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At least 19 recordsLinked to original sources
PubMed1992

Present management of hepatic artery aneurysms. Symptomatic left hepatic artery aneurysm; right hepatic artery aneurysm with erosion into the gallbladder and simultaneous colocholecystic fistula--a report of two unusual cases and the current state of etiology, diagnosis, histology and treatment.

A left hepatic artery aneurysm has an incidence of 0.8% among the splanchnic artery aneurysms. 20% of splanchnic artery aneurysms are hepatic artery aneurysms. Atherosclerosis (32%) is the most prevalent etiology, followed by trauma (22%) and inflammatory lesions (10%). The average age is 40 (10-83) years, the male to female ratio 2:1. In 64-80% of cases rupture of the aneurysm is the first clinical manifestation. The mortality is then about 35%. The case of a 64 years old female with a symptomatic aneurysm of the left hepatic artery and the case of a 70 years old female, who underwent emergency laparotomy for acute colorectal hemorrhage, with a right hepatic artery aneurysm, which perforated into the gallbladder, with simultaneous colocholecystic fistula is reported and the etiology, histology, and present diagnostic and therapeutic management of hepatic artery aneurysms is discussed.

Aged↗
PubMed1991

Can early admission reduce aneurysmal rebleeds? A prospective study on aneurysmal incidence, aneurysmal rebleeds, admission and treatment delays in a defined region.

One-hundred and eighty-five patients sustaining an aneurysmal subarachnoid bleed were detected in a well-defined urban region in Stockholm, during a 3-year period. Of all detected patients, 21% died before coming to neurosurgical attention. In this prospective series 54 of the admitted patients had more than one bleed. In 29 of them rebleed was subsequently verified. There were 25 patients with a clinical history of a minor bleed or a warning leak preceding the major bleed. Of all rebleeds--minor bleeds included--35% occurred in the first 24 h, 5% between days 1 and 3, 19% between days 4 and 7 and 41% after the first week. Although the greatest distance to the hospital was 65 km, not more than 53% of the patients were admitted within the first 12 h post bleed. This delayed admission was attributed almost equally to a patient delay or a referral delay by doctors. The outcome of the patients was more gloomy if referral delay was apparent. A substantial number of rebleeds could have been avoided had the patient not disregarded the first bleed or the first doctor on line had not misunderstood the symptoms. Thus, 35 of the 54 rebleeds were regarded as avoidable, if admitted in time. Hypothetically a better outcome was expected in 20 of these 35 avoidable rebleeds. Substantiated by this study, aiming at early admission and treatment in the first 72 h post bleed, almost 65% of the late (after 72 h) rebleeds could be avoided.

Adult↗
PubMed1978

[Angiographical study of ruptured aneurysm in the multiple aneurysm patients (author's transl)].

Sixty four multiple intracranial aneurysm cases have been analysed for the purpose of identifying the relation between aneurysm rupture and aneurysmal features, mass signs, vasospasms and locations of the aneurysms. 1) 85% of the larger and largest aneurysm in each case were the ruptured aneurysm. 2) Aneurysms with a greater ratio of length to width showed a high frequency of rupturing. 3) Irregularities of the aneurysmal wall and the existence of a daughter aneurysm attached to the main aneurysm have a tendency to rupture. 4) Evidence of mass signs, associated with intracerebral, subarachnoid and subdural hematoma or a cerebral edema is also useful for the identification of the ruptured aneurysm. 5) Anterior communicating artery aneurysms have a relatively high frequency of being the ruptured aneurysm in cases of multiple aneurysm. 6) By utilizing all the investigated factors of the angiogram, the ruptured aneurysm might be identified in about 90% of the cases of multiple aneurysms.

Adult↗
PubMed1976

Progression of popliteal aneurysmal disease following popliteal aneurysm resection with graft: a twenty year experience.

Multifocal occurrence of peripheral atherosclerotic aneurysm is well known. However, little attention has been directed to subsequent progressive aneurysmal development adjacent to sites of previously resected and grafted popliteal aneurysms. During a 20 year follow-up study of 79 patients with 115 popliteal aneurysms, we have observed the development of six atherosclerotic femoropopliteal aneurysms adjacent to the original aneurysm site in four patients, occurring 5 months to 10 years (average, 5 1/2 years) after the initial operation. Operative repaire was accomplished successfully of five of the six aneurysms; one popliteal aneurysm has not been operlateral popliteal aneurysm (46 percent). Fifty-seven patients (72 percent) presented with complications of the aneurysm, including 35 with thrombosis. As initial therapy, 69 grafting procedures were performed on 58 patients; nine extremities had sympathectomy only; four aneurysms were ligated or resected without grafting; and four extremities required amputation as the only procedure. Among patients with grafts, nine subsequent amputations were necessary in the early postoperative period, all occurring in patients presenting with thrombosed aneurysms. No patient who developed pedal pulses in the period immediately after operation required amputation. In addition, two patients developed aneurysmal degeneration in popliteal homografts. These data demonstrate the progressive nature of popliteal aneurysmal disease and emphasize the need for regular and life-long follow-up.

Adult↗
PubMed1992

[False aneurysm formation during the chronic phase of myocardial infarction at the margin of a previously-detected true aneurysm].

The patient was a 59-year-old man who had acute extensive anterior myocardial infarction in October, 1989. One month later, he was transferred to Kyoto University Hospital and underwent cardiac catheterization. Left ventricular aneurysm and significant stenosis in the proximal portion of the left anterior descending artery were documented. Because he experienced chest pain on slight exertion accompanied by a slight increase in the depth of the negative T wave on electrocardiogram, percutaneous transluminal coronary angioplasty (PTCA) was performed. Thereafter, chest pain disappeared, and the patient was discharged. Three months later, he was re-admitted to Kyoto University Hospital for a repeat cardiac catheterization after PTCA. PTCA site was found to be restenosed, and a small diverticulous aneurysm was found at the margin of the previously-detected ventricular aneurysm. As the diverticulous aneurysm was considered likely to precipitate the ventricular aneurysm into rupture, expeditious left ventricular aneurysmectomy was performed to prevent cardiac rupture. Ventricular aneurysms, common complications in myocardial infarction, are of two types, either true or false. Most aneurysms develop during the acute phase of myocardial infarction, and rupture of true aneurysms during the chronic phase of myocardial infarction rarely occurs. However, in the present case, a small diverticulous aneurysm, which was not demonstrated at the initial cardiac catheterization, developed during the chronic phase of myocardial infarction. Pathological examination revealed that the diverticulous aneurysm was a false aneurysm due to incomplete rupture. When the common pathogenesis of ventricular aneurysms in myocardial infarction is considered, the present report might represent an extraordinary rare case.(ABSTRACT TRUNCATED AT 250 WORDS)

Aneurysm, Ruptured↗
PubMed1991

Late iliac artery aneurysms and occlusive disease after aortic tube grafts for abdominal aortic aneurysm repair. A 35-year experience.

Controversy continues over whether patients treated with straight Dacron aortic tube grafts for an abdominal aortic aneurysm remain at significant risk for subsequent development of iliac aneurysm or occlusive disease. To address this issue, the authors performed a population-based analysis of 432 patients who had an abdominal aortic aneurysm diagnosed between 1951 and 1984. Aneurysm repair was performed eventually in 206 patients (48%). To ascertain differences in late development of graft-related complications, iliac aneurysms, and arterial occlusions, the authors compared all tube-graft patients with similar numbers of bifurcated-graft patients matched for age and year of operation. In the tube-graft group, no subsequent clinically evident or autopsy-proven iliac aneurysms or iliac occlusive disease were noted. Over a mean follow-up of 6 years (range, 4 to 18 years), new aortic aneurysms occurred in the proximal aorta in both tube and bifurcated-graft patients (5.0% and 2.5%, respectively). In contrast the cumulative incidence of graft-related complications was higher with a bifurcated prosthesis (12.8%) compared with a straight graft (5.0%) (p = 0.15). These problems generally occurred 5 to 15 years postoperatively and emphasize the need for long-term graft surveillance. The authors conclude that straight tube-grafts for repair of abdominal aortic aneurysms provide excellent late patency with minimal risk of subsequent iliac aneurysm development.

Aged↗
PubMed1991

The spontaneous course of small abdominal aortic aneurysms. Aneurysmal growth rates and life expectancy.

Since abdominal ultrasonography has become a routine diagnostic procedure, increasing numbers of small asymptomatic abdominal aortic aneurysms are detected incidentally. Of 128 patients (108 male, 20 female) with abdominal aortic aneurysms, 96 patients were observed clinically and by repeated ultrasound studies for an average of 3.47 years, adding up to a total observation period of 333 patient-years. Among these 96 patients, 72 had small aneurysms (averaged diameters less than 5 cm). Three of them were lost to follow up. None of the remaining 69 patients died from rupture, 20 died from other causes and 8 patients were successfully operated. Of the patients with a large aneurysm one was lost to follow up. Five patients of the remaining 23 died as a result of rupture, 7 were successfully operated. The average growth rate of small aneurysms was 0.18 cm/year, whereas the larger aneurysms showed a growth rate of 0.28 cm/year (diameter). The survival rate of patients with small aneurysms was 94% after one year, 80% after 3 years, and 73% after 5 years, indicating that life expectancy is reduced in patients with an aneurysm of the abdominal aorta, but not because of complications of the aneurysm.

Adult↗
PubMed1992

Giant aneurysm of the distal anterior cerebral artery: associated with an anterior communicating artery aneurysm and a dural arteriovenous fistula.

We describe an unusual case of a giant pericallosal artery aneurysm, producing psychomotor depression from mass effect, associated with a smaller aneurysm of the anterior communicating artery, a dural arteriovenous fistula, and a meningioma. Magnetic resonance imaging (MRI) and cerebral angiography demonstrated the giant aneurysm and the meningioma. Cerebral angiography provided a detailed appreciation of the cerebral circulation, including both aneurysms, the dural arteriovenous fistula, and the potential collateral supply to the involved anterior cerebral distribution. The anterior communicating artery aneurysm was successfully clipped as was the distal anterior cerebral branch supplying the giant aneurysm before its resection. The patient made a full recovery but with persisting, slight dysphasia. We conclude that computed tomography, cerebral angiography, and MRI are of specific value in the assessment of giant aneurysms, but only angiography can provide detailed characterization of the aneurysm and demonstrate other possible cerebrovascular pathology such as multiple aneurysms and arteriovenous fistulas.

Adult↗
PubMed1992

Aneurysm of lateral circumflex femoral artery in association with multiple atherosclerotic aneurysms.

Femoral aneurysms are uncommon and are frequently associated with other aneurysms, particularly those of the aorta and popliteal arteries. Other peripheral aneurysms are even more rare. As far as we are aware, only one aneurysm of the lateral circumflex artery has been previously described. We describe such an aneurysm in association with a common femoral aneurysm on the same side, an abdominal aortic aneurysm and an iliac aneurysm on the contralateral side.

Aneurysm↗
PubMed1992

Delayed rupture of an internal iliac artery aneurysm following proximal ligation for abdominal aortic aneurysm repair.

This is a report of a patient presenting with a contained rupture of an internal iliac aneurysm following proximal ligation after abdominal aortic aneurysm repair three years earlier. The patient presented with a large pelvic mass with symptoms of urgency, frequency, dysuria, tenesmus and fevers associated with anemia. Following evacuation of the aneurysm and direct suture ligation of the distal branches of the internal iliac artery, the patient's aortic graft was covered with omentum which also filled the pelvic cavity. The importance of proximal and distal control of aneurysms and/or the importance of complete luminal control of internal iliac artery aneurysms is emphasized by this case.

Aged↗
PubMed1992

Coexistence of extracranial internal carotid artery aneurysm and multiple intracranial aneurysms--case report.

A rare case of extracranial internal carotid artery (ICA) aneurysm coexisting with intracranial multiple aneurysms in a 64-year-old female is reported. The three intracranial aneurysms were clipped uneventfully by two-stage craniotomies. The extracranial ICA aneurysm at the infratemporal region was excised through a high cervical route and ICA was reconstructed by an end-to-end direct anastomosis. Ours is the first case reported of extra- and intracranial aneurysms surgically treated successfully.

Aneurysm↗
PubMed1992

[A successful surgical treatment of ascending aortic aneurysm, left common carotid artery aneurysm and left subclavian artery obstruction due to aortitis syndrome in active phase].

A 24-year-old female was admitted complaining of coldness of left upper extremity and pulsating tumor of the neck. She was diagnosed as ascending aortic aneurysm, left common carotid artery aneurysm and left subclavian artery obstruction due to aortitis syndrome on examinations. Although steroid treatment appeared to be effective in controlling inflammatory reaction, the left common carotid artery aneurysm increased in size and severe neck pain started. The risk of rupture was feared, and surgical intervention was carried out in spite of aortitis in active phase. The patient underwent surgery where aneurysmectomy and graft replacement for ascending aortic aneurysm, aneurysmectomy and graft replacement using autogenous saphenous vein for left common carotid artery aneurysm and bypass grafting for left subclavian artery obstruction were performed. The histology of resected specimens of aortic wall showed active aortitis. The postoperative course was uneventful and the patient was discharged on steroid.

Adult↗
PubMed1976

Noninvasive diagnosis of a false left ventricular aneurysm with radioisotope gated cardiac blood pool imaging. Differentiation from true aneurysm.

Unlike the true left ventricular aneurysm, false aneurysms have recently been shown to be subject to late rupture. Rarely diagnosed before surgery or autopsy, the false aneurysm has never been identified by noninvasive techniques. We report the first such noninvasive diagnosis employing radioisotope gated cardiac blood pool imaging. Due to the unique and possibly life-threatening clinical course and potential for surgical cure of false left ventricular aneurysm, early noninvasive diagnosis by imaging techniques may be critical. The methods shown here are generally applicable, becoming widely available and may help in evaluation of false left ventricular aneurysm as a cause of sudden death.

Aged↗
PubMedDate not supplied

Symptomatic aneurysm of the abdominal aorta: successful surgery in elderly patients, one with a massive aneurysm.

Three cases of symptomatic aneurysm of the abdominal aorta are presented. One patient age 96, described with this condition, is perhaps the oldest patient in the literature. In another patient the aneurysm measured two feet in length, extending from the diaphragm to the pelvic outlet. This was perhaps the biggest aneurysm yet recorded. All three patients presented difficult medical problems, withstood the operaion, and were discharged from the hospitals with successful results. Aneurysm of the abdominal aorta is a serious condition. It is commonly found in patients in their seventh decade. The condition carries a high mortality with advancing age, especially when associated with other diseases. In symptomatic aneurysms where expansion, dissection or frank hemorrhage is suspected, emergency resection and replacement with dacron graft is carried out.

Aged↗
PubMed1978

Aneurysm of the main stem of the left coronary artery associated with aortic insufficiency and aneurysm of the ascending aorta. Report of a case with successful surgical repair.

A case of aneurysm of the main stem of the left coronary artery associated with aortic insufficiency and an aneurysm of the ascending aorta is reported. The importance of coronary angiography in diagnosing this condition is illustrated. Surgical repair included isolation of the coronary aneurysm and replacement of the ascending aorta and aortic valve, combined with triple aortocoronary saphenous vein bypass grafts. A review of the aetiology, clinical features, and surgical management of coronary artery aneurysms is presented.

Adult↗
PubMed1992

[A case of Marfan's syndrome that required emergency Bentall's operation due to acute dissecting aortic aneurysm (DeBakey type II) following surgery of abdominal aortic aneurysm].

Graft replacement was performed in a 29-year-old man for an abdominal aortic aneurysm associated with Marfan's syndrome. Since the dissecting aortic aneurysm (DeBakey type II) accompanied by disruption of the right coronary artery developed 74 days after operation, the emergency Bentall's operation was successfully carried out with bypassing of the right coronary artery using a saphenous vein graft. Fifteen Japanese cases operated on for abdominal aortic aneurysm associated with Marfan's syndrome are reviewed, and the problems concerning surgery of abdominal aortic aneurysm and Bentall's operation are discussed.

Acute Disease↗