ABSTRACT
BACKGROUND/AIM: To investigate the differences in perioperative oxidative stress (OS) in abdominal aortic aneurysm (AAA) patients treated with either endovascular repair (EVAR) or open repair (OR). MATERIALS AND METHODS: Twenty patients (11 OR, 9 EVAR) treated for AAA with no known malignant or inflammatory disease and an aneurysm diameter of over 5 cm and no rupture were included in the study. Blood samples were obtained preoperatively, during aortic occlusion, and 1 h and 24 h after reperfusion. Total antioxidant status (TAS), total oxidative stress (TOS), and malondialdehyde (MDA) levels were measured and oxidative stress index (OSI) was calculated. RESULTS: OSI at 1 h and 24 h after reperfusion was higher in the EVAR group (P = 0.004 and P = 0.002, respectively). TAS levels were higher (P = 0.001, P = 0,029). MDA levels showed no difference (P = 0.291, P = 0.076). TOS levels were lower 24 h after reperfusion in the EVAR group (P = 0.018). CONCLUSION: Markers of oxidative stress were lower in the EVAR group. This may be associated with advantages of EVAR. More studies are required for a clear-cut conclusion.
Subject(s)
Aortic Aneurysm, Abdominal/epidemiology , Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis Implantation/methods , Endovascular Procedures/methods , Oxidative Stress , Adolescent , Aged , Aged, 80 and over , Antioxidants/analysis , Aortic Aneurysm, Abdominal/blood , Aortic Aneurysm, Abdominal/physiopathology , Cohort Studies , Female , Humans , Male , Malondialdehyde/blood , Middle Aged , Perioperative Period , Treatment OutcomeSubject(s)
Anticoagulants/adverse effects , Enoxaparin/adverse effects , Hematoma/chemically induced , Anticoagulants/therapeutic use , Drainage , Enoxaparin/therapeutic use , Hematoma/therapy , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Male , Treatment Outcome , Venous Thrombosis/drug therapySubject(s)
Pneumopericardium/diagnosis , Pneumothorax/diagnosis , Accidents, Traffic , Adult , Diagnosis, Differential , Dyspnea/etiology , Humans , Injury Severity Score , Male , Pneumopericardium/complications , Pneumopericardium/diagnostic imaging , Pneumopericardium/pathology , Pneumopericardium/therapy , Pneumothorax/complications , Pneumothorax/diagnostic imaging , Pneumothorax/surgery , Pneumothorax/therapy , Subcutaneous Emphysema/etiology , Thoracic Injuries/complications , Thoracic Injuries/diagnosis , Thoracic Injuries/diagnostic imaging , Thoracic Injuries/pathology , Thoracic Injuries/therapy , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: There is a well-recognized association between chronic back pain and the existence of an AAA. In literature, there are few reported AAA cases that describe patients with extensive pressure erosion of the vertebral body. CASE DESCRIPTION: The authors present the case of a 38-year-old woman with chronic low back pain for the last 2 years in whom an AAA was formed during the follow-up period. The patient presented with an episode of low back pain following hard work 2 years ago. MR imaging of the lumbar spine was reported as disc degeneration at the L4-5 and L5-S1 levels. She was given medical treatment and was doing well with occasional back pain for a year. One year later, she suffered another disabling pain attack, and MR imaging revealed an additional focal disc protrusion at the L4-5 level. She was again medically treated. In August 2004, she presented with severe low back pain, and this time, MR imaging showed edema and erosion at the anterior part of L3 vertebra body. MR imaging studies (2- and 3-dimensional) depicted AAA as the cause. She was operated on, and the aneurysm was resected with graft repair of the site. She was pain-free in the postoperative period. CONCLUSIONS: The evaluation of a patient with chronic back pain needs a thorough clinical and radiological workup. Limited evaluation of the bony and nervous structures of the spinal canal radiologically is insufficient. Pre- and paravertebral structures as well as vertebral body should carefully be evaluated to diagnose other causes of pain.
Subject(s)
Aorta, Abdominal/pathology , Aortic Aneurysm, Abdominal/complications , Aortic Aneurysm, Abdominal/diagnosis , Low Back Pain/diagnosis , Low Back Pain/etiology , Lumbar Vertebrae/pathology , Adult , Aorta, Abdominal/physiopathology , Aorta, Abdominal/surgery , Aortic Aneurysm, Abdominal/surgery , Atherosclerosis/pathology , Atherosclerosis/physiopathology , Chronic Disease/therapy , Diagnosis, Differential , Female , Humans , Intervertebral Disc Displacement/complications , Intervertebral Disc Displacement/diagnosis , Intervertebral Disc Displacement/physiopathology , Low Back Pain/physiopathology , Lumbar Vertebrae/physiopathology , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Pain, Intractable/diagnosis , Pain, Intractable/etiology , Pain, Intractable/physiopathology , Treatment Outcome , Vascular Surgical ProceduresABSTRACT
BACKGROUND AND AIM: There are few reports about injury to forearm nerves and its potential mechanisms during radial artery (RA) harvesting. We studied electrophysiologic changes in these nerves not sought until now. METHODS: Among 152 consecutive patients who underwent coronary artery bypass surgery between February 2002 and August 2002, 20 were randomized for RA harvesting and formed the study group and 20 were randomized as control group. Neurologic examination and electrophysiologic studies were performed for sensory and motor impairment of the nerves in both groups pre- and postoperatively. RESULTS: There was no change on neurologic examinations before and after surgery. Electromyography (EMG) revealed significant reduction in sensory and motor conduction amplitudes of median, ulnar, and radial nerves and motor conduction velocities of median and ulnar nerves at the level of forearm in the study group. In the control group, ulnar nerve was mostly affected. When two groups are compared, sensory and motor amplitude drops of median and radial nerves and motor velocity impairment of median nerve in the study group are significant. Ulnar nerve impairments are identical in both groups. CONCLUSIONS: Handling of tissues, minor hematoma or edema along with chest retraction best explains these impairments. Patients were asymptomatic after surgery showing that EMG is highly sensitive and is not predictive of clinical impairment.
Subject(s)
Coronary Artery Bypass/methods , Forearm/innervation , Median Nerve/injuries , Radial Artery/transplantation , Radial Nerve/injuries , Tissue and Organ Harvesting/adverse effects , Ulnar Nerve/injuries , Action Potentials/physiology , Aged , Coronary Disease/surgery , Electromyography , Female , Humans , Male , Median Nerve/physiopathology , Neural Conduction/physiology , Radial Nerve/physiopathology , Sensory Thresholds/physiology , Ulnar Nerve/physiopathologyABSTRACT
A 33-year-old man with a 9-year history of Behçet's disease was hospitalized with a giant pseudo aneurysm of left anterior descending and true aneurysm of right coronary artery. This unusual vascular complication of Behçet's disease treated successfully is presented.
