Takayasu's disease. A report of 3 cases.

Three patients with Takayasu's disease are described. In 2 cases aortography demonstrated an occlusion of the great vessels at the origin of the arch of the aorta. In 1 patient there was concomitant aneurysmal dilatation of the brachiocephalic trunk. Common and internal carotid artery stenosis occurred in 1 patient and was associated with hemiplegia and blindness. All 3 patients had constitutional symptoms and signs of the disease as well as markedly elevated erythrocyte sedimentation rates; 2 patients had moderate clinical responses to steroid administration in the short term and 1 developed bilateral calf vein thrombosis, which responded satisfactorily to conservative management.

Syphilitic aortitis. A case report.

A case of syphilitic aortitis with total occlusion of the infrarenal aorta without aneurysmal dilatation is presented. Incapacitating claudication of both legs together with pain at rest necessitated an aortobifemoral bypass operation, which resulted in complete relief of symptoms. Histological examination of the aorta showed atherosclerosis together with characteristic perivascular lymphocytic infiltration of the aortic vasa vasorum.

Deep-vein thrombosis in pregnancy. A case report.

The incidence of thrombo-embolic complications in pregnancy varies between 2 and 5 per 1000 deliveries. Deep-vein thrombosis (DVT) is classically associated with pulmonary embolism and chronic venous insufficiency, which are leading causes of maternal morbidity and mortality. An accurate diagnosis of iliofemoral or calf vein thrombosis should be confirmed by either Doppler ultrasonography, impedance plethysmography or ascending phlebography. Full-dose continuous intravenous heparin for 5-10 days is the established method of therapy for acute DVT and pulmonary embolism occurring during pregnancy or in the puerperium. Thereafter, long-term treatment with self-administered subcutaneous injections of heparin in low doses is feasible and effective. During pregnancy, coumarin administration results in embryopathy as it readily crosses the placenta; it should be avoided until after delivery. In view of its safety and effectiveness, low-dosage intravenous heparin or heparin by subcutaneous injection seems to be the anticoagulant of choice for the expectant mother.