Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From January 1975 to December 1985, 1454 patients had an intra-aortic balloon inserted for cardiac assistance. Eighty balloon-dependent patients had severe limb ischemia and required a femorofemoral graft (FFG) (5% of the total group of patients). Twenty-nine of the 80 patients with grafts (or 36%) left the hospital and 28 were followed up for an average of 40 months to determine late complications associated with the crossover grafts. All grafts remained patent. The 28 patients were classified into five groups according to the degree and type of lower limb ischemia. Group I consisted of 13 asymptomatic patients (46%); group II had four (14%) patients with mild claudication caused by preexisting peripheral arteriosclerosis; group III comprised four patients (14%) without preexisting disease but claudication subsequent to the FFG; group IV had five patients with irreversible ischemic sequelae before grafting ending in amputation, foot drop, or persistent paresthesia; and group V consisted of two patients with graft infection (7%). The perioperative mortality rate of the balloon-dependent patients with an FFG (64%) reflects the gravity of the cardiac condition. Placement of an FFG to relieve limb ischemia in these patients is followed by few immediate or late complications in the survivors and any persistent limb changes were related to the prolonged ischemia present before revascularization. Our data suggest that in balloon-dependent patients with limb-threatening ischemia, aggressive use of the FFG is limb-saving, durable, and allows continuation of balloon support.
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PMID:Femorofemoral grafts for lower limb ischemia caused by intra-aortic balloon pump. 379 84

Clinical ergotism as seen today results almost exclusively from the excessive intake of ergotamine tartrate in the treatment of migraine headache. Although both gangrenous and convulsive symptoms are seen in naturally occurring ergotism resulting from the ingestion of fungus infected rye, only gangrenous ergotism has been reported following the excessive ingestion of ergotamine tartrate. The symptoms of both iatrogenic and naturally occurring ergotism appear to result from regional ischemia caused by ergot induced vasospasm. This report discribes experiences in the diagnosis and management of two patients with unusual manifestations of iatrogenic ergotism. One patient presented with ischemia of all extremities and bilateral foot drop probably due to ischemic damage to the common peroneal nerves, a finding not previously described in ergot intoxication. The foot drop totally resolved in several months following the discontinuation of ergot. A second patient presented with unilateral leg ischemia and transient monocular blindness, both of which resolved after discontinuation of ergot. Both patients displayed typical angiographic findings of ergotism. There is no convincing evidence that any treatment other than discontinuation of ergotamine is of benefit in the treatment of iatrogenic ergotism.
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PMID:Ergot intoxication: historical review and description of unusual clinical manifestations. 437 16

Eight-nine consecutive patients who were considered candidates for counterpulsation were reviewed for complications of the percutaneous intraaortic balloon pump (PIABP). Indications for counterpulsation were cardiogenic shock in 37 patients, refractory ischemia in 35, postcardiotomy shock in nine, acute infarction with threatened extension in four, septic shock in three and elective preoperative use in one patient. In 67 patients (75.3%), successful passage of the balloon was accomplished in a single attempt; the opposite-side attempt was successful in 10 patients (11.2%) and neither attempt was successful in 12 (13.5%). Seventy-seven patients who underwent PIABP had major complications, including limb ischemia in 12, bleeding at the puncture site in three, permanent foot drop in three, aortic dissection in three, renal embolism in one and false aneurysm at the puncture site in one. Fourteen patients had minor complications: asymptomatic loss of pedal pulses in eight, transient bacteremia in two, parasthesias in two and wound hematoma in two. No patient had free perforation, balloon rupture or wound infection. The rate and severity of complications of PIABP are similar to those with conventional IABP insertion. Ease of insertion alone should not be grounds for using PIABP in patients who can be managed without counterpulsation.
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PMID:Complications of percutaneous intraaortic balloon pumping. 724 11

To determine the frequency of inadequate decompression and its complications, the medical records of 108 pediatric burn patients requiring escharotomies or fasciotomies were reviewed. Of 108 patients, 100 (93%) had escharotomies or fasciotomies performed at an outlying facility before transfer. Of these 100 patients, 44 (117 limbs) were inadequately decompressed and required further decompression after admission to our facility. Initial mean compartment pressures were 50.3 +/- 1.3 mm Hg, which were reduced to 16.3 +/- 0.5 mm Hg after decompression. Pulses were present in 74% of limbs requiring decompression. Twenty limbs required decompression despite noncircumferential burns. Complications of inadequate or delayed decompression included foot drop in 20 patients (35 limbs) and muscle necrosis in 13 patients (23 limbs). Four patients (seven limbs) required amputations because of progressive muscle necrosis and infection. Complications of the procedure itself were limited to bleeding in three patients. In conclusion, compartment pressures should be followed in patients with significant burns since pressures may increase over time and pulses are not predictive of ischemia. Failure to decompress extremities with elevated pressures leads to significant but preventable complications.
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PMID:The adequacy of limb escharotomies-fasciotomies after referral to a major burn center. 799 4

Popliteal aneurysms are the most common peripheral arterial aneurysm and occur most commonly among older men with established cardiovascular disease. Popliteal aneurysms are asymptomatic or otherwise present with intermittent claudication, pressure symptoms in the popliteal fossa, distal embolization, and, rarely, rupture. We present a patient with a remarkably large popliteal aneurysm of 10 cm presenting as a popliteal swelling with foot drop and no signs of limb ischemia. According to our literature search, it is the largest reported popliteal aneurysm, and its corresponding symptoms are unusual. The diagnostic workup and treatment are presented.
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PMID:Giant popliteal aneurysm presenting with foot drop. 1701 13

Persistent sciatic artery (PSA) is a rare vascular anomaly present in 0.025% to 0.05% of the population. They are particularly prone to aneurysmal degeneration, potentially leading to distal ischemia, sciatic neuropathy, or rarely rupture. Here, we describe a case of a ruptured PSA aneurysm managed by endovascular embolization. A 70-year-old man initially presented with acute left lower extremity ischemia. He was found to have a popliteal embolus originating from a complete persistent sciatic artery aneurysm. He underwent thrombolysis followed by a femoropopliteal bypass and ligation of the proximal popliteal artery to exclude the PSA. Four weeks later he re-presented with severe pain, a pulsatile buttock mass, and anemia in the setting of hemodynamic instability. A ruptured PSA aneurysm was confirmed by computed tomography angiography (CTA). This was managed emergently by endovascular exclusion of the inflow and outflow vessels using Amplatzer vascular plugs. His postoperative course was complicated by both a foot drop, likely secondary to sciatic nerve ischemia, and a buttock abscess. To our knowledge, this is the first report detailing the endovascular management of a ruptured PSA aneurysm. The etiology, management, and complications associated with the treatment of this rare vascular entity are discussed.
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PMID:Ruptured persistent sciatic artery aneurysm managed by endovascular embolization. 1989 17

Neurologic complications are not uncommon in renal transplant recipients. Acute femoral neuropathy, lumbosacral plexopathy, and sciatic neuropathy have been reported after kidney transplantation probably due to perioperative nerve compression and ischemia. To the best of our knowledge, common peroneal nerve (CPN) palsy has not been described in the early postoperative period following renal transplantation. Also, mononeuropathy due to tacrolimus (TAC) therapy has not been described so far. We report a case of isolated CPN palsy presenting as unilateral foot drop following renal transplantation and that improved only after replacing TAC with cyclosporine.
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PMID:Unilateral common peroneal nerve palsy following renal transplantation: a case report of tacrolimus neurotoxicity. 2165 35

The complete musculature loss of the anterior compartment of the leg is a rare complication that occurs as a result of local tissue damage, intracompartmental bleeding and ischemia-reperfusion events. It causes foot drop and equinovarus deformity that negatively impact the quality of life of affected patients. This report describes a modified bridle tendon transfer procedure to correct this defect in a case of extensive muscle necrosis secondary to local hemorrhage. A review of the literature was carried out to elucidate the benefits and risks associated to this technique.
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PMID:Modified bridle tendon transfer procedure following a complete musculature loss of the anterior leg compartment: Case report and literature review. 3187 26