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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

False aneurysm formation in a twenty-nine year old black woman treated for renovascular hypertension secondary to fibromuscular hyperplasia by knitted Dacron prosthetic patch angioplasty is reported. Etiologic mechanisms are discussed. The most likely factors leading to false aneurysm formation in this patient are disproportionate compliance between the arterial wall and the prosthesis and increased rigidity of the prosthesis, associated with increased shearing and vibratory stress. This patient was treated successfully by resection of the prosthetic path and involved artery with end-to-end reanastomosis of the artery.
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PMID:Renal artery false aneurysm. An unusual complication of prosthetic patch angioplasty. 13 10

False aneurysm formation is a well-recognized late complication of prosthetic graft insertion. Despite the fact that other etiologic factors may be involved, the behavior of the suture material remains of central importance. In a retrospective review of 1,330 peripheral vascular cases, we found 26 cases involving a total of 39 false aneurysms, or an incidence of 2% (26/1,330). Twenty-four of these were directly attributable to failure of the monofilament plastic suture or silk suture material. Braided Dacron suture was used in the original anastomosis in another seven cases, and in these instances the false aneurysms were not related to suture failure but were association with such factors as previous endarterectomy, failure of arterial wall, and chronic hypertension. None of the 39 aneurysms was secondary to infection or trauma. These results emphasize the importance of using a braided, nonabsorbable suture material to ensure the continued integrity of an anastomosis involving prosthetic grafts.
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PMID:Suture material as a factor in the occurrence of anastomotic false aneurysms. An analysis of 26 cases. 15 40

Two cases are presented illustrating the emergent and potentially lethal complications of neonatal umbilical artery catheterization that may confront the pediatric urologist. Immediate aortography via the umbilical artery catheter usually will be diagnostic. Prompt surgical intervention is advocated if uncontrollable renovascular hypertension or a false aneurysm is found.
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PMID:Urologic complications of neonatal umbilical arterial catheterization. 71 6

In a 2 year prospective study of the fate of arterio-venous haemodialysis fistulae, the influence of several clinical and non-invasive measured variables in 90 patients on maintenance haemodialysis was evaluated. A total of 58 Brescia/Cimino fistulae, 30 graft fistulae and two elbow fistulae were investigated by means of Duplex ultrasound scanning. Sixty-two out of these 90 patients had no problems with their AV fistulae, 28 developed 29 complications, including poor flow (six), thrombosis (seven), venous hypertension (eight), false aneurysm formation (four), distal ischaemia (two) and puncture problems (two). Univariate statistical analysis was performed on a number of clinical variables including diabetes, previous access surgery, type of fistula, duration of functioning fistula, congestive heart failure, peripheral arterial disease, age and sex. Results indicated that the type of fistula, previous access surgery, congestive heart failure and sex were significantly correlated to the development of poor flow and thrombosis (flow-related complications). Measurement of the maximal systolic frequency, end-diastolic frequency and the frequency ratio in the brachial artery Doppler spectrum, was of prognostic value in discriminating between non-complicated fistulae and those which developed flow-related complications. The total number of fistula stenoses (greater than 50% diameter reduction), detected by the Duplex scan, also correlated with the rate of thrombosis and poor flow. The presence of peripheral arterial disease and the number of stenoses in the efferent veins were of predictive value for the development of venous hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The correlation between clinical and duplex ultrasound parameters and the development of complications in arterio-venous fistulae for haemodialysis. 219 Aug 48

Renal artery branch injury resulting from stab wounds of iatrogenic origin or street violence is an important cause of renal hemorrhage. Over a period of 10 years we accurately diagnosed the injury and successfully managed the associated hemorrhage in 15 patients by using angiography and percutaneous embolization techniques. Nine branch injuries in eight patients were due to street knifings and seven injuries were complications of invasive medical procedures (four from renal biopsy, two from nephrostolithotomy, and one from nephrostomy). All patients had gross hematuria at the time of angiographic evaluation. False aneurysms were present in six patients (one with associated frank extravasation), false aneurysm/arteriovenous fistula in three, false aneurysm/arteriocaliceal fistula in one, and isolated arteriovenous fistula in two. Frank extravasation without associated false aneurysm/arteriovenous fistula was present in two. One patient had two injuries, an upper-pole false aneurysm and a lower-pole false aneurysm/arteriovenous fistula. In the eight patients injured in street knifings, hematuria recurred after surgical exploration and treatment. None of the 16 injuries involved the main renal artery. Gelfoam was used for embolization of nine lesions and steel coils for four. Three others were treated with Gelfoam plus coils. Hemostasis was achieved in all and none required subsequent surgery. Renal tissue loss was small to moderate (less than 30%) in 12 patients and large (30-50%) in three patients. Transient postembolization hypertension occurred in one of the latter. We consider selective angiography/embolization to be an effective and safe means for diagnosing and treating wounds of the renal artery branches.
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PMID:Stab wounds of the renal artery branches: angiographic diagnosis and treatment by embolization. 271 60

Several aspects of false aneurysm development after prosthetic resconstruction for aortoiliac obstructive disease were studied. For this purpose the long-term results (up to 20 years of follow-up) of 518 patients with implanted arterial prostheses in the aortoiliofemoral tract were retrospectively evaluated. Completeness of follow-up data was 83.2% 15 years after operation. A total of 101 false aneurysms (21 aortic, 53 iliac, and 27 femoral) were detected in 69 patients and verified by operation. The incidence per patient was 69 of 518 patients (13.3%). The incidences per anastomosis were: aortic, 21 of 438 anastomoses (4.8%); iliac, 53 of 835 anastomoses (6.3%); and femoral, 27 of 198 anastomoses (13.6%). Almost one half (47.5%) of all the false aneurysms were asymptomatic and were detected by angiography or ultrasonography. Chances for late survivors to develop a false aneurysm during follow-up were calculated by the life-table method. The chance to be free of a false aneurysm at any site was 77.2% 15 years after operation. These chances were 92.3%, 84.5%, and 76.2% for aortic, iliac, and femoral anastomoses, respectively. Analyses of subgroups showed that the development of a false aneurysm was significantly correlated with the presence of hypertension, multilevel disease, the type of suture material, and the type of anastomosis. These results indicate unexpectedly high chances for the development of false aneurysms in long-term survivors after aortoiliac or aortofemoral prosthetic reconstructions. We advocate the use of a life-long follow-up schedule with periodic angiography and ultrasonography for these patients.
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PMID:False aneurysms after prosthetic reconstructions for aortoiliac obstructive disease. 281 34

Fifty-six revascularizations of the renal arteries were performed in 52 patients with renovascular hypertension with the use of polytetrafluorethylene grafts between June 1979 and October 1984, with an average follow-up of 25.0 +/- 7.7 months. Ninety-two percent of the patients were considered to have good results (30% cured and 62% improved). Four patients were classified as unsuccessfully treated; one died postoperatively of myocardial infarction. All patients underwent late angiographic studies, with only one graft thrombosis being identified. No evidence of anastomotic stenosis, graft dilatation, or false aneurysm occurred during the follow-up period. From this experience, we believe polytetrafluoroethylene grafts are a valuable alternative to other graft materials for renal artery bypass and may be the preferred graft in the management of atheromatous lesions.
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PMID:Use of polytetrafluoroethylene grafts for renal bypass. 357 12

Percutaneous high brachial aortography with a small diameter catheter (5 gauge) was used as an alternative to the translumbar approach in 45 patients in whom access via the femoral route was not considered possible. Only one serious complication occurred: the late development of a bleeding false aneurysm in a patient with renal failure and severe hypertension who was being treated with anticoagulants. The relevant limitations and complications of the translumbar and axillary approaches are discussed. We consider this technique to be a safe and simple alternative to translumbar aortography when femoral access is not possible.
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PMID:Percutaneous high brachial aortography: a safe alternative to the translumbar approach. 379 60

From 1970 through 1980, 47 patients developed a total of 69 false femoral artery aneurysms. Of these aneurysms, 58 occurred an average of 6.2 +/- 3.1 (SD) years after the original revascularization procedure. Ten of these aneurysms occurred once after initial repair and one occurred a second time. Endarterectomy was performed in almost one third of the arteries that later developed false aneurysms. Aneurysms developed in 18 endarterectomized arteries after performance of an anastomosis with a vein patch or Dacron graft. Infection was present in only one case. The suture material in the primary anastomosis was predominantly braided Dacron. Hypertension and bleeding were not commonly associated. Endarterectomy weakens anastomoses and is a factor in false aneurysm formation.
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PMID:Host-artery weakness in the etiology of femoral anastomotic false aneurysms. 669 32

Sixty patients who had primary aortic disease (aortic stenosis or aneurysm) and required simultaneous aortic and renal artery operations were divided according to the indications for renal artery repair as follows: group 1, renovascular hypertension (ten patients); group 2, kidney salvage (11 patients); group 3, improvement of renal function (three patients); and group 4, renal artery involvement in the diseased aorta (36 patients). Renal artery reimplantation and aortorenal grafting were usually employed. Two kidneys in the renal salvage group failed, and two main and three accessory arteries were found to be occluded on late follow-up. Three patients died after emergency surgery for aneurysm rupture (two patients) and infected false aneurysm (one patient). The mortality rate for combined operations is higher (5%) than for aortic or renal surgery alone, but simultaneous repair may be needed for technical reasons, or to treat renovascular disease.
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PMID:Management of renovascular problems during aortic operations. 673 77


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