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Chronic Limb-Threatening Ischaemia (CLTI)
Published in James Michael Forsyth, How to Be a Safe Consultant Vascular Surgeon from Day One, 2023
Can you please interpret this CT angiogram?“This CT angiogram reveals severe bilateral common femoral artery disease, and severe external iliac artery disease bilaterally. The common iliac arteries are slightly diseased, but the infra-renal aorta appears disease free. Both the internal iliac arteries appear occluded. The superficial femoral arteries are patent and there is three-vessel run off below the knee.”
Complications of open repair of juxtarenal aortic aneurysm
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
The juxtarenal aorta can be approached from a trans-peritoneal or retroperitoneal incision (Figure 21.2). The benefits of the trans-peritoneal approach include easy access to iliac artery aneurysms, a universal familiarity among surgeons, and shorter times to achieving proximal control of the aorta. However, it is less ideal for patients who have had previous abdominal surgery, have a horseshoe kidney or known inflammatory aneurysm. In addition, the presence of the upper abdominal organs can limit access to the superior visceral segment of the aorta. A left retroperitoneal incision provides easy access to even the supra-celiac aorta and is preferred for patients who are obese, have had prior surgery, or require a high clamp site. However, access to the right renal and common iliac arteries can be challenging with this approach, and these patients are better approached from the front. A recent comparison of the two approaches to open AAA repair in the National Surgical Quality Improvement Program (NSQIP) found no difference in 30-day outcomes on multivariable analysis.11
Heart disease
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
There may be symptoms or signs from territory supplied by the coronary, carotid, subclavian, spinal or common iliac arteries or aortic regurgitation. Most cases in pregnancy are type A dissections involving the ascending aorta.
Flow analysis of aortic dissection: comparison of inflow boundary conditions for computational models based on 4D PCMRI and Doppler ultrasound
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Zhenfeng Li, Shichao Liang, Huanming Xu, Minjia Zhu, Yuqian Mei, Jiang Xiong, Duanduan Chen
The current study focused on investigating the influence of the IBCs on the downstream flow system of AD. All the outlets of the models were thus unified. Velocity information of the three aortic arch branches was extracted from 4D PCMRI of the patient case, as shown in Figure 2b. Approximately 12.7% of the inlet flow volume was diverted to brachiocephalic trunk, while 3.2% and 3.1% of the inflow were diverted to the left common carotid artery and left subclavian artery respectively. Generally, they presented the parabolic velocity profile and the time-variant flow waveforms could be captured by the 4D PCMRI. Detailed information regarding the personalized flow division was displayed in S4, Supporting Document. Apart from the aortic arch branches, the outlets of the celiac artery, superior mesenteric artery, renal arteries and the common iliac arteries were assigned as the pressure outlets. So far, non-invasive pressure measurements of these sites were not available. A few computational studies applied the pressure data that were published previously(Tse et al. 2011; Naim et al. 2016). Here we applied the pulsatile pressure waveforms that were also used in our previous study (Vignon-Clementel et al. 2006). Its rationality was discussed in S5, Supporting Document.
A fatal and unusual iatrogenic fourth right lumbar artery injury complicating wrong-level hemilaminectomy: a case report and literature review
Published in British Journal of Neurosurgery, 2019
Francesco Ventura, Rosario Barranco, Carlo Bernabei, Lara Castelletti, Lucio Castellan
Vascular damage is most commonly related to L4-L5 and L5-S1 level laminectomy.12–14 Within these levels, the inferior vena cava is interposed between the disc and the right or common iliac arteries.12 The left common iliac artery is susceptible to injury due to its medial course and intimate relationship with the L4-L5 intervertebral disc. The aorta and inferior vena cava are subject to surgical injury at the level comprised within the second and fourth lumbar vertebrae, whereas the distal segments of the iliac vessels are exposed to any injury at the level of the fourth lumbar vertebra.15 Finally, the internal iliac veins, lumbar arteries, inferior mesenteric artery, median sacral artery and the superior rectal artery are other vessels that may also be injured during lumbar disc surgery.5,16
Large-vessel giant cell arteritis after COVID-19 vaccine
Published in Scandinavian Journal of Rheumatology, 2022
A Mejren, CM Sørensen, LC Gormsen, RS Tougaard, BD Nielsen
After 7 weeks of illness, she consulted her general practitioner. The initial evaluation revealed a C-reactive protein (CRP) of 98 mg/L, normal leucocytes, and slightly increased immunoglobulin A and G. No focus of infection was found. Computed tomography (CT) of the thorax, abdomen, and pelvis showed no signs of malignancy. However, the scan revealed wall thickening throughout the aorta, common iliac arteries bilaterally, left subclavian artery, and proximal brachiocephalic artery, raising the suspicion of arteritis/aortitis. In addition, the CT scan showed signs of pericardial effusion as well as fatty liver. Echocardiography showed a minimal, haemodynamically irrelevant pericardial effusion of 0.8−1.3 cm and an otherwise normal heart. Electrocardiography was normal.