis and uncontrolled arterial hypertension, who was diagnosed with dolichoectasia of basilar artery in 2008. Although relatively stable at this point, eventually his mobility deteriorated and signs from the cranial nerves, such as trigeminal neuralgia and bilateral palsy of the VI and the VII nerves were added in the clinical picture. In 2014, both computed tomography and magnetic resonance imaging of the brain revealed the formation of an unruptured aneurysm of the basilar artery. PMID:25765208

  8. Case report: rupture of popliteal artery aneurysm

    Directory of Open Access Journals (Sweden)

    Altino Ono Moraes

    2015-06-01

    Full Text Available An 83-year-old female patient with a history of prior endovascular treatment to repair an abdominal aortic aneurysm presented with intense pain and edema in the left leg, with hyperemia and localized temperature increase. Doppler ultrasonography revealed a voluminous aneurysm of the popliteal artery with a contained rupture, and hematoma involving the popliteal fossa and the medial and anterior surfaces of the knee causing compression of the popliteal vein. Endovascular repair was accomplished with covered stents and the rupture was confirmed. during the procedure The aneurysm was excluded and the signs and symptoms it had caused resolved completely, but during the postoperative period the patient developed sepsis of pulmonary origin and died.

  9. Hemodynamic patterns of anterior communicating artery aneurysms: a possible association with rupture

    Science.gov (United States)

    Castro, Marcelo A.; Putman, Christopher M.; Cebral, Juan R.

    2007-03-01

    The aim of this study is to characterize the different flows present at anterior communicating artery (AcoA) aneurysms and investigate possible associations with rupture. For that purpose, patient-specific computational models of 26 AcoA aneurysms were constructed from 3D rotational angiography images. Bilateral images were acquired in 15 patients who had both A1 segments of the anterior cerebral arteries and models were created by fusing the reconstructed left and right arterial trees. Computational fluid dynamics simulations were performed under pulsatile flow conditions. Visualizations of the flow velocity pattern were created to classify the aneurysms into the following flow types: A) inflow from both A1 segments, B) flow jet in the parent artery splits into three secondary jets, one enters the aneurysm and the other two are directed to the A2 segments, C) the parent artery jet splits into two secondary jets, one is directed to one of the A2 segments and the other enters the aneurysm before being directed to the other A2 segment, and D) the parent artery jet enters the aneurysm before being directed towards the A2 segments. The maximum wall shear stress in the aneurysm at the systolic peak (MWSS) was calculated. Most aneurysms in group A were unruptured and had the lowest MWSS. Group B had the same number of unruptured and ruptured aneurysms, and a low MWSS. Groups C and D had high rupture ratios, being the average MWSS significantly higher in group C. Finally, it was found that the MWSS was higher for ruptured aneurysms of all flow types.

  10. Low-pressure pulmonary artery aneurysm presenting with pulmonary embolism: a case series

    Directory of Open Access Journals (Sweden)

    Papoulidis Pavlos

    2011-04-01

    Full Text Available Abstract Introduction Pulmonary artery aneurysm is an uncommon disorder with severe complications. The diagnosis is often difficult, since the clinical manifestations are non-specific and the treatment is controversial, as the natural history of the disease is not completely understood. Case presentation We describe the cases of two patients with pulmonary artery aneurysms. The first patient was a 68-year-old Caucasian man with an idiopathic low-pressure pulmonary artery aneurysm together with a pulmonary embolism. The patient preferred a conservative approach and was stable at the 10-month follow-up visit after being placed on anti-coagulant treatment. The second patient was a 66-year-old Caucasian woman with a low-pressure pulmonary artery aneurysm also presented together with a pulmonary embolism. The aneurysm was secondary to pulmonary valve stenosis. She received anti-coagulants and, after stabilization, underwent percutaneous balloon valvuloplasty. Conclusion Pulmonary embolism may be the initial presentation of a low-pressure pulmonary artery aneurysm. No underlying cause for pulmonary embolism was found in either of our patients, suggesting a causal association with low-pressure pulmonary artery aneurysm.

  11. Variant PTA Terminating in Cerebellar Artery, Associated with Multiple Aneurysms

    Directory of Open Access Journals (Sweden)

    Yeong Uk Hwang

    2016-01-01

    Full Text Available Persistent trigeminal artery (PTA is one of the remnant fetal anastomoses between the carotid artery and basilar artery. PTAs are classified according to angiographic appearance and various connection. Among them, those directly terminating in the cerebellar arteries are rare subtype. In addition, aneurysms of the PTA are unusual in the literature and have not previously accompanied this subtype of PTA connecting cerebellar artery. We present the first case of an aneurysm of the PTA which is directly terminating in the cerebellar arteries and combined with multiple aneurysms.

  12. Variant PTA Terminating in Cerebellar Artery, Associated with Multiple Aneurysms.

    Science.gov (United States)

    Hwang, Yeong Uk; Kim, Jin Woo

    2016-01-01

    Persistent trigeminal artery (PTA) is one of the remnant fetal anastomoses between the carotid artery and basilar artery. PTAs are classified according to angiographic appearance and various connection. Among them, those directly terminating in the cerebellar arteries are rare subtype. In addition, aneurysms of the PTA are unusual in the literature and have not previously accompanied this subtype of PTA connecting cerebellar artery. We present the first case of an aneurysm of the PTA which is directly terminating in the cerebellar arteries and combined with multiple aneurysms. PMID:27446623

  13. Management of Giant Splenic Artery Aneurysm

    Science.gov (United States)

    Akbulut, Sami; Otan, Emrah

    2015-01-01

    Abstract To provide an overview of the medical literature on giant splenic artery aneurysm (SAA). The PubMed, Medline, Google Scholar, and Google databases were searched using keywords to identify articles related to SAA. Keywords used were splenic artery aneurysm, giant splenic artery aneuryms, huge splenic artery aneurysm, splenic artery aneurysm rupture, and visceral artery aneurysm. SAAs with a diameter ≥5 cm are considered as giant and included in this study. The language of the publication was not a limitation criterion, and publications dated before January 15, 2015 were considered. The literature review included 69 papers (62 fulltext, 6 abstract, 1 nonavailable) on giant SAA. A sum of 78 patients (50 males, 28 females) involved in the study with an age range of 27–87 years (mean ± SD: 55.8 ± 14.0 years). Age range for male was 30–87 (mean ± SD: 57.5 ± 12.0 years) and for female was 27–84 (mean ± SD: 52.7 ± 16.6 years). Most frequent predisposing factors were acute or chronic pancreatitis, atherosclerosis, hypertension, and cirrhosis. Aneurysm dimensions were obtained for 77 patients with a range of 50–300 mm (mean ± SD: 97.1 ± 46.0 mm). Aneurysm dimension range for females was 50–210 mm (mean ± SD: 97.5 ± 40.2 mm) and for males was 50–300 mm (mean ± SD: 96.9 ± 48.9 mm). Intraperitoneal/retroperitoneal rupture was present in 15, among which with a lesion dimension range of 50–180 mm (mean ± SD; 100 ± 49.3 mm) which was range of 50–300 mm (mean ± SD: 96.3 ± 45.2 mm) in cases without rupture. Mortality for rupture patients was 33.3%. Other frequent complications were gastrosplenic fistula (n = 3), colosplenic fistula (n = 1), pancreatic fistula (n = 1), splenic arteriovenous fistula (n = 3), and portosplenic fistula (n = 1). Eight of the patients died in early postoperative period while 67 survived. Survival status of the

  14. Basilar artery aneurysm at a persistent trigeminal artery junction. A case report and literature review.

    Science.gov (United States)

    Aguiar, G B; Conti, M L M; Veiga, J C E; Jory, M; Souza, R B

    2011-09-01

    The trigeminal artery is an anastomosis between the embryonic precursors of the vertebrobasilar and carotid systems, and may persist into adult life. The association of the persistent primitive trigeminal artery (PTA) with cerebral aneurysm is well documented in the literature and, in general, aneurysms are located in the anterior circulation. We describe a patient who presented with a panencephalic Fisher III subarachnoid hemorrhage due to rupture of an intracranial aneurysm. Digital arteriography showed a saccular aneurysm in the middle third of the basilar artery, adjacent to the junction with a persistent trigeminal artery. She was submitted to endovascular treatment with embolization of the basilar artery aneurysm with coils. Aneurysms at the PTA junction with the basilar artery are rare. This paper describes a case of PTA associated with an aneurysm in the basilar artery at PTA junction and briefly reviews the literature. PMID:22005697

  15. Distal posterior inferior cerebellar artery aneurysm in a child

    OpenAIRE

    J. FRANCISCO SALOMÃO; René D. Leibinger; Yara M. S. Lima Ciro de A. Cunha; Ilton G. Shinzato; Paulo de T. L. Dantas

    1992-01-01

    The case of a 7-year-old boy presenting with recurrent episodes of subarachnoid hemorrhage due to a distal posterior inferior cerebellar artery aneurysm (PICA), successfully operated, is reported.' The low incidence of intracranial aneurysms in the first decade of life and the rare occurrence of distal PICA aneurysms are unusual features of this case. The theories regarding the origin of intracranial berry aneurysms are discussed.

  16. Basilar artery aneurysm with autonomic features: an interesting pathophysiological problem

    OpenAIRE

    Giffin, N; Goadsby, P

    2001-01-01

    Unruptured cerebral aneurysms often present with neuro-ophthalmological symptoms but ocular autonomic involvement from an aneurysm of the posterior circulation has not previously been reported. A patient is described with a basilar artery aneurysm presenting with headache and unilateral autonomic symptoms. After angiographic coiling of the aneurysm there was a near complete resolution of these features. The relevant anatomy and proposed mechanism of autonomic involvement of what may be ...

  17. Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage

    Science.gov (United States)

    Pahl, Felix Hendrik; de Oliveira, Matheus Fernandes; Rotta, Marcus Alexandre Cavalcanti; Dias, Guilherme Marcos Soares; Rezende, André Luiz; Rotta, José Marcus

    2014-01-01

    Background: Isolated cervical anterior spinal artery aneurysms are extremely rare. Subarachnoid hemorrhage (SAH) secondary to such lesions have been described only in six cases to the best of our knowledge. Case Description: We describe an unusual clinical picture of SAH due to rupture of anterior spinal artery aneurysm in a patient with previous normal angiogram. Due to the location of the aneurysm and clinical status of the patient, conservative management was proposed, and she was discharged to further follow-up. Monthly routine angiograms revealed resolution of the aneurysm 90 days after bleeding, which was highly suggestive of vascular dissection. Conclusion: We highlight the need to consider these aneurysms in the differential diagnosis of SAH, especially when occurring in the posterior fossa and when angiography findings are inconclusive. PMID:25317354

  18. [Isolated true aneurysm of the deep femoral artery].

    Science.gov (United States)

    Salomon du Mont, L; Holzer, T; Kazandjian, C; Saucy, F; Corpataux, J M; Rinckenbach, S; Déglise, S

    2016-07-01

    Aneurysms of the deep femoral artery, accounting for 5% of all femoral aneurysms, are uncommon. There is a serious risk of rupture. We report the case of an 83-year-old patient with a painless pulsatile mass in the right groin due to an aneurysm of the deep femoral artery. History taking revealed no cardiovascular risk factors and no other aneurysms at other localizations. The etiology remained unclear because no recent history of local trauma or puncture was found. ACT angiography was performed, revealing a true isolated aneurysm of the deep femoral artery with a diameter of 90mm, beginning 1cm after its origin. There were no signs of rupture or distal emboli. Due to unsuitable anatomy for an endovascular approach, the patient underwent open surgery, with exclusion of the aneurysm and interposition of an 8-mm Dacron graft to preserve deep femoral artery flow. Due to their localization, the diagnosis and the management of aneurysms of the deep femoral artery can be difficult. Options are surgical exclusion or an endovascular approach in the absence of symptoms or as a bridging therapy. If possible, blood flow to the distal deep femoral artery should be maintained, the decision depending also on the patency of the superficial femoral artery. In case of large size, aneurysms of the deep femoral artery should be treated without any delay. PMID:27289256

  19. Individualized management for intracranial vertebral artery dissecting aneurysms

    Directory of Open Access Journals (Sweden)

    SHANG Yan-guo

    2012-02-01

    Full Text Available Objective To discuss the individualized management strategy for intracranial vertebral artery dissecting aneurysms. Methods Eighteen patients with intracranial vertebral artery dissecting aneurysms were treated with different surgical methods. Results Eighteen patients underwent different surgical treatment. Five patients underwent complete occlusion of the aneurysm and parent artery by coiling, 5 were treated by stent -assisted coiling (3 densely packed coiling and 2 non-densely packed coiling, 4 underwent stent-only therapy and 3 of them presented hemodynamic improvement after surgery, 3 were treated by direct surgical clipping, and 1 underwent occipital artery-posterior inferior cerebellar artery bypass. Two aneurysms ruptured immaturely, in which one patient died on the third day after operation and one patient occurred moderate disablity. Only 1 patient who underwent complete occlusion of aneurysm and parent artery presented temporarily ischemic symptoms. No adverse effects were seen in other patients. Seventeen patients were followed up for 1 month to 3 years, and all the aneurysms were stable. Conclusion There are many kinds of therapeutic methods for intracranial vertebral artery dissecting aneurysms. The patients should be treated according to several factors such as the clinical manifestations, aneurysm configuration, and relationship with the posterior inferior cerebellar artery. The treatment should be individualized.

  20. Giant aneurysm in a left coronary artery fistula

    DEFF Research Database (Denmark)

    Frestad, Daria; Helqvist, Steffen; Helvind, Morten;

    2013-01-01

    Congenital coronary artery fistula complicated with giant coronary artery aneurysm is a very rare condition. In this case report, we present a 65-year-old woman, referred to us with a continuous heart murmur, occasional atypical chest pain and few episodes of fainting. A giant aneurysm and a coro...

  1. Very late coronary aneurysm formation with subsequent stent thrombosis secondary to drug-eluting stent

    Institute of Scientific and Technical Information of China (English)

    Ibrahim Akin,; Stephan Kische; Tim C Rehders; Henrik Schneider; G(o)kmen R Turan; Tilo Kleinfeldt; Jasmin Ortak; Christoph A. Nienaber; Hüseyin Ince

    2011-01-01

    Drug-eluting stents have changed the practice in interventional cardiology.With the widespread use of these stents important safety concerns regarding stent thrombosis and formation of coronary artery aneurysm have been expressed.While the majority of attention was focused on stent thrombosis,the formation of coronary aneurysm was only described in anecdotal reports.We report on a patient who suffered from very late stent thrombosis in association with coronary artery aneurysm formation secondary to drug-eluting stent but not to bare-metal stent.

  2. Vertebral Artery Aneurysm Mimicking as Left Subclavian Artery Aneurysm in a Patient with Transforming Growth Factor Beta Receptor II Mutation.

    Science.gov (United States)

    Afifi, Rana O; Dhillon, Baltej Singh; Sandhu, Harleen K; Charlton-Ouw, Kristofer M; Estrera, Anthony L; Azizzadeh, Ali

    2015-10-01

    We report successful endovascular repair of a left vertebral artery aneurysm in a patient with transforming growth factor beta receptor II mutation. The patient was initially diagnosed with a left subclavian artery aneurysm on computed tomography angiography. The patient consented to publication of this report.

  3. An unusual case of bilateral coronary artery aneurysms and aortic aneurysms complicated by stenotic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Nakamizo, Reiichirou; Toda, Genji; Koide, Yuji; Kawahara, Fumitaka; Seto, Shinji; Yano, Katsusuke [Nagasaki Univ. (Japan). Graduate School of Biomedical Sciences

    2003-03-01

    A 71-year-old Japanese woman presented with a chief complaint of throbbing sensations in the abdomen. When she was 16 years old, she was exposed to atomic radiation since she was 1.2 km away from the drop zone of the Nagasaki atomic bomb. Abdominal CT performed at the age of 61 revealed the presence of localized calcification below the renal artery, together with abdominal aortic aneurysms measuring 4.9 cm in maximum diameter. Since the abdominal aortic aneurysms enlarged in May 2000, the patient was admitted to our department for further examinations and treatment on July 7. Although the patient did not complain of thoracic symptoms, cardiac catheterization revealed the presence of multiple coronary artery aneurysms and severe stenosis in the main trunk of the left coronary artery and proximal regions of the right coronary artery, together with a complicated collateral circulation course. Coronary artery aneurysms were localized similar to the abdominal aortic aneurysms, and were complicated by severe calcification and obstructive lesions. Coronary arterial bypass grafting was performed after the severity of the coronary artery aneurysms was morphologically evaluated. The course of the abdominal aortic aneurysms was followed without surgical treatment. Although the etiology of the aneurysm formation in this patient was investigated, it remained unclear. (author)

  4. Percutaneous endovascular management of recurrent aneurysm of transplant renal artery anastomosed to internal iliac artery

    OpenAIRE

    Hegde, Umapati N.; Rajapurkar, Mohan M; Gang, Sishir D.; Lele, Suhas S.

    2008-01-01

    Aneurysm formation constitutes 0.5 to 1% of all vascular complications in transplant patients. Aneurysms may result from infection, injury during procurement or preservation, faulty suture technique or trauma. Transplant renal artery aneurysm presents with hypertension, graft dysfunction and bleeding. We report a case of percutaneous covered stent-graft for recurrent aneurysm with stenosis of transplant renal artery. To our knowledge this is the first report of successful treatment of transpl...

  5. Multilocular True Ulnar Artery Aneurysm in a Pediatric Patient.

    Science.gov (United States)

    Stalder, Mark W; Sanders, Christopher; Lago, Mary; Hilaire, Hugo St

    2016-01-01

    Ulnar artery aneurysms are an exceedingly rare entity in the pediatric population and have no consistent etiologic mechanism. We present the case of a 15-year-old male with a multilocular ulnar artery aneurysm in the setting of no antecedent history of trauma, no identifiable connective tissue disorders, and no other apparent etiological factors. Furthermore, the patient's arterial palmar arch system was absent. The aneurysm was resected, and arterial reconstruction was successfully performed via open surgical approach with cephalic vein interposition graft. We believe this treatment modality should be considered as the primary approach in all of these pediatric cases in consideration of the possible pitfalls of less comprehensive measures.

  6. Gastrointestinal bleeding and obstructive jaundice: Think of hepatic artery aneurysm.

    Science.gov (United States)

    Vultaggio, Fabrice; Morère, Pierre-Henri; Constantin, Christophe; Christodoulou, Michel; Roulin, Didier

    2016-06-27

    Hemobilia is an uncommon and potential life-threatening condition mainly due to hepato-biliary tree traumatic or iatrogenic injuries. Spontaneously ruptured aneurysm of the hepatic artery is seldom described. We report the case of an 89-year-old woman presenting with abdominal pain, jaundice and gastrointestinal bleeding, whose ultrasound and computed tomography revealed a non-traumatic, spontaneous aneurysm of the right hepatic artery. The oeso-gastro-duodenoscopy and colonoscopy did not reveal any bleeding at the ampulla of Vater, nor anywhere else. Selective angiography confirmed the diagnosis of hepatic artery aneurysm and revealed a full hepatic artery originating from the superior mesenteric artery. The patient was successfully treated by selective embolization of microcoils. We discuss the etiologies of hemobilia and its treatment with selective embolization, which remains favored over surgical treatment. Although aneurysm of the hepatic artery is rare, especially without trauma, a high index of suspicion is needed in order to ensure appropriate treatment. PMID:27358680

  7. Internal mammary artery aneurysm in Marfan syndrome: case report

    International Nuclear Information System (INIS)

    Marfan syndrome has a pleomorphic phenotype. Those affected have abnormalities in the eyes and in the nervous, cardiovascular and musculoskeletal systems. Among these abnormalities are many reported aneurysms, involving the ascending, descending thoracic and abdominal aorta, the sinus of Valsalva, and the internal carotid artery. We report a left internal mammary artery (LIMA) aneurysm in a patient with Marfan syndrome and no other known predisposition to such an aneurysm. No other case of LIMA aneurysm in Marfan syndrome has, to our knowledge, been reported. (author)

  8. Internal mammary artery aneurysm in Marfan syndrome: case report

    Energy Technology Data Exchange (ETDEWEB)

    Common, A.A.; Pressacco, J.; Wilson, J.K. [Univ. of Toronto, Dept. of Mecial Imaging, Toronto, Ontario (Canada)

    1999-02-01

    Marfan syndrome has a pleomorphic phenotype. Those affected have abnormalities in the eyes and in the nervous, cardiovascular and musculoskeletal systems. Among these abnormalities are many reported aneurysms, involving the ascending, descending thoracic and abdominal aorta, the sinus of Valsalva, and the internal carotid artery. We report a left internal mammary artery (LIMA) aneurysm in a patient with Marfan syndrome and no other known predisposition to such an aneurysm. No other case of LIMA aneurysm in Marfan syndrome has, to our knowledge, been reported. (author)

  9. The treatment of isolated iliac artery aneurysm in patients with non-aneurysmal aorta

    OpenAIRE

    Dorigo, W.; PULLI, R.; N. TROISI; A. Alessi Innocenti; G. Pratesi; L. AZAS; C. Pratesi

    2008-01-01

    OBJECTIVES: The aim of the study was to evaluate early and mid-term results of surgical repair of isolated iliac artery aneurysm (IAA) in patients with non aneurysmal abdominal aorta. METHODS: From January 1996 to December 2006, 34 patients with IAA had elective surgery. In 32 cases open repair was performed. Two patients had endovascular repair using a tube endoprosthesis and internal iliac artery coil embolization. The diameters of the abdominal aorta and iliac arteries were measur...

  10. Morphological predictors of posterior communicating artery aneurysms rupture

    Institute of Scientific and Technical Information of China (English)

    Nan Lv; Yibin Fang; Ying Yu; Jinyu Xu; Jianmin Liu; Qinghai Huang

    2015-01-01

    Objective:The conflicting findings of previous morphological studies on intracranial aneurysm rupture may be caused by the different locations of aneurysms. We aimed to determine the independent risk factors of aneurysm rupture by focusing on only posterior communicating artery (PcomA) aneurysms. Methods:In 89 PcomA aneurysms (58 ruptured, 31 unruptured), clinical and morphological characteristics were compared between the ruptured and unruptured groups. Multivariate logistic regression analysis was performed to determine the independent predictors for the rupture status of PcomA aneurysms. Results:In univariate analyses, the aneurysm dome size, aspect ratio, size ratio, dome‐to‐neck ratio, and inflow angle were significant parameters. With multivariate analyses, only the aneurysm dome size and inflow angle were significantly associated with the rupture status of PcomA aneurysms. Conclusions:Morphology was related with rupture of PcomA aneurysms. The aneurysm dome size and inflow angle were found to be the independent parameters characterizing the rupture status of PcomA aneurysms.

  11. Endovascular treatment of posterior cerebral artery aneurysms using detachable coils

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Hong Gee [Kangwon National University Hospital, Department of Radiology, Chuncheon, Kangwon-do (Korea); Konkuk University Hospital, Department of Radiology, Seoul (Korea); Kim, Sam Soo; Han, Heon [Kangwon National University Hospital, Department of Radiology, Chuncheon, Kangwon-do (Korea); Kang, Hyun-Seung [Konkuk University Hospital, Department of Neurosurgery, Seoul (Korea); Moon, Won-Jin [Konkuk University Hospital, Department of Radiology, Seoul (Korea); Byun, Hong Sik [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea)

    2008-03-15

    Aneurysms of the posterior cerebral artery (PCA) are rare, and most of the studies reported in the literature in which the endovascular approach was applied were carried out on a limited number of patients with PCA aneurysms. We retrospectively reviewed our cases of PCA aneurysms - at various locations and of differing shapes - that received endovascular treatment and evaluated the treatment outcome. From January 1996 to December 2006, 13 patients (eight females and five males) with 17 PCA aneurysms (nine fusiform and eight saccular) were treated using the endovascular approach. The age of the patients ranged from 20 to 67 years, with a mean age of 44 years. Of the 13 patients, ten presented with intracranial hemorrhage, and one patient, with a large P2 aneurysm, presented with trigeminal neuralgia; the aneurysms were asymptomatic in the remaining two patients. All 13 patients were successfully treated, with only one procedure-related symptomatic complication. Seven patients were treated by occlusion of the aneurysm and parent artery together; five patients, by selective embolization of the aneurysm; one patient, by partial coiling. Although infarctions were found in two patients treated with selective embolization and in three patients treated with parent artery occlusion, only one patient with a ruptured P2 aneurysm treated with parent artery occlusion developed transient amnesia as an ischemic symptom. Posterior cerebral artery aneurysms can be treated safely with either occlusion of the aneurysm together with the PCA or with a selective coil embolization. Infarctions may occur after endovascular treatment, but they are rarely the cause of a disabling symptom. (orig.)

  12. Renal arterial aneurysm--an incidental finding at autopsy.

    Directory of Open Access Journals (Sweden)

    Vaideeswar P

    1998-01-01

    Full Text Available Herein we describe a rare case of saccular renal artery aneurysm seen as an incidental autopsy finding in an elderly, hypertensive female. The aneurysm was seen as a small exophytic mass with calcified wall and lumen occluded by recanalized thrombus.

  13. Extracranial arterial aneurysms: a cause of crescendo transient ischaemic attacks.

    Science.gov (United States)

    Paterson, H M; Holdsworth, R J

    2000-12-01

    Crescendo transient ischaemic attacks (TIAs) should be regarded as a medical emergency. Patients require hospitalisation with urgent assessment and symptom control with anticoagulant therapy. We report on three patients, all of whom had atherosclerotic aneurysmal disease of the extracranial arterial circulation who presented with crescendo TIAs. The possibility of extracranial aneurysmal disease should always be considered and excluded.

  14. Pediatric isolated bilateral iliac aneurysm.

    Science.gov (United States)

    Chithra, R; Sundar, R Ajai; Velladuraichi, B; Sritharan, N; Amalorpavanathan, J; Vidyasagaran, T

    2013-07-01

    Aneurysms are rare in children. Isolated iliac artery aneurysms are very rare, especially bilateral aneurysms. Pediatric aneurysms are usually secondary to connective tissue disorders, arteritis, or mycotic causes. We present a case of a 3-year-old child with bilateral idiopathic common iliac aneurysms that were successfully repaired with autogenous vein grafts.

  15. CT of ruptured aneurysm of aberrant right subclavian artery.

    Science.gov (United States)

    Vega, A; Ortíz, A; Longo, J M; Pagola, M A

    1987-01-01

    This paper presents the first description of a ruptured aneurysm of an aberrant right subclavian artery. CT clearly demonstrated the vascular malformation as well as the existence of a bilateral hemothorax. PMID:3102065

  16. Ruptured mycotic aneurysm of the subclavian artery after irradiation

    International Nuclear Information System (INIS)

    The late effects of radiation injury to large arteries have been well described, and include mainly atherosclerotic changes which present clinically as occlusive disease. Formation of an aneurysm after irradiation is rare to our knowledge. The management of arterial injury after irradiation is made more difficult by associated injuries to the adjacent skin and surrounding tissues. We know of no previous work of an irradiation-induced, ruptured and infected aneurysm and we report this case to emphasis the complexities of its management

  17. Giant atrial septal aneurysm originating from the right coronary artery.

    Science.gov (United States)

    Osada, Hiroaki; Kanemitsu, Naoki; Meshii, Katsuaki; Ohnaka, Motoaki

    2016-08-01

    Giant coronary artery aneurysm is a rare clinical entity and its involvement in the interatrial space is extremely rare. We here report the rare surgical case of a 67-year old man with giant right coronary artery aneurysm located in the atrial septum with fistula formation to the right atrium, complicated with congestive heart failure, rapid atrial fibrillation and left atrial appendage thrombus. The patient eventually recovered fully without sequelae. PMID:27118290

  18. Ruptured ileocolic artery aneurysm: An unusual cause of hemoperitoneum

    Directory of Open Access Journals (Sweden)

    Zakaur R Siddiqui

    2012-01-01

    Full Text Available Ruptured aneurysm of a branch of ileocolic artery is a rare finding and is an unusual cause of haemoperitoneum. Rapid diagnosis, and surgical or endovascular intervention are necessary to avoid devastating consequences and high mortality rates following an emergency operation after rupture. Resection is a good choice for surgical intervention for some aneurysms that are not suitable for endovascular repair. This report describes the case of a middle-aged man with a ruptured superior mesenteric artery branch aneurysm and his subsequent surgical management.

  19. Ruptured Ileocolic Artery Aneurysm: An Unusual Cause of Hemoperitoneum

    Science.gov (United States)

    Siddiqui, Zakaur R.; Yousif, Omer F.; Halliday, Mark W.; Hubaishah, Nasser A.; Adam, Khalid A.

    2012-01-01

    Ruptured aneurysm of a branch of ileocolic artery is a rare finding and is an unusual cause of haemoperitoneum. Rapid diagnosis, and surgical or endovascular intervention are necessary to avoid devastating consequences and high mortality rates following an emergency operation after rupture. Resection is a good choice for surgical intervention for some aneurysms that are not suitable for endovascular repair. This report describes the case of a middle-aged man with a ruptured superior mesenteric artery branch aneurysm and his subsequent surgical management. PMID:23006464

  20. A large unilateral renal artery aneurysm in a young child

    International Nuclear Information System (INIS)

    The case of a 13-month-old boy with fibromuscular dysplasia (FMD) presenting with a large saccular aneurysm of the left renal artery and renovascular hypertension is reported. Renal and intrarenal arteries showed numerous small aneurysms alternating with stenoses. All arterial lesions were localized to the left kidney. After left nephrectomy, the patient's blood pressure normalized. Histopathologic examination of the arteries disclosed changes typical of medial fibroplasias, the most frequently described form of FMD in children. This diagnosis is rewarding as it represents a surgically curable cause of severe hypertension. (orig.)

  1. Giant Cavernous Aneurysm Associated with a Persistent Trigeminal Artery and Persistent Otic Artery

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Chang Wei; Xie, Xiao Dong; Yang, Zhi Gang; Wang, Chao Hua; You, Chao; Mao, Bo Yong; He, Min; Sun, Hong [West China Hospital, Sichuan University, Sichuan (China)

    2009-10-15

    Primitive trigeminal artery (PTA) and primitive otic artery (POA) is a very rare entity in adult life. We present a case of PTA and POA associated with a giant unruptured cavernous aneurysm in a 54-year-old woman. The PTA and the POA arose from the sac of the aneurysm directly, which greatly complicated endovascular therapy management

  2. Giant Cavernous Aneurysm Associated with a Persistent Trigeminal Artery and Persistent Otic Artery

    Science.gov (United States)

    Zhang, Chang-wei; Yang, Zhi-gang; Wang, Chao-hua; You, Chao; Mao, Bo-yong; He, Min; Sun, Hong

    2009-01-01

    Primitive trigeminal artery (PTA) and primitive otic artery (POA) is a very rare entity in adult life. We present a case of PTA and POA associated with a giant unruptured cavernous aneurysm in a 54-year-old woman. The PTA and the POA arose from the sac of the aneurysm directly, which greatly complicated endovascular therapy management. PMID:19721839

  3. A study of the hemodynamics of anterior communicating artery aneurysms

    Science.gov (United States)

    Cebral, Juan R.; Castro, Marcelo A.; Putman, Christopher M.

    2006-03-01

    In this study, the effects of unequal physiologic flow conditions in the internal carotid arteries on the intra-aneurysmal hemodynamics of anterior communicating artery aneurysms were investigated. Patient-specific vascular computational fluid dynamics models of five cerebral aneurysms were constructed from bilateral 3D rotational angiography images. The aneurysmal hemodynamics was analyzed under a range of physiologic flow conditions including the effects of unequal mean flows and phase shifts between the flow waveforms of the left and right internal carotid arteries. A total of five simulations were performed for each patient, and unsteady wall shear stress (WSS) maps were created for each flow condition. Time dependent curves of average WSS magnitude over selected regions on the aneurysms were constructed and used to analyze the influence of the inflow conditions. It was found that mean flow imbalances in the feeding vessels tend to shift the regions of elevated WSS (flow impingement region) towards the dominating inflow jet and to change the magnitude of the WSS peaks. However, the overall qualitative appearance of the WSS distribution and velocity simulations is not substantially affected. In contrast, phase differences tend to increase the temporal complexity of the hemodynamic patterns and to destabilize the intra-aneurysmal flow pattern. However, these effects are less important when the A1 confluence is less symmetric, i.e. dominated by one of the A1 segments. Conditions affecting the flow characteristics in the parent arteries of cerebral aneurysms with more than one avenue of inflow should be incorporated into flow models.

  4. A case of angiographically occult, distal small anterior inferior cerebellar artery aneurysm

    OpenAIRE

    Hisashi Kubota; Yasuhiro Sanada; Kazuhiro Nagatsuka; Amami Kato

    2015-01-01

    Background: A small aneurysm at an unusual location, such as a distal anterior inferior cerebellar artery (AICA) aneurysm, may conceal as a computed tomography angiography (CTA) and digital subtraction angiography (DSA)-occult aneurysm. Case Description: We herein present the case of a patient suffering from a subarachnoid hemorrhage (SAH) with two aneurysms in which the AICA aneurysm was negative by CTA and DSA. CTA demonstrated a right anterior choroidal artery aneurysm, which was revea...

  5. A Case of Ruptured Splenic Artery Aneurysm in Pregnancy

    Directory of Open Access Journals (Sweden)

    Elizabeth K. Corey

    2014-01-01

    Full Text Available Background. Rupture of a splenic artery aneurysm is rare complication of pregnancy that is associated with a significant maternal and fetal mortality. Case. A multiparous female presented in the third trimester with hypotension, tachycardia, and altered mental status. A ruptured splenic artery aneurysm was discovered at the time of laparotomy and cesarean delivery. The patient made a full recovery following resection of the aneurysm. The neonate survived but suffered severe neurologic impairment. Conclusion. The diagnosis of ruptured splenic artery aneurysm should be considered in a pregnant woman presenting with signs of intra-abdominal hemorrhage. Early intervention by a multidisciplinary surgical team is key to preserving the life of the mother and fetus.

  6. Aneurysmal Bone Cyst: An Uncommon Secondary Event in Calcaneal Chondroblastoma

    OpenAIRE

    Barman, Sandip; Diwaker, Preeti; Bansal, Divya; Wadhwa, Neelam; Singh, Gurvinder

    2016-01-01

    Chondroblastoma is an uncommon benign bone tumour, involvement of epiphysis of long bones is typical. Chondroblastoma of the calcaneum is uncommon and its association with secondary aneurysmal bone cyst is even rarer. Only two cases of calcaneal chondroblastoma associated with secondary aneurysmal bone cyst have been reported till date.

  7. Case of radiation induced aneurysm of extracranial carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Tashiro, Takashi; Ikota, Toshio; Yamashita, Kousuke; Kodama, Takao

    1988-08-01

    An unusual case of post-irradiation aneurysm of extracranial internal carotid artery is presented. A 70-year-old man, complaining of left cervical throbbing mass with focal pain, was admitted on February 8, 1985. It was noted, from his past history, that he had had surgery of the removal of cervical lymphnodes and that unknown dosage of irradiation had been added to the cervical region 30 years before. Left carotid angiography (on admission) demonstrated a giant aneurysm in the cervical portion of internal carotid artery. Right carotid angiography with compression of left carotid artery revealed good cross filling through anterior communicating artery. Computed tomography with contrast media showed a ring like enhanced mass, which was thought to suggest that a large part of the aneurysm was filled with intraluminal thrombosis. During 30 days of evaluation, the aneurysm grew larger and his cervical pain became untolerable. Operation, the resection of the aneurysm and the reconstruction (of circulation) with vein graft, was challenged on March 12. It was so difficult with meticulous work that the ligation of left common carotid artery was performed after all. Seven days after the operation, he suffered from the gastrointestinal bleeding, which was enough to lead him to hypovolemic shock. Thereafter, right hemiparesis and aphasia were brought about. Two months later, he died of pneumonia. On histological examination, it was demonstrated that the aneurysm communicated with the necrotic tissue and that the normal structure of the blood vessel was not observed in the aneurysmal wall and consisted of the collagenous fiber and granulated tissue. The aneurysm was interpreted as a false one.

  8. Ruptured ovarian artery aneurysm in puerperium: a rare occurrence

    OpenAIRE

    Bindu Bajaj; Sunil Kumar Bajaj; Ritu Misra; Rohini Gupta

    2015-01-01

    We present a rare case of Ovarian Artery Aneurysm in a puerperium. It was managed by endocopic banding of the ovarian artery following failed attempts at endovascular embolisation. The patient remained stable on three months follow up. The pathogenesis of this rare condition is also discussed. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000): 272-274

  9. Ruptured ovarian artery aneurysm in puerperium: a rare occurrence

    Directory of Open Access Journals (Sweden)

    Bindu Bajaj

    2015-02-01

    Full Text Available We present a rare case of Ovarian Artery Aneurysm in a puerperium. It was managed by endocopic banding of the ovarian artery following failed attempts at endovascular embolisation. The patient remained stable on three months follow up. The pathogenesis of this rare condition is also discussed. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 272-274

  10. A Case Report: Balloon Occlusion Of Vertebral Artery In A Giant Vertebral Artery Aneurysm

    Directory of Open Access Journals (Sweden)

    K. Edraki

    2005-08-01

    Full Text Available Introduction & Background: True aneurysms of extra cranial vertebral arteries are rare. The usual pathogenesis of aneurysms in this location is either penetrating or blunt trauma with resultant pseudo- aneurysm formation. We report a patient with a presumed pseudo-aneurysm of the extra- cranial vertebral artery presenting with painful neck mass, without obvious history of trauma. Case description: A 59-year old man presented with painful left lateral neck mass from 3 month ago with a bruit over it on physical examination. Patient had a history of long term anticoagulant therapy because of chronic lower extremity DVT. Patient was referred to our DSA (Department for angiography. After color Doppler US, CT scan and MR-angiography were performed and a giant aneurysm in left vertebral artery was detected. The lesion was successfully treated by an endovascular technique of balloon occlusion of the verte-bral artery.

  11. Recurrent giant hypogastric artery aneurysms--a case report.

    Science.gov (United States)

    Golden, R L; Bauman, J; Johnstone, M; Pindyck, F

    1988-07-01

    Aneurysms of the hypogastric artery are rare occurrences that are frequently asymptomatic until the time of rupture. When signs and symptoms are present, a pulsatile pelvic mass, frequently detected by rectal or vaginal examination, may produce compression symptoms with urologic, gastrointestinal, and neurologic manifestations. In addition to classical invasive methods of detection such as angiography, newer noninvasive imaging techniques, including ultrasonography, computerized tomography, and magnetic resonance imaging, may be employed to establish the diagnosis. Proximal ligation of the hypogastric artery is the usual method of treatment. A case of bilateral, giant hypogastric artery aneurysms with successful surgical management is reported. PMID:3044197

  12. Surgical treatment for ruptured anterior inferior cerebellar artery aneurysms

    Directory of Open Access Journals (Sweden)

    TONG Xiao-guang

    2013-03-01

    Full Text Available Background Anterior inferior cerebellar artery (AICA aneurysm is an extremely raretumor, which can cause severe results after ruptured. This article retrospectively analyzed the clinical symptoms, imaging manifestations, surgical approaches, endovascular therapy and postoperative outcomes of 12 cases with AICA aneurysms, so as to provide reference for clinical practice. Methods Clinical data of patients with AICA aneurysms, who were treated in our hospital between June 2004 and June 2012, were carefully collected and studied. Glasgow Outcome Scale (GOS scores were used to evaluate the patients' living status. Results There were 12 patients (the average age was 54 years old with 13 ruptured aneurysms, accounting for 0.19% of all aneurysms (6467 cases treated in the same period. CT showed simple subarachnoid hemorrhage (SAH in 6 patients, simple ventricular hemorrhage in 1 patient and SAH complicated with ventricular hemorrhage in 5 patients. According to Hunt-Hess Grade, 2 patients were classified as Grade Ⅰ; 7 were Grade Ⅱ; 3 were Grade Ⅲ. Digital subtraction angiography (DSA showed there were 10 saccular aneurysms and 3 fusiform aneurysms. Three aneurysms were located in the proximal segment of AICA (the junction of AICA and basilar artery, 3 premeatal segment (first bifurcation of AICA, 3 meatal and 4 postmeatal. The mean diameter was 3.90 mm. Three patients with 4 aneurysms were treated with microsurgery, of which clipping was carried out in 2 patients with 3 aneurysms and trapping in 1 case. Other 9 patients were treated with endovascular therapy, of which 2 cases underwent coil embolization, 3 stent-assisted coil, and 4 parent artery occlusion (PAO. Postoperative complications included facial paralysis (1 case, dysphagia and coughing when drinking (1 case and contralateral hemianopia in both eyes (1 case. Follow-up was available in all of these cases for a mean of 36.41 months, with GOS scores 3 in 1 case, 4 in 2 cases and 5 in 9

  13. Giant vertebral artery aneurysm in a child treated with endovascular parent artery occlusion and coil embolization

    OpenAIRE

    Hun-Soo Park; Ichiro Nakagawa; Takeshi Wada; Hiroyuki Nakagawa; Yasuo Hironaka; Kimihiko Kichikawa; Hiroyuki Nakase

    2014-01-01

    Background: Intracranial giant vertebral artery aneurysms are extremely rare in the pediatric population and are associated with significant morbidity and mortality. The present report describes a case of a pediatric patient with giant vertebral artery aneurysm who presented with intracranial mass effect. This patient was successfully treated with endovascular parent artery occlusion and coil embolization. Case Description: A 7-year-old girl presented with tetraparesis, ataxia, dysphagia,...

  14. Endovascular treatment of aneurysm of splenic artery arising from splenomesentric trunk using stent graft

    Energy Technology Data Exchange (ETDEWEB)

    Kulkami, Chinmay Bhimaji; Moorthy Srikanth; Pullara Sreekumar Karumathil; Kannan, Rajesh Ramaih [Department of Radiology, Amrita Institute of Medical Sciences, Amrita Lane (India)

    2013-12-15

    We report a rare case of aneurysm of splenic artery arising anomalously from the superior mesenteric artery (SMA). The aneurysm was treated successfully by coil embolization of the splenic artery distal to aneurysm and then deploying a stent graft in the SMA. A combination of stent graft and coil embolization for the treatment of aberrant splenic artery aneurysm has been reported only once. We describe the imaging findings and the endovascular procedure in this patient.

  15. Posterior spinal artery aneurysm rupture after 'Ecstasy' abuse.

    Science.gov (United States)

    Johnson, Jeremiah; Patel, Shnehal; Saraf-Lavi, Efrat; Aziz-Sultan, Mohammad Ali; Yavagal, Dileep R

    2015-07-01

    Posterior spinal artery (PSA) aneurysms are a rare cause of subarachnoid hemorrhage (SAH). The commonly abused street drug 3,4-methylenedioxymethamphetamine (MDMA) or 'Ecstasy' has been linked to both systemic and neurological complications. A teenager presented with neck stiffness, headaches and nausea after ingesting 'Ecstasy'. A brain CT was negative for SAH but a CT angiogram suggested cerebral vasculitis. A lumbar puncture showed SAH but a cerebral angiogram was negative. After a spinal MR angiogram identified abnormalities on the dorsal surface of the cervical spinal cord, a spinal angiogram demonstrated a left PSA 2 mm fusiform aneurysm. The patient underwent surgery and the aneurysmal portion of the PSA was excised without postoperative neurological sequelae. 'Ecstasy' can lead to neurovascular inflammation, intracranial hemorrhage, SAH and potentially even de novo aneurysm formation and subsequent rupture. PSA aneurysms may be treated by endovascular proximal vessel occlusion or open surgical excision.

  16. Aneurysmal Bone Cyst: An Uncommon Secondary Event in Calcaneal Chondroblastoma.

    Science.gov (United States)

    Barman, Sandip; Diwaker, Preeti; Bansal, Divya; Wadhwa, Neelam; Singh, Gurvinder

    2016-06-01

    Chondroblastoma is an uncommon benign bone tumour, involvement of epiphysis of long bones is typical. Chondroblastoma of the calcaneum is uncommon and its association with secondary aneurysmal bone cyst is even rarer. Only two cases of calcaneal chondroblastoma associated with secondary aneurysmal bone cyst have been reported till date. A 22-year-old male presented to the department of orthopaedics with complains of pain and swelling in the left heel since the last 10 months. On clinico-radiological grounds differentials considered were giant cell tumour of bone and aneurysmal bone cyst. In view of the histopathological findings of bone curettage and results of special stain and immunohistochemical marker, final diagnosis of chondroblastoma with secondary aneurysmal bone cyst, left calcaneum was rendered. Although rare, chondroblastoma should always be considered in osteolytic lesions of calcaneum. The identification of secondary aneurysmal bone cyst component is important as it has higher chances of recurrence than usual chondroblastoma. PMID:27504302

  17. Aneurysmal Bone Cyst: An Uncommon Secondary Event in Calcaneal Chondroblastoma.

    Science.gov (United States)

    Barman, Sandip; Diwaker, Preeti; Bansal, Divya; Wadhwa, Neelam; Singh, Gurvinder

    2016-06-01

    Chondroblastoma is an uncommon benign bone tumour, involvement of epiphysis of long bones is typical. Chondroblastoma of the calcaneum is uncommon and its association with secondary aneurysmal bone cyst is even rarer. Only two cases of calcaneal chondroblastoma associated with secondary aneurysmal bone cyst have been reported till date. A 22-year-old male presented to the department of orthopaedics with complains of pain and swelling in the left heel since the last 10 months. On clinico-radiological grounds differentials considered were giant cell tumour of bone and aneurysmal bone cyst. In view of the histopathological findings of bone curettage and results of special stain and immunohistochemical marker, final diagnosis of chondroblastoma with secondary aneurysmal bone cyst, left calcaneum was rendered. Although rare, chondroblastoma should always be considered in osteolytic lesions of calcaneum. The identification of secondary aneurysmal bone cyst component is important as it has higher chances of recurrence than usual chondroblastoma.

  18. Nursing experience in clinical endovascular treatment for renal artery aneurysms

    International Nuclear Information System (INIS)

    Objective: To discuss the standardized clinical nursing measures for patients receiving endovascular treatment of renal artery aneurysms. Methods: The clinical data of 9 patients with renal artery aneurysm, who were admitted to authors' hospital during the period from Jan. 2010 to Aug. 2011 and received endovascular treatment, were retrospectively analyzed. The related nursing points as well as the received endovascular. Results: A total of 9 cases with renal artery aneurysm were treated nursing measures were summarized. Results: A total of 9 cases with renal artery aneurysm were with interventional management, including embolization (n = 6), stent implantation (n = 2) and stent implantation together with coil embolization (n = 1). The mean hospitalization time was (10±2) days. Postoperative retention of urine was observed in one patient and postoperative retroperitoneal hemorrhage occurred in another patient. Neither nursing-related nor operation-related complications occurred. Conclusion: Standardized perioperative nursing care for patients with renal artery aneurysm can surely help enhance the patient's tolerance to the surgery, and effectively prevent the complications. (authors)

  19. Pituitary Insufficiency and Hyperprolactinemia Associated with Giant Intra- and Suprasellar Carotid Artery Aneurysm

    Directory of Open Access Journals (Sweden)

    A. Gungor

    2015-01-01

    Full Text Available Pituitary insufficiency secondary to internal carotid artery (ICA aneurysm is a very rare condition. Its prevalence is reported as 0.17% (Heshmati et al., 2001. We present a case of pituitary insufficiency and hyperprolactinemia secondary to suprasellar giant intracranial aneurysm. A 71-year-old man was admitted to our clinic with symptoms of hypopituitarism, hyperprolactinemia, and visual field defect. His pituitary MRI and cerebral angiography revealed a giant saccular aneurysm filling suprasellar cistern arising from the ophthalmic segment of the right ICA. Endovascular treatment was performed on the patient to decrease the mass effect of aneurysm and improve the hypophysis dysfunction. After treatment, his one-year follow-up showed the persistence of hypophysis insufficiency, decrease of prolactin (PRL level, and normal visual field. An intracranial aneurysm can mimic the appearance and behavior of a pituitary adenoma. Intracranial aneurysms should be taken into consideration in the situation of hypopituitarism and hyperprolactinemia. It is important to distinguish them because their treatment approach is different from the others.

  20. The multidetector computed tomography angiography (MDCTA) in the diagnosis of splenic artery aneurysm and pseudoaneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Mallarini, Giorgio (Dept. of Radiology, Azienda Ospedaliero Universitaria (AOU), Cagliari (Italy)), email: lucasaba@tiscali.it; Anzidei, Michele; Lucatelli, Pierleone (Dept. of Radiological Sciences, Univ. of Rome La Sapienza, Rome (Italy))

    2011-06-15

    Splenic artery aneurysm is the most frequent visceral artery aneurysm and rupture of the aneurysm is associated with a high mortality rate. It is important to discriminate between a true aneurysm and a pseudoaneurysm that may be caused by pancreatitis, iatrogenic and postoperative causes, trauma and peptic ulcer disease. Multidetector-row CT angiography (MDCTA) allows detailed visualization of the vascular anatomy and may allow identification of aneurysms and pseudoaneurysms that affect the splenic artery. The objective of this article is to provide a review of the general characteristics of splenic artery aneurysms and pseudoaneurysms and to describe the findings of MDCTA

  1. Resolution of third nerve palsy despite persistent aneurysmal mass effect after flow diversion embolization of posterior communicating artery aneurysms.

    Science.gov (United States)

    Binyamin, Tamar R; Dahlin, Brian C; Waldau, Ben

    2016-09-01

    Posterior communicating artery (PCOM) aneurysms may cause third nerve palsies. The optimal treatment with clipping versus coiling remains controversial. Here we report on two cases of resolution of third nerve palsy after flow diversion embolization of large and giant PCOM aneurysms without adjuvant coil placement. The resolution of third nerve palsy was not preceded by significant shrinkage of the aneurysmal sac on MRI. However, one patient showed resolution of T2-weighted signal abnormalities in the midbrain and mesial temporal lobe despite a similar size of the aneurysm. Therefore, flow diversion embolization of a PCOM aneurysm may resolve oculomotor nerve palsies through decreasing arterial pulsations against the nerve or midbrain. PMID:27183957

  2. Clipping Surgery for Unruptured Middle Cerebral Artery Aneurysms.

    Science.gov (United States)

    Nakagomi, Tadayoshi; Furuya, Kazuhide; Tanaka, Junichi; Takanashi, Shigehiko; Watanabe, Takehiro; Shinohara, Takayuki; Ogawa, Akiko; Fujii, Norio

    2016-01-01

    Clipping surgeries for 139 consecutive unruptured middle cerebral aneurysms were performed between April 1991 and March 2014. Left hemiparesis occurred in one case (0.7 %). Transient symptoms arose in six patients due to perforator injury, arterial branch occlusion, damage to the venous system, or chronic subdural hematoma. Neither mortality nor decline in cognitive function was noted in this study. Clipping surgery for unruptured middle cerebral artery aneurysms can be done with minimal morbidity. However, meticulous management during the perioperative period as well as the use of modern technologies during the surgery, such as MEP monitoring and ICG videoangiography, are needed for safe and secure clipping surgery. PMID:27637633

  3. Surgical repair of an aberrant splenic artery aneurysm: report of a case.

    Science.gov (United States)

    Illuminati, Giulio; LaMuraglia, Glenn; Nigri, Giuseppe; Vietri, Francesco

    2007-03-01

    Aneurysms of the splenic artery are the most common splanchnic aneurysms. Aneurysms of a splenic artery with an anomalous origin from the superior mesenteric artery are however rare, with eight previously reported cases. Their indications for treatment are superposable to those of aneurysms affecting an orthotopic artery. Methods of treatment of this condition include endovascular, minimally invasive techniques and surgical resection. We report one more case of aneurysm of an aberrant splenic artery, treated with surgical resection, and preservation of the spleen. PMID:17349366

  4. Post-traumatic hepatic artery pseudo-aneurysm combined with subphrenic liver abscess treated with embolization

    Institute of Scientific and Technical Information of China (English)

    Long Sun; Yong-Song Guan; Hua Wu; Wei-Min Pan; Xiao Li; Qing He; Yuan Liu

    2006-01-01

    A 23-year-old man with post-traumatic hepatic artery pseudo-aneurysm and subphrenic liver abscess was admitted. He underwent coil embolization of hepatic artery pseudo-aneurysm. The pseudo-aneurysm was successfully obstructed and subphrenic liver abscess was controlled. Super-selective trans-catheter coil embolization may represent an effective treatment for hepatic artery pseudo-aneurysm combined with subphrenic liver abscess in the absence of other therapeutic alternatives.

  5. Surgical options for the management of visceral artery aneurysms.

    Science.gov (United States)

    Van Petersen, A; Meerwaldt, R; Geelkerken, R; Zeebregts, C

    2011-06-01

    Visceral artery aneurysm (VAA) is a rare entity but increased use of abdominal imaging has led to an increased prevalence. Rupture is related to a high mortality rate. Open repair, endovascular treatment and laparoscopic techniques have been described as treatment options. In this systematic review we describe the surgical options for treating VAA. A literature search identified articles focussing on the key issues of visceral artery aneurysms and surgical options using the Pubmed and Cochrane databases. Case reports dominate the literature about VAA. Twenty-seven small case series and ten review articles have been published in the last 20 years concerning the surgical options for VAA. The evidence does not exceed level 3. Surgical treatment is dictated by both patient and aneurysm characteristics. Whether VAA should be treated largely depends upon age, gender, presence of hypertension (e.g. in renal aneurysm), aneurysm size and presentation. Aneurysm size and characteristics, anatomical location and presence of collateral circulation dictate the surgical option to be chosen. The mortality and morbidity rates after elective open repair are low. Literature about surgical options for treating VAA remains scarce. Only a few clinical trials have shown the possibilities and results of open surgical repair. In general, there is no consensus on the surgical treatment of VAA and the highest level of evidence is based upon expert opinions.

  6. Computational analysis of anterior communicating artery aneurysm shear stress before and after aneurysm formation

    Science.gov (United States)

    Castro, Marcelo A.; Putman, Christopher M.; Cebral, Juan R.

    2011-12-01

    It is widely accepted that complexity in the flow pattern at the anterior communicating artery (AComA) is associated with the high rate of aneurysm formation at that location observed in large studies. The purpose of this work is to study associations between hemodynamic patterns, and AComA aneurysm initiation by comparing hemodynamics in the aneurysm and the normal model where the aneurysm was computationally removed. Vascular models of both right and left circulation were independently reconstructed from three-dimensional rotational angiography images using deformable models after image registration of both images, and fused using a surface merging algorithm. The geometric models were then used to generate high-quality volumetric finite element grids of tetrahedra with an advancing front technique. For each patient, the second anatomical model was created by digitally removing the aneurysm. It was iteratively achieved by applying a Laplacian smoothing filter and remeshing the surface. Finite element blood flow numerical simulations were performed for both the pathological and normal models under the same personalized pulsatile flow conditions imposed at the inlets of both models. The Navier-Stokes equations were numerically integrated by using a finite-element formulation. It was observed that aneurysms initiated in regions of high and moderate WSS in the counterpart normal models. Adjacent or close to those regions, low WSS portions of the arterial wall were not affected by the disease. These results are in line with previous observations at other vascular locations.

  7. Simulation of Aorta Artery Aneurysms Using Active Electronic Circuit

    Directory of Open Access Journals (Sweden)

    Kamran Hassani

    2007-01-01

    Full Text Available The fusiform and saccular aneurysms in different aorta artery sections were studied using an electronic circuit of cardiovascular system. The geometrical model of each artery section including thoracic and abdominal were generated in accordance with original anatomical data. By increasing the rate of aneurysm in each studied section, the pressure drop were calculated using CFD method, furthermore the compliance variations due to aneurysms were determined by mathematical method. The equivalent electronic circuit was then used to study the effects of the pressure drops and compliance variations on whole cardiovascular system. The results of the simulation exhibited the features of the pathology, including hypertension, the increase of the pulse pressure with the rate of aneurysm and the large magnitude of back flow during systole. Finally, the obtained results were compared with relevant clinical data .We have concluded from the study that aorta aneurysms in both fusiform and saccular, especially at highest diameters, may be the most important determinant of the artery rapture and heart failure.

  8. Calcaneal chondroblastoma with secondary aneurysmal bone cyst: a case report.

    Science.gov (United States)

    Guedes, Alex; Barreto, Bruno; Soares Barreto, Lara Grimaldi; Athanazio, Daniel A; Athanazio, Paulo R F

    2010-01-01

    We present a case of destructive chondroblastoma associated with secondary aneurysmal bone cyst involving the left calcaneus. Because of the extensive destruction of the calcaneus, total calcanectomy was the treatment of choice. PMID:20350821

  9. Calcaneal chondroblastoma with secondary aneurysmal bone cyst: a case report.

    Science.gov (United States)

    Guedes, Alex; Barreto, Bruno; Soares Barreto, Lara Grimaldi; Athanazio, Daniel A; Athanazio, Paulo R F

    2010-01-01

    We present a case of destructive chondroblastoma associated with secondary aneurysmal bone cyst involving the left calcaneus. Because of the extensive destruction of the calcaneus, total calcanectomy was the treatment of choice.

  10. Atherosclerotic Aneurysm of the Basilar Artery and Hydrocephalus. A Case Report

    Directory of Open Access Journals (Sweden)

    Ania Alvarado Borges

    2014-08-01

    Full Text Available Intracranial aneurysms are fairly common. Many of them produce no symptoms, often remaining undiagnosed during life. At autopsy, aneurysms of the basilar artery appear in 2 to 5% of the cases; among them, saccular and congenital aneurysms are more common than atherosclerotic and fusiform aneurysms. A case of atherosclerotic aneurysm of the basilar artery diagnosed at autopsy in an 88-year-old man is presented. This patient had been admitted with a diagnosis of ischemic stroke, intracranial hypertension and hydrocephalus, which led physicians to consider a posterior fossa tumor. This paper aims at presenting the autopsy findings that showed the presence of an atherosclerotic aneurysm of the basilar artery.

  11. False-negative indocyanine green videoangiography among complex unruptured middle cerebral artery aneurysms: the importance of further aneurysm inspection.

    Science.gov (United States)

    Kulwin, Charles; Cohen-Gadol, Aaron A

    2014-10-01

    Successful surgical treatment of cerebral aneurysms requires complete occlusion of the aneurysm lumen while maintaining patency of the adjacent branching and perforating arteries. Intraoperative flow assessment allows aneurysm clip repositioning in the event these requirements are not met, avoiding the risk of postoperative rehemorrhage or infarction. A number of modalities have been proposed for primarily intraoperative qualitative blood flow assessment, including microdoppler ultrasonography, intraoperative digital subtraction angiography (DSA), and more recently noninvasive fluorescent angiography including indocyanine green (ICG) fluorescent imaging. Puncture of the aneurysm dome to exclude aneurysm sac filling may also assess the efficacy of clip placement. Although a high concordance between ICG and DSA has been reported, there remains an important subset of aneurysms for which negative ICG study may erroneously suggest aneurysm occlusion. A high-risk situation for such a false-negative study is an atherosclerotic middle cerebral artery (MCA) aneurysm in which vessel wall plaque interferes with the ICG signal. Furthermore, a decreased flow within the aneurysm may not allow enough emission light for detection under the current technology. In this report, we describe our experience with cases of MCA aneurysms with false-negative ICG-VA studies requiring clip adjustment for optimal surgical treatment and discuss two illustrative cases of MCA aneurysms with intraoperative fluorescence studies that were falsely negative, requiring puncture of the aneurysm to correctly identify incomplete aneurysm occlusion. PMID:24552255

  12. Morphological and hemodynamic analysis of mirror posterior communicating artery aneurysms.

    Directory of Open Access Journals (Sweden)

    Jinyu Xu

    Full Text Available BACKGROUND AND PURPOSE: Hemodynamic factors are commonly believed to play an important role in the pathogenesis, progression, and rupture of cerebral aneurysms. In this study, we aimed to identify significant hemodynamic and morphological parameters that discriminate intracranial aneurysm rupture status using 3-dimensional-angiography and computational fluid dynamics technology. MATERIALS AND METHODS: 3D-DSA was performed in 8 patients with mirror posterior communicating artery aneurysms (Pcom-MANs. Each pair was divided into ruptured and unruptured groups. Five morphological and three hemodynamic parameters were evaluated for significance with respect to rupture. RESULTS: The normalized mean wall shear stress (WSS of the aneurysm sac in the ruptured group was significantly lower than that in the unruptured group (0.52±0.20 versus 0.81±0.21, P = .012. The percentage of the low WSS area in the ruptured group was higher than that in the unruptured group (4.11±4.66% versus 0.02±0.06%, P = .018. The AR was 1.04±0.21 in the ruptured group, which was significantly higher than 0.70±0.17 in the unruptured group (P = .012. By contrast, parameters that had no significant differences between the two groups were OSI (P = .674, aneurysm size (P = .327, size ratio (P = .779, vessel angle (P = 1.000 and aneurysm inclination angle (P = 1.000. CONCLUSIONS: Pcom-MANs may be a useful disease model to investigate possible causes of aneurysm rupture. The ruptured aneurysms manifested lower WSS, higher percentage of low WSS area, and higher AR, compared with the unruptured one. And hemodynamics is as important as morphology in discriminating aneurysm rupture status.

  13. [Ruptured Internal Carotid Artery Aneurysm Coiling in a Patient with Ipsilateral Internal Carotid Artery Occlusion via the Posterior Communicating Artery].

    Science.gov (United States)

    Ashida, Noriaki; Saitoh, Minoru; Fujita, Atsushi; Kohmura, Eiji

    2016-09-01

    Background:De novo aneurysms after internal carotid artery(ICA)occlusion occur in the contralateral ICA or anterior communicating artery. Hemodynamic changes with increased blood flow to the contralateral carotid circulation were considered the main factor for the formation of these aneurysms. We report a rare case of ruptured ICA aneurysm associated with ipsilateral ICA occlusion treated with coil embolization via the vertebrobasilar and posterior communicating arteries. Case Presentation:An 82-year-old woman presented with sudden-onset disturbance of consciousness at our outpatient clinic and went into cardiopulmonary arrest. Computed tomography(CT)performed after cardiopulmonary resuscitation revealed diffuse subarachnoid hemorrhage. Three-dimensional CT angiography revealed a right ICA aneurysm associated with the ipsilateral ICA occlusion. Considering that the patient showed clinical improvement with the critical care for neurogenic pulmonary edema, the aneurysm was treated with endovascular coil embolization via the posterior communicating artery. With this technique, complete obliteration was attained without perioperative complication. Conclusion:Endovascular coil embolization via the posterior communicating artery was proven effective as a treatment method for ruptured ICA aneurysms with ipsilateral ICA occlusion. Hemodynamic stress due to increased blood flow in the posterior communicating artery may play an important role in the growth and rupture of ICA aneurysms. PMID:27605482

  14. Renal artery aneurysm in a hypertensive child treated by percutaneous coil embolization

    International Nuclear Information System (INIS)

    A 16-year-old boy was admitted to our hospital with uncontrolled hypertension. A left renal artery aneurysm was detected on colour Doppler US and CT. Renal arteriography demonstrated the aneurysm and focal renal parenchymal areas of decreased perfusion. The renal artery aneurysm was successfully treated by transcatheter coil embolization. (orig.)

  15. Blood transfusion requirement in surgery for femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1997-01-01

    Audit of blood usage in various surgical specialities have shown that over-ordering of blood is widespread, causing unnecessary pressure on the transfusion facilities and giving growing concern over the expense of cross-matching blood. The aim of this study was to assess the blood transfusion req...... requirement in patients undergoing surgery for femoral artery aneurysms....

  16. Aneurysm flow characteristics in realistic carotid artery aneurysm models induced by proximal virtual stenotic plaques: a computational hemodynamics study

    Science.gov (United States)

    Castro, Marcelo A.; Peloc, Nora L.; Chien, Aichi; Goldberg, Ezequiel; Putman, Christopher M.; Cebral, Juan R.

    2015-03-01

    Cerebral aneurysms may rarely coexist with a proximal artery stenosis. In that small percent of patients, such coexistence poses a challenge for interventional neuroradiologists and neurosurgeons to make the best treatment decision. According to previous studies, the incidence of cerebral aneurysms in patients with internal carotid artery stenosis is no greater than five percent, where the aneurysm is usually incidentally detected, being about two percent for aneurysms and stenoses in the same cerebral circulation. Those cases pose a difficult management decision for the physician. Case reports showed patients who died due to aneurysm rupture months after endarterectomy but before aneurysm clipping, while others did not show any change in the aneurysm after plaque removal, having optimum outcome after aneurysm coiling. The aim of this study is to investigate the intra-aneurysmal hemodynamic changes before and after treatment of stenotic plaque. Virtually created moderate stenoses in vascular models of internal carotid artery aneurysm patients were considered in a number of cases reconstructed from three dimensional rotational angiography images. The strategy to create those plaques was based on parameters analyzed in a previous work where idealized models were considered, including relative distance and stenosis grade. Ipsilateral and contralateral plaques were modeled. Wall shear stress and velocity pattern were computed from finite element pulsatile blood flow simulations. The results may suggest that wall shear stress changes depend on relative angular position between the aneurysm and the plaque.

  17. Role of TGF beta signaling in Remodeling of Non-Coronary Artery Aneurysms in Kawasaki disease /

    OpenAIRE

    Lee, Aaron Ming

    2014-01-01

    Coronary artery aneurysms remain a life-threatening complication of Kawasaki disease (KD), the most common form of pediatric acquired heart disease in developed countries (1). Potentially life-threatening coronary artery aneurysms (CAA) develop in 25% of untreated children and 5% of children treated with high dose intravenous immunoglobulin during the acute phase of the self-limited vasculitis (2). Non-coronary artery aneurysms (NCAA) in extra-parenchymal, muscular arteries occur in a minorit...

  18. Endovascular coil embolization in internal carotid artery bifurcation aneurysms

    International Nuclear Information System (INIS)

    Aim: To present the clinical and radiological results of coil embolization in internal carotid artery (ICA) bifurcation aneurysms (BA). Materials and methods: The records of 65 patients with 66 ICA BA were retrieved from data prospectively accrued between September 1999 and July 2013. Clinical and morphological outcomes of the aneurysms were assessed, including technical aspects of treatment. Results: The aneurysms under study were directed either superiorly (41/66, 62.1%), anteriorly (24/66, 36.4%), or posteriorly (1/66, 1.5%), and all were devoid of perforators. Aneurysmal necks were situated symmetrically at the terminal ICA (37/66, 56.1%) or slightly deviated to the proximal A1 segment (29/66, 43.9%). The steam-shaped S microcatheter (73.8%) was most commonly used to select the aneurysms, and the single microcatheter technique was most commonly applied (56.1%) to perform coil embolization, followed by balloon remodelling (21.2%), multiple microcatheter (15.1%), and stent-protection (7.6%). Successful aneurysmal occlusion was achieved in 100% of cases, with no procedure-related morbidity or mortality. Imaging performed in the course of follow-up (mean duration 27.3 months) confirmed stable occlusion of most lesions (47/53, 88.7%). Conclusion: Through tailored technical strategies, ICA BA are amenable to safe and effective endovascular coil embolization, with a tendency for stable occlusion long-term

  19. Acute retroperitoneal bleeding due to inferior mesenteric artery aneurysm: Case report

    Directory of Open Access Journals (Sweden)

    Ferrón JA

    2010-06-01

    Full Text Available Abstract Background Visceral artery aneurysms (VAA, although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm associated with stenosis of the superior mesenteric artery (SMA and celiac trunk, successfully treated with surgery. Methods A 65-year-old man presented with abdominal pain and hypovolemic shock. Abdominal CT scan showed an aneurysm of the inferior mesenteric artery with retroperitoneal hematoma. In addition, an obstructive disease of the superior mesenteric artery and celiac axis was observed. Results Upon emergency laparotomy a ruptured inferior mesenteric artery aneurysm was detected. The aneurysm was excised and the artery reconstructed by end-to-end anastomosis. Conclusions This report discusses the etiology, presentation, diagnosis and case management of inferior mesenteric artery aneurysms.

  20. Bilateral hypoplasia of the internal carotid arteries with basilar aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Briganti, F.; Tortora, F.; Elefante, A. [Universita di Napoli Federico II, Dipartimento di Scienze Neurologiche, Cattedra di Neuroradiologia, 80131, Napoli (Italy); Maiuri, F. [Universita di Napoli Federico II, Department of Neurological Sciences, Neurosurgery Service, Napoli (Italy)

    2004-10-01

    We report a rare case of bilateral hypoplasia of the internal carotid arteries with an associated aneurysm of the basilar tip, studied by CT angiography, MR angiography and digital angiography. The patient became symptomatic with an episode of loss of consciousness, likely due to reduced blood perfusion. The other 20 reported cases of bilateral carotid hypoplasia (only four of which with an associated aneurysm) are reviewed. The findings of noninvasive procedures (including narrowing of the carotid canals on CT) may lead to a correct diagnosis before angiography is performed; they may also help to differentiate angiographic narrowing of the hypoplastic internal carotids from the string sign often observed in some acquired conditions. (orig.)

  1. Pericallosal lipoma and middle cerebral artery aneurysm: a coincidence?

    Energy Technology Data Exchange (ETDEWEB)

    Sommet, Julie; Schiff, Manuel; Evrard, Philippe [Hopital Robert Debre, APHP, Department of Paediatric Neurology and Metabolic Diseases, Paris Cedex 19 (France); Blanc, Raphael [Fondation Rothschild, Department of Interventional Radiology, Paris (France); Elmaleh-Berges, Monique [Hopital Robert Debre, Department of Paediatric Radiology, Paris (France)

    2010-08-15

    Intracranial lipomas are rare congenital malformations that can often be seen in association with other brain malformations; agenesis or dysgenesis of the corpus callosum is the most frequently associated brain anomaly. They are usually pericallosal asymptomatic midline lesions. Intracranial lipomas associated with a non-contiguous cerebral aneurysm are extremely rare. We report an infant with partial agenesis of the corpus callosum and pericallosal lipoma associated with cerebral haemorrhage due to a distal middle cerebral artery aneurysm. Such an association is probably not fortuitous and could suggest a pathogenic relationship. (orig.)

  2. Pericallosal lipoma and middle cerebral artery aneurysm: a coincidence?

    International Nuclear Information System (INIS)

    Intracranial lipomas are rare congenital malformations that can often be seen in association with other brain malformations; agenesis or dysgenesis of the corpus callosum is the most frequently associated brain anomaly. They are usually pericallosal asymptomatic midline lesions. Intracranial lipomas associated with a non-contiguous cerebral aneurysm are extremely rare. We report an infant with partial agenesis of the corpus callosum and pericallosal lipoma associated with cerebral haemorrhage due to a distal middle cerebral artery aneurysm. Such an association is probably not fortuitous and could suggest a pathogenic relationship. (orig.)

  3. Percutaneous treatment of a ruptured superior mesenteric artery aneurysm in a child

    International Nuclear Information System (INIS)

    Splanchnic artery aneurysms are very rare in children. We report a 10-year-old girl with a large atraumatic ruptured superior mesenteric artery aneurysm that was considered inoperable. She was ultimately treated with two percutaneous US-guided thrombin injections, which led to complete occlusion of the aneurysm. The aetiology of the aneurysm remained unclear, but a family history was suggestive of a congenital connective tissue disease such as Ehlers-Danlos syndrome subtype IV. (orig.)

  4. Percutaneous treatment of a ruptured superior mesenteric artery aneurysm in a child

    Energy Technology Data Exchange (ETDEWEB)

    Oechsle, Susanne; Vollert, Kurt; Buecklein, Wolfgang; Michl, Wolfgang; Roemer, Frank W. [Klinikum Augsburg, Department of Radiology, Augsburg (Germany)

    2006-03-15

    Splanchnic artery aneurysms are very rare in children. We report a 10-year-old girl with a large atraumatic ruptured superior mesenteric artery aneurysm that was considered inoperable. She was ultimately treated with two percutaneous US-guided thrombin injections, which led to complete occlusion of the aneurysm. The aetiology of the aneurysm remained unclear, but a family history was suggestive of a congenital connective tissue disease such as Ehlers-Danlos syndrome subtype IV. (orig.)

  5. Fusiform aneurysm of a persistent trigeminal artery associated with rare intracranial arterial variations and subarachnoid hemorrhage.

    Science.gov (United States)

    Kimball, David; Ples, Horia; Kimball, Heather; Miclaus, Gratian D; Matusz, Petru; Loukas, Marios

    2015-01-01

    The trigeminal artery is one of four primitive anastomoses between the internal carotid artery and vertebrobasilar system that regresses in the sixth week of fetal development. A persistent trigeminal artery (PTA) is generally an incidental finding but may also be associated with intracranial vascular pathologies such as aneurysms, arteriovenous malformations, and cranial nerve compression syndromes. We present an extremely rare case of a right PTA with an associated bleeding fusiform aneurysm located in the carotidian (lateral) part of the PTA. In addition, this rare anatomic variation was associated with bilateral absence of the posterior communicating arteries, a left posterior cerebral artery originating from the left internal carotid artery, and agenesis of the A1 segment of the left anterior cerebral artery. PMID:25053265

  6. Mycotic aneurysm of the posterior tibial artery – a rare complication of bacterial endocarditis: a case report

    Directory of Open Access Journals (Sweden)

    Patel S

    2008-11-01

    Full Text Available Abstract Introduction Distal arterial embolisation and subsequent aneurysm formation are rare occurrences and most are secondary to trauma. We have found no case reports that describe posterior tibial aneurysm formation secondary to bacterial endocarditis. Case presentation We report the case of a 47-year-old Caucasian man who, 2 years after an episode of subacute bacterial endocarditis, presented with signs and symptoms consistent with posterior tibial aneurysm formation. Conclusion Posterior tibial aneurysm formation is a rare occurrence, most commonly occurring after trauma and, although other causes have been described, to our knowledge, endocarditis has not been implicated before, and as such should therefore be borne in mind when dealing with cases where no obvious aetiology is evident.

  7. Splenic artery aneurysms in liver transplant patients

    NARCIS (Netherlands)

    Kobori, L; de Jong, KP; Peeters, PMJG; Klompmaker, IJ; Kok, T; Haagsma, EB; Slooff, MJH

    1997-01-01

    Background/Aims: The purpose of the study was to investigate the incidence of Methods: Medical records and the pre- and 1-year postoperative angiograms of 337 liver transplant patients were reviewed to assess the presence and characteristics of these aneurysms. Results: Forty-five patients with aneu

  8. Aneurysms of the P2P Segment of Posterior Cerebral Artery: Case Report and Surgical Steps

    Directory of Open Access Journals (Sweden)

    Paulo Aguiar

    2014-01-01

    Full Text Available The posterior cerebral artery (PCA is divided into 4 segments: precommunicating segment (P1, postcommunicating segment (P2, quadrigeminal segment (P3, and calcarine segment (P4. Small aneurysms are more prevalent than large aneurysms in patients with ruptured aneurysms. P2 and P3 aneurysms are usually managed by the subtemporal approach. This is a case report of rupture saccular aneurysm of posterior cerebral artery on P2P segment. The authors show the surgical steps of these rare aneurysms with an illustrative case.

  9. Endovascular treatment of large and giant ophthalmic aneurysms with preservation of parent artery

    International Nuclear Information System (INIS)

    Objective: To evaluate the endovascular embolization treatment of large and giant ophthalmic aneurysms. Methods: Three aneurysms were embolized with coils only and 5 aneurysms were treated with stent placement together with subsequent coiling. Results: In the 3 aneurysms treated only with GDC, total embolization was achieved in 1 and partial embolization in 2. In the stent placement and coiling case, 4 aneurysms were densely packed and another one was partially packed. Conclusions: Combined stenting and coiling is effective and safe for the treatment of large and giant ophthalmic artery aneurysm with the preservation of parent artery

  10. [Incidentally detected bronchial artery aneurysm with combined operation for mitral regurgitation;report of a case].

    Science.gov (United States)

    Sato, Hisashi; Oteki, Hitoshi; Naito, Kozo; Yunoki, Junji

    2015-02-01

    A 77-year-old woman was admitted to the hospital for heart failure with orthopnea. Echocardiography revealed massive mitral regurgitation. During preoperative cardiac catheterization, an aneurysm was indentified incidentally just below the tracheal carina. Three dimensional computed tomography showed three bronchial artery aneurysms behind the pulmonary artery and the left atrium. The proximal aneurysm was the largest and was 22 mm in diameter. It was resected by retracting the ascending aorta to the left, the superior vana cava to the right and right pulmonary artery cranially under cardiopulmonary bypass, and mitral valve plasty was performed. We believed that resection of the proximal aneurysm would cause thrombotic occlusion of the other 2 aneurysms. Bronchial artery aneurysm is a rare entity that is observed in fewer than 1% of those who undergo selective bronchial arteriography. In addition, because bronchial artery aneurysm is a potentially life-threatening lesion, it should be treated promptly when diagnosed.

  11. [Pediatric case of congenital coronary artery fistula; surgical result and late changes in coronary artery aneurysm].

    Science.gov (United States)

    Sugawara, Masaaki; Oguma, Fumiaki; Hirahara, Hiroyuki

    2014-07-01

    Congenital coronary artery fistula is an uncommon heart anomaly involving the coronary arteries. We report here a case of a 4-year-old boy who had a coronary fistula from the right coronary artery to the right ventricle, with a coronary aneurysm. He was asymptomatic, but the calculated ratio of pulmonary blood flow to systemic blood flow was shown to be high [pulmonary flow (Qp)/systemic flow(Qs)=1.78]. The coronary angiography showed that the right coronary artery was dilated beginning at the ostium and had an aneurysm at the acute marginal portion. A large spherical aneurysm approximately 20 mm in diameter was found to have been connected with coronary fistula opening into the right ventricle. Surgical repair by closure of the fistula under direct vision, partial resection and suture closure of the aneurysm was performed. Plication of the proximal portion of the right coronary artery was not performed, and the diffusely dilated artery was left untouched. After this operation, he recovered well under anticoagulant treatment with warfarin and aspirin. Postoperative angiography was performed 17 months after the surgery to evaluate morphological changes in the coronary artery. The angiography confirmed the closure of the fistula and the regression of coronary artery dilatation.

  12. Mycotic aneurysm of the left subclavian artery presenting as mediastinal abscess: case report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jae Kweong; Jeong, Hae Woong; Koo, Yong Woon [Marynoll Hospital, Pusan (Korea, Republic of)

    2002-11-01

    Mycotic aneurysms most commonly occur in femoral arteries or the abdominal aorta. Mycotic aneurysm arising from the left subclavian artery is very rare. The morbidity and mortality of ruptured mycotic aneurysms, regardless of their location, remain high despite the current practice of administering an intensive antibiotic regimen. We encountered a case of mycotic aneurysm presenting as mediastinal abscess and arising from in the left subclavian artery. Therefore, we report this case with radiologic findings to remind readers of the possibility of this unusual location of mycotic aneurysm.

  13. A traumatic superficial temporal artery aneurysm after a bicycle accident.

    Science.gov (United States)

    Veen, Egbert J D; Poelmann, Floris B; IJpma, Frank F A

    2014-01-01

    A male cyclist presented with a swelling on the forehead. Six weeks before, he fell of his bike and smashed his head on the ground while wearing a helmet. A smooth lump of 1 cm had evolved on the temporal side of his forehead in a few weeks. Duplex ultrasonography demonstrated a dilated vessel with a minor defect in the luminal wall. Surgical exploration revealed an aneurysm of the superficial temporal artery (STA). The aneurysm was surgically removed and the patient recovered uneventfully. Owing to its superficial course, the STA is vulnerable to blunt head trauma. Traumatic aneurysms of the STA should be a differential diagnostic consideration in patients with a history of trauma and a swelling on their head. PMID:25352578

  14. A traumatic superficial temporal artery aneurysm after a bicycle accident

    Science.gov (United States)

    Veen, Egbert J.D.; Poelmann, Floris B.; IJpma, Frank F.A.

    2014-01-01

    A male cyclist presented with a swelling on the forehead. Six weeks before, he fell of his bike and smashed his head on the ground while wearing a helmet. A smooth lump of 1 cm had evolved on the temporal side of his forehead in a few weeks. Duplex ultrasonography demonstrated a dilated vessel with a minor defect in the luminal wall. Surgical exploration revealed an aneurysm of the superficial temporal artery (STA). The aneurysm was surgically removed and the patient recovered uneventfully. Owing to its superficial course, the STA is vulnerable to blunt head trauma. Traumatic aneurysms of the STA should be a differential diagnostic consideration in patients with a history of trauma and a swelling on their head. PMID:25352578

  15. A Rare Case of Aneurysm of Arc of Riolan Artery and Gastroduodenal Artery

    OpenAIRE

    Athiyappan Kumaresh; Ramachandran Rajoo; Sellappan Rajamanickam Babu; Subramanian Ilanchezhian

    2014-01-01

    Arc of Riolan is a collateral channel that connects the proximal superior mesenteric artery (SMA) or its middle colic branch and the proximal inferior mesenteric artery or its left colic branch in case of stenosis of either of the arteries. A 65-year-old diabetic female presented with vague abdominal pain. Ultrasonography showed a large aneurysm within the abdomen in the left lumbar region. Computed tomography (CT) angiography done showed severe diffuse atherosclerotic calcification of the ab...

  16. Giant saccular aneurysm of the left main coronary artery

    Institute of Scientific and Technical Information of China (English)

    Esref Tuncer; Ugur Onsel Turk; Emin Alioglu

    2013-01-01

    uniform definition of this pathology. Aneurysms of the left main coronary artery (LMCA) are extremely uncommon, with an incidence of 0.1%. It has been demonstrated that atherosclerosis is the main cause of these anomalies in adults, and Kawasaki disease in children and adolescents. Other causes include connective tissue disorders, trauma, vasculitis, congenital, mycotic, and idiopathic. These dilated sections of the coronary artery are not benign pathology because they are subject to spasm, thrombosis, and subsequent distal embolism, spontaneous dissection and rupture. Treatment options include anticoagulation, custom-made covered stents, reconstruction, resection, and exclusion with bypass. Our report on an old case illustrates the giant saccular LMCA aneurysm leading to myocardial ischemia due to coronary steal phenomenon.

  17. Balloon-assisted coil embolization of a posterior cerebral artery aneurysm via a persistent primitive trigeminal artery: technical note

    Energy Technology Data Exchange (ETDEWEB)

    Schlamann, Marc; Doerfler, Arnd; Forsting, Michael; Wanke, Isabel [University of Essen Medical School, Department of Neuroradiology, Institute of Diagnostic and Interventional Radiology, Essen (Germany); Schoch, Beate [University of Essen Medical School, Department of Neurosurgery, Essen (Germany)

    2006-12-15

    We present a patient with an acutely ruptured, wide-necked aneurysm of the left posterior cerebral artery (PCA) treated with Guglielmi detachable coils using the remodeling technique. Since the left vertebral artery was compressed due to a tumor in the cerebellopontine angle and the right vertebral artery was hypoplastic, we used a carotid artery approach via a persistent primitive trigeminal artery (PPTA) to selectively catheterize the aneurysm. The aneurysm was occluded completely. To our knowledge this is the first case of a wide-necked PCA aneurysm treated via a PPTA and using the remodeling technique. In patients with hypoplastic vertebral arteries and a PPTA, this approach may represent an alternative for selective embolization of posterior circulation aneurysms not amenable to the conventional approach. (orig.)

  18. A Rare Case of Aneurysm of Arc of Riolan Artery and Gastroduodenal Artery

    Directory of Open Access Journals (Sweden)

    Athiyappan Kumaresh

    2014-01-01

    Full Text Available Arc of Riolan is a collateral channel that connects the proximal superior mesenteric artery (SMA or its middle colic branch and the proximal inferior mesenteric artery or its left colic branch in case of stenosis of either of the arteries. A 65-year-old diabetic female presented with vague abdominal pain. Ultrasonography showed a large aneurysm within the abdomen in the left lumbar region. Computed tomography (CT angiography done showed severe diffuse atherosclerotic calcification of the abdominal aorta with complete occlusion of the celiac trunk and mild stenosis of SMA origin. The arc of Riolan was seen between the middle colic artery and the ascending branch of the left colic artery, with a large saccular aneurysm in its mid section. No evidence of rupture or hematoma was visible. Another saccular aneurysm was also seen involving the gastro-duodenal and the pancreatico-duodenal collateral arcade. As far as we know, this is the first case of arc of Riolan artery aneurysm to be reported in English literature.

  19. Extracranial Vertebral Artery Aneurysm Presenting as a Chronic Cervical Mass Lesion

    Directory of Open Access Journals (Sweden)

    Lampis C. Stavrinou

    2010-01-01

    Full Text Available Background. Aneurysms of the extracranial vertebral artery are rare and can provide a diagnostic and therapeutic challenge. Methods. We reviewed the clinical history of a patient presenting with cervical radiculopathy, who harboured an extracranial vertebral artery aneurysm eroding the cervical spine. Results. CT Angiography and MR Angiography set the diagnosis, by revealing a left C5-C6 vertebral artery aneurysm with cervical root impingement. Bony reconstruction depicted enlargement of the C6 transverse foramen and a marked enlargement of the C6-C7 intravertebral foramen. The lesion was treated by intravascular proximal vertebral artery occlusion. Conclusions. Extracranial vertebral artery aneurysms require a high index of clinical suspicion. This is the first report of a vertebral artery pseudoaneurysm presenting with bony erosion, which supports a less minacious portrayal of vertebral artery aneurysms.

  20. Management strategy for bilateral complex vertebral artery aneurysms.

    Science.gov (United States)

    Saito, Norihiro; Kamiyama, Hiroyasu; Takizawa, Katsumi; Takebayashi, Seiji; Asano, Takeshi; Kobayashi, Tohru; Kobayashi, Rina; Kubota, Shunsuke; Ito, Yasuhiro; Karagiozov, Kostadin L

    2016-04-01

    Bilateral complex vertebral artery aneurysms (BCoVAAns) have no established strategy of management. We retrospectively reviewed five consecutive patients with unruptured BCoVAAns between January 2006 and December 2012. Considering surgical risks of lower cranial nerve (LCN) injuries and eventual growth of an opposite side lesion after unilateral vertebral artery (VA) occlusion, we proposed a strategy of combined open and interventional treatment using revascularization. We applied the following several specific techniques: (1) proximal clipping and occipital artery-posterior inferior cerebellar artery (OA-PICA) and/or superficial temporary artery (STA)-superior cerebellar artery (SCA) bypasses; (2) Distal blood pressure, motor evoked potentials (MEPs), and somatosensory evoked potentials (SEPs) monitoring after parent artery temporary occlusion for safe permanent occlusion of the proximal portions of VA and PICA; (3) V3 to V4 bypass using radial artery (RA) graft with proximal clipping or trapping, two of them combined with OA-PICA bypass; (4) VA fenestration as an opportunity to preserve the flow of the parent artery. Two patients were treated bilaterally and 3 unilaterally, with modified Rankin scale assessed at 39 months postoperatively in average 0 in 2, 1 in 2, and 2 in 1, respectively, and the untreated opposite side lesions without regrowth or bleeding. Two patients with patent V3-RA-V4 bypass complained of dysphagia due to LCN palsies. One of them however suffered a cerebellar infarction due to occlusion of the OA-PICA bypass. When BCoVAAns require surgical treatment, revascularization or preservation of the VA should be considered at the first operation. By doing so, the opposite aneurysm can be effectively occluded by coil embolization, even with VA sacrifice if required. PMID:26564148

  1. Surgical clipping as the preferred treatment for aneurysms of the middle cerebral artery

    NARCIS (Netherlands)

    van Dijk, J. Marc C.; Groen, Rob J. M.; Ter Laan, Mark; Jeltema, Johanna Rinck; Mooij, Jan Jacob A.; Metzemaekers, Jan D. M.

    2011-01-01

    In recent years the endovascular treatment of intracranial aneurysms (coiling) has progressively gained recognition, particularly after the publication of the International Subarachnoid Aneurysm Trial (ISAT) in 2002. Despite the fact that in ISAT middle cerebral artery (MCA) aneurysms were clearly u

  2. Management of Giant Splenic Artery Aneurysm: Comprehensive Literature Review.

    Science.gov (United States)

    Akbulut, Sami; Otan, Emrah

    2015-07-01

    To provide an overview of the medical literature on giant splenic artery aneurysm (SAA).The PubMed, Medline, Google Scholar, and Google databases were searched using keywords to identify articles related to SAA. Keywords used were splenic artery aneurysm, giant splenic artery aneuryms, huge splenic artery aneurysm, splenic artery aneurysm rupture, and visceral artery aneurysm. SAAs with a diameter ≥5 cm are considered as giant and included in this study. The language of the publication was not a limitation criterion, and publications dated before January 15, 2015 were considered.The literature review included 69 papers (62 fulltext, 6 abstract, 1 nonavailable) on giant SAA. A sum of 78 patients (50 males, 28 females) involved in the study with an age range of 27-87 years (mean ± SD: 55.8 ± 14.0 years). Age range for male was 30-87 (mean ± SD: 57.5 ± 12.0 years) and for female was 27-84 (mean ± SD: 52.7 ± 16.6 years). Most frequent predisposing factors were acute or chronic pancreatitis, atherosclerosis, hypertension, and cirrhosis. Aneurysm dimensions were obtained for 77 patients with a range of 50-300 mm (mean ± SD: 97.1 ± 46.0 mm). Aneurysm dimension range for females was 50-210 mm (mean ± SD: 97.5 ± 40.2 mm) and for males was 50-300 mm (mean ± SD: 96.9 ± 48.9 mm). Intraperitoneal/retroperitoneal rupture was present in 15, among which with a lesion dimension range of 50-180 mm (mean ± SD; 100 ± 49.3 mm) which was range of 50-300 mm (mean ± SD: 96.3 ± 45.2 mm) in cases without rupture. Mortality for rupture patients was 33.3%. Other frequent complications were gastrosplenic fistula (n = 3), colosplenic fistula (n = 1), pancreatic fistula (n = 1), splenic arteriovenous fistula (n = 3), and portosplenic fistula (n = 1). Eight of the patients died in early postoperative period while 67 survived. Survival status of the remaining 3 patients is

  3. Giant, thrombosed, sellar-suprasellar internal carotid artery aneurysm with persistent, primitive trigeminal artery causing hypopituitarism.

    Science.gov (United States)

    Tungaria, Arun; Kumar, Vijendra; Garg, Pallav; Jaiswal, Awadhesh K; Behari, Sanjay

    2011-05-01

    A rare case of a giant, thrombosed, sellar-suprasellar paraclinoid internal carotid artery (ICA) aneurysm with persistent primitive trigeminal artery (PPTA) causing hypopituitarism that manifested as hypogonadism, hypothyroidism, and hypocortisolism is reported. There were no visual/neurological deficits, diabetes insipidus, or episodes of subarachnoid hemorrhage. The alteration in the flow dynamics of the circle of Willis due to the presence of PPTA may have been responsible for both the genesis of the giant aneurysm as well as for the induction of thrombogenesis within its lumen. As the digital subtraction angiogram showed complete thrombosis within the aneurysm and hormonal replacement therapy was effective in ensuring complete normalization of symptoms, the patient was unwilling to undergo surgical clipping of the aneurysm and removal of the suprasellar clot in an attempt to restore pituitary functions. Hypopituitarism recurred when the patient stopped her hormonal supplementation therapy after 7 years, and she again became symptom-free on restarting the therapy. To the best of the authors' knowledge, this represents the first reported case in the literature of hypopituitarism consequent to a giant, thrombosed, sellar-suprasellar ICA aneurysm with an associated PPTA on the side of the aneurysm. PMID:21234615

  4. Treatment of a pediatric recurrent fusiform middle cerebral artery (MCA) aneurysm with a flow diverter.

    Science.gov (United States)

    Burrows, Anthony M; Zipfel, Gregory; Lanzino, Giuseppe

    2013-11-01

    Pediatric patients with aneurysm often have different localizations and morphologies from adults and recurrences are not uncommon after successful clip reconstruction/obliteration. Treatment of a recurrent pediatric aneurysm after clip ligation is a technical challenge. We present the case of an adolescent with a middle cerebral artery (MCA) fusiform aneurysm which recurred following clip reconstruction and bypass. The aneurysm was successfully treated with endovascular flow diversion.

  5. Treatment of a pediatric recurrent fusiform middle cerebral artery (MCA) aneurysm with a flow diverter

    OpenAIRE

    Burrows, Anthony M; Zipfel, Gregory; Lanzino, Giuseppe

    2012-01-01

    Pediatric patients with aneurysm often have different localizations and morphologies from adults and recurrences are not uncommon after successful clip reconstruction/obliteration. Treatment of a recurrent pediatric aneurysm after clip ligation is a technical challenge. We present the case of an adolescent with a middle cerebral artery (MCA) fusiform aneurysm which recurred following clip reconstruction and bypass. The aneurysm was successfully treated with endovascular flow diversion.

  6. Progressive Deconstruction of a Distal Posterior Cerebral Artery Aneurysm Using Competitive Flow Diversion.

    Science.gov (United States)

    Johnson, Andrew K; Tan, Lee A; Lopes, Demetrius K; Moftakhar, Roham

    2016-03-01

    Progressive deconstruction is an endovascular technique for aneurysm treatment that utilizes flow diverting stents to promote progressive thrombosis by diverting blood flow away from the aneurysm's parent vessel. While the aneurysm thromboses, collateral blood vessels develop over time to avoid infarction that can often accompany acute parent vessel occlusion. We report a 37-year-old woman with a left distal posterior cerebral artery aneurysm that was successfully treated with this strategy. The concept and rationale of progressive deconstruction are discussed in detail.

  7. Spontaneous Thrombosis in Giant Aneurysm of the Anterior Communicating Artery Complex in Pediatric Age: Five-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Vítor M. Gonçalves

    2014-01-01

    Full Text Available Intracranial aneurysms are rare in the pediatric population, especially in infancy, representing less than 1% of all aneurysms. In this age group, they are more frequent at the carotid bifurcation and in the posterior circulation, with a greater number of giant aneurysms and spontaneous aneurysm thrombosis when compared with the adults. They are life-threatening, and, therefore, early investigation, characterization of the lesion, and treatment are essential. The appropriate management depends on the child’s condition, aneurysm characteristics, and the experience of a multidisciplinary team. Noninvasive and radiation-free imagiological studies play an important role in the diagnosis and follow-up of these young patients. We present the case of a 3-month-old boy with an intracranial hemorrhage secondary to the rupture of a giant aneurysm of the anterior communicating artery complex, with spontaneous thrombosis, which is a rare situation due to its location. A conservative approach was assumed and noninvasive evolutive imagiological studies revealed a reduction in the thrombosed aneurysm size and no signs of recanalization. The child recovered to his baseline neurological condition and has had no rehemorrhage until 5 years of follow-up.

  8. Spontaneous thrombosis in giant aneurysm of the anterior communicating artery complex in pediatric age: five-year follow-up.

    Science.gov (United States)

    Gonçalves, Vítor M; Cristino, N; Cunha E Sá, M

    2014-01-01

    Intracranial aneurysms are rare in the pediatric population, especially in infancy, representing less than 1% of all aneurysms. In this age group, they are more frequent at the carotid bifurcation and in the posterior circulation, with a greater number of giant aneurysms and spontaneous aneurysm thrombosis when compared with the adults. They are life-threatening, and, therefore, early investigation, characterization of the lesion, and treatment are essential. The appropriate management depends on the child's condition, aneurysm characteristics, and the experience of a multidisciplinary team. Noninvasive and radiation-free imagiological studies play an important role in the diagnosis and follow-up of these young patients. We present the case of a 3-month-old boy with an intracranial hemorrhage secondary to the rupture of a giant aneurysm of the anterior communicating artery complex, with spontaneous thrombosis, which is a rare situation due to its location. A conservative approach was assumed and noninvasive evolutive imagiological studies revealed a reduction in the thrombosed aneurysm size and no signs of recanalization. The child recovered to his baseline neurological condition and has had no rehemorrhage until 5 years of follow-up.

  9. Giant Serpentine Internal Carotid Artery Aneurysm: Endovascular Parent Artery Occlusion: A Pediatric Case Report

    OpenAIRE

    Prochazka, V.; Chmelova, J.; Cizek, V.; Skoloudik, D.; Hrbac, T.

    2007-01-01

    We report on a case of a 14-year-old boy with a giant serpentine aneurysm of the left internal carotid artery cavernous segment with symptoms of acute mass-effect cranial nerve dysfunction. After a balloon occlusion test of the collateral circulation, the patient underwent parent artery occlusion with platinum Guglielmi detachable coils and fibered coils. An optimal angiographic result and successful clinical outcome were achieved with resolution of IIIrd, IVth and Vlth cranial nerve ischemic...

  10. Is it renal colic or ruptured dissecting aneurysm of renal artery?: A case report

    OpenAIRE

    Marwah, Sanjay; Singla, Sham; Kalra, Rajnish; Marwah, Nisha; Singh, Shashi Pratap

    2009-01-01

    Introduction The dissecting aneurysm of renal artery is a form of renal artery occlusive disease that is infrequently recognized in the literature. However, when encountered, it is of great clinical significance because symptoms related to aneurysm are rarely seen and there is risk of its rupture. Case Presentation The present case was a 30 year old Indian male, who presented with recurrent episodes of pain mimicking renal colic, which turned out to be a ruptured dissecting aneurysm of renal ...

  11. Mycotic aneurysm of abdominal aorta causing the right renal arterial stenosis: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Ran; Kim, Jang Ho [Fatima Hospital, Daegu (Korea, Republic of)

    2003-10-01

    Mycotic aneurysm of the abdominal aorta is a rare disease. Despite intensive antibiotic therapy, rupture leads to a high mortality rate, so early diagnosis and treatment is very important. Rupture is the most common complication of abdominal aortic aneurysm, while renal artery stenosis is very rare. We report the radiologic findings of mycotic aneurysm of the suprarenal abdominal aorta leading to right renal artery stenosis induced by mass effect and renovascular hypertension.

  12. A mycotic pulmonary artery aneurysm associated with candida endocarditis: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Jin Il; Lee, Ji Won; Jeong, Yeon Joo; Song, Seung Hwan [Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of)

    2014-03-15

    We report a case of a mycotic pulmonary aneurysm associated with Candida endocarditis in a 53-year-old male with lymphoma. The initial diagnosis was a pulmonary artery aneurysm attributable to vasculitis, such as that associated with Behcet's disease, but a mycotic pulmonary artery aneurysm was later considered as a differential diagnosis. Identification of valve vegetation on the chest CT was helpful in this regard. We review the literature on the disease etiology, radiological findings, and management options.

  13. A mycotic pulmonary artery aneurysm associated with candida endocarditis: Case report

    International Nuclear Information System (INIS)

    We report a case of a mycotic pulmonary aneurysm associated with Candida endocarditis in a 53-year-old male with lymphoma. The initial diagnosis was a pulmonary artery aneurysm attributable to vasculitis, such as that associated with Behcet's disease, but a mycotic pulmonary artery aneurysm was later considered as a differential diagnosis. Identification of valve vegetation on the chest CT was helpful in this regard. We review the literature on the disease etiology, radiological findings, and management options.

  14. Endovascular treatment of ectopic bronchial artery aneurysm with brachiocephalic artery stent placement and coil embolization

    Science.gov (United States)

    Di, Xiao; Ji, Dong-Hua; Chen, Yu; Liu, Chang-Wei; Liu, Bao; Yang, Juan

    2016-01-01

    Abstract Background: Bronchial artery aneurysm (BAA) is an uncommon but potentially life-threatening disease, and multiple BAAs are even rarer. Clinically, the tortuous and short neck of a BAA may present significant challenges for invasive intervention. Methods: This report describes the detailed process of diagnosis and treatment and includes a literature review of the etiology, clinical presentation, and therapeutic management of BAA. Results: A rare case of multiple BAAs, with one having an inflow artery arising from the brachiocephalic trunk, was referred to our hospital. The patient was successfully treated with coil embolization and brachiocephalic artery stent placement. In addition, we conducted a literature review involving 63 cases of BAA. BAA was most commonly associated with bronchiectasis and was located predominantly in the mediastinum. There was no significant difference between the diameters of the ruptured aneurysms and those of the nonruptured aneurysms (P = 0.115). Transcatheter arterial embolization was the most commonly adopted technique to treat BAA, while thoracic aortic endovascular repair was selected if the neck between the aneurysm and the aorta was short. Subgroup analysis suggested that patients with > 1 BAA were significantly more likely to be female than male (χ2 test, P = 0.034). Conclusion: Transcatheter coil embolization combined with stent placement could be a reasonable treatment option for BAAs with a tortuous and short neck. According to our literature review, patients with multiple BAAs display distinctive clinical characteristics compared with patients with a single BAA. PMID:27583854

  15. CT finding of ruptured splenic artery aneurysm after cesarean section : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Chang Woo; Kim, Hee Jin [CHA Medical College, Pundang CHA Gerneral Hospital Sungnam, (Korea, Republic of)

    2000-03-01

    Spontaneous rupture of a splenic artery aneurysm during puerperium is rare and is due to the non-specific clinical appearance, diagnosis is difficult. We describe a case of spontaneous rupture of splenic artery aneurysm after a Cesarean section. CT showed high-density ascites localized in the lesser sac and left retroperitoneum.

  16. Surgical Treatment of A Dissecting Aneurysm of the Superior Cerebellar Artery: Case Report

    Directory of Open Access Journals (Sweden)

    Stefanescu Florin

    2014-10-01

    Full Text Available Dissecting aneurysm located in the peripheral region of the superior cerebellar artery is very rare. There is little experience regarding their surgical or endovascular treatment. We present the case of a peripheral dissecting superior cerebellar artery aneurysm treated by surgical clipping.

  17. Constipation following bilateral of internal iliac artery aneurysms

    Directory of Open Access Journals (Sweden)

    S Morita

    2012-09-01

    Full Text Available A 72-year-old man presented with constipation. He was hypertensive and suffered from chronic constipation. On arrival, the patient was fully conscious, and his vital signs were stable. He requested an enema because this treatment had proved effective in the past. On physical examination, a hard palpable mass was detected in the lower abdomen. Computed tomography was performed with contrast media. It revealed an abdominal aortic aneurysm (AAA and bilateral internal iliac artery aneurysms (IIAAs; the latter obstructing the sigmoid colon. We believe that this obstruction was the cause of constipation. The patient underwent Y-graft replacement for the treatment of the AAA and bilateral IIAAs. The surgery was successful, and constipation has not recurred since. As constipation is the most common digestive disorder in the general population, all physicians should be aware that chronic constipation can be caused by bilateral IIAAs.

  18. Ruptured aneurysm of the hepatic artery: a mismatching diagnosis

    Directory of Open Access Journals (Sweden)

    Vincenzo Bua

    2013-04-01

    Full Text Available Background: Hepatic aneurysms are extremely rare with very few cases reported, and most have been source of misdiagnosis and clinical pitfalls in emergency medicine. Presentation with intraabdominal hemorrhage is associated with a high mortality rate. Case report: We report the case of an adult male, referred for a severe acute pain in the left lower chest-upper quadrant abdomen pain. We present multislice contrast-enhanced CT-scanning and angiographic findings, and a life-saving emergency trancatheter embolization, using fragments of absorbable gelatin sponge. Emergency doctors should consider ruptured hepatic artery aneurysms in the differential diagnosis of acute abdominal pain and promptly cooperate with endovascular specialists to treat this life-threatening condition.

  19. Endovascular Management of True Renal Arterial Aneurysms: Results from a Single Centre

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Raymond, E-mail: chung.raymond.jh@alexandrahealth.com.sg [Khoo Teck Puat Hospital, Department of Radiology (Singapore); Touska, Philip, E-mail: p.touska@doctors.org.uk [St. George’s Hospital NHS Trust, Department of Radiology (United Kingdom); Morgan, Robert; Belli, Anna-Maria [St. George’s Hospital NHS Trust, Department of Interventional Radiology (United Kingdom)

    2016-01-15

    PurposeTo report a single centre’s experience of the endovascular treatment of renal arterial aneurysms, including techniques and outcomes.Materials and MethodsThis is a retrospective analysis of true renal arterial aneurysms (TRAAs) treated using endovascular techniques over a period of 12 years and 10 months. The clinical presentations, aneurysm characteristics, endovascular techniques and outcomes are reported.ResultsThere were nine TRAA cases with a mean aneurysm size of 21.0 mm, located at the main renal arterial bifurcation in all cases. Onyx{sup ®} was used as the embolic agent of choice (88.9 % cases), with concurrent balloon remodelling. The overall primary technical success rate was 100 %. Repeat intervention was carried out in 1 case, secondary to reperfusion >8 years post-initial treatment. Long-term clinical follow-up was available in 55.6 % of cases (mean 29.8 months; range 3.3–90.1 months). Early post-procedural renal function, as measured by serum creatinine, remained within the normal reference range. Renal parenchymal loss post-embolisation was ≤20 % in 77.8 % of cases, as estimated on imaging. Minor complications included non-target embolization of Onyx{sup ®} with no clinical sequelae (n = 1), transient pain requiring only oral analgesia with no prolongation of hospital stay (n = 2). No major complications occurred as a consequence of embolisation.ConclusionEndovascular therapy is an effective and safe primary therapy for TRAA with high success rate and low morbidity, supplanting surgery as primary therapy. Current experience in the use of Onyx{sup ®} in TRAA is primarily limited to individual case reports, and this represents the largest case series of Onyx{sup ®}-treated TRAAs to date.

  20. Microsurgical subtemporal approach to aneurysms on the P 2 segment of the posterior cerebral artery

    Directory of Open Access Journals (Sweden)

    Zhitao Jing

    2010-01-01

    Full Text Available Background: Aneurysms arising from the P 2 segment of the posterior cerebral artery (PCA are rare, accounting for less than 1% of all intracranial aneurysms. To date, few studies concerning the management of P 2 segment aneurysms have been reported. Objective: To review the microsurgical techniques and clinical outcomes of microsurgical treatment by different approaches in patients with aneurysms on the P 2 segment of the PCA. Materials and Methods: Forty-two patients with P2 segment aneurysms had microsurgical treatment by subtemporal approach. All the patients had drainage of cerebrospinal fluid for decompression, and indocyanine green (ICG angiography was used in 20 patients to assess the effect of clipping. Results: Of the 42 patients, 16 were operated by combined pterional-subtemporal approach. In 40 patients aneurysms were successfully treated by clipping the P 2 aneurysmal neck while preserving the parent artery. Two patients with giant aneurysms were treated using surgical trapping. Postoperatively, 41 patients had a good recovery. One patient after aneurysm trapping had ischemic infarction in the PCA tertiary and presented with hemiparesis and homonymous hemianopia. However, this patient recovered after three weeks of treatment. Conclusion: Subtemporal approach is the most appropriate approach to clip the aneurysms of the P 2 segment. It allows the neurosurgeon to operate on the aneurysms while preserving the patency of the parent artery. Gaint P 2 segment aneurysms can safely be treated by rapping of the aneurysm by combined subtemporal or pterional-subtemporal approach in experienced hands.ICG angiography will be an important tool in monitoring for the presence of residual aneurysm or perforating artery occlusion during aneurysm clipping. Preoperative lumbar drainage of cerebrospinal fluid may help to avoid temporal lobe damage.

  1. From arteritis to mycotic aneurysm: visualization of the progression of mycotic aneurysm development following femoral arterial line insertion in an infant

    Energy Technology Data Exchange (ETDEWEB)

    Beck-Razi, Nira [Israel Institute of Technology, Department of Medical Imaging, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Rambam Medical Center, Department of Medical Imaging, Haifa (Israel); Bar-Joseph, Gad [Israel Institute of Technology, Pediatric Critical Care Unit, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Ofer, Amos; Gaitini, Diana [Israel Institute of Technology, Department of Medical Imaging, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Hoffman, Aharon [Israel Institute of Technology, Department of Vascular Surgery, Rambam Health Care Center, The Rappaport Faculty of Medicine, Technion, Haifa (Israel)

    2010-12-15

    Although uncommon, mycotic aneurysms in infants can be lethal because of the high risk of rapid expansion and rupture. Most catheter-associated mycotic aneurysms reported in the first year of life develop following umbilical artery catheterizations. We describe the sonographic detection of an early stage mycotic aneurysm in a 4-month-old following femoral artery catheterization complicated by methicillin-resistant Staphylococcus aureus (MRSA) septicemia. We also describe the sonographic and radiographic progression of this mycotic aneurysm before surgery. (orig.)

  2. From arteritis to mycotic aneurysm: visualization of the progression of mycotic aneurysm development following femoral arterial line insertion in an infant

    International Nuclear Information System (INIS)

    Although uncommon, mycotic aneurysms in infants can be lethal because of the high risk of rapid expansion and rupture. Most catheter-associated mycotic aneurysms reported in the first year of life develop following umbilical artery catheterizations. We describe the sonographic detection of an early stage mycotic aneurysm in a 4-month-old following femoral artery catheterization complicated by methicillin-resistant Staphylococcus aureus (MRSA) septicemia. We also describe the sonographic and radiographic progression of this mycotic aneurysm before surgery. (orig.)

  3. Persistent Sciatic Artery Aneurysm with Lower Limb Ischemia

    Directory of Open Access Journals (Sweden)

    Gaurav Kesri

    2014-01-01

    Full Text Available Persistent sciatic artery is a very rare clinical entity. Those of us who have not seen the lesion regard this as a condition which is described in the literature through less than 200 cases. We report, here, a case of a 60-year-old female who presented to the surgical outdoor with complaints of a pulsatile gluteal swelling associated with ischemic changes in the ipsilateral lower limb. On Doppler and CT angiographic analysis, the patient was determined as having persistent sciatic artery aneurysm which was then managed by a combined surgical and endovascular approach. Ours is probably the first such case to be reported from India. The objective of this case report is to highlight the relevant embryology, the pathognomonic presenting features, the diagnostic dilemma, management, and complications associated with a case of persistent sciatic artery (PSA.

  4. Secondary aneurysmal bone cyst following chondroblastoma of the patella

    Directory of Open Access Journals (Sweden)

    Tomoyuki Kato

    2013-09-01

    Full Text Available Aneurysmal bone cyst (ABC is a rare benign cystic lesion of the bone that composes 1-2% of the entire bone tumors. Some are idiopathic, and some occur secondary to other tumors such as giant cell tumor and chondroblastoma. In this article, we report the clinical, radiographic, and histological findings of a secondary ABC following chondroblastoma of the patella with a review of the literature.

  5. Secondary aneurysmal bone cyst following chondroblastoma of the patella

    OpenAIRE

    Tomoyuki Kato; Michiro Susa; Robert Nakayama; Itsuo Watanabe; Keisuke Horiuchi; Yoshiaki Toyama; Hideo Morioka

    2013-01-01

    Aneurysmal bone cyst (ABC) is a rare benign cystic lesion of the bone that composes 1-2% of the entire bone tumors. Some are idiopathic, and some occur secondary to other tumors such as giant cell tumor and chondroblastoma. In this article, we report the clinical, radiographic, and histological findings of a secondary ABC following chondroblastoma of the patella with a review of the literature.

  6. Secondary aneurysmal bone cyst following chondroblastoma of the patella.

    Science.gov (United States)

    Tomoyuki, Kato; Susa, Michiro; Nakayama, Robert; Watanabe, Itsuo; Horiuchi, Keisuke; Toyama, Yoshiaki; Morioka, Hideo

    2013-01-01

    Aneurysmal bone cyst (ABC) is a rare benign cystic lesion of the bone that composes 1-2% of the entire bone tumors. Some are idiopathic, and some occur secondary to other tumors such as giant cell tumor and chondroblastoma. In this article, we report the clinical, radiographic, and histological findings of a secondary ABC following chondroblastoma of the patella with a review of the literature.

  7. A Case of Ruptured Aneurysm of the Proper Esophageal Artery with Symptomatic Mediastinal Hematoma.

    Science.gov (United States)

    Liu, Jiajia; Sato, Yusuke; Takahashi, Satoshi; Motoyama, Satoru; Yoshino, Kei; Sasaki, Tomohiko; Imai, Kazuhiro; Saito, Hajime; Minamiya, Yoshihiro

    2016-08-01

    Mediastinal aneurysms are rare but potentially life-threatening. Among these, bronchial artery aneurysms are most frequently reported, whereas up to now aneurysms of the proper esophageal artery had never been reported. A 69-year-old woman was referred to our hospital for treatment of a massive mediastinal hematoma. Enhanced computed tomography and selective proper esophageal arteriography revealed a 5-mm aneurysm in the proper esophageal artery that arises from the thoracic aorta at the Th8 level and has an anastomotic branch with the bronchial artery peripherally. Transcatheter arterial embolization was successfully performed using a mixture of N-butyl cyanoacrylate and lipiodol (1:3 ratio, 0.3 ml). Post-embolization angiography showed no filling into the aneurysm. The patient recovered with no complications and was discharged on the 25th post-procedure day. PMID:27094689

  8. [Large distal anterior cerebral artery aneurysm associated with azygos anterior cerebral artery: case report].

    Science.gov (United States)

    Suzuki, Y; Kawamata, T; Matsumoto, H; Kunii, N; Matsumoto, K

    1998-10-01

    A 51-year-old woman presented with a distal anterior cerebral artery aneurysm (DACAA) manifesting as severe headache and monoparesis of the left lower limb. Computed tomography revealed subarachnoid hemorrhage in the interhemispheric fissure, bilateral sylvian fissures, and basal cistern, and a hematoma in the supracallosal region. Angiography showed a large aneurysm (23 x 18 mm) located on the distal end of the azygos anterior cerebral artery (azygos ACA) at the supracallosal portion. T2-weighted magnetic resonance imaging demonstrated the hematoma as a mixed intensity mass, compressing the corpus callosum downward, and the aneurysm as a flow void anterior to the hematoma. Unilateral frontoparietal parasagittal craniotomy was performed with a horse-shoe shaped incision. The aneurysm was clipped via the interhemispheric approach, and the hematoma was aspirated. Postoperative angiography showed disappearance of the aneurysm and intact azygos ACA. The patient was discharged with mild monoparesis, paresthesia of the left lower limb and diagnostic dyspraxia. DACAA almost always arises at or near the genu of the corpus callosum and is often associated with vascular anomaly. In the literature, 22 of 26 cases of large and giant DACAA were located at or near the genu, but only 3 cases, including ours, in the supracallosal area. 11 cases were associated with azygos ACA. Therefore, hemodynamic stress caused by vascular anomaly may be involved in the formation of large or giant DACAA in contrast with cases of normal DACAA. PMID:9789300

  9. Cine-CT diagnosis of coronary artery aneurysms in patients with Kawasaki

    International Nuclear Information System (INIS)

    Coronary artery aneurysms (CAA) are the most serious late sequelae of Kawasaki disease, and periodic screening examinations are necessary. Two-dimensional (2D) echocardiography represents the standard screening method; however, visualization of the distal coronary arteries is often limited. This report documents the complimentary role of cine-CT with 2D echocardiography in the evaluation of CAA induced by Kawasaki disease. Six pediatric patients with coronary aneurysms were evaluated with both 2D echocardiography and cine-CT. Cine-CT detected ten of 11 lesions. The one misdiagnosed CAA was one of the two contiguous aneurysms. Owing to intersection thickness, these two discrete aneurysms were interpreted as a solitary aneurysm. Cine-CT detected one CAA not initially visualized on echocardiography. Cine-CT is effective and complementary to 2D echocardigraphy as a noninvasive method for the evaluation of coronary artery aneurysms occurring as sequelae of Kawasaki disease

  10. Dual Stent-Assisted Coil Embolization for Fusiform Aneurysm Arising From Persistent Trigeminal Artery

    Science.gov (United States)

    John, Dickinson

    2016-01-01

    Aneurysms of the persistent trigeminal artery (PTA) trunk are exceptionally rare and have a high risk for rupture. Dual stent placement through each internal carotid and basilar artery for endovascular coil embolization of a fusiform aneurysm arising from the PTA has not been described in the literature. A 44-year-old female with a history of chronic headache was identified to have a fusiform aneurysm arising from medially coursing adult type, Saltzman type 3 PTA trunk. Sacrifice of the PTA trunk inclusive of the aneurysm was performed with dual stent placement through each basilar and internal carotid artery across their respective junctions with the PTA. Six-month follow-up angiography showed complete occlusion of the PTA and the aneurysm. The patient's symptoms resolved. Our case demonstrated that the sacrifice of an adult type, Saltzman type 3 PTA inclusive of an associated fusiform aneurysm is feasible with dual stent-assisted coil embolization. PMID:27621951

  11. Dual Stent-Assisted Coil Embolization for Fusiform Aneurysm Arising From Persistent Trigeminal Artery.

    Science.gov (United States)

    Ajeet, Gordhan; John, Dickinson

    2016-09-01

    Aneurysms of the persistent trigeminal artery (PTA) trunk are exceptionally rare and have a high risk for rupture. Dual stent placement through each internal carotid and basilar artery for endovascular coil embolization of a fusiform aneurysm arising from the PTA has not been described in the literature. A 44-year-old female with a history of chronic headache was identified to have a fusiform aneurysm arising from medially coursing adult type, Saltzman type 3 PTA trunk. Sacrifice of the PTA trunk inclusive of the aneurysm was performed with dual stent placement through each basilar and internal carotid artery across their respective junctions with the PTA. Six-month follow-up angiography showed complete occlusion of the PTA and the aneurysm. The patient's symptoms resolved. Our case demonstrated that the sacrifice of an adult type, Saltzman type 3 PTA inclusive of an associated fusiform aneurysm is feasible with dual stent-assisted coil embolization. PMID:27621951

  12. A Rare Case of Spontaneous True Aneurysm of the Occipital Artery

    OpenAIRE

    Kim, Hyung-Seok; Son, Byung-chul; Lee, Sang-Won; Kim, Il-Sup

    2010-01-01

    A 51-year-old man presented with a pulsatile scalp mass over the right occipital region, which had increased in size over the previous 1 month. He had no previous history of head trauma. Three-dimensional computed tomography (3D-CT) angiography of the brain revealed a 3.0 × 1.5 cm occipital artery aneurysm arising from the occipital artery. The occipital artery aneurysm was removed following the ligation of the proximal and distal portion of the occipital artery aneurysm. The histological dia...

  13. Posterior cerebral artery angle and the rupture of basilar tip aneurysms.

    Directory of Open Access Journals (Sweden)

    Allen L Ho

    Full Text Available Since the initial publication of the International Study of Unruptured Intracranial Aneurysms (ISUIA, management of unruptured intracranial aneurysms has been mainly based on the size of the aneurysm. The contribution of morphological characteristics to treatment decisions of unruptured aneurysms has not been well studied in a systematic and location specific manner. We present a large sample of basilar artery tip aneurysms (BTA that were assessed using a diverse array of morphological variables to determine the parameters associated with ruptured aneurysms. Demographic and clinical risk factors of aneurysm rupture were obtained from chart review. CT angiograms (CTA were evaluated with Slicer, an open source visualization and image analysis software, to generate 3-D models of the aneurysms and surrounding vascular architecture. Morphological parameters examined in each model included aneurysm volume, aspect ratio, size ratio, aneurysm angle, basilar vessel angle, basilar flow angle, and vessel to vessel angles. Univariate and multivariate analyses were performed to determine statistical significance. From 2008-2013, 54 patients with BTA aneurysms were evaluated in a single institution, and CTAs from 33 patients (15 ruptured, 18 unruptured were available and analyzed. Aneurysms that underwent reoperation, that were associated with arteriovenous malformations, or that lacked preoperative CTA were excluded. Multivariate logistic regression revealed that a larger angle between the posterior cerebral arteries (P1-P1 angle, p = 0.037 was most strongly associated with aneurysm rupture after adjusting for other morphological variables. In this location specific study of BTA aneurysms, the larger the angle formed between posterior cerebral arteries was found to be a new morphological parameter significantly associated with ruptured BTA aneurysms. This is a physically intuitive parameter that can be measured easily and readily applied in the clinical

  14. Deviation from optimal vascular caliber control at middle cerebral artery bifurcations harboring aneurysms.

    Science.gov (United States)

    Baharoglu, Merih I; Lauric, Alexandra; Wu, Chengyuan; Hippelheuser, James; Malek, Adel M

    2014-10-17

    Cerebral aneurysms form preferentially at arterial bifurcations. The vascular optimality principle (VOP) decrees that minimal energy loss across bifurcations requires optimal caliber control between radii of parent (r₀) and daughter branches (r1 and r2): r₀(n)=r₁(n)+r₂(n), with n approximating three. VOP entails constant wall shear stress (WSS), an endothelial phenotype regulator. We sought to determine if caliber control is maintained in aneurysmal intracranial bifurcations. Three-dimensional rotational angiographic volumes of 159 middle cerebral artery (MCA) bifurcations (62 aneurysmal) were processed using 3D gradient edge-detection filtering, enabling threshold-insensitive radius measurement. Radius ratio (RR)=r₀(3)/(r₁(3)+r₂(3)) and estimated junction exponent (n) were compared between aneurysmal and non-aneurysmal bifurcations using Student t-test and Wilcoxon rank-sum analysis. The results show that non-aneurysmal bifurcations display optimal caliber control with mean RR of 1.05 and median n of 2.84. In contrast, aneurysmal bifurcations had significantly lower RR (0.76, pbifurcations revealed a daughter branch larger than its parent vessel, an absolute violation of optimality, not witnessed in non-aneurysmal bifurcations. The aneurysms originated more often off the smaller daughter (52%) vs. larger daughter branch (16%). Aneurysm size was not statistically correlated to RR or n. Aneurysmal males showed higher deviation from VOP. Non-aneurysmal MCA bifurcations contralateral to aneurysmal ones showed optimal caliber control. Aneurysmal bifurcations, in contrast to non-aneurysmal counterparts, disobey the VOP and may exhibit dysregulation in WSS-mediated caliber control. The mechanism of this focal divergence from optimality may underlie aneurysm pathogenesis and requires further study.

  15. Expanding giant right coronary artery aneurysm: An acute need for new management strategies

    Directory of Open Access Journals (Sweden)

    Anurag Bajaj

    2014-01-01

    Full Text Available Angiography use has become increasingly common worldwide. Coronary artery aneurysm may be an incidental finding during angiography. Occasionally it might be symptomatic or may become symptomatic over the course of time. Rupture of aneurysm may lead to disastrous complications. Here we present a case in which aneurysm was asymptomatic but surgical intervention was done because of rapid increase in the size of aneurysm. This is to drive home the point that timely surgical intervention is instrumental in preventing complications associated with possible rupture of the aneurysm.

  16. Expanding giant right coronary artery aneurysm: an acute need for new management strategies.

    Science.gov (United States)

    Bajaj, Anurag; Sehgal, Vishal; Bajwa, Sukhminder Jit Singh; Sethi, Ankur; Pancholy, Samir B

    2014-01-01

    Angiography use has become increasingly common worldwide. Coronary artery aneurysm may be an incidental finding during angiography. Occasionally it might be symptomatic or may become symptomatic over the course of time. Rupture of aneurysm may lead to disastrous complications. Here we present a case in which aneurysm was asymptomatic but surgical intervention was done because of rapid increase in the size of aneurysm. This is to drive home the point that timely surgical intervention is instrumental in preventing complications associated with possible rupture of the aneurysm.

  17. ENDOVASCULAR TREATMENT OF SACCULAR CEREBRAL ANEURYSMS IN PATIENTS WITH PATHOLOGICAL KINKING AND LOOPING BRACHIOCEPHALIC ARTERIES IN ARTERIAL SPASM

    OpenAIRE

    Kuharuk, V.

    2013-01-01

    The objective — to analyses the results of endovascular treatment of cerebral aneurysm in patients with pathological kinking and looping in brachiocephalic arteries against the background of vasospasm. Materials and methods. The analysis of endovascular treatment of patients with saccular cerebral aneurysms was made in the neurosurgical department of Volyn Regional Hospital in 2008-2012. All patients that underwent various types of aneurysms and hemorrhage were operated by endovascular method...

  18. Bilateral True Giant Aneurysm of the Profunda Femoral Artery: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Alessandro Robaldo

    2012-01-01

    Full Text Available We report a rare case of a bilateral true giant aneurysm of the profunda femoral artery aneurysms (PFAAs in a 80-year-old man with a previous history of “open” abdominal aortic surgery and small bilateral popliteal artery aneurysm. In the English Literature only seven previously cases of true bilateral PFAAs are reported. Due to its location, this lesion may require surgical intervention and removal. The presentation, the diagnostic evaluation, and the surgical management of the aneurysm are discussed.

  19. Mycotic pulmonary artery aneurysm as an unusual complication of thoracic actinomycosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyung-Soo; Lee, Sang-Yeub [Wonkwang University College, Iksan (Korea, Republic of); Oh, Yu-Whan; Noh, Hyung-Jun; Lee, Ki-Yeol; Kang, Eun-Young [Korea University Hospital and Korea University College, Seoul (Korea, Republic of)

    2004-03-15

    Although pulmonary artery aneurysms are a rare vascular anomaly, they are seen in a wide variety of conditions, such as congenital heart disease, infection, trauma, pulmonary hypertension, cystic medial necrosis and generalized vasculitis. To our knowledge, mycotic aneurysms caused by pulmonary actinomycosis have not been reported in the radiologic literature. Herein, a case of pulmonary actinomycosis complicated by mycotic aneurysm is presented. On CT scans, this case showed focal aneurysmal dilatation of a peripheral pulmonary artery within necrotizing pneumonia of the right lower lobe, which was successfully treated with transcatheter embolization using wire coils.

  20. Role of TGF-β signaling in remodeling of noncoronary artery aneurysms in kawasaki disease

    OpenAIRE

    Lee, AM; Shimizu, C.; Oharaseki, T; K. Takahashi; Daniels, LB; Kahn, A.; Adamson, R.; Dembitsky, W; Gordon, JB; Burns, JC

    2015-01-01

    © 2015 Society for Pediatric Pathology. Coronary artery aneurysms (CAA) remain an important complication of Kawasaki disease (KD), the most common form of pediatric acquired heart disease in developed countries. Potentially life-threatening CAA develop in 25% of untreated children and 5% of children treated with highdose intravenous immunoglobulin during the acute phase of the self-limited vasculitis. Noncoronary artery aneurysms (NCAA) in extraparenchymal, muscular arteries occur in aminorit...

  1. A case of left main pulmonary artery aneurysm associated with valvular pulmonary stenosis in a child.

    Science.gov (United States)

    Lee, Ran; Son, Jae Sung; Park, Yong Mean

    2011-10-01

    Aneurysm of the main pulmonary artery is a rare clinical entity that can be congenital or acquired. Most cases occur in association with other congenital malformations, severe pulmonary hypertension, vasculitides, infectious agents, or collagen vascular disorders. We report here a pediatric case of left pulmonary artery aneurysm associated with valvular pulmonary stenosis and a hypoplastic right pulmonary artery, which we confirmed via multidetector computed tomography angiography.

  2. Resolution of trigeminal neuralgia by coil embolization of a persistent primitive trigeminal artery aneurysm

    OpenAIRE

    Ladner, Travis R; Ehtesham, Moneeb; Davis, Brandon J; Khan, Imad S; Ghiassi, Mayshan; Ghiassi, Mahan; Singer, Robert J

    2013-01-01

    The persistent primitive trigeminal artery (PTA) is a rare anastomosis between the carotid artery and basilar artery. While most PTAs are asymptomatic, lateral variants can occasionally compress the trigeminal nerve and precipitate trigeminal neuralgia. Aneurysms of the PTA are exceptionally rare in the literature and have not previously been associated with trigeminal neuralgia. We present the first case of an aneurysm of the PTA causing trigeminal neuralgia. The patient underwent coil embol...

  3. Coil embolization in precommunicating (A1) segment aneurysms of anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Dae; Ahn, Jun Hyong; Jung, Seung Chai; Kim, Chang Hun [Seoul National University Hospital, Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kang, Hyun-Seung; Kim, Jeong Eun [Seoul National University Hospital, Seoul National University College of Medicine, Department of Neurosurgery, 28 Yongon-dong, Jongno-gu, Seoul (Korea, Republic of); Son, Young Je [Seoul National University Boramae Hospital, Seoul National University College of Medicine, Department of Neurosurgery, Seoul (Korea, Republic of); Han, Moon Hee [Seoul National University Hospital, Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Hospital, Seoul National University College of Medicine, Department of Neurosurgery, 28 Yongon-dong, Jongno-gu, Seoul (Korea, Republic of)

    2014-03-15

    Precommunicating (A1) segment aneurysms of the anterior cerebral artery are rare and often pose technical challenges for coil embolization due to their distinctive configurations. Clinical and radiologic outcomes of treating such aneurysms through endovascular coil embolization are presented herein. Data accruing prospectively from May 2002 to August 2013 yielded 48 patients harboring 50 A1 segment aneurysms, each classified as proximal, middle, or distal by location. Clinical outcome of the patients and morphological outcome of the aneurysms were assessed, with emphasis on technical aspects of treatment. The aneurysms studied occupied either proximal (n = 39), middle (n = 6), or distal (n = 5). Proximal aneurysms were largely directed posteriorly (80 %), and most (97 %) were devoid of branches. Middle and distal aneurysms were associated with the medial lenticulostriate artery, cortical branches, or fenestrations. The preshaped ''S'' and steam-shaped ''S'' microcatheters facilitated aneurysm selection in 60 % of lesions. Single-microcatheter technique was most commonly applied for coil embolization (62 %), followed by balloon protection (16 %). Successful aneurysmal occlusion could be achieved in 76 % of the patients, with no procedure-related morbidity and mortality. At final follow-up (mean interval, 29.9 months), stable aneurysmal occlusion was sustained in 93 % of the patients (40/43). A1 segment aneurysms are amenable to safe and efficacious endovascular coil embolization by adjusting procedural strategy to accommodate distinctive anatomic configurations. (orig.)

  4. Giant pulmonary artery aneurysm in a patient with rheumatic mitral stenosis

    Directory of Open Access Journals (Sweden)

    Vikas Singh

    2014-01-01

    Full Text Available 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.

  5. Surgical treatment of an aneurysm of a distal branch of the renal artery.

    Science.gov (United States)

    Abdalla, Solafah; Pierret, Charles; Ba, Bakar; Mlynski, Amélie; de Kerangal, Xavier; Houlgatte, Alain

    2014-01-01

    Aneurysms of the renal artery and its branches are rare, but are associated with significant morbimortality due to the absence of clinical symptoms and hemorrhagic risk in the event of rupture. We report the case of a patient with an aneurysm of a distal branch of the right renal artery that measured 25 mm in diameter. The diagnosis and localization were obtained using selective arteriography. Treatment consisted of resection of the aneurysmal sac associated with closure with a saphenous vein patch rather than an endovascular treatment in order to preserve the nephronic capital. Right renal parenchymatous vascularization was satisfactory on arterial echo-Doppler and angioscanner assessment at 1 year.

  6. Clinical and imaging features of intracranial arterial aneurysms in the pediatric population

    International Nuclear Information System (INIS)

    Intracranial arterial aneurysms (IAAs) are rare in children. Nevertheless, IAAs account for at least 10 % - 15 % of hemorrhagic strokes during the first two decades of life. Traditional vascular risk factors, which are common in the adult population, are generally absent in the pediatric population, engendering distinct modes of IAA pathogenesis. Classification of pediatric IAAs according to the pathogenetic mechanism shows eight distinct categories: idiopathic, traumatic, those due to excessive hemodynamic stress, vasculopathic, infectious, noninfectious inflammatory, oncotic, and familial. Pathogenetic mechanism is the best predictor of the clinical course of the disease, response to treatment, and long-term prognosis. The pathogenetic subtypes of pediatric IAA show characteristic and variably overlapping features. In most cases, IAAs manifesting during the first two decades of life are idiopathic. IAAs that are idiopathic, traumatic (second most common type), or due to excessive hemodynamic stresses (third most common type) account for more than 80 % of IAAs in the pediatric age group. Most of the remaining pediatric IAAs are the result of congenital cerebral aneurysmal arteriopathies or infection. Multiple IAAs are unusual in young children except in those with acquired (secondary to immune deficiency states) or congenital cerebral aneurysmal arteriopathies or infectious IAAs. (orig.)

  7. Subarachnoid Hemorrhage from Posterior Cerebral Artery Aneurysm during Puerperium – Case Report and Review of Literature

    OpenAIRE

    Schebesch, Karl-Michael; Schödel, Petra; Rennert, Janine; Mark, Karl-Heinz; Brawanski, Alexander

    2012-01-01

    Subarachnoid hemorrhages (SAH) due to true aneurysms of the Posterior Cerebral Artery (PCA) during puerperium in young and healthy females are extremely rare. We present the case of a 31-year old, healthy woman that experienced a spontaneous SAH due to a PCA aneurysm, arising from the P3 segment, 9 days post-delivery. The aneurysm was successfully treated via an endovascular approach and the patient recovered well. After 21 days she was discharged from hospital without neurological defici...

  8. Treatment of middle cerebral artery (MCA) aneurysms: a review of the literature

    Institute of Scientific and Technical Information of China (English)

    Wuyang Yang; Judy Huang

    2015-01-01

    Microsurgical treatment is well established as the preferred strategy for definitive obliteration of middle cerebral artery (MCA) aneurysms.However, increasing reports on the feasibility and efficacy of endovascular treatment of MCA aneurysms in large case series suggest coiling as a viable alternative to microsurgery.This review provides a critical overview of the current literature regarding MCA aneurysm treatment, with the objective to clarify the available evidence of efficacy with microsurgical compared to endovascular treatment.

  9. Supraclinoid Internal Carotid Arterial Aneurysm Presenting as a Suprasellar Mass-like Lesion in a Child

    OpenAIRE

    Chul Suh, D.; Alvarez, H.; Sainte Rose, C.; Lasjaunias, P.

    2001-01-01

    We present the case of a two-year and seven-month-old boy with a partially-thrombosed giant lobulated aneurysm in the supraclinoid portion of the internal carotid artery. He presented with several months of symptoms of progressive frontal headache and visual loss. CT revealed a large lobulated suprasellar mass lesion mimicking a craniopharyngioma. After the aneurysm was successfully obliterated by an endovascular procedure, regression of the giant aneurysm was confirmed on followed-up MRI. Th...

  10. Clinical-radiological spectrum of giant supraclinoid internal carotid artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Vinuela, F.; Fox, A.; Chang, J.K.; Drake, C.G.; Peerless, S.J.

    1984-03-01

    A review of a series of 312 giant intracranial aneurysms treated at University Hospital in London, Ontario, showed that 93 of those aneurysms were located between the intracavernous portion and the bifurcation of the internal carotid artery. Sixty-five of those aneurysms were carotid ophthalmic, 12 were located in the internal carotid-posterior communicating-anterior choroidal artery regions and 16 involved the internal carotid artery bifurcation. For the majority, clinical presentation was related to the mass of the aneurysms and compression of surrounding structures such as visual pathways, ocular motor cranial nerves, the fifth nerve, and hypothalamic-pituitary axis. Fourteen patients presented with subarachnoid hemorrhage. Cerebral angiography, computed tomography and xenon inhalation studies of cerebral blood flow were the tools used to study the morphology of the aneurysm and dynamics of the circle of Willis.

  11. Rupture of multiple splenic artery aneurysms: A common presentation of a rare disease with a review of literature

    Directory of Open Access Journals (Sweden)

    Zubaidi Ahmad

    2009-01-01

    Full Text Available The splenic artery is the most frequent site of visceral arterial aneurysms. Usually a splenic artery aneurysm occurs as a single event; rupture is frequent, sometimes occurring as the first symptom and is sometimes fatal. This article presents a case of ruptured multiple splenic artery aneurysms-the symptoms and signs, operative and perioperative management, as well as a literature review of this clinically important entity.

  12. A fusiform aneurysm of a persistent trigeminal artery variant: case report and literature review.

    Science.gov (United States)

    Yang, Zhigang; Liu, Jianmin; Zhao, Wenyuan; Xu, Yi; Hong, Bo; Huang, Qinghai; He, Shike

    2010-04-01

    A 48-year-old man suffered from spontaneous subarachnoid hemorrhage. Emergent right internal carotid angiography showed the presence of a persistent trigeminal artery (PTA) variant with a fusiform aneurysm on its proximal segment where it branched from the internal carotid artery. This artery supplied the territory of the anterior inferior cerebellar artery. After consideration of the adequacy of the cerebellar circulation without this anomalous artery, intraluminal occlusion of the aneurysm together with the PTA variant was performed using detachable coils. The patient recovered uneventfully without any neurologic deficits. PMID:19690795

  13. Endovascular management of bilateral superior intercostal artery aneurysms following late repair of coarctation of the aorta.

    Science.gov (United States)

    Tapping, C R; Ettles, D F

    2011-08-01

    Endovascular management of massive bilateral superior intercostal artery aneurysms following late surgical repair of juxtaductal coarctation of the aorta is described in a 40-year-old male patient. Both aneurysms were successfully treated by coil embolisation without the need for further surgical intervention.

  14. Endovascular treatment of popliteal artery aneurysm. Early and midterm results

    Directory of Open Access Journals (Sweden)

    Rodrigo Borges Domingues

    2015-02-01

    Full Text Available OBJECTIVE: to evaluate the efficacy of endovascular repair of popliteal artery aneurysms on maintaining patency of the stent in the short and medium term. METHODS: this was a retrospective, descriptive and analytical study, conducted at the Integrated Vascular Surgery Service at the Hospital da Beneficência Portuguesa de São Paulo. We followed-up 15 patients with popliteal aneurysm, totaling 18 limbs, treated with stent from May 2008 to December 2012. RESULTS: the mean follow-up was 14.8 months. During this period, 61.1% of the stents were patent. The average aneurysm diameter was 2.5cm, ranging from 1.1 to 4.5cm. The average length was 5cm, ranging from 1.5 to 10 cm. In eight cases (47.1%, the lesion crossed the joint line, and in four of these occlusion of the prosthesis occurred. In 66.7% of cases, treatment was elective and only 33.3% were symptomatic patients treated on an emergency basis. The stents used were Viabahn (Gore in 12 cases (66.7%, Fluency (Bard in three cases (16.7%, Multilayer (Cardiatis in two cases (11.1% and Hemobahn (Gore in one case (5.6%. In three cases, there was early occlusion (16.6%. During follow-up, 88.2% of patients maintained antiplatelet therapy. There was no leakage at ultrasound (endoleak. No fracture was observed in the stents. CONCLUSION: the results of this study are similar to other published series. Probably, with the development of new devices that support the mechanical characteristics found on the thighs, there will be improved performance and prognosis of endovascular restoration.

  15. Splenic artery aneurysm: a diagnostic challenge in the setting of extensive portal venous collaterals

    International Nuclear Information System (INIS)

    We present a 16-year-old boy with autoimmune liver disease and longstanding portal hypertension in whom a CT arteriogram demonstrated a large aneurysm arising from the distal, extra-parenchymal portion of the splenic artery. Because of its location adjacent to multiple venous collaterals, the aneurysm was indistinguishable from splenic varices on initial imaging with Doppler sonography and on portal venous-phase CT. There is an increased risk of rupture of splenic artery aneurysms in the post-liver transplant period, with high associated mortality, and therefore diagnosis of splenic artery aneurysm prior to liver transplantation is clinically important. It is quite possible that the diagnosis of splenic artery aneurysm in this case would have been missed in the absence of dedicated arterial-phase imaging. As radiologists strive to reduce radiation exposure in children, this case highlights a potential diagnostic pitfall of both Doppler sonography and venous or single-acquisition arterial/venous-phase CT angiogram in children with venous collaterals and an undiagnosed splenic artery aneurysm. (orig.)

  16. Splenic artery aneurysm: a diagnostic challenge in the setting of extensive portal venous collaterals

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, Grace S.; Vo, Nghia J.; Ishak, Gisele E.; Swanson, Jonathan O.; Otto, Randolph K. [University of Washington, Seattle Children' s Hospital, Department of Radiology, Seattle, WA (United States)

    2010-07-15

    We present a 16-year-old boy with autoimmune liver disease and longstanding portal hypertension in whom a CT arteriogram demonstrated a large aneurysm arising from the distal, extra-parenchymal portion of the splenic artery. Because of its location adjacent to multiple venous collaterals, the aneurysm was indistinguishable from splenic varices on initial imaging with Doppler sonography and on portal venous-phase CT. There is an increased risk of rupture of splenic artery aneurysms in the post-liver transplant period, with high associated mortality, and therefore diagnosis of splenic artery aneurysm prior to liver transplantation is clinically important. It is quite possible that the diagnosis of splenic artery aneurysm in this case would have been missed in the absence of dedicated arterial-phase imaging. As radiologists strive to reduce radiation exposure in children, this case highlights a potential diagnostic pitfall of both Doppler sonography and venous or single-acquisition arterial/venous-phase CT angiogram in children with venous collaterals and an undiagnosed splenic artery aneurysm. (orig.)

  17. Giant pediatric aneurysm treated with ligation of the middle cerebral artery with the Drake tourniquet and extracranial-intracranial bypass.

    Science.gov (United States)

    Lansen, T A; Kasoff, S S; Arguelles, J H

    1989-07-01

    Saccular intracranial aneurysms occur infrequently in children, and the incidence of pediatric giant aneurysms is statistically in the same proportion as in adults. The management of these giant aneurysms can be treacherous. This paper presents a case of a 9-year-old boy with a giant aneurysm of the right middle cerebral artery that was successfully managed by ligation of the middle cerebral artery using a Drake tourniquet with the patient awake and by augmentation of the middle cerebral artery circulation with superficial temporal artery-middle cerebral artery anastomosis without excision of the lesion.

  18. Ruptured cerebral aneurysm associated with a persistent primitive trigeminal artery variant

    Science.gov (United States)

    Yamamoto, Takahiro; Hasegawa, Yu; Ohmori, Yuki; Kawano, Takayuki; Kai, Yutaka; Morioka, Motohiro; Kuratsu, Jun-ichi

    2011-01-01

    Background: Primitive trigeminal artery variants (PTAVs) are one of the rare persistent fetal anastomoses between the carotid and vertebrobasilar circulations. They originate from the internal carotid artery and join one of the cerebellar arteries instead of the basilar artery. Case Description: We present an 82-year-old woman with subarachnoid hemorrhage due to a ruptured aneurysm originating at a PTAV. Three-dimensional computed tomography angiogram and cerebral angiography revealed bilateral PTAV and two aneurysms originating at the left PTAV. The proximal and distal aneurysms were saccular and fusiform, respectively. She underwent surgical treatment and her postoperative course was uneventful. Conclusion: Our case demonstrates that extremely rare cerebral aneurysms associated with PTAV can be addressed successfully by surgical intervention. PMID:22059121

  19. Anterior communicating artery aneurysm associated with an infraoptic course of anterior cerebral artery and rare variant of the persistent trigeminal artery: a case report and literature review.

    Science.gov (United States)

    Turkoglu, Erhan; Arat, Anıl; Patel, Nirav; Kertmen, Hayri; Başkaya, Mustafa K

    2011-05-01

    Infraoptic course of the precommunicating segment of the anterior cerebral artery (A1) is a rare anomaly. Furthermore, the presence of this anomaly associated with persistent trigeminal artery variant has been reported in the literature only once. We present a patient who had infraoptic course of A1 associated with an ipsilateral persistent trigeminal artery variant arising from the right internal carotid artery with no apparent connection to the basilar artery. The persistent trigeminal artery variant supplied to the right posteroinferior cerebellar artery territory. The patient also had hypoplastic left vertebral artery, superior cerebellar arteries originating from posterior cerebellar arteries bilaterally, and a bilobed aneurysm of the anterior communicating artery. The aneurysm was clipped and the infraoptic course was verified during the surgery. The post-operative course was uneventful and a follow-up arteriogram on the 7th postoperative day revealed successful obliteration of the aneurysm. We reviewed the literature with respect to presentation, associated vascular anomalies, imaging, associated cerebral aneurysms and other cerebral abnormalities, and treatment of the associated aneurysms. A discussion of the embryogenesis of this rare anomaly is also provided. PMID:21269759

  20. Selective treatment of an anterior spinal artery aneurysm with endosaccular coil therapy. Case report.

    Science.gov (United States)

    Lavoie, Pascale; Raymond, Jean; Roy, Daniel; Guilbert, François; Weill, Alain

    2007-05-01

    The authors report the case of a 12-year-old boy with spinal cord arteriovenous malformation (AVM) and an associated anterior spinal artery (ASA) aneurysm treated with selective coil placement in the context of subarachnoid hemorrhage (SAH). The patient presented with headache. Head computed tomography scanning revealed no abnormal findings. The cerebrospinal fluid was sampled and analyzed and a diagnosis of SAH was established. Investigation, including magnetic resonance imaging of the cord as well as cerebral and spinal angiography, revealed a conus medullaris AVM and a saccular aneurysm located on the ASA at the T-11 level. The aneurysm was thought to be responsible for the bleeding. Superselective ASA angiography showed that the aneurysm was at the bifurcation between a large coronal artery supplying the AVM and the ASA. The relation of the aneurysm's neck to the main spinal axis and the aneurysm's morphological features indicated that the lesion was suited for endosaccular coil therapy. The aneurysm was selectively occluded, using electrodetachable bare platinum coils. Follow-up angiography immediately after surgery and at 6 months thereafter demonstrated complete occlusion of the aneurysm and a perfectly patent anterior spinal axis. On clinical follow-up examination, the patient remained neurologically intact. When the morphological features of a spinal aneurysm and its relation with the anterior spinal axis are favorable, selective endosaccular coil placement can successfully be achieved. PMID:17542515

  1. Diagnosis of ruptured superior mesenteric artery aneurysm mimicking a pancreatic mass

    Institute of Scientific and Technical Information of China (English)

    Stefano; Palmucci; Letizia; Antonella; Mauro; Pietro; Milone; Francesco; Di; Stefano; Antonino; Scolaro; Antonio; Di; Cataldo; Giovanni; Carlo; Ettorre

    2010-01-01

    Aneurysms and pseudoaneurysms of the superior mesenteric artery are potentially lethal and should be treated as urgently as possible.In a 52-year-old man with occasional epigastric pain,we accidentally discovered a superior mesenteric artery aneurysm that was ruptured with spontaneous tamponade in the uncinate process and in the head of the pancreas.The ruptured aneurysm had a heterogeneous appearance due to its thrombotic and hemorrhagic content,and it simulated a voluminous mass in the head and uncinate p...

  2. Distal posterior cerebral artery aneurysms: Retrospective review of characteristics and endovascular treatment

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Jin Wook [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Jeong, Bae Woong [Dept. of Diagnostic Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan (Korea, Republic of); Seung, Won Bae [Dept. of Neurosurgery, Kosin University College of Medicine, Gospel Hospital, Busan (Korea, Republic of)

    2016-04-15

    The objective of this study was to review the clinical outcome after treatment of distal posterior cerebral artery (PCA) aneurysms via endovascular approach. Eleven patients with 11 distal PCA aneurysms who were treated via endovascular approach in Inje University Busan Paik Hospital and Kosin University Gospel Hospital from December 2002 to December 2013 were retrospectively reviewed. Among the 11 patients, there were 3 males (27.3%) and 8 females (72.7%). The mean age was 56.6 years (range 44 -72 years) and the mean aneurysm size was 8.45 mm (3 - 30 mm). Four (36.4%) aneurysms were located in the P2 segment, 6 (54.5%) in the P3 segment and 1 (9.1%) in the P1/2 junction. Seven (63.6%) aneurysms were treated with preservation of the parent artery; and the remaining 4 (36.4%) aneurysms were treated with parent artery occlusion. After treatment, the overall complication rate was 27% with the morbidity rate of 9.1% and the mortality rate of 18%. Endovascular treatment of distal PCA aneurysm might be used to minimize neurologic deficit, considering the diverse and rich collaterals of posterior cerebral artery.

  3. Safety and Feasibility of Simultaneous Ipsilateral Proximal Carotid Artery Stenting and Cerebral Aneurysm Coiling

    Directory of Open Access Journals (Sweden)

    Aamir Badruddin

    2010-10-01

    Full Text Available Background: Coexistence of cerebral aneurysm and carotid artery disease may be encountered in clinical practice. Theoretical increase in aneurysmal blood flow may increase risk of rupture if carotid artery disease is treated first. If aneurysm coiling is performed first, stroke risk may increase while repeatedly crossing the diseased artery. It is controversial which disease to treat first, and whether it is safe to treat both simultaneously via endovascular procedures. We document the safety and feasibility of such an approach. Methods: Review of collected neurointerventional database at our institution was performed for patients who underwent both Carotid artery stenting (CAS and aneurysm coil embolization (ACE simultaneously. All patients underwent carotid stenting followed by aneurysm coiling in the same setting. Demographic, clinical data and outcome measures including success rate and periprocedural complications were collected. Results: 590 aneurysms coiling were screened for patients who underwent combined CAS and ACE. Ten patients were identified. Mean age was 67.7 years (range 51 to 89. The success rate for stenting and coiling was 100% with no immediate complications. No stroke, TIAs, or aneurysmal rebleeding was found on their most recent follow up. Conclusions: Our case series demonstrates that it is safe and feasible to perform CAS and ACE simultaneously as one procedure which may avoid unwanted risk of treating either disease at two separate time sessions.

  4. A novel arterial pouch model of saccular aneurysm by concomitant elastase and collagenase digestion

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Background: An ideal aneurysm model of cerebral aneurysm is of great importance for studying the pathogenesis of the lesion and testing new techniques for diagnosis and treatment. Several models have been created in rabbits and are now widely used in experimental studies; however, every model has certain intrinsic limitations. Here we report the development of a novel saccular aneurysm model in rabbits using an arterial pouch that is subject to in vitro pre-digestion with combined elastase and collagenase. Methods: A segment of right common carotid artery (CCA) was dissected out and treated with elastase (60 U/ml, 20 min) followed by type I collagenase (1 mg/ml, 15 min) in vitro. The graft was anastomosed to an arterial arch built with the left CCA and the remaining right CCA, while the other end of the graft was ligated. The dimension and tissue structure of the pouch were analysed immediately, 2 or 8 weeks after operation. Findings: Ten terminal aneurysms were produced. The gross morphology of the aneurysm resembles the human cerebral terminal aneurysms. We have observed the following pathological changes:(1) growth of the aneurysm (mean diameter increased from (2.0±0.1) to (3.2±0.3) mm at 2 weeks, P<0.001, n=7~10); (2) thinning of the aneurysmal wall (the mean wall thickness decreased to 44% at 2 weeks), which was accompanied by significant losses of elastic fibres, collagen and the cellular component; and (3) spontaneous rupture (3 out of 9, one aneurysm ruptured 24 h after operation with the other two at 2 and 4 weeks respectively). Conclusion: This rabbit arterial pouch model mimics human cerebral aneurysms in relation to morphology and histology. In particular, this model exhibited an increased tendency of spontaneous rupture.

  5. Classical surgical approach and treatment with clips of extracranial internal carotid artery berry aneurysm

    Directory of Open Access Journals (Sweden)

    Haris Vukas

    2016-06-01

    Full Text Available Introduction: We can define extracranial carotid artery aneurysm (ECAA as bulb dilatation greater than 200% of the diameter of the internal carotid artery (ICA or in a case of common carotid artery (CCA greater than 150% of the diameter. Surgical intervention is required for the treatment of this disease.Case report: This study presents an open vascular surgical procedure to resolve ECAA. We report a case of 61 years old woman with an extracranial internal carotid artery berry aneurysm, presented with a headache and dizziness when turning the head aside. Classic open surgery was performed and the lumen of berry aneurysm was separated with three clips from the lumen of ICA.Conclusions: The open surgical approach is the method of choice for the treatment of extracranial internal carotid artery pathological conditions.

  6. Comparison of arterial stiffness and microcirculatory changes following abdominal aortic aneurysm grafting.

    LENUS (Irish Health Repository)

    Moloney, M A

    2012-02-01

    BACKGOUND: Abdominal aortic aneurysm (AAA) surgery provides a unique opportunity to study the impact of arterial stiffness on central haemodynamics, reflected in augmentation index (AI). The aneurysmal aorta is significantly stiffer than undilated age-matched aorta. AIM: We investigated whether replacement of an aneurysmal aorta with a compliant graft would result in a decrease in AI, which would thus decrease myocardial workload parameters. METHODS: Patients undergoing elective open or endovascular AAA repair were assessed with applanation tonometry and laser fluximetry pre-operatively, immediately and long-term post-operatively. RESULTS: Replacement of a small segment of abnormal conduit vessel resulted in improvements in AI, demonstrating that arterial stiffness can be surgically manipulated. CONCLUSIONS: These results reflect a decreased myocardial workload post-aortic grafting. This decrease in AI is important from a risk factor management perspective, and arterial stiffness should become a further recognised and screened for risk factor in patients with known aneurysmal disease.

  7. Comparison of arterial stiffness and microcirculatory changes following abdominal aortic aneurysm grafting.

    LENUS (Irish Health Repository)

    Moloney, M A

    2010-11-11

    BACKGOUND: Abdominal aortic aneurysm (AAA) surgery provides a unique opportunity to study the impact of arterial stiffness on central haemodynamics, reflected in augmentation index (AI). The aneurysmal aorta is significantly stiffer than undilated age-matched aorta. AIM: We investigated whether replacement of an aneurysmal aorta with a compliant graft would result in a decrease in AI, which would thus decrease myocardial workload parameters. METHODS: Patients undergoing elective open or endovascular AAA repair were assessed with applanation tonometry and laser fluximetry pre-operatively, immediately and long-term post-operatively. RESULTS: Replacement of a small segment of abnormal conduit vessel resulted in improvements in AI, demonstrating that arterial stiffness can be surgically manipulated. CONCLUSIONS: These results reflect a decreased myocardial workload post-aortic grafting. This decrease in AI is important from a risk factor management perspective, and arterial stiffness should become a further recognised and screened for risk factor in patients with known aneurysmal disease.

  8. Aneurysm and infundibular dilatation at an unusual origin of the ophthalmic artery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Soo; Kim, Eui Jong; Lee, Kyung Mi; Choi, Woo Suk [Dept. of Radiology, Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2014-10-15

    The ophthalmic artery usually arises from the anteromedial or superomedial aspect of the internal carotid artery. Rarely does it arise from the medial or posteromedial aspect of the internal carotid artery. In this paper, the authors report two cases of aneurysm and infundibular dilatation found at unusual sites of origin in the ophthalmic artery and review the literature about possible etiologies contributing to the anatomic variations.

  9. Aneurysm and infundibular dilatation at an unusual origin of the ophthalmic artery

    International Nuclear Information System (INIS)

    The ophthalmic artery usually arises from the anteromedial or superomedial aspect of the internal carotid artery. Rarely does it arise from the medial or posteromedial aspect of the internal carotid artery. In this paper, the authors report two cases of aneurysm and infundibular dilatation found at unusual sites of origin in the ophthalmic artery and review the literature about possible etiologies contributing to the anatomic variations.

  10. Retrograde amnesia in patients with rupture and surgical repair of anterior communicating artery aneurysms.

    Science.gov (United States)

    O'Connor, Margaret G; Lafleche, Ginette M C

    2004-03-01

    The retrograde amnesia of patients with memory loss related to rupture and surgical repair of anterior communicating artery (ACoA) aneurysms is compared with the retrograde amnesia of temporal amnesic patients and nonamnesic control participants. Two tests which focus on popular culture but which differ according to extent of news exposure and the cognitive processes necessary for task performance were used to measure retrograde memory. ACoA patients demonstrated more significant retrograde memory problems than did nonamnesic controls; however, the severity and pattern of their memory loss was less severe than that seen in association with temporal amnesia. Different factors influenced the remote memory loss of respective groups: ACoA patients' problems were related to impaired lexical retrieval whereas temporal amnesic patients had problems secondary to both retrieval and storage deficits. PMID:15012842

  11. Chondroblastoma with secondary aneurysmal bone cyst of the capitate.

    Science.gov (United States)

    Sato, Eiichi; Ichikawa, Jiro; Ando, Takashi; Sato, Nobutaka; Kawasaki, Tomonori; Haro, Hirotaka

    2014-05-01

    Chondroblastoma is a benign tumor that typically arises in the epiphysis of a long bone. There have been only 2 reported cases of chondroblastoma involving the capitate. This is the first report of chondroblastoma with secondary aneurysmal bone cyst involving the capitate. A 33-year-old man presented with a 3-year history of pain and swelling of the right wrist. Radiography as well as computed tomography showed a radiolucent area and no matrix calcification within the capitate. Magnetic resonance imaging revealed a homogeneous signal that was low on T1-weighted images and high on T2-weighted images and showed only slight enhancement. On the basis of imaging findings, the authors chose excisional biopsy. The bone tumor in the capitate was explored through a dorsal approach by dividing the extensor tendons. After repeated curettages, bone graft substitute using allograft bone was packed into the capitate. Histologically, the authors diagnosed this tumor as a chondroblastoma with a secondary aneurysmal bone cyst. At the final 2-year follow-up, there was evidence of bone union, full range of motion, and recovery and no evidence of recurrence. Although the recurrence of chondroblastoma is occasionally reported, the principal treatment is intralesional curettage and bone graft. High-speed burring, phenol, bone cement, and cryosurgery have been reported to reduce local recurrence. Complete excision of the carpal bone seems to be overtreatment.

  12. Chondroblastoma with secondary aneurysmal bone cyst of the capitate.

    Science.gov (United States)

    Sato, Eiichi; Ichikawa, Jiro; Ando, Takashi; Sato, Nobutaka; Kawasaki, Tomonori; Haro, Hirotaka

    2014-05-01

    Chondroblastoma is a benign tumor that typically arises in the epiphysis of a long bone. There have been only 2 reported cases of chondroblastoma involving the capitate. This is the first report of chondroblastoma with secondary aneurysmal bone cyst involving the capitate. A 33-year-old man presented with a 3-year history of pain and swelling of the right wrist. Radiography as well as computed tomography showed a radiolucent area and no matrix calcification within the capitate. Magnetic resonance imaging revealed a homogeneous signal that was low on T1-weighted images and high on T2-weighted images and showed only slight enhancement. On the basis of imaging findings, the authors chose excisional biopsy. The bone tumor in the capitate was explored through a dorsal approach by dividing the extensor tendons. After repeated curettages, bone graft substitute using allograft bone was packed into the capitate. Histologically, the authors diagnosed this tumor as a chondroblastoma with a secondary aneurysmal bone cyst. At the final 2-year follow-up, there was evidence of bone union, full range of motion, and recovery and no evidence of recurrence. Although the recurrence of chondroblastoma is occasionally reported, the principal treatment is intralesional curettage and bone graft. High-speed burring, phenol, bone cement, and cryosurgery have been reported to reduce local recurrence. Complete excision of the carpal bone seems to be overtreatment. PMID:24810829

  13. Stent-assisted coil embolization of a symptomatic middle cerebral artery aneurysm in an infant.

    Science.gov (United States)

    Savastano, Luis E; Chaudhary, Neeraj; Gemmete, Joseph J; Garton, Hugh J L; Maher, Cormac O; Pandey, Aditya S

    2014-11-01

    Pediatric intracranial aneurysms are rare and challenging to treat. Achieving efficacy and durability of aneurysmal occlusion while maintaining parent vessel patency requires innovative treatment strategies, especially in cases in which aneurysmal location or morphology pose substantial morbidity associated with microsurgical treatment. In the last 3 decades, endovascular treatments have had a remarkable evolution and are currently considered safe and effective therapeutic options for cerebral aneurysms. While endovascular techniques are well described in the English literature, the endovascular management of pediatric aneurysms continues to pose a challenge. In this report, the authors describe the case of a 9-month-old infant who presented with a 1-day history of acute-onset left-sided hemiparesis and left facial droop. Imaging revealed a large symptomatic saccular middle cerebral artery aneurysm. Treatment included successful stent-assisted aneurysm coiling. At follow-up, the patient continued to fare well and MR angiography confirmed complete occlusion of the aneurysm dome. This case features the youngest patient in the English literature to harbor an intracranial aneurysm successfully treated with stent-assisted coiling. Based on this experience, endovascular intervention with vascular reconstruction can be safe and effective for the treatment of infants and could further improve prognosis; however, further studies are necessary to confirm these findings.

  14. Using Onyx in endovascular embolization of internal carotid artery large or giant aneurysms

    International Nuclear Information System (INIS)

    Background and purpose: Internal carotid artery (ICA) large or giant saccular aneurysms is challenging for endovascular coil embolization and surgical clipping with a high recanalization and rebleeding rate. We report our results using Onyx in the endovascular treatment of ICA large or giant saccular aneurysms. Methods: During 2008–2010, 5 patients with 5 large or giant saccular aneurysms in ICA were treated with a liquid embolic agent (Onyx; Micro Therapeutics, Irvine, CA). One aneurysm was small (<10 mm), 2 were large (≥10 mm, <25 mm) and 2 were giant saccular aneurysms (≥25 mm). Of 3 female and 2 male patients, 3 were incidental and 2 had bleeding. Selective embolization was performed with Onyx alone or a combination with coils. Clinical and anatomic outcomes were assessed with the Modified Glasgow Outcome Scale and follow-up angiography was performed at 4–21 months (mean 12.2 months). Results: Complete aneurysm occlusion was obtained in all of the aneurysms on immediate control angiogram. There was not any procedure-related complication. No recanalization was observed at the follow- up periods. There were 2 ICA occlusions in giant ICA aneurysms. The 5 patients were all clinically asymptomatic at follow-up. Conclusion: Endovascular embolization with Onyx is a useful treatment for ICA large or giant aneurysms, which is unsuitable for coiling or surgical treatment.

  15. Rescue microsurgery with bypass and stent removal following Pipeline treatment of a giant internal carotid artery terminus aneurysm.

    Science.gov (United States)

    Bowers, Christian A; Taussky, Philip; Park, Min S; Neil, Jayson A; Couldwell, William T

    2015-12-01

    We report the microsurgical rescue and removal of a Pipeline stent embolization of a giant internal carotid artery terminus aneurysm. After the initial placement of a Pipeline Embolization Device (PED), it migrated proximally to the cavernous carotid with the distal end free in the middle of the aneurysm, resulting in only partial aneurysm neck coverage. The patient underwent microsurgical rescue with trapping, bypass, and opening of the aneurysm with PED removal. The vessel remained patent in the proximal segment previously covered by the Pipeline stent. Microsurgical rescue for definitive aneurysm treatment with PED removal can be safe and effective for aneurysms unsuccessfully treated with PED.

  16. Fusiform superior cerebellar artery aneurysm treated with STA-SCA bypass and trapping

    Directory of Open Access Journals (Sweden)

    Fabricio C Lamis

    2014-01-01

    Full Text Available Background: Fusiform aneurysms of cerebellar arteries are rare. Different surgical techniques to address these challenging lesions have been described, and their application depends on whether the goal is to maintain the flow in the parent vessel or to occlude it. Case Description: The authors reported a case of a fusiform aneurysm located in the lateral pontomesencephalic segment of the superior cerebellar artery (SCA in a 32-year-old man who presented with subarachnoid hemorrhage. The patient was subjected to aneurysm trapping followed by a bypass between the superficial temporal artery (STA and SCA and had an uneventful recovery. Conclusions: Although only a few cases of fusiform aneurysms in the supracerebellar artery have been reported in the literature, the treatment strategies adopted were diverse. In selected cases of patients in good neurological condition with ruptured fusiform aneurysms at the proximal segments of SCA and who have poor evidence of collateral supply, the possibility of a STA-SCA bypass with aneurysm trapping must be considered. A review of the current treatment modalities of this pathology is also presented.

  17. A rare association of cerebral dural arteriovenous fistula with venous aneurysm and contralateral flow-related middle cerebral artery aneurysm.

    Science.gov (United States)

    Onu, David O; Hunn, Andrew W; Harle, Robin A

    2013-01-01

    The association of cerebral dural arteriovenous fistula (DAVF) and ipsilateral flow related aneurysm has infrequently been reported. We describe a male patient who presented with an acute haemorrhagic stroke and was found to have a large right fronto-parietal intra-parenchymal haemorrhage from the ruptured Borden type II DAVF in addition to a large venous aneurysm and a flow related intraosseous aneurysm of the contralateral middle meningeal artery (MMA) all clearly delineated by CT and DSA. He underwent emergency stereotactic evacuation of the intraparenchymal haemorrhage and successful surgical treatment of all the vascular lesions at the same time with residual neurological deficit. To our knowledge, this is the first such reported case. We discuss the challenging surgical treatment, emphasising the role of CT/DSA in management, and provide a literature review.

  18. Contained rupture of mycotic aneurysm of the left circumflex coronary artery in a child.

    Science.gov (United States)

    Joshi, Reena K; Jyoti, Aman; Aggarwal, Neeraj; Aggarwal, Mridul; Joshi, Raja

    2015-01-01

    Coronary artery aneurysm (CAA) is defined as dilatation of a coronary artery segment to a diameter of more than 1.5-fold normal size. Rupture of CAA is a catastrophic event and may result in sudden death or myocardial infarction. We report this unusual case of contained rupture of the left circumflex CAA.

  19. Endovascular aneurysm repair alters renal artery movement : A preliminary evaluation using dynamic CTA

    NARCIS (Netherlands)

    Muhs, Bart E.; Teutelink, Arno; Prokop, Matthias; Vincken, Koen L.; Moll, Frans L.; Verhagen, Hence J. M.

    2006-01-01

    Purpose: To observe the natural renal artery motion during cardiac cycles in patients with abdominal aortic aneurysm (AAA) and how the implantation of stent-grafts may distort this movement. Methods: Data on 29 renal arteries from 15 male patients (mean age 72.6 years, range 66-83) treated with Tale

  20. Endovascular treatment of a giant internal carotid artery bifurcation aneurysm with drainage into cavernous sinus

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhen-hai; YANG Xin-jian; WU Zhong-xue; LI You-xiang; JIANG Peng

    2012-01-01

    This report documents the treatment of a giant aneurysm of the internal carotid artery bifurcation with a fistula to the cavernous sinus,which appeared following closed head trauma.A 39-year-old man suffered from a blunt head trauma in an automobile accident.Two weeks after the trauma,progressive chemosis of left eye was presented.Four months after the trauma,digital subtraction angiography showed an internal carotid artery bifurcation aneurysm,with drainage into the cavernous sinus.The lesion was successfully obliterated with preservation of the parent artery by using coils in conjunction with Onyx.Follow-up angiography obtained 3 months postoperatively revealed persistent obliteration of the aneurysm and fistula as well as patency of the parent artery.Endovascular treatment involving the use of coils combined with Onyx appears to be a feasible and effective option for treatment of this hard-to-treat lesion.

  1. Far-lateral transcondylar approach for microsurgical trapping of an anterior inferior cerebellar artery aneurysm.

    Science.gov (United States)

    Caplan, Justin M; Jusue-Torres, Ignacio; Kim, Jennifer E; Luksik, Andrew; Liauw, Jason; Gottschalk, Allan; Tamargo, Rafael J

    2015-07-01

    Aneurysms of the posterior circulation remain challenging lesions given their proximity to the brainstem and cranial nerves. Many of these aneurysms may best be approached through a retrosigmoid-suboccipital craniectomy with a far-lateral transcondylar extension. In this narrated video illustration, we present the case of a 37-year-old man with an incidentally discovered right-sided anterior inferior cerebellar artery (AICA) aneurysm. Diagnostic studies included CT angiography and cerebral angiography. A suboccipital craniectomy and far-lateral transcondylar extension were performed for microsurgical trapping and excision of the AICA aneurysm. The techniques of the retrosigmoid craniectomy, C-1 laminectomy, condylectomy and microsurgical trapping of the aneurysm are reviewed. The video can be found here: http://youtu.be/JiM3CXVwXnk. PMID:26132623

  2. Spontaneous healing and complete disappearance of a ruptured posterior inferior cerebellar artery dissecting aneurysm.

    Science.gov (United States)

    Su, Tsung-Ming; Cheng, Ching-Hsiao; Chen, Wu-Fu; Hsu, Shih-Wei

    2014-05-01

    A 7-month-old baby presented with a 4-day history of drowsiness and vomiting after a falling accident. Magnetic resonance imaging demonstrated diffuse subarachnoid hemorrhage, intraventricular hemorrhage, and variable stages of subdural hematoma in bilateral occipital and left temporal subdural spaces. A partially thrombosed aneurysm was noted in the right craniocervical junction. Ophthalmological examination revealed bilateral retinal petechial hemorrhages. Conventional cerebral angiography revealed a dissecting aneurysm in the right posterior inferior cerebellar artery (PICA). Endovascular embolization was suggested, but the family refused. After conservative treatment, follow-up MRI revealed that the PICA aneurysm had remodeled and ultimately disappeared completely at the 10th month. This case illustrates the relatively plastic nature of intracranial aneurysms in pediatric patients. More studies are necessary to clarify the natural history of spontaneously thrombosed aneurysms to assist in their overall management.

  3. Giant partially thrombosed 4 th ventricular posterior inferior cerebellar artery aneurysm; microsurgical management

    Directory of Open Access Journals (Sweden)

    Forhad Hossain Chowdhury

    2014-01-01

    Full Text Available A 42-year-old woman presented with a 3-month history of progressive occipital headache, vomiting, walking difficulty, and repeated fall. She had no history of sudden and severe headache. She had positive cerebellar signs, predominantly on the right side. Computerized tomography (CT scan, CT angiogram, and magnetic resonance image (MRI of the brain showed suspected partially thrombosed giant 4 th ventricular posterior inferior cerebellar artery aneurysm. Patient developed severe hypersensitivity reaction during both CT scan and MRI after contrast injection. Though needed, digital subtraction angiogram (DSA of cerebral vessels was not done. The aneurysm was managed by microsurgical clipping of the aneurysm neck and partial excision of thrombosed aneurysm. Here, we report the details of management of these difficult giant aneurysm without DSA.

  4. Endovascular therapy for abdominal aortic aneurysm and iliac artery aneurysm using SEAL aortic stent-graft: A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Park, Su Young; Kim, Jeong Ho; Byun, Sung Su; Kang, Jin Mo; Choi, Sang Tae; Park, Jae Hyung [Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2015-03-15

    The aim of this study was to evaluate the safety and efficacy of SEAL aortic stent-graft for abdominal aortoiliac aneurysms. Between October 2007 and January 2014, 33 patients with abdominal aortoiliac aneurysms were treated with SEAL aortic stent-graft. We evaluated the technical success rate, clinical and CT follow-up periods, major complications, need for additional interventional treatment, aneurysm-related mortality and clinical success rate. SEAL bifurcated aortic stent-graft was successfully placed in 32 patients (97%). Clinical and CT follow-up periods were 24 and 14 months, respectively. Endoleak developed in 13 patients (41%): spontaneous regression or decrease in 6, need for additional treatment in 4 and follow-up loss in 3. Significant stenosis of stent-graft occurred in 4 patients (12%) and was treated with stenting in 3. Migration of stent-graft was noted in 3 patients (9%) and treated with additional stent-grafting. Aneurysm-related mortality was 9% (3 of 33). The placement of SEAL stent-graft was effective in 26 patients (79%). The placement of SEAL aortic stent-graft was safe and effective in patients with aneurysms of abdominal aorta and iliac arteries. However, complicating endoleaks, stenosis and migration of the stent-graft developed during the follow-up. Therefore, regular CT follow-up seems to be mandatory.

  5. Call-Fleming Syndrome (Reversible Cerebral Artery Vasoconstriction and Aneurysm Associated with Multiple Recreational Drug Use

    Directory of Open Access Journals (Sweden)

    Doniel Drazin

    2013-01-01

    Full Text Available Drug abuse represents a significant health issue. Evidence suggests that recreational drug use has a direct effect on the cerebral vasculature and is of greater concern in those with undiagnosed aneurysms or vascular malformations. The authors report a case of thunderclap headache with a negative head CT and equivocal lumbar puncture after a drug-fueled weekend. The patient underwent diagnostic cerebral angiogram which demonstrated multisegmental, distal areas of focal narrowing of the middle, anterior, posterior, and posterior inferior cerebral artery and an incidental aneurysm. It is often difficult to determine the exact origin of symptoms; thus we were left with a bit of a chicken or the egg debate, trying to decipher which part came first. Either the aneurysm ruptured with associated concomitant vasospasm or it is a case of Call-Fleming syndrome (reversible cerebral artery vasoconstriction with an incidental aneurysm. The authors proposed their management and rationale of this complex case.

  6. Call-fleming syndrome (reversible cerebral artery vasoconstriction) and aneurysm associated with multiple recreational drug use.

    Science.gov (United States)

    Drazin, Doniel; Alexander, Michael J

    2013-01-01

    Drug abuse represents a significant health issue. Evidence suggests that recreational drug use has a direct effect on the cerebral vasculature and is of greater concern in those with undiagnosed aneurysms or vascular malformations. The authors report a case of thunderclap headache with a negative head CT and equivocal lumbar puncture after a drug-fueled weekend. The patient underwent diagnostic cerebral angiogram which demonstrated multisegmental, distal areas of focal narrowing of the middle, anterior, posterior, and posterior inferior cerebral artery and an incidental aneurysm. It is often difficult to determine the exact origin of symptoms; thus we were left with a bit of a chicken or the egg debate, trying to decipher which part came first. Either the aneurysm ruptured with associated concomitant vasospasm or it is a case of Call-Fleming syndrome (reversible cerebral artery vasoconstriction) with an incidental aneurysm. The authors proposed their management and rationale of this complex case.

  7. Risk factors and consequences of unexpected trapping for ruptured anterior communicating artery aneurysms

    Directory of Open Access Journals (Sweden)

    Hitoshi Fukuda

    2014-01-01

    Full Text Available Background: While clipping cerebral aneurysms at the neck is optimal, in some cases this is not possible and other strategies are necessary. The purpose of this study was to describe the incidence, risk factors, and outcomes for inability to clip reconstruct ruptured anterior communicating artery (ACoA aneurysms. Methods: Of the 70 cases of ruptured ACoA aneurysms between January 2006 and December 2013, our institutional experience revealed four cases of small ACoA aneurysms that had been considered clippable prior to operation but required trapping. When a unilateral A2 segment of anterior cerebral artery (ACA was compromised by trapping, revascularization was performed by bypass surgery. Clinical presentation, angiographic characteristics, operative approach, intraoperative findings, and treatment outcomes were assessed. Results: Very small aneurysm under 3 mm was a risk factor for unexpected trapping. The reason for unexpected trapping was laceration of the aneurysmal neck in two cases, and lack of clippaple component due to disintegration of entire aneurysmal wall at the time of rupture in the others. Aneurysms with bilateral A1 were treated with sole trapping through pterional approach in two cases. The other two cases had hypoplastic unilateral A1 segment of ACA and were treated with combination of aneurysm trapping and revascularization of A2 segment of ACA through interhemispheric approach. No patients had new cerebral infarctions of cortical ACA territory from surgery. Cognitive dysfunction was observed in three cases, but all patients became independent at 12-month follow up. Conclusions: Unexpected trapping was performed when ruptured ACoA aneurysms were unclippable. Trapping with or without bypass can result in reasonable outcomes, with acceptable risk of cognitive dysfunction.

  8. Clinically occult chronic dissecting aneurysm of the superior cerebellar artery in a child

    International Nuclear Information System (INIS)

    An isolated chronic dissecting aneurysm of the left superior cerebellar artery was discovered incidentally in a 12-year-old girl. There was no history of any previous trauma or witnessed abnormal neurological incident at any stage during her life. She was and has since remained asymptomatic and the aneurysm has remained radiologically stable for over 3 years. A conservative approach to the management of such incidental asymptomatic lesions is thus suggested. (orig.)

  9. Arterial aneurysms and tuberous sclerosis: a classic but little known association

    International Nuclear Information System (INIS)

    Tuberous sclerosis is a rare autosomal dominant syndrome in which aortic aneurysm is a classic but little known cause of sudden death. We report a 20-month-old boy with tuberous sclerosis and iliofemoral arterial aneurysms. This case highlights the importance of systematic screening for such vascular complications. Multislice CT or MRI is mandatory as a screening and diagnostic tool in this setting to complement US with Doppler examination. (orig.)

  10. Stent implantation for the treatment of wide-necked aneurysms located at internal carotid artery bifurcation

    International Nuclear Information System (INIS)

    Objective: To preliminarily evaluate the feasibility, safety and efficacy of stent placement for the treatment of wide-necked aneurysms located at internal carotid artery bifurcation. Methods: Eleven patients with wide-necked aneurysms located at internal carotid artery bifurcation, who were encountered during the period from Jan. 2004 to Dec. 2010 in hospital, were collected. A total of 16 intracranial aneurysms were detected, of which 11 were wide-necked and were located at internal carotid artery bifurcation. The diameters of the aneurysms ranged from 2.5 mm to 18 mm. Individual stent type and stenting technique was employed for each patient. Follow-up at 1, 3, 6 and 12 months after the procedure was conducted. Results: A total of 11 different stents were successfully deployed in the eleven patients. The stents included balloon expandable stent (n=1) and self-expanding stent (n=10). According to Raymond grading for the immediate occlusion of the aneurysm, grade Ⅰ (complete obliteration) was obtained in 4, grade Ⅱ (residual neck) in 2 and grade Ⅲ (residual aneurysm) in 5 cases. No procedure-related complications occurred. At the time of discharge, the modified Rankin score was 0-1 in the eleven patients. During the follow-up period lasting for 1-108 months, all the patients were in stable condition and no newly-developed neurological dysfunction or bleeding observed. Follow-up examination with angiography (1-48 months) showed that the aneurysms were cured (no visualization) in 4 cases, improved in 2 cases and in stable condition in one case. Conclusion: For the treatment of wide-necked aneurysms located at internal carotid artery bifurcation, stent implantation is clinically feasible, safe and effective. Further studies are required to evaluate its long-term efficacy. (authors)

  11. Endovascular Treatment of an Aneurysmal Aberrant Systemic Artery Supplying a Pulmonary Sequestrum

    DEFF Research Database (Denmark)

    Kristensen, Katrine Lawaetz; Duus, Louise Aarup; Elle, Bo

    2015-01-01

    An aberrant systemic artery originating from the abdominal aorta supplying a pulmonary sequestration is a rare congenital malformation. This causes a left-to-left shunt. Symptoms include recurrent pneumonias, hemoptysis, and, in the long term, heart failure. Aneurysm of the aberrant vessel...... aneurysmal branch from the abdominal aorta to the normal basal segments of the lung, successfully occluded with an Amplatzer Vascular Plug II (AVP II, St.Jude Medical, MN, USA) alone....

  12. Endovascular Treatment of a Ruptured Posterior Inferior Cerebellar Artery Aneurysm during Pregnancy

    OpenAIRE

    Kim, Ki Dae; Chang, Chul Hoon; Choi, Byung Yon; Jung, Young Jin

    2014-01-01

    Aneurysmal subarachnoid hemorrhage (SAH) during pregnancy is quite rare, however it has a high maternal mortality rate. A pregnant woman in the 16th gestational week was admitted to our hospital with a drowsy level of consciousness. A brain magnetic resonance (MR) image showed hemorrhage on the prepontine cistern, and both sylvian fissures, and MR angiography and cerebral digital subtraction angiography demonstrated an aneurysm at the left posterior inferior cerebellar artery (PICA). We perfo...

  13. Severe optochiasmatic arachnoiditis after rupture of an internal carotid artery aneurysm

    Directory of Open Access Journals (Sweden)

    Ricardo Ramina

    1989-06-01

    Full Text Available The case of a 24-year-old man with progressive visual loss due to optochiasmatic arachnoiditis is presented. The cause of the arachnoiditis was subarachnoidal bleeding due to rupture of an internal carotid artery aneurysm. The aneurysm was clipped 5 years after the first episode of bleeding. The diagnosis of optochiasmatic arachnoiditis was confirmed during the operation. This case, is presented in order to discuss the causes, the symptoms and the therapeutical possibilities of this rare condition.

  14. Multiple giant coronary aneurysms arising from coronary istula to the pulmonary artery revealed in aorta CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Ju; Lee, Ki Nam [Dept. of Radiology, Dong A University Hospital, Dong-A University College of Medicine, Busan (Korea, Republic of); Lee, Jong Min [Dept. of Radiology, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu (Korea, Republic of)

    2015-12-15

    Coronary fistula is a rare coronary abnormality through which blood drains into the cardiac chamber, great vessel or other vessels. In addition, giant aneurysm arising from coronary fistula is rare pathologic manifestation. Herein, we presented a rare case of multiple giant coronary artery aneurysms arising from coronary to pulmonary artery fistula in a 79-year-old woman presenting with sudden loss of consciousness. The aneurysms were detected using thoracic computed tomography angiography and consequently confirmed by invasive coronary angiography.

  15. Basic fibroblast growth factor gene transfection in repair of internal carotid artery aneurysm wall

    Institute of Scientific and Technical Information of China (English)

    Lei Jiao; Ming Jiang; Jinghai Fang; Yinsheng Deng; Zejun Chen; Min Wu

    2012-01-01

    Surgery or interventional therapy has some risks in the treatment of cerebral aneurysm. We established an internal carotid artery aneurysm model by dripping elastase in the crotch of the right internal and external carotid arteries of New Zealand rabbits. Following model induction, lentivirus carrying basic fibroblast growth factor was injected through the ear vein. We found that the longer the action time of the lentivirus, the smaller the aneurysm volume. Moreover, platelet-derived growth factor expression in the aneurysm increased, but smooth muscle 22 alpha and hypertension-related gene 1 mRNA expression decreased. At 1, 2, 3, and 4 weeks following model establishment, following 1 week of injection of lentivirus carrying basic fibroblast growth factor, the later the intervention time, the more severe the blood vessel damage, and the bigger the aneurysm volume, the lower the smooth muscle 22 alpha and hypertension-related gene 1 mRNA expression. Simultaneously, platelet-derived growth factor expression decreased. These data suggest that recombinant lentivirus carrying basic fibroblast growth factor can repair damaged cells in the aneurysmal wall and inhibit aneurysm dynamic growth, and that the effect is dependent on therapeutic duration.

  16. Coil embolization of an aneurysm located at the trunk of the persistent primitive trigeminal artery.

    Science.gov (United States)

    Kai, Yutaka; Ohmori, Yuki; Watanabe, Masaki; Morioka, Motohiro; Hirano, Teruyuki; Kawano, Takayuki; Sakurama, Tomotaka; Miura, Akiko; Kuratsu, Jun-Ichi

    2011-01-01

    A 71-year-old woman presented with an aneurysm at the trunk of the persistent primitive trigeminal artery (PPTA) manifesting as subarachnoid hemorrhage. Angiography and three-dimensional computed tomography revealed a wide-necked saccular aneurysm at the trunk of the left PPTA. Coil embolization with the balloon-assist technique was successful and PPTA patency was preserved. Preoperative conventional angiography should be performed to check for cross-filling of the PPTA. This case demonstrates that an aneurysm of the trunk of the PPTA can be successfully treated by coil embolization using the balloon-assist technique. PMID:21613761

  17. Primary internal carotid artery aneurysm in a 15-year-old male: case report and review of the literature.

    Science.gov (United States)

    Lopez, Daniel; Sarac, Timur; Lorenz, Robert

    2015-01-01

    Extracranial internal carotid artery aneurysms are a rare entity in the adult population. Very little information is known in the pediatric population. We present a case of a 15-year-old male with an isolated internal carotid artery aneurysm and a review of the literature.

  18. Endovascular treatment of a ruptured pulmonary artery aneurysm in a patient with Behcet's disease using the amplatzer vascular plug 4

    International Nuclear Information System (INIS)

    A pulmonary artery aneurysm is a common manifestation and the leading cause of mortality in Behcet's disease. We describe a case of spontaneous rupture of a pulmonary artery aneurysm that, due to the inadequacy of medical therapy and the disadvantages of surgery, became the ideal candidate for endovascular management and was successfully performed by using the Amplatzer Vascular Plug 4.

  19. Evolution of Giant P2-Posterior Cerebral Artery Aneurysm over 16 Years: Saccular to Serpentine. A Case Report.

    Science.gov (United States)

    Sharma, S

    2009-12-14

    Giant intracranial aneurysms account for only about 5% of all intracranial aneurysms. Giant intradural aneurysms are associated with severe natural history, yet remain potentially curable. These aneurysms cause symptoms due to their mass effect, and only 14-35% of cases present with subarachnoid haemorrhage (SAH). The present case report is an imaging evolution of a giant posterior cerebral artery (PCA) aneurysm in a patient who was lost on follow-up from 1992 to 2008 giving insight into the natural history and morphologic evolution of giant serpentine aneurysms. Attempted surgery 16 years previously for a saccular PCA aneurysm produced encephalomalacia and created a more spacious perianeurysmal environment, preventing any mass effect on vital structures in its vicinity. This allowed the patient to have a long symptom-free period and also allowed the aneurysm to follow a morphologic evolution over a long period without causing symptoms which would have called for intervention. This unusual development gave a unique opportunity to study the evolution of a gaint serpentine aneurysm from a saccular aneurysm and also the clinical and morphologic changes in an aneurysm if it can be prevented from producing mass effect. The Coanda effect, or boundary wall effect, has been considered responsible for the development of the serpentine channel in the original globular aneurysm . However many Authors conclude that giant serpentine aneurysms are not derived from saccular aneurysms. PMID:24209407

  20. A Huge Thrombosed Pulmonary Artery Aneurysm without Pulmonary Hypertension in a Patient with Hepatosplenic Schistosomiasis

    Science.gov (United States)

    Abo-Salem, Elsayed S.; Ramadan, Mahmoud M.

    2015-01-01

    Patient: Male, 55 Final Diagnosis: Thrombosed pulmonary artery aneurysm Symptoms: Cough productive • fever • shortness of breath Medication: — Clinical Procedure: Pericardiocentesis Specialty: Cardiology Objective: Rare disease Background: We herein report a case of huge pulmonary artery aneurysm in a 55-year-old male farmer from the Nile delta (Lower-Egypt), mostly due to infestation with Schistosoma mansoni, which is the parasite causing hepatosplenic schistosomiasis. Case Report: This male patient was admitted with a month-long history of progressive shortness of breath, 2-month history of fever, and a cough with mucoid sputum for 10 days. On examination, he had normal temperature and blood pressure, but he had tachypnea, tachycardia, and congested neck veins. Electrocardiography showed multifocal atrial tachycardia and right bundle branch block. Conclusions: The present case is unique in that it shows the presence of a huge pulmonary artery aneurysm despite the absence of pulmonary hypertension. PMID:25746428

  1. Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, Michael B.; Dappa, Evelyn; Jungmann, Florian; Kloeckner, Roman; Schotten, Sebastian; Wirth, Gesine M.; Mildenberger, Peter; Kreitner, Karl-Friedrich; Oberholzer, Katja; Dueber, Christoph [University Hospital of Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Mittler, Jens; Lang, Hauke [University Hospital of Mainz, Department of Abdominal, Visceral and Transplantation Surgery, Mainz (Germany)

    2015-07-15

    To evaluate the incidence, management, and outcome of visceral artery aneurysms (VAA) over one decade. 233 patients with 253 VAA were analyzed according to location, diameter, aneurysm type, aetiology, rupture, management, and outcome. VAA were localized at the splenic artery, coeliac trunk, renal artery, hepatic artery, superior mesenteric artery, and other locations. The aetiology was degenerative, iatrogenic after medical procedures, connective tissue disease, and others. The rate of rupture was much higher in pseudoaneurysms than true aneurysms (76.3 % vs.3.1 %). Fifty-nine VAA were treated by intervention (n = 45) or surgery (n = 14). Interventions included embolization with coils or glue, covered stents, or combinations of these. Thirty-five cases with ruptured VAA were treated on an emergency basis. There was no difference in size between ruptured and non-ruptured VAA. After interventional treatment, the 30-day mortality was 6.7 % in ruptured VAA compared to no mortality in non-ruptured cases. Follow-up included CT and/or MRI after a mean period of 18.0 ± 26.8 months. The current status of the patient was obtained by a structured telephone survey. Pseudoaneurysms of visceral arteries have a high risk for rupture. Aneurysm size seems to be no reliable predictor for rupture. Interventional treatment is safe and effective for management of VAA. (orig.)

  2. Endovascular Therapeutic Occlusion of the Posterior Cerebral Artery: An Option for Ruptured Giant Aneurysm in a Child.

    Science.gov (United States)

    Demartini, Zeferino; Matos, Luiz Afonso Dias; Dos Santos, Marcio Luis Tostes; Cardoso-Demartini, Adriane de Andre

    2016-01-01

    The incidence of intracranial aneurysms in the pediatric population is low, and surgical clipping remains a good long-term treatment option. However, posterior circulation aneurysms are even more complex to manage in children than in adults. We report a case of a giant aneurysm of the posterior cerebral artery in a 10-year-old boy presenting with subarachnoid hemorrhage. Endovascular treatment with platinum coils was performed with total occlusion of the aneurysm and the affected arterial segment without complications. The patient achieved good recovery, and a late control angiogram confirmed exclusion of the aneurysm. Occurrence of special features of cerebral aneurysm in children, in comparison to adults, is also described. Parent artery sacrifice is an effective therapeutic option, but long-term follow-up is necessary to avoid recurrence and rebleeding.

  3. Development of bilateral coronary artery aneurysms in a child with Noonan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Mauro, David M.; Flors, Lucia; Norton, Patrick T.; Hagspiel, Klaus D. [University of Virginia Health System, Department of Radiology and Medical Imaging, Charlottesville, VA (United States); Hoyer, Andrew W. [University of Virginia Health System, Department of Pediatrics, Division of Pediatric Cardiology, Charlottesville, VA (United States); Pediatric Cardiology Center of Oregon, Portland, OR (United States)

    2016-03-15

    Noonan syndrome is a constellation of congenital malformations including heart defects, facial anomalies and short stature. The cardiovascular defects are variable and extensive, with the most common being pulmonary stenosis and hypertrophic cardiomyopathy. Coronary artery anomalies have only been reported in a few cases. We report a child with Noonan syndrome status post pulmonary stenosis and atrial septal defect repair, who developed bilateral coronary artery aneurysms. The aneurysms were diagnosed with both cardiac magnetic resonance imaging and coronary computed tomography angiography. There had been no evidence of them on a cardiac MR exam 5 years previously. (orig.)

  4. Development of bilateral coronary artery aneurysms in a child with Noonan syndrome.

    Science.gov (United States)

    Mauro, David M; Flors, Lucia; Hoyer, Andrew W; Norton, Patrick T; Hagspiel, Klaus D

    2016-03-01

    Noonan syndrome is a constellation of congenital malformations including heart defects, facial anomalies and short stature. The cardiovascular defects are variable and extensive, with the most common being pulmonary stenosis and hypertrophic cardiomyopathy. Coronary artery anomalies have only been reported in a few cases. We report a child with Noonan syndrome status post pulmonary stenosis and atrial septal defect repair, who developed bilateral coronary artery aneurysms. The aneurysms were diagnosed with both cardiac magnetic resonance imaging and coronary computed tomography angiography. There had been no evidence of them on a cardiac MR exam 5 years previously. PMID:26515448

  5. Unilateral supraorbital keyhole approach in patients with middle cerebral artery (M1-M2 segment) symmetrical aneurysms.

    Science.gov (United States)

    Martellotta, N; Gigante, N; Toscano, S; Maddalena, G F; Tripodi, M; Settembrini, G; Stroscio, C; Distefano, G; Citro, E

    2003-08-01

    A left middle cerebral artery aneurysm at the bifurcation (M1-M2 segment) and a right smaller aneurysm, symmetrical to the previous one were diagnosed in a 69-year-old female after angiographic examination for subarachnoid hemorrhage. The preoperative radiological study did not enable us to identify the bleeding aneurysm so a left supraorbital keyhole approach was performed to operate on the bigger aneurysm. In the same surgical session, using the same way of approach, we decided to attack also the right aneurysm which then revealed itself as being responsible for bleeding. The postoperative angiograms confirmed the complete exclusion of both aneurysms and the patient was discharged after good recovery. Although there are remarkable controversies about the surgical strategies for multiple aneurysms, our experience gives us the opportunity to emphasize the supraorbital keyhole approach and to reconsider the "timing" of multiple/bilateral aneurysms.

  6. Operative strategy of complex internal carotid artery-posterior communicating artery aneurysms Defensive effect on perioperative nerve injury

    Institute of Scientific and Technical Information of China (English)

    Xinmin Wang; Wende Xiong; Xuqin Li

    2007-01-01

    BACKGROUND: The two problems in treating intracranial aneurysm are the vascular reconstruction and brain protection, especially for complex internal carotid artery-posterior communicating artery (ICA-PComA)aneurysms.OBJECTIVE: To analyze the anatomic features and operative technique of complex ICA-PComA aneurysms, and investigate how to better protect the brain tissue.DESIGN: A retrospective case analysis.SETTING: Department ofNeurosurgery, Dalian Central Hospital.PARTICIPANTS: Totally 154 inpatients with ICA-PComA aneurysms were selected from the Department of Neurosurgery, Dalian Central Hospital from January 1998 to December 2006, including 19 cases (12.3%)of complex ICA-PComA aneurysms, 8 males and 11 females, 38 - 67 years of age. Informed contents for surgery and observation were obtained from all the patients or their relatives.METHODS: The clinical manifestations, including initial symptoms and Hunt&Hess grading, were observed. Corresponding strategies were selected for different types of ICA-PComA aneurysms. The patients were followed up at 3 months postoperatively. According to the results of Glasgow scoring, the curative effects were classified as good (4 - 5 points), bad (2 - 3 points) and dead (1 point). The results at discharge were taken as early results, whereas the follow-up results as late results.MAIN OUTCOME MEASURES: Clinical manifestations and curative effects of the patients.RESULTS: All the 19 patients with ICA-PComA were involved in the analysis of results. For clinical manifestations, the initial symptoms were subarachnoid hemorrhage (n =15), paralysis of oculomotor nerve (n =3), and occasional attack (n =1); The Hunt&Hess grading was grade Ⅰ in 4 cases, grade Ⅱ in 6 cases,grade Ⅲ in 6 cases, grade Ⅳ in 2 cases, and grade Ⅴ in 1 case. The curative effects were that aneurysm breakage and bleeding occurred in 6 cases perioperatively, uncomplete clipping of aneurysm in 2 cases and constriction of parent artery in 1 case. The

  7. Surgical Repair of Abdominal Aortic and Renal Artery Aneurysms in Takayasu's Arteritis.

    Science.gov (United States)

    Wetstein, Paul J; Clark, Margaret E; Cafasso, Danielle E; Golarz, Scott R; Ayubi, Farhan S; Kellicut, Dwight C

    2016-01-01

    Takayasu's arteritis is a large vessel vasculitis that can be a challenging diagnosis to make and has a varied clinical presentation. Management largely depends on affected vessel disease severity and individual patient considerations. The diagnosis must be considered in a young patient with large vessel aneurysms. We present a case of a 30 year-old woman of Pacific Islander descent who presented to the Tripler Army medical Center Vascular Surgery Department in Honolulu, Hawai'i seeking repair of her abdominal aortic and renal artery aneurysms prior to conception. A 30 year-old Pacific Islander woman with a history of a saccular abdominal aortic aneurysm and renal artery aneurysms presented to our clinic seeking vascular surgery consultation prior to a planned pregnancy. She had a renal artery stent placed at an outside institution for hypertension. She met the diagnosis of Takayasu's arteritis by Sharma's criteria. Physical exam was significant for a palpable, pulsatile, abdominal mass and CT angiography revealed a saccular irregular-appearing infra-renal abdominal aortic aneurysm, extending to the aortic bifurcation, with a maximum diameter of 3.3 cm. A right renal artery aneurysm was also identified proximally, contiguous with the aorta, with a maximal transverse diameter of 1.7 cm. The patient underwent a supraceliac bypass to the right renal artery with a 7 mm Dacron graft, as well as excision of the right renal artery aneurysm. The abdominal aortic aneurysm was replaced using a Hemashield Dacron bifurcated 14 mm x 7 mm bypass graft. Intraoperative measurements of the renal artery aneurysm were 1.5 x 1.5 cm and the saccular appearing distal abdominal aortic aneurysm measured 3.6 x 3.3 cm. The patient was discharged from the hospital 7 days post-operatively. At 1-year follow up, CT scan of the abdominal aorta revealed the repair was without any evidence of aneurysm formation, anastomotic pseudoaneurysm formation, or areas of stenosis. She has remained

  8. Numerical simulations of post-surgical flow and thrombosis in basilar artery aneurysms

    Science.gov (United States)

    Seshadhri, Santhosh; Lawton, Michael; Boussel, Loic; Saloner, David; Rayz, Vitaliy

    2015-11-01

    Surgical treatment of basilar artery aneurysms presents a major challenge since it is crucial to preserve the flow to the vital brainstem perforators branching of the basilar artery. In some cases, basilar aneurysms can be treated by clipping vessels in order to induce flow reduction and aneurysm thrombosis. Patient-specific CFD models can provide guidance to clinicians by simulating postoperative flows resulting from alternative surgeries. Several surgical options were evaluated for four basilar aneurysm patients. Patient-specific models were generated from preoperative MR angiography and MR velocimetry data and modified to simulate different procedures. The Navier-Stokes equations were solved with a finite-volume solver Fluent. Virtual contrast injections were simulated by solving the advection-diffusion equation in order to estimate the flow residence time and determine thrombus-prone regions. The results indicated on procedures that reduce intra-aneurysmal velocities and flow regions which are likely to become thrombosed. Thus CFD modeling can help improve the outcome of surgeries altering the flow in basilar aneurysms.

  9. Arterial Ligation for Infected Femoral Psuedo-Aneurysm in Drug Injecting Abusers

    Directory of Open Access Journals (Sweden)

    Mohammadzade Mohammad Ali

    2009-10-01

    Full Text Available Pseudo-aneurysm of the femoral artery is the most common arterial complication in drug injecting abusers. Scholars in vascular surgery have published debating statements regarding techniques of successful surgical management during last two decades. We present the results of simple arterial ligation in a series of 32 patients presenting with infected femoral pseudo-aneurysm. Most of the patients were males (89%. Young persons in the age group of 15-44 years were mostly affected. Site of lesion included common femoral artery in 65% , superficial femoral artery 28% and at bifurcation 6.2%. celulitis in 14 (53%, abscess & "ncelulitis in 6 (19%, necrosing fasciitis in 2 (6.2% and vascular abscess in 7 (22% cases were the forms of associated local infection. There was no hemorrhage, vascular thrombosis, amputation, or mortality. Claudicating were the only complications identified in 2 patients with Tripe ligation. Ligation is the optimal management for infected pseudo-aneurysms because it is easy, cost-effective, and safe. Early reconstruction is not recommended, since there is an extended infection in the location of the pseudo-aneurysm.

  10. Endovascular management of visceral artery aneurysms: When to watch, when to intervene?

    Institute of Scientific and Technical Information of China (English)

    Romaric; Loffroy; Sylvain; Favelier; Pierre; Pottecher; Pierre-Yves; Genson; Louis; Estivalet; Sophie; Gehin; Jean-Pierre; Cercueil; Denis; Krausé

    2015-01-01

    Visceral artery aneurysms(VAA) include splanchnic and renal artery aneurysms. They represent a rare clinical entity, although their detection is rising due to an increased use of cross-sectional imaging. Rupture is the most devastating complication, and is associated with a high morbidity and mortality. In addition, increased percutaneous endovascular interventions have raised the incidence of iatrogenic visceral artery pseudoaneurysms(VAPAs). For this reason, elective repair is preferable in the appropriately chosen patient. Controversy still exists regarding their treatment. Over the past decade, there has been steady increase in the utilization of minimally invasive, non-operative interventions, for vascular aneurysmal disease. All VAAs and VAPAs can technically be fixed by endovascular techniques but that does not mean they should. These catheter-based techniques constitute an excellent approach in the elective setting. However, in the emergent setting it may carry a higher morbidity and mortality. The decision for intervention has to take into account the size and the natural history of the lesion, the risk of rupture, which is high during pregnancy, and the relative risk of surgical or radiological intervention. For splanchnic artery aneurysms, we should recognize that we are not, in reality, well informed about their natural history. For most asymptomatic aneurysms, expectant treatment is acceptable. For large, symptomatic or aneurysms with a high risk of rupture, endovascular treatment has become the firstline therapy. Treatment of VAPAs is always mandatory because of the high risk of rupture. We present our point of view on interventional radiology in the splanchnic arteries, focusing on what has been achieved and the remaining challenges.

  11. Carotid-cavernous fistula caused by rupture of persistent primitive trigeminal artery trunk aneurysm--case report.

    Science.gov (United States)

    Yoshida, Masahiro; Ezura, Masayuki; Mino, Masaki

    2011-01-01

    A 60-year-old female presented with a carotid-cavernous fistula (CCF) manifesting as left abducens nerve palsy. Left internal carotid digital subtraction angiography showed a persistent primitive trigeminal artery (PPTA) near the CCF. Super-selective angiography showed direct shunt flow between the PPTA trunk aneurysm and the left cavernous sinus. The aneurysm was successfully occluded with detachable coils. The CCF disappeared and the PPTA was preserved. The abducens nerve paralysis had disappeared 6 months later. CCF caused by a PPTA trunk aneurysm is extremely rare. We speculate that the PPTA trunk aneurysm formed and then ruptured due to hemodynamic stress caused by hypoplasia of the basilar artery. PMID:21785245

  12. Transluminal Attenuation Gradient for Thrombotic Risk Assessment in Kawasaki Disease Patients with Coronary Artery Aneurysms

    Science.gov (United States)

    Grande Gutierrez, Noelia; Kahn, Andrew; Burns, Jane; Marsden, Alison

    2014-11-01

    Kawasaki Disease (KD) can result in coronary aneurysms in up to 25% of patients if not treated early putting patients at risk of thrombus formation, myocardial infarction and sudden death. Clinical guidelines for administering anti-coagulation therapy currently rely on anatomy alone. Previous studies including patient specific modeling and computer simulations in KD patients have suggested that hemodynamic data can predict regions susceptible to thrombus formation. In particular, high Particle Residence Time gradient (PRTg) regions have shown to correlate with regions of thrombus formation. Transluminal Attenuation Gradient (TAG) is determined from the change in radiological attenuation per vessel length. TAG has been used for characterizing coronary artery stenoses, however this approach has not yet been used in aneurysmal vessels. The aim of this study is to analyze the correlation between TAG and PRTg in KD patients with aneurysms and evaluate the use of TAG as an index to quantify thrombotic risk. Patient specific anatomic models for fluids simulations were constructed from CT angiographic image data from 3 KD aneurysm patients and one normal control. TAG values for the aneurysm patients were markedly lower than for the non-aneurysmal patient (mean -18.38 vs. -2). In addition, TAG values were compared to PRTg obtained for each patient. Thrombotic risk stratification for KD aneurysms may be improved by incorporating TAG and should be evaluated in future prospective studies.

  13. Magnetic resonance angiography of intracranial aneurysms: comparison with intra-arterial digital subtraction angiography

    International Nuclear Information System (INIS)

    Magnetic resonance angiography (MRA) with flow rephased gradient-echo sequences is a new non-invasive method for vascular imaging. We compared MRA and intra-arterial digital subtraction angiography in 18 patients with intracranial aneurysms to test whether MRA presently provides an alternative to cerebral angiography for the diagnosis of these anomalies. MRA showed 19 of the 22 aneurysms detected (86.4%). However, problems, especially with turbulent or slow flow, resulted in 6 studies (27.3%) with limited and 2 with questionable demonstration of an aneurysm, and 1 false negative study. At present, MRA is definitely inferior to angiography for the demonstration of intracranial aneurysms, due to its lower resolution and other limitations. (orig.)

  14. Spontaneous extrusion of guglielmi detachable coils from anterior communicating artery aneurysm

    Directory of Open Access Journals (Sweden)

    Choudhari Kishor

    2007-01-01

    Full Text Available Recurrence of coiled aneurysm usually due to coil compaction is a known phenomenon. Extent of recurrence and its relation to re-bleeding is not known. The authors report a case of spontaneous asymptomatic extrusion of guglielmi detachable coils from the dome of a previously ruptured anterior communicating artery aneurysm two years after the initial endovascular obliteration. The initial aneurysm had a suitable neck-aspect ratio for endovascular obliteration with uncomplicated coiling procedure. Extreme degree of coil compaction with subsequent expulsion of the coils from the dome due to water-hammer effect of blood flow is thought to be the main pathogenic mechanism of this rare but worrying complication. Surgical management includes clipping at the neck ensuring complete obliteration of the aneurysm. Postoperative angiogram to confirm its satisfactory obliteration is advised.

  15. Position dependent right ventricular dysfunction caused by a giant right coronary artery aneurysm.

    Science.gov (United States)

    Mora, Bruno; Urbanek, Bernhard; Loewe, Christian; Grimm, Michael; Dworschak, Martin

    2011-01-01

    We describe an instructive case of a 79-year-old patient with a giant coronary aneurysm and a second smaller aneurysm with an uncommon symptomatology. Giant coronary artery aneurysms (>2 cm diameter) are rare pathologic entities with a prevalence of 0.02%. They either can be congenital malformations or are atherosclerotic in origin. Although spontaneous rupture of giant coronary artery aneurysms has been reported, they generally remain silent or induce myocardial ischemia. Our patient, however, showed no signs of myocardial malperfusion but transient position-dependent pre-syncope. The cardiologic work-up and the intraoperative considerations regarding patient management are described. During surgery, manipulation of the giant coronary artery aneurysm caused impairment of right ventricular function and regional wall hypokinesia, as assessed by transesophageal echocardiography. Venous cannulation of the right atrium was thus abandoned and extracorporeal circulation was established via the femoral vein. Subsequent dissection and surgical repair were uneventful and further recovery of the elderly patient was uncomplicated. This case underlines that once the diagnosis is established, proper perioperative management enables successful surgical treatment even of patients of advanced age. PMID:21253776

  16. ENDOVASCULAR CORRECTION OF A POST-TRAUMATIC FALSE ANEURYSM OF THE RIGHT SUBCLAVIAN ARTERY. A CASE REPORT

    OpenAIRE

    Kvashin, A.; Atamanov, S.; Melnik, Alexey; Bykov, A.; Pomkin, A.; Shirkin, M.; Kyshtymov, S.

    2011-01-01

    False aneurysm of the subclavian artery is an uncommon complication. Most frequently this pathology is caused by fracture of clavicle, however other causes also can exist. We present a case of diagnosis and endovascular treatment of a false aneurysm of the right subclavian artery in a 31-years-old man, heroin addict, who performed multiple injections into the right subclavian artery. At admission he had paresis and decreased sensitivity in the right arm due to compression neuritis of the brac...

  17. Rare anatomical variations of persistent trigeminal artery in two patients with non-aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Samaniego, Edgar A; Dabus, Guilherme; Andreone, Vincenzo; Linfante, Italo

    2011-09-01

    Carotid-basilar anastomoses are remnants of the fetal circulation and although rare, they may become symptomatic and should be recognized during cerebral angiography. Two patients are described with non-aneurysmal subarachnoid hemorrhage and persistent trigeminal arteries (PTA) found on cerebral angiography. In the first patient, the PTA ended in the anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery. The second patient had a PTA terminating in the AICA and superior cerebellar artery. These rare anatomical PTA variants should be recognized on cerebral angiography. PMID:21990842

  18. Aortic Aneurysm

    Science.gov (United States)

    ... Most aneurysms are in the aorta, the main artery that runs from the heart through the chest and abdomen. There are two types of aortic aneurysm: Thoracic aortic aneurysms (TAA) - these occur in the part of the aorta running through the chest Abdominal aortic aneurysms (AAA) - these occur in the part ...

  19. Treatment of distal internal carotid artery aneurysm with the willis covered stent: a prospective pilot study

    International Nuclear Information System (INIS)

    Objective: To evaluate the flexibility and efficacy of the Willis covered stent in the treatment of distal internal carotid artery (DICA) aneurysms. Methods: The study was approved by the authors' institutional review board, and the research was conducted by the authors' institution and the MicroPort Medical Company (Shanghai, China). Thirty-one patients with 33 DICA aneurysms were considered for treatment with a Willis covered stent. The angiographic assessments were categorized as complete or incomplete occlusion. The data on technical success, initial and final angiographic results, mortality, morbidity, and final clinical outcome were collected, and follow-up was performed at 1, 3, 6, and 12 months and yearly after the procedures. Results: Navigation and deployment of the covered stents were successful in 97.6% (41 of 42; 95% confidence interval [CI]: 93%, 102%) of the attempted stent placement procedures. The initial angiographic results showed a complete occlusion in 23 patients with 25 aneurysms (of 32 aneurysms, 78.1% [95% CI: 63%, 93%]) and an incomplete occlusion in seven patients with seven aneurysms (21.9%). The angiographic follow-up (mean, 14 months [95% CI: 12, 15 months]) findings exhibited a complete occlusion in 27 patients with 29 aneurysms (of 31 aneurysms, 93.5% [95% CI: 84%, 103%]) and an incomplete occlusion in two aneurysms (6.5%), with a mild in-stent stenosis in two patients.The clinical follow-up (mean, 27 months [95% CI: 23, 30 months]) demonstrated that 15 patients experienced a full recovery and 14 patients improved. Conclusion: The preliminary results demonstrate good flexibility and efficacy of the Willis covered stent in the treatment of DICA aneurysms in selected patients; longer follow-up and expanded clinical trials are needed. (authors)

  20. Intra-arterial tirofiban infusion for thromboembolic complication during coil embolization of ruptured intracranial aneurysms

    International Nuclear Information System (INIS)

    Introduction: Intra-arterial (IA) thrombolytic intervention for acute thrombosis has been challenged due to the risk of bleeding during the endovascular treatment of ruptured aneurysms. We present the results of IA tirofiban infusion for thromboembolic complications during coil embolization in patients with ruptured intracranial aneurysms. Methods: Thromboembolic events requiring thrombolytic intervention occurred in 39 (10.5%) cases during coil embolization of 372 consecutive ruptured intracranial aneurysms. Maximal aneurysm diameters of 39 patients (mean age, 54.7 ± 13.2 years; 23 female, 16 male) ranged from 2.1 to 13.1 mm (mean, 6.6 ± 3.0 mm). The anterior communicating artery was the most common site (n = 13), followed by the middle cerebral artery (n = 9) and the posterior communicating artery (n = 7). In this series, we used intracranial stents in 10 patients during the procedure. Superselective IA tirofiban infusion through a microcatheter was performed to resolve thrombi and emboli. We assessed the efficacy and safety of IA tirofiban infusion in patients with ruptured aneurysms. Results: Intraarterially administered tirofiban doses ranged from 0.25 to 1.25 mg (mean, 0.71 ± 0.26 mg). Effective thrombolysis or recanalization was achieved in 34 patients (87.2%), and three patients (7.7%) suffered distal migration of clots with partial recanalization. The rest (5.1%) had no recanalization. Nonconsequent intracerebral hemorrhage occurred in two patients (5.1%) after the procedure. Thromboemboli-related cerebral infarction developed in eight patients, and only two patients remained infarction related disabilities. Conclusion: IA tirofiban infusion seems to be efficacious and safe for thrombolysis during coil embolization in patients with ruptured intracranial aneurysms

  1. Percutaneous transhepatic venous embolization of pulmonary artery aneurysm in Hughes-Stovin syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Ah; Kim, Man Deuk; Oh, Do Yun; Park, Pil Won [Bundang CHA General Hospital, Pochon CHA University, Seongnam (Korea, Republic of)

    2007-08-15

    Hughes-Stovin syndrome is an extremely rare entity. We present a case of a 42-year-old man, who developed deep vein and inferior vena cava (IVC) thrombosis, repeated internal bleeding and pulmonary artery aneurysms (PAAs). The patient presented with massive hemoptysis and with PAAs of a 2.5 cm maximum diameter. We describe the successful percutaneous transhepatic venous embolization of the PAAs due to occluded common vascular pathways to the pulmonary artery.

  2. An unusual combination of myocardial bridging and coronary artery aneurysm identified on 64-detector coronary angiography.

    Science.gov (United States)

    Meraj, Perwaiz M; Makaryus, Amgad N; Boxt, Lawrence M

    2007-10-01

    Coronary artery aneurysm is an uncommon finding. It is defined as a dilated coronary artery which exceeds the diameter of the normal adjacent vessel by 1.5-2 times. Although theorized mechanisms include atherosclerotic coronary artery disease (CAD) and iatrogenic causes such as the use of percutaneous coronary interventions (PCI), the natural history and prognosis of this disease remain obscure. We describe a case of a 75 year old man who was found to have a long segmental myocardial bridge immediately followed by a 5 mm inner diameter aneurysm in the left anterior descending artery (LAD) detected on 64-detector cardiac computed tomography (64-CT). The post myocardial bridge aneurysmal dilatation in this case is unique, and has not been previously described. With the advent of 64-CT, more incidental cardiac anomalies and irregularities are likely to be found. In the end, the question as to the clinical significance of these findings and their treatment remains controversial. We report this novel case and review the literature for recommendations on treatment and management of patients with coronary aneurysms. PMID:17043905

  3. Stent-grafting combined with transcatheter embolization for a ruptured isolated hypogastric artery aneurysm

    Institute of Scientific and Technical Information of China (English)

    DONG Zhi-hui; FU Wei-guo; GUO Da-qiao; XU Xin; CHEN Bin; JIANG Jun-hao; YANG Jue; SHI Zheng-yu; WANG Yu-qi

    2006-01-01

    @@ Rupture of isolated hypogastric artery aneurysm (HAA) is rarely encountered and is associated with a high mortality rate. Conventional surgery can not achieve distal control easily and may cause substantial blood loss, yielding high operative morbidity and mortality. On March 17, 2005, we treated a patient with such a disease successfully by using endovascular stent-grafting combined with transcatheter embolization.

  4. Pathological observation of brain arteries and spontaneous aneurysms in hypertensive rats

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Objective To investigate the role of hypertension in the pathogenesis of cerebral aneurysms in rats.Methods Twenty spontaneous hypertensive rats (SHR) and 10 Wistar-Kyoto rats (WKY) were included in this observational study. Animals were fed with normal diet and drinking water. No experimental modifications were undertaken in either group. They were sacrificed at one year of age, the bifurcations of the circle of Willis were dissected and longitudinal serial sections were prepared for light microscopic and transmission electron microscopic study.Results In the SHR group, 2 of the 20 rats formed an aneurysm respectively at the bifurcations of the basilar artery. As revealed by electron microscopy, injury at the bifurcation of the artery first occurred on the steeper side of the intimal pad. Furthermore, loss of endothelial cells, small depressions on the intima, disruptive internal elastic lamina and lymphocytes or red blood cells infiltration were noted at the steeper side of the intimal pad. No significant changes were observed in WKY group.Conclusions Cerebral aneurysms can form spontaneously in SHR without ligation of the common carotid artery and without a diet containing β-aminoproprionitrile. Long-standing systemic arterial hypertension is one of the etiological factors that contributes to aneurysm formation in SHR rats.

  5. Bilateral Stenosis of the Internal carotid artery , associated with aneurysm of the basilar trunk

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    A.A. MORSHED

    1975-01-01

    Full Text Available I A case of bilateral stenosis of the internal carotid artery with aneurysm"nof basilar trunk is reported."n2 Via femoral angiography confirmed the diagnosis which is strongly"nrecommended in diagnosing such cases."n3 No surgica l treatment is considered."n4 No similar case has been reported in literature.

  6. Managing adipsic diabetes insipidus following anterior communicating artery aneurysm in a subtropical climate.

    Science.gov (United States)

    Nolan, Brendan; Inder, Warrick J

    2016-07-01

    Diabetes insipidus without perception of thirst, as may follow an anterior communicating artery aneurysm, requires prescription of fluid intake as well as desmopressin. The management goal of maintaining a normal serum sodium is rendered more challenging in a humid subtropical environment, where insensible losses are higher.

  7. Changing Profiles of Diagnostic and Treatment Options in Subclavian Artery Aneurysms

    NARCIS (Netherlands)

    Vierhout, B. P.; Zeebregts, C. J.; van den Dungen, J. J. A. M.; Reijnen, M. M. P. J.

    2010-01-01

    Background: Subclavian artery aneurysms (SAAs) are rare and may cause life- and limb-threatening complications. Therapeutic options greatly differ as do access alternatives. The aim of the study was to assess its clinical presentation, diagnostics and therapeutic options as reported in the literatur

  8. Giant coronary artery aneurysms in juvenile polyarteritis nodosa: a case report

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    Canares Therese L

    2012-01-01

    Full Text Available Abstract Juvenile polyarteritis nodosa (PAN is a rare, necrotizing vasculitis, primarily affecting small to medium-sized muscular arteries. Cardiac involvement amongst patients with PAN is uncommon and reports of coronary artery aneurysms in juvenile PAN are exceedingly rare. We describe a 16 year old girl who presented with fever, arthritis and two giant coronary artery aneurysms, initially diagnosed as atypical Kawasaki disease and treated with IVIG and methylprednisolone. Her persistent fevers, arthritis, myalgias were refractory to treatment, and onset of a vasculitic rash suggested an alternative diagnosis. Based on angiographic abnormalities, polymyalgia, hypertension and skin involvement, this patient met criteria for juvenile PAN. She was treated with six months of intravenous cyclophosphamide and high dose corticosteroids for presumed PAN related coronary vasculitis. Maintenance therapy was continued with azathioprine and the patient currently remains without evidence of active vasculitis. She remains on anticoagulation for persistence of the aneurysms. This case illustrates a rare and unusual presentation of giant coronary artery aneurysms in the setting of juvenile PAN.

  9. Managing adipsic diabetes insipidus following anterior communicating artery aneurysm in a subtropical climate.

    Science.gov (United States)

    Nolan, Brendan; Inder, Warrick J

    2016-07-01

    Diabetes insipidus without perception of thirst, as may follow an anterior communicating artery aneurysm, requires prescription of fluid intake as well as desmopressin. The management goal of maintaining a normal serum sodium is rendered more challenging in a humid subtropical environment, where insensible losses are higher. PMID:27386124

  10. A RARE CASE OF PERSISTENT TRIGEMINAL ARTERY IN AN ADULT FEMALE WITH PARA POSTERIOR COMMUNICATING ARTERY ANEURYSM

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    Banavathu Daya Bharath Singh

    2015-05-01

    Full Text Available Anastomosis found in the adulthood between the carotid and vertebro - basilar systems, apart from the posterior communicating artery, are extremely infrequent and are due to the persistence of vessels that joined both systems during the fetal period. This carotid - vertebrobasilar anastomosis are the trigeminal, otic, and hypoglossal and proatlantal arteries. P ersistent trigeminal artery is the commonest of the above mentioned four arteries. The reported incidence is about 0.2%. Patients may be asymptomatic or present symptoms due to low flow of posterior circulation or carotid microembolization from posterior circulation. PTA can cause trigemina l neuralgia. We report in this paper a case of a persistant trigeminal artery found in an adult female with a para p com aneurysm who had persistent trigeminal artery which was seen in C T angiogram .

  11. Successful endovascular reconstruction of a recurrent giant middle cerebral artery aneurysm with multiple telescoping flow diverters in a pediatric patient.

    Science.gov (United States)

    Ikeda, Daniel S; Marlin, Evan S; Shaw, Andrew; Powers, Ciarán J

    2015-01-01

    Intracranial aneurysms of the pediatric population are rare, but giant fusiform aneurysms (GFAs) of the middle cerebral artery (MCA) are common within this cohort of patients. These aneurysms are difficult to treat and often require advanced microsurgical skills, as they are usually not amenable to direct clipping. Here, we report the successful treatment of a recurrent GFA of the MCA with three telescoping Pipeline Embolization Devices 6 months after attempted clip reconstruction in a pediatric patient.

  12. A ruptured aneurysm arising at the leptomeningeal collateral circulation from the extracranial vertebral artery to the posterior inferior cerebellar artery associated with bilateral vertebral artery occlusion.

    Science.gov (United States)

    Chonan, Masashi; Nishimura, Shinjitu; Kimura, Naoto; Ezura, Masayuki; Uenohara, Hiroshi; Tominaga, Teiji

    2014-02-01

    We report an extremely rare case of a small ruptured aneurysm of the leptomeningeal collateral circulation from the vertebral artery (VA) to the posterior inferior cerebellar artery (PICA); this aneurysm was associated with bilateral VA occlusion. A 72-year-old woman with sudden headache, nausea, and subarachnoid hemorrhage (SAH) was admitted to our hospital. On admission, no evidence of cerebral signs or cranial nerve palsy was found. Computed tomography imaging showed SAH predominantly in the posterior fossa, and digital subtraction angiography revealed bilateral VA occlusion and the left VA aneurysm located proximal to the VA union. In addition, a small aneurysm was observed at the leptomeningeal collateral circulation located between the extracranial left VA and the left PICA. The patient underwent radical surgery on the day of the onset of the symptoms associated with SAH. However, the VA aneurysm was unruptured and surgically trapped. The small aneurysm arising at the leptomeningeal collateral circulation was ruptured during the surgery and was electrocoagulated; the collateral circulation was preserved, and no neurologic deficits were observed. The postoperative course was uneventful. SAH with the occlusion of major vessels should be diagnosed with utmost caution to allow preoperative neurologic and radiological assessments.

  13. Treatment of carotid artery aneurysms with covered stents; Aneurysmabehandlung der Arteria carotis interna mit gecoverten Stents

    Energy Technology Data Exchange (ETDEWEB)

    Rohr, A.; Alfke, K.; Doerner, L.; Jansen, O. [UKSH Kiel (Germany). Neurochirurgie Neuroradiologie; Bartsch, T.; Stingele, R. [UKSH Kiel (Germany). Neurologie

    2007-10-15

    Purpose: Evaluation of the use of covered stents in treating pseudoaneurysms of the cervical and intracranial/extradural carotid artery and determination of the periprocedural and short- to mid-term complication rate. Materials and Methods: 8 patients with 9 spontaneous dissecting aneurysms of the cervical carotid artery - 5 of which were symptomatic - plus one patient with ofthalmoplegia due to an aneurysm of the cavernous carotid artery were studied. While the latter was treated with a PTFE-covered balloon-mounted stainless steel stent (Jostent/Graftmaster), a self-expanding PTFE-covered Nitonol Stent (Symbiot) was used in all other cases. Intervention was performed with local anesthesia. Aspirin and Clopidogrel were both used as antiplatelet drugs. Clinical signs and symptoms and vascular imaging with DS, MR, CT angiography and ultrasound were recorded during patient follow-up, with a mean follow-up period of 14.6 months (4 - 30). Results: We were able to treat 8 out of 10 aneurysms (80 %) using covered stents. The aneurysms were immediately occluded and the associated stenoses of the parent vessel were eliminated. No clinically relevant complications occurred during the procedure or in the follow-up interval. In two cases, elongation of the carotid artery prevented the stent from being positioned over the aneurysm neck. These cases were shown to be stable with the use of antiplatelet drugs. Conclusion: Covered stents can be used in the treatment of pseudoaneurysms of the carotid artery as an alternative to long-term antithrombotic medication or surgery. In our study treatment was effective (80 %) and free of complications in the short- and mid-term follow-up. Possible indications, technique and the use of imaging modalities for patient follow-up are discussed. (orig.)

  14. Differences between middle cerebral artery bifurcations with normal anatomy and those with aneurysms.

    Science.gov (United States)

    Sadatomo, Takashi; Yuki, Kiyoshi; Migita, Keisuke; Imada, Yasutaka; Kuwabara, Masashi; Kurisu, Kaoru

    2013-07-01

    The objectives of this study were to elucidate the normal anatomy of middle cerebral artery (MCA) bifurcations and to analyze the differences in patients with MCA aneurysms. In the present study, 62 patients underwent three-dimensional magnetic resonance angiography, and no intracranial lesions were noted. The widths of M1 and the superior and inferior M2 branches, as well as their respective lateral angles, were measured. These values were used to calculate the daughter artery ratio (DA ratio; width of larger M2/width of smaller M2) and the lateral angle ratio (LA ratio; lateral angle between M1 and larger M2/lateral angle between M1 and smaller M2). The DA and LA ratios of 54 MCA aneurysm patients (34 with ruptured aneurysms, 20 with unruptured aneurysms) were also calculated, using three-dimensional digital subtraction angiography, and compared with the normal values. In normal patients, the widths of M1 and the branches of M2, the lateral angles, and the LA and DA ratios were not significantly different between the right and left sides. The bilateral superior and inferior lateral angles of normal MCAs were significantly wider than those of MCAs with aneurysms. The DA ratio was 1.5 ± 0.4 in normal MCAs and 1.7 ± 0.7 in MCAs with aneurysms; this difference was significant (p bifurcations show close to symmetric structure in the M2 branches and the lateral angles, whereas aneurysmal MCAs do not show this symmetry.

  15. [An infected partially thrombosed giant aneurysm of the azygos anterior cerebral artery].

    Science.gov (United States)

    Mishima, K; Watanabe, T; Sasaki, T; Saito, I; Takakura, K

    1990-05-01

    The authors report a case of partially thrombosed giant aneurysm which was secondarily infected with purulent meningitis. The relationship between the infection of the aneurysm, the rapid growth of the aneurysm and the development of severe cerebral edema was discussed. A 53 year-old man was admitted on September 1, 1986, with a diagnosis of bacterial meningitis. On his admission, his body temperature was 39 degrees C, and he showed mental confusion but no neurological deficits. Laboratory data revealed signs of infection in white blood cell count, CRP, and erythrocyte sedimentation rate. Computerized tomographic (CT) scan and magnetic resonance (MR) imaging showed a massive round mass with perifocal edema measuring 40mm in the maximum diameter in the left paramedian frontal region. T1 weighted MR image also showed the presence of pus accumulation in the left ventricle. Cerebral angiography demonstrated a giant aneurysm at the distal portion of the azygos anterior cerebral artery, and irregular narrowing of both the supraclinoid segment of the carotid artery and its main branches indicating arteritis due to purulent meningitis. The patient was treated with ventricular drainage and administration of antibiotics. Culture of the purulent CSF was negative. The patient's lab data, CSF finding and neurological status improved progressively. However, follow-up CT scan and angiogram a month later showed enlargement of the aneurysm, dilatation of the patent lumen and perifocal edema. On October 8, the patient suddenly became comatose with anisocoria. A CT scan showed massive edema with marked midline shift. Emergency bifrontal craniotomy was carried out, and clipping was completed after removal of the thrombosed portion of the aneurysm, and thromboendarterectomy of the aneurysmal neck.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2385324

  16. Giant coronary artery aneurysms in a 58-year-old

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    Anil Kumar Singhi

    2014-01-01

    Full Text Available All giant Kawasaki aneurysms may not regress fully; some may eventually calcify, undergo thrombosis, and get detected in asymptomatic adults at later age. Tomisaku Kawasaki initially described this illness as mucocutaneous lymph node syndrome in childhood in 1967 and coronary arteritis was recognized later. We present a 58-year-old male, possibly one of the oldest surviving patients with giant coronary aneurysms who presented with large secundum atrial septal defect (ASD with heart failure. This indicates that the disease was perhaps prevalent outside Japan even before the first Kawasaki′s description.

  17. Endovascular Treatment of the Huge Dissecting Aneurysms Involving the Basilar Artery by the Internal Trapping Technique: Technical Note

    Directory of Open Access Journals (Sweden)

    Shi-Qing Mu

    2015-01-01

    Full Text Available Background: The endovascular strategy of the huge dissecting aneurysms involving the basilar artery (BA is controversial and challenging. This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping (IT technique. Methods: We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of Interventional Neuroradiology of Beijing Tiantan Hospital. Clinical and angiographic data were reviewed and evaluated. Results: All patients were treated by the IT technique. That meant the dissecting artery and aneurysm segments were completed occlusion. After the procedure, the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion. Follow-up angiography was performed at 3-6 months or 12-18 months after the endovascular treatment (median 8 months, 14 patients had a good recovery. Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA. After the second treatment, the patient died by the ventricular tachycardia. Conclusions: The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms, but it is not necessarily the safest or most definitive treatment modality. The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.

  18. Endovascular Treatment of the Huge Dissecting Aneurysms Involving the Basilar Artery by the Internal Trapping Technique: Technical Note

    Institute of Scientific and Technical Information of China (English)

    Shi-Qing Mu; Xin-Jian Yang; You-Xiang Li; Chu-Han Jiang; Zhong-Xue Wu

    2015-01-01

    Background:The endovascular strategy of the huge dissecting aneurysms involving the basilar artery (BA) is controversial and challenging.This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping (IT) technique.Methods:We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of lnterventional Neuroradiology of Beijing Tiantan Hospital.Clinical and angiographic data were reviewed and evaluated.Results:All patients were treated by the IT technique.That meant the dissecting artery and aneurysm segments were completed occlusion.After the procedure,the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion.Follow-up angiography was performed at 3-6 months or 12-18 months after the endovascular treatment (median 8 months),14 patients had a good recovery.Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA.After the second treatment,the patient died by the ventricular tachycardia.Conclusions:The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms,but it is not necessarily the safest or most definitive treatment modality.The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.

  19. The experimental study on aneurysm with PIV system

    Science.gov (United States)

    Yueshe, Wang; Xiaoqi, Ma; Di, Li

    2013-07-01

    Cerebral aneurysm, a local enlargement of an artery caused by weakness in the wall of a cerebral artery, has the high death rate and disability rate, and is a threat to public health. The forming mechanism of aneurysm is complex, which motivated many researchers to conduct studies in this field. The results indicated that increasing heart frequency can aggravate the oscillation of wall shear stress, and push The growth points of aneurysm along the aneurysm wall, thereby significantly affecting bthe growth and rupture mechanism of aneurysm. In addition, it is found that the curvature of the vessel is the key to induce the secondary vortex in the aneurysm; the secondary vortex increases the magnitude of WSS near the dome of aneurysm, which can cause the rupture of aneurysm dome. there is a linear relationship between the velocity of blood flow and the square root of hear frequency.

  20. Nursing assistance for spring coil occlusion for the treatment of intracranial giant internal carotid artery aneurysms

    International Nuclear Information System (INIS)

    Objective: To discuss the importance of balloon occlusion test before interventional treatment of the intracranial giant internal carotid artery aneurysms and to sum up the nursing experience in assisting the procedure. Methods: Proper perioperative nursing measures were carried out for 12 patients, who suffered from intracranial giant internal carotid artery aneurysm and underwent spring coil occlusion treatment. Nursing measures included mental care, observation of the vital signs, prevention of the complications, etc. Results: Neither death nor exacerbation of the condition occurred in all the 12 patients. The patients were discharged from the hospital with a mean hospitalization of nine days. During a follow-up period ranged from 4 months to one year, seven patients had no disagreeable feeling, one patient complained of discomfort but no abnormality was found on follow-up DSA, and disappearance of the aneurysm was observed in 4 patients. Conclusion: The monitoring of the vital signs, the prevention of the complications and the standard nursing care are the key points for ensuring a successful operation in treating intracranial giant internal carotid artery aneurysms with spring coil occlusion. (authors)

  1. Vascular reconstruction of a ruptured and infected aneurysm of extracranial carotid artery

    Institute of Scientific and Technical Information of China (English)

    SONG Jin-qiu; ZHANG Jian; YIN Ming-di; SHAN Shao-yin; WU Bin; DUAN Zhi-quan; XIN Shi-jie

    2008-01-01

    @@ Extracranial carotid artery aneurysm represents an uncommon vascular condition with relatively higher incidence in China than in the West.1 The complication with infection and rupture is even rarer,but potentially lethal.Management of mis condition is challenging but urgent because of high risks for embolization,generalized sepsis,further expansion,rupture,and life threatening.1,2 We present an exceptional case of carotid aneurysm at bifurcation complicated with rupture and infection and discuss the Dathogenesis and vailOUS aspects of diagnosis and surgical management.

  2. Arteriosclerotic coronary arterial aneurysms in a 49-year-old man with crescendo angina: family history, natural course and prevalence.

    Science.gov (United States)

    Schneider, K W; Jesse, R; Deeg, P

    1977-01-01

    In a 49-year-old man with crescendo angina, elevated serum cholesterol level and an old posterior myocardial infarction, selective coronary arteriography showed multiple arteriosclerotic aneurysms of the right coronary artery associated with extensive and severe arteriosclerotic disease of the left coronary artery. The patient's mother and brother have both died of a myocardial infarction. Another brother suffers from angina and has documented arteriosclerotic coronary artery disease. Two sisters suffer from angina as well. The possibility of embolization of distal vessels from a friable clot of the aneurysms as a cause of the patient's infarction is discussed. To the best of our knowledge, this is the tenth patient with nonfistulous arteriosclerotic coronary artery aneurysm diagnosed and documented angiographically ante mortem. Including the present case and reviewing the literature, the prevalence of this condition among nonfistulous coronary aneurysms diagnosed ante mortem is 35 per cent and henceforth cannot be regarded as an incidental autopsy finding in cardiac asymptomatic patients.

  3. Double-balloon remodeling for coil embolization of a primitive trigeminal artery variant aneurysm. A case report.

    Science.gov (United States)

    Takigawa, Tomoji; Suzuki, Kensuke; Sugiura, Yoshiki; Suzuki, Ryotaro; Takano, Issei; Shimizu, Nobuyuki; Tanaka, Yoshihiro; Hyodo, Akio

    2014-01-01

    Here we describe the case of a patient with a wide-necked unruptured aneurysm arising at origin of a persistent primitive trigeminal artery (PTA) variant from the right internal carotid artery (ICA), supplying the territory of the right superior cerebellar artery and the anterior inferior cerebellar artery. To preserve the ICA and the PTA variant, coil embolization of the aneurysm was performed using a double-balloon remodeling technique (HyperForm™ and HyperGlide™ Occlusion Balloon Systems; ev3 Endovascular Inc., Irvine, CA, USA). The association of a PTA variant with an aneurysm is very rare. To our knowledge, this is the first description of the use of coil embolization using double-balloon remodeling to treat a PTA variant aneurysm. This technique permits complete embolization and reduces the risk of cerebral and cerebellar ischemia. PMID:24976091

  4. Endovascular repair of ruptured aneurysm arising from fenestration of the horizontal segment of the anterior cerebral artery: case report.

    Science.gov (United States)

    Yoshida, Masahiro; Ezura, Masayuki; Sasaki, Kazuto; Chonan, Masashi; Mino, Masaki

    2012-01-01

    A 50-year-old man presented with an aneurysm arising from a fenestration of horizontal portion (A(1)) of the anterior cerebral artery manifesting as subarachnoid hemorrhage. Coil embolization was conducted and the aneurysm was occluded easily. Most reported cases of these types of aneurysms underwent direct surgery. Aneurysm arising from the A(1) fenestration is rare, but the present case shows that coil embolization can be an effective treatment modality. Three-dimensional rotational angiography and aneurysmography were helpful to characterize this complicated vascular structure.

  5. Intracranial-to-intracranial bypass for posterior inferior cerebellar artery aneurysms: options, technical challenges, and results in 35 patients.

    Science.gov (United States)

    Abla, Adib A; McDougall, Cameron M; Breshears, Jonathan D; Lawton, Michael T

    2016-05-01

    OBJECT Intracranial-to-intracranial (IC-IC) bypasses are alternatives to traditional extracranial-to-intracranial (EC-IC) bypasses to reanastomose parent arteries, reimplant efferent branches, revascularize branches with in situ donor arteries, and reconstruct bifurcations with interposition grafts that are entirely intracranial. These bypasses represent an evolution in bypass surgery from using scalp arteries and remote donor sites toward a more local and reconstructive approach. IC-IC bypass can be utilized preferentially when revascularization is needed in the management of complex aneurysms. Experiences using IC-IC bypass, as applied to posterior inferior cerebellar artery (PICA) aneurysms in 35 patients, were reviewed. METHODS Patients with PICA aneurysms and vertebral artery (VA) aneurysms involving the PICA's origin were identified from a prospectively maintained database of the Vascular Neurosurgery Service, and patients who underwent bypass procedures for PICA revascularization were included. RESULTS During a 17-year period in which 129 PICA aneurysms in 125 patients were treated microsurgically, 35 IC-IC bypasses were performed as part of PICA aneurysm management, including in situ p3-p3 PICA-PICA bypass in 11 patients (31%), PICA reimplantation in 9 patients (26%), reanastomosis in 14 patients (40%), and 1 V3 VA-to-PICA bypass with an interposition graft (3%). All aneurysms were completely or nearly completely obliterated, 94% of bypasses were patent, 77% of patients were improved or unchanged after treatment, and good outcomes (modified Rankin Scale ≤ 2) were observed in 76% of patients. Two patients died expectantly. Ischemic complications were limited to 2 patients in whom the bypasses occluded, and permanent lower cranial nerve morbidity was limited to 3 patients and did not compromise independent function in any of the patients. CONCLUSIONS PICA aneurysms receive the application of IC-IC bypass better than any other aneurysm, with nearly one

  6. Unfavorable iliac artery anatomy causing access limitations during endovascular abdominal aortic aneurysm repair: application of the endoconduit technique

    Directory of Open Access Journals (Sweden)

    Rodrigo Gibin Jaldin

    2014-12-01

    Full Text Available Endovascular aneurysm repair (EVAR is already considered the first choice treatment for abdominal aortic aneurysms (AAA. Several different strategies have been used to address limitations to arterial access caused by unfavorable iliac artery anatomy. The aim of this report is to illustrate the advantages and limitations of each option and present the results of using the internal endoconduit technique and the difficulties involved.

  7. Emergency endovascular treatment of petrous carotid artery false aneurysm

    Directory of Open Access Journals (Sweden)

    Francesca Graziano, MD

    2015-03-01

    Conclusions: The combination of parent artery balloon protection and low viscosity Onyx embolization can provide an effective occlusion of the IFA while maintaining parent artery patency. Normal distal filling of the parent artery, and optimal obliteration of the IFA are easily achievable.

  8. Does lower limb exercise worsen renal artery hemodynamics in patients with abdominal aortic aneurysm?

    Directory of Open Access Journals (Sweden)

    Anqiang Sun

    Full Text Available Renal artery stenosis (RAS and renal complications emerge in some patients after endovascular aneurysm repair (EVAR to treat abdominal aorta aneurysm (AAA. The mechanisms for the causes of these problems are not clear. We hypothesized that for EVAR patients, lower limb exercise could negatively influence the physiology of the renal artery and the renal function, by decreasing the blood flow velocity and changing the hemodynamics in the renal arteries. To evaluate this hypothesis, pre- and post-operative models of the abdominal aorta were reconstructed based on CT images. The hemodynamic environment was numerically simulated under rest and lower limb exercise conditions. The results revealed that in the renal arteries, lower limb exercise decreased the wall shear stress (WSS, increased the oscillatory shear index (OSI and increased the relative residence time (RRT. EVAR further enhanced these effects. Because these parameters are related to artery stenosis and atherosclerosis, this preliminary study concluded that lower limb exercise may increase the potential risk of inducing renal artery stenosis and renal complications for AAA patients. This finding could help elucidate the mechanism of renal artery stenosis and renal complications after EVAR and warn us to reconsider the management and nursing care of AAA patients.

  9. Embolization of a giant pediatric, posttraumatic, skull base internal carotid artery aneurysm with a liquid embolic agent.

    Science.gov (United States)

    Reig, Adam S; Simon, Scott; Mericle, Robert A

    2009-11-01

    Many treatments for posttraumatic, skull base aneurysms have been described. Eight months after an all-terrain-vehicle accident, this 12-year-old girl presented with right-side Horner syndrome caused by a 33 x 19-mm internal carotid artery aneurysm at the C-1 level. We chose to treat the aneurysm with a new liquid embolic agent for wide-necked, side-wall aneurysms (Onyx HD 500). We felt this treatment would result in less morbidity than surgery and was less likely to occlude the parent artery than placement of a covered stent, especially in a smaller artery in a pediatric patient. Liquid embolic agents also appear to be associated with a lower chance of recanalization and lower cost compared with stent-assisted coil embolization. After the patient was treated with loading doses of aspirin, clopidogrel bisulfate, and heparin, 99% of the aneurysm was embolized with 9 cc of the liquid embolic agent. There were no complications, and the patient remained neurologically stable. Follow-up angiography revealed durable aneurysm occlusion after 1 year. The cost of Onyx was less than the cost of coils required for coil embolization of similarly sized intracranial aneurysms at our institution. Liquid embolic agents can provide a safe, efficacious, and cost-effective approach to treatment of select giant, posttraumatic, skull base aneurysms in pediatric patients.

  10. Giant serpentine aneurysm arising from the middle cerebral artery successfully treated with trapping and anastomosis: case report.

    Science.gov (United States)

    Abiko, Masaru; Ikawa, Fusao; Ohbayashi, Naohiko; Mitsuhara, Takafumi; Nosaka, Ryo; Inagawa, Tetsuji

    2009-02-01

    A 56-year-old man presented with a giant serpentine aneurysm arising from the middle cerebral artery (MCA) manifesting as right hemiparesis and motor aphasia. Magnetic resonance imaging and digital subtraction angiography identified the giant serpentine aneurysm arising from the MCA. The patient was treated surgically. Temporary clipping of the distal channel induced thrombosis in the vascular channel, and the thrombosis was aspirated with an ultrasonic suction device after superficial temporal artery-MCA anastomosis. This case shows that initial occlusion of the distal channel is effective to treat giant serpentine aneurysm. PMID:19246869

  11. Endovascular Treatment of a Symptomatic Thoracoabdominal Aortic Aneurysm by Chimney and Periscope Techniques for Total Visceral and Renal Artery Revascularization

    Energy Technology Data Exchange (ETDEWEB)

    Cariati, Maurizio, E-mail: cariati.maurizio@sancarlo.mi.it [San Carlo Borromeo Hospital, Department of Diagnostic Sciences (Italy); Mingazzini, Pietro; Dallatana, Raffaello [San Carlo Borromeo Hospital, Department of Vascular Surgery (Italy); Rossi, Umberto G. [San Carlo Borromeo Hospital, Department of Diagnostic Sciences (Italy); Settembrini, Alberto [San Carlo Borromeo Hospital, Università degli Studi di Milano (Italy); Santuari, Davide [San Carlo Borromeo Hospital, Department of Vascular Surgery (Italy)

    2013-05-02

    Conventional endovascular therapy of thoracoabdominal aortic aneurysm with involving visceral and renal arteries is limited by the absence of a landing zone for the aortic endograft. Solutions have been proposed to overcome the problem of no landing zone; however, most of them are not feasible in urgent and high-risk patients. We describe a case that was successfully treated by total endovascular technique with a two-by-two chimney-and-periscope approach in a patient with acute symptomatic type IV thoracoabdominal aortic aneurysm with supra-anastomotic aneurysm formation involving the renal and visceral arteries and a pseduaneurismatic sac localized in the left ileopsoas muscle.

  12. Normal anatomy and aneurysms of middle cerebral artery

    International Nuclear Information System (INIS)

    The aim of the present study is to clarify the existing anatomical knowledge and the nomenclature used in describing the normal anatomy of the MCA and its main and cortical branches. The different classifications now available have led to anatomical and terminological confusion and inaccuracy. In this study, it is proposed to make out a new classification and to correlate this with the radiological and operative findings in patients with MCA aneurysms. (orig.)

  13. A Case Report of Coronary Arteriovenous Fistulas with an Unruptured Coronary Artery Aneurysm Successfully Treated by Surgery

    Directory of Open Access Journals (Sweden)

    Nobuhiro Takeuchi

    2012-01-01

    Full Text Available A 58-year-old female with a history of Wolff-Parkinson-White syndrome presented at our institution with palpitations and chest pain. Electrocardiography revealed paroxysmal supraventricular tachycardia with a heart rate of 188 beats/min. Antiarrhythmic drugs were ineffective, and tachycardia was resolved by electrical cardioversion. Transthoracic echocardiography revealed abnormal vessels around the right coronary artery (RCA and pulmonary artery (PA; in addition, we suspected coronary arteriovenous fistula (CAVF. Coronary angiography and coronary computed tomography revealed dilated fistula vessels, with a 1 cm saccular aneurysm around the RCA, originating from the proximal RCA and left anterior descending artery into the main trunk of PA. Therefore, we confirmed the diagnosis of CAVF with an unruptured aneurysm. We surgically ligated and clipped the fistula vessels and resected the aneurysm. The resected aneurysm measured  cm in size. Pathological examination of the resected aneurysm revealed hypertrophic walls comprising proliferating fibroblasts cells thin elastic fibers. Very few atherosclerotic changes manifested in the aneurysm walls. We report the case of a patient with CAVF and an unruptured coronary artery aneurysm who was successfully treated by surgery.

  14. [Stent-Assisted Coil Embolization of a Dissecting Aneurysm of the Posterior Cerebral Artery: A Case Report].

    Science.gov (United States)

    Haruma, Jun; Sugiu, Kenji; Yukiue, Tadato; Sasaki, Tatsuya; Hattori, Yasuhiko; Kobayashi, Kazuki; Yoshida, Hideyuki; Muneda, Koji; Date, Isao

    2015-12-01

    Dissecting aneurysms of the posterior cerebral artery (PCA) are rare, especially those at the P1 segment. Here, we describe the case of a 57-year-old woman with a subarachnoid hemorrhage (SAH). Computed tomography angiography (CTA) and digital subtraction angiography (DSA) revealed a small (3 mm) dissecting aneurysm with the typical pearl-and-string sign at the right P1 segment. Fourteen days after onset, the patient developed aphasia. DSA revealed vasospasm of the right middle cerebral artery, and we performed endovascular treatment by the intra-arterial injection of 1-(5-isoquinolinesulfonyl) homopiperazine. After this treatment, the patient's symptoms recovered immediately. Vertebral angiography revealed enlargement of the dissecting aneurysm (up to 7 mm diameter). We started a loading dose of 300 mg aspirin and 400 mg clopidogrel after observing growth of the aneurysm. Fifteen days after onset, we performed a stent-assisted coil embolization, and obtained nearly complete obliteration of the aneurysm with preserved patency of the parent artery. Six-month follow-up DSA demonstrated complete occlusion of the aneurysm with good patency of the stented PCA; the patient was at modified Rankin Scale 1. In the treatment of ruptured dissecting aneurysms, parent vessel occlusion (PVO) with aneurysm is common. However, PVO may cause both cerebral infarction of the distal area and perforator occlusion of the occluded vessel. Stent-assisted coil embolization can preserve parent vessel flow and obliterate the aneurysm. Stents offer a therapeutic alternative for PCA dissecting aneurysms, especially when PVO cannot be tolerated. PMID:26646176

  15. Giant coronary sinus aneurysm and multiple coronary artery aneurysms in a pediatric patient

    OpenAIRE

    Abbas, U.; Brownlee, J.; Adebo, D

    2015-01-01

    Giant coronary sinus aneurysm is extremely rare in pediatric population. It was first reported in 1983 by Ho SY et al. Cerebrovascular accident, shock, myocarditis and severe myocardial dysfunction requiring extracorporeal membrane oxygenation are also very rare presentations of Kawasaki disease. Such rare cases are often misdiagnosed at first as septic shock. Kawasaki disease should be considered in all children presenting with toxic shock. This article reports a rare case of ...

  16. Endovascular internal carotid artery trapping for ruptured blood blister-like aneurysms: long-term results from a single centre

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Byong-Cheol [Dongguk University Ilsan Hospital, Department of Neurosurgery, Goyang (Korea, Republic of); Kwon, O-Ki; Oh, Chang Wan; Bang, Jae Seung; Hwang, Gyojun [Seoul National University Bundang Hospital, Department of Neurosurgery, Seongnam, Gyeonggi (Korea, Republic of); Jin, Sung-Chul [Inje University Haeundae Paik Hospital, Department of Neurosurgery, Busan (Korea, Republic of); Park, Hyun [Gyeongsang National University Hospital, Department of Neurosurgery, Gyeongsangnam-do (Korea, Republic of)

    2014-03-15

    Endovascular internal carotid artery (ICA) trapping was performed to treat ruptured blood blister-like aneurysms (BBAs). The aim of this study was to evaluate the procedural risks and long-term follow-up results. The records of 11 consecutive patients with BBAs who underwent endovascular ICA trapping between 2005 and 2010 were reviewed. Clinical outcomes were assessed with modified Rankin Scale (mRS) scores. Endovascular ICA trapping was performed in 11 patients as either the primary treatment (7 patients) or the secondary treatment (4 patients) after the patient underwent other treatments. Three patients underwent superficial temporal artery (STA)-middle cerebral artery (MCA) bypass when balloon test occlusion (BTO) revealed inadequate collateral circulation. In the primary ICA trapping group (seven patients), six patients had good outcomes (mRS 0 in five, mRS 1 in one), and one patient had a poor outcome (mRS 6: dead). In the secondary ICA trapping group (four patients), two patients had good outcomes (mRS 0), and two patients had poor outcomes (mRS 4, 5). All ten of the surviving patients were clinically stable during the follow-up period (mean 39 months). A radiological follow-up of nine patients (mean 22 months) demonstrated stable occlusion, with the exception of one reopening of the ICA because of coil migration. Perfusion studies of nine patients (mean: 23 months) demonstrated no perfusion decrease. Endovascular ICA trapping is an effective and durable treatment for BBAs. (orig.)

  17. Endovascular internal carotid artery trapping for ruptured blood blister-like aneurysms: long-term results from a single centre

    International Nuclear Information System (INIS)

    Endovascular internal carotid artery (ICA) trapping was performed to treat ruptured blood blister-like aneurysms (BBAs). The aim of this study was to evaluate the procedural risks and long-term follow-up results. The records of 11 consecutive patients with BBAs who underwent endovascular ICA trapping between 2005 and 2010 were reviewed. Clinical outcomes were assessed with modified Rankin Scale (mRS) scores. Endovascular ICA trapping was performed in 11 patients as either the primary treatment (7 patients) or the secondary treatment (4 patients) after the patient underwent other treatments. Three patients underwent superficial temporal artery (STA)-middle cerebral artery (MCA) bypass when balloon test occlusion (BTO) revealed inadequate collateral circulation. In the primary ICA trapping group (seven patients), six patients had good outcomes (mRS 0 in five, mRS 1 in one), and one patient had a poor outcome (mRS 6: dead). In the secondary ICA trapping group (four patients), two patients had good outcomes (mRS 0), and two patients had poor outcomes (mRS 4, 5). All ten of the surviving patients were clinically stable during the follow-up period (mean 39 months). A radiological follow-up of nine patients (mean 22 months) demonstrated stable occlusion, with the exception of one reopening of the ICA because of coil migration. Perfusion studies of nine patients (mean: 23 months) demonstrated no perfusion decrease. Endovascular ICA trapping is an effective and durable treatment for BBAs. (orig.)

  18. Therapeutic algorithm to treat common iliac artery aneurysms by endovascular means.

    Science.gov (United States)

    Panuccio, Giuseppe; Torsello, Giovanni F; Torsello, Giovanni B; Donas, Konstantinos P

    2016-10-01

    Use of endovascular means is gaining ever greater acceptance in the treatment of aorto-iliac aneurysms. Especially, the treatment of patients with common iliac aneurysms (CIAs) may be very challenging due to the complexity of the underlying disease with often involvement of the hypogastric artery. Additionally, the variety of endovascular therapeutic options such as the use of iliac branch devices, parallel grafts, the bell-bottom technique or coil embolization of the hypogastric artery and overstenting of the origin represents significant limitation regarding the presentation of a clear and robust endovascular therapeutic algorithm. Aim of the present article was the demonstration of the institutional experience with the endovascular management of CIAs in order to provide a clinical recommendation and algorithm. PMID:27406396

  19. Axillary artery aneurysm in tuberous sclerosis: cross-sectional imaging findings

    International Nuclear Information System (INIS)

    A 10-month-old boy with a known diagnosis of tuberous sclerosis presented with axillary and brachial masses. Cross-sectional imaging with computed tomography, magnetic resonance, and ultrasound demonstrated unsuspected aneurysms of the axillary and brachial arteries. The results of these studies significantly changed the preoperative planning for this patient, who was scheduled for a biopsy of a presumed soft-tissue tumor. To our knowledge, this is the first description of the cross-sectional imaging findings in the extremity peripheral vascular manifestation of tuberous sclerosis; it has only been previously described on angiography in one case. The rare association of peripheral arterial aneurysms with tuberous sclerosis is important to recognize not only for clinical diagnosis but also for appropriate surgical treatment and genetic counseling. (orig.)

  20. [Stent-assisted mechanical removal of tromboembolism after embolization of middle cerebral artery aneurysm].

    Science.gov (United States)

    Poncyljusz, Wojciech; Falkowski, Aleksander; Rać, Monika; Sagan, Leszek; Kojder, Ireneusz

    2012-01-01

    Thrombotic occlusion of the middle cerebral artery's branch occurred just after embolization of a nonruptured cerebral aneurysm. Bail-out stent-assisted mechanical thrombectomy of the clot was performed. DSA revealed normal vessel patency at the end of the procedure. There were no adverse events related to this thrombectomy, and the patient recovered from the embolization with minor neurologic deficit. There was no neurologic deficit after 90 days follow-up. PMID:23276015

  1. Ruptured Left Gastric Artery Aneurysm Successfully Treated by Thrombin Injection: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    S. Chandran

    2005-01-01

    Full Text Available This short report describes the successful use of a new minimally invasive technique for the treatment of acute gastric artery aneurysm rupture. It emphasises the importance of persistence and multiple imaging modalities in the presence of gastrointestinal bleeding. The photographs and case history clearly illustrate the nonoperative management and highlight learning points for experienced surgeons and trainees alike in the management of this potentially fatal condition.

  2. Genetic variants of glutamate receptor gene family in Taiwanese Kawasaki disease children with coronary artery aneurysms

    OpenAIRE

    Lin, Ying-Ju; Chang, Jeng-Sheng; Liu, Xiang(Research Center for Hadron and CSR Physics, Lanzhou University and Institute of Modern Physics of CAS, 730000, Lanzhou , China); Tsang, Hsinyi; Lin, Ting-Hsu; Liao, Chiu-Chu; Huang, Shao-Mei; Chien, Wen-Kuei; Chen, Jin-Hua; Wu, Jer-Yuarn; Chen, Chien-Hsiun; Chang, Li-Ching; Lin, Cheng-Wen; Ho, Tsung-Jung; Tsai, Fuu-Jen

    2014-01-01

    Background Patients with Kawasaki disease (KD), a pediatric systemic vasculitis, may develop coronary artery aneurysm (CAA) as a complication. To investigate the role of glutamate receptors in KD and its CAA development, we performed genetic association studies. Methods and results We examined the whole family of glutamate receptors by genetic association studies in a Taiwanese cohort of 262 KD patients. We identified glutamate receptor ionotropic, kainate 1 (GRIK1) as a novel susceptibility ...

  3. Arteriovenous fistula complicating iliac artery pseudo aneurysm: diagnosis by CT angiography.

    Science.gov (United States)

    Huawei, L; Bei, D; Huan, Z; Zilai, P; Aorong, T; Kemin, C

    2002-01-01

    Fistula formation to the inferior vena cava is a rare complication of aortic aneurysm which is often misdiagnosed clinically. In one hundred of reported arteriocaval fistulae, none was originating from the right common iliac artery. We report a case of ileo-caval fistula due to a iatrogenic pseudoaneurysm. High resolution 3D imaging using breath-hold CT angiography is highly specific in identifying the location, extent of the aortocaval fistula as well as the neighbouring anatomic structures.

  4. Repair of left ventricular aneurysm during off-pump coronary artery bypass surgery

    Institute of Scientific and Technical Information of China (English)

    YU Yang; GU Cheng-xiong; WEI Hua; LIU Rui; CHEN Chang-cheng; FANG Ying

    2005-01-01

    Background Acute myocardial infarction can result in left ventricular aneurysm, which may in turn cause congestive heart failure, ventricular arrhythmia and thromboembolic events. This study evaluates results achieved with a modified linear closure of left ventricular aneurysms during off-pump coronary artery bypass surgery.Methods From January 2001 to May 2004, 75 patients were operated on for nonruptured, postinfarctional, left ventricular aneurysm during off-pump coronary artery bypass surgery. Repair was completed on the beating heart to minimize ischaemia and allow assessment of wall function and viability to guide closure. All patients presented with symptoms of angina and congestive heart failure or ventricular arrhythmia. The majority (75%) of the patients were in NYHA functional class Ⅲ or Ⅳ. Preoperative ejection fraction was 26%±9%. The mean left ventricular, end diastolic diameter was (57.5±7.1) mm. The ventricular preoperative and postoperative performances were compared. χ2 test and Student's t test were used to analyse the outcomes. A P value less than 0.05 was considered significant.Results Hospital mortality was 1.3% (1/75). Coronary artery bypass was performed with an average of (3.3±1.2) grafts per patient. At the time of followup, all the patients had no symptoms. The mean NYHA class and ejection fraction increased significantly (P<0.001). The mean left ventricular, end diastolic diameter decreased significantly (P<0.001). Conclusions Surgical closure of left ventricular aneurysm can be performed during off-pump coronary artery bypass. The operation is associated with a low inhospital mortality and morbidity. A postoperative improvement in the early term cardiac functions and symptoms and quality of life was documented, increasing our expectations of an increased long-term survival.

  5. Aneurysm of the aberrant right subclavian artery – a case report

    International Nuclear Information System (INIS)

    The right subclavian artery, originating not from the brachiocephalic trunk but directly from the aortic arch, is a rare anatomical abnormality. ‘Arteria lusoria’ is the accepted name of the retroesophageal right subclavian artery. Such a vessel location, between the vertebral column and the esophagus, determines its course to the right. This defect may be asymptomatic, found during autopsy or coincidentally during diagnostic procedures. However, it may also be symptomatic. The course of this major blood vessel in the limited anatomical space may cause symptoms of mediastinal organ compression. The aim of this paper was to present two cases of abnormal anatomical course of the right subclavian artery and its aneurismal dilation. In this study, CT scans of the saccular aneurysm of the retroesophageal right subclavian artery were used: of a male patient diagnosed at Euromedic Diagnostics in Olsztyn and of a female patient, from the resources of the Radiological Dept. at MSWiA Hospital in Olsztyn An 85-year-old female was admitted to Hospital ER for congestive heart failure decompensation. Her chest X-ray revealed a round mass in the upper right mediastinum. Chest CT confirmed the presence of a saccular aneurysm of the lusory artery, 6.5 cm in diameter, partially filled with thrombotic material. The patient died in hospital from myocardial infarction that was not related to the aneurysm. A 61-year-old male patient had a chest X-ray which showed a round opacity on the apex of the right lung. The diagnostic process comprised also chest computed tomography. The examination showed an anomalous origin of the right subclavian artery, with aneurysmal dilation and compression of the oesophagus and of the trachea. An intraluminal thrombus was found. The patient remained under observation till the next CT examination, 6 months later. The presented rare cases of arteria lusoria aneurysm are not only casuistic reports. They also show the value of modern MDCT diagnostics

  6. Giant mycotic aneurysm of the internal carotid artery in a child: endovascular treatment

    International Nuclear Information System (INIS)

    We present a case of a giant mycotic aneurysm of the left internal carotid artery in a child, the result of direct extension of a deep neck space infection. This lesion is life threatening and may put the patient at risk of unwarranted biopsy or drainage if not recognized. Diagnosis and treatment planning rely heavily on cross-sectional imaging, and angiography is frequently necessary. This case is unique for two reasons: (1) we present for the first time the MRI findings and (2) we describe an alternative to surgical ligation -- neurointerventional embolotherapy. Minimally invasive transcatheter embolization was successfully performed on our patient to occlude the abnormal left internal carotid artery segment. (orig.)

  7. Successful coil embolization of a ruptured basilar artery aneurysm in a child with leukemia: a case report.

    Science.gov (United States)

    Hayashi, Shihori; Maehara, Taketoshi; Mukawa, Maki; Aoyagi, Masaru; Yoshino, Yoshikazu; Nemoto, Shigeru; Ono, Toshiaki; Ohno, Kikuo

    2014-01-01

    Ruptured intracranial aneurysms are rare in the pediatric population compared to adults. This has incited considerable discussion on how to treat children with this condition. Here, we report a child with a ruptured saccular basilar artery aneurysm that was successfully treated with coil embolization. A 12-year-old boy with acute lymphoblastic leukemia and accompanying abdominal candidiasis after chemotherapy suddenly complained of a severe headache and suffered consciousness disturbance moments later. Computed tomography scans and cerebral angiography demonstrated acute hydrocephalus and subarachnoid hemorrhage caused by saccular basilar artery aneurysm rupture. External ventricular drainage was performed immediately. Because the patient was in severe condition and did not show remarkable signs of central nervous system infection in cerebrospinal fluid studies, we applied endovascular treatment for the ruptured saccular basilar artery aneurysm, which was successfully occluded with coils. The patient recovered without new neurological deficits after ventriculoperitoneal shunting. Recent reports indicate that both endovascular and microsurgical techniques can be used to effectively treat ruptured cerebral aneurysms in pediatric patients. A minimally invasive endovascular treatment was effective in the present case, but long-term follow-up will be necessary to confirm the efficiency of endovascular treatment for children with ruptured saccular basilar artery aneurysms.

  8. Brain Aneurysm

    Science.gov (United States)

    A brain aneurysm is an abnormal bulge or "ballooning" in the wall of an artery in the brain. They are sometimes called berry aneurysms because they ... often the size of a small berry. Most brain aneurysms produce no symptoms until they become large, ...

  9. Radiological Changes in Infantile Dissecting Anterior Communicating Artery Aneurysm Treated Endovascularly : A Case Report and Five-Year Follow-Up

    OpenAIRE

    Yatomi, Kenji; Oishi, Hidenori; Yamamoto, Munetaka; Suga, Yasuo; NONAKA, Senshu; Yoshida, Kensaku; Arai, Hajime

    2014-01-01

    Intracranial aneurysms are extremely rare in infants, and to our knowledge only seven infants treated for ruptured spontaneous dissecting aneurysms have been reported. Good outcomes have been achieved with endovascular treatment of infantile aneurysm. We the endovascular treatment of a one-month-old girl for ruptured dissecting aneurysm located in the anterior communicating artery, and the unique radiological changes that were observed during the perioperative and follow-up periods. These cha...

  10. Interventional Exclusion of Iliac Artery Aneurysms Using the Flow-Diverting Multilayer Stent

    Energy Technology Data Exchange (ETDEWEB)

    Pieper, Claus Christian, E-mail: Claus.christian.pieper@ukb.uni-bonn.de; Meyer, Carsten, E-mail: Carsten.Meyer@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany); Rudolph, Jens, E-mail: jens.rudolph@ukb.uni-bonn.de; Verrel, Frauke, E-mail: frauke.verrel@ukb.uni-bonn.de [University of Bonn, Department of Surgery (Germany); Schild, Hans Heinz, E-mail: hans.schild@ukb.uni-bonn.de; Wilhelm, Kai E., E-mail: kai.wilhelm@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany)

    2013-08-01

    PurposeThis study was designed to evaluate retrospectively the results of complex iliac artery aneurysm (IAA) exclusion using the Cardiatis-Multilayer-Stent.MethodsBetween October 2010 and August 2012, ten IAAs were treated in eight males (mean age 75 (59-91) years) using the Multilayer Stent. All IAA exceeded a diameter of 3 cm or were symptomatic. Follow-up (FU) examinations included CT or MR angiography, sonography, and clinical assessment up to 2 years.ResultsPrimary stent placement was technically successful in eight of ten cases. In two cases, severe stent retraction during deployment necessitated placement of an additional stent. Immediately after stent placement, a marked reduction of flow within the sac was observed in all cases (peri-interventional mortality 0 %). During FU, there were two thrombotic stent occlusions, making reintervention necessary (primary patency rate 80 %, secondary patency 100 %). Four IAA were completely occluded at FU, whereas the original vessel and covered branches (n = 8) were patent. In four IAA, there was still residual perfusion. In one patient, IAA diameter decreased slightly, while it remained constant in seven (mean imaging FU 195 (range 1-695) days). There were no adverse events on clinical FU (mean FU 467 (range 101-695) days).ConclusionsOther studies showed the Cardiatis-Multilayer-Stent to be a technically relatively simple treatment option for complex IAA with inadequate landing zones, especially in patients with multiple comorbidities to avoid ipsilateral IIA obstruction. However, in our series complication rate was high. Incomplete sac exclusion, stent-shortening, and thrombotic occlusion can complicate treatment, making meticulous patient selection necessary. Close imaging surveillance is mandatory especially in the early postinterventional period.

  11. Assessment of coronary artery aneurysms in paediatric patients with Kawasaki disease by multidetector row CT angiography: feasibility and comparison with 2D echocardiography

    International Nuclear Information System (INIS)

    Transthoracic ECHO is the locally accepted method for coronary surveillance of patients with Kawasaki disease but it may have limited visualization in the older child. To assess the feasibility of multidetector CT (MDCT) angiography in the follow-up of coronary artery aneurysms in children with previous Kawasaki disease. Six children (5 boys, 1 girl; mean age 11.5 years) with known Kawasaki disease and coronary artery involvement underwent CT coronary angiography using 16-detector MDCT. The visualized lengths and diameter of all coronary segments were measured. The number, size and location of coronary artery aneurysms were recorded and compared with recent ECHO. Twelve coronary artery aneurysms (seven saccular, five fusiform) were identified by MDCT angiography. One saccular aneurysm at the junction of the distal right coronary artery and posterior descending artery was not detected by ECHO while the remaining six in proximal segments were detected by both modalities. Two of five fusiform aneurysms were not detected by ECHO due to their small sizes. Excellent agreement was found between CT and ECHO for maximal diameter and length of the visualized aneurysms. MDCT angiography accurately defines coronary artery aneurysms. It is more sensitive for detecting aneurysms at distal coronary segments and fusiform aneurysms of small size

  12. Subclavian vein aneurysm secondary to a benign vessel wall hamartoma

    International Nuclear Information System (INIS)

    Venous aneurysms are rare clinical entities, particularly in children, and their presentation and natural history often depend on the anatomical location and underlying etiology. We present a single case of a 12-year-old girl who presented with a palpable right supraclavicular mass. Imaging evaluation with CT, conventional venography, MRI and sonography revealed a large fusiform subclavian vein aneurysm with an unusual, mass-like fibrofatty component incorporated into the vessel wall. The girl ultimately required complete resection of the right subclavian vein with placement of a synthetic interposition graft. This case provides a radiology/pathology correlation of an entity that has not previously been described as well as an example of the utility of multiple imaging modalities to aid diagnosis and preoperative planning. (orig.)

  13. Subclavian vein aneurysm secondary to a benign vessel wall hamartoma.

    Science.gov (United States)

    Warren, Patrick; Spaeth, Maya; Prasad, Vinay; McConnell, Patrick

    2013-11-01

    Venous aneurysms are rare clinical entities, particularly in children, and their presentation and natural history often depend on the anatomical location and underlying etiology. We present a single case of a 12-year-old girl who presented with a palpable right supraclavicular mass. Imaging evaluation with CT, conventional venography, MRI and sonography revealed a large fusiform subclavian vein aneurysm with an unusual, mass-like fibrofatty component incorporated into the vessel wall. The girl ultimately required complete resection of the right subclavian vein with placement of a synthetic interposition graft. This case provides a radiology/pathology correlation of an entity that has not previously been described as well as an example of the utility of multiple imaging modalities to aid diagnosis and preoperative planning.

  14. Subclavian vein aneurysm secondary to a benign vessel wall hamartoma

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Patrick [Nationwide Children' s Hospital, Section of Pediatric Interventional Radiology, Columbus, OH (United States); Spaeth, Maya [Nationwide Children' s Hospital, Section of Plastic and Reconstructive Surgery, Columbus, OH (United States); Prasad, Vinay [Nationwide Children' s Hospital, Section of Pediatric Pathology, Columbus, OH (United States); McConnell, Patrick [Nationwide Children' s Hospital, Section of Cardiothoracic Surgery, Columbus, OH (United States)

    2013-11-15

    Venous aneurysms are rare clinical entities, particularly in children, and their presentation and natural history often depend on the anatomical location and underlying etiology. We present a single case of a 12-year-old girl who presented with a palpable right supraclavicular mass. Imaging evaluation with CT, conventional venography, MRI and sonography revealed a large fusiform subclavian vein aneurysm with an unusual, mass-like fibrofatty component incorporated into the vessel wall. The girl ultimately required complete resection of the right subclavian vein with placement of a synthetic interposition graft. This case provides a radiology/pathology correlation of an entity that has not previously been described as well as an example of the utility of multiple imaging modalities to aid diagnosis and preoperative planning. (orig.)

  15. Combined Neuroform Intracranial Stent and Bioactive Matrix Detachable Coil for Embolization of a Broad-Necked Persistent Primitive Trigeminal Artery Aneurysm

    Science.gov (United States)

    Zhao, Q.P.; Li, T.L.; Duan, C.Z.; Chen, G.Z.

    2005-01-01

    Summary We report a patient with a wide-necked aneurysm arising at the bifurcation of the right internal carotid artery and the persistent primitive trigeminal artery (PPTA) treated successfully by Matrix detachable coil occlusion and assisted by a Neuroform intracranial stent. First, a Neuroform self-expanding intracranial stent was delivered via a 5-F Guider Softtip XP and placed as desired, then the aneurysm dome was embolized with two Matrix detachable coils through the interstices of the stent. The aneurysm was 80% occluded angiographically and the parent artery was patent. DSA imaging six months after the procedure showed the aneurysm to be obliterated at angiography and the neck tissue thickness of the aneurysm to be increased, but the parent artery diameter was not impacted. We describe the case in detail and discuss our preliminary experience of using the Neuroform stent and Matrix detachable coils for the treatment of a PPTA wide-necked aneurysm. PMID:20584437

  16. Selective arterial embolization of 36 aneurysmal bone cysts of the skeleton with N-2-butyl cyanoacrylate

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Giuseppe [Rizzoli Orthopaedic Institute, Department of Interventional Angiographic Radiology, Bologna (Italy); Rimondi, Eugenio; Vanel, Daniel [Rizzoli Orthopaedic Institute, Department of Radiology, Bologna (Italy); Bartalena, Tommaso [University of Bologna, Bologna (Italy); Gerardi, Antonio [Rizzoli Orthopaedic Institute, Department of Anatomical Human Science and Physiopathology of the Musculoskeletal System, Bologna (Italy); Alberghini, Marco [Rizzoli Orthopaedic Institute, Department of Pathological Anatomy, Bologna (Italy); Staals, Eric Lodwijk; Errani, Costantino; Bianchi, Giuseppe; Toscano, Angelo; Mercuri, Mario [Rizzoli Orthopaedic Institute, V Division of Musculoskeletal Tumors, Bologna (Italy)

    2010-02-15

    Aneurysmal bone cyst (ABC) is a lytic benign bone lesion representing about 1% of all primary bone tumors. The lesion causes pain and swelling, which are generally present for less than 3 months. From April 2003 to April 2008 36 patients affected by aneurysmal bone cysts were treated by selective arterial embolization with N-2-butyl cyanoacrylate. The study population comprised 20 male and 16 female patients with an age range of 3.3-60.8 years. Nine lesions were localized in the appendicular skeleton (1 in the upper and 8 in the lower limb), 4 in the thoracic cage (1 rib lesion and 3 scapular lesions), 17 in the pelvis and 6 in the spine (1 thoracic and 5 sacral localizations). A total of 55 embolizations were performed: in 22 cases (61%) only one embolization was needed, whilst two embolizations were necessary in 9 cases (25%) and 3 in the remaining 5 patients (14%). The treatment was effective in 32 patients (94%): follow-up was 0.9-5 years. In one patient, previously surgically treated, only the cyanoacrylate embolization turned out to be useful for healing the lesion. Another 7 patients underwent surgery during the study period. In the 55 procedures we performed we had 3 complications (5%): 2 cases of skin necrosis and 1 of transient paresis. Arterial embolization with cyanoacrylate may be the treatment of choice for aneurysmal bone cysts. Embolization is a less invasive, lower cost, simpler procedure than surgery and is easily repeatable. (orig.)

  17. Akinetic Mutism Following Bilateral Anterior Cerebral Artery Territory Infarction Due to Aneurysm: A Case Report

    Directory of Open Access Journals (Sweden)

    Zeynep Özözen Ayas

    2014-04-01

    Full Text Available BACKGROUND AND PURPOSE: Bilateral anterior cerebral artery (ACA territory infarction is rare localization in stroke which should always prompt a search for an anterior communicating artery (ACoA aneurysm. The common neurological manifestations are contralateral weakness predominate in the lower extremite, behavior disturbance, motor inertia, muteness, incontinence, grasp reflex, diffuse rigidity, akinetic mutism. CASE DESCRIPTION: We describe a 38-year-old woman presented with a left sided hemiparesia and decrease of speech for last days. She was a smoker and morbide obese. She had no any diagnosed disease. Her neurological examination had weakness of left extremites affected leg more than the arm and akinetic mutism like as no spontaneously speech and move and grasp reflex. CT showed bilateral ACA infarction which included cingulate gyrus, the right side more than left and subarachnoid hemorrhage in the interhemispheric fissure. MRI angiography showed the appearance of AcoA aneurysm. CONCLUSION: We report a patient with bilateral infarction in the ACA which a rare localization and clinicians must be alert to exist AcoA aneurysm which may bleed, different symptoms and signs like as akinetic mutism, primitive reflexes.

  18. Spontaneous Rupture of an Ovarian Artery Aneurysm: A Rare Postpartum Complication

    Directory of Open Access Journals (Sweden)

    Christopher A. Enakpene

    2016-01-01

    Full Text Available Background. Spontaneous rupture of an ovarian artery aneurysm is a rare but usually life-threatening event. It is most often associated with pregnancy or fibroids. Our case followed a normal vaginal delivery and then a delayed presentation with features similar to other less life-threatening postpartum conditions. The diagnosis could have been missed but for the meticulous and timely interventions which avoided catastrophic outcome. Case. This is a case of a multiparous woman with rupture of a left ovarian artery aneurysm, causing massive retroperitoneal hemorrhage and hematoma that required a combination of arterial embolization, percutaneous CT scan guided drainage, and surgical evacuation of the hematoma. Conclusion. Spontaneous rupture of ovarian artery should be considered as one of the differential diagnoses in the immediate postpartum period especially when the clinical symptoms do not correlate with the amount of blood loss. A high index of suspicion, prompt diagnosis, intervention, and a multidisciplinary approach in the management were the elements of a successful outcome in this case.

  19. Internal Iliac Artery Embolization during an Endovascular Aneurysm Repair with Detachable Interlock Microcoils

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Woo ChuL; Jeon, Yong Sun; Hong, Kee Chun; Cho, Soon Gu; Park, Jae Young [Inha University Hospital, Inha University School of Medicine, Incheon (Korea, Republic of); Kim, Jang Yong [Dept. of Vascular and Endovascular Surgery, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    The purpose of this study was to evaluate the effectiveness of detachable interlock microcoils for an embolization of the internal iliac artery during an endovascular aneurysm repair (EVAR). A retrospective review was conducted on 40 patients with aortic aneurysms, who had undergone an EVAR between January 2010 and March 2012. Among them, 16 patients were referred for embolization of the internal iliac artery for the prevention of type II endoleaks. Among 16 patients, 13 patients underwent embolization using detachable interlock microcoils during an EVAR. Computed tomographic angiographies and clinical examinations were performed during the follow-up period. Technical success, clinical outcome, and complications were reviewed. Internal iliac artery embolizations using detachable interlock microcoils were technically successful in all 13 patients, with no occurrence of procedure-related complications. Follow-up imaging was accomplished in the 13 cases. In all cases, type II endoleak was not observed with computed tomographic angiography during the median follow-up of 3 months (range, 1-27 months) and the median clinical follow-up of 12 months (range, 1-27 months). Two of 13 (15%) patients had symptoms of buttock pain, and one patient died due to underlying stomach cancer. No significant clinical symptoms such as bowel ischemia were observed. Internal iliac artery embolization during an EVAR using detachable interlock microcoils to prevent type II endoleaks appears safe and effective, although this should be further proven in a larger population.

  20. Case Report: Carotid–cavernous fistula due to aneurysmal rupture in a case of aortoaortitis with bilateral giant internal carotid artery aneurysms

    International Nuclear Information System (INIS)

    Takayasu aortoarteritis (TA) rarely affects the nervous system, but when it does, it usually manifests as cerebral ischemia or stroke. These strokes have mainly been attributed to stenotic extracranial vessels. Stenoses of intracranial vessels, although rare in TA, can occur due to either embolization into the vessel or because of the vasculitic process itself. Intracranial aneurysms are very rare in patients with TA. Bilateral cavernous internal carotid artery (ICA) aneurysms are rarer. They have been reported following radiation therapy and in association with fibromuscular dysplasia and juvenile Paget disease. Bilateral mycotic intracavernous aneurysms also occur. Bilateral giant cavernous ICA aneurysms with carotid-cavernous fistula (CCF) consequent to rupture into the cavernous sinus in a case of TA are extremely unusual. We report a case that fulfilled both American College of Rheumatology and European League against Rheumatology criteria for TA. The patient had bilateral cavernous sinus giant aneurysms and CCF because the right-sided aneurysm had ruptured and was leaking into the cavernous sinus

  1. Secondary Headaches Attributed to Arterial Hypertension

    Directory of Open Access Journals (Sweden)

    Farhad Assarzadegan

    2013-07-01

    Full Text Available Mild (140 to 159/90 to 99 mmHg or moderate (160 to 179/100 to 109 mmHg chronic arterial hypertension does not appear to cause headache. Whether moderate hypertension predisposes patients to headache at all remains controversial, but there is little evidence that it does. Ambulatory blood pressure monitoring in patients with mild and moderate hypertension has shown no convincing relationship between blood pressure fluctuations over a 24-hour period and presence or absence of headache. However, headaches are associated to various disorders that lead to abrupt, severe, and paroxysmal elevations in blood pressure. In this paper, the secondary headaches attributed to acute crises of hypertension and the criteria for diagnosing each of them have been reviewed. These are headaches attributed to pheochromocytoma, hypertensive crisis without encephalopathy, hypertensive encephalopathy, pre-eclampsia, eclampsia, and acute pressure response to exogenous agents.

  2. Case of Behçet's disease complicated by oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm.

    Science.gov (United States)

    Yamaoka, Toshifumi; Murota, Hiroyuki; Katayama, Ichiro

    2015-03-01

    Behçet's disease (BD) is a relapsing systemic inflammatory disorder of unknown etiology involving systemic vasculitis. Vasculitis in BD results from the involvement of arteries, veins and blood vessels of all sizes, which leads to the three major manifestations of this condition: venous occlusion, arterial occlusion and aneurysm formation. Therefore, whole-body vascular involvement should always be considered in BD patients. Here, we describe the first appearance of an internal carotid-posterior communicating artery aneurysm, resulting in complete oculomotor nerve palsy in a BD patient. A 44-year-old Japanese man suffered from recurrent episodes of erythema nodosum that had presented on the lower extremities for the past 2 years. His condition was diagnosed as an incomplete type of BD based on relapsing oral and genital ulcers, skin eruptions, such as erythema nodosum and folliculitis, a positive pathergy test and systemic arthralgia. Ten years after his initial clinical presentation, he had manifestations of right-sided ptosis and cyclic dull pain in his right temporal region. Magnetic resonance imaging and angiography revealed a right internal carotid artery-posterior communicating artery aneurysm. Although oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm in a BD patient has not been reported previously, our report highlights the fact that this abnormal manifestation should be considered in those with vasculo-BD. PMID:25573207

  3. Successful Coil Embolization of a Ruptured Basilar Artery Aneurysm in a Child with Leukemia: A Case Report

    OpenAIRE

    HAYASHI, Shihori; Maehara, Taketoshi; Mukawa, Maki; Aoyagi, Masaru; YOSHINO, Yoshikazu; NEMOTO, Shigeru; Ono, Toshiaki; Ohno, Kikuo

    2013-01-01

    Ruptured intracranial aneurysms are rare in the pediatric population compared to adults. This has incited considerable discussion on how to treat children with this condition. Here, we report a child with a ruptured saccular basilar artery aneurysm that was successfully treated with coil embolization. A 12-year-old boy with acute lymphoblastic leukemia and accompanying abdominal candidiasis after chemotherapy suddenly complained of a severe headache and suffered consciousness disturbance mome...

  4. Aneurysm of the anterior inferior cerebellar artery (AICA) associated with high-flow lesion: report of two cases and review of literature.

    NARCIS (Netherlands)

    Menovsky, T.; Grotenhuis, J.A.; Bartels, R.H.M.A.

    2002-01-01

    OBJECTIVE AND IMPORTANCE: Although aneurysms of the anterior inferior cerebellar artery (AICA) are rare lesions, their occurrence in combination with high-flow lesions in the same arterial territory is even more striking. Two cases of an AICA aneurysm in combination with a high -flow lesion are desc

  5. Endovascular Treatment of an Aneurysmal Aberrant Systemic Artery Supplying a Pulmonary Sequestrum

    Energy Technology Data Exchange (ETDEWEB)

    Kristensen, Katrine Lawaetz, E-mail: klk@dadlnet.dk [Odense University Hospital, Department of Thoracic and Vascular Surgery (Denmark); Duus, Louise Aarup, E-mail: louise.brodersen@gmail.com [Sygehus Lillebaelt Vejle, Department of Radiology (Denmark); Elle, Bo, E-mail: Bo.Elle@rsyd.dk [Odense University Hospital, Department of Radiology (Denmark)

    2015-10-15

    An aberrant systemic artery originating from the abdominal aorta supplying a pulmonary sequestration is a rare congenital malformation. This causes a left-to-left shunt. Symptoms include recurrent pneumonias, hemoptysis, and, in the long term, heart failure. Aneurysm of the aberrant vessel is rarely seen. Traditionally, treatment of pulmonary sequestrations includes ligation of the feeding vessel and lobectomy. A new promising treatment is an endovascular approach. Only a few cases describe endovascular treatment of pulmonary sequestration. This is the first published case of a giant aneurysmal branch from the abdominal aorta to the normal basal segments of the lung, successfully occluded with an Amplatzer Vascular Plug II (AVP II, St.Jude Medical, MN, USA) alone.

  6. Endovascular Treatment of an Aneurysmal Aberrant Systemic Artery Supplying a Pulmonary Sequestrum

    International Nuclear Information System (INIS)

    An aberrant systemic artery originating from the abdominal aorta supplying a pulmonary sequestration is a rare congenital malformation. This causes a left-to-left shunt. Symptoms include recurrent pneumonias, hemoptysis, and, in the long term, heart failure. Aneurysm of the aberrant vessel is rarely seen. Traditionally, treatment of pulmonary sequestrations includes ligation of the feeding vessel and lobectomy. A new promising treatment is an endovascular approach. Only a few cases describe endovascular treatment of pulmonary sequestration. This is the first published case of a giant aneurysmal branch from the abdominal aorta to the normal basal segments of the lung, successfully occluded with an Amplatzer Vascular Plug II (AVP II, St.Jude Medical, MN, USA) alone

  7. Flow Instability Detected by High-Resolution Computational Fluid Dynamics in Fifty-Six Middle Cerebral Artery Aneurysms.

    Science.gov (United States)

    Varble, Nicole; Xiang, Jianping; Lin, Ning; Levy, Elad; Meng, Hui

    2016-06-01

    Recent high-resolution computational fluid dynamics (CFD) studies have detected persistent flow instability in intracranial aneurysms (IAs) that was not observed in previous in silico studies. These flow fluctuations have shown incidental association with rupture in a small aneurysm dataset. The aims of this study are to explore the capabilities and limitations of a commercial cfd solver in capturing such velocity fluctuations, whether fluctuation kinetic energy (fKE) as a marker to quantify such instability could be a potential parameter to predict aneurysm rupture, and what geometric parameters might be associated with such fluctuations. First, we confirmed that the second-order discretization schemes and high spatial and temporal resolutions are required to capture these aneurysmal flow fluctuations. Next, we analyzed 56 patient-specific middle cerebral artery (MCA) aneurysms (12 ruptured) by transient, high-resolution CFD simulations with a cycle-averaged, constant inflow boundary condition. Finally, to explore the mechanism by which such flow instabilities might arise, we investigated correlations between fKE and several aneurysm geometrical parameters. Our results show that flow instabilities were present in 8 of 56 MCA aneurysms, all of which were unruptured bifurcation aneurysms. Statistical analysis revealed that fKE could not differentiate ruptured from unruptured aneurysms. Thus, our study does not lend support to these flow instabilities (based on a cycle-averaged constant inflow as opposed to peak velocity) being a marker for rupture. We found a positive correlation between fKE and aneurysm size as well as size ratio. This suggests that the intrinsic flow instability may be associated with the breakdown of an inflow jet penetrating the aneurysm space. PMID:27109451

  8. Ruptured, dissecting posterior inferior cerebellar artery aneurysms: endovascular treatment without parent vessel occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Cellerini, Martino [Careggi Hospital, Interventional Neuroradiology, Florence (Italy); Centro Traumatologico-Ortopedico, Unita di Neuroradiologia, Florence (Italy); Mangiafico, Salvatore [Careggi Hospital, Interventional Neuroradiology, Florence (Italy); Ammannati, Franco; Mennonna, Pasquale [Careggi Hospital, Neurosurgery, Florence (Italy); Ambrosanio, Gennaro; Muto, Mario [Cardarelli Hospital, Neuroradiology, Naples (Italy); Galasso, Luigi [S. Luca Hospital, Neuroradiology, Salerno (Italy)

    2008-04-15

    Treatment of a dissecting aneurysm of the medullary segments of the posterior inferior cerebellar artery (PICA) usually entails trapping of the diseased arterial segment with possible sacrifice of brainstem perforators. The goal of the work was to review our experience with selective coiling of ruptured, dissecting aneurysms of the anterolateral segments of the PICA without parent vessel occlusion. Eleven consecutive patients (9 women, 2 men, mean age 47.2 years) were retrospectively reviewed from a prospectively acquired neuroradiological database. On admission three patients had Hunt and Hess (HH) grade I, three HH grade II, two HH grade III, and one HH grade IV. Outcome was evaluated according to the modified Rankin scale (mRS) score. Follow-up (mean:19.4 months) consisted of magnetic resonance angiography and/or digital subtraction angiography in ten patients. Ten patients had mRS score 0 and one mRS score 2. No treatment failure occurred. The aneurysm was completely occluded in seven patients, a neck residue was present in two, and a loose coil mesh was present in two. Recurrence occurred in three patients, and all were successfully retreated for a total of 13 procedures. Procedure-related complications were all without clinical consequences and included a coil perforation in one procedure and stagnant filling of the parent vessel in six procedures. PICA occlusion did not occur in any patient. Coiling of ruptured, isolated dissecting aneurysms of the PICA without parent vessel occlusion is feasible, relatively safe and effective in preventing early/medium-term rebleeding. A strict angiographic follow-up program is, however, necessary to detect recurrence. (orig.)

  9. Tuberculous iliac artery aneurysm in a pediatric patient.

    Science.gov (United States)

    Cox, Sharon Gail; Naidoo, Nadraj G; Wood, Richard John; Clark, Lizelle; Kilborn, Tracy

    2013-03-01

    Vascular complications of tuberculous infections are rare and occur even less frequently in the pediatric population. Tuberculous pseudoaneurysms can occur either as a result of contiguous spread from a neighboring focus-invariably infected lymph nodes-or by hematogenous spread and seeding of acid-fast bacilli that lodge in the adventitia or media via the vasa vasorum. We report a case of turberculous right common iliac artery pseudoaneurysm in a 12-year-old and review the relevant literature.

  10. Loss of visual evoked potential following temporary occlusion of the superior hypophyseal artery during aneurysm clip placement surgery. Case report.

    Science.gov (United States)

    Goto, Tetsuya; Tanaka, Yuichiro; Kodama, Kunihiko; Kusano, Yoshikazu; Sakai, Keiichi; Hongo, Kazuhiro

    2007-10-01

    The authors report a case in which a 62-year-old woman with a history of subarachnoid hemorrhage due to a ruptured aneurysm was found to have a de novo paraclinoid aneurysm in the right internal carotid artery during a routine medical examination. Surgical clip placement was performed via a contralateral pterional approach under visual evoked potential (VEP) monitoring. The superior hypophyseal artery (SHA) was found to originate from the aneurysm body. The artery was temporarily occluded prior to application of the clip to the aneurysm neck. The VEP signal was lost 3 minutes after the SHA was occluded, and the potentials gradually recovered 10 minutes after the artery was released. The disappearance of VEP signal was reproducible with SHA occlusion. The clip was applied to the aneurysm body to preserve the origin of the SHA. The patient did not have any deterioration of vision after surgery. Intraoperative VEP monitoring can be used to help determine whether the SHA can be sacrificed safely.

  11. Pituitary dysfunction in survivors of spontaneous subarachnoid hemorrhage of anterior communicating artery and middle cerebral artery aneurysms: A comparative study

    Directory of Open Access Journals (Sweden)

    Pinaki Dutta

    2012-01-01

    Full Text Available Background: The data on incidence of hypopituitarism after SAH are conflicting. Furthermore, it is still not known whether there is any difference in hormonal deficiencies between SAH due to anterior communicating artery (A-com and middle cerebral artery (MCA aneurysms. Materials and Methods: This study includes both retrospective and prospective arms. The data collected included baseline demographic profile, clinical severity on admission to the hospital by the Hunt and Hess grading system and World Federation of Neurological Surgeons (WFNS grading, radiological severity of bleed by the Fisher′s classification, and treatment details. All the patients underwent detailed hormonal evaluation at baseline and 6 months in prospective group while at the end of 1 year in the retrospective group. Hormonal deficiencies between patients with A-com and MCA aneurysmal SAH were compared using appropriate statistical tests. Results: Of 60 patients studied, 47 patients (A-com: 28 and MCA: 19 were in the retrospective group, while 13 patients (A-com-9, MCA-4 were in the prospective group. The baseline data were comparable between the two groups. At or after 6 months follow-up, 19 (31.6% patients, 10 patients with A-com and 9 patients with MCA aneurysmal SAH, had some form of hormone deficiency. Furthermore, there was no difference in endocrine dysfunctions between the two groups. There was no correlation between the severity of hormonal deficiency and the clinical severity of SAH grade by Hunt and Hess and radiological grade of SAH by Fisher′s grade. Conclusion: Hormonal deficiencies are not uncommon in patients with SAH. There is no difference in hormonal deficiencies and severity of hypopituitarism in patients with SAH due to A-com and MCA bleed.

  12. "Ultrasonographic Screening for Abdominal Aortic Aneurysm in Iranian Candidates of Coronary Artery Bypass Graft"

    Directory of Open Access Journals (Sweden)

    Sh. Shirani

    2007-07-01

    Full Text Available Background/Objective: To evaluate the prevalence of abdominal aortic aneurysm (AAA in Iranian candidates of coronary artery bypass graft and its associated factors. Patients and Methods: 1,647 consecutive candidates of coronary artery bypass graft underwent abdominal aorta sonography. The relation of AAA with gender, age, smoking, dyslipidemia, hypertension, diabetes mellitus, carotid and coronary stenosis was evaluated. Results: The prevalence of AAA was 3.7% in men and 1% in women. The prevalence was 5.2% in men older than 65 years. The largest diameter f AAA was 51 mm. Gender, age, smoking and carotid stenosis were associated factors of AAA. Conclusion: The prevalence of AAA is lower in Iran comparing with western studies (p<0.0001. The mean diameter of aneurysm was lesser in our study too (p<0.0001. The associated factors of AAA in our study were similar with previous reports. Screening of AAA is not recommended in Iranian candidates of coronary artery bypass graft.

  13. Assessment Of Coronary Artery Aneurysms Using Transluminal Attenuation Gradient And Computational Modeling In Kawasaki Disease Patients

    Science.gov (United States)

    Grande Gutierrez, Noelia; Kahn, Andrew; Shirinsky, Olga; Gagarina, Nina; Lyskina, Galina; Fukazawa, Ryuji; Owaga, Shunichi; Burns, Jane; Marsden, Alison

    2015-11-01

    Kawasaki Disease (KD) can result in coronary artery aneurysms (CAA) in up to 25% of patients, putting them at risk of thrombus formation, myocardial infarction and sudden death. Clinical guidelines recommend CAA diameter >8 mm as the arbitrary criterion for initiating systemic anticoagulation. KD patient specific modeling and flow simulations suggest that hemodynamic data can predict regions at increased risk of thrombosis. Transluminal Attenuation Gradient (TAG) is determined from the change in radiological attenuation per vessel length and has been proposed as a non-invasive method for characterizing coronary stenosis from CT Angiography. We hypothesized that CAA abnormal flow could be quantified using TAG. We computed hemodynamics for patient specific coronary models using a stabilized finite element method, coupled numerically to a lumped parameter network to model the heart and vascular boundary conditions. TAG was quantified in the major coronary arteries. We compared TAG for aneurysmal and normal arteries and we analyzed TAG correlation with hemodynamic and geometrical parameters. Our results suggest that TAG may provide hemodynamic data not available from anatomy alone. TAG represents a possible extension to standard CTA that could help to better evaluate the risk of thrombus formation in KD.

  14. Transretroperitoneal CT-guided Embolization of Growing Internal Iliac Artery Aneurysm after Repair of Abdominal Aortic Aneurysm: A Transretroperitoneal Approach with Intramuscular Lidocaine Injection Technique

    International Nuclear Information System (INIS)

    This study was designed to evaluate the efficacy and safety of CT-guided embolization of internal iliac artery aneurysm (IIAA) after repair of abdominal aortic aneurysm by transretroperitoneal approach using the lidocaine injection technique to iliacus muscle, making window for safe needle path for three patients for whom CT-guided embolization of IIAA was performed by transretroperitoneal approach with intramuscular lidocaine injection technique. Transretroperitoneal access to the IIAA was successful in all three patients. In all three patients, the IIAA was first embolized using microcoils. The aneurysmal sac was then embolized with glue and coils without complication. With a mean follow-up of 7 months, the volume of the IIAAs remained stable without residual endoleaks. Transretroperitoneal CT-guided embolization of IIAA using intramuscular lidocaine injection technique is effective, safe, and results in good outcome

  15. Transretroperitoneal CT-guided Embolization of Growing Internal Iliac Artery Aneurysm after Repair of Abdominal Aortic Aneurysm: A Transretroperitoneal Approach with Intramuscular Lidocaine Injection Technique

    Energy Technology Data Exchange (ETDEWEB)

    Park, Joon Young, E-mail: pjy1331@hanmail.net; Kim, Shin Jung, E-mail: witdd2@hanmail.net; Kim, Hyoung Ook, E-mail: chaos821209@hanmail.net [Chonnam National University Hospital, Department of Radiology (Korea, Republic of); Kim, Yong Tae, E-mail: mono-111@hanmail.net [Chonnam National University Hwasun Hospital, Department of Radiology (Korea, Republic of); Lim, Nam Yeol, E-mail: apleseed@hanmail.net; Kim, Jae Kyu, E-mail: kjkrad@jnu.ac.kr [Chonnam National University Hospital, Department of Radiology (Korea, Republic of); Chung, Sang Young, E-mail: sycpvts@jnu.ac.kr; Choi, Soo Jin Na, E-mail: choisjn@jnu.ac.kr; Lee, Ho Kyun, E-mail: mhaha@hanmail.net [Chonnam National University Hospital, Department of Surgery (Korea, Republic of)

    2015-02-15

    This study was designed to evaluate the efficacy and safety of CT-guided embolization of internal iliac artery aneurysm (IIAA) after repair of abdominal aortic aneurysm by transretroperitoneal approach using the lidocaine injection technique to iliacus muscle, making window for safe needle path for three patients for whom CT-guided embolization of IIAA was performed by transretroperitoneal approach with intramuscular lidocaine injection technique. Transretroperitoneal access to the IIAA was successful in all three patients. In all three patients, the IIAA was first embolized using microcoils. The aneurysmal sac was then embolized with glue and coils without complication. With a mean follow-up of 7 months, the volume of the IIAAs remained stable without residual endoleaks. Transretroperitoneal CT-guided embolization of IIAA using intramuscular lidocaine injection technique is effective, safe, and results in good outcome.

  16. [Medullary venous malformation with azygos anterior cerebral artery aneurysm: a case report].

    Science.gov (United States)

    Harada, K; Kobayashi, S; Sigemori, M; Watanabe, M; Kuramoto, S

    1987-03-01

    A case of medullary venous malformation with azygos anterior cerebral artery aneurysm is reported, which was associated with the leptomenigeal angiomatosis on the cortex of the right frontal lobe. A 62-year-old female was admitted to the Kurume University Hospital on June 21, 1985, because of a convulsive seizure. On admission, neurological and general examinations, except for slightly liver function disorder, was no abnormality. Plain CT scan showed the cortical atrophy and two small high-density areas in the right frontal lobe. Enhanced CT scan showed a high-density area in the genu of the corpus callosum. MRI (magnetic resonance imaging), on T2 weighted image, showed a high signal intensity area in the right paraventricular deep white matter and the right frontal region. A right internal carotid angiogram in the venous phase showed numerous enlarged medullary veins in the deep frontal region, converging into a single large draining vein that empties into the basal vein of Rosenthal. An azygos anterior cerebral artery was visualized on the right and left carotid angiograms. The aneurysm was situated at the distal end of the azygos artery. Twenty eight days after admission, a right frontal cranioplastic craniotomy was performed. During operation, the surface of the right frontal lobe was covered by fine, vascular networks, which was reddish brown. A right frontal lobectomy, including venous malformation and vascular networks, was performed. The aneurysm was clipped via an interhemispheric approach. Histologically, the malformation vessels had spread into the subarachnoid space.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3600991

  17. Bilateral Intracavernous Carotid Artery Aneurysms Presenting as Diplopia in a Young Patient

    Directory of Open Access Journals (Sweden)

    Nikolaos Kopsachilis

    2013-01-01

    Full Text Available Introduction. Bilateral intracavernous carotid artery aneurysms (ICAAs are extremely rare and difficult to treat. Case Report. A 26-year-old female presented in our clinic with acute diplopia due to oculomotor nerve palsy on the left side. Magnetic resonance imaging of the brain showed two heterogeneously enhanced masses indicating bilateral ICAA. An endovascular coil embolization was performed on the left side successfully, resulting in resolution of her symptoms. Conclusion. Thorough systemic evaluation in young patients with diplopia can reveal life-threatening underlying pathology and prevent major complications.

  18. Recurrent Massive Hemoptysis due to Postbronchotomy Bronchial Artery Aneurysm: A Case Report

    Directory of Open Access Journals (Sweden)

    Achilleas Lioulias

    2008-01-01

    Full Text Available Bronchial artery aneurysm (BAA is a rare clinical entity. A case of intrapulmonary BAA associated with previous bronchotomy at the same site is described. A 22-year-old woman, who had undergone bronchotomy of the intermediate bronchus for the removal of a foreign body four years previously, presented with recurrent hemoptysis. Because of an increased risk for spinal cord ischemia, she immediately underwent lung resection rather than therapeutic embolization. The incidental finding of a BAA of any cause cannot be assumed to be stable, and immediate management should be undertaken regardless of the presence or absence of symptoms.

  19. Aneurisma da Artéria Renal: caso clínico Renal Artery Aneurysm

    Directory of Open Access Journals (Sweden)

    Joana Moreira

    2011-12-01

    Full Text Available Apresenta-se o caso clínico de um doente com volumoso aneurisma da artéria renal esquerda. Do sexo masculino, de 22 anos de idade, com lombalgia à esquerda com algumas semanas de evolução. Recorreu ao médico assistente que solicitou estudo imagiológico por ecografia abdominal. Detectada imagem sugestiva de aneurisma da aorta abdominal. Este achado motivou a transferência para o nosso Hospital onde foi admitido consciente e orientado, hemodinamicamente estável, apresentando uma massa pulsátil epigástrica, com frémito e sopro sistólico à auscultação. Angio-TC revelou um aneurisma da artéria renal esquerda com 16 cm de diâmetro. Dada a estabilidade clínica e topografia lesional optou-se por tentar embolizar, sem sucesso, o tronco da artéria renal esquerda antes da abordagem cirúrgica. O doente foi então submetido a Nefrectomia total esquerda por via toraco-abdominal. Pós-operatório sem complicações, locais ou sistémicas. Alta ao 8ºdia, mantendo boa função renal e com níveis normais de hemoglobina. Diagnóstico de aneurisma da artéria renal confirmado por estudo anátomo-patológico da peça operatória.One case of a large left renal artery aneurysm in a young patient 22 years old is presented. He appealed to his assistant physician a few weeks after development of left back pain. Abdominal ultrasound imaging study has been requested. Suggestive abdominal aortic aneurysm was detected. This finding led to the transfer to our hospital where he was admitted conscious and hemodynamically stable. A pulsatile epigastric mass with a systolic murmur on auscultation and thrill were detected. Angio-CT scan revealed a left renal artery aneurysm, 16 cm in diameter. Given the clinical stability and lesional topography we decide a previous embolization of left renal artery, unsuccessfully. The patient underwent then left total nephrectomy, through thoraco-abdominal incision. No local or systemic complications in the postoperative

  20. Secondary aneurysmal bone cystic change of the chondroblastoma, mistaken for a primary aneurysmal bone cyst in the patella.

    Science.gov (United States)

    Chung, Jin Wha; Lee, Hwa Sung

    2014-03-01

    A 29-year-old woman complained of a 3-month history of left knee pain without trauma history. X-ray showed a well-defined osteolytic lesion with a sclerotic margin in the patella and magnetic resonance imaging showed T1-low and T2-high signal intensity with different fluid level. Our impression was an aneurysmal bone cyst. At surgery, the lesion was a blood-filled cystic cavity, surrounded by a gray or brownish tissue. Hemorrhagic soft tissues with recognizable bone fragments were observed. Curettage and autogenous bone graft was done. Microscopically, sheets of tumor cells were intermingled with some areas of eosinophilic chondroid matrix. The tumor cells showed oval-shaped nuclei with moderate eosinophilic cytoplasm. Several multinucleated giant cells and blood filled cystic cavities were observed. The final diagnosis was a chondroblastoma with a secondary aneurysmal bone cyst. At the post-operative 1.5-year follow-up, grafted bones were well incorporated radiographically and there were no recurrent evidence or any other abnormal symptoms. PMID:24639947

  1. Secondary aneurysmal bone cystic change of the chondroblastoma, mistaken for a primary aneurysmal bone cyst in the patella.

    Science.gov (United States)

    Chung, Jin Wha; Lee, Hwa Sung

    2014-03-01

    A 29-year-old woman complained of a 3-month history of left knee pain without trauma history. X-ray showed a well-defined osteolytic lesion with a sclerotic margin in the patella and magnetic resonance imaging showed T1-low and T2-high signal intensity with different fluid level. Our impression was an aneurysmal bone cyst. At surgery, the lesion was a blood-filled cystic cavity, surrounded by a gray or brownish tissue. Hemorrhagic soft tissues with recognizable bone fragments were observed. Curettage and autogenous bone graft was done. Microscopically, sheets of tumor cells were intermingled with some areas of eosinophilic chondroid matrix. The tumor cells showed oval-shaped nuclei with moderate eosinophilic cytoplasm. Several multinucleated giant cells and blood filled cystic cavities were observed. The final diagnosis was a chondroblastoma with a secondary aneurysmal bone cyst. At the post-operative 1.5-year follow-up, grafted bones were well incorporated radiographically and there were no recurrent evidence or any other abnormal symptoms.

  2. Acute coronary syndrome with unusual form of right coronary artery aneurysm and treated with overlapping two covered stents across coronary aneurysm: case report

    Directory of Open Access Journals (Sweden)

    Naresh Sen

    2016-04-01

    Full Text Available A 27-year old male presented with acute inferior wall myocardial infarction. Coronary angiogram revealed normal left coronary arteries and a giant coronary aneurysm in Right coronary artery (RCA. Primary angioplasty of RCA was performed. Large thrombus burden was retrieved with aspiration device and coronary flow restored. However, despite best efforts some thrombus remained and decision to stent was deferred to a later date. Dimensions of aneurysm on quantitative coronary angiogram were 16 mm in width and 43 mm in length. Two weeks later coronary angiogram revealed normal flow in RCA without any angiographically visible thrombus. PCI was performed with two 3.0 and times; 28 mm covered stents, graft master (JoStent deployed across the aneurysm, overlapping each other. This completely sealed the aneurysm and intravascular ultrasound confirmed no leakage through the covered stents. Patient remains asymptomatic 2 months post procedure on triple antiplatelet therapy. [Int J Res Med Sci 2016; 4(4.000: 1295-1297

  3. Comparison Between Balloon-Assisted and Stent-Assisted Technique for Treatment of Unruptured Internal Carotid Artery Aneurysms

    Science.gov (United States)

    Park, Keun Young; Kim, Dong Joon

    2016-01-01

    Purpose To compare clinical and angiographic outcomes between balloon-assisted (BAC) and stent-assisted coiling for internal carotid artery unruptured aneurysms (ICA-UA). Materials and Methods A total of 227 ICA-UA in 190 patients were treated with BAC (120 patients, 141 ICA-UA) or SAC (70 patients, 86 ICA-UA. We compared characteristics of patients and ICA-UA, and clinical and angiographic outcomes between groups. Results Aneurysm size and neck diameter were greater for SAC than in BAC, but aneurysm volume and coil packing density were not different between groups. Immediate angiographic occlusion grade was better for BAC than for SAC. Periprocedural thromboembolic events were more frequent during SAC (11.6%) than BAC (2.4%) per aneurysm, but hemorrhagic events were the opposite (2.4% for BAC and none for SAC per aneurysm) (p aneurysms [95.7%] for 28.3 months; SAC, 81 aneurysms [94.1%] for 23.9 months), BAC and SAC showed stable or improved occlusion in 94.1% and 95.0%, minor recurrence in 4.4% and 2.5%, and major recurrence in 1.5% and 2.5%, respectively. Conclusion Both BAC and SAC were safe and effective techniques for ICA-UA. There were no differences in morbi-mortality and recurrence rates between groups. PMID:27621946

  4. Adolescent External Iliac Artery Trauma: Recurrent Aneurysmal Dilatation of an Iliofemoral Saphenous Vein Graft Treated by Stent-Grafting

    International Nuclear Information System (INIS)

    An adolescent male sustained a severe penetrating injury to the external iliac artery. Emergency surgical revascularization was with a reversed long saphenous vein interposition graft. The primary graft and the subsequent revision graft both became aneurysmal. The second graft aneurysm was successfully excluded by endovascular stent-grafts with medium-term primary patency. A venous graft was used initially rather than a synthetic graft to reduce the risk of infection and the potential problems from future growth. Aneurysmal dilatation of venous grafts in children and adolescents is a rare but recognized complication. To the best of our knowledge, exclusion of these aneurysms with stent-grafts has not been previously reported in the adolescent population.

  5. Complex Regional Pain Syndrome Type II Secondary to Endovascular Aneurysm Repair

    Directory of Open Access Journals (Sweden)

    Hamilton Chen

    2015-01-01

    Full Text Available Complex regional pain syndrome (CRPS is a chronic pain disorder characterized by severe pain and vasomotor and pseudomotor changes. Endovascular aneurysm repair (EVAR of abdominal aortic aneurysms is a recent advance in vascular surgery that has allowed repair of AAA while offering reduced intensive care unit and hospital lengths of stay, reduced blood loss, fewer major complications, and more rapid recovery. Pseudoaneurysms are a rare complication of an EVAR procedure that may result in a wide range of complications. The present report examines CRPS type II as a novel consequence of pseudoaneurysm formation from brachial artery access in the EVAR procedure. To our knowledge, this is the first reported case of CRPS type II presentation as sequelae of an EVAR procedure.

  6. Multidetector CT findings of splenic artery aneurysm in children with chronic liver disease

    International Nuclear Information System (INIS)

    Splenic artery aneurysm (SAA) is a well-known complication of chronic liver disease and portal hypertension in adults. The incidence of SAA in children undergoing selective hepatic angiography prior to liver transplantation is reported as 4%, but there are few systematic studies. To investigate the SAAs detected by multidetector CT angiography (MDCTA) among children with chronic liver disease. A total of 124 children (71 girls, 53 boys; mean age 118 months; age range 5 days to 204 months) with chronic liver disease underwent MDCTA to display the vascular anatomy and any vascular complications during the pretransplantation period. Of these children, 23 also underwent coeliac angiography. The digital subtraction angiography (DSA) and MDCTA findings were compared. SAAs were detected in 13 children (10.4%); none was detectable by US. All patients had more than one aneurysm; ten patients had more than three. In all except one patient, the SAAs were located only in the intraparenchymal branches of the splenic artery; in one patient they were located in the intraparenchymal segment and in the distal third of the splenic artery. The mean size of the aneurysms was 6.5 mm (range 2.5-18 mm). All patients with aneurysms had splenomegaly and vascular collaterals. Nine of the children with SAAs had portal vein pathologies (two occlusions, two stenoses, five dilatations). A statistically significant difference existed with regard to the size of spleen (P < 0.05) and patient age (P < 0.05) between children with SAAs and children without SAAs. There was an increased risk of SAAs in patients with portal vein pathologies. In 19 patients without SAAs on MDCTA, no SAAs were seen on DSA. It is likely that the incidence of SAA in children with chronic liver disease will increase with improved survival of children with long-standing portal hypertension and chronic liver disease. MDCTA with multiplanar reconstruction is a noninvasive and effective means of imaging paediatric patients with

  7. Pulmonary artery aneurysm in Bechcet's disease: helical computed tomography study; Aneurisma de la arteria pulmonar en la enfermedad de Behcet. Estudio con tomografia computarizada helicoidal

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, J.; Caballero, P.; Olivera, M. J.; Cajal, M. L.; Caniego, J. L. [Hospital de la Princesa. Iniversidad Autonoma. Madrid (Spain)

    2000-07-01

    Behcet's disease is a vasculitis of unknown etiology that affects arteries and veins of different sizes and can be associated with pulmonary artery aneurysms. We report the case of a patient with Behcet's disease and a pulmonary artery aneurysm who was studied by means of plain chest X ray, helical computed tomography and pulmonary arteriography. Helical computed tomography is a reliable technique for the diagnosis and follow-up of these patients. (Author) 9 refs.

  8. Multiple giant succular and fusiform right and left coronary artery aneurysms after early and adequate treatment of atypical kawasaki disease with unusual presentation.

    Directory of Open Access Journals (Sweden)

    Mostafa Behjati-Ardakani

    2014-06-01

    Full Text Available The major complication of Kawasaki disease is coronary artery dilatation and aneurysm. It occurs in approximately 15-25% of untreated children with Kawasaki Disease. Early diagnosis and treatment with Intravenous immune globulin (IVIG and aspirin (ASA can reduce the incidence of coronary artery abnormality to 2%-5%. We report one case of Atypical Kawasaki Disease with Multiple giant coronary artery aneurysms despite early adequate treatment with IVIG and ASA.

  9. Microsurgical Strategies Following Failed Endovascular Treatment with the Pipeline Embolization Device: Case of a Giant Posterior Cerebral Artery Aneurysm

    OpenAIRE

    Ding, Dale; Starke, Robert M.; Kenneth C. Liu

    2014-01-01

    Treatment of giant posterior circulation aneurysms, via endovascular or microsurgical approaches, carries a high risk of morbidity and mortality. While flow-diverting stents (FDSs) represent a potent therapy for endovascular reconstruction of complex aneurysms, they are also associated with novel complications for which effective salvage techniques are lacking. We present a unique complication from failed treatment with a FDS. A 51 year-old male presented with increasing headaches secondary t...

  10. Infundibular dilation and aneurysm at the origin of the posterior communicating artery: differential diagnosis by CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Min, Kyung-Jun; Yoon, Dae-Young [Hallym University College of Medicine, Department of Radiology, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of); Kim, Heung-Chul [Hallym University College of Medicine, Department of Radiology, Chuncheon Sacred Heart Hospital, Chuncheon (Korea, Republic of); Lee, Jong-Young; Cho, Byung-Moon [Hallym University College of Medicine, Department of Neurosurgery, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of)

    2014-11-15

    Infundibular dilation (ID) and aneurysm at the internal carotid artery (ICA)-posterior communicating artery (PComA) junction can be difficult to distinguish but may differ in clinical significance. The aim of this study was to evaluate the utility of CT angiography (CTA) in differentially diagnosing IDs and small unruptured aneurysms at the ICA-PComA junction. This retrospective study comprised 88 patients diagnosed with 107 protrusions (70 IDs and 37 aneurysms <5 mm; 19 bilateral lesions) at the ICA-PComA junction who underwent both CTA and digital subtraction angiography (DSA). Two neuroradiologists independently reviewed CTA and DSA images according to these criteria: (a) size (maximum dimension <3 or ≥3 mm), (b) shape (triangular or round/oval/irregular), (c) aneurysmal neck (absent or present), (d) horizontal direction (posteriomedial or posteriolateral), and (e) PComA origin (apex, no PComA, or base). The intermodality (between CTA and DSA) and interobserver (between the two readers) agreement were determined for each finding. We also evaluated the sensitivity and specificity of CTA for distinguishing ID and aneurysm, using DSA as the reference standard. The mean κ values of intermodality agreement for the size, shape, aneurysmal neck, horizontal direction, and PComA origin were 0.88, 0.87, 0.84, 0.71, and 0.56, respectively. All interobserver agreements of CTA and DSA were excellent. The sensitivity, specificity, and accuracy of CTA for differentiating aneurysms from IDs were 94.6, 100, and 98.0 %, respectively. CTA may be a useful noninvasive modality for differential diagnosis of ID and aneurysm at the ICA-PComA junction. (orig.)

  11. Chondroblastoma with secondary aneurysmal bone cyst in the anterior skull base

    OpenAIRE

    Ming Jie Wang, MD, PhD; Bing Zhou, MD

    2016-01-01

    Chondroblastoma with secondary aneurysmal bone cyst (ABC), especially in the anterior skull base, is an extremely rare condition. A 5-year-old boy presented with a large space-occupying lesion in the anterior skull base along with a left sided-epistaxis, proptosis and decreased vision. Radical excision of the lesion was performed by an endoscopic transnasal and transethmoidal approach. The patient recovered without any recurrence during a follow-up period of up to 28 months. Here, we review t...

  12. A Rare Case of Streptococcus alactolyticus Infective Endocarditis Complicated by Septic Emboli and Mycotic Left Middle Cerebral Artery Aneurysm.

    Science.gov (United States)

    Almeida, Patricia; Railsback, Jaclyn; Gleason, James Benjamin

    2016-01-01

    To date, S. alactolyticus endocarditis complicated by middle cerebral artery aneurysm has not been reported. We describe the case of a 65-year-old female with a history of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction presenting with confusion and a apical holosystolic murmur. Angiography of the brain identified new bilobed left middle cerebral artery aneurysm. Serial blood cultures grew S. alactolyticus, and aortic and mitral valve vegetation were discovered on transesophageal echocardiography. The patient was treated with antimicrobial therapy, mitral and aortic valve replacements, and microsurgical clipping of cerebral aneurysm. This case serves to highlight the pathogenicity of a sparsely described bacterium belonging to the heterogenous S. bovis complex. PMID:27525136

  13. Role of transesophageal echocardiography in the clinical management of a patients with a giant coronary artery aneurysm.

    Science.gov (United States)

    Wolford, D C; Jost, C M; Madu, E C; Walker, W; Ramanatian, K B

    1997-06-01

    Transthoracic echocardiography (TTE) has substantial limitations for the study of abnormalities of the coronary tree. Transesophageal echocardiography (TEE) allows a more complete examination of the coronary arteries, particularly the proximal segments. This report describes the use of TEE after cardiac catheterization in the clinical management of a patient with unstable angina. While angiography first showed the giant aneurysm of the left circumflex coronary artery. TEE, by revealing an active thrombus of the lumen, prompted an immediate surgical resolution.

  14. Angle change of the parent arteries after stent-assisted coil embolization of wide-necked intracranial bifurcation aneurysms

    International Nuclear Information System (INIS)

    Aim: To investigate the angle changes of the parent arteries after stent-assisted coil embolization of wide-necked intracranial bifurcation aneurysms. Materials and methods: The adjacent parent arterial angles before and after stent-assisted coil embolization were measured in 38 patients with aneurysms of the anterior communicating artery (ACoAA) and 41 patients with bifurcation aneurysms of the middle cerebral artery (MCABA). Variables were analysed in relation to the angle changes. Results: Vascular angles of the parent arteries significantly increased by 27.8° (±18.5°) immediately after stent-assisted coil embolization in 79 cases (p < 0.001), with 25.7° (±14.8°) in ACoAA and 29.7° (±21.4°) in MCABA, respectively. In 51 (64.6%) cases with follow-up angiography (mean interval 13.5 ± 4.1 months), vascular angles increased by 27.2° (±17.1°) immediately after treatment and further increased by 20.7° (±14.3°) at the last follow-up (all p < 0.001). More acute pre-stent angles of the parent arteries correlated with greater post-stent angle changes (p = 0.006). Younger age tended to be inversely related to post-stent angle changes (p = 0.091). Conclusion: Stent placement during coil embolization induced significant changes in the aneurysm–parent artery relationship. Further study is needed to elicit the association between angle change of the parent arteries and aneurysmal stability after coil embolization

  15. Acute myocardial infarction in a 35-year-old man with coronary artery aneurysm most probably caused by Kawasaki disease

    Institute of Scientific and Technical Information of China (English)

    Saeed Alipour Parsa; Isa Khaheshi; Koosha Paydary; Habib Haybar

    2014-01-01

    We present a 35-year-old man with history of Kawasaki disease who referred with myocardial infarction, and angiography, revealing aneurysm of left main and left anterior descending coronary arteries. The patient underwent percutaneous coronary intervention and thrombectomy and was discharged after 6 d. Coronary artery sequels of Kawasaki disease should be considered as one of the underlying causes of acute myocardial infarction in young adults.

  16. A rare cause of bleeding after laparoscopic sleeve gastrectomy : pseudo-aneurysm of the gastro-omental artery.

    Science.gov (United States)

    Mege, D; Louis, G; Berthet, B

    2013-01-01

    A serious complication of laparoscopic sleeve gastrectomy (LSG) is bleeding that is primarily located along the staples lines. Bleeding may be due to several causes, including hematomas, trocar sites, or visceral pseudo-aneurysms. We reported here a case of bleeding related to a pseudo-aneurysm of the gastro-omental artery. An LSG was performed on a 43-year-old woman (BMI = 46 kg/m2) without apparent surgical complications. Fifteen days later, she was admitted to the emergency department for hematemesis and symptoms of hemorrhagic shock. Abdominal computed tomography angiography revealed blood in the stomach, without a digestive leak, and active bleeding from a pseudo-aneurysm of the gastro-omental artery. An arterial embolisation was performed with the sandwich technique and angiographic guide wires and the placement of several detachable coils. The patient was discharged two days later. We demonstrated for the first time that post-LSG bleeding may involve a pseudo-aneurysm of the gastro-omental artery.

  17. Hepatic artery aneurysm in a patient with Behcet's disease and segmental pancreatitis developing after its embolization

    Energy Technology Data Exchange (ETDEWEB)

    Oto, A.; Cekirge, S.; Guelsuen, M.; Balkanci, F.; Besim, A. [Department of Radiology, Hacettepe University, Ankara (Turkey)

    2000-08-01

    Segmental pancreatitis is an unusual form of acute pancreatitis mostly seen in the head of pancreas. We present the CT findings of a segmental pancreatitis in the body and tail of the pancreas developed following endovascular embolization of a giant hepatic artery aneurysm and arterioportal fistula in a patient with Behcet's disease. (orig.)

  18. Magnetic resonance angiography and CT angiography of persistent primitive olfactory artery: Incidence and association rate with aneurysm in Korea

    International Nuclear Information System (INIS)

    Japanese data indicates an incidence of persistent primitive olfactory artery (PPOA) of 0.14%. We studied the incidence of PPOA and associated cerebral vascular variation or anomalies in Korea. We retrospectively reviewed cranial magnetic resonance angiography (MRA) and computed tomography angiography (CTA) images of a total of 9841 patients of our institution. The diagnostic criterion of PPOA is extreme anterioinferior course of the proximal anterior cerebral artery, with a hairpin turn of the lateral projection. We found 29 cases (0.29%) with PPOA. The PPOA location was on the left in 19 cases, bilateral in 3 cases, and on the right in 7 cases. An aneurysm was found at the hairpin turn in 2 patients. There were aneurysms in other sites in 3 cases. There were hypoplasia of anterior cerebral artery in 3 cases, and fenestration of intracranial artery in 1 case. In Korean populations, the incidence of PPOA found in MRA and CTA was twice as high as that shown in the previous Japanese data. Within Korea, left side laterality is more common than right side or bilalterality. Aneurysmal dilatations at the hairpin turning point and aneurysms at other sites were found, and other vascular variations were observed in several cases

  19. Balloon occlusion of the internal carotid artery in 40 cases of giant intracavernous aneurysm: Technical aspects, cerebral monitoring, and results

    International Nuclear Information System (INIS)

    We have studied the results of carotid occlusion in the treatment of giant intracavernous carotid artery (ICA) aneurysms in 40 patients. Clinical, angiographic, Doppler and cerebral blood flow (CBF) criteria for tolerance of occlusion are discussed. The patients had headaches (47.5%), cranial nerve compression (87.5%), decreased visual acuity (20%), ruptured aneurysm (15%) and 5% were asymptomatic. Balloon occlusion tests were performed under light sedation anaesthesia; a successful test required perfect clinical tolerance and adequate angiographic collateral circulation in arterial, parenchymatous, and venous phases. Additional criteria included xenon 133 CBF measurements, and transcranial Doppler sonography of the middle cerebral artery. According to these criteria, 5 patients did not tolerate test occlusion and required an extra-intracranial (EC-IC) bypass. Mean follow-up was 4.7 years. All patients were radiologically cured of their aneurysm, and in 35 the symptoms resolved, although 3 had persistent ocular motor nerve palsies, and in 4 visual defects were unchanged. Complications were 1 permament and 3 transient neurological deficits. Balloon occlusion of the ICA is an effective, reliable form of treatment for intracavernous giant aneurysm and should replace surgical ligation of the cervical carotid artery. With CBF or Doppler monitoring, the risk of neurological deficit is diminished. EC-IC bypass prior to ICA occlusion is indicated if test occlusion is not tolerated. (orig.)

  20. Giant hepatic artery aneurysm associated with immunoglobulin G4-related disease successfully treated using a liquid embolic agent

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Michele; Virgilio, Edoardo; Laurino, Florindo; Orgera, Gianluigi; Mene, Paolo; Pirozzi, Nicola; Ziparo, Vincenzo; Cavallini, Marco [St. Andrea Hospital, Rome (Italy)

    2015-08-15

    The occurrence of a giant hepatic artery aneurysm (GHAA) in a patient with systemic vasculitis is very rare. Herein, we describe our endovascular treatment experience of a GHAA associated with immunoglobulin G4-related disease (IgG4-RD) consisting primarily of a liquid embolic injection and deployment of a vascular plug.

  1. Non heamoptytic massive Rasmussen's pulmonary artery aneurysm caused by aggressive cavitating squamous cell carcinoma metastasis

    International Nuclear Information System (INIS)

    The authors report an extremely rare occurrence of a massive aneurysm of a major pulmonary artery branch vessel caused by adjacent necrotizing aggressive squamous cell carcinoma metastatic mediastinal nodes. Despite the huge size, there was no hemoptysis due to the walling off effect by the necrotic nodes

  2. Superior mesenteric artery aneurysm in a 9-year-old boy with classical Ehlers-Danlos syndrome

    NARCIS (Netherlands)

    de Leeuw, K.; Goorhuis, J. F.; Tielliu, I. F. J.; Symoens, S.; Malfait, F.; de Paepe, A.; van Tintelen, J. P.; Hulscher, J. B. F.

    2012-01-01

    A 9-year-old boy with the classical type of EhlersDanlos syndrome (EDS) developed a symptomatic aneurysm of the superior mesenteric artery. His EDS diagnosis had been confirmed biochemically and genetically. Vascular complications are known to be associated with the vascular type of EDS, but this is

  3. Endovascular management of the patent inferior mesenteric artery in two cases of uncontrolled type II endoleak after endovascular aneurysm repair

    Directory of Open Access Journals (Sweden)

    Iswanto Sucandy

    2011-01-01

    Full Text Available Context : Endovascular aneurysm repair (EVAR has well documented advantages over traditional open repair and has been widely adopted as the alternative treatment modality for abdominal aortic aneurysm. However, endoleaks specifically type II can be a significant problem with this technique leading to aortic sac expansion and potential rupture. A large number of type II endoleaks are caused by persistent inferior mesenteric artery (IMA retrograde bleeding. Various methods to try to manage this complication have been previously described. IMA embolization via the marginal artery of Drummond, however, has not been adequately popularized as an alternative less invasive approach to the treatment of type II endoleak. Case Report : Two men, ages 77 and 81, underwent uneventful EVAR for 5.5 and 5.0 cm infrarenal abdominal aortic aneurysms, respectively, using Zenith Cook; bifurcated stent grafts. Computed tomography angiography at 1 and 6 months postoperatively demonstrated small type II endoleaks in both cases which were followed clinically. Subsequent follow-up tomography scan at 12 months revealed persistent type II endoleaks related to retrograde filling from the IMA with significant enlargement of the aneurysm sacs. Both patients underwent successful IMA coil embolization via the marginal artery of Drummond. Conclusions : Percutaneous IMA embolization using standard endovascular techniques to access the marginal artery of Drummond is an alternative, and in our opinion, preferred technique for controlling type II endoleaks caused by a persistently patent IMA.

  4. Mycotic aneurysm of the extracranial internal carotid artery - report of a case and review of the literature

    International Nuclear Information System (INIS)

    The authors report a case of mycotic aneurysm of the extracranial internal carotid artery in a 4-year-old- male child, resulting from tonsillar infection. The authors relate the difficulties to initially suggest the diagnosis, stress the importance of the differential diagnosis particularly in children and describe the findings on conventional films, US colour-Doppler, CT and carotid digital subtraction angiography. (author)

  5. An intramural left main coronary artery with a left sinus of valsalva aneurysm: a unique combination of congenital anomalies.

    Science.gov (United States)

    Altarabsheh, Salah Eldien; Deo, Salil V; Spitell, Peter; Araoz, Philip; Park, Soon J

    2013-02-01

    The congenital anomaly of an intramural left main coronary artery arising in the anatomically correct aortic sinus is very infrequent. Aneurysms involving the sinus of Valsalva rarely arise from the left aortic sinus. We present the clinical features and surgical correction of this rare anomaly along with a short discussion of these congenital malformations. PMID:23439356

  6. Fusiform aneurysm of a persistent primitive trigeminal artery associated with cerebrovascular anatomic variations: a report of two cases.

    Science.gov (United States)

    Pleş, Horia; Loukas, Marios; Andall, Rebecca G; Andall, Naomi R; Iacob, Nicoleta; Miclăuş, GraŢian Dragoslav; Matusz, Petru; Tubbs, R Shane

    2015-01-01

    There are four embryonic anastomoses that exist between the internal carotid artery (ICA) and the vertebrobasilar (VB) system, which may fail to regress postfetal life; one of which is the trigeminal artery. Other persistent anastomoses include those formed by the hypoglossal, otic and proatlantic intersegmental arteries. In addition, other cerebrovascular variations may accompany a persistent primitive trigeminal artery (PPTA); such as arteriovenous malformations, aneurysms, carotid-cavernous fistulas and stenotic cerebral vessels. We present two very rare cases of a left PPTA. In the first case, there was a past medical history significant for cervico-thoraco-lumbar spondylitis and in the second case of an operated occipital astrocytoma. In both cases, the PPTA was associated with a fusiform aneurysm located in the carotidian (lateral) aspect of the PPTA as well as other cerebrovascular anatomic variations. In the first case, the length of the PPTA was 26.0 mm and its endoluminal diameter, at its origin at the ICA, was 1.8 mm; the aneurysm has a length of 8.4 mm. In the second case, the length of the PPTA was 31.0 mm and its endoluminal diameter at its origin at the ICA was 3.0 mm; the aneurysm have a length of 7.6 mm. Identification of these variant vessels should not be ignored before planning and execution of neurosurgeries to prevent possible perioperative risks. PMID:26662153

  7. Endovascular Treatment of Isolated Bilateral Internal Ili- ac Artery Aneurysms with a Branched Endograft: A Case Report

    Directory of Open Access Journals (Sweden)

    SeyedEbrahim Kassaian

    2015-10-01

    Full Text Available Isolated bilateral internal iliac artery (IIA aneurysm is a rare and potentially lethal disease. Endovascular repair of this disorder is a matter of debate. A symptomatic 68-year-old male presented with severe pelvic pains. Computed tomography revealed a leaking 46-mm aneurysm in the right IIA, a 27-mm aneurysm in the left IIA, and ectatic changes at a diameter of 31 mm in the right common iliac artery (CIA. Due to lower rates of morbidity and mortality, an endovascular approach was chosen instead of open surgical repair. However, due to anatomical constraints, an endograft had to be implanted in a healthy aorta in order to support an iliac branch endograft in the left CIA. Subsequently, following coil embolization of the left IIA, an iliac stent graft was extended to the right external iliac artery (EIA. Two-year follow-up CT imaging showed complete exclusion of all the aneurysms and patency of the pelvic visceral arteries. The patient is currently asymptomatic.Endovascular repair of bilateral isolated IIAs can be a feasible treatment option. However, due to limited availability of sizes in iliac branch devices currently on the market, a main body device is sometimes required to be deployed in a healthy aorta for additional endograft support.

  8. Aneurysm of the Left Coronary Artery in Postoperative Bland-White-Garland Syndrome

    Directory of Open Access Journals (Sweden)

    Nathalie Jeanne Magioli Bravo-Valenzuela

    2015-01-01

    Full Text Available We report a case of anomalous left coronary artery from the pulmonary artery (ALCAPA or Bland-White-Garland syndrome, present the challenges of performing a differential diagnosis, and discuss the treatment of the syndrome. Although ALCAPA is a rare congenital heart disease, it is one of the most common causes of myocardial ischemia in childhood and presents a diagnostic challenge. A four-year-old girl was referred to a pediatric cardiologist for evaluation of mitral valve regurgitation murmur and heart failure. The transthoracic echocardiogram demonstrated the left coronary artery (LCA not arising from the aorta, presence of coronary collateral circulation, and moderate mitral valve regurgitation. ALCAPA was confirmed using angiotomography. The LCA was surgically reimplanted into the aorta. After 3 years of postoperative follow-up, the patient developed an LCA aneurysm. Diagnosis of cardiac ischemia in childhood remains a challenge, and careful evaluation of coronary arteries on the echocardiogram is an important tool. In this report, we present a case of ALCAPA with an uncommon postoperative outcome.

  9. Aneurysm of the Left Coronary Artery in Postoperative Bland-White-Garland Syndrome.

    Science.gov (United States)

    Bravo-Valenzuela, Nathalie Jeanne Magioli; Silva, Guilherme Ricardo Nunes

    2015-01-01

    We report a case of anomalous left coronary artery from the pulmonary artery (ALCAPA) or Bland-White-Garland syndrome, present the challenges of performing a differential diagnosis, and discuss the treatment of the syndrome. Although ALCAPA is a rare congenital heart disease, it is one of the most common causes of myocardial ischemia in childhood and presents a diagnostic challenge. A four-year-old girl was referred to a pediatric cardiologist for evaluation of mitral valve regurgitation murmur and heart failure. The transthoracic echocardiogram demonstrated the left coronary artery (LCA) not arising from the aorta, presence of coronary collateral circulation, and moderate mitral valve regurgitation. ALCAPA was confirmed using angiotomography. The LCA was surgically reimplanted into the aorta. After 3 years of postoperative follow-up, the patient developed an LCA aneurysm. Diagnosis of cardiac ischemia in childhood remains a challenge, and careful evaluation of coronary arteries on the echocardiogram is an important tool. In this report, we present a case of ALCAPA with an uncommon postoperative outcome. PMID:26770839

  10. Clinical and imaging features of intracranial arterial aneurysms in the pediatric population; Klinische und radiologische Merkmale des intrakraniellen arteriellen Aneurysmas bei Kindern und Jugendlichen

    Energy Technology Data Exchange (ETDEWEB)

    Abruzzo, Todd A. [Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States). Dept. of Radiology; Aeron, Gunjan; Jones, Blaise V.

    2013-07-15

    Intracranial arterial aneurysms (IAAs) are rare in children. Nevertheless, IAAs account for at least 10 % - 15 % of hemorrhagic strokes during the first two decades of life. Traditional vascular risk factors, which are common in the adult population, are generally absent in the pediatric population, engendering distinct modes of IAA pathogenesis. Classification of pediatric IAAs according to the pathogenetic mechanism shows eight distinct categories: idiopathic, traumatic, those due to excessive hemodynamic stress, vasculopathic, infectious, noninfectious inflammatory, oncotic, and familial. Pathogenetic mechanism is the best predictor of the clinical course of the disease, response to treatment, and long-term prognosis. The pathogenetic subtypes of pediatric IAA show characteristic and variably overlapping features. In most cases, IAAs manifesting during the first two decades of life are idiopathic. IAAs that are idiopathic, traumatic (second most common type), or due to excessive hemodynamic stresses (third most common type) account for more than 80 % of IAAs in the pediatric age group. Most of the remaining pediatric IAAs are the result of congenital cerebral aneurysmal arteriopathies or infection. Multiple IAAs are unusual in young children except in those with acquired (secondary to immune deficiency states) or congenital cerebral aneurysmal arteriopathies or infectious IAAs. (orig.)

  11. Three-dimensional fusion angiography of a giant basilar aneurysm for coil embolization

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joo Yeon; Suh, Dae Chul [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2015-05-15

    A giant aneurysm was unexpectedly found on computed tomography angiogram in a 54-year-old female. Cerebral angiogram showed a giant aneurysm at the ventral side of the lower basilar artery trunk. However, it was difficult to demonstrate the precise relationship between the aneurysmal sac and the parent artery because of the incomplete filling of the contrast medium secondary to the preferential flows from a well-balanced development of both vertebral arteries. Three-dimensional (3D) fusion angiography revealed complete filling of the aneurysm as well as the basilar trunk itself beyond the aneurysm, which was dysplastic. Coiling of the aneurysm was safely and completely accomplished based on the fusion images. In this report, we demonstrate a case of giant basilar aneurysm with 3D fusion angiography proving useful in assisting with treatment planning.

  12. [Ruptured distal anterior cerebral artery aneurysm and diagnostic dyspraxia: a case report].

    Science.gov (United States)

    Wada, M; Kajikawa, H; Fujii, S; Yamamura, K; Kajikawa, M

    1995-04-01

    A case of ruptured distal anterior cerebral artery aneurysm presenting with diagnostic dyspraxia is presented. A 54-year-old female was referred to our hospital with the complaint of sudden onset of headache followed by disturbance of consciousness. CT and MRI revealed subarachnoid hemorrhage with hematomas in the interhemispheric fissure and the supracallosal area, and CAG revealed a left-sided callosomarginal artery aneurysm. During and after hospitalization, she showed diagnostic dyspraxia characterized by behavior of both her hands opposite to what might be expected e.g. when she tried to pick up a bowl, both her hands moved forward and held it at once; she wiped her head and face with toilet paper after urination. At times her hands behaved in opposite ways. For example, while folding cloths, her right hand tended to fold them while the left hand tended to unfold them; when she put on a sweater, as the right hand put it on, the left hand took it off; when she put her shirt into her trousers, one hand pushed it in while the other hand pulled it out. This unusual behavior was considered to be caused by the impairment of the corpus callosum due to compression by the hematoma. It disappeared gradually over a period of one year. Involuntary motor behavior of the left hand while the right hand is in voluntary action is known as diagnostic dyspraxia. Although this symptom has rarely been reported so far in cases of ruptured distal anterior cerebral artery, it may become noticed more frequently through careful observation. PMID:7739777

  13. Fractional modeling of viscoelasticity in 3D cerebral arteries and aneurysms

    Science.gov (United States)

    Yu, Yue; Perdikaris, Paris; Karniadakis, George Em

    2016-10-01

    We develop efficient numerical methods for fractional order PDEs, and employ them to investigate viscoelastic constitutive laws for arterial wall mechanics. Recent simulations using one-dimensional models [1] have indicated that fractional order models may offer a more powerful alternative for modeling the arterial wall response, exhibiting reduced sensitivity to parametric uncertainties compared with the integer-calculus-based models. Here, we study three-dimensional (3D) fractional PDEs that naturally model the continuous relaxation properties of soft tissue, and for the first time employ them to simulate flow structure interactions for patient-specific brain aneurysms. To deal with the high memory requirements and in order to accelerate the numerical evaluation of hereditary integrals, we employ a fast convolution method [2] that reduces the memory cost to O (log ⁡ (N)) and the computational complexity to O (Nlog ⁡ (N)). Furthermore, we combine the fast convolution with high-order backward differentiation to achieve third-order time integration accuracy. We confirm that in 3D viscoelastic simulations, the integer order models strongly depends on the relaxation parameters, while the fractional order models are less sensitive. As an application to long-time simulations in complex geometries, we also apply the method to modeling fluid-structure interaction of a 3D patient-specific compliant cerebral artery with an aneurysm. Taken together, our findings demonstrate that fractional calculus can be employed effectively in modeling complex behavior of materials in realistic 3D time-dependent problems if properly designed efficient algorithms are employed to overcome the extra memory requirements and computational complexity associated with the non-local character of fractional derivatives.

  14. Inferior Pancreaticoduodenal Artery Aneurysms Associated with Occlusive Lesions of the Celiac Axis: Diagnosis, Treatment Options, Outcomes, and Review of the Literature

    Energy Technology Data Exchange (ETDEWEB)

    Flood, Karen, E-mail: karenrogers@doctors.org.uk; Nicholson, Anthony A. [Leeds Teaching Hospitals, Department of Radiology (United Kingdom)

    2013-06-15

    Purpose. To describe the presentation, treatment, and outcomes for 14 patients with aneurysms of the inferior pancreaticoduodenal arteries associated with occlusive lesions of the celiac axis, and to review the literature for similar cases. Methods, Over a period of 12 years, 14 patients (10 women and 4 men) ranging in age from 26 to 50 (mean 46) years were demonstrated to have aneurysms of the inferior pancreaticoduodenal artery origin associated with stenosis or occlusion of the celiac axis. All patients were treated by a combination of surgery and interventional radiology. Results. Outcome data collected between 3 months and 4 years (mean 2 years) demonstrated that all aneurysms remained excluded, and all 14 patients were well. The 49 case reports in the literature confirm the findings of this cohort. Conclusion. In inferior pancreaticoduodenal artery aneurysm resulting from celiac occlusive disease, endovascular treatment is best achieved by stenting the celiac axis and/or embolizing the aneurysm when necessary.

  15. Epicardial radiofrequency ablation for left ventricular aneurysm related ventricular arrhythmias during off-pump coronary artery bypass surgery

    Institute of Scientific and Technical Information of China (English)

    YU Yang; GAO Ming-xin; LI Hai-tao; ZHANG Fan; GU Cheng-xiong

    2012-01-01

    Background Left ventricular aneurysm (LVA) is one of the serious complications after acute myocardial infarction.We attempted to evaluate the preliminary efficacy of LVA repair combined with epicardial radiofrequency ablation for ventricular arrhythmia during off-pump coronary artery bypass grafting (OPCAB).Methods From June 2009 to April 2011,31 patients with LVA had angina symptoms and ventricular arrhythmia.In all patients,circular and cross-shaped radiofrequency epicardial ablations were performed using unipolar ablation pen along the border between the aneurysm wall and normal cardiac tissue and in the central zone of the aneurysms,followed by a linear placation of ventricular aneurysms on beating heart.Results All the patients showed complete recovery.The average number of grafted vessels was 2.7±1.3.Intraoperative examinations revealed that the ventricular arrhythmia was effectively controlled by radiofrequency ablation.All cases had been followed up for one year.Holter monitoring revealed a significant reduction in ventricular arrhythmias (P <0.05).Echocardiography showed significant increase in left ventricular ejection fraction (P <0.05) and decrease in left ventricular end-diastolic diameter (P <0.05).Conclusions For patients with ventricular aneurysm and preoperative malignant arrhythmia,aneurysm repair plus epicardial radiofrequency ablation in OPCAB was found to be an effective and feasible therapeutic technique.However,medium-to long-term therapeutic efficacy of this method remains to be determined by future studies and observations.

  16. Measurements of Coronary Artery Aneurysms Due to Kawasaki Disease by Dual-Source Computed Tomography (DSCT).

    Science.gov (United States)

    Tsujii, Nobuyuki; Tsuda, Etsuko; Kanzaki, Suzu; Kurosaki, Kenichi

    2016-03-01

    Diameters of coronary artery aneurysms (CAAs) complicating acute phase KD can strongly predict the long-term prognosis of coronary artery lesions (CAL). Recently, computed tomographic angiography (CTA) has been used to detect CAL, and the purpose of this study was to determine whether coronary artery diameters measurements by CTA using dual-source computed tomography (DSCT) can be used instead of coronary angiogram (CAG) measurements. Twenty-five patients (22 males and three females) with CAL due to KD, who had undergone both CTA and CAG within one year, were retrospectively evaluated between 2007 and 2013. A prospective electrocardiogram-triggered CTA was performed on a DSCT (SOMATOM(®) Definition, Siemens Healthcare, Germany). Two pediatric cardiologists independently measured the diameters of CAAs twice in each maximum intensity projection (MIP), curved multiplaner reconstruction (MPR) and CAG. We measured 161 segments in total (segment 1-3, 5-7, 11, 13). Diagnostic accuracy was expressed as κ coefficient. A Bland-Altman analysis was also used to assess the intra-observer, inter-observer and inter-modality agreement. The diagnostic quality of CTA was excellent (κ = 0.93). Excellent inter-observer agreement for the diameters of CAAs was obtained for MIP, MPR and CAG and for the intra-observer agreement. The inter-modality agreement was also excellent in measurements of CAA (MPR-CAG: y = 0.9x + 0.40, r = 0.97, p < 0.0001 MIP-CAG: y = x + 0.1, r = 0.94, p < 0.0001). These values in normal coronary arteries were also obtained. We found a significant correlation between CTA and CAG in measuring the coronary arteries. We conclude that measuring coronary artery diameters by CTA is reliable and useful. PMID:26515298

  17. Interventional therapy of huge aneurysm

    International Nuclear Information System (INIS)

    Objective: To evaluate the methods and the efficacy of interventional therapy for huge aneurysm. Methods: Seven patients with huge aneurysm including 2 with pulmonary aneurysm, 2 with renal aneurysm, 1 with humeral artery aneurysm, 1 with right common iliac artery aneurysm, 1 with right internal iliac artery aneurysm. Among these, 5 were true aneurysm, and 2 were pseudoaneurysms caused by congenital, trauma, arteriosclerosis. Three patients were treated with endovascular covered stent graft and 2 patients with embolization containing metallic coils. Two patients were treated with partial aneurysm and feeding artery trunk embolization with metallic coils. Results: All 7 patients were successful carried out the interventional therapy with successful rate of 100%. Six aneurysms were completely obstructed with disappearance of symptoms and signs. One died of aneurysm rupture. No other complication occurred. Conclusion: Interventional therapy for huge aneurysm is an effective method. (authors)

  18. A completely thrombosed, nongiant middle cerebral artery aneurysm mimicking an intra-axial neoplasm

    Directory of Open Access Journals (Sweden)

    Ha Son Nguyen

    2015-01-01

    Conclusion: Completely thrombosed, nongiant aneurysms can mimic an intra-axial neoplasm. Typical imaging features for thrombosed aneurysms may be missed, especially if the aneurysms are small, where imaging characteristics of the intraluminal contents is more difficult to appreciate. Although imaging may be consistent with a neoplastic lesion, there should be suspicion for a potential underlying aneurysm.

  19. Autopsy case of a giant aneurysm of the anterior communicating artery. Correlation of CT findings and angiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Shinmura, Fujio; Takayasu, Kenji; Ohiwa, Yasuyuki; Sakata, Ryuichi; Ariwa, Rokuro

    1983-06-01

    A 64-year-old female was admitted to the hospital with a history of three previous subarachnoid hemorrhages. Neurological examinations revealed incontinentia urinae, gait disturbance, recent memory disturbance and motor weakness on the left side. Plain X-ray films showed a ring-like calcification in the right frontal region. A plain CT scan showed a ring-shaped iso- and high-density area in the intra hemispheric region, the intra bilateral anterior horn of the lateral ventricle, the intra septum pellucidum, and the intra anterior part of the third ventricle. Left carotid angiography showed a large aneurysmal shadow arising from the anterior communicating artery and another from the left middle cerebral artery. In the venous phase the venous angle was supero-posteriorly shifted, and the septal vein was elevated. She died unexpectedly with a status epilepticus of unknown origin. An autopsy specimen revealed that a giant aneurysm occupied the intra ventricular space, the anterior horn of the lateral ventricle, and the right thalamic region. Also, there was a large berry aneurysm arising from the middle cerebral artery. A coronary section through the giant aneurysm showed a markedly compressed left lateral ventricle, right thalamus, and hypothalamus, while the third ventricle had shifted toward the left side.

  20. Inadvertent Complication of a Pipeline Embolization Device for Treatment with Vertebral Artery Dissecting Aneurysm : Distal Tip Fracture of Delivery Wire.

    Science.gov (United States)

    Park, Jung Soo; Kwak, Hyo Sung; Lee, Jong Myong

    2016-09-01

    Use of the Pipeline embolization device (PED) has increased based on studies about its safety and effectiveness, and new reports that describe peri- or postprocedural complications are now emerging. We report a rare periprocedural device-related complication that occurred during endovascular treatment with the pipeline embolization device for a dissecting aneurysm on the vertebral artery. A 55-year old woman was admitted due to left medullary infarction, and angiography showed a fusiform dilatation in the left vertebral artery that was suspicious for dissecting aneurysm. Endovascular treatment with PED was planned. Under general anesthesia, the procedure was performed without significant problems and a PED was deployed in an appropriate position. However, in the final step of the procedure, the distal tip of the PED delivery wire became engaged within a small branch of the posterior cerebral artery and fractured. Fortunately, imaging studies after the procedure revealed neither hemorrhagic nor ischemic stroke, and the patient recovered without neurological morbidities except initial symptoms. PMID:27651873

  1. Inadvertent Complication of a Pipeline Embolization Device for Treatment with Vertebral Artery Dissecting Aneurysm : Distal Tip Fracture of Delivery Wire.

    Science.gov (United States)

    Park, Jung Soo; Kwak, Hyo Sung; Lee, Jong Myong

    2016-09-01

    Use of the Pipeline embolization device (PED) has increased based on studies about its safety and effectiveness, and new reports that describe peri- or postprocedural complications are now emerging. We report a rare periprocedural device-related complication that occurred during endovascular treatment with the pipeline embolization device for a dissecting aneurysm on the vertebral artery. A 55-year old woman was admitted due to left medullary infarction, and angiography showed a fusiform dilatation in the left vertebral artery that was suspicious for dissecting aneurysm. Endovascular treatment with PED was planned. Under general anesthesia, the procedure was performed without significant problems and a PED was deployed in an appropriate position. However, in the final step of the procedure, the distal tip of the PED delivery wire became engaged within a small branch of the posterior cerebral artery and fractured. Fortunately, imaging studies after the procedure revealed neither hemorrhagic nor ischemic stroke, and the patient recovered without neurological morbidities except initial symptoms.

  2. Mitral valve replacement in a patient with infective endocarditis and aneurysm of the cerebral artery: A case report

    Directory of Open Access Journals (Sweden)

    Senka Mesihović-Dinarević

    2014-11-01

    Full Text Available Objective. Endocarditis can have profound and devastating neurological consequences, with the vast majority of these complications in patients with left-sided valvular disease. The approach to the acute management of stroke in children with infective endocarditis is limited by the inadequacy of published data on their clinical course and outcome. Case report. This case report presents a 12 year old girl with diagnosed endocarditis, complicated with intracranial hemorrhage, due to the rupture of an aneurysm of the peripheral branch medial cerebral artery and gradient therapeutic approach, with an excellent final result. Conclusion. Congestive heart failure resulting from valvular insufficiency required mitral valve replacement, after cerebral aneurysm clipping.

  3. Compression of the Right Pulmonary Artery by a Massive Descending Aortic Aneurysm Causing Bilateral Perfusion Defects on Pulmonary Scintigraphy

    OpenAIRE

    Makis, William; Derbekyan, Vilma

    2011-01-01

    A 67-year-old woman, who presented with a 2 month history of dyspnea, had a ventilation and perfusion lung scan that showed absent perfusion of the entire right lung with normal ventilation, as well as a rounded matched defect in the left lower lung adjacent to midline, suspicious for an aortic aneurysm or dissection. CT pulmonary angiography revealed a massive descending aortic aneurysm compressing the right pulmonary artery as well as the left lung parenchyma, accounting for the bilateral p...

  4. Measurements of Coronary Artery Aneurysms Due to Kawasaki Disease by Dual-Source Computed Tomography (DSCT).

    Science.gov (United States)

    Tsujii, Nobuyuki; Tsuda, Etsuko; Kanzaki, Suzu; Kurosaki, Kenichi

    2016-03-01

    Diameters of coronary artery aneurysms (CAAs) complicating acute phase KD can strongly predict the long-term prognosis of coronary artery lesions (CAL). Recently, computed tomographic angiography (CTA) has been used to detect CAL, and the purpose of this study was to determine whether coronary artery diameters measurements by CTA using dual-source computed tomography (DSCT) can be used instead of coronary angiogram (CAG) measurements. Twenty-five patients (22 males and three females) with CAL due to KD, who had undergone both CTA and CAG within one year, were retrospectively evaluated between 2007 and 2013. A prospective electrocardiogram-triggered CTA was performed on a DSCT (SOMATOM(®) Definition, Siemens Healthcare, Germany). Two pediatric cardiologists independently measured the diameters of CAAs twice in each maximum intensity projection (MIP), curved multiplaner reconstruction (MPR) and CAG. We measured 161 segments in total (segment 1-3, 5-7, 11, 13). Diagnostic accuracy was expressed as κ coefficient. A Bland-Altman analysis was also used to assess the intra-observer, inter-observer and inter-modality agreement. The diagnostic quality of CTA was excellent (κ = 0.93). Excellent inter-observer agreement for the diameters of CAAs was obtained for MIP, MPR and CAG and for the intra-observer agreement. The inter-modality agreement was also excellent in measurements of CAA (MPR-CAG: y = 0.9x + 0.40, r = 0.97, p correlation between CTA and CAG in measuring the coronary arteries. We conclude that measuring coronary artery diameters by CTA is reliable and useful.

  5. Late Complication after Superficial Femoral Artery (SFA) Aneurysm: Stent-graft Expulsion Outside the Skin

    Energy Technology Data Exchange (ETDEWEB)

    Pecoraro, Felice, E-mail: felicepecoraro@libero.it; Sabatino, Ermanno R.; Dinoto, Ettore; Rosa, Giuliana La; Corte, Giuseppe; Bajardi, Guido [University of Palermo, Vascular Surgery Unit (Italy)

    2015-10-15

    A 78-year-old man presented with a 7-cm aneurysm in the left superficial femoral artery, which was considered unfit and anatomically unsuitable for conventional open surgery for multiple comorbidities. The patient was treated with stent-graft [Viabhan stent-graft (WL Gore and Associates, Flagstaff, AZ)]. Two years from stent-graft implantation, the patient presented a purulent secretion and a spontaneous external expulsion through a fistulous channel. No claudication symptoms or hemorrhagic signs were present. The pus and device cultures were positive for Staphylococcus aureus sensitive to piperacillin/tazobactam. Patient management consisted of fistula drainage, systemic antibiotic therapy, and daily wound dressing. At 1-month follow-up, the wound was closed. To our knowledge, this is the first case of this type of stent-graft complication presenting with external expulsion.

  6. Calcified aneurysm of the abdominal aorta 12 years after umbilical artery catheterization

    International Nuclear Information System (INIS)

    We report a 12-year-old boy who presented with abdominal pain and who was found to have an aneurysm of the abdominal aorta (AAA). The patient was born from a quadruplet pregnancy induced by in vitro fertilization. Postnatal transient respiratory distress required assisted ventilation that had been monitored by two consecutive umbilical arterial catheters (UAC). AAA is a rare condition in childhood. Infection and/or trauma are known to be the most frequent causes. Most of the reported cases have occurred in children in whom a UAC had been placed during the neonatal period. In this patient the delay between UAC placement and diagnosis was considerable. At the time of this report the patient had remained well during a follow-up of 8 years after treatment. (orig.)

  7. Lipoprotein Lipase Deficiency (R243H) in a Type 2 Diabetes Patient with Multiple Arterial Aneurysms.

    Science.gov (United States)

    Suzuki, Toru; Sawada, Shojiro; Ishigaki, Yasushi; Tsukita, Sohei; Kodama, Shinjiro; Sugisawa, Takashi; Imai, Junta; Yamada, Tetsuya; Yamaguchi, Takashi; Murano, Takeyoshi; Katagiri, Hideki

    2016-01-01

    Lipoprotein lipase (LPL) deficiency is a rare monogenic disorder that manifests as severe hypertriglyceridemia. Whether or not LPL deficiency accelerates the development of atherosclerosis remains controversial. We herein report a 66-year-old woman who was homozygous for the R243H LPL mutation. She had developed multiple arterial aneurysms and systemic atherosclerosis despite good control of other atherogenic risk factors, including diabetes. Furthermore, although intensive pharmaceutical therapies had been minimally effective, medium chain triglyceride (MCT) therapy reduced the serum triglyceride levels. Thus, this case suggests important role that mutated LPL protein plays in the progression of atherosclerosis and that MCT therapy is potentially effective, even for severe hypertriglyceridemia due to LPL deficiency. PMID:27150867

  8. Calcified aneurysm of the abdominal aorta 12 years after umbilical artery catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Blondiaux, Eleonore; Miquel, Julie [Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); Thomas, Pascale; Watelet, Jacques [Rouen University Hospital Charles Nicolle, Department of Vascular Surgery, Rouen (France); Laloum, Denis [Caen University Hospital, Pediatric Intensive Care Unit, Department of Neonatal Medicine, Caen (France); Dacher, Jean-Nicolas [Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); UFR Medecine et Pharmacie, Laboratoire Quant-If, Rouen Cedex 01 (France)

    2008-02-15

    We report a 12-year-old boy who presented with abdominal pain and who was found to have an aneurysm of the abdominal aorta (AAA). The patient was born from a quadruplet pregnancy induced by in vitro fertilization. Postnatal transient respiratory distress required assisted ventilation that had been monitored by two consecutive umbilical arterial catheters (UAC). AAA is a rare condition in childhood. Infection and/or trauma are known to be the most frequent causes. Most of the reported cases have occurred in children in whom a UAC had been placed during the neonatal period. In this patient the delay between UAC placement and diagnosis was considerable. At the time of this report the patient had remained well during a follow-up of 8 years after treatment. (orig.)

  9. The forgotten disease: Bilateral lemierre’s disease with mycotic aneurysm of the vertebral artery

    Science.gov (United States)

    Gupta, Tanush; Parikh, Kaushal; Puri, Sonam; Agrawal, Sahil; Agrawal, Nikhil; Sharma, Divakar; DeLorenzo, Lawrence

    2014-01-01

    Patient: Male, 25 Final Diagnosis: Lemierre’s disease Symptoms: Back pain • fever • headache • tachycardia • tachypnoe Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Rare disease Background: Lemierre’s disease, also known as the forgotten disease, postanginal sepsis, or necrobacillosis, was first reported in 1890 by Courmont and Cade, but it was Dr. Andre Lemierre, a professor of microbiology, who described this disease in 1936. The typical causative agent is Fusobacterium necrophorum, although other organisms may be involved. The pathogenesis of Lemierre’s disease is not well understood. It is characterized by a primary oropharyngeal infection associated with septicemia, internal jugular vein thrombosis, and metastatic septic emboli. Case Report: We report a case of Lemierre’s disease with bilateral internal jugular vein (IJV) thrombosis and metastatic septic emboli to the lungs and brain, associated with epidural abscess and mycotic aneurysm of the vertebral artery, which is quite rare in Lemierre’s disease. This is the first report of a case of Lemierre’s disease associated with mycotic aneurysm of the vertebral artery. Conclusions: Lemierre’s disease is a rare and perplexing medical entity. Clinical suspicion should be high in previously healthy young adults presenting with fever and neck pain following oropharyngeal infection. Dr. Lemierre stated that ‘symptoms and signs of Lemierre’s disease are so characteristic that it permits diagnosis before bacteriological examination’. The prognosis of patients with Lemierre’s disease is generally good, provided prompt recognition and appropriate treatment. PMID:24883173

  10. Non-marfan idiopathic medionecrosis (cystic medial necrosis) presenting with multiple visceral artery aneurysms and diffuse connective tissue fragility: Two brothers

    International Nuclear Information System (INIS)

    Two brothers with multiple visceral artery aneurysms or dilatations and diffuse connective tissue fragility who did not have clinical features of Marfan syndrome are reported. One presented with retroperitoneal hemorrhage during angiography, and idiopathic medionecrosis was proved by resection of the aneurysms. These cases belong to the heterogeneous group of Marfan syndrome. The angiographical features (multiple dilation of visceral arteries) suggests fragility of connective tissue and is predictive of hazards during and after a catheterization and operation

  11. Treatment of Ruptured Vertebral Artery Dissecting Aneurysms Distal to the Posterior Inferior Cerebellar Artery: Stenting or Trapping?

    Energy Technology Data Exchange (ETDEWEB)

    Fang, Yi-Bin, E-mail: fangyibin@163.com; Zhao, Kai-Jun, E-mail: zkjwcfzwh@163.com; Wu, Yi-Na, E-mail: wuyina0923@163.com; Zhou, Yu, E-mail: yzhou-2011@126.com; Li, Qiang, E-mail: lqeimm@126.com; Yang, Peng-Fei, E-mail: 15921196312@163.com; Huang, Qing-Hai, E-mail: ocinhqh@163.com; Zhao, Wen-Yuan, E-mail: doczhaowy@163.com; Xu, Yi, E-mail: xuyichyy@163.com; Liu, Jian-Min, E-mail: chstroke@163.com [Second Military Medical University, Department of Neurosurgery, Changhai Hospital (China)

    2015-06-15

    PurposeThe treatment of ruptured vertebral artery dissecting aneurysms (VADAs) continues to be controversial. Our goal was to evaluate the safety, efficacy, and long-term outcomes of internal trapping and stent-assisted coiling (SAC) for ruptured VADAs distal to the posterior inferior cerebellar artery (supra-PICA VADAs), which is the most common subset.MethodsA retrospective review was conducted of 39 consecutive ruptured supra-PICA VADAs treated with internal trapping (n = 20) or with SAC (n = 19) at our institution. The clinical and angiographic data were retrospectively compared.ResultsThe immediate total occlusion rate of the VADAs was 80 % in the trapping group, which improved to 88.9 % at the follow-ups (45 months on average). Unwanted occlusions of the posterior inferior cerebellar artery (PICA) were detected in three trapped cases. Incomplete obliteration of the VADA or unwanted occlusions of the PICA were detected primarily in the VADAs closest to the PICA. In the stenting group, the immediate total occlusion rate was 47.4 %, which improved to 100 % at the follow-ups (39 months on average). The immediate total occlusion rate of the VADAs was higher in the trapping group (p < 0.05), but the later total occlusion was slightly higher in the stenting group (p > 0.05).ConclusionsOur preliminary results showed that internal trapping and stent-assisted coiling are both technically feasible for treating ruptured supra-PICA VADAs. Although not statistically significant, procedural related complications occurred more frequently in the trapping group. When the VADAs are close to the PICA, we suggest that the lesions should be treated using SAC.

  12. Chondroblastoma with secondary aneurysmal bone cyst of the hamate: case report.

    Science.gov (United States)

    Rhee, Peter C; Novais, Eduardo N; Shives, Thomas C; Shin, Alexander Y

    2012-03-01

    Chondroblastoma of the carpals is rare, can mimic other benign bone tumors, and presents a diagnostic challenge. There have been few cases of benign tumors involving the hamate, with only one reported case of chondroblastoma, which was treated with complete hamate excision. We present a case of chondroblastoma with secondary aneurysmal bone cyst of the hamate treated with curettage, high-speed burring, phenol, and autogenous iliac crest bone grafting. At the time of the most recent radiographic follow-up, there was full graft incorporation, preserved hamate morphology, and no evidence of recurrence.

  13. Chondroblastoma with secondary aneurysmal bone cyst in the anterior skull base

    Directory of Open Access Journals (Sweden)

    Ming Jie Wang, MD, PhD

    2016-06-01

    Full Text Available Chondroblastoma with secondary aneurysmal bone cyst (ABC, especially in the anterior skull base, is an extremely rare condition. A 5-year-old boy presented with a large space-occupying lesion in the anterior skull base along with a left sided-epistaxis, proptosis and decreased vision. Radical excision of the lesion was performed by an endoscopic transnasal and transethmoidal approach. The patient recovered without any recurrence during a follow-up period of up to 28 months. Here, we review this rare case and discuss the clinical presentation and surgical treatment.

  14. Comparison Between Balloon-Assisted and Stent-Assisted Technique for Treatment of Unruptured Internal Carotid Artery Aneurysms

    Science.gov (United States)

    Park, Keun Young; Kim, Dong Joon

    2016-01-01

    Purpose To compare clinical and angiographic outcomes between balloon-assisted (BAC) and stent-assisted coiling for internal carotid artery unruptured aneurysms (ICA-UA). Materials and Methods A total of 227 ICA-UA in 190 patients were treated with BAC (120 patients, 141 ICA-UA) or SAC (70 patients, 86 ICA-UA. We compared characteristics of patients and ICA-UA, and clinical and angiographic outcomes between groups. Results Aneurysm size and neck diameter were greater for SAC than in BAC, but aneurysm volume and coil packing density were not different between groups. Immediate angiographic occlusion grade was better for BAC than for SAC. Periprocedural thromboembolic events were more frequent during SAC (11.6%) than BAC (2.4%) per aneurysm, but hemorrhagic events were the opposite (2.4% for BAC and none for SAC per aneurysm) (p resulting in a modified Rankin scale score of 4. Thus, overall treatment-related morbi-mortality rates were 1.7% in BAC and 2.9% in SAC. At imaging follow-up (BAC, 135 aneurysms [95.7%] for 28.3 months; SAC, 81 aneurysms [94.1%] for 23.9 months), BAC and SAC showed stable or improved occlusion in 94.1% and 95.0%, minor recurrence in 4.4% and 2.5%, and major recurrence in 1.5% and 2.5%, respectively. Conclusion Both BAC and SAC were safe and effective techniques for ICA-UA. There were no differences in morbi-mortality and recurrence rates between groups. PMID:27621946

  15. [A case of Rathke's cleft cyst in association with anterior communicating artery aneurysm presenting a rare visual field defect].

    Science.gov (United States)

    Yuki, K; Katsuzo, K; Ikawa, F; Takeshita, S; Hamasaki, O; Tohru, U

    1996-05-01

    We report a case of Rathke's cleft cyst associated with anterior communicating artery aneurysm. The patient was 60-year-old woman who developed visual disturbance two months before admission to our hospital. Visual acuity on the right was 0.06 and on the left was 0.08. The visual fields showed a complete temporal hemianopsia on the left eye and an incomplete temporal hemianopsia of the right eye with a central defect of the temporal visual field. CT and MR imagings showed an intra- and suprasellar mass lesion with no enhancement. Angiography showed bilateral A1 elevations and anterior communicating artery aneurysm. The operation was performed through interhemispheric approach. Suprasellar cystic mass compressed upward the optic nerves and chiasm, and aneurysmal dome stuck in the central region of chiasm. This anatomical disorders affected to the optic chiasm resulted in a rare visual field defect. Neck clipping of aneurysm and opening of the cyst were performed. A diagnosis of Rathke's cleft cyst was made. Following surgery, her visual fields resolved but she suffered from diabetes insipidus. PMID:8672308

  16. Hybrid procedure for a descending thoracic and subclavian artery aneurysm in a patient with previous abdominal aortic surgery: Case report

    Directory of Open Access Journals (Sweden)

    Radak Đorđe

    2015-01-01

    Full Text Available Introduction. Hybrid procedures represent staged or simultaneous endovascular and open surgical techniques in the treatment of complex pathologies of the thoracic and abdominal aorta. We are presenting a patient with previous abdominal aortic surgery in whom hybrid vascular procedure for descending aorta and left subclavian artery aneurysm was performed. Case Outline. A 63-year-old female patient was admitted for computed tomography angiography. Descending aorta aneurysm (7.6 cm as well as aneurysm of the left subclavian artery (LSA was noted. Eight years ago she underwent abdominal aortic aneurysm resection and aortoiliac bypass. Standard TEVAR (thoracic endovascular aortic repair procedure couldn’t be done due to small dimensions of previous “Y” graft (12.6 mm, so first we did LSA transposition and after three days hybrid procedure. After “Y” graft exposure, anastomosis between the corps of “Y” graft and tubular graft 10 mm was created and through this conduit thoracic stent-graft was placed followed by complete “Y” graft replacement. After 6 months angiography showed regular postoperative findings. Conclusion. Combined surgical and endovascular procedures in thoracic aorta pathology treatment could be useful solutions with favorable outcome. [Projekat Ministarstva nauke Republike Srbije, br. 41002

  17. Hemodynamic Impact of a Spontaneous Cervical Dissection on an Ipsilateral Saccular Aneurysm

    Science.gov (United States)

    See, Alfred P.; Penn, David L.; Du, Rose; Frerichs, Kai U

    2016-01-01

    The dynamic, hemodynamic impact of a cervical dissection on an ipsilateral, intracranial saccular aneurysm has not been well illustrated. This 45-year-old female was found to have a small, supraclinoid aneurysm ipsilateral to a spontaneous cervical internal carotid artery dissection. With healing of the dissection, the aneurysm appeared to have significantly enlarged. Retrospective review of the magnetic resonance imaging (MRI) at the time of the initial dissection demonstrated thrombus, similar in overall morphology to the angiographic appearance of the "enlarged" aneurysm. As the dissection healed far proximal to the intradural portion of the internal carotid artery, this suggested that the aneurysm was likely a typical, saccular posterior communicating artery aneurysm that had thrombosed and then recanalized secondary to flow changes from the dissection. The aneurysm was coiled uneventfully, in distinction from more complex treatment approaches such as flow diversion or proximal occlusion to treat an enlarging, dissecting pseudoaneurysm. This case illustrates that flow changes from cervical dissections may result in thrombosis of downstream saccular aneurysms. With healing, these aneurysms may recanalize and be misidentified as enlarging dissecting pseudoaneurysms. Review of an MRI from the time of the dissection facilitated the conclusion that the aneurysm was a saccular posterior communicating artery aneurysm, influencing treatment approach.

  18. [Hybrid surgical intervention in a patient with an aortic arch aneurysm and coronary artery disease].

    Science.gov (United States)

    Charchan, E R; Abugov, S A; Puretsky, M V; Kim, S Yu; Skvortsov, A A; Khachatryan, Z R

    2015-01-01

    Presented herein is a clinical case report regarding the use of hybrid technology in surgical treatment of a patient with an aneurysm of the distal portion of the aortic arch and coronary artery disease. The patient underwent a hybrid operation, i.e. debranching of the aortic arch branches, exoprosthetic repair of the ascending aorta, autovenous prosthetic coronary bypass grafting of the branch of the blunt edge of the anterior interventricular artery, stenting of the ascending portion, arch and descending portion of the aorta (stent graft "Medtronic Valiant"). In doing so, we used a non-standard approach to connecting the artificial circulation unit and to choosing the place for establishing proximal anastomoses of autovenous coronary bypass grafts. The early postoperative period was complicated by the development of respiratory insufficiency requiring continuation artificial pulmonary ventilation. The duration of the hospital stay of the patient amounted to 15 days. The check-up multispiral computed tomography showed normal functioning of the reconstruction zones, the stent graft is expanded, with no leak observed. The conclusion was made that hybrid interventions may be considered as an alternative to the classical surgical treatment associated in patients of older age group with a severe course of the postoperative period and high lethality. PMID:26035581

  19. Assessment of Coronary Artery Aneurysms Cased By Kawasaki Diesease Using Transluminal Attenuation Gradient Analysis of CT Angiograms

    OpenAIRE

    Gutierrez, Noelia Grande

    2015-01-01

    Patients with coronary artery aneurysms (CAA) resulting from Kawasaki Disease (KD) are at risk for thrombosis and myocardial infarction. Current guidelines recommend using CAA diameter >8 mm as the criterion for initiating systemic anticoagulation, but there is little outcome data to support this choice. Transluminal Attenuation Gradient (TAG) has been proposed as a non-invasive method for evaluating the functional significance of coronary stenoses using CT Angiography (CTA). However TAG has ...

  20. Association between GRIN3A Gene Polymorphism in Kawasaki Disease and Coronary Artery Aneurysms in Taiwanese Children

    OpenAIRE

    Ying-Ju Lin; Jeng-Sheng Chang; Xiang Liu; Chien-Hui Hung; Ting-Hsu Lin; Shao-Mei Huang; Kuan-Teh Jeang; Chia-Yen Chen; Chiu-Chu Liao; Cheng-Wen Lin; Chih-Ho Lai; Ni Tien; Yu-Ching Lan; Mao-Wang Ho; Wen-Kuei Chien

    2013-01-01

    Kawasaki disease (KD) is pediatric systemic vasculitis with the classic complication of coronary artery aneurysm (CAA). It is the leading cause of acquired cardiovascular diseases in children. Some severe cases present with multi-organ involvement or neurological dysfunction. To identify the role of the glutamate receptor, ionotropic, N-methyl-d-aspartate 3A (GRIN3A) in KD, we investigated genetic variations in GRIN3A in a Taiwanese cohort of 262 KD patients (76 with and 186 without CAA compl...

  1. Sirolimus-eluting stent fractures associated with aneurysm and very late stent thrombosis in the right coronary artery

    Institute of Scientific and Technical Information of China (English)

    LIU Xuebo; Gary S.Mintz; Stéphane G.Carlier; Martin B.Leon

    2007-01-01

      Although the occurrence of coronary stent fracture is rare,recent reports showed that stent fracture after sirolimus-eluting stent(SES)implantation may be associated with neointimal hyperplasia and restenosis.We report two cases of stent fracture that occurred late after elective SES implantation into the right coronary artery(RCA)that were related to the aneurysm,restenosis,thrombosis,and vessel occlusion.……

  2. Hybrid procedure for a descending thoracic and subclavian artery aneurysm in a patient with previous abdominal aortic surgery: Case report

    OpenAIRE

    Radak Đorđe; Tanasković Slobodan; Unić-Stojanović Dragana; Jović Miomir; Babić Srđan; Sagić Dragan

    2015-01-01

    Introduction. Hybrid procedures represent staged or simultaneous endovascular and open surgical techniques in the treatment of complex pathologies of the thoracic and abdominal aorta. We are presenting a patient with previous abdominal aortic surgery in whom hybrid vascular procedure for descending aorta and left subclavian artery aneurysm was performed. Case Outline. A 63-year-old female patient was admitted for computed tomography angiography. Descending ...

  3. Aneurisma verdadeiro de artéria plantar medial: relato de caso True aneurysm of medial plantar artery: case report

    Directory of Open Access Journals (Sweden)

    Flavio Renato de Almeida Senefonte

    2011-09-01

    Full Text Available Os aneurismas periféricos merecem atenção pela sua baixa frequência e associação com outros aneurismas arteriais, principalmente o de aorta abdominal. O aneurisma de artéria plantar verdadeiro é ainda mais raro. A escassa literatura disponível concentra-se nos casos de pseudoaneurisma pós-traumático dessa artéria. Relata-se o caso de uma paciente do sexo feminino, 85 anos, com queixa de dor no pé direito ao deambular durante um ano, acompanhada de nódulo pulsátil em região plantar, próximo da base do primeiro pododáctilo. Não havia história prévia de trauma ou cirurgia na região plantar acometida. Realizou-se ecografia vascular e angiorressonância, que diagnosticaram aneurisma de artéria plantar. A paciente foi então submetida à aneurismectomia com ligadura das artérias nutricionais, apresentando boa evolução pós- operatória.Peripheral aneurysms deserve attention because of their low frequency and potential association with other aneurysms, especially of the abdominal aorta. The true aneurysm of the plantar artery is even less frequent. The literature available is scarce and focuses on cases of post-traumatic arterial pseudoaneurysms. In this paper, we report the case of an 85-year-old female patient with a one-year history of pain on the right foot when walking associated with a pulsatile tumor in the plantar region at the base of the big toe. The patient had no history of trauma or foot surgery. Vascular ultrasonography and MR angiography showed a plantar artery aneurysm. Aneurysmectomy with ligation of the medial plantar artery was performed. The patient had a good postoperative course.

  4. A Case of Ischemic Duodenitis Associated with Superior Mesenteric Artery Syndrome Caused by an Abdominal Aortic Aneurysm

    OpenAIRE

    OKUYAMA, Yusuke; Kawakami, Takumi; Ito, Haruki; Otsuka, Hirotomo; Enoki, Yasuyuki; Nishimura, Masahito; Yoshida, Norimasa; Fujimoto, Sotaro

    2011-01-01

    A 74-year-old woman was admitted to our hospital with upper abdominal pain and bloody vomiting. An abdominal aneurysm compressed the third portion of the duodenum and the second portion of duodenum was distended with thickened walls as in superior mesenteric artery syndrome. Endoscopic examination showed an edematous mucosa with hemorrhagic erosions, shallow longitudinal ulcers, and star-shaped ulcers in the duodenum. We diagnosed this case as ischemic duodenitis associated with superior mese...

  5. Treating patients with abdominal aortic aneurysm with endovascular repair and the crossover chimney technique in the internal iliac artery to protect the unilateral internal iliac artery

    Science.gov (United States)

    Guo, Xi; Li, Peng; Liu, Guang-Rui; Huang, Xiao-Yong; Huang, Lian-Jun

    2015-01-01

    This study aims to explore the treatment methods for patients with abdominal aortic aneurysms (AAAs) that required occlusion of the openings of the bilateral internal iliac arteries (IIAs) in endovascular aneurysm repair (EVAR) and to evaluate the efficacy of these treatments. Four patients with AAA were treated with endovascular aneurysm repair (EVAR) and the crossover chimney technique in the bilateral internal iliac arteries (IIAs). We inserted and released the abdominal aortic stent as usual and implanted the bypass stent graft simultaneously. The intraoperative immediate angiography showed complete isolation of the AAA and patency of the bypass. One month after surgery, it showed contrast engorgement in the bypass stent in three patients. The IIA on the bypass side and its branches had good developing. Another case in which we utilized a COOK stent, occlusion started at the opening of the bypass stent, with no occurrence of other complications. For patients in whom AAAs involve bilateral iliac arteries and the openings of the bilateral IIAs need to be occluded, EVAR and a crossover chimney technique can protect the unilateral IIA. PMID:26885136

  6. Aneurisma idiopático de artéria radial: relato de caso Idiopathic radial artery aneurysm: case report

    Directory of Open Access Journals (Sweden)

    Luiz Ernani Meira Jr.

    2011-12-01

    Full Text Available Os aneurismas da artéria radial são extremamente raros. Em sua maioria, consistem de pseudoaneurismas pós-traumáticos. Os aneurismas da artéria radial verdadeiros podem ser idiopáticos, congênitos, pós-estenóticos ou associados a patologias, tais como vasculites e doenças do tecido conjuntivo. Foi relatado um caso de aneurisma idiopático de artéria radial em uma criança de três anos, que, após completa investigação diagnóstica complementar, foi submetida à ressecção cirúrgica.Radial artery aneurysms are extremely rare. Post-traumatic pseudoaneurysms are the vast majority. True radial artery aneurysms can be idiopathic, congenital, poststenotic, or associated with some pathologies, such as vasculitis and conjunctive tissue diseases. We report a case of an idiopathic aneurysm of the radial artery in a three-year-old child who was submitted to surgical resection after a complete diagnostic approach.

  7. Interventional Therapy of Splenic Artery Aneurysms and Pseudoaneurysms%脾动脉瘤的介入治疗

    Institute of Scientific and Technical Information of China (English)

    宋进华; 顾建平; 楼文胜; 何旭; 陈亮; 陈国平; 苏浩波; 汪涛

    2012-01-01

    Objective To evaluate the value of the endovascular interventional therapy in treatment of splenic artery an-eurysms and pseudoaneurysms. Methods Sixteen patients with splenic artery aneurysms (n - 10) and false aneurysms (n=6) proveded by color doppler ultrasound, CT and DSA angiography were collected in the study. Embolization with coils were carried out to the artery aneurysms or parent artery in 14 cases. Coils were deployed into the aneurysms assisted by stents in 2 case. Routine blood tests and serum amylase were checked at 3 and 7 days after the procedure. Enhanced CT was performed at 7 days, 3 and 6 months after the procedure. Results The splenic artery has been embolized successfully in 14 cases. The aneurysms and pseudoaneurysms in all patients were not enhanced on CT angiography at 3 or 6 months after embolization. Complete aneurysms thrombosis and normal splenic artery branching has been showed on CT images 3 or 6 months after the stents and coils implanted in 2 cases. Low grade fever and bellyache were occurred after embolization in 7 and 8 cases respectively, which were relieved after 3 to 5 days. Transient elevation of serum aniylase was recovered in 1 week in 5 patients. Conclusion Endovascular treatment is a simple ,minimally invasive, safe and effective treatment for splenic artery aneurysms and pseudoaneurysms.%目的 探讨介入血管腔内治疗脾动脉瘤的临床价值.方法 16例脾动脉瘤患者,其中真性脾动脉瘤10例,假性脾动脉瘤6例,介入治疗术前均经血管超声、CT及DSA明确诊断.14例行弹簧圈动脉瘤或载瘤动脉栓塞术,2例采用支架辅助弹簧圈瘤体内填塞.患者术后3天和1周复查血常规和血淀粉酶;术后1周、3个月、6个月CT增强扫描复查.结果 14例弹簧圈栓塞患者术后CT增强扫描均未见栓塞以远脾动脉主干显影,动脉瘤体无对比剂填充,2例支架辅助弹簧圈瘤体内填塞患者术后3个月、6个月CT增强扫描示脾动脉主干及

  8. Direct clipping of a blister-like aneurysm in the supraclinoid segment of the internal carotid artery: a clinical analysis of nine cases.

    Science.gov (United States)

    Yu, Jinlu; Xu, Baofeng; Guo, Yunbao; Xu, Kan

    2015-01-01

    To investigate the method and outcome from direct clipping of a blister-like aneurysm (BBA) of the internal carotid artery supraclinoid segment. This study featured nine BBA patients, including eight females and one male. The patients presented subarachnoid hemorrhage (SAH) as the initial symptom and were diagnosed with BBA in the supraclinoid segment through a vascular exam and imaging. During the exam, the internal carotid artery was pressed to block the blood flow, and a transcranial Doppler (TCD) was performed to examine the blood flow in the (BBA) ipsilateral middle cerebral artery. The results showed that the blood flow was reduced by less than 40% in all nine patients. During surgery, a pterional craniotomy was used to fully expose the aneurysm for clipping. While clipping the aneurysm, the arterial wall at the root of the aneurysm was also clipped to improve stability. Intraoperative ultrasonography was performed before and after clipping to examine the blood flow in the parent artery, middle cerebral artery and anterior cerebral artery. Moreover, a TCD was performed within one week after surgery to monitor intracranial blood flow. During BBA clipping, four patients exhibited stenosis of the parent artery, but intraoperative ultrasonography showed adequate blood flow in the anterior cerebral artery and middle cerebral artery. TCD was performed within one week after surgery to examine the blood flow in the middle cerebral artery on the operative side; the TCD showed adequate blood flow. The patients recovered well after surgery and were discharged. Digital subtraction angiography (DSA) or computed tomography angiography (CTA) was performed six to 12 months after the surgery and showed no aneurysm relapse. Moreover, six patients exhibited no stenosis of the parent artery, 20% stenosis was observed in one patient, 30% stenosis was observed in one patient, and 50% stenosis was observed in one patient; none of the patients showed clinical symptoms, and all

  9. Unusual Case of Left Bronchial Compression by Aneurysmal Pulmonary Arteries in a Child With Atrial Septal Defect.

    Science.gov (United States)

    Pawar, Ranjit; Kumar, Gaurav; Sharma, Vipul; Dalal, S S

    2016-07-01

    We report an uncommon case of large ostium secundum atrial septal defect (ASD) with severe pulmonary arterial hypertension, with associated aneurysmal dilatation of the pulmonary arteries (PAs) leading to compression of the left main bronchus and collapse of the entire left lung in a 15-month-old female child. The patient was managed by surgical closure of the ASD, translocation of the right PA anterior to the aorta with PA aneurysmorrhaphy. Left bronchial compression was relieved with complete lung expansion on the third postoperative day. PMID:26865068

  10. SECONDARY PULMONARY ARTERIAL HYPERTENSION IN SYSTEMIC DISEASES OF CONNECTIVE TISSUE

    Directory of Open Access Journals (Sweden)

    N. A. Shostak

    2009-01-01

    Full Text Available Modern definition of pulmonary arterial hypertension (PAH as well as data on prevalence and incidence of secondary PAH in systemic disease of connective tissue is presented,  including data of USA, France and Scotland registers. The main chains of pathogenesis, classification approaches, clinical features and diagnostics are described. 

  11. SECONDARY PULMONARY ARTERIAL HYPERTENSION IN SYSTEMIC DISEASES OF CONNECTIVE TISSUE

    Directory of Open Access Journals (Sweden)

    N. A. Shostak

    2016-01-01

    Full Text Available Modern definition of pulmonary arterial hypertension (PAH as well as data on prevalence and incidence of secondary PAH in systemic disease of connective tissue is presented,  including data of USA, France and Scotland registers. The main chains of pathogenesis, classification approaches, clinical features and diagnostics are described. 

  12. Pseudoaneurysm of the pancreas and aneurysm spurions of the splenic artery - diagnosis by angio-CT and ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Gamroth, A.; Hirning, T.; Rosenthal, R.

    1986-02-01

    Pseudoaneurysm of the pancreas is a severe complication secondary to pancreatitis. The splenic artery is most often involved, followed by the pancreaticoduodenal vessels and the gastroduodenal artery. Selective arteriography is considered the method of choice in preoperative diagnosis. In a patient with chronic pancreatitis angio-CT and ultrasound enable a definitive diagnosis of pseudoaneurysm of the splenic artery. (orig.).

  13. Anomalous Origin of the Right Coronary Artery from the Left Anterior Descending Coronary Artery in a Patient with Ascending Aortic Aneurysm

    Directory of Open Access Journals (Sweden)

    Ufuk Gürkan

    2012-04-01

    Full Text Available The incidence of coronary artery anomalies has been reported between 0.6 to 1.3% in angiographic series and 0.3% in autopsy series. An isolated single coronary artery (SCA is even a rarer congenital anomaly occurring in approximately 0.02% of the population. The ectopic origin of the right coronary artery (RCA from the left anterior descending (LAD artery is relatively rare and more benign than other types of anomalous origin of the RCAs. We report a case of an adult male patient with SCA anomaly in which the RCA takes off from the mid LAD. To the best of our knowledge, SCA anomaly coinciding with ascending aortic aneurysm which was treated with Bentall operation has never been described before.

  14. Fenestrated Stent Graft Repair of Abdominal Aortic Aneurysm: Hemodynamic Analysis of the Effect of Fenestrated Stents on the Renal Arteries

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Zhonghua; Chaichana, Thanapong [Curtin University of Technology, Perth (Australia)

    2010-02-15

    We wanted to investigate the hemodynamic effect of fenestrated stents on the renal arteries with using a fluid structure interaction method. Two representative patients who each had abdominal aortic aneurysm that was treated with fenestrated stent grafts were selected for the study. 3D realistic aorta models for the main artery branches and aneurysm were generated based on the multislice CT scans from two patients with different aortic geometries. The simulated fenestrated stents were designed and modelled based on the 3D intraluminal appearance, and these were placed inside the renal artery with an intra-aortic protrusion of 5.0-7.0 mm to reflect the actual patients' treatment. The stent wire thickness was simulated with a diameter of 0.4 mm and hemodynamic analysis was performed at different cardiac cycles. Our results showed that the effect of the fenestrated stent wires on the renal blood flow was minimal because the flow velocity was not significantly affected when compared to that calculated at pre-stent graft implantation, and this was despite the presence of recirculation patterns at the proximal part of the renal arteries. The wall pressure was found to be significantly decreased after fenestration, yet no significant change of the wall shear stress was noticed at post-fenestration, although the wall shear stress was shown to decrease slightly at the proximal aneurysm necks. Our analysis demonstrates that the hemodynamic effect of fenestrated renal stents on the renal arteries is insignificant. Further studies are needed to investigate the effect of different lengths of stent protrusion with variable stent thicknesses on the renal blood flow, and this is valuable for understanding the long-term outcomes of fenestrated repair.

  15. Secondary arterial hypertension: when, who, and how to screen?

    Science.gov (United States)

    Rimoldi, Stefano F; Scherrer, Urs; Messerli, Franz H

    2014-05-14

    Secondary hypertension refers to arterial hypertension due to an identifiable cause and affects ∼5-10% of the general hypertensive population. Because secondary forms are rare and work up is time-consuming and expensive, only patients with clinical suspicion should be screened. In recent years, some new aspects gained importance regarding this screening. In particular, increasing evidence suggests that 24 h ambulatory blood pressure (BP) monitoring plays a central role in the work up of patients with suspected secondary hypertension. Moreover, obstructive sleep apnoea has been identified as one of the most frequent causes. Finally, the introduction of catheter-based renal denervation for the treatment of patients with resistant hypertension has dramatically increased the interest and the number of patients evaluated for renal artery stenosis. We review the clinical clues of the most common causes of secondary hypertension. Specific recommendations are given as to evaluation and treatment of various forms of secondary hypertension. Despite appropriate therapy or even removal of the secondary cause, BP rarely ever returns to normal with long-term follow-up. Such residue hypertension indicates either that some patients with secondary hypertension also have concomitant essential hypertension or that irreversible vascular remodelling has taken place. Thus, in patients with potentially reversible causes of hypertension, early detection and treatment are important to minimize/prevent irreversible changes in the vasculature and target organs.

  16. Is emergency endovascular aneurysm repair associated with higher secondary intervention risk at mid-term follow-up?

    NARCIS (Netherlands)

    Oranen, Bjorn I.; Bos, Wendy T. G. J.; Verhoeven, Eric L. G.; Tielliu, Ignace F. J.; Zeebregts, Clark J.; Prins, Ted R.; van den Dungen, Jan J. A. M.

    2006-01-01

    Objective: The study assessed mid-term outcome of emergency endovascular repair for acute infrarenal abdominal aortic aneurysms, with special attention to secondary interventions. Methods. Between May 1998 and August 2005, 56 patients underwent emergent endovascular repair for a ruptured abdominal a

  17. Endovascular treatment of splenic artery aneurysms; Trattamento endovascolare degli aneurismi dell'arteria splenica

    Energy Technology Data Exchange (ETDEWEB)

    Lagana, Domenico; Carrafiello, Gianpaolo; Mangini, Monica; Fontana, Federico; Dizonno, Massimiliano; Fugazzola, Carlo [Insubria Univ., Varese (Italy). Cattedra di radiologia; Castelli, Patrizio [Insubria Univ., Varese (Italy). Chirurgia vascolare

    2005-07-15

    Purpose. To assess the feasibility and effectiveness of endovascular treatment of splenic artery aneurysm (SAAs). Materials and methods. Between May 2000 and June 2003 we treated 11 true SAAs in 9 patients (7 females and 2 males; mean age 58 years), 8 saccular and 3 fusiform, 4 located at the middle tract of the splenic artery, 5 at the distal tract and 2 intra-parenchymal. The diagnosis was performed with colour-Doppler ultrasound and/or CT-angiography; 7 patients were symptomless, 1 had left hypochondriac pain, and 1 had acute abdomen caused by a ruptured SAA. Four SAAs were treated by micro coil embolisation of the aneurysmal sac with preservation of splenic artery patency; in 2 cases this was associated with transcatheter injection of N-butyl-2-cyanoacrylate. Four cases were treated by endovascular ligature, with sectoral spleen ischaemia. One ruptured SAA received emergency treatment with splenic artery cyanoacrylate embolisation. Two intra-parenchymal SAAs were excluded, one by cyanoacrylate embolisation of the afferent artery and the other by transcatheter thrombin injection in the aneurysmal sac. Results. Technical success was observed in all cases (in 10/11 at the end of the procedure; in 1/11 at CT performed 3 days after the procedure). The follow-up (mean 18 months; range 6-36) was performed by colour-Doppler ultrasound and/or CT-angiography 3, 6 and 12 months after the procedure and subsequently once a year; the complete exclusion of the aneurysms was confirmed in 11/11 cases. The complications were: 4 cases of mild pleuritis; fever and left hypochondriac pain 1 day after the procedure (in the same 4 patients and in one other case); 5 cases of sectorial spleen ischaemia and 1 case of diffuse spleen infarction with partial revascularization by collateral vessels. No alteration of the levels of pancreatic enzymes was found; a transitory increase in platelet count occurred only in the patient with diffuse spleen infarction. Conclusions. Using different

  18. Mycotic aneurysm of the femoral artery resulting from mismanagement of a pathological femur fracture due to chronic osteomyelitis: a case report

    Directory of Open Access Journals (Sweden)

    Mwaka Erisa Sabakaki

    2013-01-01

    Full Text Available Abstract Introduction Mycotic aneurysms are rarely listed among the possible complications of osteomyelitis of the long bones. To the best of our knowledge this is the first case of chronic osteomyelitis associated with a pathological fracture of the femur and a mycotic aneurysm of the femoral artery. Case presentation We present the case of a 13-year-old Ugandan boy who was referred to our hospital with chronic osteomyelitis associated with a pathological fracture of the right femur and a mycotic aneurysm of the femoral artery. He underwent a successful above-knee amputation and is currently undergoing rehabilitation. Conclusions Aneurysms associated with chronic osteomyelitis of the long bones are very rare. However, in Africa, where people often still believe in crude traditional remedies, they should be considered among the possible diagnoses especially where acute injuries of the limbs are massaged and manipulated.

  19. Effect of intra arterial nimodipine infusion for the treatment of symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jin Young; Shin, Hwa Seon; Choi, Hye Young; Chung, Sung Hoon; You, Jin Jong; Choi, Dae Seob; Son, Seung Nam [Gyeongsang National Univ. Hospital/Gyeongsang National Univ. School of Medicine, Jinju (Korea, Republic of); Ryu, Jae Wook [Samsung Seoul Hospital, Seoul (Korea, Republic of)

    2012-06-15

    Symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage (SAH) is one of the major factors which cause morbidity and mortality of patients. The purpose of this study was to evaluate the effectiveness of intra-arterial nimodipine (IAN) infusion therapy in patients with symptomatic cerebral vasospasm. Between February 2005 and April 2011, fifty patients with symptomatic cerebral vasospasm following an aneurysmal SAH were treated with IAN infusion. After selective arterial catheterization, nimodipine was infused at a rate of 0.1 mg/min and a total of 2-3 mg per vessel was infused. We retrospectively reviewed the immediate angiographic results and clinical outcome at discharge. A grade of 5 and 4 in the Glasgow Outcome Scale (GOS) were considered favorable outcomes. In 50 patients, 117 procedures of IAN infusion (1-7; mean, 2.3)were done. After the treatment, immediate angiographic improvement was achieved in 113 (96.6%) of 117 procedures. No major complications occurred. At discharge, 38 (76%) patients showed a favorable clinical outcome in the GOS. IAN infusion therapy is safe and effective for the treatment of cerebral vasospasm following an aneurysmal SAH. However, the limitation is that repeated treatment is needed.

  20. Effect of intra arterial nimodipine infusion for the treatment of symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage (SAH) is one of the major factors which cause morbidity and mortality of patients. The purpose of this study was to evaluate the effectiveness of intra-arterial nimodipine (IAN) infusion therapy in patients with symptomatic cerebral vasospasm. Between February 2005 and April 2011, fifty patients with symptomatic cerebral vasospasm following an aneurysmal SAH were treated with IAN infusion. After selective arterial catheterization, nimodipine was infused at a rate of 0.1 mg/min and a total of 2-3 mg per vessel was infused. We retrospectively reviewed the immediate angiographic results and clinical outcome at discharge. A grade of 5 and 4 in the Glasgow Outcome Scale (GOS) were considered favorable outcomes. In 50 patients, 117 procedures of IAN infusion (1-7; mean, 2.3)were done. After the treatment, immediate angiographic improvement was achieved in 113 (96.6%) of 117 procedures. No major complications occurred. At discharge, 38 (76%) patients showed a favorable clinical outcome in the GOS. IAN infusion therapy is safe and effective for the treatment of cerebral vasospasm following an aneurysmal SAH. However, the limitation is that repeated treatment is needed

  1. Right hemithoracic pseudocyst with splenic artery aneurysm: two rare complications of uncommon disease

    Directory of Open Access Journals (Sweden)

    John Freels

    2006-06-01

    Full Text Available Pleural involvement is an uncommon but well recognized complication of chronic pancreatitis, mainly in the form of pleural effusion affecting the left hemithorax. Pancreatic pseudocyst extending to the posterior mediastinum with or without communication with the pleural space is another rare form of this involvement.The treatment of chronic pancreatic pleural effusions and pancreatic pseudocysts generally starts with a conservative approach including bowel rest, drainage of the pleural effusion by repeated thoracentesis or a chest tube, and total parenteral nutrition (TPN for a period of time determined by the clinical course. Other treatment modalities including percutaneous drainage, endoscopic retrograde cholangiopancreatogram (ERCP with stenting of the pancreatic duct and surgical drainage are used if conservative approaches fail.We report a patient with a complicated pancreatic pseudocyst who showed an involvement of the posterior mediastinum and right pleural space, with conspectus sparing of the left hemithorax. The patient had a prolonged and complicated course that included recurrence of the pseudocyst with oral feedings and the development of a splenic artery aneurysm. Some of the above findings have been reported separately as uncommon complications of chronic pancreatitis and pancreatic pseudcyst, but to our knowledge a single case with all these complications was not published in the English literature.

  2. Subarachnoid Hemorrhage from a Dissecting Aneurysm of the Posterior Cerebral Artery in a Child : Rebleeding after Stent-Assisted Coiling Followed by Stent-Within-Stent Technique

    OpenAIRE

    Lee, Ji Yeoun; Kwon, Bae Ju; Kang, Hyun-Seung; Wang, Kyu-Chang

    2011-01-01

    Pediatric patients with dissecting aneurysms usually present with ischemia rather than bleeding. We report a case of a 15-year-old boy with a dissecting aneurysm of the posterior cerebral artery (PCA) presenting with hemorrhage. He was first treated with stent-assisted coil embolization, in an attempt to avoid trapping of the PCA and preserve the perforators. After the procedure, he recovered well from general anesthesia, but rebleeding occurred from the same lesion 6 hours after the procedur...

  3. The “focus on aneurysm” principle: Classification and surgical principles of management of concurrent arterial aneurysm with arteriovenous malformation causing intracranial hemorrhage

    OpenAIRE

    Jha, Vikas; Behari, Sanjay; Jaiswal, Awadhesh K.; Bhaisora, Kamlesh Singh; Shende, Yogesh P.; Phadke, Rajendra V.

    2016-01-01

    Context: Concurrent arterial aneurysms (AAs) occurring in 2.7-16.7% patients harboring an arteriovenous malformation (AVM) aggravate the risk of intracranial hemorrhage. Aim: We evaluate the variations of aneurysms simultaneously coexisting with AVMs. A classification-based management strategy and an abbreviated nomenclature that describes their radiological features is also proposed. Setting: Tertiary care academic institute. Statistics: Test of significance applied to determine the factors ...

  4. Operative and endovascular management of extracranial vertebral artery aneurysm in Ehlers-Danlos syndrome:a clinical dilemma--case report and literature review.

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2002-01-01

    The most prevalent lesion of the vertebral artery is an atheromatous plaque located at its origin from the subclavian artery. A case of successful management of a symptomatic vertebral artery aneurysm due to Ehlers-Danlos syndrome is reported. The patient had asymptomatic posterior intracerebral artery dissection on the contralateral side. A common carotid artery to V-3 segment bypass using reversed saphenous vein graft was carried out. Avulsion of the V-2 segment occurred peroperatively and endovascular coil embolization of the vertebral artery aneurysm was performed. Endovascular equipment and training must be in the armamentarium of vascular surgeons as more complex cases are being treated, which demands new approaches for ultimate clinical success. This unique case outlines what might unexpectedly occur. Endovascular intervention as an adjuvant procedure provides a satisfactory outcome in what could have been a catastrophe.

  5. Transcatheter embolization of a large aneurysm in a congenital coronary cameral fistula from the left coronary artery to the right ventricle.

    Science.gov (United States)

    Freund, Jan Erik; Yuko-Jowi, Christine; Freund, Matthias W

    2015-02-15

    A congenital coronary cameral fistula (CCCF) is characterized by left ventricular dysfunction, electrocardiographic changes due to a reduced left coronary blood flow and impaired physical activity. CCCF's with a giant aneurysm are very rarely seen. The presence of a giant aneurysm imposes even greater health risks. We report a case of a CCCF from the left coronary artery to the right ventricle with a large distal aneurysm in a 20-year-old woman that we closed percutaneously with coils for the closure of ventricular septal defects (VSD) and persistent ductus arteriosus (PDA).

  6. Brain atrophy and neuropsychological outcome after treatment of ruptured anterior cerebral artery aneurysms: a voxel-based morphometric study

    Energy Technology Data Exchange (ETDEWEB)

    Bendel, Paula; Koskenkorva, Paeivi; Vanninen, Ritva [Kuopio University Hospital and University of Kuopio, Department of Clinical Radiology, Kuopio (Finland); Koivisto, Timo; Aeikiae, Marja [Kuopio University Hospital and University of Kuopio, Department of Neurosurgery, Kuopio (Finland); Niskanen, Eini [Kuopio University Hospital and University of Kuopio, Department of Neurology, Kuopio (Finland); Kuopio University Hospital and University of Kuopio, Department of Physics, Kuopio (Finland); Koenoenen, Mervi [Kuopio University Hospital and University of Kuopio, Department of Clinical Radiology, Kuopio (Finland); Kuopio University Hospital and University of Kuopio, Department of Clinical Neurophysiology, Kuopio (Finland); Haenninen, Tuomo [Kuopio University Hospital and University of Kuopio, Department of Neurology, Kuopio (Finland)

    2009-11-15

    Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) is frequently detected. Here, we describe the pattern of cerebral (gray matter) atrophy and its clinical relevance after treatment of aSAH caused by a ruptured anterior cerebral artery (ACA) aneurysm. Thirty-seven aSAH patients with ACA aneurysm (17 surgical, 20 endovascular treatment) and a good or moderate clinical outcome (Glasgow Outcome Scale V or IV) and 30 controls underwent brain MRI. Voxel-based morphometric analysis was applied to compare the patients and controls. Patients also underwent a detailed neuropsychological assessment. The comparisons between controls and either all patients (n=37) or the subgroup of surgically treated patients (n=17) revealed bilateral cortical atrophy in the frontal lobes, mainly in the basal areas. The brainstem, bilateral thalamic and hypothalamic areas, and ipsilateral caudate nucleus were also involved. Small areas of atrophy were detected in temporal lobes. The hippocampus and parahippocampal gyrus showed atrophy ipsilateral to the surgical approach. In the subgroup of endovascularly treated patients (n = 15), small areas of atrophy were detected in the bilateral orbitofrontal cortex and in the thalamic region. Twenty patients (54%) showed cognitive deficits in neuropsychological assessment. Group analysis after aSAH and treatment of the ruptured ACA aneurysm revealed gray matter atrophy, principally involving the frontobasal cortical areas and hippocampus ipsilateral to the surgical approach. Areas of reduced gray matter were more pronounced after surgical than endovascular treatment. Together with possible focal cortical infarctions and brain retraction deficits in individual patients, this finding may explain the neuropsychological disturbances commonly detected after treatment of ruptured ACA aneurysms. (orig.)

  7. Brain atrophy and neuropsychological outcome after treatment of ruptured anterior cerebral artery aneurysms: a voxel-based morphometric study

    International Nuclear Information System (INIS)

    Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) is frequently detected. Here, we describe the pattern of cerebral (gray matter) atrophy and its clinical relevance after treatment of aSAH caused by a ruptured anterior cerebral artery (ACA) aneurysm. Thirty-seven aSAH patients with ACA aneurysm (17 surgical, 20 endovascular treatment) and a good or moderate clinical outcome (Glasgow Outcome Scale V or IV) and 30 controls underwent brain MRI. Voxel-based morphometric analysis was applied to compare the patients and controls. Patients also underwent a detailed neuropsychological assessment. The comparisons between controls and either all patients (n=37) or the subgroup of surgically treated patients (n=17) revealed bilateral cortical atrophy in the frontal lobes, mainly in the basal areas. The brainstem, bilateral thalamic and hypothalamic areas, and ipsilateral caudate nucleus were also involved. Small areas of atrophy were detected in temporal lobes. The hippocampus and parahippocampal gyrus showed atrophy ipsilateral to the surgical approach. In the subgroup of endovascularly treated patients (n = 15), small areas of atrophy were detected in the bilateral orbitofrontal cortex and in the thalamic region. Twenty patients (54%) showed cognitive deficits in neuropsychological assessment. Group analysis after aSAH and treatment of the ruptured ACA aneurysm revealed gray matter atrophy, principally involving the frontobasal cortical areas and hippocampus ipsilateral to the surgical approach. Areas of reduced gray matter were more pronounced after surgical than endovascular treatment. Together with possible focal cortical infarctions and brain retraction deficits in individual patients, this finding may explain the neuropsychological disturbances commonly detected after treatment of ruptured ACA aneurysms. (orig.)

  8. Using a Surgeon-modified Iliac Branch Device to Preserve the Internal Iliac Artery during Endovascular Aneurysm Repair: Single-center Experiences and Early Results

    Institute of Scientific and Technical Information of China (English)

    Wei-Wei Wu; Chen Lin; Bao Liu; Chang-Wei Liu

    2015-01-01

    Background:To evaluate the feasibility of a new surgeon-modified iliac branch device (IBD) technique to maintain pelvic perfusion in the management of common iliac artery (CIA) aneurysm during endovascular aneurysm repair (EVAR).Methods:From January 2011 to December 2013,a new surgeon-modified IBD technique was performed in department of vascular surgery of Peking Union Medical College Hospital in five patients treated for CIA aneurysm with or without abdominal aortic aneurysm.A stent-graft limb was initially deployed in vitro,anastomosed with vascular graft,creating a modified IBD reloaded into a larger sheath,with or without a guidewire preloaded into the side branch.The reloaded IBD was then placed in the iliac artery,with a covered stent bridging internal iliac artery and the branch.Finally,a bifurcated stent-graft was deployed,and a limb device was used to connect the main body and IBD.Results:Technical successes were obtained in all patients.The mean follow-up length was 24 months (range:6-38 months).All grafts remained patent without any sign of endoleaks.There were no aneurysm ruptures,deaths,or other complications related to pelvic flow.Conclusions:Using the surgeon-modified IBD to preserve pelvic flow is a feasible endovascular technique and an appealing solution for personalized treatment of CIA aneurysm during EVAR.

  9. Using a Surgeon-modified Iliac Branch Device to Preserve the Internal Iliac Artery during Endovascular Aneurysm Repair: Single-center Experiences and Early Results

    Directory of Open Access Journals (Sweden)

    Wei-Wei Wu

    2015-01-01

    Full Text Available Background: To evaluate the feasibility of a new surgeon-modified iliac branch device (IBD technique to maintain pelvic perfusion in the management of common iliac artery (CIA aneurysm during endovascular aneurysm repair (EVAR. Methods: From January 2011 to December 2013, a new surgeon-modified IBD technique was performed in department of vascular surgery of Peking Union Medical College Hospital in five patients treated for CIA aneurysm with or without abdominal aortic aneurysm. A stent-graft limb was initially deployed in vitro, anastomosed with vascular graft, creating a modified IBD reloaded into a larger sheath, with or without a guidewire preloaded into the side branch. The reloaded IBD was then placed in the iliac artery, with a covered stent bridging internal iliac artery and the branch. Finally, a bifurcated stent-graft was deployed, and a limb device was used to connect the main body and IBD. Results: Technical successes were obtained in all patients. The mean follow-up length was 24 months (range: 6-38 months. All grafts remained patent without any sign of endoleaks. There were no aneurysm ruptures, deaths, or other complications related to pelvic flow. Conclusions: Using the surgeon-modified IBD to preserve pelvic flow is a feasible endovascular technique and an appealing solution for personalized treatment of CIA aneurysm during EVAR.

  10. Perigraft Plug Embolization of the Internal Iliac Artery and Implantation of a Bifurcated Stentgraft: One Treatment Option for Insufficient Tubular Stentgraft Repair of a Common Iliac Artery Aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Goltz, Jan Peter, E-mail: janpeter.goltz@uksh.de; Loesaus, Julia; Frydrychowicz, Alex; Barkhausen, Jörg [University Hospital of Schleswig-Holstein, Department for Radiology and Nuclear Medicine (Germany); Wiedner, Marcus [University Hospital of Schleswig-Holstein, Clinic for Surgery (Germany)

    2016-02-15

    We report an endovascular technique for the treatment of type Ia endoleak after a plain tubular stentgraft had been implanted for a large common iliac artery aneurysm with an insufficient proximal landing zone and without occlusion of the hypogastric in another hospital. CT follow-up showed an endoleak with continuous sac expansion over 12 months. This was classified as type Ia by means of dynamic contrast-enhanced MRI. Before a bifurcated stentgraft was implanted to relocate the landing zone more proximally, the still perfused ipsilateral hypogastric artery was embolized to prevent a type II endoleak. A guidewire was manipulated alongside the indwelling stentgraft. The internal iliac artery could then be selectively intubated followed by successful plug embolization of the vessel’s orifice despite the stentgraft being in place.

  11. Risk Stratification of Patients with Peripheral Arterial Disease and Abdominal Aortic Aneurysm Using Aortic Augmentation Index

    Science.gov (United States)

    Beckmann, Marianne; Husmann, Marc

    2015-01-01

    Background Central augmentation index (cAIx) is an indicator for vascular stiffness. Obstructive and aneurysmatic vascular disease can affect pulse wave propagation and reflection, causing changes in central aortic pressures. Aim To assess and compare cAIx in patients with peripheral arterial disease (PAD) and / or abdominal aortic aneurysm (AAA). Methods cAIx was assessed by radial applanation tonometry (Sphygmocor) in a total of 184 patients at a tertiary referral centre. Patients were grouped as having PAD only, AAA only, or both AAA and PAD. Differences in cAIx measurements between the three patient groups were tested by non-parametric tests and stepwise multivariate linear regression analysis to investigate associations with obstructive or aneurysmatic patterns of vascular disease. Results In the study sample of 184 patients, 130 had PAD only, 20 had AAA only, and 34 patients had both AAA and PAD. Mean cAIx (%) was 30.5 ± 8.2 across all patients. It was significantly higher in females (35.2 ± 6.1, n = 55) than males (28.4 ± 8.2, n = 129), and significantly higher in patients over 80 years of age (34.4 ± 6.9, n = 22) than in those under 80 years (30.0 ± 8.2, n = 162). Intergroup comparison revealed a significant difference in cAIx between the three patient groups (AAA: 27.3 ± 9.5; PAD: 31.4 ± 7.8; AAA & PAD: 28.8 ± 8.5). cAIx was significantly lower in patients with AAA, higher in patients with both AAA and PAD, and highest in patients with PAD only (beta = 0.21, p = 0.006). Conclusion Non-invasive assessment of arterial stiffness in high-risk patients indicates that cAIx differs according to the pattern of vascular disease. Measurements revealed significantly higher cAIx values for patients with obstructive peripheral arterial disease than for patients with aneurysmatic disease. PMID:26452151

  12. Secondary Pulmonary Arterial Hypertension Treated with Endothelin Receptor Blockade

    OpenAIRE

    Sharma, Sat; Kashour, Tarek; Philipp, Roger

    2005-01-01

    Secondary pulmonary arterial hypertension (SPAH) is an adverse outcome of a variety of systemic disorders. These include collagen vascular diseases, chronic thromboembolism, human immunodeficiency virus, portopulmonary hypertension, and other diseases. Progression of SPAH may persist despite stabilization of the causative disease, thereby contributing to the poor quality of life and unfavorable survival in these patients. Treatment of the underlying cause and oxygen supplementation may allevi...

  13. Mirror aneurysms : a reflection on natural history

    NARCIS (Netherlands)

    Meissner, Irene; Torner, James; Huston III, John; Rajput, Michele L.; Wiebers, David O.; Jones, Lyell K.; Brown, Robert D.; Groen, Rob

    2012-01-01

    OBJECT: Investigators conducting the International Study of Unruptured Intracranial Aneurysms, sponsored by the National Institutes of Health, sought to evaluate predictors of future hemorrhage in patients who had unruptured mirror aneurysms. These paired aneurysms in bilateral arterial positions mi

  14. An Unusual Cause of Pediatric Stroke Secondary to Congenital Basilar Artery Fenestration

    OpenAIRE

    Gold, J. J.; Crawford, J R

    2013-01-01

    Basilar artery fenestration is an uncommon congenital variant that has been associated with aneurysms and posterior circulation infarcts in the adult literature. Little is known about the functional consequences of basilar artery fenestration, if any, in childhood. We present a case of a previously healthy 12-year-old boy who presented with diplopia, tinnitus, and ataxia who had subtle findings on diffusion-weighted magnetic resonance imaging consistent with posterior circulation territory in...

  15. Wall shear stress and initiation of aneurysm around anterior communicating artery in pulsating flow; Myakudoryuchu no nozen kotsu domyaku mawari no kabe sendan oryoku to domyakuryu hasse

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, R.; Kudo, S.; Nakashima, M. [Shibaura Institute of University, Tokyo (Japan); Yamanobe, H. [Ishikawajima-Harima Heavy Industries Co. Ltd., Tokyo (Japan); Ujiie, H. [Tokyo Women' s Medical College, Tokyo (Japan); Suhihara, R.

    2000-12-25

    In the present paper, the velocity profile, the wall shear stress and its gradient at the apex of the anterior communicating artery are described in pulsating flow. The anterior communicating artery composing the circle of Willis is one of the predilection sites where the cerebral aneurysm occurs frequently. The flow field around the anterior communicating artery is simulated by two confluent tubes joining at the angle of 60 degrees, two parallel bifurcating tubes, and the junctional tube, bypass, connecting four tubes. The velocity profile is clarified around the apex where the cerebral aneurysm is apt to initiate. In particular, the gradient of wall shear stress around the apex at one confluent tube with much flow rate is estimated, and the relation between the gradient of wall shear stress and the initiation of aneurysm is discussed physiologically. (author)

  16. Visceral Artery Aneurysms in Liver Transplant Candidates and in Patients after Liver Transplantation

    OpenAIRE

    Umberto Maggi; Daniele Dondossola; Dario Consonni; Stefano Gatti; Rossella Arnoldi; Manuela Bossi; Giorgio Rossi

    2011-01-01

    There are only few reviews concerning visceral aneurysms in cirrhotics, and a small number of papers on visceral aneurysms in liver transplant patients. The present paper investigates this condition in both groups of patients in a 10-year-retrospective study.

  17. Treatment of popliteal artery aneurysms with the Hemobahn stent-graft

    NARCIS (Netherlands)

    Tielliu, IFJ; Verhoeven, ELG; Prins, TR; Post, WJ; Hulsebos, RG; van den Dungen, JJAM

    2003-01-01

    Purpose: To report a prospective study to ascertain the results of popliteal aneurysm treatment with a self-expanding stent-graft. Methods: In a recent 3-year period, 21 patients (18 men; median age 67 years, range 5282) with 23 popliteal aneurysms were treated with Hemobahn stent-grafts. Follow-up

  18. Pulmonary Artery Aneurysm as a Cause of Massive Hemoptysis: Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Peter Corr

    2011-01-01

    Full Text Available Massive hemoptysis is a life-threatening medical emergency. Prompt radiological diagnosis and management are essential. I present a case of an inflammatory pulmonary aneurysm (Rasmussen aneurysm from active pulmonary tuberculosis. This is an uncommon cause for massive hemoptysis which was successfully treated by endovascular coiling.

  19. Preoperative evaluation of the artery of adamkiewicz by MR angiography and CT angiography in patients with a thoracic aortic aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Niinuma, Hiroyuki; Ohira, Atsushi; Makita, Shinji; Moriai, Yoshiteru; Hiramori, Katsuhiko [Iwate Medical Univ., Morioka (Japan). School of Medicine; Yoshioka, Kunihiro; Nakajima, Takayuki; Kawazoe, Kohei [Iwate Medical Univ., Morioka (Japan). Memorial Heart Center

    2002-08-01

    Paraplegia is known as an extremely serious and important complication of surgical repair in patients with a thoraco-abdominal aortic aneurysm. It is important to evaluate the artery of Adamkiewicz (AdA) before surgical repair to prevent paraplegia. But the AdA is difficult to visualize by the invasive and hazardous, conventional selective angiography. The aim of this study was to visualize AdA by MR angiography (MRA) and CT angiography (CTA). Twenty-one consecutive patients with a thoracic aortic aneurysm underwent both gadolinium-enhanced, three-dimensional MRA and CTA using multislice helical CT. The AdA was successfully visualized in 15 of the 21 patients (71.4%) by MRA, and in 17 of those 21 patients (80.9%) by CTA. Its continuity was depicted in 12 of 15 patients (80%) by MRA, and in 9 of 17 patients (47%) by CTA. AdA was visualized at 85.7% by MRA or CTA, respectively. This study shows that CTA is a much more sensitive method to detect AdA than MRA. On the other hand, MRA is better to evaluate the continuity of AdA from the descending aorta to the anterior spinal artery, than CTA. Therefore, MRA and CTA are both useful for a preoperative evaluation of AdA and its detailed vascular anatomy from the aorta to the anterior spinal artery. (author)

  20. In situ thrombosis in pulmonary arterial aneurysms due to Behçet’s disease and efficacy of ımmunosuppressive therapy

    Directory of Open Access Journals (Sweden)

    Ozkaya Sevket

    2012-10-01

    Full Text Available Abstract BehçetDisease (BD is a systemic vasculitis characterized by recurrent oral and genital ulcers and uveitis, arthritis, and involvement of the gastrointestinal tract, central nervous system and blood vessels. The aneurysms of the pulmonary arteries, with or without thrombosis, are typical manifestation of BD. We report a case with BD, pulmonary arterial aneurysms(PAA and in situ thrombosis. We aimed to show the effectiveness of immunosuppressive treatment on in situ thrombosis in a case with PAA and BD.

  1. Endovascular stent-graft placement and secondary intervention for abdominal aortic aneurysm in a patient who had a previously inserted iliac stent

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Yong Sun; Cho, Soon Gu; Hong, Kee Chun [Inha University College of Medicine, Incheon (Korea, Republic of)

    2007-04-15

    Endovascular repair of abdominal aortic aneurysm is associated with low morbidity and mortality rates when compared to open surgery, and this can be used in patients who are at a high risk for open surgical repair. Also, secondary intervention is an important for achieving intermediate and long term success of endovascular repair of abdominal aortic aneurysm as this can resolve complications. We report here on endovascular stent-graft placement and a secondary interventional procedure in the abdominal aortic aneurysm of a patient who had a previously inserted iliac stent.

  2. Aneurysmal bone cyst secondary to a giant cell tumor of the patella: A case report

    Science.gov (United States)

    YU, XIAOLONG; GUO, RUNSHENG; FAN, CONGLIANG; LIU, HUCHENG; ZHANG, BIN; NIE, TAO; TU, YI; DAI, MIN

    2016-01-01

    The patella is an unusual location for primary and metastatic bone tumors to develop. The most frequently encountered primary osteolytic lesions at the patella include giant cell tumors of the bone (GCT), chondroblastoma and aneurysmal bone cysts (ABC). However, the presentation of an ABC originating secondary to a GCT at the patella is rare. The present study describes such a case in a 46-year-old female. The differential diagnosis of the condition was extensive. The patient underwent curettage and the addition of bone cement to fill the defect. Pathological analysis of the resected tissue demonstrated that the lesion was consistent with an ABC forming secondary to a GCT. A 3-month follow-up was completed subsequent to the surgery, with a computed tomography scan demonstrating no evidence of recurrence. However, frequent and continuous observations of the patient following diagnosis are planned in order to evaluate the long-term efficacy of the surgical treatment. To the best of our knowledge, the present study describes the third reported case in the literature of this rare, double synchronous, benign tumor located at the patella. PMID:26893764

  3. Neurological Deterioration after Decompressive Suboccipital Craniectomy in a Patient with a Brainstem-compressing Thrombosed Giant Aneurysm of the Vertebral Artery

    Science.gov (United States)

    Lee, Woosung; Choo, Yeon Soo; Kim, Yong Bae

    2016-01-01

    We experienced a case of neurological deterioration after decompressive suboccipital craniectomy (DSC) in a patient with a brainstem-compressing thrombosed giant aneurysm of the vertebral artery (VA). A 60-year-old male harboring a thrombosed giant aneurysm (about 4 cm) of the right vertebral artery presented with quadriparesis. We treated the aneurysm by endovascular coil trapping of the right VA and expected the aneurysm to shrink slowly. After 7 days, however, he suffered aggravated symptoms as his aneurysm increased in size due to internal thrombosis. The medulla compression was aggravated, and so we performed DSC with C1 laminectomy. After the third post-operative day, unfortunately, his neurologic symptoms were more aggravated than in the pre-DSC state. Despite of conservative treatment, neurological symptoms did not improve, and microsurgical aneurysmectomy was performed for the medulla decompression. Unfortunately, the post-operative recovery was not as good as anticipated. DSC should not be used to release the brainstem when treating a brainstem-compressing thrombosed giant aneurysm of the VA.

  4. Arterial secondary blood flow patterns visualized with vector flow ultrasound

    DEFF Research Database (Denmark)

    Pedersen, Mads Møller; Pihl, Michael Johannes; Hansen, Jens Munk;

    2011-01-01

    This study presents the first quantification and visualisation of secondary flow patterns with vector flow ultrasound. The first commercial implementation of the vector flow method Transverse Oscillation was used to obtain in-vivo, 2D vector fields in real-time. The hypothesis of this study...... was that the rotational direction is constant within each artery. Three data sets of 10 seconds were obtained from three main arteries in healthy volunteers. For each data set the rotational flow patterns were identified during the diastole. Each data set contains a 2D vector field over time and with the vector angles...... and velocity magnitudes the blood flow patterns were visualised with streamlines in Matlab (Mathworks, Natick, MA, USA). The rotational flow was quantified by the angular frequency for each cardiac cycle, and the mean rotational frequencies and standard deviations were calculated for the abdominal aorta f-1...

  5. An apparent case of undiagnosed donor Kawasaki disease manifesting as coronary artery aneurysm in a pediatric heart transplant recipient.

    Science.gov (United States)

    Friedland-Little, Joshua; Aiyagari, Ranjit; Gajarski, Robert J; Schumacher, Kurt R

    2013-02-01

    We present a case of coronary ectasia and LAD coronary artery aneurysm with angiographic characteristics of Kawasaki disease in a three-yr-old girl two-yr status post-orthotopic heart transplant. Coronary anomalies were noted during initial screening coronary angiography two yr after transplant. Subsequent review of the donor echocardiogram revealed that the LMCA had been mildly dilated prior to transplant. In the absence of any symptoms consistent with Kawasaki disease in the transplant recipient, this appears to be a case of Kawasaki disease in the organ donor manifesting with coronary anomalies in the transplant recipient. The patient has done well clinically, and repeat coronary angiography has revealed partial regression of coronary anomalies. Given multiple reports in the literature of persistent abnormalities of coronary artery morphology and function after Kawasaki disease, close monitoring is warranted, with consideration of potential coronary protective medical therapies.

  6. Endovascular Aortic Aneurysm Repair with the Talent Stent-Graft: Outcomes in Patients with Large Iliac Arteries

    International Nuclear Information System (INIS)

    The purpose of this study is to report outcomes following endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) in patients with ectatic common iliac arteries (CIAs). Of 117 AAA patients treated by EVAR between 1998 and 2005, 87 (74%) had CIAs diameters 18 but <25 mm. All patients were treated with Talent stent-grafts, 114 bifurcated and 3 AUI devices. Departmental databases and patient records were reviewed to assess outcomes. Technical success, iliac-related outcome, and iliac-related reintervention (IRSI) were analyzed. Patients with EVAR extending into the external iliac artery were excluded. Median (range) follow-up for the study group was 24 (1-84) months. Initial technical success was 98% for CIAs <18 mm and 100% for CIAs ≥18 mm (p = 0.551). There were three distal type I endoleaks (two in the ectatic group) and six iliac limb occlusions (one in an ectatic patient); there were no statistically significant differences between groups (p = 0.4). There were nine IRSIs (three stent-graft extensions, six femorofemoral crossover grafts); three of these patients had one or both CIAs ≥18 mm (p = 0.232). One-year freedom from IRSI was 92% ± 3% and 84% ± 9% for the <18-mm and ≥18-mm CIA groups, respectively (p = 0.232). We conclude that the treatment of AAA by EVAR in patients with CIAs 18-24 mm appears to be safe and effective, however, it may be associated with more frequent reinterventions.

  7. CT angiography with three-dimensional techniques for the early diagnosis of intracranial aneurysms. Comparison with intra-arterial DSA and the surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Karamessini, Maria T.; Kagadis, George C.; Petsas, Theodore; Karnabatidis, Dimitrios; Konstantinou, Dimitrios; Sakellaropoulos, George C.; Nikiforidis, George C.; Siablis, Dimitrios E-mail: siablis@med.upatras.gr

    2004-03-01

    Introduction: Cerebral CT angiography (CTA) is an established method applied to both the detection and treatment planning of intracranial aneurysms. The aim of our study was to compare CTA and digital subtraction angiography (DSA) findings with the surgical results mainly in patients with acute SAH and to evaluate the clinical usefulness of CTA. Materials and methods: During the last 2 years, 82 consecutive patients were admitted under clinical symptoms and signs suggestive of harboring an intracranial aneurysm. CT angiography performed immediately afterwards the plain CT, while DSA was performed within the first 48 h of admission. All aneurysms detected were confirmed during surgery or endovascular embolization. Repeat DSA was performed in all patients having both the initial CTA and the DSA 15 days after the onset of symptoms negative. CT angiograms and conventional angiographies were studied by a consensus of two radiologists for each technique, who performed aneurysm detection, morphological features characterization and evaluation of the technique. Results: Surgical or/and endovascular treatment was performed in 45 patients and 53 aneurysms were confirmed. Using 3D-CT angiography, we detected 47 aneurysms in 42 patients. Conventional angiography depicted 43 aneurysms in 39 patients. The sensitivity of CTA for the detection of all aneurysms versus surgery was 88.7%, the specificity 100%, the positive predictive value (PPV) 100%, the negative predictive value (NPV) 80.7% and the accuracy 92.3%. Accordingly, the sensitivity of DSA was 87.8%, the specificity 98%, the PPV 97.7%, the NPV 89.1% and the accuracy 92.9%. Considering aneurysms {>=}3 mm, CTA showed a sensitivity ranging from 93.3 to 100%, equal to that of DSA. Conclusion: Cerebral CT angiography has an equal sensitivity to DSA in the detection of intracranial aneurysms >3 mm. It has also 100% detection rate in AcoA and MCA bifurcation aneurysms, while some locations, like posterior communicating artery

  8. Direct clipping of a blister-like aneurysm in the supraclinoid segment of the internal carotid artery: a clinical analysis of nine cases

    OpenAIRE

    Yu, Jinlu; Xu, Baofeng; Guo, Yunbao; Xu, Kan

    2015-01-01

    To investigate the method and outcome from direct clipping of a blister-like aneurysm (BBA) of the internal carotid artery supraclinoid segment. This study featured nine BBA patients, including eight females and one male. The patients presented subarachnoid hemorrhage (SAH) as the initial symptom and were diagnosed with BBA in the supraclinoid segment through a vascular exam and imaging. During the exam, the internal carotid artery was pressed to block the blood flow, and a transcranial Doppl...

  9. The experience for stent assisted therapy application on complicated basilar artery apex aneurysm%支架辅助技术介入治疗复杂基底动脉顶端动脉瘤的临床应用

    Institute of Scientific and Technical Information of China (English)

    张金峰; 张向艳; 左书浩; 王东; 李建华; 屈浙; 田军; 胡昱红

    2015-01-01

    目的:总结采用支架辅助技术结合弹簧圈介入治疗复杂基底动脉顶端动脉瘤中的经验,并评估其安全性。方法回顾分析27例复杂基底动脉顶端动脉瘤,采用支架技术结合弹簧圈栓塞基底动脉顶端动脉瘤的临床资料。结果27例手术完成,影像学示完全填塞19例,近全填塞7例,疏松填塞1例。手术并发症3例:1例出血,1例载瘤动脉闭塞,1例弹簧圈脱落。死亡2例:1例V级,1例术前2次出血。结论支架辅助技术结合弹簧圈介入治疗复杂基底动脉顶端动脉瘤是一种可选择的、安全的、有效的方法。%Objective To evaluate the security of application with stent assisted therapy combined with axiom detach-able coil on complicated basilar artery apex aneurysm. Method To review and analyze 27 complicated basilar artery apex aneurysm surgery cases, using the application of stent assisted therapy combined with detachable coil deal with the basilar artery apex aneurysm. Result The image of the 27 surgery cases showed that 19 cases were completed tamponed, and 7 cased were nearly completed tamponed, 1 loose tamponed. It also had three operation complica-tions:one hemorrhaged, one parent artery occlusion, one coil detached. 2 death cases: one was V-level, another had secondary hemorrhaged before surgery. Conclusion The application with stent assisted therapy on complicated basilar artery apex aneurysm is selectable, safe and effective.

  10. Treatment of a Celiac Trunk Aneurysm Close to the Hepato-splenic Bifurcation by Using Hepatic Stent-graft Implantation and Splenic Artery Embolization

    International Nuclear Information System (INIS)

    We present a case of a 73-year-old man in whom a celiac trunk aneurysm close to the hepato-splenic bifurcation was discovered and treated by using celiac-hepatic stent-grafts implantation and splenic artery embolization

  11. Rupture and bleeding secondary to renal infarction in a patient with an abdominal aortic aneurysm.

    Science.gov (United States)

    Hiraoka, Toshifumi; Mukai, Shogo; Obata, Shogo; Morimoto, Hironobu; Uchida, Hiroaki; Yamane, Yoshitaka

    2014-01-01

    A 57-year-old man had been followed up for severe left ventricular dysfunction after acute myocardial infarction with a left ventricular thrombus. He had been treated with anticoagulant and antiplatelet therapy and was admitted to our hospital because of abdominal pain and shock. He had no prior episode of trauma. The electrocardiogram (ECG) showed no changes compared with the previous ECG. Enhanced abdominal computed tomography (CT) showed a retroperitoneal hematoma around an abdominal aortic aneurysm (AAA) and the right kidney. We suspected rupture of AAA or the right kidney, and we performed AAA replacement with a Y-shaped graft and nephrectomy of the right kidney. Pathological examination revealed hemorrhagic infarction of the lower part of the right kidney, with hemorrhage and rupture at the center of the infarct. In our case, enhanced CT showed extravasation from the lower part of the right kidney. In addition, postoperative echocardiography showed that the left ventricular thrombus had disappeared. We report a case of rupture and bleeding secondary to renal infarction in a patient with an AAA.

  12. Synergy between shear-induced migration and secondary flows on red blood cells transport in arteries: considerations on oxygen transport.

    Science.gov (United States)

    Biasetti, Jacopo; Spazzini, Pier Giorgio; Hedin, Ulf; Gasser, T Christian

    2014-08-01

    Shear-induced migration of red blood cells (RBCs) is a well-known phenomenon characterizing blood flow in the small vessels (micrometre to millimetre size) of the cardiovascular system. In large vessels, like the abdominal aorta and the carotid artery (millimetre to centimetre size), the extent of this migration and its interaction with secondary flows has not been fully elucidated. RBC migration exerts its influence primarily on platelet concentration, oxygen transport and oxygen availability at the luminal surface, which could influence vessel wall disease processes in and adjacent to the intima. Phillips' shear-induced particle migration model, coupled to the Quemada viscosity model, was employed to simulate the macroscopic behaviour of RBCs in four patient-specific geometries: a normal abdominal aorta, an abdominal aortic aneurysm (AAA), a normal carotid bifurcation and a stenotic carotid bifurcation. Simulations show a migration of RBCs from the near-wall region with a lowering of wall haematocrit (volume fraction of RBCs) on the posterior side of the normal aorta and on the lateral-external side of the iliac arteries. A marked migration is observed on the outer wall of the carotid sinus, along the common carotid artery and in the carotid stenosis. No significant migration is observed in the AAA. The spatial and temporal patterns of wall haematocrit are correlated with the near-wall shear layer and with the secondary flows induced by the vessel curvature. In particular, secondary flows accentuate the initial lowering in RBC near-wall concentration by convecting RBCs from the inner curvature side to the outer curvature side. The results reinforce data in literature showing a decrease in oxygen partial pressure on the inner curvature wall of the carotid sinus induced by the presence of secondary flows. The lowering of wall haematocrit is postulated to induce a decrease in oxygen availability at the luminal surface through a diminished concentration of

  13. Neurofibromatosis 1 vasculopathy manifesting as a peripheral aneurysm in an adolescent

    Energy Technology Data Exchange (ETDEWEB)

    Farmakis, Shannon G.; Khanna, Geetika [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Han, Min; White, Frances [Washington University School of Medicine, Department of Pathology and Immunology, St. Louis, MO (United States)

    2014-10-15

    Arterial vasculopathy is a well-recognized but uncommon manifestation of neurofibromatosis type 1 (NF-1). It can manifest as stenoses, aneurysms or arteriovenous malformations. NF-1 vasculopathy typically involves the aorta, visceral arteries or carotid-vertebral circulation. Aortic and visceral vasculopathy typically presents as stenotic lesions, while aneurysms have been reported primarily in the subclavian/vertebral arteries. Aneurysms of the peripheral/extremity arteries are an extremely rare complication of NF-1 that may present as a mass or spontaneous rupture. We present the case of a teenage boy with an arm mass secondary to an aneurysm. We hope this case will increase recognition of the variable clinical manifestations of NF-1 vasculopathy among radiologists. (orig.)

  14. Neurofibromatosis 1 vasculopathy manifesting as a peripheral aneurysm in an adolescent

    International Nuclear Information System (INIS)

    Arterial vasculopathy is a well-recognized but uncommon manifestation of neurofibromatosis type 1 (NF-1). It can manifest as stenoses, aneurysms or arteriovenous malformations. NF-1 vasculopathy typically involves the aorta, visceral arteries or carotid-vertebral circulation. Aortic and visceral vasculopathy typically presents as stenotic lesions, while aneurysms have been reported primarily in the subclavian/vertebral arteries. Aneurysms of the peripheral/extremity arteries are an extremely rare complication of NF-1 that may present as a mass or spontaneous rupture. We present the case of a teenage boy with an arm mass secondary to an aneurysm. We hope this case will increase recognition of the variable clinical manifestations of NF-1 vasculopathy among radiologists. (orig.)

  15. Celiac artery disease and fatal rupture of a hepatic artery aneurysm in the Ehlers-Danlos syndrome.

    Science.gov (United States)

    Nat, Amritpal; George, Tanya; Mak, Gregory; Sharma, Amit; Nat, Amitpal; Lebel, Robert

    2014-04-01

    Isolated visceral arteriopathies of the celiac and hepatic artery are rare. We present a case of a Caucasian man who presented with abdominal pain and was found to have a spontaneous celiac artery dissection. Genetic analysis revealed a mutation consistent with Ehlers-Danlos syndrome type IV. The patient died 2 months later from a spontaneous rupture of his hepatic artery. PMID:24688192

  16. Celiac artery disease and fatal rupture of a hepatic artery aneurysm in the Ehlers-Danlos syndrome

    OpenAIRE

    Nat, Amritpal; George, Tanya; Mak, Gregory; Sharma, Amit; Nat, Amitpal; Lebel, Robert

    2014-01-01

    Isolated visceral arteriopathies of the celiac and hepatic artery are rare. We present a case of a Caucasian man who presented with abdominal pain and was found to have a spontaneous celiac artery dissection. Genetic analysis revealed a mutation consistent with Ehlers-Danlos syndrome type IV. The patient died 2 months later from a spontaneous rupture of his hepatic artery.

  17. Genome-Wide Association Study Identifies Novel Susceptibility Genes Associated with Coronary Artery Aneurysm Formation in Kawasaki Disease

    Science.gov (United States)

    Guo, Mindy Ming-Huey; Huang, Ying-Hsien; Yu, Hong-Ren; Huang, Fu-Chen; Jiao, Fuyong; Kuo, Hsing-Chun; Andrade, Jorge

    2016-01-01

    Kawasaki disease (KD) or Kawasaki syndrome is known as a vasculitis of small to medium-sized vessels, and coronary arteries are predominantly involved in childhood. Generally, 20–25% of untreated with IVIG and 3–5% of treated KD patients have been developed coronary artery lesions (CALs), such as dilatation and aneurysm. Understanding how coronary artery aneurysms (CAAs) are established and maintained in KD patients is therefore of great importance. Upon our previous genotyping data of 157 valid KD subjects, a genome-wide association study (GWAS) has been conducted among 11 (7%) CAA-developed KD patients to reveal five significant genetic variants passed pre-defined thresholds and resulted in two novel susceptibility protein-coding genes, which are NEBL (rs16921209 (P = 7.44 × 10−9; OR = 32.22) and rs7922552 (P = 8.43 × 10−9; OR = 32.0)) and TUBA3C (rs17076896 (P = 8.04 × 10−9; OR = 21.03)). Their known functions have been reported to associate with cardiac muscle and tubulin, respectively. As a result, this might imply their putative roles of establishing CAAs during KD progression. Additionally, various model analyses have been utilized to determine dominant and recessive inheritance patterns of identified susceptibility mutations. Finally, all susceptibility genes hit by significant genetic variants were further investigated and the top three representative gene-ontology (GO) clusters were regulation of cell projection organization, neuron recognition, and peptidyl-threonine phosphorylation. Our results help to depict the potential routes of the pathogenesis of CAAs in KD patients and will facilitate researchers to improve the diagnosis and prognosis of KD in personalized medicine. PMID:27171184

  18. A novel approach using Neuron 6F guiding catheter for the embolization of intracranial aneurysm with coiling of the parent internal carotid artery.

    Science.gov (United States)

    Wang, Donghai; Wang, Ying; Su, Wandong; Wang, Yunyan; Li, Gang; Li, Xingang

    2015-01-01

    To describe our initial experience and early outcomes with distal placement of the Neuron 6F guiding catheter through coiled ICA for aneurysmal EVT. We examined the utility of the Neuronf 70 6F guiding catheter for the embolization procedure in such cases, fourteen cases of aneurysm with coiling of the parent ICA are presented via traditional guiding catheters. With the support of 8F ENVOY guiding catheter as a shuttle sheath, the Neuron(TM) 70 6F guiding catheter was successfully placed through coiled extracranial ICA, so the mirocatheter could be delivered to a more strategic position for embolization of the aneurysm. Coiling of extracranial ICA was found as parent artery on angiogram in all patients with ruptured aneurysms. Even where there were two curvatures of more than 360° in the coiled segment of the ICA, Neuron(TM) 70 6F guiding catheter could be placed through the coiling to a distal position and enabled EVT of intracranial aneurysms with no related neurological complications. Neuron guiding catheter is a useful device for embolization of aneurysm where there is coiling of parent ICA, easily placed through the coiling of the ICA and provided robust anatomical support via enhanced catheter-to-vessel wall engagement. PMID:25785169

  19. Giant aneurysm of the left anterior descending coronary artery in a pediatric patient with Behcet's disease.

    Science.gov (United States)

    Cook, Amanda L; Rouster-Stevens, Kelly; Williams, Derek A; Hines, Michael H

    2010-07-01

    Behcet's disease is a rare autoimmune vasculitis characterized by oral aphthosis, genital ulcers, and ocular and cutaneous lesions. Vascular involvement usually affects the veins more commonly than the arteries, and coronary arterial involvement is extremely rare. We report an adolescent with Behcet's disease who developed a large pseudoaneurysm of the left anterior descending coronary artery requiring a coronary arterial bypass graft.

  20. COMPUTER SIMULATION OF BLOOD FLOW IN ARTERIES AFFECTED BY MULTIPLE ANEURYSM

    Directory of Open Access Journals (Sweden)

    H. GIRIJA BAI

    2012-12-01

    Full Text Available The aim of this study is a numerical simulation of hemodynamics in blood vessels with multiple fusiform aneurysms. Dilation of 0.25 is considered. Using computational fluid dynamics, hemodynamic factors such as velocity and pressure are investigated. The problem is solved by finite volume method. Numerical simulation is prescribed using the CFD softwares Fluent and Gambit. High pressure and low velocity is observed in the region of aneurysm. This is an indication to the interruption of blood flow. These techniques based on computer flow study are important for understanding the relationship between hemodynamic parameters and risk of rupture.

  1. COMPLICATION ANALYSIS OF INTRACRANIAL ANEURYSM EMBOLIZATION WITH CONTROLLABLE COILS

    Institute of Scientific and Technical Information of China (English)

    王大明; 凌锋; 王安顺

    2004-01-01

    Objective To explore the causes, prevention, and management of the complications during intracranial aneurysm embolization with controllable coils (mechanical detachable spiral, MDS; and Guglielmi detachable coil, GDC). Methods Retrospective review of 120 cases with 125 intracranial aneurysms embolized with controllable coils from March 1995 to July 1999 was conducted. The 20 accidents (in 18 cases) including aneurysm rupture, over-embolization, protrusion of coil end into the parent artery, and thrombosis of the parent artery were analyzed. Results Among the 20 accidents, there were 6 aneurysm ruptures, 6 over-embolizations (in 5cases), 6 coil protrusions, and 2 thromboses (one was secondary to coil protrusion). The embolizationrelated mortality was 3.33% (4/120), the permanent neurological deficit was 1.67% (2/120), and the transitory neurological deficit was 3.33% (4/120). The occurrence and outcome of the complications were related to the embolizing technique, the pattern of aneurysm and its parent artery, the imperfection of embolic materials, and the observation and management during embolization. Conclusion Skilled embolizing technique, better understanding of the angio-anatomy of an aneurysm and its parent artery, correct judgement and management during embolization, and improvement of embolic materials are beneficial to the reduction of complications and to the melioration of the outcome of complications.

  2. Abdominal aortic aneurysm in a premature neonate with disseminated candidiasis: Ultrasound and angiography

    International Nuclear Information System (INIS)

    When using ultrasound for detection of kidney enlargement, we found an acute abdominal aortic aneurysm secondary to aortitis arising from umbilical artery catheterisation in a premature neonate with systemic candidiasis. Aortography was performed to provide vascular details such as involvement of celiac, renal, iliac and femoral arteries. (orig.)

  3. Abdominal aortic aneurysm in a premature neonate with disseminated candidiasis: Ultrasound and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Khoss, A.E.; Ponhold, W.; Pollak, A.; Schlemmer, M.; Weninger, M.

    1985-09-01

    When using ultrasound for detection of kidney enlargement, we found an acute abdominal aortic aneurysm secondary to aortitis arising from umbilical artery catheterisation in a premature neonate with systemic candidiasis. Aortography was performed to provide vascular details such as involvement of celiac, renal, iliac and femoral arteries.

  4. False aneurysm of perforating branch of the deep femoral artery—Report of two cases

    Directory of Open Access Journals (Sweden)

    H. Naouli

    2015-01-01

    Full Text Available Pseudoaneurysms of the deep femoral artery are uncommon and occur as a late complication of various traumas. Usually associated with femoral fractures, We report two cases of profunda femoris artery injury which presented as false aneurysm secondary to penetrating trauma. Because of its insidious onset, awareness and careful follow-up are the key issues for the early diagnosis.

  5. Single-Center Experience and 1-Year Follow-up Results of 'Sandwich Technique' in the Management of Common Iliac Artery Aneurysms During EVAR

    Energy Technology Data Exchange (ETDEWEB)

    Ricci, Carmelo; Ceccherini, Claudio, E-mail: claudiocec@hotmail.it; Cini, Marco; Vigni, Francesco; Leonini, Sara [Policlinico Santa Maria alle Scotte, Azienda Ospedaliera Universitaria Senese, Radiologia Interventistica (Italy); Tommasino, Giulio; Muzzi, Luigi; Tucci, Enrico; Benvenuti, Antonio; Neri, Eugenio [Policlinico Santa Maria alle Scotte, Azienda Ospedaliera Universitaria Senese, Chirurgia del Cuore e dei grossi vasi (Italy)

    2012-10-15

    Purpose: Abdominal aortic aneurysm (AAA) accompanied by common iliac artery (CIA) aneurysms requires a more demanding procedure owing to the difficulties in obtaining an adequate distal landing zone for the stent-graft limb(s), a potential site of endoleak. The 'sandwich technique' is a procedure to increase EVAR feasibility in the setting of adverse or challenging CIA anatomy. Its main advantages include no restrictions in terms of CIA diameter or length or internal iliac artery (IIA) diameter, no need to wait for a specific stent-graft. Our purpose is to describe our single-center experience and one year follow-up results of this new procedure. Materials and Methods: From April 2009 to June 2010, the sandwich technique was performed in our institution in 7 patients treated for AAA and unilateral CIA aneurysms (n. 5) or bilateral CIA aneurysms (n. 2). Inclusion criteria were the presence of unilateral or bilateral CIA aneurysm (independently from its diameter), IIA artery measuring up to 9 mm in its maximum diameter, not dilatation of IIA and EIA. Results: The mean follow-up length was 15 months (range: 14-20 months). All stent-implanted iliac branches remained patent on 1 year follow-up and IIA flow was preserved. None of the patients had symptoms of pelvic ischemia. CT scan follow-up showed aneurysm shrinkage in five patients, without any sign of endoleaks in all cases. Conclusions: In selected cases, the 'sandwich technique' showed good outcomes confirming to be a safe and easy to perform way to overcome anatomical constraints and expanding the limits of EVAR.

  6. Risk factors for neurological worsening and symptomatic watershed infarction in internal carotid artery aneurysm treated by extracranial-intracranial bypass using radial artery graft.

    Science.gov (United States)

    Matsukawa, Hidetoshi; Tanikawa, Rokuya; Kamiyama, Hiroyasu; Tsuboi, Toshiyuki; Noda, Kosumo; Ota, Nakao; Miyata, Shiro; Oda, Jumpei; Takeda, Rihee; Tokuda, Sadahisa; Kamada, Kyousuke

    2016-08-01

    OBJECT The revascularization technique, including bypass created using the external carotid artery (ECA), radial artery (RA), and M2 portion of middle cerebral artery (MCA), has remained indispensable for treatment of complex aneurysms. To date, it remains unknown whether diameters of the RA, superficial temporal artery (STA), and C2 portion of the internal carotid artery (ICA) and intraoperative MCA blood pressure have influences on the outcome and the symptomatic watershed infarction (WI). The aim of the present study was to evaluate the factors for the symptomatic WI and neurological worsening in patients treated by ECA-RA-M2 bypass for complex ICA aneurysm with therapeutic ICA occlusion. METHODS The authors measured the sizes of vessels (RA, C2, M2, and STA) and intraoperative MCA blood pressure (initial, after ICA occlusion, and after releasing the RA graft bypass) in 37 patients. Symptomatic WI was defined as presence of the following: postoperative new neurological deficits, WI on postoperative diffusion-weighted imaging, and ipsilateral cerebral blood flow reduction on SPECT. Neurological worsening was defined as the increase in 1 or more modified Rankin Scale scores. First, the authors performed receiver operating characteristic curve analysis for continuous variables and the binary end point of the symptomatic WI. The clinical, radiological, and physiological characteristics of patients with and without the symptomatic WI were compared using the log-rank test. Then, the authors compared the variables between patients with and without neurological worsening at discharge and at the 12-month follow-up examination or last hospital visit. RESULTS Symptomatic WI was observed in 2 (5.4%) patients. The mean MCA pressure after releasing the RA graft (< 55 mm Hg; p = 0.017), mean (MCA pressure after releasing the RA graft)/(initial MCA pressure) (< 0.70 mm Hg; p = 0.032), and mean cross-sectional area ratio ([RA/C2 diameter](2) < 0.40 mm [p < 0.0001] and [STA/C2

  7. Transesophageal echocardiography in surgical management of pseudoaneurysm of mitral-aortic intervalvular fibrosa with aneurysms of right sinus of Valsalva and left main coronary artery

    Directory of Open Access Journals (Sweden)

    Shreedhar S Joshi

    2013-01-01

    Full Text Available Pseudoaneurysm of mitral-aortic intervalvular fibrosa (MAIVF is a rare complication associated with aortic and/or mitral valve surgery complicated by infective endocarditis. We report pseudoaneurysm of MAIVF in a young adult without overt cardiac disease or previous cardiac surgery. The patient had a rare combination of pseudoaneurysm of MAIVF impinging on anterior mitral leaflet causing moderate mitral regurgitation, right sinus of Valsalva aneurysm extending into interventricular septum, and left main coronary artery aneurysm. Transesophageal echocardiography helped in confirming the lesions, delineating the anatomy of all the lesions, and assessing the adequacy of surgical repair.

  8. Pseudoaneurysm of the superior gluteal artery following polytrauma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dennis [Vancouver General Hospital, University of British Columbia and Department of Radiology, Vancouver, BC (Canada); Legiehn, Gerald M. [Vancouver General Hospital, Interventional Radiology, University of British Columbia and Department of Radiology, Vancouver, BC (Canada); Munk, Peter L. [Vancouver General Hospital, MSK Section, University of British Columbia and Department of Radiology, Vancouver, BC (Canada)

    2007-09-15

    Gluteal artery aneurysms are rare and often secondary to pelvic fractures, blunt or penetrating trauma. We describe a case of a superior gluteal artery pseudoaneurysm that presented as back pain with numbness and weakness of the lower extremities. Diagnosis was confirmed by color Doppler sonography and angiography. A proximal and distal control was obtained over the aneurysm neck via coil embolization with excellent hemostasis within the pseudoaneurysm and maintenance of perfusion to the left pelvis. (orig.)

  9. An incidentally detected giant membranous interventricular septal aneurysm secondary to previous surgery for subaortic valvular stenosis

    Science.gov (United States)

    Karagöz, Ahmet; Çelik, Abdullah; Vural, Aslı; Başer, Bengi

    2014-01-01

    Ventricular septal aneurysms are rare clinical entities and their certain prevalence and clinical significance are not well known. Most of them are thought to develop during or after the closure process of the accompanying ventricular septal defects. Although a majority of the patients are typically asymptomatic, the potential risks should also be kept in mind. We present a case of a membranous interventricular septal aneurysm that developed after surgery for subaortic valvular stenosis. The points that make our case worth reporting are development of the aneurysm after aortic surgery and lack of a concomitant ventricular septal defect. On the basis of the existence of an aortic valve surgery history and reports that do not mention any ventricular septal defect and ventricular septal aneurysm when she was operated, we suggest that the aneurysmatic formation in the membranous portion of the interventricular septum developed due to valve surgery in the postoperative wound healing period. PMID:25240004

  10. Upper gastrointestinal obstruction secondary to aortoduodenal syndrome owing to a noninflammatory abdominal aortic aneurysm.

    LENUS (Irish Health Repository)

    Cahill, Kevin

    2012-01-31

    Aortoduodenal syndrome is a rare complication of an abdominal aortic aneurysm wherein the aneurysm sac obstructs the patient\\'s duodenum. It presents with the symptoms of an upper gastrointestinal tract obstruction and requires surgical intervention to relieve it. Previously, gastric bypass surgery was advocated, but now aortic replacement is the mainstay of treatment. We report a case of a 67-year-old woman whose aortoduodenal syndrome was successfully managed and review the literature on this topic.

  11. Vascular prosthesis implantation for treatment of isolated lilac artery aneurysm A 33-case report%人工血管移植治疗髂动脉瘤33例

    Institute of Scientific and Technical Information of China (English)

    王春喜; 胡海地; 宋清彬; 段志泉; 陈刚; 梁发启

    2009-01-01

    A total of 33 patients with isolated lilac artery aneurysms, 19 males and 14 females, who received treatment between January 1997 and June 2007, were retrospectively analyzed. Among these patients, 29 suffered from unilateral iliac artery aneurysm and 4 from bilateral iliac artery aneurysm. Under general anesthesia, all patients were subjected to aneurysmectomy, followed by vascular prosthesis implantation for vascular reconstruction. Results revealed that among 4 cases of bilateral iliac artery aneurysm, there was 1 case who was subjected to aorta-bilateral femoral artery vascular prosthesis implantation, and there were 3 cases who underwent aorta-bilateral lilac artery vascular prosthesis implantation; among 29 cases of unilateral lilac artery aneurysm, there was 1 case receiving aorta-common lilac artery vascular prosthesis implantation, 3 cases undergoing iliac-femoral artery vascular prosthesis implantation, 21 cases subjected to common-external iliac artery vascular prosthesis implantation, and 4 cases undertaking common -common lilac artery bypass. Color Doppler ultrasonic examination, spiral CT angiography, or digital subtraction arteriography was performed 3, 6 months, 1, 3, 5, 8, and 10 years after surgery. The mean follow-up time was 5 years. Three cases died of acute cerebral infarction, myocardial infarction, and traffic accident 3, 6, and 2 years after surgery, respectively. The remaining cases well survived as determined by no recurred Uiac artery aneurysm, anastomotic stoma stenosis or lower limb ischemia found. These results indicated that aneurysmectomy and subsequent vascular prosthesis implantation remained a good and primary means for treatment of isolated iliac artery aneurysm under the present medical condition.%回顾性分析1997-01/2007-06收治孤立性骼动脉瘤患者共33例,男19例,女14例,其中单侧髂动脉瘤29例,双侧4例.均在全身麻醉下行动脉瘤切除、人工血管移植血管重建.结果显示4

  12. Treatment of chondroblastoma of the calcaneus with a secondary aneurysmal bone cyst using endoscopic curettage without bone grafting.

    Science.gov (United States)

    Otsuka, Takanobu; Kobayashi, Masaaki; Yonezawa, Masato; Kamiyama, Fumiaki; Matsushita, Yasusi; Matsui, Nobuo

    2002-04-01

    Chondroblastoma is a relatively rare benign bone tumor. Approximately 7% of chondroblastomas occur in the calcaneus, and 17% of chondroblastoma associated with cystic lesions. We report a case of a chondroblastoma in the calcaneus with a secondary aneurysmal bone cyst treated successfully by endoscopic curettage without bone grafting. New bone formation is facilitated by minimal damage to the bone and soft tissue. The cosmetic results of this procedure are good. Two years later, the patient is asymptomatic with no radiographic evidence of recurrence. Endoscopic curettage without bone grafting is a promising new treatment for chondroblastoma.

  13. Rupture of hepatic artery aneurysm associated with ischemic hepatitis Rotura de arteria hepática aneurismática asociada con hepatitis isquémica

    Directory of Open Access Journals (Sweden)

    V.M. Santos

    2010-08-01

    Full Text Available Hepatic artery aneurysms are scarcely reported, mainly because of non-specific symptoms. More often, they are incidental findings during imaging studies to investigate other acute or chronic abdominal conditions. These aneurysms are usually detected in the sixth decade of life, predominantly among males. We report the case of a 69 year-old female with an unsuspected huge hepatic artery aneurysm associated with ischemic hepatitis. Suspicion of aneurysm arose during imaging studies to clarify the origin of jaundice and abdominal pain. After establishment of the diagnosis, but before open surgery, there was a spontaneous rupture of the aneurysm, which caused hemoperitoneum and death. The necropsy study confirmed ischemic hepatitis. Hepatic artery aneurysms are second among the visceral aneurysms, and may cause abdominal pain, jaundice, and hemorrhagic events. One should suspect abdominal aneurysms in elderly patients with unclear abdominal pain, and this hypothesis should be ruled out by imaging studies.La publicación de trabajos sobre aneurismas en la arteria hepática es escasa, debido a los síntomas no específicos y a que constituyen hallazgos incidentales durante investigación de otras condiciones abdominales agudas o crónicas. Estos aneurismas son más frecuentes en varones y en la sexta década de la vida. Presentamos el caso de una mujer de 69 años de edad que ingresa en el hospital con un aneurisma de arteria hepática no sospechado previamente, asociado con hepatitis isquémica. La sospecha de aneurisma empezó durante estudio de imágenes para aclaramiento del origen de ictericia y dolor abdominal. Después de confirmado el diagnóstico, pero antes de la operación planeada, ocurrió rotura espontánea del aneurisma causando hemoperitoneo y muerte. El estudio de necropsia confirmó hepatitis isquémica. Los aneurismas de la arteria hepática son los segundos entre los aneurismas viscerales y pueden causar dolor abdominal, ictericia

  14. Mycotic aneurysm of the superior mesenteric artery after septic embolism; Entwicklung eines mykotischen Aneurysmas der A. mesenterica superior nach septischer Embolie

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, F.; Dinkel, H.P. [Institut fuer Diagnostische Radiologie, Inselspital, Universitaetsklinik Bern (Switzerland)

    2002-07-01

    Mycotic aneurysms of the aorta and the visceral arteries are life-threatening diseases, due to potential rupture and organ or limb ischemia. They occur in endocarditis, immunodeficiency, bacteremia and fungemia, and have a poor prognosis.We report on a case of a 54-year-old male patient suffering from abdominal angina after mitral valve replacement for septic mycotic endocarditis. In presence of a mycotic-embolic occlusion of the left popliteal artery and multiple septic organ infarctions a mycotic aneurysm of the superior mesenteric artery was found in abdominal spiral-CT.Based on sequential spiral-CT examinations, this case demonstrates the development of a septic aneurysm of the superior mesenteric artery. (orig.) [German] Mykotische Aneurysmen der Aorta und ihrer Aeste stellen wegen Rupturgefahr und moeglicher Minderperfusion von Organen und Extremitaeten eine lebensgefaehrliche Erkrankung mit unguenstiger Prognose dar. Beguenstigende Faktoren sind geschwaechte Immunabwehr, Endokarditis, Bakteriaemie und Fungaemie.Wir berichten ueber einen 54-jaehrigen Patienten, der nach einem Mitralklappenersatz bei mykotischer Endokarditis zunehmende abdominelle Beschwerden im Sinne einer Angina abdominalis entwickelte. Die abdominelle Spiralcomputertomographie zeigte ein mykotisches Aneurysma der A. mesenterica superior. Daneben bestanden ein mykotischer Verschluss der linken A. poplitea und multiple septische Organinfarkte.Der Fall demonstriert anhand sequentieller Computertomographien eindrucksvoll die Entwicklung eines septischen Viszeralarterienaneurysmas. (orig.)

  15. Usefulness of 64-slice MDCT for follow-up of young children with coronary artery aneurysm due to Kawasaki disease: Initial experience

    International Nuclear Information System (INIS)

    To evaluate the initial application and value of 64-slice multidetector computed tomography as an alternative diagnostic modality in the follow-up of young children with coronary artery aneurysm due to Kawasaki disease. Twelve boys (mean age 5.1 years, range 1.8-7.8 years) for follow-up (time range from 1.1 to 5.1 years) of known Kawasaki disease and coronary artery aneurysm underwent 64-slice MDCT ECG-gated coronary angiography. All data were acquired without breath holding. Two pediatric radiologists independently assessed image quality and the diameter of all coronary segments were measured for each patient. The number, position, shape and size of each coronary artery aneurysm were observed and compared with those of ECHO performed previously. A total of 118/156 segments permitted visualization with diagnostic image quality, the CT measurements showed good inter-observer and intra-observer reliability, coefficients were 0.93 and 0.88, respectively. A total of 30 coronary artery aneurysms were identified with measured mean of 7.5 ± 3.8 mm in diameter, and of 12.4 ± 9.1 mm in longitudinal lengths.10 tumors were small, 8 tumors were medium and 12 tumors were giant aneurysm. The affected segments included LM7/12(58.3%), 9/12(75%) of LAD1, 4/12(33.3%) of LAD2, 2/12(16.7%) of LCX1; 6/12(50%) of RCA1, 9/12(75%) of RCA2 and 4/12(33.3%) of RCA3, including affected two segments in 9 tumors and three segments in 1 tumor. Calcifications were found in 5 aneurysms and 3/5 with thrombosis; six stenotic segments were found. ECHO failed to detect 8 tumors with 2/8 in LAD, 1/8 in LCX and 5/8 in RCA, and those included 4 small aneurysms. The use of 64-slice MDCT angiography proved valuable for monitoring young children with Kawasaki disease. However, further study is necessary to specify the sensitivity and specificity of MDCT in the follow-up.

  16. Multiscale simulation of blood flow in brain arteries with an aneurysm

    CERN Document Server

    Grinberg, Leopold; Fedosov, Dmitry A; Insley, Joseph A; Papka, Michael E; Kumaran, Kalyan; Karniadakis, George Em

    2011-01-01

    Interfacing atomistic-based with continuum-based simulation codes is now required in many multiscale physical and biological systems. We present the first results from coupled atomistic-continuum simulations on 190,000 processors. Platelet aggregation in the patient-specific model of an aneurysm has been modeled using a high-order spectral/hp element Navier-Stokes solver with a stochastic (coarse-grained) Molecular Dynamics solver based on Dissipative Particle Dynamics (DPD).

  17. Microsurgical treatment for posterior communicating artery aneurysms%后交通动脉瘤的显微手术治疗

    Institute of Scientific and Technical Information of China (English)

    谢飞; 孙鸿; 毛伯镛; 游潮; 贺民; 刘翼; 毛庆

    2011-01-01

    Objective To review experience with microsurgical treatment for posterior communicating artery (PCoA) aneurysms. Methods Clinical data of 108 patients with PCoA aneurysms treated by microsurgery through the pterional approach were analyzed retrospectively, including clipping of aneurysmal neck in 107 cases and wrapping of aneurysm in 1. Aneurismal incision and the indocyanine green angiography were routinely performed after the clipping. Results Total clipping of aneurysmal neck in 107 cases and wrapping of aneurysm in 1. Intraoperatively intracranial aneurysm burst ruptured in 18 patients. Preoperative hydrocephalus occurred in 11 cases, and improved in 6 and no significantly improved in S postoperatively. The postoperative GOS scores were as follows: 4 to 5 scores in 93 patients, 2 to 3 in 11 and 1 (death) in 4. Eighty-four patients were followed up for 6 to 12 months, and there was no residual aneurysm or recurrence. Conclusions Microsurgery is an ideal method for treatment of PCoA aneurysms. Intraoperatively aneurysmal incision and the indocyanine green angiography are useful in judging the clipping effect.%目的 总结显微手术治疗后交通动脉瘤的经验.方法 回顾性分析108例后交通动脉瘤病人的临床资料,采用翼点入路显微手术治疗,行瘤颈夹闭术107例,动脉瘤包裹术1例.瘤颈夹闭后术中常规切开瘤体并行吲哚菁绿荧光血管造影.结果 动脉瘤颈完全夹闭107例,动脉瘤包裹1例.术中动脉瘤破裂18例.术前脑积水11例,术后改善6例,无明显改善5例.术后GOS评分:4~5分93例,2~3分11例,1分(死亡)4例.84例获随访6~12个月,无动脉瘤残留及复发.结论 显微手术是治疗后交通动脉瘤的理想方法,术中常规切开瘤体并行吲哚菁绿荧光血管造影可有效判断夹闭效果.

  18. Nocardia abscessus-related intracranial aneurysm of the internal carotid artery with associated brain abscess: A case report and review of the literature.

    Science.gov (United States)

    Farran, Yvette; Antony, Suresh

    2016-01-01

    Nocardia infections primarily begin in the lungs and spread hematogenously to other sites in the body. Thus, a Nocardia brain abscess is not a completely uncommon occurrence. However, a Nocardia brain abscess complicated by a middle cerebral artery and infectious intracranial aneurysm is a very rare clinical entity. We present a case of an infectious intracranial aneurysm with an associated Nocardia brain abscess that required surgical intervention and resection. The patient was an immunocompetent 60-year-old male who presented with a chief complaint of headache and was found to have an infected intracranial aneurysm and cerebral abscess. He underwent drainage of the abscess with subsequent resection of the infected aneurysm. Cultures from both the blood vessel and brain tissue grew Nocardia abscessus. He was successfully treated with 6 weeks of ceftriaxone and high-dose trimethoprim-sulfamethoxazole. Infectious intracranial aneurysms of the brain caused by Nocardia are rare occurrences, and only a single previous case has been described in the literature. The outcomes of this condition can be catastrophic if it is not treated with a combination of surgery and intravenous antibiotics. The guidelines for the management of this infection are not well defined at this time. PMID:26724261

  19. Aneurisma da artéria cerebelar ântero-inferior: relato de caso Aneurysm of the anterior inferior cerebellar artery: case report

    Directory of Open Access Journals (Sweden)

    Juan Oscar Alarcón Adorno

    2002-12-01

    Full Text Available Os aneurismas intracranianos do sistema vértebro-basilar representam cerca de 5 a 10% de todos os aneurismas cerebrais. Os aneurismas da artéria cerebelar ântero-inferior (AICA são considerados raros, podendo causar síndrome do ângulo ponto cerebelar, com ou sem hemorragia subaracnóidea. Desde 1948, foram descritos poucos casos na literatura. Apresentamos o caso de uma paciente, de 33 anos, na qual, após investigação de quadro de hemorragia subaracnóidea, diagnosticou-se aneurisma sacular da AICA esquerda. Foi submetida a clipagem do aneurisma, com ótimo resultado pós operatório.The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA are considered rare, can cause cerebello pontine angle (CPA syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.

  20. Aneurisma sacular da artéria radial: a propósito de um caso clínico Sacular aneurysm of the radial artery: a case report

    Directory of Open Access Journals (Sweden)

    Nádia Duarte

    2011-06-01

    Full Text Available Os aneurismas da artéria radial são raros e esporádicos, sendo que os pseudoaneurismas são mais frequentes do que os aneurismas verdadeiros e maioritariamente de configuração sacular. A etiologia é variada e diferenciam-se de outros diagnósticos pela pulsação e frémito. Raramente se complicam de ruptura, sendo a trombose e embolização as principais complicações. Dos casos publicados sobre aneurismas verdadeiros da artéria radial, apenas um está descrito como sendo secundário a lesão ocupacional repetitiva, sendo a maioria de causa idiopática. Os autores descrevem um caso de uma mulher de 63 anos, referenciada à consulta de Cirurgia Vascular por crescimento de massa pulsátil na tabaqueira anatómica da mão esquerda. O estudo por eco-doppler e angiografia, confirmaram o diagnóstico de aneurisma sacular da artéria radial, com 20 mm de maior eixo, arcada palmar permeável e sem sinais de embolização distal. Foi submetida a aneurismectomia parcial com laqueação dupla proximal e distal e endoaneurismorrafia. A cirurgia e pós-operatório decorreram sem complicações, nomeadamente complicações isquémicas. A propósito desde caso clínico, discute-se a abordagem diagnóstica e opções terapêuticas.Radial artery aneurysms are sporadic and rare, pseudoaneurysms are more common than true aneurysms, mainly in saccular configuration. The etiology is varied and difference from other diagnostics is done by the presence of pulse and thrill. Thrombosis and embolization are the main complications, while rupture is rare. From the reported cases of true aneurysms of the radial artery, only one is described as being secondary to repetitive occupational injury, the majority being idiopathic. The authors describe the case of a 63 year old woman, referred to a Vascular Surgery consultation because of a growing pulsatile mass in the anatomical snuffbox of the left hand. The Doppler and Angiography studies confirmed the diagnosis of

  1. Comparison of enterprise and neuroform stent-assisted coil embolization of distal internal carotid artery aneurysms: Midterm results from a single-center experience

    International Nuclear Information System (INIS)

    To compare the mid-term follow-up angiographic findings in distal internal carotid artery (ICA) aneurysms treated by stent-assisted coil embolization using the Enterprise or Neuroform stent. We included 68 patients with 70 aneurysms: 31 cases with Enterprise and 39 cases with Neuroform. Inclusion criteria were 1) location of the stent within the distal ICA, including the carotid siphon; 2) follow-up angiogram after > 6 months, and 3) single use of the stent for 1 parent artery. The patients' mean age was 54.9 years (16 male and 52 female). Mean follow-up duration was 9.1 months. At follow-up, there were intraluminal filling defects of the parent artery in 19.4% of the Enterprise group and no filling defect in the Neuroform group. There was no significant in-stent stenosis in either group. Straightening of the parent artery was seen in 35.5% of the Enterprise group and 20.5% of the Neuroform group. Two Enterprise cases showed delayed migration. The Enterprise showed statistically significant intraluminal filling defects of the parent artery compared with the Neuroform. The rates of significant in-stent stenosis and straightening of the parent artery were not significantly different between the Enterprise and the Neuroform groups.

  2. Ruptured Anterior Spinal Artery Aneurysm Associated with Coarctation of Aorta: Case Report and Literature Review

    OpenAIRE

    Jiarakongmun, P.; Chewit, P.; Pongpech, S.

    2002-01-01

    A 39-year-old man presented with acute headache and neck pain, followed by quadriparesis and quadriparesthesia, accompanied by urinary and bowel incontinence. Lumbar puncture showed subarachnoid haemorrhage. Angiogram via a right axillary approach revealed severe coarctation of the aorta, between the left common carotid artery and left subclavian artery. Multiple collateral circulation including an enlarged anterior spinal arterial axis bridging the stenosed arch provided collateral circulati...

  3. Contrast Extravasation on Computed Tomography Angiography Imitating a Basilar Artery Trunk Aneurysm in Subsequent Conventional Angiogram-Negative Subarachnoid Hemorrhage: Report of Two Cases with Different Clinical Courses.

    Science.gov (United States)

    Cho, Won Ho; Choi, Hyuk Jin; Nam, Kyoung Hyup; Lee, Jae Il

    2015-12-01

    Contrast extravasation on computed tomography angiography (CTA) is rare but becoming more common, with increasing use of CTA for various cerebral vascular diseases. We report on two cases of spontaneous subarachnoid hemorrhage (SAH) in which the CTA showed an upper basilar trunk saccular lesion suggesting ruptured aneurysm. However, immediate subsequent digital subtraction angiography (DSA) failed to show a vascular lesion. In one case, repeated follow up DSA was also negative. The patient was treated conservatively and discharged without any neurologic deficit. In the other case, the patient showed sudden mental deterioration on the third hospital day and her brain CT showed rebleeding. The immediate follow up DSA showed contrast stagnation in the vicinity of the upper basilar artery, suggestive of pseudoaneurysm. Double stents deployment at the disease segment was performed. Due to the frequent use of CTA, contrast extravasation is an increasingly common observation. Physicians should be aware that basilar artery extravasation can mimic the appearance of an aneurysm. PMID:27066442

  4. Verminous aneurysm caused by filaria.

    Science.gov (United States)

    Toledo, F V; de Araújo, A P; da Cunha, A M; Sidow, J R; Pavão, S G; de Araújo, E D

    1983-06-01

    Aneurysms caused by atherosclerosis are relatively frequent, as a consequence of the high incidence of this degenerative disease of the arteries. Other types of aneurysm, for example, those of infectious etiology, are more uncommon. Bacterias and fungi are able to cause aneurysms in several parts of the arterial tree. Stengel et al (1943), in a review of world literature described 217 cases of mycotic aneurysms. The Stedman's Medical Dictionary refers to a special type of aneurysm observed in horses, caused by intra-vascular migration of a worm, the Strongylus vulgaris. It has been named verminous aneurysm and generally involves the mesenteric arteries. We haven't found in medical literature any similar observations refering to human cases. The purpose of this paper is to describe a case of aneurysm the etiology of which we have imputed to the filaria (Wuchereria bancrofti). This case was observed in Marcilio Dias Naval Hospital, Rio de Janeiro, Brazil. PMID:6346961

  5. Spontaneous Thrombosis in Giant Aneurysm of the Anterior Communicating Artery Complex in Pediatric Age: Five-Year Follow-Up

    OpenAIRE

    Gonçalves, Vítor M.; Cristino, N.; M. Cunha e Sá

    2014-01-01

    Intracranial aneurysms are rare in the pediatric population, especially in infancy, representing less than 1% of all aneurysms. In this age group, they are more frequent at the carotid bifurcation and in the posterior circulation, with a greater number of giant aneurysms and spontaneous aneurysm thrombosis when compared with the adults. They are life-threatening, and, therefore, early investigation, characterization of the lesion, and treatment are essential. The appropriate management depend...

  6. Benign osteoblastoma of the odontoid process of the axis with secondary aneurysmal bone cyst component: a case report.

    Science.gov (United States)

    Tarantino, Roberto; Piccirilli, Manolo; Anichini, Giulio; Delfini, Roberto

    2008-01-01

    The authors report their experience on one patient with osteoblatoma of the odontoid process of the axis with secondary aneurysmal bone cyst. According to their knowledge, this is the first case, reported in the literature, of this kind of lesion in that particular anatomical region. Because of the rarity of this lesion, it was difficult to have a certain preoperative diagnosis. Therefore, the patient underwent a biopsy via a transoral route. The biopsy was performed over the noncalcified component of the lesion. The intraoperative histological examination showed the benign nature of the lesion. Thereafter, the lesion was totally removed, succeeding in preserving the remaining part of the odontoid process and the anterior arch of C1. In the follow-up, there was no evidence of cranio-vertebral instability. The histological examination revealed an osteoblastoma of the odontoid process of the axis with a secondary aneurysmal bone cyst. To the best of our knowledge, this is the first case reported in the literature.

  7. A Procedure of Combination of Sequential Internal Thoracic Artery Grafting and Cooley's Technique for Complicated Case With Multi-vessel Disease,Left Ventricular Aneurysm and Mitral Regurgitation

    Institute of Scientific and Technical Information of China (English)

    Meng-ya LIANG; Guang-xian CHEN; Zhong-kai WU; Xi ZHANG

    2009-01-01

    @@ INTRODUCTION Left ventricular aneurysm and ischemic mitral regurgitation are two of most common complications of acute myocardial infarction (AMI).Combination of both these two fatal complications is not rare and the management of these complicated cases is always a challenge to cardiac surgeon because of its relatively high mortality[1]. We reported a rare case of AMI in which a singlestage correction of mitral valve replacement with preservation of mitral apparatus, sequential left internal thoracic artery (ITA) grafting and Cooley's technique.

  8. The relationship between the morphological features of A1 segment of anterior cerebral artery and anterior communicating artery aneurysms

    Institute of Scientific and Technical Information of China (English)

    冯文峰

    2013-01-01

    Objective To improve the predictability of surgical clipping and guide the steam shaping of microcatheters in endovascular embolization by analyzing the association of morphological features of A1 segment of anterior cerebral artery(ACA) with formation and classification of anterior

  9. Hypogastric artery autograft treating hemorrhage with infection of external iliac artery secondary to renal transplantation

    Institute of Scientific and Technical Information of China (English)

    WANG Ze-hou; YI Shan-hong; YAO Zhi-yong; SUN Bin; HONG Quan; ZHANG Zhi-chao

    2008-01-01

    @@ Massive hemorrhage from infected anastomosed site between the graft artery and the external iliac artery is one of the most serious complications of renal transplantation. Clinically, it is a rare but fatal occasion. We reported here one case of hemorrhage with infection in the iliac artery anastomosed site treated successfully with hypogastric artery autograft interposition in March 2003.

  10. Aneurysm of the Left Coronary Artery in Postoperative Bland-White-Garland Syndrome

    OpenAIRE

    Nathalie Jeanne Magioli Bravo-Valenzuela; Guilherme Ricardo Nunes Silva

    2015-01-01

    We report a case of anomalous left coronary artery from the pulmonary artery (ALCAPA) or Bland-White-Garland syndrome, present the challenges of performing a differential diagnosis, and discuss the treatment of the syndrome. Although ALCAPA is a rare congenital heart disease, it is one of the most common causes of myocardial ischemia in childhood and presents a diagnostic challenge. A four-year-old girl was referred to a pediatric cardiologist for evaluation of mitral valve regurgitation murm...

  11. 血管内支架治疗椎动脉梭形动脉瘤%Endovascular treatment of fusiform aneurysms of vertebral artery using stents

    Institute of Scientific and Technical Information of China (English)

    孟凡国; 于建军; 费昶

    2009-01-01

    目的 探讨血管内支架治疗颅内椎动脉梭形动脉瘤的临床效果.方法 回顾血管内支架治疗的23例椎动脉瘤患者(12例破裂,11例未破裂).临床结果进行GOS评分.结果 23例发现24个椎动脉梭形动脉瘤,共放置了25个支架.所有支架均成功释放,19例用弹簧圈栓塞动脉瘤,3例只放置了支架,1例放置了2枚Neuroform支架来覆盖瘤颈.没有发生与操作技术相关的并发症.临床随访22例(96%)恢复良好(GOS=5),1例(4%)由于术中动脉瘤破裂出血而死亡(GOS=1).结论 血管内应用支架是治疗累及小脑后下动脉上、对侧椎动脉发育不好或未破裂的椎动脉梭形动脉瘤的一种有效的治疗方法.%Objective To report clinical outcomes of endovascular treatment of fusiform aneurysms of vertebral artery (VA) using stents. Methods Consecutive 23 cases (12 ruptured, 11 unruptured) of vertebral artery fusiform aneurysms treated with stents were retrospectively reviewed. Their clinical outcomes were graded with Glasgow outcome scale. Results Twenty-five stents were placed in 23 patients for 24 fusiform VA aneurysms. All patients were successfully treated using stents. In 19 patients coil-embolization of the aneurysmal lumen was used. One aneurysm was treated by placement of 2 stents covering the dissection site. There was no technique-related complication. According to the Glasgow Outcome Scale (GOS), 22 patients (96 %) had a good recovery and 1 (4 %) died due to intraoperative rebleeding. Conclusion Endovascular therapy using stents may be a useful treatment in patients with fusiform VA aneurysms involving the PICA or hypoplasia of the eontralateral VA or unruptured VA aneurysms.

  12. Intracranial aneurysm associated with relapsing polychondritis

    Energy Technology Data Exchange (ETDEWEB)

    Coumbaras, M.; Boulin, A.; Pierot, L. [Dept. of Neuroradiology, Hopital Foch, Suresnes (France); Piette, A.M.; Bletry, O. [Dept. of Medicine, Hopital Foch, Suresnes (France); Graveleau, P. [Dept. of Neurology, Hopital Foch, Suresnes (France)

    2001-07-01

    We describe a 50-year-old man with relapsing polychondritis (RP) involving auricular cartilage, uveitis and hearing loss, who had an aneurysm of the anterior cerebral artery. Intracranial aneurysm is a rare manifestation of RP. (orig.)

  13. Aortoduodenal fistula and aortic aneurysm secondary to biliary stent-induced retroperitoneal perforation

    Institute of Scientific and Technical Information of China (English)

    Tae Hoon Lee; Do Hyun Park; Ji-Young Park; Suck-Ho Lee; Il-Kwun Chung; Hong Soo Kim; Sang-Heum Park; Sun-Joo Kim

    2008-01-01

    Duodenal perforations caused by biliary prostheses are not uncommon, and they are potentially life threatening and require immediate treatment. We describe an unusual case of aortic aneurysm and rupture which occurred after retroperitoneal aortoduodenal fistula formation as a rare complication caused by biliary metallic stent-related duodenal perforation. To our knowledge, this is the first report describing a lethal complication of a bleeding, aortoduodenal fistula and caused by biliary metallic stent-induced perforation.

  14. Aneurisma de artéria ilíaca interna roto: relato de caso Ruptured internal iliac artery aneurysm: case report

    Directory of Open Access Journals (Sweden)

    Cristina Toledo Afonso

    2009-03-01

    Full Text Available Aneurismas isolados da artéria ilíaca interna são raros, acometem 0,1% da população e correspondem a 1% dos aneurismas aorto-ilíacos. Na maioria das vezes, os pacientes são assintomáticos, mas podem apresentar dor abdominal, massa pulsátil no hipogástrio ou na fossa ilíaca, sintomas compressivos urinários, gastrointestinais ou neurológicos. Podem ocasionar quadro de abdome agudo, principalmente quando há ruptura. O diagnóstico precoce dos aneurismas isolados de artéria ilíaca interna é incomum, sendo identificados quando mais volumosos ou rotos, o que aumenta significativamente sua morbimortalidade e torna seu prognóstico mais reservado. Dessa forma, representam um desafio terapêutico. A ligadura cirúrgica tem sido o tratamento mais comum, entretanto a cirurgia endovascular tem mostrado bons resultados, inclusive nos aneurismas rotos. É relatado caso de aneurisma de artéria ilíaca interna isolado roto diagnosticado durante laparotomia para abordagem de abdome agudo.Isolated internal iliac artery aneurysms are rare. They affect 0.1% of the population, and account for 1% of aortoiliac aneurysms. Patients are mostly asymptomatic, yet they can have abdominal pain, pulsatile mass in the hypogastrium or iliac fossa, or urinary, gastrointestinal or neurological compressive symptoms. Such aneurysms are likely to course with an acute abdomen, especially when ruptured. Early diagnosis of isolated internal iliac artery aneurysms is difficult, as they are more easily detected when larger or ruptured, which significantly raises their morbidity and mortality rate and determines a poor prognosis. Therefore, they are a therapeutic challenge. Surgical ligation has been the most common treatment; however, the endovascular approach has presented good outcomes, even in the event of ruptured aneurysms. A case of ruptured isolated iliac artery aneurysm diagnosed during a laparotomy (acute abdomen approach is reported.

  15. Urgent treatment of severe symptomatic direct carotid cavernous fistula caused by ruptured cavernous internal carotid artery aneurysm using high-flow bypass, proximal ligation, and direct distal clipping: Technical case report

    Directory of Open Access Journals (Sweden)

    Hirotaka Hasegawa

    2014-01-01

    Full Text Available Background: Direct carotid cavernous fistula (CCF secondary to ruptured carotid cavernous aneurysms (CCAs is rare, but patients with this condition who develop acutely worsening and severe neuro-ophthalmic symptoms require urgent treatment. Endovascular methods are the first-line option, but this modality may not be available on an urgent basis. Case Description: In this article, we report a 45-year-old female with severe direct CCF due to rupture of the CCA. She presented with intractable headache and acute worsening of double vision and visual acuity. Emergent radiographic study revealed high-flow fistula tracked from the CCA toward the contralateral cavernous sinus and drained into the engorged left superior orbital vein. To prevent permanent devastating neuro-ophthalmic damages, urgent high-flow bypass with placement of a radial artery graft was performed followed by right cervical internal carotid artery (ICA ligation and the clipping of the ICA at the C3 portion, proximal to the ophthalmic artery. In the immediate postoperative period, her symptoms resolved and angiography confirmed patency of the high-flow bypass and complete occlusion of the CCF. Conclusion: With due consideration of strategy and techniques to secure safety, open surgical intervention with trapping and bypass is a good treatment option for direct severe CCF when the endovascular method is not available, not possible, or is unsuccessful.

  16. Hygroma following endovascular femoral aneurysm exclusion

    DEFF Research Database (Denmark)

    Wad, Morten; Pedersen, Brian Lindegaard; Lönn, Lars;

    2013-01-01

    Endovascular treatment of aneurysms in the superficial femoral artery (SFA) and popliteal segments is a suggested alternative to open surgical repair. Careful selection of patients for endovascular treatment of SFA aneurysms is mandatory.......Endovascular treatment of aneurysms in the superficial femoral artery (SFA) and popliteal segments is a suggested alternative to open surgical repair. Careful selection of patients for endovascular treatment of SFA aneurysms is mandatory....

  17. Severe coronary artery disease in Chinese patients with abdominal aortic aneurysm: prevalence and impact on operative mortality

    Institute of Scientific and Technical Information of China (English)

    SUN Tao; CHENG Yu-tong; ZHANG Hong-ju; CHEN Shun-hua; ZHANG Dong-hua; HUANG Ji; ZHANG Jing-mei; LI Zhi-zhong

    2012-01-01

    Background Little is known about the prognosis of coronary artery disease (CAD) in Chinese patients with abdominal aortic aneurysm (AAA).The aim of this study was to evaluate the predictors of in-hospital all-cause mortality of severe CAD in Chinese patients who were hospitalized for AAAs.Methods From January 2003 to August 2009,368 patients were operated on for AAAs.The clinical characteristics were retrospectively collected.The primary outcome was the in-hospital all-cause mortality.The clinical risk factors were subjected to a multivariate analysis to determine the predictors of in-hospital all-cause mortality.Results During their hospitalization,23% (85/368) of the patients underwent coronary angiography,which revealed significant lesions in 93% (79/85) of the patients.In 25 cases,coronary artery bypass grafting (CABG) was performed before the AAA repair and in 16 cases of percutaneous coronary intervention (PCI) was performed.Ten patients with AAA alone died before discharge,and eight patients diagnosed with AAA combined with CAD died.There was no statistical difference in the postoperative death between the two groups.The logistic analysis showed that age >70 years and CAD (vessels ≥2) were the significant factors in predicting the adverse clinical outcome.Conclusions The prevalence of severe CAD in Chinese patients with AAAs seemed lower than those that were reported.Myocardial evaluation and subsequent revascularization before AAA surgery could improve the clinical outcome for these patients who have severe CAD.

  18. A Behcet’s Disease Patient with Right Ventricular Thrombus, Pulmonary Artery Aneurysms, and Deep Vein Thrombosis Complicating Recurrent Pulmonary Thromboembolism

    Directory of Open Access Journals (Sweden)

    Selvi Aşker

    2013-01-01

    Full Text Available Intracardiac thrombus, pulmonary artery aneurysms, deep vein thrombosis, and pulmonary thromboembolism are rarely seen symptoms of Behcet’s disease. A 20-year-old female patient was admitted for complaints of cough, fever, palpitations, and chest pain. On the dynamic thorax computed tomograms (CT obtained because of significantly enlarged hilar structures seen on chest radiograms, aneurysmal dilatation of the pulmonary artery segments bilaterally, chronic thrombus with collapse, and consolidation substances compatible with pulmonary embolism involving both lower lobes have been observed. It is learned that, four years ago, the patient had been diagnosed with Behcet’s disease and received colchicine treatment but not regularly. The patient was hospitalized. On the transthoracic echocardiogram, a thrombosis with a dimension of 4.2 × 1.6 cm was recognized in the right ventricle. On abdomen CT, aneurysmal iliac veins and deep vein thrombus on Doppler ultrasonograms were diagnosed. At the controls after three months of immunosuppressive and anticoagulant therapies, some clinical and radiological improvements were recognized. The patient suspended the treatment for a month and the thrombus recurred. We present our case in order to show the effectiveness of immunosuppressive and anticoagulant therapies and rarely seen pulmonary thromboembolism in recurrent Behcet’s disease.

  19. Prevalence and prognosis of asymptomatic coronary artery disease in patients with abdominal aortic aneurysm and minor or no perioperative risks

    International Nuclear Information System (INIS)

    According to the American Heart Association (AHA)/ American College of Cardiology (ACC) guideline 2002, patients with abdominal aortic aneurysm (AAA) with minor or no clinical risk for perioperative cardiovascular events require no preoperative coronary assessment if they have functional capacity greater than 4 METS. Further coronary assessment is not often performed, even after the operation, because of absence of symptoms. The aim of this study was to clarify the prevalence, and prognosis of asymptomatic coronary artery disease (CAD) in such AAA patients. From 2002 to 2006, 201 patients (161 men; mean age 73.1±7.7 years) were classified as minor or no clinical risk for perioperative cardiovascular events. Medical history, and physical, laboratory, plus imaging examinations were evaluated. Prognosis was assessed by telephone canvass. Asymptomatic CAD was found in 59 patients (29.4%). By multivariate analysis, advanced age (≥75 years: odds ratio (OR) 2.43, P=0.018) and family history of CAD (OR 5.27, P=0.001) independently predicted asymptomatic CAD. Asymptomatic CAD did not significantly affect death or cardiac events when treated appropriately. A high prevalence of asymptomatic CAD requiring treatment was shown in these AAA patients. Under appropriate therapies, prognosis was as well preserved as in patients without asymptomatic CAD, which underscored the importance of appropriate assessment and management of asymptomatic CAD. (author)

  20. Pulmonary arterial hypertension secondary to chronic left-sided cardiac dysfunction in dogs.

    Science.gov (United States)

    Stepien, Rebecca L

    2009-09-01

    Pulmonary arterial hypertension is a description of a physiological finding rather than a diagnosis. Pulmonary arterial pressure is the result of interactions among pulmonary blood flow (right ventricular cardiac output), pulmonary vascular impedance and post-capillary pressure (typically reflecting left atrial pressure). When elevations in pulmonary arterial pressure (systolic/diastolic pulmonary arterial pressure > approximately 30/19 mmHg at rest) are accompanied by increased left atrial pressure, pulmonary arterial hypertension may be considered secondary to left-heart failure. Introduction of Doppler methods to diagnose pulmonary arterial hypertension has increased the awareness of the prevalence and importance of pulmonary arterial hypertension dogs with left-heart failure. Increasing understanding of the mechanism of development of pulmonary venous hypertension and reactive pulmonary arterial hypertension in dogs with left-heart disease has led to the development of successful additive therapies for progressive clinical signs in the setting of chronic therapy for congestive heart failure due to left-sided valvular and myocardial dysfunction. Because effective therapies for pulmonary arterial hypertension secondary to chronic left-sided cardiac dysfunction are now available, screening for pulmonary arterial hypertension should be a regular part of the Doppler echocardiographic examination in a clinical setting of chronic therapy for left-sided congestive heart failure due to valvular or myocardial disease.