Open repair of a recurrent abdominal aorta pseudoaneurysm in Behçet's disease.

Vascular involvement is one of the major causes of mortality and morbidity in Behçet's disease (BD). Aneurysm or pseudoaneurysm formation is one of the vascular complications, and the aorta is the most common site. Currently, there is no definitive therapeutic modality. Both open surgery and endovascular repair are safe and effective options. However, the recurrence rate over the anastomotic sites is a major concern. We report a case of BD in a patient with recurrent abdominal aorta pseudoaneurysm 10 months after the first surgery. Preoperative corticosteroids followed by open repair were performed with good outcomes.

Recurrent floating common carotid artery thrombus related to COVID-19: A case report.

The occurrence of arterial and venous thrombosis during coronavirus infection has been widely reported since the beginning of the epidemic. Floating carotid thrombus (FCT) in the common carotid artery is exceptional and its main known cause is atherosclerosis. We describe the case of a 54-year-old man who developed, one week after the onset symptomatology of related to COVID-19 infection, an ischemic stroke, complicating a large intraluminal floating thrombus in the left common carotid artery. Despite surgery and anticoagulation, a local recurrence with other thrombotic complications occurred and the patient died.

Iatrogenic cervical arterio-venous fistula.

Arteriovenous fistula (AVF) are the preferred hemodialysis vascular access. However, central venous catheter (CVC) placement rates remain very high in patients initiating hemodialysis and/or in whom with a fistula dysfunction. Several complications are associated with the insertion of these catheters, including infection, thrombosis and arterial injuries. Iatrogenic AVF are uncommon complications. Herein, we report the case of a 53-year-old female with an iatrogenic right subclavian artery - internal jugular vein fistula secondary to a right internal jugular catheter malposition. Through a median sternotomy combined with supraclavicular approach, AVF exclusion with direct suture of subclavian artery and the internal jugular vein was performed. The patient was discharged without any complications.

Post-traumatic pseudoaneurysm of temporo-maxillary trunk in a child: A case report.

Post-traumatic pseudoaneurysm of branches of external carotid artery is very rare and is at high risk of engaging vital prognosis by a rupture, even more in child. So, it must be evoked in emergency in front of any beating mass after a local trauma. We report the case of a 14-year-old child with a pseudoaneurysm of the temporo-maxillary trunk that occurred after a local trauma. The diagnosis was based on clinical examination and angio-MRI. The treatment was hybrid. After an embolization of the arterial trunk we performed a surgical flattering of the pseudoaneurysm and suture of maxillary and temporal orifices.

Iliac arteriovenous fistula following lumbar disc surgery. A case report.

Iliac arteriovenous (AV) fistula after lumbar disc surgery are uncommon entities with limited reported cases. This report describes a 44-year-old man with history of L4-L5 spinal discectomy who complained of congestive heart failure symptoms four years later. Computed tomography angiography (CTA) revealed an AV fistula connecting the right common iliac artery and vein. AV closure with lateral suturing of common iliac artery and vein was performed through transperitoneal aorto-iliac approach. Postoperatively, the patient's symptoms of orthopnea resolved. Follow-up at six years was uneventful.

Concomitant common iliac and common femoral artery pseudoaneurysms revealing Behcet's disease.

Vascular involvement is one of the major causes of mortality and morbidity in Behçet's disease (BD). Vasculo-Behçet patients are at risk for multiple vessel-related complications including thromboses, stenoses, occlusions, and aneurysms. In this report, we describe the case of a young woman admitted in our department for management of a concomitant common iliac and common femoral artery pseudoaneurysms revealing Behçet's disease.

Primary and secondary aorto-digestive fistulas in Behçet's disease: A case report and review of the literature.

Behçet's disease (BD) is a multisystem chronic autoimmune inflammatory disorder that involves multiple organs. Arterial involvements in BD are rare. One of severe manifestation is the aortic aneurysm which can lead to a rupture. Aorto-duodenal fistulas (ADFs) are the most frequent aorto-digestive fistulas. In this article we will describe and discuss primary and secondary ADFs which occurred in a same patient.

Intracardiac Thrombosis and Multiple Arterial Thromboembolism with Acute Limb Ischemia: A Rare Complication of Carbon Monoxide Intoxication.

Carbon monoxide (CO) poisoning is a very common reason for emergency ward admission, with symptoms varying from a simple headache and dizziness to severe neurological and cardiac impairment. We report here a rare clinical presentation of CO intoxication manifested by a severe cardiac impairment with intracardiac thrombus formation, acute limb ischemia, renal infarction, and carotid artery thrombosis. There have been initial reports of thromboembolic events in acute CO poisoning with intracardiac thrombosis being sparsely reported. Contrary to venous thromboembolism, arterial thromboembolism in CO poisoning seems to be extremely rare. To the best of our knowledge, this is the first report in recent literature of a combined intracardiac thrombosis and multiple arterial thromboembolism induced by CO poisoning.

Urinary retention revealing a large common iliac artery aneurysm.

Isolated aneurysms of the common iliac artery are rare, affecting less than 0.01% of the general adult population. Most of these aneurysms are asymptomatic and are discovered as an incidental finding. We describe an elderly patient presented with a urinary retention, which the investigations had led to the diagnosis of a large left common iliac artery aneurysm.

Open surgical repair of abdominal aortic aneurysms in Behçet's disease.

BACKGROUND: Behçet's disease (BD) is a multisystem chronic autoimmune inflammatory disorder that involves multiple organs. Arterial involvement in BD is rare. Aortic involvement is one of the most severe manifestations and is associated with a much higher mortality. In this article, we will present our experience in open surgical repair of abdominal aortic aneurysm combined with immunosuppressive therapy. METHODS: Between January 2010 and December 2017, 7 patients were treated for abdominal aortic aneurysms (5 infra-renal and 2 supra-renal, in 1 woman and 6 men). All patients were Moroccan, the age range being 25-59 years, mean age 43.2 years. Three Dacron tube grafts, two Dacron aortobiiliac grafts and two patch closures were used. All 7 patients received immunosuppresive therapy after surgery. RESULTS: All patients underwent successful open surgical repair without major complications during the 30 days immediately after the procedure. During a mean follow-up of 36 months, there was no recurrent aneurysmal localization, but one patient had lost their sight. Until now, we have been following 6 patients and they continue to receive immunosuppressive therapy. CONCLUSION: Long-term immunosuppressive therapy after aneurysm repair is important to limit pseudoaneurysm recurrence. Through our serie, we describe the results of the combination of surgical treatment and adjunctive immunosuppressive therapy, with a literature review.

[Post-traumatic concomitant popliteal artery pseudoaneurysm and arteriovenous fistula]. / Fistule artérioveineuse poplitée post-traumatique associée à un faux anévrysme.

Popliteal injuries are well known to be serious with a high rate of mortality due to damage caused to popliteal vessels. Pseudoaneurysm formation and arteriovenous fistulas are well-known complications of arterial injury, but are rarely concomitant. Diagnosis is usually done by computed tomography (CT) angiography. Treatment strategies consist of surgery or endovascular management. We report the surgical treatment of two cases of popliteal arteriovenous fistula associated with pseudoaneurysm complicating stab wounds.

[Intracardiac myxoma complicated by acute aortic occlusion (case report)]. / Myxome de l'oreillette gauche compliqué par une occlusion aortique aiguë (À propos d'un cas).

We report the case for a 44-year-old patient without medical history, admitted in our department for bilateral acute limb ischemia (H6). The patient was hemodynamically stable and the physical examination shows limb sever ischemia (no femoral arterial pulses, coldness, cyanosis and paralysis). Abdominal CT angiography showed a complete occlusion of the infra renal abdominal aorta compatible with embolus. An embolectomy with Fogarty catheters was performed. Echocardiography showed a mass in the left atrium. Pathological examination of the material embolic confirmed the diagnosis of the cardiac myxoma. The clinical course was marked by the development of a sever syndrome of revascularization, death occurred the third day of hospitalization. Cardiac myxomas are the most common primary cardiac tumor. The mobility of the tumor and its gelatinous and crumbly consistency generates peripheral emboli.

Axillary artery injury from a closed humeral neck fracture: A case report.

Axillary artery injury from humeral neck fracture is an uncommon event. Vascular damage due to these injuries may threaten limb loss. In some cases, the signs of ischemia may not be evident just after the injury and may only appear later on. Therefore, a high index of suspicion is essential. It is important to bear this association in mind, so as to make an early diagnosis and avoid serious complications. We are describing the case of a young patient involved in a motor vehicle crash with an axillary artery trauma due to the surgical neck of humerus fracture. The patient underwent a basilic vein grafting, the postoperative course was good.

Embolic lower limb ischemia as a rare complication of ulcerative colitis: A case report and literature review.

Thromboembolic events in chronic inflammatory bowel diseases are rare and predominated by venous damage. Arterial thromboembolic events are extremely uncommon. We are reporting the case of a 50-year-old male patient with an 8-year history of ulcerative colitis, who presented a recurring severe lower limb ischemia during hospital stay for exacerbation of his inflammatory bowel disease. During the first visit, the patient underwent a balloon thromboembolectomy via femoral approach, with fasciotomy of the leg. Because of recurrence of symptoms, he underwent a second and a third thromboembolectomy by a popliteal approach, with an uneventful postoperative course and was discharged home 10 days later, on warfarin therapy and oral corticosteroids. After an extensive literature review using PubMed, we found 20 reported cases in the English literature over the past 25 years; not including this present case. In the absence of major cardiovascular risk factors, inherited thrombophilia and intracardiac thrombi, we consider active ulcerative colitis to be the major trigger of the embolic lower limb ischemia in our patient. By means of this report, we seek to create awareness of the increased risk of arterial thromboembolism in inflammatory bowel diseases patients.

[Infectious aortitis caused by Streptococcus pneumoniae]. / Aortite infectieuse à Streptococcus pneumoniae.

Infectious aortitis is a rare clinical entity that most often manifests itself by an aortic aneurysm. The syphilitic or tubercular forms can be subacute. When it is caused by Salmonella sp., Staphylococcus sp. or Streptococcus pneumoniae, the aortitis is acute with alarming symptoms. Germs found in most cases are Salmonella and Staphylococcus aureus. S. pneumoniae rarely causes infectious aortitis. We report the case of a 75-year-old patient seen in an emergency setting for sudden-onset abdominal pain with fever. An abdominal angio-computed tomography (CT) scan showed a sacciform infrarenal abdominal aortic aneurysm, with an inflammatory aspect and periaortic hematoma. Surgical cure was undertaken because of the impending rupture. An interposition aortic replacement graft was implanted. Blood cultures and bacteriological study of the aortic wall isolated a S. pneumoniae. The anatomical pathology study reported fibrin clot leukocyte remodeling of the aortic wall. An intravenous antibiotic regimen was started. Several organisms, including Streptococcus, can cause infectious aortitis. We found 36 cases described in the literature in addition to our patient.

A ruptured superficial femoral artery aneurysm: A case report.

True atherosclerotic aneurysms of superficial femoral artery (SFA) are rare and often associated with other peripheral or aortic aneurysms. We are reporting the case of a 78-year-old man who has been admitted with a ruptured superficial femoral artery aneurysm associated with bilateral popliteal artery aneurysm. The patient underwent successful aneurysm resection and bypass grafting.

False aneurysm of perforating branch of the deep femoral artery-Report of two cases.

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.

[An abdominal aortic aneurysm revealing Behçet's disease]. / Un anévrysme de l'aorte abdominale révélant une maladie de Behçet.

Behçet's disease is a vasculitis of unknown origin. Vascular lesions predominantly affect veins. Arterial involvement is rare but usually associated with poor prognosis. Aortic syndromes are usually aneurysmal and occasionally reveal Behçet's disease. We report the case of a 46-year-old man whose Behçet's disease was revealed by a sub-renal abdominal aortic aneurysm in pre-rupture state. The diagnosis of this disease was retained based on clinical, biological and radiological criteria. The surgical procedure consisted in the resection of the aneurysmal sac and the interposition of a prosthetic PTFE tube.