Assuntos
Aorta Abdominal/lesões , Derivação Gástrica/efeitos adversos , Obesidade Mórbida/cirurgia , Hemorragia Pós-Operatória/etiologia , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/cirurgia , Procedimentos Endovasculares , Evolução Fatal , Derivação Gástrica/instrumentação , Derivação Gástrica/métodos , Hematoma/etiologia , Hematoma/cirurgia , Humanos , Laparoscopia , Hemorragia Pós-Operatória/cirurgia , Espaço Retroperitoneal , Tomografia Computadorizada por Raios XAssuntos
Aneurisma Aórtico/etiologia , Aneurisma Aórtico/cirurgia , Aortite/complicações , Aortite/cirurgia , Prótese Vascular , Micoses/cirurgia , Stents , Aneurisma Aórtico/diagnóstico por imagem , Aortite/diagnóstico por imagem , Cuidados Críticos/métodos , Análise de Falha de Equipamento , Feminino , Humanos , Pessoa de Meia-Idade , Micoses/diagnóstico por imagem , Desenho de Prótese , Radiografia , Resultado do TratamentoRESUMO
BACKGROUND: Popliteal vein aneurysm is a rare but potentially problematic disease with a risk of pulmonary embolism. METHOD: A systematic literature search was performed. RESULTS: A total of 105 popliteal vein aneurysms were identified, with a slight female and left-sided preponderance. Dominating symptoms are caused by pulmonary embolism, followed by local symptoms with a palpable mass. In four patients arterial symptoms were reported. The most frequently used diagnostic test was phlebography, increasingly replaced by duplex ultrasonography in recent years. Because pulmonary embolism is a potential, it motivates surgical removal. In most cases excision and lateral suture is possible. Four fatal cases were reported. Unfortunately follow-up time and results are poorly documented. CONCLUSION: Popliteal venous aneurysm is rare but should be considered as a local source of pulmonary embolism when no other explanation is found.
Assuntos
Aneurisma/diagnóstico , Aneurisma/cirurgia , Doenças Vasculares Periféricas/diagnóstico , Doenças Vasculares Periféricas/cirurgia , Veia Poplítea , Humanos , Fatores de RiscoRESUMO
The purpose of this study was to evaluate the technique of whole-body magnetic resonance angiography (MRA) of patients with a standard clinical scanner. Thirty-three patients referred for stenoses, occlusions, aneurysms, assessment of patency of vascular grafts, vasculitis and vascular aplasia were examined in a 1.5-T scanner using its standard body coil. Three-dimensional sequences were acquired in four stations after administration of one intravenous injection of 40 ml conventional gadolinium contrast agent. Different vessel segments were evaluated as either diagnostic or nondiagnostic and regarding the presence of stenoses with more than 50% diameter reduction, occlusions or aneurysms. Of 923 vessel segments, 67 were not evaluable because of poor contrast filling (n=31), motion artefacts (n=20), venous overlap (n=12) and other reasons (n=4). Stenoses of more than 50%, occlusions or aneurysms were observed in 26 patients (129 segments). In nine patients additional unsuspected pathology was found. In 10 out of 14 patients (71/79 segments) there was conformity between MRA and digital subtraction angiography regarding the grade of stenosis. This study shows that whole-body MRA with a standard clinical scanner is feasible. Motion artefacts and the timing of the contrast agent through the different segments are still problems to be solved.
Assuntos
Angiografia por Ressonância Magnética/métodos , Imagem Corporal Total/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Aneurisma/diagnóstico , Angiografia Digital/métodos , Artefatos , Criança , Constrição Patológica/diagnóstico , Meios de Contraste/administração & dosagem , Estudos de Viabilidade , Feminino , Gadolínio , Humanos , Aumento da Imagem/métodos , Imageamento Tridimensional/métodos , Masculino , Pessoa de Meia-IdadeRESUMO
A 19 year old male patient is described with a large popliteal venous aneurysm causing pulmonary embolism and intermittent claudication. It was resected and replaced with a saphenous vein graft.
Assuntos
Aneurisma/complicações , Claudicação Intermitente/etiologia , Veia Poplítea/anormalidades , Embolia Pulmonar/etiologia , Adulto , Aneurisma/diagnóstico por imagem , Aneurisma/cirurgia , Implante de Prótese Vascular , Humanos , Claudicação Intermitente/diagnóstico , Masculino , Veia Poplítea/diagnóstico por imagem , Veia Poplítea/cirurgia , Embolia Pulmonar/diagnóstico , Radiografia , Veia Safena/transplanteRESUMO
The objective of this study was to evaluate the feasibility of performing surgical reconstructions in patients with aortoiliac occlusive disease with findings obtained solely from duplex scanning. Between January 1995 through December 1999, among 112 patients who underwent surgical intervention due to aortoiliac occlusive disease, 44 were operated on with findings obtained solely from preoperative duplex scanning. Deviations from preoperatively planned surgical interventions according to duplex scan findings and the outcome were analyzed. Our results showed that surgical reconstructions for treatment of aortoiliac occlusive disease can be safely performed by using duplex scanning as the sole preoperative diagnostic modality in patients with conclusive duplex scan findings.
Assuntos
Doenças da Aorta/cirurgia , Arteriopatias Oclusivas/diagnóstico por imagem , Arteriopatias Oclusivas/cirurgia , Artéria Ilíaca , Ultrassonografia Doppler Dupla , Idoso , Idoso de 80 Anos ou mais , Aortografia , Estudos de Viabilidade , Feminino , Humanos , Artéria Ilíaca/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Grau de Desobstrução VascularRESUMO
The purpose of this study was to review experience with carotid artery surgery based on findings obtained solely from duplex scanning with special regard to unexpected findings during surgery and the early outcome. From January 1993 through December 1999, 271 consecutive patients underwent 287 carotid endarterectomies (CEAs), 229 (80%) of which were performed solely based on duplex scan findings. During the study period 5,932 carotid artery duplex scans were performed in 4,466 patients. Of 589 patients with internal carotid artery (ICA) stenosis 70%, 246 underwent CEA compared to 25 of 156 with 50-69% ICA stenosis. The indications for CEA were transient ischemic attack (TIA) in 88 (30.7%), amaurosis fugax in 60 (20.9%), previous stroke in 91 (31.7%) and asymptomatic disease in 48 (16.7%) cases. There were no statistically significant differences between the groups operated on with and without preoperative angiography with respect to the indications for surgery, associated risk factors, or the degree of stenosis on the contralateral side. In patients undergoing surgery without angiography, there were no unexpected findings that influenced the performance of surgery, in all except 1. There were no significant differences in perioperative morbidity and mortality in patients undergoing surgery with and without conventional angiography. The combined mortality and major stroke rates were 3.4% and 2.2%, respectively. It is concluded that CEA can safely be performed without preoperative angiography in cases with conclusive duplex scan findings.