Annals of vascular surgery
-
Case Reports
Repetitive contained rupture of an infected abdominal aortic aneurysm with concomitant vertebral erosion.
We describe a rare case of surgical treatment for a repeated contained rupture of an infected abdominal aortic aneurysm (AAA) with concomitant vertebral erosion. A 59-year-old man presented to a nearby hospital with abdominal pain and fever. On admission, computed tomography (CT) scan revealed a contained rupture of AAA, but the patient declined the offer of surgical therapy. ⋯ Repetitive contained AAA rupture may be another entity in contrast to chronic contained AAA rupture. Vertebral erosion could be associated with infection rather than mass effects of the contained hematoma. Surgical treatment is indicated to prevent life-threatening re-rupture and severe spinal instability.
-
A 78-year-old woman was admitted to our hospital with intermittent hemoptysis. She had undergone descending aortic replacement through a left thoracotomy 7 years previously. Enhanced computed tomography revealed a pseudoaneurysm at the proximal suture line in the descending aorta and an ascending aortic aneurysm. ⋯ Selective antegrade cerebral perfusion and moderate hypothermia were used during these procedures. The postoperative course was favorable. Open stent-graft placement is a good alternative for treating aortobronchial fistula caused by suture line pseudoaneurysm in the descending aorta.
-
We describe a rare case of an arteriosclerotic aneurysm in the right-sided descending thoracic aorta with a left-sided aortic arch and concomitant aberrant right subclavian artery. A 76-year-old woman, who was found to have an aneurysm of the right-sided descending thoracic aorta, was referred to our hospital for surgical treatment. Contrast computed tomography scan revealed a left-sided aortic arch with an aberrant right subclavian artery, a descending thoracic aorta passing downward behind the esophagus, and an aneurysm of the right-sided and distal (level between the 8th and 10th vertebral bodies) descending thoracic aorta. ⋯ The patient had an uneventful postoperative course and was discharged 24 days after surgery. Histological microscopic examination of the resected aneurysmal wall revealed an arteriosclerotic aneurysm. The postoperative computed tomography scan 18 days after surgery revealed no anastomotic aneurysm or abnormal fluid collection.
-
The purpose of this study was to evaluate the effectiveness of a standardized preoperative cardiac assessment in reducing the rate of perioperative cardiac complications in patients undergoing aortic surgery, paying particular attention to the analysis of the factors affecting perioperative cardiac outcomes. ⋯ In our experience, the use of a routine preoperative cardiac assessment allowed us to obtain satisfactory perioperative results in patients undergoing abdominal aortic surgery. Very few patients, however, require cardiac revascularization before abdominal aortic surgery. Patients with positive stress test may benefit from an endovascular treatment if anatomically feasible.
-
Spinal cord injury is a major complication of thoracoabdominal aortic operations. We aimed to investigate neuroprotective role of olmesartan administered to rats before ischemia against ischemia-reperfusion (I-R) injury. ⋯ Olmesartan may protect the spinal cord from I-R injury and reduce the incidence of associated neurological dysfunction after temporary aortic occlusion.