ABSTRACT
Fungal endocarditis becomes complicated by peripheral arterial embolization of the lower limbs in 33%-75% of cases. Although the prognosis of patients with fungal endocarditis has improved somewhat over recent years, it remains poor, especially when the disease is associated with peripheral arterial embolization. We report herein our experience of treating a patient in whom occlusion of the right common iliac artery developed secondary to endocarditis caused by Candida parapsilosis, and review the literature on this subject.
Subject(s)
Arterial Occlusive Diseases/etiology , Candidiasis , Endocarditis/complications , Endocarditis/microbiology , Iliac Artery , Adult , Arterial Occlusive Diseases/pathology , Candida/pathogenicity , Embolization, Therapeutic , Endocarditis/therapy , Female , HumansABSTRACT
Aneurysms of the celiac trunk are the rarest forms of aneurysms of the visceral arteries. Since 1958, when Schumaker reported the first case to be successfully treated surgically, only 69 cases have been reported in the international literature. The detection of such aneurysms, which are often asymptomatic, is mostly occasional. Approximately 15-20% of cases may be complicated by rupture with a mortality rate of around 80%. This eventuality makes surgical treatment mandatory even in asymptomatic cases. The authors report on their experience with the surgical treatment of one case of aneurysm of the celiac trunk and then go on to review the relevant literature.
Subject(s)
Aneurysm/diagnostic imaging , Celiac Artery/diagnostic imaging , Ultrasonography, Doppler, Color , Anastomosis, Surgical , Aneurysm/pathology , Aneurysm/surgery , Angiography, Digital Subtraction , Arteriosclerosis/diagnostic imaging , Arteriosclerosis/pathology , Arteriosclerosis/surgery , Celiac Artery/pathology , Celiac Artery/surgery , Humans , Male , Middle Aged , Sensitivity and Specificity , Tomography, X-Ray ComputedABSTRACT
The management of simultaneously occurring abdominal aortic aneurysm and malignancy is controversial. It is unclear whether to treat the aneurysm first or the malignancy, or both simultaneously. If the malignancy is resected first there is a risk of postoperative rupture of the aneurysm. If simultaneous surgery is performed there is a risk of prosthetic graft infection. This condition leads to many therapeutic problems which, by the light of 18 personal cases occurred in almost ten years and the recent literature, are discussed in this paper.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Colorectal Neoplasms/surgery , Kidney Neoplasms/surgery , Stomach Neoplasms/surgery , Thoracic Neoplasms/surgery , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Reoperation , Time FactorsABSTRACT
PURPOSE: To analyze perspectively a set of 13 patients affected by femoral artery pseudoaneurysm treated with Us-guided compression. MATERIAL AND METHODS: From January to December 1997 we observed 13 patients (7 females and 6 males; mean age: 67.4 years old) affected by femoral artery pseudoaneurysm which were treated with Us-guided compression. The compression was repeated for 15 minutes up to complete closure of the pseudoaneurysm. Every patient was followed up 24 hours after the procedure, before the discharge and every 3 months. RESULTS: In 6 cases the cardiologic procedure had diagnostic purposes while in 7 cases had interventional purposes. The pseudoaneurysm was located in the common femoral artery in 10 cases, in the superficial femoral artery in 2 cases and in the profunda femoris in the last case. The fistula between the aneurysmatic chamber and the arterial lumen had a mean length of 1 centimeter (range: 0.5-2.5 cm) and the mean diameter of the pseudoaneurysm was 3 centimeters (range: 1.5-6 cm). The mean length of the compression was 34 minutes (range: 10-120 min). The technical success rate was 92.3% with one case of failure in the unique localization in the profunda femoris. The procedure was well tolerated from the patients, with minimal discomfort. After the treatment the mean hospital stay was 2 days and to date we have had no recurrences after a mean follow-up of 18 months. CONCLUSIONS: In accordance with the data of the literature, Us-guided compression is the treatment of choice of femoral pseudoaneurysms after cardiac catheterization. The procedure is well tolerated in almost all the patients and it deters the need of surgery with reduction of complications, costs and hospital stay.
