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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intraoperative transesophageal echocardiography (TEE) was performed on a 62-year-old man who underwent abdominal aortic replacement for abdominal aortic aneurysm under general anesthesia combined with epidural anesthesia. Coronary artery spasm occurred after unexpected massive hemorrhage, and TEE showed hypokinesis in the posterior-inferior left ventricular wall. The changes in TEE preceded the ST elevation in the ECG. Bolus infusion of isosorbide dinitrate and continuous infusion of nitroglycerin alleviated these changes. TEE enabled us to detect and evaluate coronary spasm before the appearance of ST changes in ECG.
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PMID:[Usefullness of transesophageal echocardiography in early detection of coronary spasm]. 872 8

A 74-year-old man in shock was transferred to our hospital. A ruptured abdominal aortic aneurysm was diagnosed by computed tomography and an emergency operation was thereafter performed. At operation, a massive hematoma was encountered in the retroperitoneal space and a standard aneurysmectomy with bifurcated graft replacement was carried out. At the end of the operation, signs of sigmoid colonic ischemia were recognized, including mild discoloration and bowel spasm. After considering the recovery or deterioration from colonic ischemia, we chose to exteriorize the sigmoid colon. On the 4th postoperative day, patchy ischemic areas of an elevated sigmoid colon were noticed to worsen and as a result, we were forced to perform a sigmoid colectomy with end colostomy. Thereafter, the patient developed multisystem organ failure, but he recovered gradually. The patient was discharged from the hospital 3 months after the initial operation. As a complication after surgery for abdominal aortic aneurysms, colonic ischemia remains a serious problem, especially in cases of ruptured AAA. It is generally better to avoid an operation for both abdominal aortic aneurysms and a colon resection at the same time. In this case, an exteriorization of the sigmoid colon was selected for the 1st operation in order to treat a ruptured abdominal aortic aneurysm. This surgical modality was found to be useful for making a correct diagnosis of colonic ischemia before the perforation, while a 2nd look operation for colonic ischemia could thus be performed under conditions of a reduced risk of infection to the prosthetic graft. These operative procedures were considered to be important factors in saving the patient's life.
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PMID:Sigmoid colon exteriorization after ruptured abdominal aortic aneurysm. 1281 96

Acute occlusion of an abdominal aortic aneurysm is a rare phenomenon. Its possible complications include distal spasm followed by arterial thrombosis, ischemia of the distal limbs, distal embolization, acidosis, hyperkalemia, and the development of venous thrombosis of the lower limbs. Surgical correction is often complicated by cardiac decompensation, renal failure, fatal pulmonary embolism, and metabolic derangements related to toxins released from the revascularized limb. Unless contraindicated, immediate systemic heparinization must be undertaken when the diagnosis is first suspected. We present a case of sudden occlusion of an abdominal aortic aneurysm complicated by venous thrombosis involving both lower extremities. After undergoing surgical revascularization, the patient sustained massive fatal pulmonary emboli. Prophylactic interruption of the inferior vena cava may be indicated in patients who present with this complication of abdominal aortic aneurysm.
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PMID:Acute occlusion of an abdominal aortic aneurysm complicated by bilateral lower extremity venous thrombosis: A case report. 1521 31

Amplatzer Vascular Plug (AVP) is a device recently proposed for extra-cardiac procedures such as arterial and venous embolisation. In this paper, we assess the usefulness of AVP in emergency embolisation presenting our preliminary experience and reviewing the Literature. During the last year, we selected 31 patients for embolisation using AVP. The following nine procedures were performed in emergency (8 males, mean 72.4 years, range 57-85): four ruptured abdominal aortic aneurysm, one traumatic hepatic pseudoaneurysm with arterio-portal fistula, one carotid pseudoaneurysm due to neoplastic erosion, one renal tumor with active bleeding, one ruptured isolated iliac aneurysm and one ruptured hypogastric aneurysm. We used a total of 13 AVPs. The follow-up was carried out by computed tomography angiography (CTA) and/or contrast-enhanced ultrasound (CEUS), 3 months after the procedure and then every 3 months. We obtained immediate technical success in all nine cases. No rupture or dissection of the treated arteries occurred. We observed only an asymptomatic spasm. During a mean follow-up of 5.3 months (range 3-12 months), CTA and/or CEUS showed complete occlusion of the treated arteries. The AVP is useful in some emergency settings. In the authors' experience, the device allows precise, controlled release and can be deployed to the target more rapidly than other traditional methods. The device cannot be used in all patients due to limited ability to negotiate tortuous vessels and limited size availability. In our institution, the AVP is less expensive than alternatives. In our experience and as reported in the early literature, the device is easy to use, versatile, and achieved a high technical success rate. Further studies may confirm the effectiveness and demonstrate additional indications.
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PMID:Use of Amplatzer Vascular Plug (AVP) in emergency embolisation: preliminary experience and review of literature. 1819 63