The accuracy of carotid duplex scanning in the diagnosis of 70% internal carotid artery stenosis: evaluation of new duplex criteria.
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Biomedical subjects
Publications and source records attributed to B el-Asmar.
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Between January 1993 and January 1995, seventy patients over 70 years of age underwent coronary artery revascularization and were retrospectively reviewed. The anesthetic protocole, the surgical technique and the intraoperative myocardial protection were similar for all patients. Fourteen patients (19.8%) suffered major postoperative complications: stroke (3 cases), myocardial infarction (5 cases), left ventricular failure with intraaortic counter-pulsation (2 cases), gastrointestinal hemorrhage (2 cases), respiratory failure (2 cases). Thirty patients (42.6%) had minor complications with no impact on survival or hospital stay. Hospital mortality was 7.1% (5 patients) and was caused by left ventricular failure (2 cases), stroke (1 case), gastrointestinal hemorrhage (1 case), respiratory failure (1 case). Mortality was found to be correlated with preoperative renal failure, peripheral vascular disease and concomitant carotid endarterectomy. Patients remained in the cardiac surgery unit for 60 hours. The mean length of hospital stay was 8.2 days. Follow-up from 1 to 24 months revealed NYHA angina class I-II in 85% of the patients. These results are similar to other studies. We conclude that coronary artery revascularization in the elderly yields good results, with fair mortality and morbidity rates.
Vascular complications, mostly hematomas and false aneurysms, are rare after coronary angiography. Infectious problems are even less frequent and a mycotic aneurysm is an extremely rare complication. Our patient presented with a mycotic aneurysm of the external iliac artery following percutaneous transluminal coronary angioplasty.
Embolization of cholesterol crystals from atheromatous plaques is a rare entity most often seen after invasive procedures involving manipulation of the aorta. Spontaneous CE has been reported in very rare cases. Peripheral signs include livedo reticularis, muscle pain and palpable pulses. Depending on the site of the responsible plaque, emboli may involve visceral organs and produce a systemic illness. Diagnosis is confirmed using skin, muscle and/or renal biopsies. Surgery is recommended when the atheromatous disease is localized to a unique segment which can be replaced.