ABSTRACT
INTRODUCTION: False traumatic aneurysm (FTA) or pseudoaneurysm and traumatic arteriovenous fistulas (TAVF) are rare pathologies in civilian trauma and mainly result from stabs or gunshot wounds. The posterior tibial artery as site of trauma is very rare. PRESENTATION OF CASE: We report on a 39-year old female patient who was suffering from combined FTA and TAVF of the posterior tibial artery after falling into a wine glass. CT-imaging as well as duplex ultrasound and selective arteriography were performed, and two stent-grafts were inserted. DISCUSSION: Based on the presented case, incidence of the described pathology, treatment options and outcomes are discussed. CONCLUSION: Adequate imaging in penetrating wounds to the extremities is crucial in order to provide diagnosis and treatment of concomitant lesions.
ABSTRACT
BACKGROUND: Heartbeat-related pressure oscillations appear at the airway opening. We investigated whether these cardiogenic oscillations (COS) - extracted from spontaneous breathing signals - reflect the compliance of the respiratory system. METHODS: Fifteen volunteers breathed spontaneously at normal or reduced chest wall compliance, i.e. with and without thorax strapping, and at normal or reduced lung compliance, induced by positive end-expiratory pressure (PEEP). COS-related signals were extracted by averaging the flow and pressure curve sections, temporally aligned to the electrocardiogram signal. RESULTS: COS-related airway pressure and flow curves correlated closely for each subject (r(2) =0.97 ± 0.02, P<0.0001). At the unstrapped thorax, the oscillation's amplitudes were 0.07 ± 0.03 cm H(2) O (pressure) and 22 ± 10 ml/s (flow). COS-related pressure amplitudes correlated closely with the ratio of tidal volume divided by pressure amplitude (r(2) =0.88, P<0.001) and furthermore increased with either thorax strapping (P<0.001) or with increasing PEEP (P=0.049). CONCLUSION: We conclude that COS extracted from the pressure and flow signal reflect the compliance of the respiratory system and could potentially allow estimating respiratory system mechanics during spontaneous breathing.
