ABSTRACT
Melorheostosis is a rare chronic disease commonly affecting long bones of the lower extremity with the typical imaging feature of hyperostosis "candle wax pattern." Typically associated with pain, deformities, stiffness, and joint movement restriction (due to contracture and fibrosis), it may also be asymptomatic. Melorheostosis is considered a benign disease but can be extremely debilitating, especially in a pediatric context where progression can be faster than in adults. An even rarer occurrence seems to be its association with nerve impingement. In this paper, we present the case of an 8-year-old girl with a known condition of melorheostosis of the upper limbs who developed bilateral carpal syndrome. To our knowledge, very few cases of the sort have been described, and even less in a pediatric context.
ABSTRACT
Embolization has tremendously evolved in recent years and has expanded to treatment of a variety of pathologic processes. There has been emerging evidence that the level of arterial occlusion and the distribution of embolic particles may play an important role in the clinical outcome. This is a comprehensive literature review to identify variables that play important role in determination of level of occlusion of blood vessels and distribution of embolic particles. The literature searches between 1996 to 2020 through PubMed and Ovid-MEDLINE yielded over 1030 articles of which 30 studies providing details on the level of occlusion are reviewed here. We divided the playing factors into characteristics of the particles, solution/injection and vascular bed. Accordingly, particle size, type and aggregation, compressibility/deformability, and biodegradability are categorized as the factors involving particles' behavioral nature. Infusion rate and concentration/dilution of the medium are related to the carrying solution. Hemodynamics and the arterial resistance are characteristics of the vascular bed that also play an important role in the distribution of embolic particles. Understanding and predicting the level of embolization is a complex multi-factor problem that requires more evidence, warranting further randomized controlled trials, and powered human and animal studies.
Subject(s)
Embolization, Therapeutic , Animals , Arteries , Particle SizeABSTRACT
Common femoral artery pseudoaneurysm is a known complication of percutaneous vascular access. Treatment options include surgical repair of the pseudoaneurysm or endovascular methods such as ultrasound-guided compression and direct thrombin injection into the pseudoaneurysm sac. Treatment of pseudoaneurysm is more challenging when a patient is undergoing concurrent catheter-directed or systemic thrombolytic therapy. This is a case report of endovascular treatment of an iatrogenic pseudoaneurysm of common femoral artery in a patient receiving concurrent catheter-directed thrombolytic therapy. This was performed successfully by precise deployment of a MicroVascular Plug into the pseudoaneurysm neck with immediate closure of pseudoaneurysm. Midterm follow-up confirmed sustained exclusion of the pseudoaneurysm sac with continued patency of the treated femoral artery.
