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Sample records for external iliac vein

  1. Staged approach for surgical management of external iliac vein aneurysm associated with traumatic femoral arteriovenous fistula.

    PubMed

    Vasquez, Julio C; Montesinos, Efrain; DeLarosa, Jacob; Leon, Juan J

    2009-12-01

    Aneurysms of the iliac vein are rare. They can occur in association with arteriovenous fistulae located elsewhere. Here, we present a 30-year-old man who developed a large left external iliac vein aneurysm in association with a chronic traumatic arteriovenous fistula in the left thigh. Less than 25 cases of iliac vein aneurysms have been reported in the last 40 years. The presentation and treatment of this condition has been heterogeneous. We suggest that adequate surgical treatment can be offered in a staged approach: aneurysm resection with reconstruction should be done first, followed by closure of the arteriovenous fistula 6 months later.

  2. Adolescent External Iliac Artery Trauma: Recurrent Aneurysmal Dilatation of an Iliofemoral Saphenous Vein Graft Treated by Stent-Grafting

    SciTech Connect

    Lenton, James; Davies, John; Homer-Vanniasinkam, S.; McPherson, Simon

    2008-09-15

    An adolescent male sustained a severe penetrating injury to the external iliac artery. Emergency surgical revascularization was with a reversed long saphenous vein interposition graft. The primary graft and the subsequent revision graft both became aneurysmal. The second graft aneurysm was successfully excluded by endovascular stent-grafts with medium-term primary patency. A venous graft was used initially rather than a synthetic graft to reduce the risk of infection and the potential problems from future growth. Aneurysmal dilatation of venous grafts in children and adolescents is a rare but recognized complication. To the best of our knowledge, exclusion of these aneurysms with stent-grafts has not been previously reported in the adolescent population.

  3. Angiosarcoma of common iliac vein

    PubMed Central

    Ibis, Kamuran; Usta, Ufuk; Cosar, Rusen; Ibis, Cem

    2015-01-01

    Angiosarcoma is a rare malignant tumour of endothelial cells. Primary angiosarcoma of venous origin is extremely rare, and has a very poor prognosis. A 63-year-old woman with retroperitoneal mass underwent en bloc resection on a part of iliac vein followed by adjuvant radiotherapy. No recurrence was detected during 3 years of follow-up. PMID:25596292

  4. Dual compression is not an uncommon type of iliac vein compression syndrome.

    PubMed

    Shi, Wan-Yin; Gu, Jian-Ping; Liu, Chang-Jian; Lou, Wen-Sheng; He, Xu

    2017-03-13

    Typical iliac vein compression syndrome (IVCS) is characterized by compression of left common iliac vein (LCIV) by the overlying right common iliac artery (RCIA). We described an underestimated type of IVCS with dual compression by right and left common iliac arteries (LCIA) simultaneously. Thirty-one patients with IVCS were retrospectively included. All patients received trans-catheter venography and computed tomography (CT) examinations for diagnosing and evaluating IVCS. Late venography and reconstructed CT were used for evaluating the anatomical relationship among LCIV, RCIA and LCIA. Imaging manifestations as well as demographic data were collected and evaluated by two experienced radiologists. Sole and dual compression were found in 32.3% (n = 10) and 67.7% (n = 21) of 31 patients respectively. No statistical differences existed between them in terms of age, gender, LCIV diameter at the maximum compression point, pressure gradient across stenosis, and the percentage of compression level. On CT and venography, sole compression was commonly presented with a longitudinal compression at the orifice of LCIV while dual compression was usually presented as two types: one had a lengthy stenosis along the upper side of LCIV and the other was manifested by a longitudinal compression near to the orifice of external iliac vein. The presence of dual compression seemed significantly correlated with the tortuous LCIA (p = 0.006). Left common iliac vein can be presented by dual compression. This type of compression has typical manifestations on late venography and CT.

  5. Surgical Management of Ectopic Kidney with Bilateral Iliac Vein Invasion

    PubMed Central

    Tanwar, Harshwardhan V; Fernandes, Gwendolyn; Patil, Bhushan; Patwardhan, Sujata K

    2016-01-01

    Renal cell carcinoma (RCC) is a very rare phenomenon in an ectopic kidney. We come across a 61-year-old gentleman with a history of 2 months of gross, painless haematuria and palpable pelvic mass on examination. CT scan showed 6.5cm X 5.1cm X 5.8cm mass in pelvic kidney with bilateral iliac vein invasion. With the help of intra-operative ultra-sound, tumour thrombus was extracted from both iliac veins with en mass removal of tumour. Patient was well intraoperatively as well as in postoperatively. We also presented an elegant imaging for the case. PMID:27134940

  6. Sharp Recanalization for Chronic Left Iliac Vein Occlusion

    SciTech Connect

    Ito, Nobutake Isfort, Peter; Penzkofer, Tobias; Grommes, Jochen; Greiner, Andreas; Mahnken, Andreas

    2012-08-15

    Endovascular treatment has emerged as a first-line treatment for venous occlusions, but is sometimes challenging with conventional approaches. This article describes a helpful technique using a Roesch-Uchida needle to cross a chronic occlusion of the iliac vein when conventional techniques have failed.

  7. Angiographic Anatomy of External Iliac Arteries in the Sheep.

    PubMed

    Joscht, M; Martin, M; Henin, M; Nisolle, J F; Kirschvink, N; Dugdale, A; Godart, B; Coulon, H; Simon, V; Hontoir, F; Graffin, R; De Raeve, Y; Vandeweerd, J M

    2016-12-01

    External iliac artery atherosclerotic disease and aneurism occur in man. For treatment, imaging is required to facilitate minimally invasive introduction and advancement of stents within the intended vessels. Sheep are commonly used to test and improve stents. However, little information is published regarding the angiographic anatomy of the iliac arteries in the ovine species. The objective of this study was to describe the angiographic anatomy of the iliac arteries in the sheep. Computed tomography (CT) angiography and gross anatomical dissection were performed in, respectively, 10 and 43 adult ewes. Diameters and lengths of the arteries were measured. In comparison with man, salient anatomical differences were identified in the sheep: (1) the absence of common iliac arteries, (2) the common trunk at the origin of internal iliac arteries and (3) the location of the bifurcation of the external iliac arteries into femoral arteries in the pelvis (not in the limb). External iliac arteries in this series of sheep were 86 mm long in average and had a mean diameter of 7.5 mm. Lengths of arteries are only slightly different between man and sheep, while diameters are rather similar. Therefore, the sheep model appears to be sufficiently similar to man to test stent properties. This study provides useful reference images and measures of lengths and diameters of relevant arteries that could be applied to research with ovine models.

  8. Iliac vein compression syndrome: Clinical, imaging and pathologic findings

    PubMed Central

    Brinegar, Katelyn N; Sheth, Rahul A; Khademhosseini, Ali; Bautista, Jemianne; Oklu, Rahmi

    2015-01-01

    May-Thurner syndrome (MTS) is the pathologic compression of the left common iliac vein by the right common iliac artery, resulting in left lower extremity pain, swelling, and deep venous thrombosis. Though this syndrome was first described in 1851, there are currently no standardized criteria to establish the diagnosis of MTS. Since MTS is treated by a wide array of specialties, including interventional radiology, vascular surgery, cardiology, and vascular medicine, the need for an established diagnostic criterion is imperative in order to reduce misdiagnosis and inappropriate treatment. Although MTS has historically been diagnosed by the presence of pathologic features, the use of dynamic imaging techniques has led to a more radiologic based diagnosis. Thus, imaging plays an integral part in screening patients for MTS, and the utility of a wide array of imaging modalities has been evaluated. Here, we summarize the historical aspects of the clinical features of this syndrome. We then provide a comprehensive assessment of the literature on the efficacy of imaging tools available to diagnose MTS. Lastly, we provide clinical pearls and recommendations to aid physicians in diagnosing the syndrome through the use of provocative measures. PMID:26644823

  9. Successful Endovascular Treatment of Iliac Vein Compression (May-Thurner) Syndrome in a Pediatric Patient

    SciTech Connect

    Oguzkurt, Levent Tercan, Fahri; Sener, Mesut

    2006-06-15

    A 10-year-old boy presented to our clinic with left lower extremity swelling present for 1 year with deterioration of symptoms during the prior month. Laboratory investigation for deep vein thrombosis was negative. Venography and computed tomography scan of the pelvis showed compression of the left common iliac vein by the right common iliac artery. A diagnosis of iliac vein compression syndrome was made. After venography, endovascular treatment was planned. The stenosis did not respond to balloon dilatation and a 12 mm Wallstent was placed with successful outcome. The patient's symptoms improved but did not resolve completely, probably due to a chronically occluded left superficial femoral vein that did not respond to endovascular recanalization. To the best of our knowledge, this is the first case of successful endovascular treatment of iliac vein compression syndrome with stent placement in a pediatric patient.

  10. [Cockett's syndrome, May-Thurner syndrome, or iliac vein compression syndrome].

    PubMed

    Gil Martín, A R; Carreras Aja, M; Arrieta Ardieta, I; Labayen Azparren, I

    2014-01-01

    Iliac vein compression syndrome (also known as May-Thurner syndrome or Cockett's syndrome) is a rare clinical entity in which the left common iliac vein is compressed when it passes between the right common iliac artery and the spine. The sustained compression and trauma caused by the pulsatile force of the artery on the vein damage the intima and lead to the formation of membranes or bands in the vascular lumen that hinder or obstruct the flow of blood in the vein, favoring thrombus formation. The current treatment strategy of choice is endovascular vein patch angioplasty and stenting with the aim of improving the caliber of the lumen and enabling normal venous drainage. We present two cases of May-Thurner syndrome and review the clinical and CT findings.

  11. Early Palma procedure after iliac vein injury in abdominal penetrating trauma.

    PubMed

    Alcocer, Francisco; Aguilar, Jesus; Agraz, Salvador; Jordan, William D

    2008-09-01

    Ligation for penetrating abdominal vein trauma may have better outcome than a vascular reconstruction in an unstable patient. However, symptoms of chronic venous insufficiency may appear over time. We describe our surgical experience with 4 patients who underwent iliac vein ligation followed by venous bypass with a modified Palma derivation between 48 and 240 hours after sustaining penetrating abdominal trauma with concomitant iliac vein injury. Patients were assessed for venous symptoms and conduit patency with continuous wave Doppler and duplex scanning. One graft occluded acutely and the remaining three remain patent with functioning valves. In order to preserve venous outflow after severe iliac vein injury, we think that venous ligation as a part of damage control surgery followed by a modified Palma operation may prevent chronic symptoms of venous outflow obstruction without compromising an already injured patient.

  12. Common femoral endovenectomy in conjunction with iliac vein stenting to improve venous inflow in severe post-thrombotic obstruction.

    PubMed

    Verma, Himanshu; Tripathi, Ramesh K

    2017-01-01

    Post-thrombotic syndrome secondary to iliofemoral deep venous thrombosis is a significant contributor to advanced chronic venous insufficiency. Iliac vein stenting is a standard procedure to treat iliocaval obstruction. In cases with obstruction extending across the groin, venous inflow for an iliac vein stent may be poor and compromise results of iliac vein stenting. Treatment options include extension of stents across the inguinal ligament that may have limitations in improving inflow only from only one vessel. Endovenectomy in this scenario becomes an attractive option with or without iliac vein stenting to provide outflow to the profunda vein, which otherwise is "axially transformed" in chronic iliofemoral deep venous thrombosis. We describe a technique of endovenectomy in combination with iliac vein stenting to establish a patent outflow tract for profunda and femoral veins. Accompanying also is a video demonstration of endovenectomy that will help viewers understand more technical aspects of the procedure.

  13. Distal Femoral Arteriovenous Fistula with Iliac Vein Thrombosis after Blunt Trauma

    PubMed Central

    Kim, Duk Sil; Kim, Sung Wan; Lee, Hyun Seok; Byun, Kyung Hwan; Choe, Michael SungPil

    2017-01-01

    A 39-year-old woman arrived at our emergency department, complaining of severe pain and swelling of her left leg. She had slipped down stairs and injured on her left leg about 3 months ago. Computed tomography angiography showed left distal superficial femoral artery’s pseudoaneurysm with arteriovenous fistula and thrombotic occlusion of left common iliac vein. We decided to do endovascular intervention due to severe venous hypertension and chronic inflammation around the fistula. The femoral arteriovenous fistula was closed via stent-graft (7 mm×5, 9 mm×5 cm) deployment. The occluded left iliac vein was reopened by nitinol metal stenting (12 mm×4 cm, 14 mm×4 cm). The authors report a very rare case of femoral arteriovenous fistula combined with iliac vein thrombosis developed after a blunt trauma. PMID:28377911

  14. Distal Femoral Arteriovenous Fistula with Iliac Vein Thrombosis after Blunt Trauma.

    PubMed

    Kim, Duk Sil; Kim, Sung Wan; Lee, Hyun Seok; Byun, Kyung Hwan; Choe, Michael SungPil

    2017-03-01

    A 39-year-old woman arrived at our emergency department, complaining of severe pain and swelling of her left leg. She had slipped down stairs and injured on her left leg about 3 months ago. Computed tomography angiography showed left distal superficial femoral artery's pseudoaneurysm with arteriovenous fistula and thrombotic occlusion of left common iliac vein. We decided to do endovascular intervention due to severe venous hypertension and chronic inflammation around the fistula. The femoral arteriovenous fistula was closed via stent-graft (7 mm×5, 9 mm×5 cm) deployment. The occluded left iliac vein was reopened by nitinol metal stenting (12 mm×4 cm, 14 mm×4 cm). The authors report a very rare case of femoral arteriovenous fistula combined with iliac vein thrombosis developed after a blunt trauma.

  15. Mechanical Thrombectomy of Iliac Vein Thrombosis in a Pig Model Using the Rotarex and Aspirex Catheters

    SciTech Connect

    Minko, P. Bücker, A.

    2013-06-08

    PurposeTo investigate the efficacy and safety of mechanical thrombectomy for iliac vein thrombosis using Rotarex and Aspirex catheters in a pig model.Materials and MethodsIliac vein thrombosis was induced in six pigs by means of an occlusion-balloon catheter and thrombin injection. The presence of thrombi was verified by digital subtraction angiography (DSA) and computed tomography (CT). Thrombectomy was performed using 6F and 8F Rotarex and 6F, 8F, and 10F Aspirex catheters (Straub Medical AG, Wangs, Switzerland). After intervention, DSA and CT were repeated to evaluate the efficacy of mechanical thrombectomy and to exclude local complications. In addition, pulmonary CT was performed to rule out pulmonary embolism. Finally, all pigs were killed, and iliac veins were dissected to perform macroscopic and histological examination.ResultsThrombus induction was successfully achieved in all animals as verified by DSA and CT. Subsequent thrombectomy lead to incomplete recanalization of the iliac veins with residual thrombi in all cases. However, the use of the 6F and 8F Rotarex catheters caused vessel perforation and retroperitoneal hemorrhage in all cases. Application of the Aspirex device caused one small transmural perforation in a vessel treated with a 10F Aspirex catheter, and this was only seen microscopically. Pulmonary embolism was detected in one animal treated with the Rotarex catheters, whereas no pulmonary emboli were seen in animals treated with the Aspirex catheters.ConclusionThe Aspirex catheter allowed subtotal and safe recanalization of iliac vein thrombosis. In contrast, the use of the Rotarex catheter caused macroscopically obvious vessel perforations in all cases.

  16. Incidence of metastasis in circumflex iliac nodes distal to the external iliac nodes in cervical cancer

    PubMed Central

    Okamoto, Kazuhira; Kato, Hidenori

    2016-01-01

    Objective A causal relationship between removal of circumflex iliac nodes distal to the external iliac nodes (CINDEIN) and lower leg edema has been recently suggested. The aim of this study was to elucidate the incidence of CINDEIN metastasis in cervical cancer. Methods A retrospective chart review was carried out for 531 patients with cervical cancer who underwent lymph node dissection between 1993 and 2014. CINDEIN metastasis was pathologically identified by microscopic investigation. After 2007, sentinel lymph node biopsy was performed selectively in patients with non-bulky cervical cancer. The sentinel node was identified using 99mTc-phytate and by scanning the pelvic cavity with a γ probe. Results Two hundred and ninety-seven patients (55.9%) underwent CINDEIN dissection and 234 (44.1%) did not. The percentage of International Federation of Gynecology and Obstetrics stage IIb to IV (42.4% vs. 23.5%, p<0.001) was significantly higher in patients who underwent CINDEIN dissection than those who did not. CINDEIN metastasis was identified in 1.9% overall and in 3.4% of patients who underwent CINDEIN dissection. For patients with stage Ia to IIa disease, CINDEIN metastasis was identified in 0.6% overall and in 1.2% of patients who underwent CINDEIN dissection. Of 115 patients with sentinel node mapping, only one (0.9%) had CINDEIN detected as a sentinel node. In this case, the other three lymph nodes were concurrently detected as sentinel lymph nodes. Conclusion CINDEIN dissection can be eliminated in patients with stage Ia to IIa disease. CINDEIN might not be regional lymph nodes in cervical cancer. PMID:27102250

  17. External-to-Internal Iliac Stent-Graft: Medium-Term Patency Following Exclusion of a Retrogradely Perfused Common Iliac Aneurysm

    SciTech Connect

    Nicholls, Marcus John; McPherson, Simon

    2010-08-15

    Following complicated aortic aneurysm surgery a complete left iliac occlusion resulted in buttock claudication. A retrogradely perfused right common iliac aneurysm expanded. Exclusion was by external-to-internal iliac stent-graft. No deterioration in claudication occurred with medium-term stent-graft patency.

  18. Right iliac arterial aneurysm in a 4-year-old girl who does not have a right external iliac artery

    PubMed Central

    Lee, Jeong-Hwan; Oh, Chaeyoun; Youn, Joong Kee; Han, Ji-Won; Jung, Sung-Eun

    2016-01-01

    Pediatric arterial aneurysm is rare disease. Among them, idiopathic-congenital arterial aneurysm is extremely rare. This is a case report of right common iliac artery idiopathic aneurysm with absence of right external iliac artery. A 4-year-old girl who had been complaining of intermittent abdominal pain since 2 years prior presented with a right lower abdominal mass that had been palpable since 6 months prior. Abdominal CT revealed a 5.2 cm × 4.5 cm × 5.1 cm, right-sided, partially thrombosed, saccular, iliac artery aneurysm. She underwent to operation, aneurismal resection. A pathological examination confirmed that it was a true aneurysm, considering that all layers of the vascular wall were stretched with no deficit. The patient was discharged 3 days after the surgery without any complication. Five months passed since the surgery, and the patient is doing well without any abdominal or leg pain. PMID:27847800

  19. Right iliac arterial aneurysm in a 4-year-old girl who does not have a right external iliac artery.

    PubMed

    Lee, Jeong-Hwan; Oh, Chaeyoun; Youn, Joong Kee; Han, Ji-Won; Kim, Hyun-Young; Jung, Sung-Eun

    2016-11-01

    Pediatric arterial aneurysm is rare disease. Among them, idiopathic-congenital arterial aneurysm is extremely rare. This is a case report of right common iliac artery idiopathic aneurysm with absence of right external iliac artery. A 4-year-old girl who had been complaining of intermittent abdominal pain since 2 years prior presented with a right lower abdominal mass that had been palpable since 6 months prior. Abdominal CT revealed a 5.2 cm × 4.5 cm × 5.1 cm, right-sided, partially thrombosed, saccular, iliac artery aneurysm. She underwent to operation, aneurismal resection. A pathological examination confirmed that it was a true aneurysm, considering that all layers of the vascular wall were stretched with no deficit. The patient was discharged 3 days after the surgery without any complication. Five months passed since the surgery, and the patient is doing well without any abdominal or leg pain.

  20. [First experience with hybrid operations for chronic obstruction of iliac-femoral segment veins in patients with post-thrombotic disease].

    PubMed

    Pokrovskiĭ, A V; Ignat'ev, I M; Volodiukhin, M Iu; Gradusov, E G

    The present study was aimed at assessing initial results of hybrid operations in obstructive lesions of the iliac-femoral veins in patients with post-thrombotic disease (PTD). Hybrid operations [open endovenectomy from the common femoral vein (CFV) with creation of an arteriovenous fistula + stenting of iliac veins] were performed carried out in a total of eleven patients with PTD. Of these, there were 7 men and 4 women aged from 34 to 52 years (mean age - 42.8±7 years). All patients had severe-degree chronic venous insufficiency (CVI). The distribution of patients according to the CEAP classification was as follows: C4a - 2 patients, C4b - 4 patients, C5 - 4 subjects, C6 - 1 patient. The time having elapsed since a newly onset episode of acute iliac-femoral venous thrombosis varied from 2 to 12 years (averagely - 7.1±3.3 years). The degree of manifestation of PTD was determined by means of the Villalta-Pradoni scale before and 6 months after the operation. Instrumental methods of study included ultrasound duplex scanning (USDS), magnetic resonance and/or multispiral computed venography, and contrast-enhanced X-ray venography. The technical success of the procedure amounted to 91%. In one patient with occlusion of the common and external iliac veins we failed to perform recanalization and stenting. A further one patient developed in-stent and CFV thrombosis on the second postoperative day. An attempt of catheter thrombolysis turned out unsuccessful. There were no wound complications in the postoperative period. Neither was pulmonary artery thromboembolism registered. The dynamic control was carried out by means of USDS before discharge from hospital and at 1, 3 and 6 months after the intervention. The outcomes of hybrid operations after 6 months were followed up in five patients. Secondary patency rate of the stented iliac veins amounted to 100%. No relapses of trophic ulcers were observed. According to the Villalta-Prandoni scale the value of the median of the

  1. Laparoscopic management of a strangulated internal hernia underneath the left external iliac artery☆

    PubMed Central

    Dumont, Karl-Andreas; Wexels, Jan Cyril

    2013-01-01

    INTRODUCTION Internal herniation of a small bowel behind pelvic vessels is a rare complication seen after pelvic lymphadenectomy. PRESENTATION OF CASE A 56-year-old woman was operated due to a gynecological cancer. 4 years thereafter she presented with a 2 days history of abdominal pain and vomiting. Clinical and radiological findings indicated a small bowel obstruction. A loop of small bowel had herniated behind the left external iliac artery. Using laparoscopic technique the herniated bowel was reduced. Due to limited peritoneum around the area and skeletonized vessel, we decided not to do any repair of the hernia orifice. The postoperative recovery was uneventful, bowel activity returned to normal and she was discharged the next day. Follow-up was done at 1 month and the latest at 10 months. She didn’t experience pain or discomfort after the operation. DISCUSSION Due to limited peritoneum around the skeletonized vessel, we decided to leave the hernia orifice unrepaired. We found it hazardous to do any direct suture of the orifice or use a free peritoneal graft to repair the defect as the fibrosis and inflammatory process might have compromised the artery or the vein. A longer follow-up of the patient is needed to clearly conclude if this simple procedure has been sufficient. We agreed that if the patient would experience any sign of recurrence and need another operation we would close the defect at that time. CONCLUSION 4 years after pelvic lymphadenectomy a small bowel herniation behind an external iliac artery occurred. The patient was successfully treated with reduction of the small bowel using laparoscopic technique. A quick recovery with minimal discomfort and no sign of recurrence after 10 months made our approach an acceptable surgical option. PMID:24121051

  2. Aberrant Ovarian Collateral Originating from External Iliac Artery During Uterine Artery Embolization

    SciTech Connect

    Kwon, Joon Ho; Kim, Man Deuk Lee, Kwang-hun; Lee, Myungsu; Lee, Mu Sook; Won, Jong Yun; Park, Sung Il; Lee, Do Yun

    2013-02-15

    We report a case of a 35-year-old woman who underwent uterine artery embolization (UAE) for symptomatic multiple uterine fibroids with collateral aberrant right ovarian artery that originated from the right external iliac artery. We believe that this is the first reported case in the literature of this collateral uterine flow by the right ovarian artery originated from the right external iliac artery. We briefly present the details of the case and review the literature on variations of ovarian artery origin that might be encountered during UAE.

  3. Iliac artery occlusion with "oxbow lake" formation following stent deployment in a tortuous external iliac artery during EVAR: a case report.

    PubMed

    Culverwell, Adam D; Kent, Patrick; Puppala, Sapna

    2011-10-01

    In this case report, we describe a complication that we term the "oxbow lake" deformity. This phenomenon occurs when a tortuous elongated external iliac artery segment is artificially straightened by an iliac stent resulting in kinking and compression of a redundant loop with lumen compromise. We describe the anatomy, corrective treatment, and outcome. This occurrence is potentially foreseeable with tortuous vascular anatomy and recognition can allow appropriate management planning avoiding complications for the patient.

  4. Unusual Presentation of Recurrent Pyogenic Bilateral Psoas Abscess Causing Bilateral Pulmonary Embolism by Iliac Vein Compression

    PubMed Central

    Ijaz, Mohsin; Sakam, Sailaja; Ashraf, Umair; Marquez, Jose Gomez

    2015-01-01

    Patient: Male, 47 Final Diagnosis: Bilateral psoas abscess • acute lower extremity deep vein thrombosis • bilateral pulmonary embolism Symptoms: Progressive left leg swelling • productive cough with whitish sputum • right flank pain Medication: Antibiotics and anticoagulation Clinical Procedure: CT-guided percutaneous drain placement Specialty: Internal Medicine/Critical Care Objective: Unusual presentation Background: Psoas abscesses are a known cause of back pain, but they have not been reported as a cause of acute lower extremity thromboses and bilateral pulmonary emboli. We report a patient with bilateral psoas abscesses causing extensive pulmonary emboli through compression of the iliac vein. Case Report: A 47-year-old man presented with bilateral leg swelling over 4 weeks. Physical examination revealed a thin male with bilateral leg swelling, extending to the thigh on his left side. He had hemoglobin of 10.5 g/dl, leukocytosis of 16 000/ml, and an elevated D-dimer. A computed tomography (CT) angiogram of his chest showed extensive bilateral pulmonary emboli and infarcts. He remained febrile with vague flank pain, prompting a CT of his abdomen and pelvis that showed large, multiloculated, septated, bilateral psoas abscesses with compression of the left femoral vein by the left psoas abscess and a thrombus distal to the occlusion. Two liters of pus was drained from the left psoas abscess by CT-guidance, and although the Gram staining showed Gram-positive cocci in clusters, cultures from the abscess and blood were negative. A repeat CT showed resolution of the abscesses, and the drain was removed. He was discharged to a nursing home to complete a course of intravenous antibiotics and anticoagulation. Conclusions: Although the infectious complications of psoas abscesses have been described in the literature, the mechanical complications of bilateral psoas abscesses are lacking. It is important to assess for complete resolution of psoas abscesses through

  5. Massive Bleeding from Guidewire Perforation of an External Iliac Artery: Treatment with Hand-made Stent-Graft Placement

    SciTech Connect

    Mehta, Vimal Pandit, Bhagya Narayan; Mehra, Pratishtha; Nigam, Arima; Vyas, Aniruddha; Yusuf, Jamal; Mukhopadhyay, Saibal; Trehan, Vijay

    2016-01-15

    We report life-threatening bleeding from an external iliac artery perforation following guidewire manipulation in a patient with atherosclerotic iliac artery disease. This complication was successfully managed by indigenous hand-made stent-graft made from two peripheral stents in the catheterization laboratory.

  6. Echocardiographic evaluation of external iliac artery Doppler waveform in patients with coronary artery disease.

    PubMed

    Styczynski, Grzegorz; Szmigielski, Cezary; Kaczynska, Anna; Kuch-Wocial, Agnieszka

    2014-04-01

    Visual interpretation of the Doppler waveform in the common femoral or distal external iliac artery (EIA) was reported to be useful in screening for proximal peripheral artery occlusive disease (PAOD) in patients with lower limb ischemia. Commonly patients with coronary artery disease (CAD) referred for echocardiography have coexistent arterial pathology. Therefore, we decided to study whether echocardiographic evaluation of the distal EIA flow can be useful for detection of PAOD in patients with CAD. We studied 150 consecutive patients (pts) with CAD referred for echocardiography. At the end of an echocardiographic examination, evaluation of the flow in the distal EIA with an echocardiographic probe was performed. The Doppler waveform was classified as normal-with early diastolic flow reversal or abnormal-without early diastolic flow reversal. Echocardiographic findings were compared in a blinded fashion with the results of the ankle brachial index measurements (ABI). Based on the ABI ≤ 0.9, peripheral artery disease was diagnosed in 54 pts (36%) and abnormal external iliac Doppler waveform was found in 27 pts (18%). Sensitivity of abnormal external iliac Doppler waveform in predicting PAOD was 48%, specificity 99%, positive predictive value (PPV) 96%, and negative predictive value 77%. Peripheral arterial occlusive disease is common in patients with CAD referred for echocardiographic study. Echocardiographic assessment of distal EIA Doppler waveform has low sensitivity, but high specificity and high PPV in the diagnosis of peripheral arterial occlusive disease.

  7. Endovascular PTFE-Covered Stent for Treatment of an External Iliac Artery Pseudoaneurysm in the Presence of Chronic Infection

    SciTech Connect

    Warren, Martin J. Fabian, Sebastian; Tisi, Paul

    2007-07-15

    A 75-year-old woman with an external iliac artery pseudoaneurysm, thought to have resulted from a chronic loosening and infection of a total hip replacement, was successfully treated by placement of a covered endoluminal stent.

  8. Descending aorta-external iliac artery bypass for middle aortic syndrome.

    PubMed

    Okamoto, Yuki; Yamamoto, Kazuo; Sugimoto, Tsutomu; Asami, Fuyuki; Nagasawa, Ayako; Shiraiwa, Satoru; Nakamura, Norihito; Yoshii, Shinpei

    2014-11-01

    We encountered a surgical case of middle aortic syndrome (MAS) in a 56-year-old man who had resistant hypertension. Computed tomography showed severe stenosis of the abdominal aorta from below the superior mesenteric artery to above the inferior mesenteric artery. Although bilateral renal artery stenosis was confirmed, renal function was within normal limits. A 10-mm vascular prosthetic graft was used to perform a descending aorta to left external iliac artery bypass. His hypertension was well controlled without medication. This extra-anatomic bypass may be a simple and useful approach for treating MAS if it is not necessary to reconstruct the renal artery or visceral artery.

  9. Successful treatment of phlegmasia cerulea dolens in a nonagenarian patient with chronic iliac vein occlusion using a Cleaner thrombectomy device.

    PubMed

    Sevuk, Utkan; Kose, Kaan; Ayaz, Firat; Ozyalcin, Sertan

    2015-08-07

    A 91-year-old man was admitted to the emergency room with a 3-day history of severe pain, swelling and cyanosis in his left leg. Duplex ultrasound findings were suggestive of acute left popliteal and iliofemoral venous thrombosis. Heparin was initiated and pharmacomechanical thrombolysis (PMT) was performed with the use of a Cleaner thrombectomy device. At the completion of PMT, repeat venography revealed chronic proximal iliac vein occlusion. After the procedure, alteplase was infused via the intra-arterial catheter at a rate of 0.5 mg/h over 24 h to clear the thrombus distal to the popliteal vein and residual thrombus. The patient's signs and symptoms improved markedly after the intervention. There were no minor or systemic bleeding problems. He was discharged home 10 days after the procedure without any complications.

  10. CT venography for deep venous thrombosis: can it predict catheter-directed thrombolysis prognosis in patients with iliac vein compression syndrome?

    PubMed

    Choi, Jin Woo; Jae, Hwan Jun; Kim, Hyo-Cheol; Min, Sang-Il; Min, Seung-Kee; Lee, Whal; Chung, Jin Wook

    2015-02-01

    To evaluate the prognostic value of CT venography for catheter-directed thrombolysis (CDT) in iliac vein compression syndrome (IVCS) patients with deep venous thrombosis (DVT). The institutional review board approved this retrospective study and waived informed consent. Among the 201 consecutive patients treated in our interventional suite for DVT from January 2001 to June 2013, 48 IVCS patients (12 men, 36 women) who underwent pre-procedural CT venography, CDT with stenting, and follow-up imaging were analyzed. To identify possible determinants of 6-month patency, CT venography was evaluated with Fisher's exact test and logistic regression analyses. Based on the analyses, image-based criteria were established and compared to the current symptom duration-based approach by receiver-operating-characteristic curve analyses and the McNemar test. Recoiling of external iliac vein (EIV) diameter (<120 %) [hazard ratio (HR) 28.652, p = .007] and severe rim enhancement (HR 20.545, p = .016) were significant risk factors for venous occlusion within 6 months of CDT. The dual-parameter image-based criteria were significantly superior to the current symptom duration-based approach in terms of area under the curve value (p = .010) and predictive accuracy (p = .031). With a 2-point cut-off, the proposed criteria demonstrated a 66.7 % sensitivity, 100.0 % specificity, and 92.9 % predictive accuracy for identifying non-responders of CDT. CT venography may be useful in assessing CDT prognoses in IVCS patients, particularly to identify non-responders who demonstrate recoiling of EIV diameter and rim enhancement on CT venography.

  11. Endovascular Treatment for Iliac Vein Compression Syndrome: a Comparison between the Presence and Absence of Secondary Thrombosis

    PubMed Central

    Lou, Wen-Sheng; He, Xu; Chen, Liang; Su, Hao-Bo; Chen, Guo-Ping; Song, Jing-Hua; Wang, Tao

    2009-01-01

    Objective To evaluate the value of early identification and endovascular treatment of iliac vein compression syndrome (IVCS), with or without deep vein thrombosis (DVT). Materials and Methods Three groups of patients, IVCS without DVT (group 1, n = 39), IVCS with fresh thrombosis (group 2, n = 52) and IVCS with non-fresh thrombosis (group 3, n = 34) were detected by Doppler ultrasonography, magnetic resonance venography, computed tomography or venography. The fresh venous thrombosis were treated by aspiration and thrombectomy, whereas the iliac vein compression per se were treated with a self-expandable stent. In cases with fresh thrombus, the inferior vena cava filter was inserted before the thrombosis suction, mechanical thrombus ablation, percutaneous transluminal angioplasty, stenting or transcatheter thrombolysis. Results Stenting was performed in 111 patients (38 of 39 group 1 patients and 73 of 86 group 2 or 3 patients). The stenting was tried in one of group 1 and in three of group 2 or 3 patients only to fail. The initial patency rates were 95% (group 1), 89% (group 2) and 65% (group 3), respectively and were significantly different (p = 0.001). Further, the six month patency rates were 93% (group 1), 83% (group 2) and 50% (group 3), respectively, and were similarly significantly different (p = 0.001). Both the initial and six month patency rates in the IVCS patients (without thrombosis or with fresh thrombosis), were significantly greater than the patency rates of IVCS patients with non-fresh thrombosis. Conclusion From the cases examined, the study suggests that endovascular treatment of IVCS, with or without thrombosis, is effective. PMID:19270859

  12. MRSA-Infected External Iliac Artery Pseudoaneurysm Treated with Endovascular Stenting

    SciTech Connect

    Clarke, M.G.; Thomas, H.G. Chester, J.F.

    2005-04-15

    A 48-year-old woman with severe juvenile-onset rheumatoid arthritis presented with a bleeding cutaneous sinus distal to her right total hip replacement scar. Methicillin resistant Staphylococcus aureus (MRSA) was isolated on culture. She had previously undergone bilateral total hip and knee replacements at aged 23 and six years later had the right knee prosthesis removed for infection, with subsequent osteomyelitis of the femoral shaft and right total hip prosthesis disruption. Peripheral arteriography was performed in view of persistent bleeding from the sinus, which revealed a 6 cm false aneurysm filling from and compressing the right external iliac artery (EIA). A PTFE-covered, balloon expandable JOSTENT was deployed in the right EIA, successfully excluding the false aneurysm and preventing further bleeding from the sinus. No graft infection was reported at 12 months. This case illustrates the potential use of endovascular stent-grafting in the treatment of an infected pseudoaneurysm.

  13. Strength of the pin-bone interface of external fixation pins in the iliac crest. A biomechanical study.

    PubMed

    Liu, J; Lai, K A; Chou, Y L

    1995-01-01

    The iliac crest is a frequent insertion site for external fixation pins in treating unstable pelvic or acetabular fractures and in iliofemoral distraction for superiorly dislocated hips. The pin-bone interface is critical for the success of treatment, but studies of the iliac crest are lacking. The purpose of this study was to investigate the strength of the pin-bone interface of different pins and different insertion methods. Four types of commercial pins, Wagner pins, Orthofix cortical and cancellous screws, and AO pins, were driven into sheep iliac crests by 2 methods: the intercortical and the transcortical. Specimens were tested for pullout and bending with an Instron testing machine (Model 1343) at a extension rate of 0.02 mm/sec to failure. The results revealed that the intercortical method had a stronger pullout force than the transcortical in all types of screws (p < 0.05), probably caused by longer insertion in the bone. In the pullout tests, the Wagner pins were the strongest and the Orthofix cancellous screws were the weakest. There were no differences in bending. In the iliac crest, the intercortical method was the better way of driving pins, and the new Orthofix screws were not proven to be stronger than the Wagner pins, nor were the cancellous screws more suitable than the cortical ones.

  14. CT Study of the Relationship Between the Common Iliac Artery and Vein and Their Juxtaposition: Implications for Conduit Construction Prior to Endosvascular Stent-Graft Repair of Aortic Aneurysms

    SciTech Connect

    Lenton, James; Homer-Vanniasinkam, Shervanthi; Kent, Patrick; Nicholson, Tony

    2008-11-15

    The objective of this study was to determine the anatomical relationship and juxtaposition between the common iliac artery and vein in a population of patients with aortic aneurysmal disease and a population clinically and radiologically free of atheroma. It was a retrospective study of 100 consecutive patients undergoing computed tomographic assessment of abdominal aortic aneurysm prior to endovascular or open surgical repair and 100 patients undergoing computed tomographic assessment for other pathologies who did not have clinical or imaging signs of aorto-iliac atheroma. In both groups the anatomical relationship between the right and left iliac artery and vein was studied, and the thickness of the fat plane separating the artery from the vein measured. The right iliac vein was posterolateral to the artery at the level of the common iliac artery bifurcation in 95% of patients in both groups. At the same level the left iliac vein was posterior in 23% (p {<=} 0.001). Eighty-three percent of patients in the aneurysm group had a fat plane between the right artery and vein that measured 0 mm (no visible fat plane = 52%) to 1 mm (= 31%). Ninety-eight percent of patients in the aneurysm group had a measurable fat plane between the left iliac artery and vein of up to 5 mm (p = 0.001). Six percent of the control group demonstrated no visible fat plane between the right iliac artery and vein (p {<=} 0.001), while the fat plane measured more than 1 mm (1-5 mm) on the left in 100%. We conclude that in patients where conduit construction is required for aortic stent-graft access, the anatomical configuration and intimate relationship of the iliac arteries and veins should be assessed and taken into account at CT scan evaluation. The distal right common iliac artery should not be used, as venous damage can be predicted from the anatomical and intimate relationship of the iliac artery and vein at this level in patients with atheroma and the difficulties this relationship

  15. Ascending colon cancer with synchronous external iliac and inguinal lymph node metastases but without regional lymph node metastasis: a case report and brief literature review.

    PubMed

    Kitano, Yuki; Kuramoto, Masafumi; Masuda, Toshiro; Kuroda, Daisuke; Yamamoto, Kenichiro; Ikeshima, Satoshi; Iyama, Ken-Ichi; Shimada, Shinya; Baba, Hideo

    2017-12-01

    Lymph node metastasis to the iliac or inguinal region of colon cancer is extremely rare. We experienced a case of ascending colon cancer with synchronous isolated right external iliac and inguinal lymph node metastases but without any regional lymph node metastasis. An 83-year-old woman was admitted to our hospital due to anemia. Colonoscopy and computed tomography revealed an ascending colon cancer and also right external iliac and inguinal lymph node swelling. Further examination by F-deoxyglucose positron emission tomography strongly suggested that these lymph nodes were metastatic. Right hemicolectomy with lymph node dissection along the superior mesenteric artery, and right external iliac and inguinal lymph node dissection were performed. Histological examination revealed that both lymph nodes were metastasized from colon cancer, and there was no evidence of regional lymph node metastasis. The patient has shown no sign of recurrence at 27 months after surgery.

  16. External Jugular Vein Thrombosis as a Sign of Metastatic Breast Cancer

    PubMed Central

    Yalaza, Metin; Kafadar, Mehmet Tolga; Çıvgın, Esra Yurduseven; Düzgün, Arife Polat

    2017-01-01

    External jugular vein thrombosis is a rare vascular event which may lead fatal complication such as sepsis and pulmonary embolism. Its relation to the visceral solid tumor as an etiologic factor has been established well. Although external jugular vein thrombosis may be seen in malignancy, it is unusual to see as a sign of breast cancer. Most of the external jugular vein thrombosis occurs secondary to compression of the vein. Vascular thrombosis due to hypercoagulability is known as Trousseau syndrome. Herein, we present a case of metastatic breast cancer which presented with external jugular vein thrombosis; Trousseau syndrome. PMID:28331768

  17. Non-cuffed dual lumen catheters in the external jugular veins versus other central veins for hemodialysis patients.

    PubMed

    Moini, Majid; Rasouli, Mohammad R; Kenari, Mohammad Mahmoodzadeh; Mahmoodi, Hamid Reza

    2009-01-01

    To compare prospective between insertion of non-cuffed dual lumen catheter in the external jugular vein and other central veins for hemodialysis (HD), we studied 68 chronic dialysis patients randomly allocated into two groups: one with external jugular vein catheterization as access for HD and another with other central venous catheterization, internal jugular or subclavian vein. Our results showed there were no significant differences regarding successful cannulation, com-plications, total numbers of dialysis, development of pain and infection at the site of cannulation, patency rate of the catheters, and efficacy of hemodialysis between both groups. In addition, the patency of the catheter in the external jugular vein was not affected by previous cannulation of other central veins. In contrast, there was a significant correlation between numbers of attempts for cannulation in both groups and development of hematoma and infection, (p< 0.05). In conclusion, our results showed that the external jugular vein may be an alternative for other central veins for insertion of temporary non-cuffed hemodialysis catheter.

  18. T-Stenting-and-Small-Protrusion Technique for Bifurcation Stenoses After End-to-Side Anastomosis of Transplant Renal Artery and External Iliac Artery: Report of Two Cases

    SciTech Connect

    Chen, Yong Ye, Peng; Jiang, Wen-jin; Ma, Shuo-yi Zhao, Jian-bo Zeng, Qing-le

    2015-10-15

    Bifurcation stenoses after end-to-side anastomosis of transplant renal artery (TRA) and external iliac artery (EIA), including stenoses at the anastomosis and the iliac artery proximal to the TRA, are rare. In the present article, we report two successfully managed cases of bifurcation stenoses after end-to-side anastomosis of the TRA and EIA using the technique of T-stenting and small protrusion (TAP stenting)

  19. Pediatric isolated bilateral iliac aneurysm.

    PubMed

    Chithra, R; Sundar, R Ajai; Velladuraichi, B; Sritharan, N; Amalorpavanathan, J; Vidyasagaran, T

    2013-07-01

    Aneurysms are rare in children. Isolated iliac artery aneurysms are very rare, especially bilateral aneurysms. Pediatric aneurysms are usually secondary to connective tissue disorders, arteritis, or mycotic causes. We present a case of a 3-year-old child with bilateral idiopathic common iliac aneurysms that were successfully repaired with autogenous vein grafts.

  20. External Iliac Artery-Appendicular Fistula due to Antegrade Unusual Migration of K-Wire from Hip to Pelvis: An Unreported Complication.

    PubMed

    Singh, Nagmani; Pandey, Chakra Raj; Pant, Bhaskar Raj; Shrestha, Uttam Krishna; Bista, Biraj

    2015-01-01

    Background. K-wires are thought to be extremely safe implants and complications as a result of direct insertion or migration are very rare. Complications may be life-threatening in some instances where migration results in injury to vital organs. We report one such case where antegrade migration of K-wire from the hip resulted in injury to external iliac artery and formation of external iliac artery-appendicular fistula. No such complication due to migration has ever been reported in the literature. Case Description. A 15-year-old boy presented with lower abdominal pain, right lower limb swelling and pain, inability to walk, and rectal bleeding for 1 month after 2 K-wires had been inserted in his right hip joint for treatment of slipped capital femoral epiphysis the previous year. On investigation, he was diagnosed to have external iliac artery-appendicular fistula for which he was surgically treated. Clinical Relevance. Antegrade migration of K-wire from hip joint may lead to life-threatening injuries which can be minimized by bending the end of the K-wire, keeping the tip protruding outside the skin wherever possible and by early removal of K-wire once its purpose has been achieved.

  1. Procedure for Human Saphenous Veins Ex Vivo Perfusion and External Reinforcement

    PubMed Central

    Berard, Xavier; Alonso, Florian; Haefliger, Jacques-Antoine

    2014-01-01

    The mainstay of contemporary therapies for extensive occlusive arterial disease is venous bypass graft. However, its durability is threatened by intimal hyperplasia (IH) that eventually leads to vessel occlusion and graft failure. Mechanical forces, particularly low shear stress and high wall tension, are thought to initiate and to sustain these cellular and molecular changes, but their exact contribution remains to be unraveled. To selectively evaluate the role of pressure and shear stress on the biology of IH, an ex vivo perfusion system (EVPS) was created to perfuse segments of human saphenous veins under arterial regimen (high shear stress and high pressure). Further technical innovations allowed the simultaneous perfusion of two segments from the same vein, one reinforced with an external mesh. Veins were harvested using a no-touch technique and immediately transferred to the laboratory for assembly in the EVPS. One segment of the freshly isolated vein was not perfused (control, day 0). The two others segments were perfused for up to 7 days, one being completely sheltered with a 4 mm (diameter) external mesh. The pressure, flow velocity, and pulse rate were continuously monitored and adjusted to mimic the hemodynamic conditions prevailing in the femoral artery. Upon completion of the perfusion, veins were dismounted and used for histological and molecular analysis. Under ex vivo conditions, high pressure perfusion (arterial, mean = 100 mm Hg) is sufficient to generate IH and remodeling of human veins. These alterations are reduced in the presence of an external polyester mesh. PMID:25350681

  2. Catheter-directed Thrombolysis with Argatroban and tPA for Massive Iliac and Femoropopliteal Vein Thrombosis

    SciTech Connect

    Sharifi, Mohsen; Bay, Curt; Nowroozi, Sasan; Bentz, Suzanne; Valeros, Gayle; Memari, Sara

    2013-12-15

    Purpose: Catheter-directed thrombolysis (CDT) is a highly effective approach in the treatment of deep venous thrombosis (DVT). There are no data on the primary use of CDT with argatroban and tissue plasminogen activator (tPA) in patients without heparin-induced thrombocytopenia (HIT). The aim of this study was to evaluate the efficacy and safety of the combined administration of argatroban and tPA during CDT for massive DVT in patients without HIT. Methods: Thirty-three patients with massive symptomatic iliac and femoropopliteal DVT underwent CDT with tPA and argatroban within 28 {+-} 6 h of presentation. The dose of tPA was 0.75-1 mg/h through the infusion port and that of argatroban at 0.3-1 {mu}g/kg/min through the side port of the sheath. The patients were evaluated for the efficacy and safety of CDT and recurrent symptomatic venous thromboembolism (VTE) at a mean follow-up of 22 months. Results: There was no bleeding or iatrogenic pulmonary embolism with the CDT regimen we used. Grade III lysis (complete resolution of thrombus on venography) was achieved in 30 patients (91 %). In 3 patients with additional inferior vena cava filter thrombosis, further thrombectomy of the filter was required. No patient developed recurrent VTE. Conclusion: Concomitant administration of argatroban and tPA is a highly safe and effective regimen for CDT for massive DVT.

  3. Ischemic-reperfusion of unilateral external iliac artery in rat: A new model for vasculitic femoral neuropathy.

    PubMed

    Muthuraman, Arunachalam; Ramesh, Muthusamy

    2016-08-15

    Clinically, ischemic environment during gynecological surgery at lithotomy position is most common causative factor for the development of vasculitic femoral neuropathy (VFN). The present study was designed to induce the clinically relevant rat model of VFN by ischemic-reperfusion (I/R) injury of unilateral external iliac artery (uEIA). The VFN was induced by 3, 4 and 5h occlusion of uEIA followed by reperfusion. The I/R of uEIA induced VFN was evaluated by (i) behavioral parameters i.e., hind limb temperature; weight bearing capacity; (ii) kinematic analysis i.e., paw posture, splay angle, static sciatic index (SSI), and ankle-angle tests; (iii) evaluation of pain perception i.e., plantar and pin prick; (iv) serum biochemical estimation i.e., nitrate, lipid peroxidation, TNF-α and calcium level; (v) evaluation of motor and sensory nerve conduction velocity; and (vi) measurement of nerve fiber density. The 4 and 5h occlusion of uEIA has produced the potential changes in behavioral, functional, electrophysiological, biochemical and histopathological assessment. The 5h occlusion of uEIA has shown to produce the mortality. Whereas, 3h occlusion does not produce the significant changes in the development of VFN. The 4h ischemic occlusion of uEIA has shown potential rat model of VFN due to its close mimicking capacity of VFN in human. Therefore, it can be useful to explore the newer anti-neuralgic medicine and with their pharmacodynamic action in the field of various neurovascular disorders.

  4. Anatomical Location of the Common Iliac Veins at the Level of the Sacrum: Relationship between Perforation Risk and the Trajectory Angle of the Screw

    PubMed Central

    Akhgar, Javid; Suhrab Rahmani, Mohammad; Tamai, Koji; Suzuki, Akinobu; Toyoda, Hiromitsu; Hoshino, Masatoshi; Abdullah Ahmadi, Sayed; Hayashi, Kazunori; Nakamura, Hiroaki

    2016-01-01

    Purpose. To determine the safety of transarticular surface screw (TASS) insertion and the anatomical location of the common iliac veins (CIVs) at the level of the promontorium. Materials and Methods. The locations of the CIVs on 1 mm computed tomography-myelography slices of 50 patients at the level of the promontorium and 20 human cadavers were investigated. Results. Among the patients, the left CIV was closer to the S1 anterior wall than the right CIV (mean distance: 5.0 ± 3.0 and 7.0 ± 4.2 mm, resp.). The level of the inferior vena cava (IVC) formation varied among the cadavers. The mean distance between the IVC formation and promontorium tip was 30.2 ± 12.8 mm. The height of the IVC formation and distance between the right and the left CIVs at the level of the promontorium were significantly correlated (P < 0.001). Conclusion. The TASS trajectory is safe as long as the screw does not penetrate the anterior cortex of S1. The level of the IVC formation can help to predict the distance between the right and the left CIVs at the level of the promontorium. The CIVs do not have a uniform anatomical location; therefore, preoperative computed tomography is necessary to confirm their location. PMID:28078279

  5. An unusual case of multiple aortic abnormalities: total occlusion of aortic arch, left external iliac artery, and bicuspid aortic valve in a 21-year-old man.

    PubMed

    Tanindi, Asli; Tavil, Yusuf; Mutluay, Ruya; Taktak, Hacer; Cengel, Atiye

    2007-03-01

    An unusual case of total occlusion of aorta just distal to the left subclavian artery, bicuspid aortic valve, and occluded left external iliac artery in a 21-year-old man who was admitted with headache and severe hypertension is presented. We wish to report this case because so far there have been none reported with such multiple aortic abnormalities, although several documented cases of isolated total occlusion of aorta exist. Our patient underwent a successful surgical correction, i.e., patch plasty to the coarcted segment and end to side - end to side aortal-aortal bypass with Dacron graft.

  6. Initial Report of a Mycotic Aneurysm of the Common Iliac Artery With Compression of the Ipsilateral Ureter and Femoral Vein: A Literature Review and Case Report

    PubMed Central

    Lippoff, Orrin; Hoover, Eddie L.; Diaz, Carlos; Webb, Hueldine; Hsu, Hwei-Kang

    1986-01-01

    Iliac artery aneurysms are rare and the usual symptoms, pelvic pain and urological complaints, are nonspecific. We describe a patient with pelvic pain, intermittent urinary retention, and lower extremity edema. A right common iliac artery aneurysm was discovered during surgery after rupture had occurred. Pathologic examination revealed a mycotic process. This case demonstrates the obscure and unreported clinical features of iliac artery aneurysms. When this lesion is suspected, an angiogram should be performed promptly in an effort to prevent the predictable catastrophic consequences. (Texas Heart Institute Journal 1986; 13:321-324) Images PMID:15226863

  7. [About the tributaries of the arch of great saphenous vein. Concerning 40 dissections].

    PubMed

    Ndiaye, Ass; Ndiaye, Ab; Diop, M; Ndoye, J M; Ciss, G; Dia, A; Ndiaye, M; Sow, M L

    2005-01-01

    The arch of the great saphenous vein cross receives numerous tributaries from the abdominal wall, male external genitalia and pelvic limbs. These collaterals present many variations relating to their number and mode of anastomosis. Their misappreciation may lead to post operative recurrences after surgical treatment of varices. For a last study of these variations, we dissected 40 inguinofemoral regions in fresh black african corpes. The conventional type in a "vein strar" shape was present in 4 cases. An abdominal common vein produced through the merging of the superficial epigastric and superficial circumflex iliac veins was found in 5 cases. A genital common vein summarising the external pudendal veins was present in 19 cases. In 8 cases the abdominal and genital common vein was simultaneously present. An anterior saphenous vein was found in 15 cases, and a posterior saphenous vein in 5 cases. These results, confirm the importance of anatomic variations. Their knowledge is necessary to avoid recurrences after surgery of varicose veins.

  8. Fistula formation between the external iliac artery and ileal conduit following a radical cystoprostatectomy: a rare complication with prewarning signs of haemorrhage

    PubMed Central

    Sukha, Anisha; Smyth, Niamh

    2015-01-01

    A 76-year-old man was admitted with bleeding per-urostomy following a collapse at home. Three weeks prior to the admission, he had undergone a radical cystoprostatectomy and formation of ileal-conduit for an extensive bladder carcinoma. A CT angiogram revealed a possible small source of bleeding within the ileal-conduit itself, which settled with conservative management. However, prior to discharge he developed profuse fresh bleeding from the urostomy, which could not be controlled. The patient underwent an emergency endoscopy of the conduit and laparotomy, which revealed a fistula between the right external iliac artery and the proximal end of the ileal-conduit. The right iliac artery was ligated and an emergency left-to-right femoral-femoral crossover bypass was performed. The right ureter was stented and rediverted through the ileal-conduit and the left ureter was stented at a later date. He unfortunately had a stormy postoperative recovery with further episodes of per-urostomy bleeding and no identified source. PMID:25819824

  9. Embolization for Acute Small-Bowel Bleeding from the Collateral Artery of the Superior Mesenteric Left Deep Circumflex Iliac Artery Associated with Narrowing of the Bilateral Common External Iliac Arteries

    SciTech Connect

    Shimohira, Masashi Ogino, Hiroyuki; Sasaki, Shigeru; Nishikawa, Hiroko; Shibamoto, Yuta

    2009-03-15

    We present a case of acute small-bowel bleeding from the collateral artery of the superior mesenteric-left deep circumflex iliac artery that was successfully managed by transarterial coil embolization.

  10. Usefulness of Groshong catheters for central venous access via the external jugular vein.

    PubMed

    Ishizuka, Mitsuru; Nagata, Hitoshi; Takagi, Kazutoshi; Horie, Toru; Sawada, Tokihiko; Kubota, Keiichi

    2008-01-01

    This study was designed to evaluate the usefulness of central venous access via the external jugular vein (EJV) employing Groshong catheters, and to compare the complications with those of conventional internal jugular venous catheterization. Central venous access was achieved by insertion of a single-lumen 4.0 Fr Groshong catheter via the EJV or internal jugular vein (IJV) with a single puncture. Complications associated with insertion and central venous catheter-related bloodstream infection (CVC-RBSI) were evaluated from the database. Two hundred and twenty-five patients received 400 catheters for a total period of 5377 catheter-days. Ninety-six patients underwent 201 internal jugular venous catheter (IJV-C) procedures for 2381 catheter-days, and 129 patients underwent 199 external jugular venous catheter (EJV-C) procedures for 2996 catheter-days. Use of EJV-C was associated with a longer catheter insertion length (p < .01) and period (p < .01), a larger number of operations (p < .01), and more frequent use of total parenteral nutrition (TPN) (p < .01) and less frequent use of chemotherapy (p < .01) than for IJV-C. However, there were no significant differences (NS) in complications associated with insertion and CVC-RBSI between IJV-C and EJV-C. There were no significant differences such complications as malposition, oozing or hematoma formation of insertion site, arterial bleeding, nerve damage, pneumothorax, and phlebitis between IJV-C and EJV-C. Moreover, EJV-C was not associated with morbidities such as pneumothorax, arterial bleeding, and nerve damage. Thus the study concluded that EJV-C using Groshong catheters has no severe complications and has the same rates of CVC-RBSI as conventional IJV-C for central venous access.

  11. Extraordinary cerebral venous drainage pathway with mastoid emissary and posterior external jugular veins detected by contrast-enhanced neck computed tomography.

    PubMed

    Bulbul, Erdogan; Yanik, Bahar; Demirpolat, Gulen; Koksal, Vildan

    2015-12-01

    An extraordinary cerebral venous drainage pathway and dilated vein at the left posterior cervical region were detected with routine contrast-enhanced neck computed tomography exam. The left sigmoid sinus was drained by dilated mastoid emissary vein (MEV). The MEV continued as posterior auricular and posterior external jugular veins (PEJVs). The left PEJV directly drained into subclavian vein. Atretic right transverse sinus, left facial vein forming the external jugular vein, atresia and hypoplasia of upper internal jugular veins at the right and left sides, respectively, were the other uncommon findings in our case. Detecting venous variations may prevent complications during surgical and interventional procedures, so the radiologists should examine the superficial cervical veins closely.

  12. Excision of extensive midfoot pigmented villonodular synovitis with microvascular anastamosis of iliac crest bone graft using external fixation: a case report.

    PubMed

    Oloff, Lawrence; Miller, Kevin

    2011-10-01

    Pigmented villonodular synovitis (PVNS) is a relatively rare lesion in the foot and ankle, most commonly involving the ankle joint and atypically, the subtalar and midtarsal joints. It is a benign proliferative disease characterized by an increase in villous or nodular synovium in joints. Resection of the tumor is often indicated in most cases because of the potentially aggressive joint destructive nature of this lesion. This report presents a case of chronic enlarging pervasive midtarsal and metatarsal-cuneiform joint PVNS in a 28-year-old male. This patient had a midtarsal mass that enlarged over a period of 2 years, causing increased pain, deformity, and difficulty with ambulation. Cross-sectional imaging studies identified evidence of erosive disease through much of the midfoot articulations, with biopsy confirming the mass as PVNS. The dimensions of the mass approximated 5.5 cm × 4.1 cm × 2.8 cm. Simple resection was problematic because of the size and multiple joints involved. Amputation was most commonly advised by multiple consultants. The patient preferred attempt at limb salvage. En bloc resection and placement of a revascularized iliac crest bone graft was used to fill the defect. The graft was microvascularly anastamosed and fixated with standard external fixation. Pathologic and histologic specimens from surgical biopsy reconfirmed the diagnosis of PVNS postoperatively. Second-stage arthrodesis was performed when the patient was stable and disease free. The patient was followed postoperatively for 10 years without recurrence and was able to return to full function and partake in moderate athletic activity at last visit. This case describes a retrospective review of the procedure and reconstruction, as well as an overview of current surgical management of PVNS.

  13. Placement of long-term hemodialysis catheter (permcath) in patients with end-stage renal disease through external jugular vein

    PubMed Central

    Beigi, Ali Akbar; Sharifi, Ali; Gaheri, Hafez; Abdollahi, Saeed; Esfahani, Morteza Abdar

    2014-01-01

    Background: The number of patients with End-Stage Renal Disease (ESRD) has progressively increased in the population. Kidney transplantation is the specific treatment for such patients; however a majority of patients will require hemodialysis before kidney transplantation. The present study aims to investigate using the external jugular vein (EJV) for Permcath placement in these patients. Materials and Methods: This descriptive and analytical study was conducted in Alzahra Medical Center, Isfahan, in 2012. Catheters were inserted by cutting down the right EJV. The patency rate and potential complications were studied. The obtained data was analyzed using SPSS 21.0. Results: Out of 45 live patients, within three months of surgery, 40 patients (81.6%) had no complications and dialysis continued through Permcath. Permcath Thrombosis occurred in two patients (4.4%). Catheter infection led to the removal of it in one patient (2.2%) 1.5 months after surgery. And accidental catheter removal occurred in one patient. Conclusion: Placement of the permcath in the external jugular vein can be a safe, uncomplicated, and reliable method for patients requiring hemodialysis, and can be a life-saving alternative in patients without accessible internal jugular vein. PMID:25590030

  14. The research and preparation of a bi-layer biodegradable external sheath with directional drug release profiles for vein graft

    NASA Astrophysics Data System (ADS)

    Liu, Zhenjie; Guo, Zhenying; Si, Yi; Zhang, Xiangman; Shi, Zhenyu; Chen, Feng; Fu, Weiguo

    2013-11-01

    External sheath has been suggested for autologous vein grafts to inhibit neointimal hyperplasia and prevent anastomosis stricture. In this study, we prepared a bi-layer biodegradable paclitaxel-loaded sheaths with a synthetic copolymer poly(ethylene carbonate-ɛ-caprolactone) at room temperature. The bi-layer drug release profiles of the Paclitaxel-loaded (PTX-loaded) sheath significantly slow down the paclitaxel (PTX) release rates and result in a directional drug release way. Moreover, the nanofibrous layer of PTX-loaded poly(EC-CL) sheaths reduced the cytotoxicity and provided a better support for fibroblast adhesion and proliferation than the PTX-loaded layer of the sheaths. Thus, this study demonstrates that the bi-layer PTX-loaded poly(EC-CL) sheath with directional drug release profiles have a promising application for vein graft to against neointimal hyperplasia and anastomotic stricture.

  15. Bioengineering studies of periodic external compression as prophylaxis against deep vein thrombosis-part I: numerical studies.

    PubMed

    Kamm, R D

    1982-05-01

    This paper presents the results of a numerical study of the technique of periodic external compression for the prevention of deep vein thrombosis. In the model the veins of the lower leg are portrayed as a continuous system rather than as discrete elements as in previous models. Consequently, we are able to explore the detailed effects of different modes of compression including (i) uniform compression, the simultaneous application of uniform pressure over the entire lower leg, (ii) graded compression, the application of nonuniform pressure, maximum at the ankle and minimum at the knee, and (iii) wavelike compression, a wave of compression proceeding from the ankle toward the knee. These numerical results indicate that the effectiveness of uniform compression is severely compromised by the formation of a flow-limiting throat at the proximal end of the compression cuff that reduces both the rate at which blood is discharged from the lower leg and the total blood volume removed. Both of these detrimental effects can be avoided by the use of either wavelike of graded compression. Both alternated methods are shown to produce more uniform augmentation of volume flow rate, flow velocity and shear stress, throughout the entire lower leg. In the companion paper, Part II [18] (see following article), these same compression modes are tested using a simple hydraulic model consisting of a single latex tube inside a foam cylinder as a highly simplified representation of a human leg.

  16. Efficacy of External Beam Radiation-Based Treatment plus Locoregional Therapy for Hepatocellular Carcinoma Associated with Portal Vein Tumor Thrombosis

    PubMed Central

    Chen, Ming-Yang; Wang, Yu-Chao; Wu, Tsung-Han; Lee, Chen-Fang; Wu, Ting-Jung; Chou, Hong-Shiue; Tsang, Ngan-Ming; Lee, Wei-Chen

    2016-01-01

    Background. Portal vein tumor thrombosis (PVTT) is a common event in advanced hepatocellular carcinoma (HCC). The optimal treatment for these patients remains controversial. Methods. A retrospective review of 149 patients who had unresectable HCC associated with PVTT between January 2005 and December 2012 was performed. Outcomes related to external beam radiation-based treatment were measured, and clinicopathological features and parameters affecting prognosis were analyzed as well. Results. The radiotherapeutic response of PVTT was an important element that affected the overall treatment response of HCC. Serum α-fetoprotein < 400 ng/mL, the presence of a radiotherapeutic response on PVTT, and receiving additional locoregional therapy were significant prognostic factors affecting the survival of patients. Patients who had received additional locoregional therapy obtained a better outcome, and six of them were eventually able to undergo surgical management with curative intent. Conclusion. The outcome of HCC associated with PVTT remains pessimistic. In addition to the current recommended treatment using sorafenib, a combination of external beam radiotherapy targeting PVTT and locoregional therapy for intrahepatic HCC might be a promising strategy for patients who had unresectable HCC with PVTT. This approach could perhaps offer patients a favorable outcome as well as a possible cure with following surgical management. PMID:27999803

  17. Pelvic Vein Embolisation in the Management of Varicose Veins

    SciTech Connect

    Ratnam, Lakshmi A.; Marsh, Petra; Holdstock, Judy M.; Harrison, Charmaine S.; Hussain, Fuad F.; Whiteley, Mark S.; Lopez, Anthony

    2008-11-15

    Pelvic vein incompetence is common in patients with atypical varicose veins, contributing to their recurrence after surgery. Therefore, refluxing pelvic veins should be identified and treated. We present our experience with pelvic vein embolisation in patients presenting with varicose veins. Patients presenting with varicose veins with a duplex-proven contribution from perivulval veins undergo transvaginal duplex sonography (TVUS) to identify refluxing pelvic veins. Those with positive scans undergo embolisation before surgical treatment of their lower limb varicose veins. A total of 218 women (mean age of 46.3 years) were treated. Parity was documented in the first 60 patients, of whom 47 (78.3%) were multiparous, 11 (18.3%) had had one previous pregnancy, and 2 (3.3%) were nulliparous. The left ovarian vein was embolised in 78%, the right internal iliac in 64.7%, the left internal iliac in 56.4%, and the right ovarian vein in 42.2% of patients. At follow-up TVUS, mild reflux only was seen in 16, marked persistent reflux in 6, and new reflux in 3 patients. These 9 women underwent successful repeat embolisation. Two patients experienced pulmonary embolisation of the coils, of whom 1 was asymptomatic and 1 was successfully retrieved; 1 patient had a misplaced coil protruding into the common femoral vein; and 1 patient had perineal thrombophlebitis. The results of our study showed that pelvic venous embolisation by way of a transjugular approach is a safe and effective technique in the treatment of pelvic vein reflux.

  18. Venous anastomosis in free flap reconstruction after radical neck dissection: is the external jugular vein a feasible option?

    PubMed

    Reiter, Maximilian; Baumeister, Philipp

    2017-01-13

    Free microvascular tissue transfer has become a reliable and wellestablished technique in reconstructive surgery. Success rates greater than 95% are constantly reported in the literature. End-to-end anastomosis to the external jugular vein (EJ) is supposed to be equally successful as anastomosis to the internal jugular vein (IJ) in patients treated with selective neck dissection. No data has been published so far when the IJ had to be resected during neck dissection. The purpose of this study was to evaluate the success rate and complications of end-to-end anastomosis to the EJ in cases of (modified) radical neck dissection with resected IJ. A retrospective mono-center cohort study was performed. All patients with end-to-end anastomosis to either the IJ or EJ-system were reviewed. 423 free-tissue transfers performed between 2009 and 2016 were included. The overall success rate was 97.0% with an anastomotic revision rate due to venous thrombosis of 12.3%. In patients when the IJ had to be resected and the venous anastomosis was performed at the ipsilateral side to the EJ (n = 53), overall flap loss was significantly higher (5/53; 9.4%). The revision rate in these cases was 22.6%. Success rate of anastomosis to the EJ when the ipsilateral IJ was still intact was 100% (n = 20). Success rate when the anastomosis was performed at the contralateral side was 100%. End-to-end anastomosis to the EJ in cases with resected IJ is more likely to result in free flap loss. Furthermore, it is associated with a higher revision rate. Therefore, in cases with resected IJ, we suggest to plan the operation beforehand with anastomosis at the contralateral side whenever possible.

  19. Laparoscopic management of massive spontaneous external haemorrhage from the umbilical varix due to recanalisation of the paraumbilical vein in a patient with 'Child's Class A' liver cirrhosis.

    PubMed

    Zachariah, Sanoop K; Krishnankutty, Sreejith L; Raja, Nirmalan

    2012-04-01

    Spontaneous external haemorrhage from the umbilical varix is an extremely rare complication of portal hypertension. Bleeding is usually into the peritoneal cavity and the treatment involves urgent laparotomy and ligation of the bleeding varices. We describe a cirrhotic 38-year-old man who presented with spontaneous external haemorrhage from the umbilical varix which was successfully managed laparoscopically by in-situ distal clipping and proximal transcutaneous ligation of the recanalised paraumbilical veins. We therefore feel that laparoscopy can be safely and effectively employed to control external haemorrhage from the umbilical varix associated with liver cirrhosis. This novel technique can help avoid a laparotomy and also help preserve the umbilicus.

  20. Percutaneous Endoluminal Bypass of Iliac Aneurysms with a Covered Stent

    SciTech Connect

    Ruebben, Alexander; Tettoni, Serena; Muratore, Pierluigi; Rossato, Dennis; Savio, Daniele; Rabbia, Claudio

    1998-07-15

    To evaluate the feasibility of percutaneous treatment of iliac aneurysms, a covered stent was inserted in nine men suffering from common iliac artery aneurysms (six cases), external iliac aneurysms (one case), or pseudoaneurysms (two cases). Placement of the stent was successful in all patients. In one patient, an endoprosthesis thrombosed after 15 days, but was successfully treated by thrombolysis and additional stent placement. At the follow-up examinations (mean period 22 months) all stent-grafts had remained patent. No late leakage or stenosis was observed.

  1. Coil Protruding into the Common Femoral Vein Following Pelvic Venous Embolization

    SciTech Connect

    Marsh, Petra Holdstock, Judith M.; Bacon, Jennifer L.; Lopez, Anthony J.; Whiteley, Mark S.; Price, Barrie A.

    2008-03-15

    Pelvic venous embolization is performed for pelvic congestion syndrome and prior to lower limb varicose vein surgery in females with associated pelvic venous insufficiency. The procedure is analogous to varicocele embolization in males, although refluxing internal iliac vein tributaries may also be embolized. We report a case of inadvertent coil placement in the common femoral vein while embolizing the obturator vein, during pelvic vein embolization for recurrent lower limb varicose veins. There were no clinical consequences and the coil was left in situ. We advise caution when embolizing internal iliac vein tributaries where there is clinically significant communication with veins of the lower limb.

  2. The arch of the great saphenous vein: anatomical bases for failures and recurrences after surgical treatment of varices in the pelvic limb. About 54 dissections.

    PubMed

    Ndiaye, Ass; Ndiaye, Abd; Ndoye, J M; Diarra, O; Diop, M; Dia, A; Ndiaye, M; Sow, M L

    2006-03-01

    The arch of the great saphenous vein presents numerous tributaries. Misappreciation of their anatomical variations might cause recurrence after surgical treatment of varices. We dissected 54 inguino-femoral regions of fresh, black African corpses. Our purpose was to study the anatomical variations in the vein confluents of the arch of the great saphenous vein; its positions in relation to the external pudendal artery; establish palpable anatomical markers for its surgical approach. The conventional type in a 'vein star' shape was not the most frequent. Upper or abdominal common vein produced through the merging of superficial veins of the anterior abdominal wall and genital or internal common vein were more frequent. An anterior saphenous vein was found in 23 cases. The external pudendal artery crossed beneath the arch of the great saphenous vein cross in 56% of cases and previously in 44% of cases. On average, the top of the arch of the great saphenous vein was projected out 10.88 cm from the ventral and cranial iliac spine, 3.83 cm from the pubic tubercle and 4.19 cm from the inguinal ligament. In view of our results, variations are real. Knowing and taking them into account are essential to prevent recurrences after surgical treatment of varices of the pelvic limb.

  3. Successful third renal transplantation in a child with an occluded inferior vena cava: A novel technique to use the venous interposition between the transplant renal vein and the infrahepatic inferior vena cava.

    PubMed

    Muramatsu, Masaki; Shishido, Seiichiro; Takahashi, Yusuke; Hamasaki, Yuko; Yoshimura, Hiroshi; Nihei, Hiroshi; Itabashi, Yoshihiro; Kawamura, Takeshi; Aikawa, Atsushi

    2017-03-19

    A girl aged 11 years and 3 months with occlusion of the inferior vena cava had experienced two renal transplant graft failures since birth. The third renal transplant from a live donor was carried out. Preoperative evaluation showed that the arteries from the right common to the right external iliac artery were absent, and the ilio-caval vein was occluded below the level of the renal vein. The donor's renal artery was anastomosed to the aorta. The donor's ovarian and large saphenous veins were used to extend the transplant renal vein to the recipient's patent inferior vena cava. The present report concludes that the extension of a short donor renal vein using other donor veins is a viable therapeutic option for pediatric patients with vascular occlusions.

  4. [Lesion of pelvic organs in secondary varicose veins of the small pelvis].

    PubMed

    Tsukanov, Yu T; Tsukanov, A Yu; Levdansky, E G

    2015-01-01

    The authors studied peculiarities of pelvic organs lesions in patients presenting with secondary small pelvic varicose veins (SPVV) induced by endured thrombosis of iliac veins. The study included a total of 70 patients after endured thrombosis of iliac veins verified by radiodiagnostic methods. The average duration of thrombosis amounted to 3.8 years. The patients were subdivided into two groups. The Study Group comprised 48 patients presenting with small pelvic varicose veins revealed by duplex scanning; the Control Group was composed of 22 patients with no varicose pelvic veins. It was determined that characteristic features of patients with secondary SPVV having developed after iliac veins thrombosis included chronic pelvic pain, dilatation of cavernous veins of the rectum, inguinal vein varicosity and varicose veins of the groin and anterior abdominal wall. Formation of secondary SPVV after endured iliac vein thrombosis leads to disorders of pelvic organs, similar to those in primary varicosity, but more often being functional. Endured iliac veins thrombosis in formation of secondary SPVV leads to urination impairments with prevalence of moderately pronounced symptomatology. Small pelvic organs dysfunction in women with secondary SPVV due to endured iliac veins thrombosis manifests itself in dyspareunia, leukorrhea, and dysmenorrhea.

  5. Iliac artery endofibrosis in a middle-aged female long-distance runner.

    PubMed

    van Rensburg, Dina Christina Janse; van Rensburg, Audrey Jansen; van Duuren, Elsa Margaretha; Grant, Catharina Cornelia

    2014-12-01

    Exercise-induced iliac artery endofibrosis is a recently described abnormality of the external iliac artery that typically affects younger, healthy endurance athletes. Characteristic of the initially termed cyclist's iliac syndrome is lower limb pain during exercise with rapid recovery after exercise. This clinically complicated case describes an older female long-distance runner in whom an incorrect diagnosis of fibromuscular dysplasia was originally made when she presented with claudication and thrombosis of the right external iliac artery. A thrombectomy and bilateral balloon angioplasty were performed; however, her symptoms persisted. Four months later, she unexpectedly complained of dual calf claudication, a diagnosis of exercise-induced iliac artery endofibrosis was made, and a bilateral prosthetic graft bypass procedure was performed, which resulted in a good outcome.

  6. The iliac passion.

    PubMed Central

    Natanson, M.

    1992-01-01

    "The Iliac Passion" traces a return from the new but busy and rapidly growing discipline of "bioethics" to its source in "fundamental philosophical inquiry." The dilemma between bioethics and medicine is examined in two ways. First, the philosophical concept of the "big question" is presented. If we ask of life or of human experience "What does it all mean?", the "it" needs to be defined, and what I propose to do is to "take on" the "it." In Part Two, the task of combining the medical-technical objectifying mode of thinking about patients, necessary to treat them effectively, with the ability to understand and sympathize with their pain and distress, is illustrated by means of a personal story or parable. PMID:1494895

  7. IVC agenesis: a rare cause of deep vein thrombosis.

    PubMed

    Man, Louise; Hendricks, Nicholas; Maitland, Hillary

    2016-04-01

    We present the case of a healthy, young Caucasian female who presented to an outside hospital with phlegmasia cerulea dolens of both lower extremities. Computed tomography angiography revealed inferior vena cava (IVC) occlusion. She was initiated on heparin infusion and transferred to University of Virginia Medical Center. Our evaluation revealed aplasia of the IVC from the infrahepatic segment to the confluence of the common iliac veins and acute bilateral iliac vein thromboses. An extensive network of collateral veins was noted. These findings were consistent with IVC agenesis. She was not pregnant or using contraception. Primary thrombophilia workup was negative. She underwent bilateral iliac vein thrombolysis and was started on anticoagulation. While IVC agenesis is rare, it carries risk for development of thrombotic sequelae and bears consideration when evaluating young patients with unexplained deep vein thrombosis, especially if extensive and bilateral.

  8. Bioengineering studies of periodic external compression as prophylaxis against deep vein thrombosis-part II: experimental studies on a stimulated leg.

    PubMed

    Olson, D A; Kamm, R D; Shapiro, A H

    1982-05-01

    In this companion paper to "Part I: Numerical Simulations, " we report in vitro experimental studies performed on a simple model leg consisting of a "vein" of thin-walled latex tubing surrounded by "tissue" of open-pore foam rubber. Three modes of periodic external compression, were investigated: i) uniform compression; (ii) graded compression, decreasing from ankle to knee; and (iii) sequential compression, progressing from ankle to knee. The modes are compared on the basis of three hemodynamic criteria: degree of vessel collapse, level of fluid velocity, and level of shear stress. In uniform compression these measures of merit are distributed very nonuniformly along the length of the leg: they are high near the proximal end of the cuff but low elsewhere, a result due to the formation proximally of a partially occlusive throat. The latter does not form in either graded or sequential compression, with the consequence that favorable values of the three measures of merit occur more uniformly along the length of the pressurized region. It is concluded that either the graded or sequential mode of compression, or perhaps a combination of the two, would be more effective than uniform compression as a prophylaxis against deep vein thrombosis.

  9. Varicose Veins

    MedlinePlus

    ... has surface (superficial) veins that are connected to deep veins by bridging (perforator) veins. Unlike arteries, which ... the valve leaflets and can develop in the deep, perforator, or superficial veins. View this table: View ...

  10. [Stents in iliac vascular changes].

    PubMed

    Gross-Fengels, W; Friedmann, G; Fischbach, R; Erasmi, H; Bulling, B

    1991-01-01

    The results of 79 iliac stent placements in 64 patients are reported. The technical success rate was 96%. The systolic pressure gradient dropped from 44 mmHg before to 2.8 mmHg after stent placement. This differed significantly as compared to a group treated by conventional PTA (gradient 5.8 mmHg). The cumulative patency after 18-20 months was 90%. Angiographic controls up to 19 months after "stenting" demonstrated only one secondary stent occlusion. Iliac stents therefore are a very valuable supplement to classic PTA.

  11. Axillo-iliac arteriovenous hemodialysis graft creation with an early cannulation device.

    PubMed

    Hinojosa, Carlos A; Anaya-Ayala, Javier E; Lopez-Mendez, Alejandra; Gomez-Arcive, Zeniff; Laparra-Escareno, Hugo; Cuen-Ojeda, Cesar; Lizola, Rene; Torres-Machorro, Adriana

    2017-03-01

    Exhaustion of superficial veins coupled with the presence of intrathoracic central venous occlusions remains a significant obstacle for hemodialysis access creation; complex arteriovenous graft (AVG) configurations have been described. The axillary-iliac AVG was first reported in 1987, and few authors have explored this access. We evaluated our experience with this AVG configuration utilizing the early cannulation (EC) graft Flixene™ (Atrium ™, Hudson, NH, USA). Eight patients (75 % men; mean age 37 ± 10 years) with End-Stage Renal Disease (ESRD) underwent axillo-iliac AVG creation with Flixene™ grafts; all had exhausted peripheral veins, occluded thoracic central veins, and inadequate femoral veins. Inflow from the axillary artery and outflow in iliocaval system was assessed prior to access creation. An axillary-to-common iliac AVG was constructed using a 6 mm (mm) EC graft and tunneled in the chest and abdominal wall. Eight grafts were implanted; all were patent after placement. Seven (88 %) were successfully used for hemodialysis within 72 h and one (12 %) within 96. During the mean follow-up of 6 months, 5 (62 %) patients underwent thrombectomy, 1 (12 %) of them had balloon angioplasty at the vein anastomosis, and 2 (25 %) grafts were removed secondary to infection. The remaining grafts are still functioning. Complications as high-output heart failure, steal syndrome and venous hypertension were not observed. Construction of axillo-iliac AVG with EC grafts in the setting of exhausted veins, occluded intrathoracic central veins and hostile groins, is a viable arteriovenous access alternative while avoiding central venous catheters.

  12. 49 CFR 572.199 - Pelvis iliac.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Pelvis iliac. 572.199 Section 572.199... Dummy, Small Adult Female § 572.199 Pelvis iliac. (a) The iliac is part of the lower torso assembly... assembled dummy (drawing 180-0000). The dummy is equipped with a laterally oriented pelvis accelerometer...

  13. Laparoscopic management of massive spontaneous external haemorrhage from the umbilical varix due to recanalisation of the paraumbilical vein in a patient with ‘Child's Class A’ liver cirrhosis

    PubMed Central

    Zachariah, Sanoop K; Krishnankutty, Sreejith L; Raja, Nirmalan

    2012-01-01

    Spontaneous external haemorrhage from the umbilical varix is an extremely rare complication of portal hypertension. Bleeding is usually into the peritoneal cavity and the treatment involves urgent laparotomy and ligation of the bleeding varices. We describe a cirrhotic 38-year-old man who presented with spontaneous external haemorrhage from the umbilical varix which was successfully managed laparoscopically by in-situ distal clipping and proximal transcutaneous ligation of the recanalised paraumbilical veins. We therefore feel that laparoscopy can be safely and effectively employed to control external haemorrhage from the umbilical varix associated with liver cirrhosis. This novel technique can help avoid a laparotomy and also help preserve the umbilicus. PMID:22623827

  14. Iatrogenic Iliac Artery Rupture: Emergency Management by Longer Stent-Graft on a Shorter Balloon

    SciTech Connect

    Trehan, Vijay; Nigam, Arima; Ramakrishnan, S.

    2007-02-15

    Rupture of an iliac artery during percutaneous transluminal coronary angioplasty is a rare but potentially devastating complication. We report a case of iatrogenic external iliac artery rupture that was successfully treated by temporary balloon occlusion followed by endovascular stent graft placement in an unusual manner. Limited availability of the hardware necessitated the use of a longer bare stent graft mounted on a relatively shorter balloon.

  15. Endovascular Stent-Grafting for Infected Iliac Artery Pseudoaneurysms

    SciTech Connect

    Sanada, Junichiro Matsui, Osamu; Arakawa, Fumitaka; Tawara, Mari; Endo, Tamao; Ito, Hiroshi; Ushijima, Satoshi; Endo, Masamitsu; Ikeda, Masahiro; Miyazu, Katsuyuki

    2005-01-15

    We report two cases of acutely infected pseudoaneurysms of the iliac arteries, successfully treated with endovascular stent-grafting. Two patients underwent stent-graft treatment for erosive rupture of the iliac artery caused by surrounding infection. The first case is that of a 61-year-old man who had undergone Miles' operation for an advanced rectal cancer. Postoperatively, he developed intrapelvic abscess formation, from which methicillin-resistant Staphylococcus aureus was cultured, followed by rupture of the right external iliac artery. The second case is that of a 60-year-old man who had a pseudoaneurysm of the left common iliac artery, which was contiguous with a left psoas muscle abscess, from which Streptococcus agalactiae was cultured. Both patients were successfully treated with only a stent-graft and antibiotic therapy, and remained symptom-free 12 months and 10 months later. Although endovascular stent-grafting should not be considered standard therapy for infected aneurysms, our cases suggest that it can result in repair of infected aneurysms even in the uncontrolled active stage.

  16. Recurrence of atrial fibrillation within three months after pulmonary vein isolation for patients with paroxysmal atrial fibrillation: Analysis using external loop recorder with auto-trigger function

    PubMed Central

    Kawasaki, Shiro; Tanno, Kaoru; Ochi, Akinori; Inokuchi, Koichiro; Chiba, Yuta; Onishi, Yoshimi; Onuma, Yoshimasa; Munetsugu, Yumi; Kikuchi, Miwa; Ito, Hiroyuki; Onuki, Tatsuya; Miyoshi, Fumito; Minoura, Yoshino; Watanabe, Norikazu; Adachi, Taro; Asano, Taku; Kobayashi, Youichi

    2014-01-01

    Background Pulmonary vein isolation (PVI) via catheter ablation has been shown to be a highly effective treatment option for patients with symptomatic paroxysmal atrial fibrillation (AF). The recurrence of AF within 3 months after PVI is not considered to be the result of ablation procedure failure, because early recurrence of AF is not always associated with late recurrence. We examined the usefulness of an external loop recorder with an auto-trigger function (ELR-AUTO) for the detection of atrial fibrillation following PVI to characterize early recurrence and to determine the implications of AF occurrence within 3 months after PVI. Methods Fifty-three consecutive symptomatic patients with paroxysmal AF (age 61.6±12.6 years, 77% male) who underwent PVI and were fitted with ELR-AUTO for 7±2.0 days within 3 months after PVI were enrolled in this study. Results Of the 33 (62.2%) patients who did not have AF recurrence within 3 months after PVI, only 1 patient experienced AF recurrence at 12 months. Seven (35%) of the 20 patients who experienced AF within 3 months of PVI experienced symptomatic AF recurrence at 12 months. The sensitivity, specificity, positive predictive value, and negative predictive value of early AF recurrence for late recurrence were 87.5%, 71.1%, 35.0%, and 96.9%, respectively. Conclusions AF recurrence measured by ELR-AUTO within 3 months after PVI can predict the late recurrence of AF. Freedom from AF in the first 3 months following ablation significantly predicts long-term AF freedom. ELR-AUTO is useful for the detection of symptomatic and asymptomatic AF. PMID:26336538

  17. Endofibrosis of Iliac Arteries in High-Performance Athletes: Diagnostic Approach and Minimally Invasive Endovascular Treatment

    SciTech Connect

    Giannoukas, Athanasios D. Berczi, Viktor; Anoop, Unnikrishnan; Cleveland, Trevor J.; Beard, Jonathan D.; Gaines, Peter A.

    2006-10-15

    The aim of this article is to report our experience in the diagnosis of two cases of iliac artery endofibrosis or arteriopathy, a rare entity occurring in high-performance athletes, presenting with intermittent claudication (right-sided in both) after maximal exercise. External iliac artery endofibrosis or arteriopathy is a likely diagnosis in competitive athletes free of cardiovascular risk factors who present with leg claudication. Arteriography and a papaverine-assisted mean pressure gradient across the iliac arteries of more than 10 mmHg is a useful diagnostic approach. Moreover, balloon angioplasty of the iliac artery in that patient, in whom a pressure gradient was detected, resulted in symptomatic relief for 2 months followed by mild symptom recurrence. Thus, although balloon angioplasty is feasible and safe, it might not be adequate to treat this entity and, thus, its value remains undefined.

  18. [Vascularized iliac crest and distal radius reconstruction].

    PubMed

    Pic Gomis, L; Gomis, R

    2010-12-01

    The authors relate their experience concerning the vascularized iliac crest flap. In the first chapter, they detail the anatomic vascularized osteocutaneous iliac crest. Blood supply arises from the deep and superficial circonflexe iliac artery. Many anastomoses connect the two systems. In the second chapter, they detail the operative technique of free and pedicule hone iliac crest flap. Composite cutaneous bone flaps are also detailed. In the third chapter, they detail informations about treatment of distal radius bone defects with associated skeen flap if necessary.

  19. Spider Veins

    MedlinePlus

    ... Stretch Marks Sun-damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkles Treatments and Procedures Ambulatory ... Stretch Marks Sun-damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkles Treatments and Procedures Ambulatory ...

  20. Results of repair of iliac artery aneurysms with the sandwich technique

    PubMed Central

    Shutze, Ryan A.; Oglesby, Wes; Lee, Allen

    2017-01-01

    Patients undergoing endovascular repair (EVAR) of aortoiliac or iliac artery aneurysm may require sacrifice of one or both internal iliac arteries (IIAs). Until Food and Drug Administration–approved commercial grafts became available, endovascular IIA preservation was accomplished using the “sandwich” technique, but limited information is available regarding the results of this method. After obtaining institutional review board approval, we identified patients undergoing IIA preservation with the sandwich technique during EVAR at our institution. The patients have been followed prospectively since being identified to record patency rates and vascular symptoms or events. Twenty-four procedures were performed from 2011 through 2015 to treat iliac artery aneurysms. Fourteen of these procedures were done with concomitant EVAR using different endografts (Gore Excluder 11, Endologix AFX 2, Cook Zenith 1). Five were done to extend a previous EVAR that had developed a type Ib endoleak, 2 for an isolated external iliac artery aneurysm, 3 for an anastomotic aneurysm from a previous aortobiiliac graft, and 2 for isolated iliac aneurysm repair. There were 25 sandwich grafts (unilateral in 19, bilateral in 6). Contralateral embolization was performed in 5 cases. Immediate success rates were high, and patency rates were excellent at intermediate follow-up. Intraoperative type 3 endoleaks were not uncommon but usually resolved postoperatively. Endovascular IIA preservation is feasible with currently available devices using this technique. This procedure is recommended for preservation of the IIA during endovascular treatment of aortoiliac and iliac artery aneurysms when anatomy requires IIA preservation. PMID:28127120

  1. Laparoscopic living donor right hemihepatectomy with venous outflow reconstruction using cadaveric common iliac artery allograft

    PubMed Central

    Li, Jiaxin; Huang, Jiwei; Wu, Hong; Zeng, Yong

    2017-01-01

    Abstract Rationale: With the development of laparoscopic technique, the total laparoscopic living donor right hemihepatectomy (LLDRH) procurement surgery has been successfully performed in many liver transplant centers all over the world, and the number of cases is continuing to increase. We report our case of laparoscopic right graft resection with venous outflow reconstruction using cadaveric common iliac artery allograft in our center and review literatures about total LLDRH surgery. Patient concerns and Diagnoses: A 40-year-old male living donor for right hepatectomy was selected after pretransplant evaluation including laboratory tests, liver volume, anatomy of hepatic vein, artery, portal vein, and bile duct. Living donor liver transplantation surgery was approved by Sichuan Provincial Health Department and the ethics committee of the West China Hospital, Sichuan University. Interventions: Hepatic parenchyma transection was performed by ultrasonic scalpel and Cavitron Ultrasonic Surgical Aspirator (CUSA). Right branch of portal vein, right hepatic artery, right hepatic duct, and right hepatic vein were meticulously dissected. The right hepatic duct was ligated and transected 2 mm far from the bifurcation of common hepatic duct, right hepatic artery, and portal vein were also ligated and transected, the right hepatic vein was transected by laparoscopic linear cutting stapler. The gap between short hepatic veins and right hepatic vein was bridged and reconstructed by cadaveric common iliac artery allograft. Outcomes: The operation time was 480 minutes and warm ischemia time was 4 minutes. Blood loss was 300 mL without blood transfusion. The donor was discharged on postoperative day 7 uneventfully without complications. Literatures about laparoscopic living donor right hemihepatectomy are compared and summarized in table. Lessons: The total laparoscopic living donor right hemihepatectomy is technically feasible and safe in some transplant centers which

  2. Clinically silent deep vein thrombosis in patients with superficial thrombophlebitis and varicose veins at legs.

    PubMed

    Jerkic, Zoran; Karic, Alen; Karic, Amela

    2009-01-01

    Although superficial thrombophlebitis is a common disorder until recently it was considered as benign disorder. Also it is associated with varicose vein at legs and it was treated effectively with conservative methods, walking and non-steroid anti-inflammatory drugs. Aims of our investigation were: determine frequency of clinically silent deep vein thrombosis at legs in patient with and without superficial thrombophlebitis, determine correlation between superficial thrombophlebitis and deep vein thrombosis regardless of localization of superficial thrombophlebitis in superficial veins of legs and determine adequacy and safety vein phlebography in early diagnosis clinically silent deep vein thrombosis in patients with superficial thrombophlebitis. Using flebography in prospective study was evaluated incidence of clinically silent deep vein thrombosis in 92 patients with varicose veins at legs. By phlebograpy in patients with varicose veins at legs and superficial thrombophlebitis at legs and without clinical signs of DVT at legs of the 49 patients we detected DVT in 12 patients (24, 48%), in three male and nine female. We detected localization of DVT in ilijacofemoral junction in 4,08% patients, although localization of DVT in femoropopliteal region was observed in 6, 12% patients and localization in crural region was in 14.28% patients. Localization of DVT at legs was detected in iliac vein in 16.66% patients, in femoral vein in 25% patients, popliteal vein 8.33% patients, anterior tibial vein 16.66%, posterior tibial vein in 25% and crural veins 8.33% patients. Also we deduced significant difference between two group of patients (chi2 = 10, 76). Such result proves thesis that in most patients with superficial thrombophlebitis and varicose veins is possibility of developing of DVT.

  3. Vein Problems Related to Varicose Veins

    MedlinePlus

    ... varicose veins include venous lakes, reticular veins, and hemorrhoids. Venous lakes are varicose veins that appear on ... flat blue veins often seen behind the knees. Hemorrhoids are varicose veins in and around the anus. ...

  4. Tearing of the left iliac vessels in lumbar surgery revealed by multiphase post-mortem CT-angiography (MPMCTA).

    PubMed

    Vilariño Villaverde, Raquel; Bruguier, Christine; Zerlauth, Jean-Baptiste; De Froidmont, Sébastien; Grabherr, Silke

    2016-05-01

    Lumbar surgery is regularly applied in cases of discal hernia and acquired lumbar stenosis. In this report, we present a case of a laceration in the left common iliac artery and iliac vein during a lumbar surgery and discuss the literature concerning this kind of event. In the present case, the surgical procedure was followed by a sudden decrease in blood pressure, and the surgeon discovered an intra-abdominal haemorrhage that led to the patient's death. Postmortem investigation confirmed the intra-abdominal haemorrhage and revealed a laceration of the proximal portion of the left common iliac artery and left iliac vein. The source of bleeding could be detected especially thanks to multi-phase postmortem CT angiography (MPMCTA), which was performed prior to autopsy. We also found a haemorrhagic path through the intervertebral disc between the L4-L5 vertebrae, caused by the surgeon's instrument (pituitary rongeur). To date, a few cases have been described of iatrogenic death resulting from a tear in the iliac vessels during lumbar surgery, but not from the postmortem perspective. Such investigations have recently been modernized thanks to the introduction of forensic imaging. In particular, MPMCTA offers new possibilities in postmortem investigations and can be considered the new gold standard for investigating deaths related to medical intervention. Here we describe the first case of a death during lumbar surgery using this new method.

  5. Veins of the thoracic limb of the Van cat.

    PubMed

    Ozüdoğru, Z; Aksoy, G; Soygüder, Z; Ozmen, E

    2003-04-01

    The drainage of the thoracic limb of the Van cat was performed by the superficial and deep vein systems. The superficial system was constituted by the cephalic vein and its branches. The deep vein system was constituted by the axillary vein and its branches. The two vein systems anastomosed with each other at various points along their courses. The cephalic vein emerged from the external jugular vein together with the superficial cervical vein. The axillary vein continued the subclavian vein. It ran caudoventrally and gave off the subscapular vein, at the level of the shoulder joint, then gave off two independent branches, which were the external thoracic veins. Then the rest of the vessel continued as the brachial vein. The thoracodorsal vein was formed by the communicate ramus vein which arose between the subscapular vein and the brachial vein. The cranial circumflex humeral vein arose double from the subscapular vein. One of them anastomosed with the deep brachial vein and the other one drained the biceps and the deep pectoral muscles. The cranial interosseous vein from the caudal aspects of the brachial vein and passed the interosseous space of the antebrachium then ran to the lateral aspect of the forearm. The caudal interosseous vein arose from the ulnar vein (in two specimens) and the median vein together with the ulnar vein (in two specimens) or independently from the median vein (in one specimen). Although many similarities were found in the veins of the thoracic limb of the Van cat as compared with the domestic cat, some significant differences were noted in the origin, course, anastomosing and ramification of veins of the thoracic limb.

  6. Post-Kidney Transplantation Iliac Artery Stenosis due toIatrogenic Injury: Case Report

    SciTech Connect

    Khankan, Azzam Anwar Maeda, Munehiro; Osuga, Keigo; Murakami, Takamichi; Nakamura, Hironobu

    2003-04-15

    We report a case of left external iliac artery lesions as a complication of post-kidney transplantation due to vascular clamp application injury. The lesions were proximal stenosis and distal occlusion just near the graft anastomosis site and they were diagnosed incidentally during the embolization for arteriovenous fistula. Angiography confirmed the diagnosis and it was managed successfully by percutaneous interventional techniques.

  7. Acute Iliac Artery Rupture: Endovascular Treatment

    SciTech Connect

    Chatziioannou, A.; Mourikis, D.; Katsimilis, J.; Skiadas, V. Koutoulidis, V.; Katsenis, K.; Vlahos, L.

    2007-04-15

    The authors present 7 patients who suffered iliac artery rupture over a 2 year period. In 5 patients, the rupture was iatrogenic: 4 cases were secondary to balloon angioplasty for iliac artery stenosis and 1 occurred during coronary angioplasty. In the last 2 patients, the rupture was secondary to iliac artery mycotic aneurysm. Direct placement of a stent-graft was performed in all cases, which was dilated until extravasation was controlled. Placement of the stent-graft was successful in all the cases, without any complications. The techniques used, results, and mid-term follow-up are presented. In conclusion, endovascular placement of a stent-graft is a quick, minimally invasive, efficient, and safe method for emergency treatment of acute iliac artery rupture, with satisfactory short- and mid-term results.

  8. An Extreme Case of CoreValve Bioprosthesis Embolization into the Abdominal Aorta and of the Delivery Catheter Cone into the Right Internal Iliac Artery.

    PubMed

    Alsancak, Yakup; Bilge, Mehmet; Ali, Sina; Duran, Mustafa; Saatci Yasar, Ayse

    2015-11-01

    Transcatheter aortic valve implantation (TAVI) is a new and hopefully therapeutic option in patients with symptomatic severe calcific aortic valve stenosis and multiple comorbidities who are not eligible for open-heart surgery due to unacceptable conventional surgical risks. Herein is reported the case of a patient who underwent TAVI in whom an unusual CoreValve bioprosthesis embolization occurred into the abdominal aorta. While attempting to retrieve the whole system, the conical tip of the catheter delivery system also became embolized into the right iliac artery. Importantly, this case demonstrated a rare complication of CoreValve bioprosthesis embolization which was managed without surgical intervention. Video 1: Peripheral angiography demonstrating the embolized CoreValve bioprosthesis. Video 2: Fluoroscopy demonstrating completely opened CoreValve bioprosthesis at a level above the iliac artery bifurcation and the mobile conical tip in the valve system. Video 3: Peripheral angiography demonstrating prosthetic valve without any flow limitation and embolized conical tip into the right internal iliac artery. Video 4: Peripheral angiography demonstrating prosthetic valve without any flow limitation and embolized conical tip into the right internal iliac artery. Video 5: Aortography demonstrating the successfully implanted second CoreValve bioprosthesis in an optimal aortic position, with no paravalvular leak. Video 6: Peripheral angiography demonstrating the embolized conical tip into the right iliac artery with a normal external iliac artery flow. Video 7: Peripheral angiography demonstrating the embolized conical tip into the right iliac artery with a normal external iliac artery flow.

  9. Intraosseous pneumatocyst of the iliac bone.

    PubMed

    Monu, J U; Crotty, J M; Pope, T L

    1996-09-01

    Intraosseous pneumatocyst of the iliac bone is usually an innocuous incidental finding with characteristic radiographic features. Because this entity is uncommon and has not been described in the orthopaedic literature, many orthopaedic surgeons are unfamiliar with the entity. Three cases of intraosseous pneumatocyst of the iliac bone are presented to illustrate some of the imaging features to assist in recognizing it for what it is: an innocuous incidental finding that should not prompt invasive procedures such as a biopsy.

  10. Is Internal Iliac Artery Embolization Essential Prior to Endovascular Repair of Aortoiliac Aneurysms?

    SciTech Connect

    Bharwani, N. Raja, J.; Choke, E.; Belli, A. M.; Thompson, M. M.; Morgan, R. A.; Munneke, G.

    2008-05-15

    Patients who undergo endovascular repair of aorto-iliac aneurysms (EVAR) require internal iliac artery (IIA) embolization (IIAE) to prevent type II endoleaks after extending the endografts into the external iliac artery. However, IIAE may not be possible in some patients due to technical factors or adverse anatomy. The aim of this study was to assess retrospectively whether patients with aorto-iliac aneurysms who fail IIAE have an increase in type II endoleak after EVAR compared with similar patients who undergo successful embolization. We retrospectively analyzed the records of 148 patients who underwent EVAR from December 1997 to June 2005. Sixty-one patients had aorto-iliac aneurysms which required IIAE before EVAR. Fifty patients had successful IIAE and 11 patients had unsuccessful IIAE prior to EVAR. The clinical and imaging follow-up was reviewed before and after EVAR. The endoleak rate of the embolized group was compared with that of the group in whom embolization failed. After a mean follow-up of 19.7 months in the study group and 25 months in the control group, there were no statistically significant differences in outcome measures between the two groups. Specifically, there were no type II endoleaks related to the IIA in patients where IIAE had failed. We conclude that failure to embolize the IIA prior to EVAR should not necessarily preclude patients from treatment. In patients where there is difficulty in achieving coil embolization, it is recommended that EVAR should proceed, as clinical sequelae are unlikely.

  11. Sclerotherapy of Varicose Veins and Spider Veins

    MedlinePlus

    ... Index A-Z Sclerotherapy of Varicose Veins and Spider Veins Sclerotherapy uses injections from a very fine, ... Sclerotherapy? What is Sclerotherapy of Varicose Veins and Spider Veins? Sclerotherapy is a minimally invasive treatment used ...

  12. Iliac arteriovenous fistula due to spinal disk surgery. Causes severe hemodynamic repercussion with pulmonary hypertension.

    PubMed Central

    Machado-Atías, I; Fornés, O; González-Bello, R; Machado-Hernández, I

    1993-01-01

    We present a case of a 46-year-old man with a pulsatile mass in the left inferior abdominal quadrant that irradiated a continuous murmur extending to the left lumbar region. Despite an 8-year history of cardiomegaly, he appeared to be asymptomatic except for the mass and could recollect no traumatic injury or surgery that might have caused it. Near the vertebral column, we found a small scar, the result of spinal disk surgery 11 years before. Following chest radiography and electrocardiography, we located the suspected arteriovenous fistula by selective angiography of the aorta and its branches: a communication of the left iliac artery with the left iliac vein had resulted in a very large left-to-right shunt and a severely dilated inferior vena cava. We then divided and isolated the arterial segment containing the fistula, but left this segment in continuity with the left iliac vein by over-sewing both ends. To avoid injury to surrounding structures, dissection was limited to the area of maximal thrill. Hemodynamic improvement was immediate, and the postoperative course was uneventful. At the present time, almost 3 years postoperatively, the patient is asymptomatic. Images PMID:8508067

  13. Varicose Veins and Spider Veins

    MedlinePlus

    ... are sold in medical supply and drugstores. Prescription-strength gradient compression hose, which offer the greatest amount ... the face. Exercise regularly to improve your leg strength, circulation, and vein strength. Focus on exercises that ...

  14. Comparison of outcome of microvascular bony head and neck reconstructions using the fibular free flap and the iliac crest flap.

    PubMed

    Mücke, Thomas; Loeffelbein, Denys J; Kolk, Andreas; Wagenpfeil, Stefan; Kanatas, Anastasios; Wolff, Klaus-Dietrich; Mitchell, David A; Kesting, Marco R

    2013-09-01

    Several microvascular free flaps are available for reconstruction of the osseous components after resections for head and neck cancer. We have prospectively evaluated patients treated by bony microsurgical reconstruction to identify predictors of adverse outcomes for delayed wound healing and failure of free flaps. All patients from July 2007 to June 2011 who had reconstructions with microvascular fibular or iliac crest flaps immediately after resection of the tumour were evaluated. There were a total of 156 bony free flaps: 120 (77%) fibular and 36 (23%) iliac crest flaps. A total of 133 (85%) were successful. Delayed wound healing was more common with the iliac crest flap (p=0.01) at the intraoral site (p=0.04). Significantly more iliac crest free flaps failed (p=0.02). Anastomosis to the facial artery (p=0.05) and facial vein (p=0.04), and duration of overall operating time were associated with a significantly higher risk of failure of the flap. Patients with cancer of the head and neck who require microsurgical bony reconstruction are at increased risk of postoperative complications. Significantly more complications were found with the iliac crest flap, whereas the fibular flap was associated with a significantly longer operating time.

  15. Calcification of Cryopreserved Arterial Graft Causing Delayed Obstruction of Portal Vein Flow After Liver Transplant.

    PubMed

    Cimsit, Bayindir; Yankol, Yucel; Mecit, Nesimi; Kanmaz, Turan; Acarli, Koray; Kalayoglu, Munci

    2015-10-01

    In patients with biliary atresia, portal vein problems may cause challenges for liver transplant. Interposition grafts have been used for vascular anastomoses in transplant recipients with varied success. A cryopreserved iliac artery graft was used for the reconstruction of the portal vein in a 29-month-old infant with biliary atresia. At 17 months after transplant, she developed upper gastrointestinal bleeding that was caused by portal vein occlusion because of vascular calcifications in the graft. Upper gastrointestinal endoscopy showed esophageal varices with fresh bleeding, and the varices were band ligated. At 3 months after the bleeding episode, the patient was asymptomatic and biochemical tests were normal. In summary, liver transplant with cryopreserved iliac artery graft may be complicated by calcifications and portal vein occlusion, and caution is advised in using this graft material for portal vein anastomoses.

  16. Technique, Complication, and Long-Term Outcome for Endovascular Treatment of Iliac Artery Occlusion

    SciTech Connect

    Ozkan, Ugur Oguzkurt, Levent; Tercan, Fahri

    2010-02-15

    The aim of this study was to report technical details, procedure-related complications, and results of endovascular treatment in chronic iliac artery occlusion. Between 2001 and 2008, endovascular treatments of 127 chronic iliac artery occlusions in 118 patients (8 women and 110 men; mean age, 59 years) were retrospectively reviewed. The study was based on Ad Hoc Committee on Reporting Standards (Society for Vascular Surgery/International Society for Cardiovascular Surgery Standards). All occlusions were treated with stent placement with or without preliminary balloon angioplasty. Kaplan-Meier estimators were used to determine patency rates. Univariate and multivariate analyses were performed to determine variables affecting successful recanalization, major complications, early stent thrombosis ({<=}30 days), and primary and secondary patency rates. Initial technical success was achieved in 117 (92%) procedures. Successful recanalization was obtained by antegrade approach in 69 of 77 (90%) procedures and by retrograde approach in 52 of 105 (50%) procedures (p < 0.001). Complications were encountered in 28 (24%) patients [minor in 7 patients (6%) and major in 22 patients (19%)]. One death occurred in the operative period secondary to iliac artery rupture. Early stent thrombosis was seen in eight (7%) patients. Presence of critical limb ischemia (p = 0.03), subintimal recanalization (p = 0.03), and major complication (p = 0.02) were the independent predictors of early stent thrombosis on multivariate analysis. Primary and secondary patency rates at 5 years were 63 and 93%, respectively. Presence of critical limb ischemia, TASC type C iliac lesions, combined occlusions of both common and external iliac arteries, and major complications were associated with decreased patency rates on univariate analysis, whereas these factors were not independent predictors of stent patency on multivariate analysis. In conclusion, endovascular treatment of iliac artery occlusion has a

  17. Iliofemoral Venous Thrombosis Mainly Related to Iliofemoral Venous Obstruction by External Tumor Compression in Cancer Patients

    PubMed Central

    Liao, Tzu-Yao; Hsu, Hui-Ching; Wen, Min-Sheng; Juan, Yu-Hsiang; Hung, Yu-Hsin; Liaw, Chuang-Chi

    2016-01-01

    Background To study iliofemoral venous thrombosis related to iliofemoral venous obstruction in cancer patients. Methods In this case series study, 829 cancer patients were surveyed for iliofemoral obstruction/thrombosis within 10 years. The criteria for inclusion were: (1) presence of unilateral lower-extremity swelling; (2) computed tomography (CT) scans showing a tumor with external compression of the iliac or femoral vein, and (3) duplex ultrasound scans showing venous thrombosis or venous flow insufficiency over a femoral vein or saphenous vein. Results Sixty-three patients (8%) developed an iliofemoral venous obstruction. The presence of iliofemoral venous thrombosis was detected in 21 of these patients (33%). The rate of iliofemoral venous thrombosis was significantly higher in patients with an invasion of the inguinal region, D-dimer levels >3,000 ng/ml, gastrointestinal cancer, or invasion of the inguinal lymph nodes. However, none of our patients with iliofemoral venous thrombosis had a detection of iliofemoral venous obstruction. Improved lower-extremity swelling was reported in 84% of the patients following combination therapy involving low-molecular-weight heparin (LMWH) and systemic therapy. Conclusion Patients with an iliofemoral venous thrombosis mainly had iliofemoral venous obstruction by external tumor compression. Combination therapy with LMWH and systemic therapy were mandatory for these patients. PMID:27990113

  18. Varicose vein - noninvasive treatment

    MedlinePlus

    Sclerotherapy; Laser therapy - varicose veins; Radiofrequency vein ablation; Endovenous thermal ablation; Ambulatory phlebectomy; Transilluminated power phlebotomy; Endovenous laser ablation; Varicose vein ...

  19. 49 CFR 572.199 - Pelvis iliac.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... specified in 49 CFR 572.200(d), and iliac wing load cell SA572-S66, mounted as shown in sheet 2 of 5 of... is parallel to the inferior-superior orientation of the spine box. (5) The midsagittal plane of the...) While maintaining the dummy's position as specified in paragraphs (b)(3), (4) and (5) of this...

  20. 49 CFR 572.199 - Pelvis iliac.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... centerline of the iliac load cell access hole, and the 88.9 mm dimension of the probe's impact surface is... V9-A in appendix A to this subpart, on a flat, rigid, horizontal surface covered with a 2-mm-thick... close together as possible. (4) Orient the arm downward to the lowest detent such that the...

  1. 49 CFR 572.199 - Pelvis iliac.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... centerline of the iliac load cell access hole, and the 88.9 mm dimension of the probe's impact surface is... V9-A in appendix A to this subpart, on a flat, rigid, horizontal surface covered with a 2-mm-thick... close together as possible. (4) Orient the arm downward to the lowest detent such that the...

  2. 49 CFR 572.199 - Pelvis iliac.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... iliac load cell access hole, and the 88.9 mm dimension of the probe's impact surface is aligned... A to this subpart, on a flat, rigid, horizontal surface covered with a 2-mm-thick PTFE (Teflon... possible. (4) Orient the arm downward to the lowest detent such that the longitudinal centerline of the...

  3. Varicose Veins

    MedlinePlus

    ... Wearing loose clothing and avoiding long periods of standing can also help. If varicose veins are painful or you don't like the way they look, your doctor may recommend procedures to remove them. NIH: National Heart, Lung, and Blood Institute

  4. Stent-triggered 'electric shock' during leg bending 2 years after emergency iliac artery percutaneous revascularization.

    PubMed

    Iaccarino, Daniele; Politi, Luigi; Curti, Tiziano; Modena, Maria Grazia; Sangiorgi, Giuseppe M

    2011-09-01

    We report a case of a 41-year-old woman who underwent surgical removal of an uterine leiomyoma, complicated by accidental injury of the left external iliac artery, treated by suturing. A few days after the intervention the patient was treated with emergency percutaneous stent implantation for acute thrombotic occlusion of the external iliac artery. Two years later, the patient began to complain of pain in the left leg, as an 'electric shock' sensation in the leg during squatting and leg adduction on the trunk. An angiographic control showed a critical in-stent restenosis at the level of a misplaced stent. Thus the patient was submitted to surgical exploration and stent removal.

  5. Treatment of Secondary Stent-Graft Collapse After Endovascular Stent-Grafting for Iliac Artery Pseudoaneurysms

    SciTech Connect

    Clevert, D.-A. Stickel, M.; Steitz, H.-O.; Kopp, R.; Strautz, T.; Flach, P.; Johnson, T.; Jung, E.M.; Jauch, K.W.; Reiser, M.

    2007-02-15

    We report the case of a patient who developed an asymptomatic pseudoaneurysm in the left external iliac artery after transplant nephrectomy. The pseudoaneurysm most probably arose as a suture aneurysm from the external iliac artery after removal of the graft renal artery. Obviously we can not exclude the possibility it was a true aneurysm, although this seems much less likely. The pseudoaneurysm was detected during a routine CT scan and was treated interventionally with a stent-graft. One month later the asymptomatic patient underwent a vascular ultrasound examination including color Doppler, power Doppler, and B-flow as a routine control. An endoleak with collapse of the stent-graft was diagnosed. There was no evidence of stent infection. At a reintervention, the pseudoaneurysm was successfully treated using two uncovered Palmaz stents at the proximal and distal edge of the stent graft. Peri- and post-interventional ultrasound and CT angiography confirmed the exclusion of the aneurysm without an endoleak.

  6. MR Venography of Deep Veins: Changes with Uterine Fibroid Embolization

    SciTech Connect

    Katsumori, Tetsuya Kasahara, Toshiyuki; Tsuchida, Yoko; Nara, Yoshinori

    2009-03-15

    Deep veins (DVs) can be compressed by a uterus enlarged with fibroids. The purpose of this study was to assess the degree of luminal narrowing of DVs caused by a myomatous uterus, and the change in DV narrowing in women with symptomatic fibroids after embolization using time-of-flight (TOF)-magnetic resonance venography (MRV). Twenty-nine consecutive women with symptomatic uterine fibroids underwent TOF-MRV and pelvic MRI before and 4 months after embolization. Based on the TOF-MRV, we evaluated the luminal narrowing of three DVs, including the inferior vena cava, and the bilateral common and external iliac veins, and divided the findings into three grades. The scores for each DV were added for each patient (lowest, 0; highest, 6). DV scores and symptom severity (SS) scores were compared between the baseline and 4 months after embolization using the paired t-test. The relationship between DV scores and uterine volume was investigated using Pearson's test. DV scores decreased significantly, from 1.52 {+-} 1.70 at baseline to 0.93 {+-} 1.56 at 4 months after embolization (p = 0.004). The uterine volume decreased from 948 {+-} 647 mL at baseline to 617 {+-} 417 mL at 4 months after embolization (p < 0.001). DV score correlated with uterine volume (r = 0.856, p < 0.001). SS scores decreased from 54.5 {+-} 14.6 at baseline to 26.8 {+-} 15.4 at 4 months after embolization (p < 0.001). In conclusion, the degree of luminal narrowing of DVs caused by a uterus with fibroids is correlated with the uterine volume. Uterine artery embolization may induce an improvement of luminal narrowing of DVs due to a reduction of the myomatous uterus volume.

  7. Preventing Deep Vein Thrombosis

    MedlinePlus

    ... Education & Events Advocacy For Patients About ACOG Preventing Deep Vein Thrombosis Home For Patients Search FAQs Preventing ... Vein Thrombosis FAQ174, August 2011 PDF Format Preventing Deep Vein Thrombosis Women's Health What is deep vein ...

  8. Contralateral approach to iliac artery recanalization with kissing nitinol stents present in the aortic bifurcation.

    PubMed

    Joseph, George; Hooda, Amit; Thomson, Viji Samuel

    2015-01-01

    A 69-year-old man, who had earlier undergone reconstruction of the aortic bifurcation with kissing nitinol stents, presented with occlusion of the left external iliac artery. The occlusion was successfully and safely recanalized using contralateral femoral approach with passage of interventional hardware through the struts of the stents in the aortic bifurcation. Presence of contemporary flexible nitinol stents with open-cell design in the aortic bifurcation is not a contraindication to the use of the contralateral femoral approach.

  9. Primary Stenting for Complex Atherosclerotic Plaques in Aortic and Iliac Stenoses

    SciTech Connect

    Onal, Baran; Ilgit, Erhan T.; Yuecel, Cem; Ozbek, Erdal; Vural, Murat; Akpek, Sergin

    1998-09-15

    Purpose: To evaluate the efficacy of primary stenting for complex atherosclerotic plaques in aortic and iliac stenoses that are not amenable to balloon angioplasty alone. Methods: Nineteen patients with complex atherosclerotic plaques were treated with a Palmaz stent (n= 19), Wallstent (n= 1), Strecker stent (n= 1), or Memotherm stent (n= 1). A total of 22 stenoses presenting with complex plaque morphology including ulcerated plaques, ulcerated plaques with focal aneurysms, plaques with heavy calcification, severely eccentric plaques, plaques with overhanging edge, and plaques with spontaneous dissection were stented. The lesions were in the aorta (n= 1), common iliac artery (n= 19), or external iliac artery (n= 2). Results: Immediate angiography after stent placement revealed restoration of patency of the stented segment. Focal aneurysms and ulcerated areas were occluded in the follow-up angiographies obtained 4-12 weeks after the procedure. In one case with poor distal runoff and multiple complex lesions of the iliac artery, subacute occlusion occurred. Clinical and angiographic follow-up (3-46 months) revealed patency of all other stented segments. Conclusion: Primary stenting is an effective and reliable approach for complex plaques in stenoses. Patency of the arterial segment with a smooth lumen can be created without the risk of acute complications such as distal embolization, dissection, or occlusion.

  10. Renal transplantation with venous drainage through the superior mesenteric vein in cases of thrombosis of the inferior vena cava.

    PubMed

    Aguirrezabalaga, Javier; Novas, Serafín; Veiga, Francisco; Chantada, Venancio; Rey, Ignacio; Gonzalez, Marcelino; Gomez, Manuel

    2002-08-15

    Renal transplantation usually is performed by placing the graft in the iliac fossa, anastomosing the renal vein to the iliac vein or, when this is not possible, to the vena cava. When vascular complications occur, particularly on the venous side, the position of the graft may have to be changed. This report describes orthotopic renal grafts and positioning of the organ with anastomosis to the splenic vessels. Venous drainage was established directly into the mesenteric-portal territory, with two cases to the portal vein and one to the inferior mesenteric vein. A new technique for the venous drainage of the renal graft is shown. We have used this model in two cases of infrarenal inferior vena cava thrombosis. The kidney was located in a retroperitoneal position, with venous drainage to the superior mesenteric vein through an orifice in the posterior peritoneum.

  11. Ruptured Internal Iliac Artery Aneurysm: Staged Emergency Endovascular Treatment in the Interventional Radiology Suite

    SciTech Connect

    Kelckhoven, Bas-Jeroen van Bruijninckx, Boy M. A.; Knippenberg, Bob; Overhagen, Hans van

    2007-07-15

    Ruptured aneurysms of the internal iliac artery (IIA) are rare and challenging to treat surgically. Due to their anatomic location they are difficult to operate on and perioperative morbidity is high. An endovascular approach can be helpful. We recently treated a patient with a ruptured IIA aneurysm in the interventional radiology suite with embolization of the side-branch of the IIA and placement of a covered stent in the ipsilateral common and external iliac arteries. A suitable stent-graft was not available initially and had to be brought in from elsewhere. An angioplasty balloon was temporarily placed across the ostium of the IIA to obtain hemostasis. Two hours later, the procedure was finished by placing the stent-graft.

  12. Spider Vein Removal

    MedlinePlus

    Spider veins: How are they removed? I have spider veins on my legs. What options are available ... M.D. Several options are available to remove spider veins — thin red lines or weblike networks of ...

  13. What Causes Varicose Veins?

    MedlinePlus

    ... weak or damaged, blood can back up and pool in your veins. This causes the veins to ... pressure in your veins due to overweight or obesity or pregnancy. Rate This Content: NEXT >> Updated: February ...

  14. A Nonlinear Thin-Wall Model for Vein Buckling.

    PubMed

    Lee, Avione Y; Han, Hai-Chao

    2010-12-01

    Tortuous or twisted veins are often seen in the retina, cerebrum, and legs (varicose veins) of one-third of the aged population, but the underlying mechanisms are poorly understood. While the collapse of veins under external pressure has been well documented, the bent buckling of long vein segments has not been studied. The objectives of this study were to develop a biomechanical model of vein buckling under internal pressure and to predict the critical pressure. Veins were modeled as thin-walled nonlinear elastic tubes with the Fung exponential strain energy function. Our results demonstrated that veins buckle due to high blood pressure or low axial tension. High axial tension stabilized veins under internal pressure. Our buckling model estimated the critical pressure accurately compared to the experimental measurements. The buckling equation provides a useful tool for studying the development of tortuous veins.

  15. DISCOVER: Dutch Iliac Stent trial: COVERed balloon-expandable versus uncovered balloon-expandable stents in the common iliac artery: study protocol for a randomized controlled trial

    PubMed Central

    2012-01-01

    revascularization of the common iliac artery, followed by placement of one or more uncovered balloon-expandable stents. The study group will undergo the same treatment, however one or more PTFE-covered balloon-expandable stents will be placed. When necessary, the aorta, external iliac artery, common femoral artery, superficial femoral artery and deep femoral artery will be treated, using the standard treatment. The primary endpoint is absence of binary restenosis rate. Secondary endpoints are reocclusion rate, target-lesion revascularization rate, clinical success, procedural success, hemodynamic success, major amputation rate, complication rate and mortality rate. Main study parameters are age, gender, relevant co-morbidity, and several patient, disease and procedure-related parameters. Trial registration Dutch Trial Register, NTR3381. PMID:23164097

  16. Endovascular repair of bilateral common iliac artery aneurysms using GORE Excluder iliac branch endoprosthesis without aortobi-iliac stent graft conjunction

    PubMed Central

    Ardita, Vincenzo; Giaquinta, Alessia; Veroux, Massimiliano; Sanfiorenzo, Angelo; Virgilio, Carla; D’Arrigo, Giuseppe; Veroux, Pierfrancesco

    2017-01-01

    Abstract Introduction: Bilateral common iliac artery (CIA) aneurysm (CIAA) is a rare entity. In the past decade, different endovascular approaches have been adopted for patients with several comorbidities or unfit for open repair (OR). Recently, the use of iliac branch stent graft has been proposed, resulting in satisfactory patency rates and decrease in morbidity. Currently, according to instruction for use, the iliac branch stent graft is to be used with aortobi-iliac stent graft conjunction. We describe a case of a successful endovascular repair of bilateral CIAAs using the GORE Excluder iliac branch endoprosthesis (IBEs) without aortobi-iliac stent graft conjunction. Case presentation: An 83-year-old man was admitted with abdominal pain and presence of pulsatile mass in the right and left iliac fossa. Computed tomographic (CT) angiography showed the presence of large bilateral CIAAs (right CIA = 66 mm; left CIA = 38 mm), without concomitant thoracic or abdominal aorta aneurysm. Moreover, CT scan demonstrated the presence of bilateral lower accessory renal artery close to the aortic bifurcation. Due to the high operative risk, the patient was scheduled for endovascular repair with bilateral IBEs, without the aortobi-iliac stent graft conjunction to avoid the renal ischemia as a consequence of renal arteries covering. The procedure was completed without complications and duplex ultrasound demonstrated the complete exclusion of both aneurysms without any type of endoleaks at 1 month of follow-up. Conclusions: GORE IBEs without aortobi-iliac stent graft conjunction seem to be a feasible and effective procedure for the treatment of isolated CIAAs in patients with highly selected anatomical conditions. PMID:28207510

  17. Trans iliac-sacral-iliac bar stabilisation to treat bilateral lesions of the sacro-iliac joint or sacrum: anatomical considerations and clinical experience.

    PubMed

    Vanderschot, P; Meuleman, C; Lefèvre, A; Broos, P

    2001-09-01

    The use of trans iliac-sacral-iliac bars is an alternative to sacro-iliac screws in the treatment of bilateral lesions of the posterior pelvic ring, and the same biomechanical principles can be applied. Of 20 patients, ten men and ten women, a CT-scan of the pelvis was performed to study the individual and common safe area at the level of S1 and S2. The location and maximal diameter of the individual safe area were studied using a computer-navigation system, displaying images in sagittal, coronal and axial anatomic planes together with a 3-D reconstruction. The common safe area was studied using three points: upper- (UA) and lower anterior corner (DA) of S1 and S2, and the centre of the safe area. It would have been possible to place an iliac-sacral-iliac bar (5 mm or more) in S1 and S2 in all the men, but in the women a bar could only have been inserted in only five in S1 and eight in S2. A statistically significant difference between men and women was found at S1 (P=0.033) but not at S2 (P=0.211). No significant correlation was found between the diameter of the safe area at both levels in men and women and age, height, and weight. Furthermore, no common safe area of 5 mm or more was measured at the same levels.Four patients were treated using trans iliac-sacral-iliac bars. Three were placed under fluoroscopic control in combination with a frame, and in one patient an image-guided system was used. A postoperative CT confirmed the correct position of the bars in each patient. The complexity and individual variability of the sacrum makes complex preoperative planning of the iliac-sacral-iliac path mandatory.

  18. Intraosseous lipoma of the iliac: case report☆

    PubMed Central

    de Moraes, Frederico Barra; Paranahyba, Rodrigo Marques; do Amaral, Rogério Andrade; Bonfim, Vinícius Mendes; Jordão, Nathalya Ducarmo; Souza, Raimundo Djalma

    2016-01-01

    Lipomas are benign tumors that attack fat cells and most often affecting soft tissues in adulthood. On rare occasions, they may affect bones, preferentially the metaphyses of the long bone. They are generally asymptomatic and radiography shows radiolucent lesions with a thin sclerotic rim or radiodense lesions with a thick sclerotic rim. Malignant transformation of these tumors is rare, as is their recurrence, and there is no need for surgery in most cases. In this report, we present a rare case of intraosseous lipoma in the iliac bone. PMID:26962507

  19. Lumbar Herniation of Kidney following Iliac Crest Bone Harvest

    PubMed Central

    2016-01-01

    The iliac crest is a popular source for autogenous bone harvesting, but the process is rife with complications. This case report presents a patient that experienced incisional lumbar herniation of her kidney following an iliac crest bone harvesting procedure. A discussion is included on the underappreciated complications of this procedure and recommendations for improving outcomes with more thorough evaluation and documentation. PMID:28042490

  20. The Endovascular Management of Iliac Artery Aneurysms

    SciTech Connect

    Stroumpouli, Evangelia; Nassef, Ahmed; Loosemore, Tom; Thompson, Matt; Morgan, Robert; Belli, Anna-Maria

    2007-11-15

    Background: Isolated aneurysms of the iliac arteries are uncommon. Previously treated by conventional surgery, there is increasing use of endografts to treat these lesions. Purpose: The purpose of this study was to assess the efficacy, safety, and durability of the stent-grafts for treatment of iliac artery aneurysms (IAAs). The results of endografting for isolated IAAs over a 10-year period were analyzed retrospectively. The treatment methods differed depending on the anatomic location of the aneurysms. Twenty-one patients (1 woman, 20 men) underwent endovascular stent-graft repair, with one procedure carried out under emergency conditions after acute rupture. The mean aneurysm diameter was 4.6 cm.Results:The procedural technical success was 100%. There was zero 30-day mortality. Follow-up was by interval CT scans. At a mean follow-up of 51.2 months, the stent-graft patency rate was 100%. Reintervention was performed in four patients (19%): one patient (4.7%) with a type I endoleak and three patients (14.3%) with type II endoleaks.Conclusion:We conclude that endovascular repair of isolated IAAs is a safe, minimally invasive technique with low morbidity rates. Follow-up results up to 10 years suggest that this approach is durable and should be regarded as a first treatment option for appropriate candidates.

  1. Pantaloon femoral vein graft as "neoaorta" in infected aortic disease.

    PubMed

    Verma, Himanshu; Mohan, Satish; Tripathi, Ramesh K

    2015-10-01

    Infected abdominal aortic disease and graft infections pose a significant challenge for the vascular surgeon. Thorough radical débridement, either preceded by extra-anatomic bypass or followed by in situ aortic replacement, is the mainstay of treatment. The role of endovascular repair by stent grafts is being increasingly described but is limited to relatively less virulent mycotic aneurysms or as a "bridging" option in sick patients with florid sepsis that necessitates eventual delayed definitive surgical management. Autologous femoral vein has been an excellent conduit for aortic bifurcation reconstruction in this setting. Although various configurations of femoral vein conduit have been described for aortobi-iliac reconstruction, an in-depth knowledge of the venous anatomy, physiology, mechanisms of "profundization," and techniques of harvest and graft preparation is essential for efficient conduct of the operation and its optimal outcomes. We review in detail these aspects of "pantaloon" femoral vein graft creation as a "neoaorta".

  2. Iliac-mesenteric-atrial shunt procedure for Budd-Chiari syndrome complicated by inferior vena caval thrombosis.

    PubMed Central

    Chapman, J E; Ochsner, J L

    1978-01-01

    A 33-year-old woman had a diagnosis of idiopathic Budd-Chiari syndrome complicated by inferior vena caval occlusion. Conservative medical therapy failed to control the symptoms of both portal hypertension and vena caval stasis. Therefore, a prosthetic shunt was placed from the right common iliac vein to the right atrium with a side-arm to the superior mesenteric vein. She exhibited almost complete relief of symptoms and the graft was documented to be patent two weeks postoperatively. In many instances aggressive surgical therapy may help these patients who, in the past, would have been relegated to symptomatic therapy. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Figs. 6A., 6B. PMID:718289

  3. Iliac Crest Avulsion Fracture in a Young Sprinter

    PubMed Central

    Casabianca, L.; Rousseau, R.; Loriaut, P.; Massein, A.; Mirouse, G.; Gerometta, A.; Khiami, F.

    2015-01-01

    Avulsion fracture of the iliac crest is an uncommon pathology. It usually occurs in teenagers during sport activities, more common in boys. We report a case of 16-year-old male competitive sprinter, who had an avulsion of a part of the iliac crest and the anterior-superior iliac spine during a competition. The traumatism occurred during the period of acceleration phase out of the blocks which corresponds to the maximum traction phase on the tendons. Then a total loss of function of the lower limb appears forcing him to stop the run. X-ray and CT scan confirmed the rare diagnosis of avulsion of the quasitotality of the iliac crest apophysis, corresponding to Salter 2 fracture. We performed an open reduction and internal fixation with two screws, allowing a return to sport after 3 months and his personal best record in the 100 meters at the 6th postoperative month. PMID:26421205

  4. Bilateral traumatic hip dislocation associated with sacro-iliac dislocation.

    PubMed

    Galois, L; Meuley, E; Pfeffer, F; Mainard, D; Delagoutte, J P

    We report a rare injury in an 18-year-old woman who sustained posterior bilateral hip dislocation with sacro-iliac dislocation after a high energy motor vehicle accident. She was treated by closed reduction and skeletal traction. Bilateral traumatic hip dislocation is an uncommon occurrence. Rarer still is bilateral traumatic hip dislocation associated with sacro-iliac dislocation because it combines two different mechanisms of trauma. (Hip International 2002; 1: 47-9).

  5. Deep Vein Thrombosis

    MedlinePlus

    ... vein swells, the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem in the lung, called a pulmonary embolism. Sitting still for a long time can make ...

  6. Deep vein thrombosis - discharge

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000027.htm Deep vein thrombosis - discharge To use the sharing features ... page, please enable JavaScript. You were treated for deep vein thrombosis ( DVT ). This is a condition in ...

  7. Varicose vein stripping

    MedlinePlus

    ... noninvasive treatment Varicose veins Venous insufficiency Patient Instructions Surgical wound care - open Varicose veins - what to ask your doctor Review Date 6/6/2016 ... Interventional Radiology & Surgical Critical Care, Philadelphia, PA. Review provided by VeriMed ...

  8. Focus on Varicose Veins

    MedlinePlus

    ... work- ing properly or have evidence of reflux. Measurement of the venous function of the leg may ... Vein stripping was the traditional treatment for bad values in the veins however it is rarely used ...

  9. Portal Vein Thrombosis

    PubMed Central

    Mallet, Thierry; Soltys, Remigiusz; Loarte, Pablo

    2015-01-01

    Portal vein thrombosis (PVT) is the blockage or narrowing of the portal vein by a thrombus. It is relatively rare and has been linked with the presence of an underlying liver disease or prothrombotic disorders. We present a case of a young male who presented with vague abdominal symptoms for approximately one week. Imaging revealed the presence of multiple nonocclusive thrombi involving the right portal vein, the splenic vein, and the left renal vein, as well as complete occlusion of the left portal vein and the superior mesenteric vein. We discuss pathogenesis, clinical presentation, and management of both acute and chronic thrombosis. The presence of PVT should be considered as a clue for prothrombotic disorders, liver disease, and other local and general factors that must be carefully investigated. It is hoped that this case report will help increase awareness of the complexity associated with portal vein thrombosis among the medical community. PMID:25802795

  10. Endovascular Aortic Aneurysm Repair with the Talent Stent-Graft: Outcomes in Patients with Large Iliac Arteries

    SciTech Connect

    England, Andrew; Butterfield, John S.; McCollum, Charles N.; Ashleigh, Raymond J.

    2008-07-15

    The purpose of this study is to report outcomes following endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) in patients with ectatic common iliac arteries (CIAs). Of 117 AAA patients treated by EVAR between 1998 and 2005, 87 (74%) had CIAs diameters <18 mm and 30 (26%) patients had one or more CIA diameters >18 but <25 mm. All patients were treated with Talent stent-grafts, 114 bifurcated and 3 AUI devices. Departmental databases and patient records were reviewed to assess outcomes. Technical success, iliac-related outcome, and iliac-related reintervention (IRSI) were analyzed. Patients with EVAR extending into the external iliac artery were excluded. Median (range) follow-up for the study group was 24 (1-84) months. Initial technical success was 98% for CIAs <18 mm and 100% for CIAs {>=}18 mm (p = 0.551). There were three distal type I endoleaks (two in the ectatic group) and six iliac limb occlusions (one in an ectatic patient); there were no statistically significant differences between groups (p = 0.4). There were nine IRSIs (three stent-graft extensions, six femorofemoral crossover grafts); three of these patients had one or both CIAs {>=}18 mm (p = 0.232). One-year freedom from IRSI was 92% {+-} 3% and 84% {+-} 9% for the <18-mm and {>=}18-mm CIA groups, respectively (p = 0.232). We conclude that the treatment of AAA by EVAR in patients with CIAs 18-24 mm appears to be safe and effective, however, it may be associated with more frequent reinterventions.

  11. Deep vein thrombosis of the lower limb secondary to lumbar discal hernia compression: a rarity? Review of the literature.

    PubMed

    Di Cello, P; Izzo, S; Pugliese, F; Di Poce, I; Orsini, A; Izzo, L; Mazzone, G; Biancucci, F; Sinaimeri, G; Valabrega, S; Almansour, M; Izzo, P

    2016-01-01

    This case report is about a 70-years-old female patient, suffering from discal hernia, with compression of the iliac vein, that led to the formation of deep vein thrombosis of the lower limbs. The angio-CT scan revealed the starting point of the L4- L5 compression where a voluminous discal hernia caused deep vein thrombosis, with the involvement the femoro-popliteal venous axis. Blood samples and PET-CT scans excluded other possible etiologic factors. This case demonstrates how a voluminous discal hernia can cause venous thrombosis.

  12. Deep vein thrombosis of the lower limb secondary to lumbar discal hernia compression: a rarity? Review of the literature

    PubMed Central

    DI CELLO, P.; IZZO, S.; PUGLIESE, F.; DI POCE, I.; ORSINI, A.; IZZO, L.; MAZZONE, G.; BIANCUCCI, F.; SINAIMERI, G.; VALABREGA, S.; ALMANSOUR, M.; IZZO, P.

    2016-01-01

    This case report is about a 70-years-old female patient, suffering from discal hernia, with compression of the iliac vein, that led to the formation of deep vein thrombosis of the lower limbs. The angio-CT scan revealed the starting point of the L4–L5 compression where a voluminous discal hernia caused deep vein thrombosis, with the involvement the femoro-popliteal venous axis. Blood samples and PET-CT scans excluded other possible etiologic factors. This case demonstrates how a voluminous discal hernia can cause venous thrombosis. PMID:27734797

  13. Ultrasound: a new tool for precisely locating posterior iliac crests to obtain adequate bone marrow trephine biopsy specimen.

    PubMed

    Islam, Anwarul

    2013-08-01

    Ultrasound imaging has evolved as a very useful tool in medical science. However, the technique of ultrasound-guided bone marrow trephine biopsy (BMTB) has not been routinely used by haematologists and oncologists to help locate the posterior iliac crest during the BMTB procedure. We have used the technique of ultrasound-guided BMTB in 20 patients diagnosed with various haematological and non-haematological malignant conditions. We found the technique simple and useful in precisely locating the posterior iliac crest. As a result, it facilitates the extraction of a satisfactory core sample or aspiration biopsy and is more surgically precise than when access to the target bone is based only on external landmarks and blind biopsy.

  14. [Femoral superficial vein thrombosis due to a large iliopsoas bursitis secondary to polyethylene wear debris in total hip arthroplasty].

    PubMed

    Lax Pérez, R; Salinas Gilabert, J E; Lajara Marco, F; Lax Pérez, A; Ferrero Manzanal, F; García-Gálvez, A; Izquierdo Plazas, L

    2012-01-01

    A 76 year old male patient with a history of implantation of a total hip arthroplasty Perfecta (Orthomet(®)), who presented with an iliac fossa mass, increased diameter of the thigh, and pain during hip flexion and extension. CT and ultrasound show the presence of a giant cystic mass in left iliac fossa about 7 cm in diameter next to the prosthesis. A pseudo-tumour secondary to wear debris after placement of a total arthroplasty is rare. We present a case of a large iliopsoas bursitis caused by polyethylene particles, which caused compression and thrombosis of the superficial femoral vein.

  15. [Superficial femoral vein thrombosis due to large psoas bursitis secondary to particle disease in total hip arthroplasty].

    PubMed

    Lax-Pérez, R; Salinas-Gilabert, J E; Lajara-Marco, F; Lax-Pérez, A; Corraliza-Zamorano, A; García-Gálvez, A; Izquierdo-Plazas, L

    2012-01-01

    Male, 76 year-old patient with a history of total hip arthroplasty who presents with a mass in the iliac fossa with swelling of the thigh and hip pain upon flexion and extension. Complementary ultrasound and computed tomography scan studies show a giant lobulated cystic mass in the left iliac fossa, 7 cm in diameter, near the prosthesis. Cyst formation caused by polyethylene disease after total hip arthroplasty is infrequent. We present a case of large psoas bursitis secondary to the release of polyethylene particles which caused superficial femoral vein compression and thrombosis.

  16. [Thrombosis of the superficial femoral vein due to psoas bursitis secondary to particle disease in total hip arthroplasty].

    PubMed

    Lax-Pérez, R; Salinas-Gilabert, J E; Lajara-Marco, F; Lax-Pérez, A; Corraliza-Zamorano, A; García-Gálvez, A; Izquierdo-Plazas, L

    2011-01-01

    The case of a male 76 year-old patient with a history of total hip replacement surgery is presented herein. The patient had tumors in the iliac fossa with swelling of the thigh and pain upon hip flexion and extension. The complementary ultrasound and computed tomography show a large lobed cystic tumor in the left iliac fossa, 7 cm in diameter, close to the prosthesis. The diagnosis was psoas bursitis secondary to the release of polyethylene particles that caused compression and thrombosis of the superficial femoral vein. Cyst formation caused by polyethylene disease after total hip arthroplasty is infrequent.

  17. Iliac Artery Injury Following Placement of the Memotherm Arterial Stent

    SciTech Connect

    Redman, Alan; Cope, Lance; Uberoi, Raman

    2001-03-15

    Iliac rupture and aneurysm formation at the site of stent placement has rarely been described in the literature. We report four cases, three of iliac rupture, including a delayed rupture, and an aneurysm, with the use of a single type of stent, the Memotherm stent. We believe the design of the stent significantly contributed to damage to the arterial wall and subsequently prevented closure of the arterial tear by balloon tamponade in the two cases where this was attempted. Two patients, one with rupture and one with an aneurysm, were successfully treated with a covered stent obviating surgery and two ruptures resulted in death. We recommend that all interventionists carrying out iliac angioplasty and/or stenting should have access to covered stents for such emergencies.

  18. Vein of Galen Aneurysms

    PubMed Central

    Komiyama, M.; Nakajima, H.; Nishikawa, M.; Yamanaka, K.; Iwai, Y.; Yasui, T.; Morikawa, T.; Kitano, S.; Sakamoto, H.; Nishio, A.

    2001-01-01

    Summary Eleven patients with so-called “vein of Galen aneurysms ” are reported, six of whom presented with vein of Galen aneurysmal malformations (four with choroidal type and two with mural type malformations). The remaining five patients presented with vein of Galen aneurysmal dilatations secondarily due to an arteriovenous malformation in one patient, an arteriovenous fistula in another, dural arteriovenous fistulas in two patients, and a varix in another. Treatments for these patients were individualised with consideration given to the clinical manifestations and the angioarchitecture of their lesions. Endovascular intervention played a critical role in the treatment of these vein of Galen aneurysms. PMID:20663385

  19. Single and Tandem Stents in Sheep Iliac Arteries: Is There a Difference in Patency?

    SciTech Connect

    Schuermann, Karl; Vorwerk, Dierk; Buecker, Arno; Grosskortenhaus, Stefanie; Guenther, Rolf W.

    1998-09-15

    Purpose: To compare patency and neointima formation of single and tandem arterial stents. Methods: In each of six sheep, two Memotherm nitinol stents (tandem stents) were inserted into the external iliac artery on one side and a single stent into the artery on the opposite side. The size of the iliac lumen was assessed in the proximal, middle, and distal segments of the stents by intravascular ultrasound (IVUS) before, immediately after, and 1 month after implantation when the sheep were killed. Neointimal thickness was determined in the proximal, middle, and distal segments of each stent by light microscopy. Results: All stents remained patent. There was no significant difference in lumen and neointimal thickness between single and tandem stents. Cranial tandem stents showed a significantly wider lumen and smaller neointimal thickness than caudal tandem stents. In the proximal and distal segments, the lumen of the stents was significantly smaller and the neointimal thickness greater than in the middle segment; differences in neointimal thickness were significant only between the proximal and the middle segment. Conclusion: In an experimental setting, tandem stents did not interfere with one another with regard to patency and neointima formation when compared with a single contralateral stent. Neointimal thickening after stent insertion seems to be inversely related to the original arterial diameter.

  20. [Endovascular treatment of persistent dysuria and chronic pelvic pain in women with pelvic varicose veins].

    PubMed

    Neĭmark, A I; Shelkovnikova, N V

    2012-01-01

    The results of the examination and treatment of 16 patients aged from 26 to 46 years with persistent urinary disorders and chronic pelvic pain due to severe pelvic varicose veins are presented. Using ultrasound with color Doppler mapping and venography of renal and ovarian vein for evaluation of condition of the venous system of the pelvis, the significant dilation of the internal iliac, ovarian and uterine veins with a pronounced decrease in blood flow in veins up to the stasis of blood, accompanied by flow turbulence and powerful backflow of renal blood through ovarian veins were found in all patients. According to uroflowmetry, there was a decrease in detrusor tone and a violation of evacuation capacity of the bladder. Evaluation of microcirculation using LDF allowed to diagnose congestive hemodynamic type of microcirculation. Scleroembolization for varicose ovarian vein with Gianturco coil and ethoxysclerol was performed in all patients. Positive therapeutic effect in the form of eliminating varicose pelvic veins, pain relieve, disappearance of persistent dysuria, and the remission of chronic cystitis was achieved in 86% of women. This intervention provided the normal outflow of blood from the pelvic veins, contributed to the normalization of uroflowmetry data and restoration of normal microcirculation in the urinary bladder.

  1. Support for varicose veins.

    PubMed Central

    Fentem, P H; Goddard, M; Gooden, B A

    1976-01-01

    A method has been devised to allow reliable comparison of different strengths and constructions of support hosiery. Five garments were evaluated for the compression they exerted on the leg and their ability to limit the distension of a model varicose vein. Stockings and tights which provide modest compression can achieve worthwhile control of vein distension. PMID:1247807

  2. Prepancreatic preduodenal portal vein.

    PubMed

    Lal, N S; Kuruvila, A P; Natesh, P B; Koshy, M M; Anandakumar, M

    1992-10-01

    We report a 17 year old girl with prepancreatic and preduodenal portal vein. She presented with recurrent vomiting. Barium study revealed malrotation of the gut. Laparotomy confirmed malrotation of the gut with a prepancreatic and preduodenal portal vein. The patient is asymptomatic after gastrojejunostomy and vagotomy.

  3. How Are Varicose Veins Diagnosed?

    MedlinePlus

    ... injected into your veins. The dye outlines your veins on x-ray images. An angiogram can help your doctor confirm whether you have varicose veins or another condition. Rate This Content: NEXT >> Updated: ...

  4. Passive biaxial mechanical response of aged human iliac arteries.

    PubMed

    Schulze-Bauer, Christian A J; Mörth, Christian; Holzapfel, Gerhard A

    2003-06-01

    Inflation and extension tests of arteries are essential for the understanding of arterial wall mechanics. Data for such tests of human arteries are rare. At autopsy we harvested 10 non-diseased external iliac arteries of aged subjects (52-87 yrs). Structural homogeneity was ensured by means of ultrasound imaging, and anamneses of patients were recorded. We measured the axial in situ stretches, load-free geometries and opening angles. Passive biaxial mechanical responses of preconditioned cylindrical specimens were studied in 37 degrees C calcium-free Tyrode solution under quasistatic loading conditions. Specimens were subjected to pressure cycles varying from 0 to 33.3 kPa (250 mmHg) at nine fixed axial loads, varying from 0 to 9.90N. For the description of the load-deformation behavior we employed five "two-dimensional" orthotropic strain-energy functions frequently used in arterial wall mechanics. The associated constitutive models were compared in regard to their ability of representing the experimental data. Histology showed that the arteries were of the muscular type. In contrast to animal arteries they exhibited intimal layers of considerable thickness. The average ratio of wall thickness to outer diameter was 7.7, which is much less than observed for common animal arteries. We found a clear correlation between age and the axial in situ stretch lambda is (r = -0.72, P = 0.03), and between age and distensibility of specimens, i.e. aged specimens are less distensible. Axial in situ stretches were clearly smaller (1.07 +/- 0.09, mean +/- SD) than in animal arteries. For one specimen lambda is was even smaller than 1.0, i.e. the vessel elongated axially upon excision. The nonlinear and anisotropic load-deformation behavior showed small hystereses. For the majority of specimens we observed axial stretches smaller than 1.3 and circumferential stretches smaller than 1.1 for the investigated loading range. Data from in situ inflation tests showed a significant

  5. [Arteriosclerotic aneurysms isolated from the internal iliac artery].

    PubMed

    Zorita, A; Vázquez, J G; Samos, R F; Morán, C F; Costilla, S; Vaquero, F

    1990-01-01

    A case of an isolate, symptomatic, atherosclerotic aneurysm of the left internal iliac artery is presented. A review from this very rare type of pathology reveal that clinical symptoms depends on the comprised anatomical structures. Diagnosis was made by rectal or vaginal touch, ultrasonography and CT. The operatoire mortality rate is high when aneurysms are ruptured.

  6. Percutaneous Endovascular Treatment of Chronic Iliac Artery Occlusion

    SciTech Connect

    Carnevale, F. C. De Blas, Mariano; Merino, Santiago; Egana, Jose M.; Caldas, Jose G.M.P.

    2004-09-15

    Purpose: To evaluate the clinical and radiological long-term results of recanalization of chronic occluded iliac arteries with balloon angioplasty and stent placement.Methods: Sixty-nine occluded iliac arteries (mean length 8.1 cm; range 4-16 cm) in 67 patients were treated by percutaneous transluminal angioplasty and stent placement. Evaluations included clinical assesment according to Fontaine stages, Doppler examinations with ankle-brachial index (ABI) and bilateral lower extremity arteriograms. Wallstent and Cragg vascular stents were inserted for iliac artery recanalization under local anesthesia. Follow-up lasted 1-83 months (mean 29.5 months).Results: Technical success rate was 97.1% (67 of 69). The mean ABI increased from 0.46 to 0.85 within 30 days after treatment and was 0.83 at the most recent follow-up. Mean hospitalization time was 2 days and major complications included arterial thrombosis (3%), arterial rupture (3%) and distal embolization (1%). During follow-up 6% stenosis and 9% thrombosis of the stents were observed. Clinical improvement occurred in 92% of patients. Primary and secondary patency rates were 75% and 95%, respectively.Conclusion: The long-term patency rates and clinical benefits suggest that percutaneous endovascular revascularization with metallic stents is a safe and effective treatment for patients with chronic iliac artery occlusion.

  7. Sacro-iliac joint scanning with technetium-99 diphosphonate.

    PubMed

    Lugon, M; Torode, A S; Travers, R L; Amaral, H; Lavender, J P; Hughes, G R

    1979-08-01

    Quantitative sacro-iliac (SI) joint scanning with methylene diphosphonate labelled with technetium-99 (99TcMDP) was performed in 25 control patients, in 16 patients with definite ankylosing spondylitis, in 23 patients with mechanical low back pain, and in 12 patients with seronegative arthritis. The mean radio-isotope index in the control group was 1.2 +/- 0.15. The highest value was 1.5. Values in excess of 1.5 were seen in patients with clinically active ankylosing spondylitis but not those with inactive disease. Three of the 12 seronegative arthritis patients (without clinical or radiological evidence of sacro-iliitis) had elevated values: all of these were positive for HL-A B27. An important finding was that six of the 23 patients with mechanical or non-specific low back pain had values above 1.5, unassociated with B27. These data emphasize the need for caution in the interpretation of abnormal sacro-iliac scans. Radio-isotope bone scanning can provide a qualitative and quantitative assessment of inflammatory activity in joints with minimal radiation exposure. Various authors have shown its value in providing early evidence of sacro-iliitis (Russell et al., 1975; Namey et al., 1977). In this study, methylene diphosphonate labelled with technetium-99 (99TcMMDP) has been used to produce quantitative sacro-iliac scans in order to evaluate sacro-iliac disease in four groups of patients presenting with or without low back pain.

  8. Very Long Segment Congenital Thoracoabdominal Aortic Coarctation (Diffuse Aortic Dysplasia) with Infrarenal Aortobi-Iliac and Cavobi-Iliac Aplasia in a 30-Year-Old Patient.

    PubMed

    Mamopoulos, Apostolos; Luther, Bernd

    2015-10-01

    Congenital dysplastic aortic syndromes range from coarctation at the aortic isthmus to more extended aortic disease (midaortic syndrome). The latter is usually restricted to dysplastic aortic segments of up to 15 cm. Long segment dysplasia of the entire abdominal or thoracic aorta is extremely rare. This case of a 30-year-old patient with a very long segment congenital thoracoabdominal aortic coarctation and infrarenal aortobi-iliac and cavobi-iliac aplasia represents to our knowledge the most extended congenital vascular malformation in a surviving adult patient. The developed extensive collateral pathways ensured the survival of the patient, so that the main clinical manifestation was a refractory hypertension. Because of the extent of the disease, open surgery represented the only viable option. Interestingly, after 30 years of uncontrollable hypertension, the patient's blood pressure promptly responded to surgical treatment. A concomitant infrarenal aplasia of both the aorta and cava vein is also very unusual and points to a major developmental deficit during vascular embryogenesis.

  9. Balloon Occlusion of the Contralateral Iliac Artery to Assist Recanalization of the Ipsilateral Iliac Artery in Total Aortoiliac Occlusion: A Technical Note

    PubMed Central

    Jaffan, Abdel Aziz A.

    2013-01-01

    Endovascular recanalization of chronic total aortoiliac occlusion is technically challenging. Inability to reenter the true aortic lumen, following retrograde iliac recanalization, is one of the most common causes of failure. We describe a case of a total aortoiliac occlusion where balloon occlusion of the right common iliac artery, following its recanalization from a brachial approach, was used to facilitate antegrade recanalization of the occluded contralateral left common iliac artery. PMID:23762730

  10. Cholestasis in children with portal vein obstruction.

    PubMed

    Gauthier-Villars, Marion; Franchi, Stéphanie; Gauthier, Frédéric; Fabre, Monique; Pariente, Danièle; Bernard, Olivier

    2005-04-01

    We describe cholestasis as a result of bile duct abnormalities in 8 children with portal vein obstruction. In a clinical, biochemical and radiological investigation of 121 children with cavernous transformation of the portal vein seen between 1986 and 2000, 8 presented with jaundice, pruritus, and/or raised serum aminotransferases and/or gamma glutamyl transpeptidase (gamma GT) activities. Each displayed dilation and narrowing of intra- and/or extrahepatic bile ducts. Surgical decompression of the portal system (portal-systemic or Rex anastomosis) resulted in the regression of the signs of cholestasis in all children. We conclude that children with portal vein obstruction may exhibit clinically significant cholestasis as a result of external compression of the bile duct by the cavernoma.

  11. Inferior vena cava filter insertion through the popliteal vein: enabling the percutaneous endovenous intervention of deep vein thrombosis with a single venous access approach in a single session

    PubMed Central

    Kim, Hyoung Ook; Kim, Jae Kyu; Park, Jin Gyoon; Yim, Nam Yeol; Kang, Yang Jun; Jung, Hye Doo

    2016-01-01

    PURPOSE We aimed to evaluate the efficiency of placing an inferior vena cava (IVC) filter through the same popliteal vein access site used for percutaneous endovenous intervention in patients with extensive lower extremity deep vein thrombosis. METHODS This retrospective study included 21 patients who underwent IVC filter insertion through the popliteal vein over a three-year period. Patient medical records were reviewed for the location of the deep vein thrombosis, result of filter removal, and total number of endovascular procedures needed for filter insertion and recanalization of the lower extremity venous system. Follow-up lower extremity computed tomography (CT) venography was also reviewed in each patient to assess the degree of filter tilt in the IVC. RESULTS All patients had extensive lower extremity deep vein thrombosis involving the iliac vein and/or femoral vein. Seventeen patients showed deep vein thrombosis of the calf veins. In all patients, IVC filter insertion and the recanalization procedure were performed during a single procedure through the single popliteal vein access site. In the 17 patients undergoing follow-up CT, the mean tilt angle of the filter was 7.14°±4.48° in the coronal plane and 8.77°±5.49° in the sagittal plane. Filter retrieval was successful in 16 of 17 patients (94.1%) in whom filter retrieval was attempted. CONCLUSION Transpopliteal IVC filter insertion is an efficient technique that results in low rates of significant filter tilt and enables a single session procedure using a single venous access site for filter insertion and percutaneous endovenous intervention. PMID:27559713

  12. Endovascular Treatment of Internal Iliac Artery Aneurysms: Single Center Experience

    PubMed Central

    Machado, Rui Manuel; Rego, Duarte Nuno Cunha; de Oliveira, Pedro Nuno Ferreira Pinto; de Almeida, Rui Manuel Gonçalves Fernandes

    2016-01-01

    Objective Internal iliac artery aneurysms (IIAA) are rare, representing only 0.3% of aortoiliac aneurysms. Its treatment with open surgery is complex and associated with high morbidity and mortality, which led to increasing application of endovascular solutions. In this study, we aimed to evaluate outcomes of endovascular aneurysm repair (EVAR) of IIAA in one institution. Methods We retrospectively reviewed all cases of IIAA treated with endovascular techniques between 2003 and 2014. Endpoints were morbidity, mortality, freedom from pelvic ischemic symptoms (buttock claudication, ischemic colitis, and spinal cord injury), and need for reintervention. Results There were 16 patients, 13 males and 3 females, with mean age of 75.1±7 years. A total of 20 IIAA (4 cases were bilateral), with mean diameter of 37.9 mm, were treated. EVAR was performed in 13 (81.3%) patients, with associated internal iliac artery's outflow occlusion in 2. Iliac branch device was used in one patient. Two patients underwent endovascular IIAA embolization alone. One patient underwent percutaneous, transgluteal, IIAA embolization. IIAA flow preservation in at least one internal iliac artery was possible in 9 (56.3%) patients. Early mortality was 7% (1 case). Early morbidity was 18.8%. Pelvic ischemic complications occurred in 1 (7%) patient with buttock claudication. Late reintervention was needed in 3 patients, none of them for IIAA related complications. Conclusion Endovascular treatment of IIAA is technically feasible and durable. Although overall morbidity is relatively high, major complications are infrequent and perioperative mortality is low. internal iliac artery flow preservation is technically challenging and, in a significant number of cases, not possible at all. PMID:27556311

  13. Iliocaval Stenosis and Iliac Venous Thrombosis in Retroperitoneal Fibrosis: Percutaneous Treatment by Use of Hydrodynamic Thrombectomy and Stenting

    SciTech Connect

    Vorwerk, Dierk; Guenther, Rolf W.; Wendt, Georg; Neuerburg, Joerg; Schuermann, Karl

    1996-11-15

    A case of bilateral iliac stenosis and caval stenosis due to retroperitoneal fibrosis was treated by caval stenting and iliac balloon angioplasty, but was complicated by subsequent iliac thrombosis. Venous thrombectomy was successfully achieved by hydrodynamic thrombectomy, and iliac patency was stabilized by bilateral stent insertion.

  14. Vascular complications following prophylactic balloon occlusion of the internal iliac arteries resolved by successful interventional thrombolysis in a patient with morbidly adherent placenta*

    PubMed Central

    Zhang, Ning; Lou, Wei-hua; Zhang, Xue-bin; Fu, Jia-ning; Chen, Yun-yan; Zhuang, Zhi-guo; Lin, Jian-hua

    2017-01-01

    The increasing incidence of morbidly adherent placenta (MAP) is placing women at a higher risk of life-threatening massive hemorrhage. The involvement of interventional radiology to manage this complex condition by performing prophylactic iliac artery balloon occlusion has been reported recently. However, the effectiveness and safety of this technique have not been fully determined. Here we report the case of a 25-year-old woman with placenta increta with preemptive bilateral internal iliac artery balloons who had external iliac artery thrombosis detected by computed tomography angiography (CTA) 72 h post cesarean section. A digital subtraction angiogram (DSA) and intra-arterial thrombolysis were instantly performed followed by supplementary conservative treatments, leading to a desirable resolution of thrombus without sequela. This is the first report of vascular complications with successful interventional thrombolysis in this setting. Our experience suggests that prophylactic iliac artery balloon occlusion should be used cautiously in cases of MAP and consideration given to minimizing vascular complications given the hypercoagulable state of pregnancy. PMID:28271663

  15. Customized Tapered Stent-Grafts in the Endovascular Management of Internal Iliac Artery Aneurysms: A Useful Adjunct to Conventional Endovascular Options

    SciTech Connect

    Haslam, J. Elizabeth Hardman, John; Horrocks, Michael; Fay, Dominic

    2009-01-15

    The endovascular exclusion of an isolated iliac artery aneurysm is recognized as a safe and favorable alternative to open surgical repair, with low associated morbidity and mortality. It has particular advantages in the treatment of internal iliac artery aneurysm (IIAA) given the technical difficulties associated with open surgical repair deep within the pelvis. We describe the use of customized tapered stent-grafts in the exclusion of wide-necked IIAA in five male patients considered high-risk for conventional surgical repair, in whom the common and external iliac artery morphology precluded the use of standard endovascular devices. In each case, IIAA outflow was selectively embolized and the aneurysm neck excluded by placement of a customized tapered stent-graft across the internal iliac artery origin. This technique was extremely effective, with 100% technical success, no serious associated morbidity, and zero mortality. In all five patients sac size was stable or reduced on computed tomography follow-up of up to 3 years (mean, 24.4 months), with a primary patency rate of 100%. We therefore advocate the use of customized tapered stent-grafts as a further endovascular option in the management of IIAA unsuitable for conventional endovascular repair.

  16. Endovascular treatment of iliofemoral deep vein thrombosis in pregnancy using US-guided percutaneous aspiration thrombectomy

    PubMed Central

    Gedikoglu, Murat; Oguzkurt, Levent

    2017-01-01

    PURPOSE We aimed to describe ultrasonography (US)-guided percutaneous aspiration thrombectomy in pregnant women with iliofemoral deep vein thrombosis. METHODS This study included nine pregnant women with acute and subacute iliofemoral deep vein thrombosis, who were severe symptomatic cases with massive swelling and pain of the leg. Patients were excluded from the study if they had only femoropopliteal deep vein thrombosis or mild symptoms of deep vein thrombosis. US-guided percutaneous aspiration thrombectomy was applied to achieve thrombus removal and uninterrupted venous flow. The treatment was considered successful if there was adequate venous patency and symptomatic relief. RESULTS Complete or significant thrombus removal and uninterrupted venous flow from the puncture site up to the iliac veins were achieved in all patients at first intervention. Complete relief of leg pain was achieved immediately in seven patients (77.8%). Two patients (22.2%) had a recurrence of thrombosis in the first week postintervention. One of them underwent a second intervention, where percutaneous aspiration thrombectomy was performed again with successful removal of thrombus and establishment of in line flow. Two patients were lost to follow-up after birth. None of the remaining seven patients had rethrombosis throughout the postpartum period. Symptomatic relief was detected clinically in these patients. CONCLUSION Endovascular treatment with US-guided percutaneous aspiration thrombectomy can be considered as a safe and effective way to remove thrombus from the deep veins in pregnant women with acute and subacute iliofemoral deep vein thrombosis. PMID:27801353

  17. Deep Vein Thrombosis (DVT)

    MedlinePlus

    ... helps reduce the chances that your blood will pool and clot. You should wear these stockings during ... Make lifestyle changes. Lose weight and quit smoking. Obesity and smoking increase your risk of deep vein ...

  18. What Are Varicose Veins?

    MedlinePlus

    ... family history, older age, gender, pregnancy, overweight or obesity , lack of movement, and leg trauma. Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment ...

  19. Surgical anatomy for pelvic external fixation.

    PubMed

    Solomon, L B; Pohl, A P; Chehade, M J; Malcolm, A M; Howie, D W; Henneberg, M

    2008-10-01

    Pelvic external fixators have a high rate of reported complications, most of which relate to pin placement. In this descriptive study, we analyzed the morphology of the ilium in cadaveric specimens and compared these with the measures obtained from normal human pelvic computer tomograph scans, and how these related to each of the three basic configurations of pin positioning for the external fixation of a pelvis: anterosuperior (Slätis type), anteroinferior (supra-acetabular), and subcristal. The irregular shape and size of the iliac wing and the abdominal wall overlying the pin's insertion site could hinder accurate placement of anterosuperior pins. Potential disadvantages of the use of anteroinferior pins was found related to the deep location of the anterior inferior iliac spine, interference with the hip flexion area, risk of hip joint penetration, and the variable obliquity of the ilium. As subcristal pins are positioned between two superficial bony landmarks of the iliac crest, our findings suggest that they are more likely to have a correct placement and avoid complications.

  20. Actinomyces infection causing acute right iliac fossa pain

    PubMed Central

    Govindarajah, Narendranath; Hameed, Waseem; Middleton, Simon; Booth, Michael

    2014-01-01

    This is a case of a 75-year-old man being admitted to the on-call surgical department with acute abdominal pain. On arrival he was clinically dehydrated and shocked with localised pain over McBurney's point and examination findings were suggestive of appendiceal or other colonic pathology. Full blood testing revealed a white cell count of 38×109/L and a C reactive protein (CRP) of 278 mg/L. A CT scan revealed a gallbladder empyema that extended into the right iliac fossa. This case highlights the potential for a hyperdistended gallbladder empyema to present as acute right iliac fossa pain with blood tests suggestive of complicated disease. Further analysis confirmed Actinomyces infection as the underlying aetiology prior to a laparoscopic subtotal cholecystectomy. This case serves to remind clinicians of this as a rare potential cause of atypical gallbladder pathology. PMID:24872493

  1. Endovascular treatment of iliac occlusive disease: review and update.

    PubMed

    Mousa, Albeir Y; Beauford, Robert B; Flores, Lucio; Faries, Peter L; Patel, Prem; Fogler, Richard

    2007-01-01

    Use of endovascular interventions for arterial occlusive lesions continues to increase. With the evolution of the technology supporting these therapeutic measures, the results of these interventions continue to improve. In general, a comparison of techniques for revascularization of iliac occlusive diseases shows similar initial technical success rates for open versus percutaneous transluminal angioplasty. Angioplasty is often associated with lower periprocedural morbidity and mortality rates. Conversely, surgery frequently provides greater long-term patency, although late failure of percutaneous therapies may occur but still can be treated successfully with reintervention. The perpetual buildup of experience with angioplasty and stenting will eventually characterize its role in the management of occlusive disease. This review outlines the current consensus and applicability of endovascular management of iliac occlusive diseases.

  2. Infrahepatic inferior caval and azygos vein formation in mammals with different degrees of mesonephric development.

    PubMed

    Hikspoors, Jill P J M; Mekonen, Hayelom K; Mommen, Greet M C; Cornillie, Pieter; Köhler, S Eleonore; Lamers, Wouter H

    2016-03-01

    Controversies regarding the development of the mammalian infrahepatic inferior caval and azygos veins arise from using topography rather than developmental origin as criteria to define venous systems and centre on veins that surround the mesonephros. We compared caudal-vein development in man with that in rodents and pigs (rudimentary and extensive mesonephric development, respectively), and used Amira 3D reconstruction and Cinema 4D-remodelling software for visualisation. The caudal cardinal veins (CCVs) were the only contributors to the inferior caval (IVC) and azygos veins. Development was comparable if temporary vessels that drain the large porcine mesonephros were taken into account. The topography of the CCVs changed concomitant with expansion of adjacent organs (lungs, meso- and metanephroi). The iliac veins arose by gradual extension of the CCVs into the caudal body region. Irrespective of the degree of mesonephric development, the infrarenal part of the IVC developed from the right CCV and the renal part from vascular sprouts of the CCVs in the mesonephros that formed 'subcardinal' veins. The azygos venous system developed from the cranial remnants of the CCVs. Temporary venous collaterals in and around the thoracic sympathetic trunk were interpreted as 'footprints' of the dorsolateral-to-ventromedial change in the local course of the intersegmental and caudal cardinal veins relative to the sympathetic trunk. Interspecies differences in timing of the same events in IVC and azygos-vein development appear to allow for proper joining of conduits for caudal venous return, whereas local changes in topography appear to accommodate efficient venous perfusion. These findings demonstrate that new systems, such as the 'supracardinal' veins, are not necessary to account for changes in the course of the main venous conduits of the embryo.

  3. Emergency Endovascular 'Bridge' Treatment for Iliac-Enteric Fistula

    SciTech Connect

    Franchin, Marco; Tozzi, Matteo; Piffaretti, Gabriele; Carrafiello, Gianpaolo; Castelli, Patrizio

    2011-10-15

    Aortic aneurysm has been reported to be the dominant cause of primary iliac-enteric fistula (IEF) in >70% of cases [1]; other less common causes of primary IEF include peptic ulcer, primary aortitis, pancreatic pseudocyst, or neoplastic erosion into an adjacent artery [2, 3]. We describe an unusual case of IEF managed with a staged approach using an endovascular stent-graft as a 'bridge' in the emergency setting to optimize the next elective definitive excision of the lesion.

  4. Tuberculous iliac artery aneurysm in a pediatric patient.

    PubMed

    Cox, Sharon Gail; Naidoo, Nadraj G; Wood, Richard John; Clark, Lizelle; Kilborn, Tracy

    2013-03-01

    Vascular complications of tuberculous infections are rare and occur even less frequently in the pediatric population. Tuberculous pseudoaneurysms can occur either as a result of contiguous spread from a neighboring focus-invariably infected lymph nodes-or by hematogenous spread and seeding of acid-fast bacilli that lodge in the adventitia or media via the vasa vasorum. We report a case of turberculous right common iliac artery pseudoaneurysm in a 12-year-old and review the relevant literature.

  5. Percutaneous Treatment in Iliac Artery Occlusion: Long-Term Results

    SciTech Connect

    Gandini, Roberto; Fabiano, Sebastiano; Chiocchi, Marcello; Chiappa, Roberto Simonetti, Giovanni

    2008-11-15

    We evaluated the long-term results of recanalization with primary stenting for patients with long and complex iliac artery occlusions. This was a retrospective nonrandomised study. Between 1995 and 1999, 138 patients underwent recanalization of an occluded iliac artery with subsequent stenting. Patency results were calculated using Kaplan-Meier analysis. The mean length of follow-up was 108 months. Variables affecting primary stent patency such as patient age; stent type and diameter; lesion site, shape, and length; Society of Cardiovascular and Interventional Radiology classification; total runoff score; Fontaine classification; and cardiovascular risk factors were analysed using Breslow test. These variables were then evaluated for their relation to stent patency using Cox proportional hazards test. Technical success was 99%. Primary patency rates were 90% (SE .024), 85% (SE .029), 80% (SE .034), and 68% (SE .052) at 3, 5, 7, and 10 years, respectively. Lesion site (p = 0.022) and stent diameter (p = 0.028) were shown to have a statistically significant influence on primary stent patency. Long-term results of iliac recanalization and stent placement were excellent, without major complications, even in highly complex vascular obstructions. A primary endovascular approach appears to be justified in the majority of patients as a less invasive alternative treatment to surgery. In any case, a first-line interventional approach should be considered in elderly patients or in patients with severe comorbidities.

  6. Selective Thrombolysis in Acute Deep Vein Thrombosis: Evaluation of Adjuvant Therapy In Vivo

    SciTech Connect

    Roy, Sumit; Brosstad, Frank; Sakariassen, Kjell S.

    1999-09-15

    Purpose: To evaluate in a porcine model of acute deep vein thrombosis (DVT) the efficacy of dalteparin and antithrombin with respect to heparin for local adjuvant therapy during selective thrombolysis, and the utility of nitroglycerin and iloprost as heparin supplements. Methods: DVT was induced in both hind limbs using a previously described technique (n = 20). Thirty minutes later, the animal was heparinized (2500 IU IV), and bilateral sequestrated thrombolysis was performed using 8 mg alteplase: both external iliac veins were endoluminally occluded with Swan-Ganz catheters, and a multi-sideport infusion wire coaxially introduced through each catheter and advanced into the ipsilateral popliteal vein. In the control limbs, tissue plasminogen activator (tPA) 8 mg was injected as 0.8-ml boluses at 3-min intervals for 2 hr as a 0.25-mg/ml solution containing heparin 50 IU/ml (n 20). On the contralateral side, heparin was substituted with either dalteparin 50 IU/ml (n = 5) or antithrombin 12.5 IU/ml (n = 5), or supplemented with either nitroglycerin 0.075 mg/ml (n = 5) or iloprost (150 ng/ml) (n = 5). Blood samples were taken at predetermined intervals to measure the activated partial thromboplastin time (aPTT), prothrombin time (PT), and fibrinogen concentration. At autopsy, the thrombus mass in the iliofemoral veins was measured, and the extent of residual thrombosis in the venous tributaries graded at four sites. Results: Bilateral thrombolysis was successfully completed in all animals. The median thrombus mass in the iliofemoral veins after thrombolysis was 0.48 g (range 0.06-1.58 g), 0.95 g (0.59-1.29 g), 0.74 g (0.52-0.96 g), and 0.29 g (0.0-0.77 g) for dalteparin, antithrombin, iloprost, and nitroglycerin respectively, as compared with 0.53 g (0.18-0.88 g) (p = 0.69), 0.97 g (0.46-1.15 g) (p = 0.69), 0.53 g (0.48-1.10 g) (p = 0.69), and 0.18 g (0.13-1.04 g) (p = 0.5) for the respective controls. Likewise, the severity of residual thrombosis in the venous

  7. [Symptomatic aorto-iliac aneurysm and situs viscerum inversus: case report].

    PubMed

    Baccellieri, Domenico; Mirenda, Francesco; Mandolfino, Tommaso; La Spada, Michele; Stilo, Francesco; Spinelli, Francesco

    2006-01-01

    We report a case of infrarenal symptomatic aorto-iliac aneurysm in a patient with acute abdominal pain. The patient was admitted to the emergency care unit for abdominal pain and CT scans showing an infrarenal aorto-iliac aneurysm in a situs viscerum inversus (SVI) totalis syndrome. The patient underwent open aneurysm repair with an aorto-iliac bifurcated graft. This case shows that situs viscerum inversus cannot be considered a technical problem for the surgical treatment of abdominal aortic aneurysm.

  8. Ruptured abdominal aortic aneurysm and aortoiliac vein fistula.

    PubMed

    Gyoten, Takayuki; Doi, Toshio; Yamashita, Akio; Fukahara, Kazuaki; Kotoh, Keiju; Yoshimura, Naoki

    2015-05-01

    A 67-year-old man was admitted with severe abdominal pain and back pain. Computed tomography showed an infrarenal abdominal aortic aneurysm (8.4 × 8.3 cm) and a large retroperitoneal hematoma. Immediately afterwards, the patient suffered circulatory collapse and was rushed to the operating theater. A fistula communicating with the left iliac vein was found. It was repaired with a Dacron patch while balloon-tipped catheters controlled the bleeding. The abdominal aortic aneurysm was replaced with a bifurcated graft. The postoperative course was uneventful. There have been few reports of successful repair of a ruptured abdominal aortic aneurysm associated with aortoiliac arteriovenous fistula.

  9. Endovascular Therapeutic Options for Isolated Iliac Aneurysms with a Working Classification

    SciTech Connect

    Fahrni, Markus; Lachat, Mario M; Wildermuth, Simon; Pfammatter, Thomas

    2003-09-15

    The purpose of this paper is to demonstrate a variety of stent-grafting and embolization techniques and describe a new classification for endovascular treatment of isolated iliac artery aneurysms. A total of 19 patients were treated for isolated iliac aneurysms. Depending on the proximal iliac neck and the uni-/bilaterality of common iliac artery aneurysms (CIAA's) the patient may be treated by a tube (Type Ia) or a bifurcated stent-graft (Type Ib) in addition to internal iliac artery embolization. Neck anatomy is also critical in determining therapeutical options for internal iliac artery aneurysms (IIAA's). These are tube stent-grafting plus internal iliac branch embolization (Type IIa), coiling of afferent and efferent internal iliac vessels (Type IIb) and IIAA packing (Type IIc). The average length of stay for these procedures was 3.8 days. During the mean follow-up of 20.9 months, aneurysm size remained unchanged in all but 4 patients. Reinterventions were necessary in option Type Ib (3/8 pat.) and Type Ia (1/7 pat.) due to extender stent-graft migration (n = 2) or reperfusion leaks (n 2). We conclude that Iliac artery aneurysms may be successfully and safely treated by a tailored approach using embolization or a combination of embolization and stent-grafting. Long-term CT imaging follow-up is necessary, particularly in patients treated with bifurcated stent-grafts (Type Ib)

  10. [Use of an iliac branched endoprostheis in endovascular treatment for an abdominal aortic aneurysm combined with aneurysms of both common iliac arteries].

    PubMed

    Imaev, T E; Kuchin, I V; Lepilin, P M; Kolegaev, A S; Medvedeva, I S; Komlev, A E; Akchurin, R S

    An abdominal aortic aneurysm appears to be combined with aneurysmatic lesions of the common iliac arteries in 30-40% of cases. Like abdominal aortic aneurysms, aneurysms of the common iliac arteries rarely manifest themselves clinically. The lethality rate in case of rupture is comparable to that for rupture of an abdominal aortic aneurysm. During endoprosthetic repair of abdominal aortic aneurysms combined with aneurysms of the common iliac arteries, in order to prevent endoleaks and to improve the distal zone of fixation of endografts surgeons often resort to embolization of internal iliac arteries, which may lead to ischaemic postoperative complications. One of the methods of preserving pelvic blood flow is the use of an iliac branched endograft. A series of studies evaluating long-term outcomes demonstrated that this method proved to be both safe and effective, and with the suitable anatomy is a method of choice in high surgical risk patients. The present article deals with a clinical case report concerning bilateral endoprosthetic repair of the common iliac arteries, combined with endoprosthetic repair of an abdominal aortic aneurysm, with the description of technical peculiarities of implanting an iliac branched graft.

  11. Portal vein thrombosis.

    PubMed

    Chawla, Yogesh K; Bodh, Vijay

    2015-03-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion.

  12. Portal Vein Thrombosis

    PubMed Central

    Chawla, Yogesh K.; Bodh, Vijay

    2015-01-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. PMID:25941431

  13. [Deep vein thrombosis prophylaxis.

    PubMed

    Sandoval-Chagoya, Gloria Alejandra; Laniado-Laborín, Rafael

    2013-01-01

    Background: despite the proven effectiveness of preventive therapy for deep vein thrombosis, a significant proportion of patients at risk for thromboembolism do not receive prophylaxis during hospitalization. Our objective was to determine the adherence to thrombosis prophylaxis guidelines in a general hospital as a quality control strategy. Methods: a random audit of clinical charts was conducted at the Tijuana General Hospital, Baja California, Mexico, to determine the degree of adherence to deep vein thrombosis prophylaxis guidelines. The instrument used was the Caprini's checklist for thrombosis risk assessment in adult patients. Results: the sample included 300 patient charts; 182 (60.7 %) were surgical patients and 118 were medical patients. Forty six patients (15.3 %) received deep vein thrombosis pharmacologic prophylaxis; 27.1 % of medical patients received deep vein thrombosis prophylaxis versus 8.3 % of surgical patients (p < 0.0001). Conclusions: our results show that adherence to DVT prophylaxis at our hospital is extremely low. Only 15.3 % of our patients at risk received treatment, and even patients with very high risk received treatment in less than 25 % of the cases. We have implemented strategies to increase compliance with clinical guidelines.

  14. [Puncture of the brachiocephalic vein].

    PubMed

    Schlarb, K

    1986-09-01

    A specific central vein catheter for puncture of the brachiocephalic vein has been developed which is provided with a valve by which air-embolism and unwanted bleeding from the catheter are eliminated. Typical and often serious complications, which can develop on insertion of central vein catheter, can nearly be totally avoided by the puncture technique described.

  15. Primary leiomyosarcoma of the jugular vein in a dog

    PubMed Central

    Pierini, Alessio; Cinti, Filippo; Binanti, Diana; Pisani, Guido

    2017-01-01

    A four-year-old, male, Labrador retriever was referred for removal of a spindle cell sarcoma involving the right jugular vein. A post-contrast CT scan showed a seven-centimeter subcutaneous mass originated from the right external jugular vein, which was partially obstructed and showing contrast stasis, suggested a primary intravascular tumor of the jugular vein. The mass was resected, and histological evaluation was consistent with grade II intravenous spindle cell sarcoma of the jugular vein. Immunohistochemical positivity for vimentin, desmin, and αSMA antibody and negativity for S-100 protein confirmed venous leiomyosarcoma. The dog received five doses of intravenous doxorubicin, and there was no recurrence of the tumor 30 months post treatment. In dogs, primary intravascular sarcomas are rare and primary venous leiomyosarcoma has not been described. A venous tumor may be considered as a differential diagnosis in dogs with ventral neck swelling. PMID:28331835

  16. Automated recognition of the iliac muscle and modeling of muscle fiber direction in torso CT images

    NASA Astrophysics Data System (ADS)

    Kamiya, N.; Zhou, X.; Azuma, K.; Muramatsu, C.; Hara, T.; Fujita, H.

    2016-03-01

    The iliac muscle is an important skeletal muscle related to ambulatory function. The muscles related to ambulatory function are the psoas major and iliac muscles, collectively defined as the iliopsoas muscle. We have proposed an automated recognition method of the iliac muscle. Muscle fibers of the iliac muscle have a characteristic running pattern. Therefore, we used 20 cases from a training database to model the movement of the muscle fibers of the iliac muscle. In the recognition process, the existing position of the iliac muscle was estimated by applying the muscle fiber model. To generate an approximation mask by using a muscle fiber model, a candidate region of the iliac muscle was obtained. Finally, the muscle region was identified by using values from the gray value and boundary information. The experiments were performed by using the 20 cases without abnormalities in the skeletal muscle for modeling. The recognition result in five cases obtained a 76.9% average concordance rate. In the visual evaluation, overextraction of other organs was not observed in 85% of the cases. Therefore, the proposed method is considered to be effective in the recognition of the initial region of the iliac muscle. In the future, we will integrate the recognition method of the psoas major muscle in developing an analytical technique for the iliopsoas area. Furthermore, development of a sophisticated muscle function analysis method is necessary.

  17. SPONTANEOUS RESOLUTION OF PSEUDOANEURYSM OF AN ILIAC ARTERY BRANCH IN A MULTIPLE TRAUMA PATIENT WITH PELVIC FRACTURE: CLINICAL CASE

    PubMed Central

    Sousa, Cristina Maria Varino; Silva, Luís Filipe Pires; Rodrigues, Maria Elisa; Félix, António; Alpoim, Bruno; Marques, Pedro; Oliveira, Joana Alexandra Gonçalves; Alves, Carlos; Costa, Maieiro; Rodrigues, António

    2015-01-01

    In patients who have been the victims of high-energy trauma, severe pelvic injury should always be suspected. Most of these fractures are stable and respond well to conservative treatment. Pelvic fractures constitute 3% of all skeletal fractures and are associated with high-energy trauma. They are potentially serious injuries with significant mortality and large numbers of associated lesions. There are fundamentally three sources of bleeding in pelvic fractures: arterial, venous and through the bone ends of the fracture. Arterial bleeding is more associated with hemodynamic instability. In such cases, both early external fixation of the pelvic fracture and angiography with selective embolization of the bleeding vessels are effective methods for achieving hemostasis. Aneurysms of iliac artery branches are rare and are mostly pseudoaneurysm relating to the traumatic event. The natural history of pseudoaneurysms is unknown because of their rarity, but if they rupture, the mortality rate is high. We report a case of spontaneous thrombosis of a pseudoaneurysm of a branch of the right iliac artery. PMID:27026992

  18. [Internal and external haemorrhoids].

    PubMed

    Schuurman, J P; Go, P M N Y H

    2011-01-01

    In this article, we present 3 cases of patients with different types of haemorrhoidal disease. The first patient is a 27-year-old woman who had been experiencing incidental rectal blood loss without pain during defecation for 3 months. The second patient is a 76-year-old woman who had been bothered by varying degrees of pain from a swelling nearby the anus for 1 year. The third case involves a 31-year-old man who had had continuous severe pain in the anal area for 3 consecutive days. The first patient appeared to have internal hemorrhoids, whereas different forms of external hemorrhoids affected the patients in the other 2 cases. Internal haemorrhoids develop from the intraluminal corpus cavernosum recti; external haemorrhoids from the perianal marginal veins. Patients with internal haemorrhoids present with symptoms that include blood loss and prolaps feeling during defecation. In patients with external haemorrhoids pain is the prominent symptom. Internal haemorrhoids are treated either conservatively or surgically, depending upon their severity. Considering external haemorrhoidal disease surgical treatment provides the most rapid and persistent relief of symptoms.

  19. [Surgical treatment of acute deep leg and pelvic vein trombosis].

    PubMed

    Gall, F; Husfeldt, K J

    1977-08-25

    In the last 3 years 93 cases of iliofermoral trombosis were treated by surgery. We prefer the method used by Brunner, but under general anaesthesia and using a Bentley-Autotransfusion-System (ATS). The average age of our patients was 55 years (age ranged between 17 and 87 years). No lethal pulmonary embolism was observed. 2, 1 percent of the patients died following apoplex or acute heart failure. Of 67 patients who were operated on 6 months ago or more 70 percent have no further complaints, 28 percent still have some residual edema and only 2 patients have a severe postthrombotic syndrome. 50 percent of 40 control-phlebograms demonstrated patency of all veins. 20 percent had short segmentary occlusions with definite signs of recanalisation, while in 27 percent of the cases occlusions of the lower leg and thigh were found, the iliac veins being free. Only 2 postoperative phlebograms showed a complete iliofemoral venous occlusion. Our results prove, that the operative thrombectomy is a successful method, with which the main complications of the iliofemoral thrombosis-pulmonary embolisation and postthrombotic syndrome-can difinitely be reduced. Also because of better long term results, the operative therapy of acute ilofemoral thrombosis should be generally prefered instead of conservative treatment.

  20. The Diagnosis of Iliac Bone Destruction in Children: 22 Cases from Two Centres

    PubMed Central

    Sun, Xiangshui; Lou, Yue

    2016-01-01

    Iliac bone destruction in children is uncommon and presents various imaging features. Correct diagnosis based on clinical and imaging features is difficult. This research aimed to retrospectively explore the clinical features, imaging, and histopathological diagnosis of children with iliac bone destruction. A total of 22 children with iliac bone destruction were enrolled in this retrospective analysis from two children's hospitals during July 2007 to April 2015. Clinical features, imaging, and histopathological findings were analysed. The mode of iliac bone destruction, lesion structure, and the relationship between the range of soft tissue mass and cortical destruction were determined based on imaging data. The data were analysed using descriptive methods. Of the iliac bone destruction cases, eight cases were neuroblastoma iliac bone metastasis, seven cases were bone eosinophilic granuloma, two cases were Ewing's sarcoma, two cases were osteomyelitis, one case was bone cyst, one case was bone fibrous dysplasia, and one case was non-Hodgkin's lymphoma. Iliac bone destruction varies widely in children. Metastatic neuroblastoma and eosinophilic granuloma are the most commonly involved childhood tumours. PMID:27579306

  1. Mechanical evaluation of two canine iliac fracture fixation systems.

    PubMed

    Vangundy, T E; Hulse, D A; Nelson, J K; Boothe, H W

    1988-01-01

    Twenty-three canine pelves were tested bilaterally to determine the stiffness and strength of intact ilium and stabilized oblique iliac osteotomies that simulated a common clinical fracture. Fixation systems tested were three 4.0 mm cancellous screws inserted ventral to dorsal across the osteotomy site and one laterally placed five hole 3.5 mm dynamic compression plate. Specimens were mechanically tested to failure under torsional, axial, or axial plus bending loads. Lag screw fixation was stiffer and stronger than plate fixation in all testing modes. The differences were statistically significant (p less than .05) in the torsional and axial plus bending loading modes. Fatigue testing was performed on implanted specimens with low-level cyclic loading under axial plus bending loading conditions. Physiologic loading conditions failed to produce mechanical failure of either fixation system after 100,000 cycles.

  2. OSTEOID OSTEOMA IN THE ILIAC BONE: REPORT ON TWO CASES

    PubMed Central

    de Araújo Loures, Elmano; do Nascimento, Bruno Fajardo; de Carvalho Amorim, Marcelo; Loures, Clarice Naya

    2015-01-01

    Osteoid osteoma is a benign bone tumor that generally presents with nighttime pain among young adults and is relieved by rest and salicylates. It can affect any bone, but occurrences in the iliac are unusual. The authors describe two cases of intramedullary osteoid osteoma next to the sacroiliac joint, with symptoms that simulated sciatic pain. The cases were diagnosed late, although the initial radiographs showed sclerotic lesions in both cases. The diagnosis was confirmed by means of CT scan and the nidus was excised surgically through en bloc resection. The definitive diagnosis was given by means of histopathological examination. Over long-term follow-up, both cases remained asymptomatic and complete bone remodeling at the surgical site was observed. The authors highlight the typical characteristics of the tumor, the unusual location, the differential diagnosis and the treatment. PMID:27042632

  3. Chest wall reconstruction using iliac bone allografts and muscle flaps.

    PubMed

    Garcia-Tutor, Emilio; Yeste, Luis; Murillo, Julio; Aubá, Cristina; Sanjulian, Mikel; Torre, Wenceslao

    2004-01-01

    Technically we can divide full-thickness thoracic reconstruction into 2 parts: providing a rigid support and ensuring well-vascularized coverage. Since 1986, the authors' center has had ample experience with bone banks and the use of cryopreserved bone grafts, which led them to consider the possibility of using these grafts for full-thickness chest wall reconstruction. They describe 3 patients in whom resection of the tumor and reconstruction of the thorax were carried out using iliac bone allografts covered with muscle flaps (1 pectoralis major and 2 rectus abdominis). None of the patients experienced breathing difficulties, pain, or instability after 14 months, 18 months, and 11 years of follow-up. The result of the reconstruction was excellent in all 3 patients in terms of function and aesthetics. The advantage of allografts compared with synthetic materials is their potential integration; they can become part of the host patient's living tissue.

  4. Biomechanical analysis of forces sustained by iliac screws in spinal instrumentation for deformity treatment: preliminary results.

    PubMed

    Perrault, Frederique D; Aubin, Carl-Eric; Wang, Xiaoyu; Schwend, Richard M

    2012-01-01

    Iliac screws used in long instrumentation for deformity treatment are subject to large forces, which may sometimes lead to fixation failures (intra- and postoperatively). The objective of this study was to analyze the biomechanics of iliac screw fixations. The study was based on a patient-specific simulation of a neuromuscular scoliosis case with a long instrumentation to the pelvis. A multi body flexible model was created using a preoperative 3D reconstructed spine and pelvis. The side bending radiographs were used to personalize the mechanical properties. The instrumentation construct was modeled as rigid bodies and flexible beams connected by kinematic joints. Three instrumentation parameters were studied: the connector length, the inter rod connectors and the use of sacral screws. The simulations showed that the forces and torques at the iliac screws were lowered by 9% and 25% respectively by reducing the lateral connector length (from 20 to 10 mm). An inter rod connector did not significantly reduce the iliac screw loads. Sacral screws reduced the functional loads on the iliac screws, but hardware related problems may be shifted onto the sacral screws. Sacral screws in conjunction with inter rod connectors reduced the loads at iliac screws without overloading the sacral screws. The preliminary results showed that the forces at the iliac screws could be lowered through different instrumentation parameters. In the next step of the study, the model validation will be further completed and used to evaluate other instrumentation factors by means of an experimental design framework. The knowledge of loading biomechanics at the iliac screw fixation is important for finding solutions to reduce the risk of failure, such as improving preoperative planning, instrumentation techniques and iliac screw construct design.

  5. A rare case of persistent jugulocephalic vein and its clinical implication

    PubMed Central

    Shetty, Prakashchandra; Thangarajan, Rajesh; D'Souza, Melanie Rose

    2016-01-01

    Persistence of jugulocephalic vein is one of the extremely rare variations of the cephalic vein. Knowledge of such a variation is of utmost importance to orthopedic surgeons while treating the fractures of the clavicle, head and neck surgeons, during surgery of the lower part of neck, for cardiothoracic surgeons and radiologists during catheterization and cardiac device placement. We report the persistent jugulocephalic vein in an adult male cadaver, observed during the routine dissection classes. The right cephalic vein ascended upwards, superficial to the lateral part of the clavicle and terminated into the external jugular vein. It also gave a communicating branch to the axillary vein below the clavicle. We discuss the embryological and clinical importance of this rare variation. PMID:27722015

  6. The clinical anatomy of the cephalic vein in the deltopectoral triangle.

    PubMed

    Loukas, M; Myers, C S; Wartmann, Ch T; Tubbs, R S; Judge, T; Curry, B; Jordan, R

    2008-02-01

    Identification and recognition of the cephalic vein in the deltopectoral triangle is of critical importance when considering emergency catheterization procedures. The aim of our study was to conduct a cadaveric study to access data regarding the topography and the distribution patterns of the cephalic vein as it relates to the deltopectoral triangle. One hundred formalin fixed cadavers were examined. The cephalic vein was found in 95% (190 right and left) specimens, while in the remaining 5% (10) the cephalic vein was absent. In 80% (152) of cases the cephalic vein was found emerging superficially in the lateral portion of the deltopectoral triangle. In 30% (52) of these 152 cases the cephalic vein received one tributary within the deltopectoral triangle, while in 70% (100) of the specimens it received two. In the remaining 20% (38) of cases the cephalic vein was located deep to the deltopectoral fascia and fat and did not emerge through the deltopectoral triangle but was identified medially to the coracobrachialis and inferior to the medial border of the deltoid. In addition, in 4 (0.2%) of the specimens the cephalic vein, after crossing the deltopectoral triangle, ascended anterior and superior to the clavicle to drain into the subclavian vein. In these specimens a collateral branch was observed to communicate between the cephalic and external jugular veins. In 65.2% (124) of the cases the cephalic vein traveled with the deltoid branch of the thoracoacromial trunk. The length of the cephalic vein within the deltopectoral triangle ranged from 3.5 cm to 8.2 cm with a mean of 4.8+/-0.7 cm. The morphometric analysis revealed a mean cephalic vein diameter of 0.8+/-0.1 cm with a range of 0.1 cm to 1.2 cm. The cephalic vein is relatively large and constant, usually allowing for easy cannulation.

  7. The economics of vein disease.

    PubMed

    Sales, Clifford M; Podnos, Joan; Levison, Jonathan

    2007-09-01

    The management of cosmetic vein problems requires a very different approach than that for the majority of most other vascular disorders that occur in a vascular surgery practice. This article focuses on the business aspects of a cosmetic vein practice, with particular attention to the uniqueness of these issues. Managing patient expectations is critical to the success of a cosmetic vein practice. Maneuvering within the insurance can be difficult and frustrating for both the patient and the practice. Practices should use cost accounting principles to evaluate the success of their vein work. Vein surgery--especially if performed within the office--can undergo an accurate break-even analysis to determine its profitability.

  8. Randomized control trial of non-vascularized fibular and iliac crest graft for mandibular reconstruction

    PubMed Central

    Agrawal, Amiya; Mehrotra, Divya; Mohammad, Shadab; Singh, R.K.; Kumar, Santhosh; Pal, U.S.

    2012-01-01

    Background Mandibular reconstruction of segmental defects caused by trauma or tumor excision is a challenge despite numerous advances in surgical and fixation techniques. Bone grafts from fibula or iliac crest are most frequently used to reconstruct mandible. Methods A prospective randomized study was performed in 20 patients with benign mandibular pathology, to compare non-vascularized fibular and iliac crest bone graft for graft success, improvement in esthetics and function, and any associated donor site complications. Results No significant difference in graft success, esthetics, function, or donor site complication were found between the two groups. Function improvement was significantly higher in fibula group as compared to iliac crest. An interesting finding of positive association between length of defect and complication was seen irrespective of the graft used, implying that patients with larger defects had higher complication rates. Conclusion Non-vascularized fibular bone graft is as better as iliac crest for reconstruction of mandibular defects of optimal length. PMID:25737842

  9. [Paralysis of the femoral nerve complicating ilio-psoas hemorrhage after iliac bone transplantation (author's transl)].

    PubMed

    Mestdagh, H

    1982-03-11

    The author reported an unusual complication of iliac bone transplantation for grafting of a tibial pseudarthrosis. In a patient having anticoagulant therapy, a large iliac haematoma developed in the donor site and extended deep to the iliacus muscle and through the osteomuscular gap into the retroperitoneal space. Moreover it spread downwards and entrapped the femoral nerve as it lies behind the iliac fascia, above the inguinal ligament. Both a paralytic ileus and a femoral nerve injury commanded surgical exploration through an oblique iliac approach; emptying of the clotted haematoma, section of the inguinal ligament and liberation of the femoral nerve enable to avoid definitive sequelae to the quadriceps but the time required is varying: three years after the accident, recovery is not complete in the operated patient probably owing to delayed surgery (three weeks).

  10. Endoluminal embolization of bilateral atherosclerotic common iliac aneurysms with fibrin tissue glue (Beriplast)

    SciTech Connect

    Beese, Richard C.; Tomlinson, Mark A.; Buckenham, Timothy M.

    2000-05-15

    The standard surgical approach to nonleaking iliac aneurysms found at repair of a leaking abdominal aortic aneurysm is to minimize the operative risk by repairing the abdominal aorta only. This means that the bypassed iliac aneurysms may have to be repaired later. As this population of patients are usually elderly with coexisting medical problems, interventional radiology is being used to embolize these aneurysms, thus avoiding the morbidity and mortality associated with further general anesthesia and surgery. Various materials and stents have been reported to be effective in the treatment of iliac aneurysms. We report the successful use of endoluminal fibrin tissue glue (Beriplast) to treat two large iliac aneurysms in a patient who had had a previous abdominal aortic aneurysm repair. We discuss the technique involved and the reasons why we used tissue glue in this patient.

  11. Modified Stent-Assisted Coil Embolization Technique to Treat an Internal Iliac Artery Aneurysm

    SciTech Connect

    Chowdhury, M. M.; Northeast, A.; Lintott, P.; Liong, W.-C.; Warakaulle, D. R.

    2010-10-15

    Stent-assisted coil embolization is a well-described technique for the treatment of wide-necked intracranial aneurysms. We describe a modification of this technique used successfully to occlude a wide-necked internal iliac artery aneurysm.

  12. Renal transplantation using external continent urinary diversion.

    PubMed

    Lucon, A M; Sabbaga, E; Ianhez, L E; Chocair, P R; Pestana, J O; Arap, S

    1994-02-01

    A 29-year-old man born with bladder exstrophy presented with end stage renal failure many years after ileal conduit diversion. Bilateral nephrectomy and continent external urinary diversion were performed, and 1.5 months later a cadaveric kidney was grafted into the right iliac fossa. The patient was well at 18 months with a serum creatinine level of 1.2 mg./dl. and he was completely dry with 4 or 5 daily catheterizations. Although followup is still short, renal transplantation with drainage into an external continent urinary diversion permits excellent quality of life and good renal function. Therefore, this alternative is worth consideration whenever other reconstructive alternatives are not possible in candidates for renal transplantation.

  13. Endovascular Treatment of Common Iliac Occlusion in the Presence of Persistent Sciatic Artery

    SciTech Connect

    Mofidi, R. Macaskill, E. J.; Griffiths, G. D.; Chakraverty, S.

    2008-07-15

    Persistent sciatic artery is a rare congenital anomaly. It is associated with increased incidence of aneurysmal dilatation, thrombosis, distal embolization, and atherosclerotic change. We describe the case of a patient with persistent sciatic artery who presented with a critically ischemic left leg as a result of an occluded left common iliac artery, which was treated by angioplasty and stenting, and discuss the endovascular iliac recanalization in the presence of a persistent sciatic artery.

  14. The free iliac flap: a lateral modification of the free groin flap.

    PubMed

    Acland, R D

    1979-07-01

    A lateral modification of the free groin flap, called the free iliac flap, is presented. By moving the outline of the free groin flap laterally, so that the medial margin lies lateral to the underlying femoral triangle, a flap is obtained which is uniformly slender and which has a long vascular pedicle. The anatomical findings, a method for safe dissection of the superficial circumflex iliac vessels, and the results of 18 clinical cases are presented.

  15. Analgesia in hip fractures. Do fascia-iliac blocks make any difference?

    PubMed Central

    Callear, Jacqueline; Shah, Ku

    2016-01-01

    Despite recent national advances in the care for the hip fracture patient, significant morbidity and mortality persists. Some of this morbidity is attributable to the analgesia provided in the hospital setting. The National Institute of Health and Care Excellence and the Association of Anaesthetists of Great Britain and Ireland recommend the use of simple oral analgesia including opioids, with fascia-iliac blocks (FIB) used as an adjunct. Literature review reveals a paucity of evidence on this. The aim of this project was to evaluate the proportion of patients receiving a fascia-iliac block prior to operative intervention. A secondary aim was to evaluate the efficacy of these blocks through analysis of pre and post-operative opioid usage, post-operative delirium, time to bowel opening, and naloxone use. Patients who received a fascia-iliac block received significantly less post-operative and total analgesia (p=0.04, p=0.03), had lower rates of delirium (p=0.03) and those patients which were discharged directly home had a shorter inpatient stay (p=0.03). No patients who received a fascia-iliac block (FIB) needed naloxone to reverse opioid toxicity, whilst two without fascia-iliac block did. The results of the project eventually led to the introduction of a hip fracture care pathway which incorporates a single shot fascia-iliac block for all patients who are eligible. Within a two year study period, compliance with fascia-iliac blocks improved from 54% to 90%. Our experience shows a great improvement in compliance with fascia-iliac blocks in the pre-operative period. This work has also underpinned the introduction of a new hip fracture care pathway ultimately to better patient care and outcomes. PMID:26893899

  16. Endovascular Treatment of Ruptured Iliac Aneurysm Previously Treated by Endovascular Means

    SciTech Connect

    Dalainas, Ilias Nano, Giovanni; Stegher, Silvia; Bianchi, Paolo; Malacrida, Giovanni; Tealdi, Domenico G.

    2008-03-15

    A patient with a ruptured iliac aneurysm was admitted to the Emergency Department in hypovolemic shock. He had previously undergone surgical treatment for an infrarenal abdominal aortic aneurysm, which was managed with a terminal-terminal Dacron tube graft. Subsequently, he developed two iliac aneurysms, which were treated endovascularly with two wall-grafts in the right and one wall-graft in the left iliac arteries. He suffered chronic renal failure and arterial hypertension. Contrast-enhanced computed tomography showed rupture of the right iliac aneurysm and dislocation of the two wall-grafts. He was treated in an emergency situation with the implantation of an iliac endograft that bridged the two wall-grafts, which resulted in hemostasis and stabilization of his condition. Five days later, in an elective surgical situation, he was treated with the implantation of an aorto-uni-iliac endograft combined with a femoral-femoral bypass. He was discharged 5 days later in good condition. At the 4 year follow-up visit, the endoprosthesis remained in place with no evidence of an endoleak. In conclusion, overlapping of endografts should be avoided, if possible. Strict surveillance of the endovascularly treated patient remains mandatory.

  17. Preduodenal portal vein with situs inversus and duodenal atresia.

    PubMed

    Ziv, Y; Lombrozo, R; Dintsman, M

    1986-02-01

    In a 7-day-old infant referred because of bile-stained vomiting, jaundice and lack of meconium, radiological examination revealed the 'double-bubble' sign of duodenal atresia as well as dextrocardia. This infant also had a strawberry haemangioma on the right shoulder. Operation disclosed situs inversus and a preduodenal portal vein as well as duodenal atresia. A side-to-side duodeno-jejunostomy was performed successfully without damage to the anomalous vein. The history of polyhydramnion during gestation, the presence of other anomalies, the rapid onset of bile-stained vomiting and the classic 'double-bubble' sign, together appeared to indicate that the duodenal atresia was intrinsic and not due to the external pressure of the anomalous vein on the duodenum.

  18. Vein matching using artificial neural network in vein authentication systems

    NASA Astrophysics Data System (ADS)

    Noori Hoshyar, Azadeh; Sulaiman, Riza

    2011-10-01

    Personal identification technology as security systems is developing rapidly. Traditional authentication modes like key; password; card are not safe enough because they could be stolen or easily forgotten. Biometric as developed technology has been applied to a wide range of systems. According to different researchers, vein biometric is a good candidate among other biometric traits such as fingerprint, hand geometry, voice, DNA and etc for authentication systems. Vein authentication systems can be designed by different methodologies. All the methodologies consist of matching stage which is too important for final verification of the system. Neural Network is an effective methodology for matching and recognizing individuals in authentication systems. Therefore, this paper explains and implements the Neural Network methodology for finger vein authentication system. Neural Network is trained in Matlab to match the vein features of authentication system. The Network simulation shows the quality of matching as 95% which is a good performance for authentication system matching.

  19. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration

    PubMed Central

    Vega-Najera, Carlos; Leal-Contreras, Carlos; Leal-Berumen, Irene

    2013-01-01

    The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis. PMID:24392235

  20. Sinusfloor elevation and grafting with autogenous iliac crest bone.

    PubMed

    van den Bergh, J P; ten Bruggenkate, C M; Krekeler, G; Tuinzing, D B

    1998-12-01

    Insufficient bone height in the posterior area of the maxilla, due to expansion of the maxillary sinus and atrophic reduction of the alveolar process of the maxilla, represents a contra-indication for insertion of dental implants. This anatomic problem can, in many cases, be solved by augmentation of the floor of the maxillary sinus. This surgical technique was introduced by Tatum. The so-called top hinge door method creates a new floor of the maxillary sinus at a more cranial level. Underneath this new floor the existing space is filled with a bone graft. Implantation in the alveolar process with increased bone height allows insertion of dental implants. This sinus grafting technique was used in the present study. In total, 62 sinusfloor elevations were performed with cancellous iliac bone grafts in 42 patients. In those 62 augmented sinuses, 161 ITI screw type implants were inserted. The follow-up was 1-6 years after implantation. In 2 cases infections occurred. One implant needed an extended integration time. No implants were lost. The ITI solid screw implant appears to be a suitable implant following sinusfloor elevation operations, due to its rough surface, its shape and the size of the thread. The sinusfloor elevation procedure with autogenous cancellous bone graft appears to be a valuable and reliable pre-implantological procedure, provided a proper pre-operative investigation and careful surgery are performed. This procedure allows dental implant placement with a high success rate.

  1. Anterior Inferior Iliac Spine (AIIS) and Subspine Hip Impingement

    PubMed Central

    Carton, Patrick; Filan, David

    2016-01-01

    Summary Background Abnormal morphology of the anterior inferior iliac spine (AIIS) and the subspine region of the acetabular rim are increasingly being recognised as a source of symptomatic extra-articular hip impingement. This review article aims to highlight important differences in the pathogenesis, clinical presentation and management of extra-articular hip impingement from both the AIIS and subspine bony regions, and the outcome following surgical intervention. Methods A literature review was undertaken to examine the supporting evidence for AIIS and subspine hip impingement. A narrative account of the Author’s professional experience in this area, including operative technique for arthroscopic correction, is also presented. Results Abnormal morphology of the AIIS and subspine region has been classified using cadaveric, radiological and arthroscopic means; the clinical presentation and operative treatment has been documented in several case series studies. Dual pathology is often present - recognition and treatment of both intra- and extra-articular components are necessary for good postoperative outcome. Conclusions AIIS and sub-spine hip impingement should be considered as distinct pathological entities, which may also co-exist. Symptom relief can be expected following arthroscopic deformity correction with the treatment of concomitant intra-articular pathology. Failure to recognise and treat the extra-articular component may affect postoperative outcome. Level of evidence V. PMID:28066737

  2. Varicose Veins and Venous Insufficiency

    MedlinePlus

    ... that impact a person’s quality of life. Endovenous laser ablation treatment (EVLT) EVLT is a minimally invasive ... ray images ), the interventional radiologist threads a thin laser fiber into the problem vein through a tiny ...

  3. How Are Varicose Veins Treated?

    MedlinePlus

    ... and scarring. Sclerotherapy Sclerotherapy (SKLER-o-ther-ah-pe) uses a liquid chemical to close off a ... Microsclerotherapy Microsclerotherapy (MI-kro-SKLER-o-ther-ah-pe) is used to treat spider veins and other ...

  4. What Is Deep Vein Thrombosis?

    MedlinePlus

    ... deep vein of the leg can break off, travel to the lungs, and block blood flow. Rate This Content: NEXT >> Updated: October 28, 2011 Twitter Facebook YouTube Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA NO FEAR ACT ...

  5. Advanced Age and Disease Predict Lack of Symptomatic Improvement after Endovascular Iliac Treatment in Male Veterans

    PubMed Central

    Assi, Roland; Brownson, Kirstyn E.; Hall, Michael R.; Kuwahara, Go; Vasilas, Penny; Dardik, Alan

    2015-01-01

    Background: Endovascular angioplasty and stent placement is currently the most frequent treatment for iliac artery occlusive disease. However, despite a successful endovascular procedure, some patients do not experience symptomatic improvement and satisfaction with their care. This study seeks to identify patient-related factors associated with lack of symptomatic improvement after endovascular iliac artery treatment in male veterans. Methods: Retrospective review of patients treated with endovascular methods for iliac artery occlusive disease between January 2008 and July 2012 at VA Connecticut Healthcare System. Symptomatic improvement on the first post-operative visit was evaluated, with bilateral treatments counted separately. Results: Sixty-two patients had 91 iliac arteries treated with angioplasty and stent placement. Forty-seven (52 percent) legs had critical limb ischemia, and 77 (85 percent) had at least two-vessel distal runoff. Angiographic success was 100 percent. Patient-reported symptomatic improvement at the first post-operative visit was 55 percent (50/91). Lack of symptomatic improvement correlated with older age (OR 1.09 [1.03-1.17], p = 0.008), presence of critical limb ischemia (OR 3.03 [1.09-8.65], p = 0.034), and need for additional surgical intervention (OR 5.61 [1.65-17.36], p = 0.006). Survival, primary and secondary patency, and freedom from restenosis were comparable between patients who reported symptomatic improvement and those who did not. Conclusions: Despite angiographically successful revascularization, patients who are older or have critical limb ischemia who are treated with isolated endovascular iliac artery intervention are more likely to require additional interventions and less likely to experience symptomatic improvement. These patients may need more extensive infra-inguinal revascularization than isolated iliac angioplasty and stent placement, despite a preserved ankle-brachial index. Quality of life needs to be measured

  6. [Surgery of essential varicose veins].

    PubMed

    Maraval, M

    1994-03-15

    Idiopathic varicose veins of the lower limbs are a frequent but benign disorder. Surgery is only a moment in the course of the disease. Although not the only treatment of essential varicose veins, surgery by an experienced team performing crossectomy, stripping by intussusception using a stripper, and phlebectomy gives fully satisfactory results, both to patient and to physician, in over 80% of cases. New techniques were recently developed that, at present, have not confirmed early hopes.

  7. Risser sign: the value of the lateral spinal radiograph to assess the excursion of the iliac apophysis.

    PubMed

    Kotwicki, T

    2008-01-01

    The course of the ossification of the iliac apophysis is considered in adolescent patients with idiopathic scoliosis, under the name of the Risser sign, to determine the remaining spinal growth. Although the iliac crest develops in the three-dimensional space as a complex structure, the iliac apophysis ossification has been assessed only on a one plane frontal spinal radiograph. This study points out the usefulness of the lateral radiograph for the visualization of the whole iliac crest, especially the posterior region which otherwise cannot be observed. Two young female pelvis specimen were examined with anatomical measurements and radiography. Lateral spinal radiographs of 201 girls were analyzed for the iliac apophysis excursion. The measures of the width of the iliac bone beneath the iliac crest revealed one anterior and one posterior thick regions, coupled with an intermediate thin region. The regions of the maximal thickness corresponded to the earliest appearance of the apophysis ossification (Risser 1), while the thin part of the iliac bone corresponded to late appearance of the apophysis ossification (Risser 3-4). The ossification of the posterior part of the crest was best visualized with the lateral radiograph, which was exclusive in showing the posterior superior iliac spine region. On the frontal spinal radiograph the end of the course of the apophysis (Risser 3-4) is usually searched at the level of the sacroiliac joint, while in reality this point was found to be situated more caudal, and accessible for observation on the lateral radiograph.

  8. A new experimental inbred Wistar rat varicocele model: anatomy of the left spermatic vein and the effect on histology.

    PubMed

    Zhang, Y; Gao, X; Liu, X; Wang, K; Pang, J; Zhou, J

    2008-02-01

    Because of venous anatomical differences between rats and humans and the personal interpretation of these differences, there is neither consistent animal prototype nor consistent results in the study of varicocele. We established a new substrain of Wistar inbred rats, of which the left testis vein has no significant branches to the common iliac vein up pampiniform plexus, but instead enters the left renal vein directly (similar to humans) and used them to create experimental varicocele model by partial ligation of the left renal vein. One month later, the predominant lesion of the left testis in induced group was spermatogenic arrest at the spermatid and preliminary spermatocyte phases, and considerable interstitial and Sertoli cell vacuolation. The right testis also showed spermatogenic arrest. Most important, the characteristics of the lesions differed in both testes, with the left testis having more severe lesions. Allowing for the unique anatomy of the left spermatic vein, the standard of the surgical procedure, the high rate of varicocele induction, and identical histological alteration as occurs in humans, we believe that this inbred Wistar rat substrain is suitable for the creation of an experimental varicocele model, which has promise for practical application in humans.

  9. The Impact of Endovascular Treatment on Isolated Iliac Artery Aneurysm Treatment and Mortality

    PubMed Central

    Buck, Dominique B.; Bensley, Rodney P.; Darling, Jeremy; Curran, Thomas; McCallum, John C.; Moll, Frans L.; van Herwaarden, Joost A.; Schermerhorn, Marc L.

    2015-01-01

    Objective Isolated Iliac artery aneurysms are rare, but potentially fatal. The impact of recent trends in the utilization of endovascular iliac aneurysm repair (EVIR) on isolated iliac artery aneurysm-associated mortality is unknown. Methods We identified all patients with a primary diagnosis of iliac artery aneurysm in the NIS from 1988 to 2011. We examined trends in management (open vs. EVIR, elective and urgent) and overall isolated iliac artery aneurysm related deaths (with or without repair). We compared in-hospital mortality and complications for the subgroup of patients undergoing elective open and EVIR from 2000-2011. Results We identified 33,161 patients undergoing isolated iliac artery aneurysm repair from 1988-2011: of which there were 9,016 EVIR and 4,933 open elective repairs from 2000-2011. Total repairs increased after introduction of EVIR from 28 to 71 per 10M US population (P<.001). EVIR surpassed open repair in 2003. Total isolated iliac artery aneurysm-related deaths, due to rupture or elective repair, decreased after the introduction of EVIR (4.4 to 2.3 per 10M US population, P<.001). However, urgent admissions have not decreased over this time period (15 to 15 procedures per 10M US population, P=0.30). Among elective repairs after 2000, EVIR patients were older (72.4 vs. 69.4 years, P=0.002) and were more likely to have a history of prior MI (14.0% vs. 11.3%, P<.001) and renal failure (7.2% vs. 3.6%, P<.001). Open repair had significantly higher in-hospital mortality (1.8% vs. 0.5%, P<0.001) and complications (17.9% vs. 6.7%, P<0.001), and a longer length of stay (6.7 vs. 2.3 days, P<0.001). Conclusions Treatment of isolated iliac artery aneurysm has increased since the introduction of EVIR and is associated with lower perioperative mortality, despite a higher burden of comorbid illness. Decreasing iliac artery aneurysm-attributable in-hospital deaths are likely related primarily to lower elective mortality with EVIR rather than rupture

  10. Relationship between width of greater trochanters and width of iliac wings in tronchanteric bursitis.

    PubMed

    Viradia, Neal K; Berger, Alex A; Dahners, Laurence E

    2011-09-01

    Trochanteric bursitis is a common disorder that is characterized by inflammation of the bursa, superficial to the greater trochanter of the femur, leading to pain in the lateral hip, and often occurs because of acute trauma or repetitive friction involving the iliotibial band, the greater trochanter, and the bursa. In the study reported here, we hypothesized that the increased incidence of bursitis may be the result of the increased prominence of the trochanter in relation to the wings of the iliac crest. Distances between the outermost edges of trochanters and iliac wings were measured in 202 patients from the University of North Carolina Health Care System-101 without a known diagnosis and 101 with a clinical diagnosis of trochanteric bursitis. To determine significance, t tests for nonpaired data were used. Mean (SD) difference between trochanter and iliac wing widths was 28 (20) mm in the group diagnosed with trochanteric bursitis and 17 (18) mm in the control group. The difference between the groups in this regard was significant (P<.00005). In addition, mean (SD) ratio of trochanter widths to iliac wing widths was 1.09 (.06) in the bursitis group and 1.05 (.06) in the control group. The difference between these groups was significant (P<.0005) in this regard as well. Having trochanters wider in relation to iliac wings was associated with the diagnosis of trochanteric bursitis.

  11. A case of gross haematuria due to an ureteric-iliac artery fistula.

    PubMed

    Madonia, Massimo; Russo, Giorgio Ivan; Trignano, Emilio; Paliogiannis, Panagiotis; Cimino, Sebastiano; Corbu, Carlo; Morgia, Giuseppe

    2013-12-23

    A case of gross haematuria due to an ureteric-iliac artery fistula We report a case of a 75-year-old man presented with gross haematuria and left hydronephrosis due to an ureteric iliac- artery fistula . Medical history included a previous positioning of aorto-bisiliac graft and an iliac artery stent placed to exclude an hypogastric aneurysm. A retrograde pyelography revealed a compression of the middle ureter and an extravasation of contrast at that level, for this reason a double J stent was inserted. Contrast-enhanced computed tomography showed the presence of a fistula between the left ureter and the internal iliac. The patient underwent endovascular treatment using a stent-graft with the subsequent patient's recovery. Ureteric iliac-artery fistula is a rare condition and it generally manifests with life threatening gross bleeding. We suggest a multidisciplinary clinical approach in order to achieve the best results for the patient and to avoid severe complications. Endovascular techniques have been demonstrated to be effective and rapid in the treatment of this emergency condition; ureteral stenting is also recommended.

  12. Cerebral infarction due to carotid occlusion and carbon monoxide exposure III. Influence of neck vein occlusion.

    PubMed Central

    Laas, R; Igloffstein, J

    1983-01-01

    Unilateral cerebral infarcts were produced in the rat by ligation of one common carotid artery and a subsequent exposure to carbon monoxide. In animals which had undergone an additional ligation of the external jugular veins leading to a moderate increase of the cephalic venous pressure the outcome of the procedure was ameliorated significantly. Venous pressure elevation was thought to reduce the venous vascular resistance effectively by preventing the leptomeningeal veins from collapsing. Collapse of the leptomeningeal veins probably occurred during the severe carbon monoxide-induced hypotension causing a steep increase of cerebral vascular resistance. Images PMID:6886722

  13. Gypsum veins in Triassic Moenkopi mudrocks of southern Utah: Analogs to calcium sulfate veins on Mars

    NASA Astrophysics Data System (ADS)

    Young, B. W.; Chan, M. A.

    2017-01-01

    Well-exposed gypsum veins in the Triassic Moenkopi formation in southern Utah, USA, are similar to veins at Endeavour and Gale Craters on Mars. Both Moenkopi and Mars veins are hydrated calcium sulfate, have fibrous textures, and crosscut other diagenetic features. Moenkopi veins are stratigraphically localized with strontium and sulfur isotope ratios similar to primary Moenkopi sulfate beds and are thus interpreted to be sourced from within the unit. Endeavour veins seem to be distributed by lithology and may have a local source. Gale veins cut across multiple lithologies and appear to be sourced from another stratigraphic interval. Evaluation of vein network geometries indicates that horizontal Moenkopi veins are longer and thicker than vertical veins. Moenkopi veins are also generally oriented with the modern stress field, so are interpreted to have formed in the latest stages of exhumation. Endeavour veins appear to be generally vertical and oriented parallel to the margins of Cape York and are interpreted to have formed in response to topographic collapse of the crater rim. Gale horizontal veins appear to be slightly more continuous than vertical veins and may have formed during exhumation. Abrupt changes in orientation, complex crosscutting relationships, and fibrous (antitaxial) texture in Moenkopi and Mars veins suggest emplacement via hydraulic fracture at low temperatures. Moenkopi and Mars veins are interpreted as late-stage diagenetic features that have experienced little alteration since emplacement. Moenkopi veins are useful terrestrial analogs for Mars veins because vein geometry, texture, and chemistry record information about crustal deformation and vein emplacement.

  14. Comparison of metasomatic reactions between a common CO2-rich vein fluid and diverse wall rocks: intensive variables, mass transfers, and Au mineralization at Alleghany, California

    USGS Publications Warehouse

    Böhlke, J.K.

    1989-01-01

    The gold deposits at Alleghany, California, are typical of many epigenetic gold-bearing hydrothermal vein systems in metamorphic terranes worldwide. Detailed analyses of alteration halos in serpentinite, mafic amphibolite, and granite wall rocks at Alleghany indicate that widely contrasting deposit types, ranging from fuchsite-carbonate schists to pyrite-albitites, resulted when different wall rocks interacted with the same externally derived CO2-rich hydrothermal vein fluid. Patterns of element redistribution within halos and among lithologic units suggest a complex process involving fluid flow along vein fractures and diffusion (?? infiltration) normal to the veins. Wall rocks locally controlled both the directions and magnitudes of chemical fluxes across vein walls. -from Author

  15. Ontogenetic changes in the internal and external morphology of the ilium in modern humans.

    PubMed

    Abel, Richard; Macho, Gabriele A

    2011-03-01

    Trabecular architecture forms an important structural component of bone and, depending on the loading conditions encountered during life, is organised in a systematic, bone- and species-specific manner. However, recent studies suggested that gross trabecular arrangement (e.g. density distribution), like overall bone shape, is predetermined and/or affected by factors other than loading and perhaps less plastic than commonly assumed. To explore this issue further, the present cross-sectional ontogenetic study investigated morphological changes in external bone shape in relation to changes in trabecular bundle orientation and anisotropy. Radiographs of 73 modern human ilia were assessed using radiographic and Geometric Morphometric techniques. The study confirmed the apparently strong predetermination of trabecular bundle development, i.e. prior to external loading, although loading clearly also had an effect on overall morphology. For example, the sacro-pubic bundle, which follows the path of load transmission from the auricular surface to the acetabulum, is well defined and shows relatively high levels of anisotropy from early stages of development; the situation for the ischio-iliac strut is similar. However, while the sacro-pubic strut retains a constant relationship with the external landmarks defining the joint surfaces, the ischio-iliac bundle changes its relationship with the external landmarks and becomes aligned with the iliac tubercle only during late adolescence/early adulthood. It is tentatively proposed that the rearrangement of the ischio-iliac strut may reflect a change in locomotor pattern and/or a shift in positional behavior with increasing mass after growth of external bone dimensions has slowed/ceased.

  16. Ontogenetic changes in the internal and external morphology of the ilium in modern humans

    PubMed Central

    Abel, Richard; Macho, Gabriele A

    2011-01-01

    Trabecular architecture forms an important structural component of bone and, depending on the loading conditions encountered during life, is organised in a systematic, bone- and species-specific manner. However, recent studies suggested that gross trabecular arrangement (e.g. density distribution), like overall bone shape, is predetermined and/or affected by factors other than loading and perhaps less plastic than commonly assumed. To explore this issue further, the present cross-sectional ontogenetic study investigated morphological changes in external bone shape in relation to changes in trabecular bundle orientation and anisotropy. Radiographs of 73 modern human ilia were assessed using radiographic and Geometric Morphometric techniques. The study confirmed the apparently strong predetermination of trabecular bundle development, i.e. prior to external loading, although loading clearly also had an effect on overall morphology. For example, the sacro-pubic bundle, which follows the path of load transmission from the auricular surface to the acetabulum, is well defined and shows relatively high levels of anisotropy from early stages of development; the situation for the ischio-iliac strut is similar. However, while the sacro-pubic strut retains a constant relationship with the external landmarks defining the joint surfaces, the ischio-iliac bundle changes its relationship with the external landmarks and becomes aligned with the iliac tubercle only during late adolescence/early adulthood. It is tentatively proposed that the rearrangement of the ischio-iliac strut may reflect a change in locomotor pattern and/or a shift in positional behavior with increasing mass after growth of external bone dimensions has slowed/ceased. PMID:21323915

  17. Investigation of the optimal collagen fibre orientation in human iliac arteries

    PubMed Central

    Qi, Nan; Gao, Hao; Ogden, Raymond W.; Hill, Nicholas A.; Holzapfel, Gerhard A.; Han, Hai-Chao; Luo, Xiaoyu

    2016-01-01

    The distribution of collagen fibres plays a significant role in the mechanical behaviour of artery walls. Experimental data show that in most artery wall layers there are two (or more) in-plane symmetrically disposed families of fibres. However, a recent investigation revealed that some artery wall layers have only one preferred fibre direction, notably in the medial layer of human common iliac arteries. This paper aims to provide a possible explanation for this intriguing phenomenon. An invariant-based constitutive model is utilized to characterize the mechanical behaviour of tissues. We then use three different hypotheses to determine the ‘optimal fibre angle’ in an iliac artery model. All three hypotheses lead to the same result that the optimal fibre angle in the medial layer of the iliac artery is close to the circumferential direction. The axial pre-stretch, in particular, is found to play an essential role in determining the optimal fibre angle. PMID:26195342

  18. Endovascular Repair of a Ruptured Mycotic Aneurysm of the Common Iliac Artery

    SciTech Connect

    Mofidi, R. Bhat, R.; Nagy, J.; Griffiths, G. D.; Chakraverty, S.

    2007-09-15

    This report describes the case of a ruptured mycotic aneurysm of the left common iliac artery, successfully treated with endovascular stent-grafting. A 64-year-old woman underwent diagnostic coronary angiography complicated by an infected hematoma of the left groin. Seven days later, she developed methicillin-resistant Staphylococcus aureus septicemia and CT scan evidence of perivascular inflammation around the left common iliac artery. This was followed by rupture of a mycotic aneurysm of the left common iliac artery. The lesion was successfully treated with a stent-graft and prolonged antibiotic therapy, and the patient remains free of infection 10 months later. Accumulating evidence suggests that endovascular repair can be used safely for the repair of ruptured infected aneurysms.

  19. Lumbo-sacro-pelvic Fixation Using Iliac Screws for the Complex Lumbo-sacral Fractures.

    PubMed

    Rhee, Woo-Tack; You, Seung-Hoon; Jang, Yeon-Gyu; Lee, Sang-Youl

    2007-12-01

    Fractures of lumbo-sacral junction involving bilateral sacral wings are rare. Posterior lumbo-sacral fixation does not always provide with sufficient stability in such cases. Various augmentation techniques including divergent sacral ala screws, S2 pedicle screws and Galveston rods have been reported to improve lumbo-sacral stabilization. Galveston technique using iliac bones would be the best surgical approach especially in patients with bilateral comminuted sacral fractures. However, original Galveston surgery is technically demanding and bending rods into the appropriate alignment is time consuming. We present a patient with unstable lumbo-sacral junction fractures and comminuted U-shaped sacral fractures treated by lumbo-sacro-pelvic fixation using iliac screws and discuss about the advantages of the iliac screws over the rod system of Galveston technique.

  20. Reconstruction of mandible with free osteocutaneous flap using deep circumflex iliac vessels as the stem

    SciTech Connect

    Miyamoto, Y.; Tani, T.

    1981-05-01

    One of the 2 patients introduced here had osteoradionecrosis, which has been difficult to reconstruct. The other had a massive adamantinoma that required replacement of the mandible from the midportion of the right ramus to the left angle with the iliac bone using the conventional method. The grafted iliac bone was severely absorbed, however. The mandible in both cases was successfully reconstructed with an osteocutaneous compound flap, using the deep circumflex iliac vessels as the stem. This method is considered a very good procedure for reconstruction of the mandible, which has been difficult by conventional procedures. Because the diameter of the stem is large, vascular anastomosis can be readily performed with an extremely high degree of safety. Pulsation of the stem can be palpated on follow-up even one year after surgery, and there are no signs of bone reabsorption.

  1. Endovascular management of ruptured common iliac mycotic aneurysm in an HIV-positive patient.

    PubMed

    Aziz, Aamir; Mooka, Busi; Clarke Moloney, Mary; Kavanagh, Eamon

    2013-08-05

    Isolated iliac artery aneurysms are a rare entity. The majority of cases are asymptomatic and often escape detection. Mortality rates after sudden rupture and emergent surgery for iliac artery aneurysm are very high. We report a case of a 56-year-old man who presented with right hip pain masquerading as septic arthritis or psoas abscess. CT showed ruptured right common iliac artery aneurysm with extensive active extravasation into psoas with a retroperitoneal haematoma. Aneurysm was repaired using an endovascular technique. Postoperative recovery was eventful with the patient experiencing severe back pain radiating down the leg accompanied with fever. CT showed persistent, right iliopsoas haematoma and pelvic haematoma with secondary hydronephrosis. Viral screen for hepatitis B, C and HIV returned positive. The patient was started on intravenous meropenem. Fever and pain settled. Repeated CT scan showed decrease in retroperitoneal pelvic haematoma.

  2. Deep vein thrombosis due to migrated graft bone after posterior lumbosacral interbody fusion. Case report.

    PubMed

    Yoshimoto, Hisashi; Sato, Shigenobu; Nakagawa, Izumi; Hyakumachi, Takahiko; Yanagibashi, Yasushi; Nitta, Fumihito; Masuda, Takeshi

    2007-01-01

    The authors report the case of an 83-year-old woman with refractory sciatica attributable to isthmic spondylolisthesis at L-5. Her symptoms were successfully improved after posterior lumbar interbody fusion (PLIF) at L5-S1; however, notable swelling in her left leg suddenly developed 2 days postoperatively. Anterior migration of a fragment of bone graft was demonstrated on computed tomography scanning, and there was obvious occlusion of the left common iliac vein (CIV) on magnetic resonance venography. Ultrasonography revealed a thrombus in the left CIV at the site of compression. To prevent a pulmonary embolism during manipulation of the affected vein, an inferior vena cava filter was placed just before excision of the migrated bone fragment. The swelling in the patient's leg subsided quickly after the surgery, and she was treated with heparin and warfarin to prevent recurrent deep vein thrombosis (DVT). Six months after the second surgery, complete restoration of blood flow to the left CIV and no recurrence of DVT were demonstrated on magnetic resonance venography. Especially in elderly patients with degenerative disc disease, excessive curettage and impaction of disc materials during the PLIF procedure may cause migration of bone graft fragments. Surgeons should be aware of the possible vascular complications of PLIF.

  3. Combined Vascular and Orthopaedic Approach for a Pseudotumor Causing Deep Vein Thrombosis after Metal-on-Metal Hip Resurfacing Arthroplasty.

    PubMed

    Abdel-Hamid, Hossam; Miles, Jonathan; Carrington, Richard W J; Hart, Alister; Loh, Alex; Skinner, John A

    2015-01-01

    Introduction. Metal-on-metal (MoM) hip resurfacings have been associated with a variety of complications resulting from adverse reaction to metal debris. Pseudotumors have rarely been reported to cause deep venous thrombosis (DVT). Study Design. A case report and a review of the literature. Case Presentation. A 75-year-old female who had left metal-on-metal hip resurfacing 6 years ago presented with left groin pain associated with unilateral lower limb edema and swelling. By duplex and MRI studies, our patient had an extensive soft tissue necrosis associated with a large pelvic mass causing extensive DVT of the lower limb secondary to mechanical compression of the left iliac vein. Results. Our case was initially treated for DVT followed by dual surgical approach. The pseudotumor was excised through a separate iliofemoral approach and revision of the hip implant was undertaken through a posterior approach in the same setting. An inferior vena cava (IVC) filter was inserted to minimise the perioperative risks of handling the iliac veins. Conclusion. A combined approach with vascular surgeons is required. Combined resection of the pseudotumor and revision of the metal bearing surfaces is essential, in order to achieve a good surgical outcome in this rare complication.

  4. Computed tomography evaluation of the iliac crest apophysis: age estimation in living individuals.

    PubMed

    Ekizoglu, Oguzhan; Inci, Ercan; Erdil, Irem; Hocaoglu, Elif; Bilgili, Mustafa Gokhan; Kazimoglu, Cemal; Reisoglu, Ali; Can, Ismail Ozgur

    2016-07-01

    Determination of the ossification properties of the iliac apophysis is important not only in the clinical evaluation of patients undergoing orthopedic surgery but also in age estimation studies for forensic purposes. The literature includes both anthropological and radiological (conventional radiography, ultrasonography, and magnetic resonance imaging modalities) investigations of the different staging systems used for these purposes. In this study, we assessed the utility of computed tomography (CT) of the iliac crest apophysis in estimating forensic age. CT scans of the iliac crest apophysis of 380 patients (187 females, 193 males, and 10-29 years of age) were evaluated according to the four-stage system. Further subclassification did not give data properly due to the reference length measurement of the iliac wing with CT. Thus, in our series, stage 2 was first seen in 12 years of age and stage 3 in those 14 years of age in both sexes and on both sides of the pelvis. Stage 4 was first seen in 17 years of both sexes but only on the right side; on the left side, it appeared in females 18 years of age and in males 17 years of age. Present data was found consistent with previous pelvic radiographic findings. First seen ages for stage 2 and 3 are 12 and 14 years respectively which presented valuable information for legally important age thresholds. However, disadvantages of CT, including high-dose radiation exposure to gonads, the difficulty of evaluating the iliac crest, and the age boundary of 17 years, could make this method infeasible, as compared with hand wrist and pelvic radiographic methods. CT of the iliac crest has probably a greater utility where preexisting CT scans of the pelvic region are available, and it may be considered as a supportive method for age-estimation purposes.

  5. A rare cause of massive haematuria: Internal iliac artery-ureteric fistula.

    PubMed

    Rao, Ahsan M; Khalil, Ahmed; Suttie, Stuart

    2015-04-01

    Ureteric fistula into the arterial tree is a well-recognised, but uncommon condition. The involvement of internal iliac artery is rare. We present a rare case of fistulous communication and subsequent infection of an internal iliac artery aneurysm and ureter secondary to insertion of ureteric stent following endovascular exclusion of the aneurysm and its management. Nephrostogram identified the fistula not seen on computerised tomography. This case highlights the awareness of such pathology allowing for prompt recognition of the condition and importance of appropriate imaging.

  6. Standard of Practice for the Interventional Management of Isolated Iliac Artery Aneurysms

    SciTech Connect

    Uberoi, Raman; Tsetis, Dimitrios; Shrivastava, Vivek; Morgan, Robert; Belli, Anna-Maria

    2011-02-15

    Isolated iliac artery aneurysms are uncommon, comprising less than 2% of all abdominal aneurysmal disease. Although they have a fairly innocuous natural history, when they have attained a large size they carry a significant risk of rupture. Rupture is associated with significant morbidity and mortality. Therefore, an early diagnosis and treatment are crucial. Over the last decade, interventional treatment options have become established alternatives to open surgical repair. These guidelines aim to review the pathogenesis, natural history, and presentation of isolated iliac artery aneurysms including a description of imaging and interventional treatment strategies.

  7. Bending the Rules in Transfemoral TAVI With the SAPIEN 3: Overcoming Severe Iliac Tortuosity.

    PubMed

    Michel, Jonathan; Frangieh, Antonio H; Ott, Ilka; Kasel, A M

    2017-03-15

    Whilst the worldwide uptake of transcatheter aortic valve implantation (TAVI) over the last 10 years has been dramatic, iliac tortuosity remains a potential barrier to the most commonly chosen access route via the femoral artery. We describe the challenges posed by severe iliac tortuosity during transfemoral TAVI and contrast a difficult procedure - at the limit of the capability of current device delivery technology - with a straightforward implantation. The use of pre-procedural multi-detector computed tomography to assess the vasculature and a bilateral stiff wire technique for managing iliofemoral tortuosity are discussed.

  8. Minimally invasive treatments for perforator vein insufficiency

    PubMed Central

    Salazar, Gloria Maria; Prabhakar, Anand M.; Ganguli, Suvranu

    2016-01-01

    Incompetent superficial veins are the most common cause of lower extremity superficial venous reflux and varicose veins; however, incompetent or insufficient perforator veins are the most common cause of recurrent varicose veins after treatment, often unrecognized. Perforator vein insufficiency can result in pain, skin changes, and skin ulcers, and often merit intervention. Minimally invasive treatments have replaced traditional surgical treatments for incompetent perforator veins. Current minimally invasive treatment options include ultrasound guided sclerotherapy (USGS) and endovascular thermal ablation (EVTA) with either laser or radiofrequency energy sources. Advantages and disadvantages of each modality and knowledge on these treatments are required to adequately address perforator venous disease. PMID:28123979

  9. Perigraft Plug Embolization of the Internal Iliac Artery and Implantation of a Bifurcated Stentgraft: One Treatment Option for Insufficient Tubular Stentgraft Repair of a Common Iliac Artery Aneurysm

    SciTech Connect

    Goltz, Jan Peter Loesaus, Julia; Frydrychowicz, Alex; Barkhausen, Jörg; Wiedner, Marcus

    2016-02-15

    We report an endovascular technique for the treatment of type Ia endoleak after a plain tubular stentgraft had been implanted for a large common iliac artery aneurysm with an insufficient proximal landing zone and without occlusion of the hypogastric in another hospital. CT follow-up showed an endoleak with continuous sac expansion over 12 months. This was classified as type Ia by means of dynamic contrast-enhanced MRI. Before a bifurcated stentgraft was implanted to relocate the landing zone more proximally, the still perfused ipsilateral hypogastric artery was embolized to prevent a type II endoleak. A guidewire was manipulated alongside the indwelling stentgraft. The internal iliac artery could then be selectively intubated followed by successful plug embolization of the vessel’s orifice despite the stentgraft being in place.

  10. Perigraft Plug Embolization of the Internal Iliac Artery and Implantation of a Bifurcated Stentgraft: One Treatment Option for Insufficient Tubular Stentgraft Repair of a Common Iliac Artery Aneurysm.

    PubMed

    Goltz, Jan Peter; Loesaus, Julia; Frydrychowicz, Alex; Barkhausen, Jörg; Wiedner, Marcus

    2016-02-01

    We report an endovascular technique for the treatment of type Ia endoleak after a plain tubular stentgraft had been implanted for a large common iliac artery aneurysm with an insufficient proximal landing zone and without occlusion of the hypogastric in another hospital. CT follow-up showed an endoleak with continuous sac expansion over 12 months. This was classified as type Ia by means of dynamic contrast-enhanced MRI. Before a bifurcated stentgraft was implanted to relocate the landing zone more proximally, the still perfused ipsilateral hypogastric artery was embolized to prevent a type II endoleak. A guidewire was manipulated alongside the indwelling stentgraft. The internal iliac artery could then be selectively intubated followed by successful plug embolization of the vessel's orifice despite the stentgraft being in place.

  11. Leiomyosarcoma of the splenic vein.

    PubMed

    Aguilar, Cristian; Socola, Francisco; Donet, Jean A; Gallastegui, Nicolas; Hernandez, Gabriel A

    2013-01-01

    Leiomyosarcomas arising from the wall of blood vessels are rare and aggressive neoplasm. We report a case of a previously healthy 66-year-old woman who presented with intermittent abdominal pain, progressive constipation, and weight loss. Abdominal computed tomography showed a 12 cm solid heterogeneous tumor in the tail of the pancreas. The patient subsequently underwent surgical resection of the pancreatic mass. Surprisingly, histological and immunohistochemical analyses revealed leiomyosarcoma arising from the smooth muscle of the splenic vein. After surgery, she received adjuvant chemotherapy. One year later, there was no evidence of local recurrence. In this paper, we discuss the available information about leiomyosarcomas of splenic vein and its management.

  12. Endovascular Repair of Arterial Iliac Vessel Wall Lesions with a Self-Expandable Nitinol Stent Graft System

    PubMed Central

    Mensel, Birger; Kühn, Jens-Peter; Hoene, Andreas; Hosten, Norbert; Puls, Ralf

    2014-01-01

    Objective To assess the therapeutic outcome after endovascular repair of iliac arterial lesions (IALs) using a self-expandable Nitinol stent graft system. Methods Between July 2006 and March 2013, 16 patients (13 males, mean age: 68 years) with a self-expandable Nitinol stent graft. A total of 19 lesions were treated: nine true aneurysms, two anastomotic aneurysms, two dissections, one arteriovenous fistula, two type 1B endoleaks after endovascular aneurysm repair, one pseudoaneurysm, and two perforations after angioplasty. Pre-, intra-, and postinterventional imaging studies and the medical records were analyzed for technical and clinical success and postinterventional complications. Results The primary technical and clinical success rate was 81.3% (13/16 patients) and 75.0% (12/16), respectively. Two patients had technical failure due to persistent type 1A endoleak and another patient due to acute stent graft thrombosis. One patient showed severe stent graft kinking on the first postinterventional day. In two patients, a second intervention was performed. The secondary technical and clinical success rate was 87.5% (14/16) and 93.8% (15/16). The minor complication rate was 6.3% (patient with painful hematoma at the access site). The major complication rate was 6.3% (patient with ipsilateral deep vein thrombosis). During median follow-up of 22.4 months, an infection of the aneurysm sac in one patient and a stent graft thrombosis in another patient were observed. Conclusion Endovascular repair of various IALs with a self-expandable Nitinol stent graft is safe and effective. PMID:25119346

  13. Extrahepatic Portal Vein Obstruction and Portal Vein Thrombosis in Special Situations: Need for a New Classification

    PubMed Central

    Wani, Zeeshan A.; Bhat, Riyaz A.; Bhadoria, Ajeet S.; Maiwall, Rakhi

    2015-01-01

    Extrahepatic portal vein obstruction is a vascular disorder of liver, which results in obstruction and cavernomatous transformation of portal vein with or without the involvement of intrahepatic portal vein, splenic vein, or superior mesenteric vein. Portal vein obstruction due to chronic liver disease, neoplasm, or postsurgery is a separate entity and is not the same as extrahepatic portal vein obstruction. Patients with extrahepatic portal vein obstruction are generally young and belong mostly to Asian countries. It is therefore very important to define portal vein thrombosis as acute or chronic from management point of view. Portal vein thrombosis in certain situations such as liver transplant and postsurgical/liver transplant period is an evolving area and needs extensive research. There is a need for a new classification, which includes all areas of the entity. In the current review, the most recent literature of extrahepatic portal vein obstruction is reviewed and summarized. PMID:26021771

  14. Treating patients with abdominal aortic aneurysm with endovascular repair and the crossover chimney technique in the internal iliac artery to protect the unilateral internal iliac artery

    PubMed Central

    Guo, Xi; Li, Peng; Liu, Guang-Rui; Huang, Xiao-Yong; Huang, Lian-Jun

    2015-01-01

    This study aims to explore the treatment methods for patients with abdominal aortic aneurysms (AAAs) that required occlusion of the openings of the bilateral internal iliac arteries (IIAs) in endovascular aneurysm repair (EVAR) and to evaluate the efficacy of these treatments. Four patients with AAA were treated with endovascular aneurysm repair (EVAR) and the crossover chimney technique in the bilateral internal iliac arteries (IIAs). We inserted and released the abdominal aortic stent as usual and implanted the bypass stent graft simultaneously. The intraoperative immediate angiography showed complete isolation of the AAA and patency of the bypass. One month after surgery, it showed contrast engorgement in the bypass stent in three patients. The IIA on the bypass side and its branches had good developing. Another case in which we utilized a COOK stent, occlusion started at the opening of the bypass stent, with no occurrence of other complications. For patients in whom AAAs involve bilateral iliac arteries and the openings of the bilateral IIAs need to be occluded, EVAR and a crossover chimney technique can protect the unilateral IIA. PMID:26885136

  15. Percutaneous Treatment of Deep Vein Thrombosis in May-Thurner Syndrome

    SciTech Connect

    Kim, Jong-Youn; Choi, Donghoon Guk Ko, Young; Park, Sungha; Jang, Yangsoo; Lee, Do Yun

    2006-08-15

    Background/Purpose. May-Thurner syndrome is an uncommon disease entity in which the left common iliac vein is compressed by the right common iliac artery with subsequent development of deep vein thrombosis and chronic venous insufficiency. We report our experience on the treatment of extensive iliofemoral deep venous thrombosis due to May-Thurner syndrome using endovascular techniques. Methods. The study group comprised 21 patients (8 men, 13 women; mean age 51 years) diagnosed with May-Thurner syndrome by venogram. Eighteen patients were treated with catheter-guided thrombolysis; 3 patients with short segment involvement did not require thrombolysis. After completion of the thrombolytic therapy, the residual venous narrowing was treated by balloon angioplasty and/or placement of a self-expandable stent. Results. The mean total dose of urokinase was 4.28 {+-} 1.89 million units, and the mean duration of infusion was 72 {+-} 35 hr. Eighteen of the 21 patients received stent deployment. The mean diameter of the stents was 12.9 {+-} 2.0 mm. Initial technical successes with immediate symptom resolution were achieved in 20 of the 21 patients (95%). We performed a follow-up venogram 6 months after procedure and checked clinical symptoms at outpatient clinics (mean follow-up duration 10.8 months). Among the patients who received stent implantation, 2 had recurrent thrombotic occlusion during the follow-up period. Three patients, who did not receive stent implantation, all had recurrent thrombosis. There were no major bleeding complications except in 1 patient who developed retroperitoneal hematoma. Conclusion. Catheter-guided thrombolysis and angioplasty with stent implantation is a safe and effective method for the treatment of May-Thurner syndrome.

  16. How Is Deep Vein Thrombosis Diagnosed?

    MedlinePlus

    ... Vein Thrombosis Diagnosed? Your doctor will diagnose deep vein thrombosis (DVT) based on your medical history, a physical exam, and test results. He or she will identify your risk factors and rule out other causes of your symptoms. ...

  17. What Are Varicose Veins? (For Kids)

    MedlinePlus

    ... Dictionary of Medical Words En Español What Other Kids Are Reading Taking Care of Your Ears Taking ... X-ray What Are Varicose Veins? KidsHealth > For Kids > What Are Varicose Veins? Print A A A ...

  18. A primary intravascular synovial sarcoma causing deep-vein thrombosis and pulmonary embolism in a 20-year-old woman

    PubMed Central

    Schreiner, M.; Sanad, W.; Pfitzner, B.M.; Baumann, G.; Knebel, F.

    2015-01-01

    Primary intravascular synovial sarcoma is a rare malignancy with only a few cases documented in the literature. On presentation, this tumour usually resembles a deep venous thrombosis (dvt) or pulmonary embolism (pe). Here, we report the case of a 20-year-old woman complaining of shortness of breath who had a history of dvt 6 weeks before presentation at our institution. Vascular ultrasound detected a suspicious mass in the right groin, which was identified as a monophasic synovial sarcoma by surgical biopsy. The tumour extended from the right superficial femoral vein into the common iliac vein, profound femoral vein, and great saphenous vein. It caused pe with near-total occlusion of the right pulmonary artery. After initial treatment on the cardiac intensive care unit, the patient was referred to the oncology department for neoadjuvant radiochemotherapy with doxorubicin–ifosfamide according to the Interdisziplinäre Arbeitsgemeinschaft Weichteilsarkome [Interdisciplinary AG Sarcomas] protocol and surgical resection of the tumour. No signs of tumour recurrence were found during the subsequent course of the disease, but the patient died from treatment complications approximately 15 months after initial presentation. This case underlines the importance of screening for malignancies even in young patients presenting with dvt or pe. We also recommend whole-leg compression ultrasonography in patients with suspected dvt or pe (as opposed to venography or simple four-point ultrasound examination in the groin and popliteal fossa) to detect possible underlying causes for thrombosis. PMID:26628882

  19. Therapeutic Consequences of Variation in Intraarterial Pressure Measurements After Iliac Angioplasty

    SciTech Connect

    Tetteroo, Eric; Haaring, Cees; Engelen, Andries D. van; Graaf, Yolanda van der; Mali, Willem P.T.M.

    1997-11-15

    Purpose: To assess the accuracy of intraarterial measurement of transstenotic pressure gradients for the detection of hemodynamically suboptimal iliac angioplasty. Methods: In 14 patients, referred for diagnostic angiography, mean pressure gradients in the aorta and iliac artery were obtained twice, using a double-sensor pressure catheter. Additional iliac measurements were performed during pharmacologically induced flow augmentation. Repeatability was assessed by calculation of the mean difference plus standard deviation (MD {+-} SD) and repeatability coefficient (2 x SD). These results were extrapolated to 137 iliac angioplasty procedures with secondary stenting where there was a residual pressure gradient > 10 mmHg. Results: MD {+-} SD for repeated measurements at rest and during flow augmentation were 0 {+-} 2 mmHg and 1 {+-} 3 mmHg, respectively. Repeatability coefficients were 3 and 6 mmHg. Mean pressure gradients after hemodynamically insufficient angioplasty were 8 {+-} 7 mmHg at rest and 17 {+-} 5 mmHg following vasodilatation. Inaccurate pressure recordings may have led to inappropriate stent placement in less than 2.5%, and inappropriate denial of stent placement in less than 5% of the lesions. Conclusion: Variability of intraarterial pressure measurements has little consequence in the detection of hemodynamically significant stenosis after angioplasty.

  20. Dental Implantation of Atrophic Jaws Reconstructed with Iliac Bone Graft Crest - Outcome of Seven Cases

    PubMed Central

    Bllaca, Florian; Toci, Ervin

    2016-01-01

    BACKGROUND: Iliac bone grafts are used to augment alveolar ridges followed by subsequent dental implants in completely edentulous patients. In Albania the information about these issues is scarce. AIM: To describe the procedure of iliac bone grafts augmentation of alveolar ridges and evaluate the survival rate of dental implants in completely edentulous patients in Albania. SUBJECTS AND METHODS: Seven totally edentulous patients (three males, average age 45.9 years) presenting at Durrës Regional Hospital during 2008-2015 and seeking a solution to their problem through implantation procedures were included in the study. Patients were thoroughly examined, evaluated and the best augmentation procedure, using iliac crest bone grafts, and dental implantation technique was chosen. The number of dental implants placed was recorded and their survival rate was calculated. RESULTS: The most common intervention site was maxillae (in 71.4% of cases). Dental implants were installed six months after augmentation, all fixed on the very stable augmented alveolar ridge. On average between 20%-30% of bone grafts, volume was resorbed. Of 37 implants settled, 36 of them or 97.3% survived. CONCLUSION: Iliac bone grafts are a suitable augmentation source of bone in a patient suffering from complete edentulism in Albania. The survival rate of dental implants is very satisfactory. PMID:28028420

  1. Donor Site Evaluation: Anterior Iliac Crest Following Secondary Alveolar Bone Grafting

    PubMed Central

    Vura, Nandagopal; Reddy K., Rajiv; R., Sudhir; G., Rajasekhar; Kaluvala, Varun Raja

    2013-01-01

    Introduction: The use of autogenous bone graft for Secondary alveolar bone grafting is well established in the treatment of cleft lip and palate patients. Aims and Objectives: To evaluate post-operative morbidity of anterior iliac crest graft after secondary alveolar bone grafting in cleft patients. Material and Methods: Forty patients during the period from July 2008 to March 2013, who underwent secondary alveolar bone grafting by harvesting graft from anterior iliac crest in Mamata Dental Hospital, Khammam, Andhra Pradesh, India are included in the present study. Unilateral and bilateral cleft patients who had undergone secondary alveolar bone grafting (SABG) with anterior iliac crest as their donor site have been selected and post- operative complications from the surgery were evaluated with the help of a questionnaire which included pain, gait disturbances, numbness and scar problems (infection, irritation). Results: Patients who were operated gave maximum score for pain as 8 on visual analogue scale. No pain was observed in any of the cases after 8 days, gait disturbances were seen in all patients (limping) for 2-6 days, there was no post-operative numbness with all the patients returning to their routine in 6- 15 days and 90% of the patients gave a satisfied response towards scar. Conclusion: From the results in our study the morbidity after harvesting bone from iliac crest was found to be moderate to low, which had minimal complications and were well tolerated and greater acceptance from the patient. PMID:24392424

  2. Endovascular Stent-Graft Placement as Emergency Treatment for Ruptured Iliac Pseudoaneurysm

    SciTech Connect

    Aytekin, Cueneyt; Boyvat, Fatih; Yildirim, Erkan; Coskun, Mehmet

    2002-08-15

    A 65-year-old woman with advanced mucinous carcinoma of the ovary presented with massive rectal bleeding caused by rupture of an iliac artery pseudoaneurysm into the bowel. Surgery was contraindicated due to the patient's poor clinical condition. We successfully placed an endovascular stent-graft that excluded the pseudoaneurysm. There were no complications, and the patient recovered well.

  3. Using ILIAC to Systematically Plan and Implement a Library Information Literacy Assessment Program for Freshman Classes

    ERIC Educational Resources Information Center

    Gustavson, Amy

    2012-01-01

    In order to prepare for the 2013 SACS reaffirmation, the Joyner Library instruction librarians developed a systematic assessment program using Oakleaf's Information Literacy Instruction Assessment Cycle (ILIAC) to plan for instruction, assess student learning and improve future student learning by reviewing data and enacting changes. The paper…

  4. Directional Atherectomy in Iliac Stent Failure: Clinical Technique and Histopathologic Correlation

    SciTech Connect

    Ettles, Duncan F.; MacDonald, Alastair W.; Burgess, Paul A.; Nicholson, Anthony A.; Dyet, John F.

    1998-11-15

    Purpose: To assess the feasibility and efficacy of directional atherectomy in the treatment of iliac stent stenosis or occlusion and to evaluate the histologic composition of excised atherectomy specimens. Methods: Directional atherectomy of six occluded and 10 severely stenosed iliac stents was undertaken in 12 patients at a mean interval of 28 months (range 3-69 months) after stent insertion for occlusive aortoiliac disease. In cases of stent occlusion, atherectomy was preceded by low-dose thrombolysis. In all patients stent clearance with return of femoral pulses was achieved within 24 hr and there were no significant complications. All excised specimens were sent for histologic examination. Results: Eleven patients (92%) remain symptom free with unlimited walking distance at a mean follow-up interval of 11.5 months (range 3-31 months) after treatment. Histologic examination revealed typical myointimal hyperplasia at three excision sites, intimal fibrosis at three sites, atheroma at four sites and organized thrombus at six sites. Conclusion: Atherectomy offers an effective treatment in iliac stent occlusion and restenosis with no significant adverse effects. Debulking of these lesions seems to offer a more logical approach than simple balloon angioplasty. Clinical and duplex follow-up confirms satisfactory outcome within the first year but longer-term results are not yet known. The histologic data obtained demonstrate that stent restenosis and occlusion are likely to be multifactorial, and challenge the assumption that myointimal hyperplasia is the sole cause of iliac stent occlusion.

  5. Snapshot quiz - recurrent right iliac fossa pain in the patient with a previous history of appendicitis.

    PubMed

    Aris Chandran, Johan; Cobb, Will A; Keeler, Barrie D; Soin, Bob

    2015-06-01

    A low threshold for computed tomography (CT) scanning in patients with previous appendicectomy and right iliac fossa pain helps facilitate timely diagnosis and exclusion of other differential diagnoses. Here, we present a rare cause which has significant medicolegal ramifications and is accurately diagnosed with CT.

  6. British Society of Interventional Radiology Iliac Artery Angioplasty-Stent Registry III

    SciTech Connect

    Uberoi, Raman Milburn, Simon; Moss, Jon

    2009-09-15

    The objective of this study was to audit current practice in iliac artery intervention in the United Kingdom. In 2001 the British Society of Interventional Radiology Iliac Artery Angioplasty-Stent (BIAS) III registry provided the first national database for iliac intervention. It recommended that data collection needed to continue in order to facilitate the dissemination of comparative data to individual units. BIAS III was designed to continue this work and has a simplified data set with an online submission form. Interventionalists were invited to complete a 3-page tick sheet for all iliac angioplasties and stents. Questions covered risk factors, procedural data, and outcome. Data for 2233 patients were submitted from 37 institutions over a 43-month period. Consultants performed 80% of the procedures, 62% of which were for claudication. Fifty-four percent of lesions were treated with stents and 25% of patients underwent bilateral intervention, resulting in a residual stenosis of <50% in 98%. Ninety-seven percent of procedures had no limb complication and there was a 98% inpatient survival rate. In conclusion, these figures provide an essential benchmark for both audit and patient information. National databases need to be expanded across the range of interventional procedures, and their collection made simple and, preferably, online.

  7. [A dynamic study of blood flow in patients with unilateral obstruction of the iliac artery].

    PubMed

    Moreno Padilla, F; Díez Herranz, M; Peñafiel Marfil, R; García Rospide, V; González Ríos, L; Ramosa Bruno, J; Ros Die, E

    1991-01-01

    Sanguineous flow is studied in a group of patients with unilateral obliteration of iliac artery. This flow was particularly studied during exercise with the purpose of determinate the modifications on the flow produced by exercise. For this purpose, 11 patients with no associated pathologies were studied during more than a year follow-up.

  8. Forensic age estimation through evaluation of the apophyseal ossification of the iliac crest in Western Chinese.

    PubMed

    Zhang, Kui; Dong, Xiao-ai; Chen, Xiao-gang; Li, Yuan; Deng, Zhen-hua

    2015-07-01

    The criminal age estimation procedures have gained greatest significance to date, a reliable age diagnostics may depend on data of skeletal maturation from different socioeconomic status. In order to establish the iliac crest apophysis as a possible criterion for forensic age estimation in a different socioeconomic status, and to examine the pace of ossification for the iliac crest apophysis in Western Chinese, one thousand seven hundreds and seventy-seven conventional pelvic radiographs relating to West China Han group routinely taken between January 2010 and June 2012 have been sighted. The data was analysed with separation of the sexes. The results indicated that stage 2a was last observed in females at the age of 17.00 and in males at the age of 18.01, stage 3a was first achieved in females at the age of 14.46 and in males at the age of 15.31, stage 4 was observed between 17.95 and 25.98 years for male and between 18.36 and 25.95 years for female. By comparison with previous studies, our research indicated that Western Chinese presents a delaying development for the iliac crest apophysis. Furthermore, the present study with eight stages of ossification for the iliac crest offers a valuable alternative method of estimation of 18 years of age for Western Chinese.

  9. Endovascular Treatment of the Internal Iliac Artery in Peripheral Arterial Disease

    SciTech Connect

    Huetink, K. Steijling, J.J.F.; Mali, W.P.T.M.

    2008-03-15

    In patients with peripheral arterial disease not much is known about the relationship between the localization of the pain and the localization of arterial occlusions in the iliac arteries. Occlusions high in the iliac arteries are assumed to be able to induce pain in the buttocks and upper leg as well as pain in the calves. Several case reports show that the symptoms of arteriosclerotic lesions in the internal iliac artery are often atypical and not easy to diagnose. In this report, 3 patients with internal iliac artery occlusions who were treated with percutaneous transluminal angioplasty (PTA) are described. One patient had isolated pain in the buttock region. In the other 2 patients the initial pain was focused on the buttock region with extension to the calves during exercise. After PTA, 2 patients were free of symptoms, while in the other patient the symptoms improved but did not disappear. Future research should clarify the relation between certain arterial occlusions and the location of the pain.

  10. Infra-red thermography in the assessment of sacro-iliac inflammation.

    PubMed

    Grennan, D M; Caygill, L

    1982-05-01

    In a cross-sectional study designed to investigate the sensitivity of infra-red thermography in the detection of sacro-iliac regions were examined by thermography in a group of patients with ankylosing spondylitis and compared with normal volunteers and patients with other causes of low back pain. Thermograms were recorded both quantitatively via profile measurements across the sacro-iliac regions and sacrum and qualitatively via the pattern recorded by photography. Sacro-iliac disease activity was recorded clinically on the same day and was low overall in the patients examined. Thirteen of the 30 ankylosing spondylitis patients were abnormal thermographically either by profile or pattern measurements. None of the 13 patients with other causes of low back pain had increased sacro-iliac activity on thermography. None of four patients without X-ray evidence of sacro-iliitis was abnormal thermographically but there was a trend for increasing thermographic activity to be associated with increasing clinical activity. It was concluded that the thermographic technique examined was of little help in the diagnosis of early sacro-iliitis but might be more helpful in the objective serial assessment of sacro-iliitis in individual patients with active disease.

  11. Small Bowel Obstruction Caused by an Incarcerated Hernia after Iliac Crest Bone Harvest

    PubMed Central

    d'Hondt, Steven; Soysal, Savas; Kirchhoff, Philipp; Oertli, Daniel; Heizmann, Oleg

    2011-01-01

    The iliac crest has become an often used site for autogenous bone graft, because of the easy access it affords. One of the less common complications that can occur after removal is a graft-site hernia. It was first reported in 1945 (see the work by Oldfield, 1945). We report a case of iliac crest bone hernia in a 53-year-old male who was admitted for elective resection of a pseudarthrosis and reconstruction of the left femur with iliac crest bone from the right side. One and a half months after initial surgery, the patient presented with increasing abdominal pain and signs of bowel obstruction. A CT scan of the abdominal cavity showed an obstruction of the small bowel caused by the bone defect of the right iliac crest. A laparoscopy showed a herniation of the small bowel. Due to collateral vessels of the peritoneum caused by portal hypertension, an IPOM (intraperitoneal onlay-mesh) occlusion could not be performed. We performed a conventional ventral hernia repair with an onlay mesh. The recovery was uneventful. PMID:22084778

  12. Break dance hip: chronic avulsion of the anterior superior iliac spine.

    PubMed

    Winkler, A R; Barnes, J C; Ogden, J A

    1987-01-01

    A case of chronic, progressive avulsion of the anterior superior iliac spine leading to the formation of a long, attenuated spur of bone in an 18-year-old black male break dancer is described. The mechanism of formation appeared to be repetitive avulsion from break dancing.

  13. Isolated Spontaneous Dissection of the Common Iliac Artery: Percutaneous Stent Placement in Two Patients

    SciTech Connect

    Kwak, Hyo-Sung; Han, Young-Min Chung, Gyung-Ho; Yu, Hee Chul; Jeong, Yeon-Jun

    2006-10-15

    Isolated spontaneous dissection of the common iliac artery (CIA) is a rare entity. Two patients with this condition were successfully treated by percutaneous stent placement. We emphasize the feasibility of nonsurgical management by percutaneous stent placement for isolated spontaneous dissection of the CIA.

  14. Effect of Atorvastatin-Eluting Stents in a Rabbit Iliac Artery Restenosis Model

    PubMed Central

    Lim, Kyung Seob; Bae, In Ho; Park, Jun-Kyu; Park, Dae Sung; Kim, Jong Min; Kim, Jung Ha; Cho, Dong Lyun; Sim, Doo Sun; Park, Keun-Ho; Hong, Young Joon; Ahn, Youngkeun

    2013-01-01

    Statins have pleiotropic effects, which include the inhibition of neointima hyperplasia, the inhibition of vascular inflammation, and platelet inhibition. The aim of this study was to examine the effect of an atorvastatin-eluting stent (AES) in a rabbit iliac artery overstretch restenosis model. Ten rabbits were used in this study (10 rabbits, 10 iliac arteries for each stent). An AES and paclitaxel-eluting stent (PES) were implanted in the left and right iliac arteries in a rabbit (2 stents in each rabbit). The stents were deployed with oversizing (stent/artery ratio 1.3:1), and histopathologic analysis was assessed at 28 days after stenting. There were no significant differences in the injury score, lumen area, or inflammation score. There were significant differences in the neointimal area (0.7±0.18 mm2 in the AES group vs. 0.4±0.25 mm2 in the PES group, p<0.01), in the percentage stenosis area (14.8±5.06% in the AES group vs. 10.5±6.80% in the PES group, p<0.05), and in the fibrin score (0.4±0.51 in the AES group vs. 2.7±0.48 in the PES group, p<0.001). Although the AES did not suppress neointimal hyperplasia compared with the PES, it showed a superior arterial healing effect in a rabbit iliac artery overstretch restenosis model. PMID:24400214

  15. Percutaneous Endovascular Stent-Graft for Iliac Pseudoaneurysm Following Lumbar Discectomy

    SciTech Connect

    Hong, Seong J.; Oh, Joo H.; Yoon, Yup

    2000-11-15

    In a 24-year-old woman, an iliac pseudoaneurysm following lumbar discectomy was successfully treated by percutaneous placement of a self-expanding stent-graft. A postprocedural angiogram demonstrated complete exclusion of the pseudoaneurysm without leakage of contrast agent.

  16. phenoVein-A Tool for Leaf Vein Segmentation and Analysis.

    PubMed

    Bühler, Jonas; Rishmawi, Louai; Pflugfelder, Daniel; Huber, Gregor; Scharr, Hanno; Hülskamp, Martin; Koornneef, Maarten; Schurr, Ulrich; Jahnke, Siegfried

    2015-12-01

    Precise measurements of leaf vein traits are an important aspect of plant phenotyping for ecological and genetic research. Here, we present a powerful and user-friendly image analysis tool named phenoVein. It is dedicated to automated segmenting and analyzing of leaf veins in images acquired with different imaging modalities (microscope, macrophotography, etc.), including options for comfortable manual correction. Advanced image filtering emphasizes veins from the background and compensates for local brightness inhomogeneities. The most important traits being calculated are total vein length, vein density, piecewise vein lengths and widths, areole area, and skeleton graph statistics, like the number of branching or ending points. For the determination of vein widths, a model-based vein edge estimation approach has been implemented. Validation was performed for the measurement of vein length, vein width, and vein density of Arabidopsis (Arabidopsis thaliana), proving the reliability of phenoVein. We demonstrate the power of phenoVein on a set of previously described vein structure mutants of Arabidopsis (hemivenata, ondulata3, and asymmetric leaves2-101) compared with wild-type accessions Columbia-0 and Landsberg erecta-0. phenoVein is freely available as open-source software.

  17. Common femoral vein reconstruction using internal jugular vein after blast injury.

    PubMed

    Holt, Andrew M; West, Charles A; Davis, James A; Gilani, Ramyar; Askenasy, Eric

    2014-10-01

    Common femoral vein traumatic injuries are rare. Surgical management is controversial and by nature case specific. In this report, we present an unusual case of an isolated common femoral vein injury from a gunshot blast repaired with an interposition internal jugular vein bypass. To our knowledge, this is the first reported case of an isolated common femoral vein reconstructed in this manner.

  18. Upper extremity deep vein thrombosis in a military patient.

    PubMed

    Bullock, Charlotte; Johnston, A McD

    2016-08-01

    We describe the case of a 23-year-old serviceman on overseas deployment who presented with a painful, swollen arm. Investigations showed an upper extremity deep vein thrombosis (UEDVT) of the right arm with an associated asymptomatic pulmonary embolism, which was treated with warfarin anticoagulation. Further investigation identified positional obstruction at the thoracic outlet, and the patient was diagnosed with Paget-Schroetter syndrome. He underwent elective resection of the first rib, and has now returned to normal duties. After review of the literature on UEDVT, it is suggested that in this military patient, the occurrence of an anatomical variant put him at risk of upper limb venous thrombosis, which was probably potentiated by the occupational factor of carrying a rifle. The external compression of the subclavian vein from the rifle butt and hypertrophied muscles, in addition to the anatomical variation, caused repetitive microtrauma of the vessel intima, which precipitated venous thrombosis.

  19. Extravascular compression of the femoral vein due to wear debris-induced iliopsoas bursitis: a rare cause of leg swelling after total hip arthroplasty.

    PubMed

    Beksaç, Burak; Tözün, Remzi; Baktiroglu, Selcuk; Sener, Nadir; Gonzalez Della Valle, Alejandro

    2007-04-01

    We present a patient with unilateral, spontaneous, late leg swelling that developed 4 years after total hip arthroplasty. The etiology was the compression of the internal iliac vein by a voluminous iliopsoas bursitis caused by polyethylene debris. The expansive lesion was detected by ultrasound, arthrography, and magnetic resonance imaging. An ultrasound-guided aspiration provided transient relief of the patient's symptoms. The patient later required surgical excision through an abdominal approach. A second recurrence was detected and treated with revision surgery. We present the diagnosis and the treatment of this rare cause of late, unilateral leg swelling after total hip arthroplasty together with a review of the literature.

  20. The iliac angle: a sonographic marker of trisomy 21 during the midtrimester: dependency of fetal lying?

    PubMed

    Massez, Anne; Rypens, Françoise; Metens, Thierry; Donner, Catherine; Avni, Fred E

    2003-09-01

    The aim of this study was to evaluate the efficiency of the fetal iliac wing angle measurements in the detection of trisomy 21 during the second trimester and the impact of the fetal position on this measurement. During a 43-month period, the iliac wing angle was prospectively measured in 695 fetuses at genetic ultrasonography performed before amniocentesis. The iliac wing angle measurements were performed in a true axial section of the fetal pelvis and the relative position of the fetal spine was recorded (decubitus, lateral). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio (LR) were computed for multiple cutoff angles. The prevalence of trisomy 21 was 1.4%; 447 fetuses were in lateral position, 240 fetuses were in decubitus position, including, respectively, 2 and 8 fetuses with trisomy 21 (8 fetuses with other chromosomal anomalies were excluded). In euploid fetuses, the mean iliac wing angle was 83.7 degrees in decubitus and 68.7 degrees in lateral position; in fetuses with trisomy 21 the respective mean angles were 104.9 degrees and 102.5 degrees. A receiver operating characteristics (ROC) curve provided an absolute cutoff angle of 90 degrees, predicting trisomy 21 with a sensitivity of 100%, a specificity of 72.4%, an NPV of 100%, a PPV value of 11.1%, and an LR of 3.6. The measurement of iliac wing angles in an axial section of the fetal pelvis is dependent on spine orientation and provides an efficient cutoff angle for the exclusion of trisomy 21 in patients at risk.

  1. Large Diameter Limbs for Dilated Common Iliac Arteries in Endovascular Aneurysm Repair. Is It Safe?

    SciTech Connect

    Malagari, Katerina Brountzos, Elias; Gougoulakis, Alexandros; Papathanasiou, Matilda; Alexopoulou, Efthymia; Mastorakou, Renata; Kelekis, Dimitris

    2004-09-15

    In this prospective study we examined whether dilated common iliac arteries (CIAs) can provide a safe distal seal in endovascular aneurysm repair (EVAR) with the use of bifurcated stent grafts with large diameter limbs. Sixteen patients with 26 dilated CIAs with a diameter of {>=}6 mm who were offered EVAR using stent grafts with large diameter limbs were included in the study (Group A). Forty-two patients who also underwent EVAR without iliac dilatation, matched for age, sex and surgical risk were used for comparison (controls-Group B). In group A mean CIA diameter was 18.2 mm (16-28) and mean abdominal aortic aneurysm (AAA) diameter was 6.87 {+-} 1.05 cm; mean age was 77.2 {+-} 4.8 yrs (67-81). Mean follow-up was 33.6 months (2.8 yrs). CIA diameter changes and development of endoleaks were assessed by CT angiography (CTA). Overall iliac dilatation was present in 16/58 of our patients (27.6%). In 10 patients dilatation was bilateral (17.3%). Partial or complete flow to the internal iliac artery (IIA) territories was preserved in all patients post-EVAR. On follow-up, stable caliber of the dilated CIAs was observed in 21 patients (84%), enlargement of 1mm in 3 (16%), and failure of the distal attachment in 1 (6.2%). Compared to the control group there was no statistical significance in the incidence of complications. Dilated common iliac arteries provide a safe distal seal in patients who have undergone EVAR, thus obviating the need for additional endovascular procedures and sparing flow in the IIA vascular bed.

  2. Treatment of a Common Iliac Aneurysm by Endovascular Exclusion Using the Amplatzer Vascular Plug and Femorofemoral Crossover Graft

    SciTech Connect

    Coupe, Nicholas J. Ling, Lynn; Cowling, Mark G.; Asquith, John R.; Hopkinson, Gregory B.

    2009-07-15

    We report our initial experience using the Amplatzer Vascular Plug II (AVP2) in the treatment of a left common iliac aneurysm. Following investigation by computerized tomographic angiography and catheter angiography, a 79-year-old man was found to have a markedly tortuous iliac system, with a left common iliac artery aneurysm that measured 48 mm in maximal diameter. Due to the patient's age and comorbidities the surgical opinion was that conventional open repair was not suitable. However, due to the tortuous nature of the aneurysm and iliac vessels, standard endovascular repair, using either a bifurcated or an aorto-uni-iliac stent graft, was also not possible. A combined approach was used by embolizing the ipsilateral internal iliac artery using coils and excluding the aneurysm using two AVP2 occlusion devices, followed by femorofemoral crossover grafting. Total aneurysm occlusion was achieved using this method and this allowed the patient to have a much less invasive surgical procedure than with conventional open repair of common iliac aneurysms, thus avoiding potential comorbidity and mortality.

  3. The sentinel vein: an important reference point for surgery in the temporal region.

    PubMed

    Trinei, F A; Januszkiewicz, J; Nahai, F

    1998-01-01

    An intimate knowledge of the anatomy of the face is essential to the aesthetic surgeon. It is this knowledge that ultimately improves results and minimizes complications. The major morbidity associated with brow lifts is trauma to the temporal branch of the facial nerve. The general course of this nerve has been well documented, but exact details are still lacking. This anatomic study was designed to further elucidate its path. Dissections were performed on each side of 10 fresh cadaver heads. These dissections revealed a consistent relationship between the temporal branch of the facial nerve and the sentinel vein. The sentinel vein is reliably located and preoperatively easily defines the "zone of caution", enabling the surgeon to operate rapidly and with confidence until the zone is reached, at which time the dissection is slower as the vein is approached. In the patient in whom the sentinel vein is not easily visualized externally, it may be identified through fixed skeletal landmarks.

  4. Protective constriction of coronary vein grafts with knitted nitinol

    PubMed Central

    Moodley, Loven; Franz, Thomas; Human, Paul; Wolf, Michael F.; Bezuidenhout, Deon; Scherman, Jacques; Zilla, Peter

    2013-01-01

    OBJECTIVES Different flow patterns and shear forces were shown to cause significantly more luminal narrowing and neointimal tissue proliferation in coronary than in infrainguinal vein grafts. As constrictive external mesh support of vein grafts led to the complete suppression of intimal hyperplasia (IH) in infrainguinal grafts, we investigated whether mesh constriction is equally effective in the coronary position. METHODS Eighteen senescent Chacma baboons (28.8 ± 3.6 kg) received aorto-coronary bypass grafts to the left anterior descending artery (LAD). Three groups of saphenous vein grafts were compared: untreated controls (CO); fibrin sealant-sprayed controls (CO + FS) and nitinol mesh-constricted grafts (ME + FS). Meshes consisted of pulse-compliant, knitted nitinol (eight needles; 50 μm wire thickness; 3.4 mm resting inner diameter, ID) spray attached to the vein grafts with FS. After 180 days of implantation, luminal dimensions and IH were analysed using post-explant angiography and macroscopic and histological image analysis. RESULTS At implantation, the calibre mismatch between control grafts and the LAD expressed as cross-sectional quotient (Qc) was pronounced [Qc = 0.21 ± 0.07 (CO) and 0.18 ± 0.05 (CO + FS)]. Mesh constriction resulted in a 29 ± 7% reduction of the outer diameter of the vein grafts from 5.23 ± 0.51 to 3.68 ± 0 mm, significantly reducing the calibre discrepancy to a Qc of 0.41 ± 0.17 (P < 0.02). After 6 months of implantation, explant angiography showed distinct luminal irregularities in control grafts (ID difference between widest and narrowest segment 74 ± 45%), while diameter variations were mild in mesh-constricted grafts. In all control grafts, thick neointimal tissue was present [600 ± 63 μm (CO); 627 ± 204 μm (CO + FS)] as opposed to thin, eccentric layers of 249 ± 83 μm in mesh-constricted grafts (ME + FS; P < 0.002). The total wall thickness had increased by 363 ± 39% (P < 0.00001) in CO and 312 ± 61% (P < 0

  5. Varicose veins; a practical approach to treatment.

    PubMed

    ELLENBURG, R

    1958-05-01

    Adequate treatment of varicose veins requires thorough mapping of perforating veins, communicating veins and "blow out" areas. Combined ligations, stripping and injection of sclerotic substances after operation is the most effective regimen of therapy. The technique of stripping is facilitated by isolating the saphenous vein at the ankle, inserting the stripper from below upward, then making a transverse groin incision over the palpable stripper. The tip of the stripper should be twice the diameter of the vein to be removed. Stripping should be done with the patient in the Trendelenburg position. All patients must be examined at regular intervals after operation and injection of sclerosing material carried out as necessary.

  6. Preduodenal portal vein: surgery and radiographic appearance.

    PubMed

    Fernandes, E T; Burton, E M; Hixson, S D; Hollabaugh, R S

    1990-12-01

    Preduodenal portal vein is rare, with 63 cases reported in the literature. In general, this anomaly occurs in children with associated small bowel obstruction. We report a newborn infant who presented with duodenal stenosis, mongolism, and preduodenal portal vein. Treatment consisted of a duodenoduodenal anastomosis without mobilizing the portal vein. The correlation between imaging techniques and the operative findings is discussed. Because identification of preduodenal portal vein at surgery is important, preoperative sonography may be useful in selected cases to define the position of the vein.

  7. Mechanical buckling of veins under internal pressure.

    PubMed

    Martinez, Ricky; Fierro, Cesar A; Shireman, Paula K; Han, Hai-Chao

    2010-04-01

    Venous tortuosity is associated with multiple disease states and is often thought to be a consequence of venous hypertension and chronic venous disease. However, the underlying mechanisms of vein tortuosity are unclear. We hypothesized that increased pressure causes vein buckling that leads to a tortuous appearance. The specific aim of this study was to determine the critical buckling pressure of veins. We determined the buckling pressure of porcine jugular veins and measured the mechanical properties of these veins. Our results showed that the veins buckle when the transmural pressure exceeds a critical pressure that is strongly related to the axial stretch ratio in the veins. The critical pressures of the eight veins tested were 14.2 +/- 5.4 and 26.4 +/- 9.0 mmHg at axial stretch ratio 1.5 and 1.7, respectively. In conclusion, veins buckle into a tortuous shape at high lumen pressures or reduced axial stretch ratios. Our results are useful in understanding the development of venous tortuosity associated with varicose veins, venous valvular insufficiency, diabetic retinopathy, and vein grafts.

  8. Management of varicose veins and venous insufficiency.

    PubMed

    Hamdan, Allen

    2012-12-26

    Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulcers and, in fact, severe skin complications of varicose veins, even when extensive, are not guaranteed. Treatment options range from conservative (eg, medications, compression stockings, lifestyle changes) to minimally invasive (eg, sclerotherapy or endoluminal ablation), invasive (surgical techniques), and hybrid (combination of ≥1 therapies). Ms L, a 68-year-old woman with varicose veins, is presented. She has had vein problems over the course of her life. Her varicose veins recurred after initial treatment, and she is now seeking guidance regarding her current treatment options.

  9. Mortality after portal vein embolization

    PubMed Central

    Lee, Eung Chang; Park, Sang-Jae; Han, Sung-Sik; Park, Hyeong Min; Lee, Seung Duk; Kim, Seong Hoon; Lee, In Joon; Kim, Hyun Beom

    2017-01-01

    Abstract Portal vein embolization (PVE) is increasingly performed worldwide to reduce the possibility of liver failure after extended hepatectomy, by inducing future liver remnant (FLR) hypertrophy and atrophy of the liver planned for resection. The procedure is known to be very safe and to have few procedure-related complications. In this study, we described 2 elderly patients with Bismuth–Corlette type IV Klatskin tumor who underwent right trisectional PVE involving the embolization of the right portal vein, the left medial sectional portal branch, and caudate portal vein. Within 1 week after PVE, patients went into sepsis combined with bile leak and died within 1 month. Sepsis can cause acute liver failure in patients with chronic liver disease. In this study, the common patient characteristics other than sepsis, that is, trisectional PVE; chronic alcoholism; aged >65 years; heart-related comorbidity; and elevated serum total bilirubin (TB) level (7.0 mg/dL) at the time of the PVE procedure in 1 patient, and concurrent biliary procedure, that is, percutaneous transhepatic biliary drainage in the other patient might have affected the outcomes of PVE. These cases highlight that PVE is not a safe procedure. Care should be taken to minimize the occurrence of infectious events because sepsis following PVE can cause acute liver failure. Additionally, prior to performing PVE, the extent of PVE, chronic alcohol consumption, age, comorbidity, long-lasting jaundice, concurrent biliary procedure, etc. should be considered for patient safety. PMID:28178122

  10. Evolution from open surgical to endovascular treatment of ureteral-iliac artery fistula

    PubMed Central

    Malgor, Rafael D.; Oderich, Gustavo S.; Andrews, James C.; McKusick, Michael; Kalra, Manju; Misra, Sanjay; Gloviczki, Peter; Bower, Thomas C.

    2015-01-01

    Purpose To review the indications and results of open surgical and endovascular treatment for ureteral-iliac artery fistula (UIAF). Methods We reviewed the clinical data of 20 consecutive patients treated for 21 UIAFs between 1996 and 2010. Since 2004, iliac artery stent grafts were the primary treatment except for complex fistulas with enteric contamination or abscess. Endpoints were early morbidity and mortality, patient survival, vessel or graft patency, freedom from vascular or stent graft/graft infection, and freedom from recurrent bleeding. Results There were 20 patients, 15 females, and five males, with mean age of 63 ± 13 years. Predisposing factors for UIAF were prior tumor resection in 18 patients, radiation in 15, ureteral stents in 15, ileal conduits in four, and ileofemoral grafts in three. All patients presented with hematuria, which was massive in 10. Treatment included iliac stent grafts in 11 patients/12 fistulas (55%), with internal iliac artery (IAA) exclusion in nine, femoral crossover graft with IAA exclusion in five, direct arterial repair in three, and ureteral exclusion with percutaneous nephrostomy and no arterial repair in one. There were no early deaths. Five of eight patients treated by open surgical repair developed complications, which included enterocutaneous fistula in three and superficial wound infection in two. Four patients (36%) treated by iliac stent grafts had complications, including pneumonia, non-ST segment elevation myocardial infarction, buttock claudication, and early stent occlusion in one each. After a median follow-up of 26 months, no one had recurrent massive hematuria, but minor bleeding was reported in three. Patient survival at 5 years was 42% compared with 93% for the general population (P < .001). Freedom from any recurrent bleeding at 3 years was 76%. In the stent graft group, primary and secondary patency rates and freedom from stent graft infection at 3 years were 81%, 92%, and 100%. Conclusions UIAF is a

  11. Static histomorphometry of human iliac crest and vertebral trabecular bone: a comparative study.

    PubMed

    Thomsen, J S; Ebbesen, E N; Mosekilde, Li

    2002-01-01

    We recently developed a new, rapid method for conducting static histomorphometry on large histologic sections. This method has now been applied on both iliac crest and lumbar vertebral bone to compare the age-related changes at these two skeletal sites and to investigate the correlation between the histomorphometric measures at the iliac crest and the vertebral body. The material comprised matched sets of unilateral transiliac crest bone biopsies and lumbar vertebral bodies (L-2) from 24 women (19-96 years) and 24 men (23-95 years) selected from a larger autopsy material. Three female subjects (80, 88, and 90 years) had a known vertebral fracture of L-2. The iliac crest biopsies and 9-mm-thick mediolateral slices of half the entire vertebral bodies were embedded in methylmetacrylate, stained with aniline blue, and scanned into a computer with a flatbed image scanner at a high resolution. With a custom-made computer program the following static histomorphometric measures were determined: trabecular bone volume; marrow and bone space star volume; node-strut analysis; trabecular bone pattern factor; trabecular thickness; trabecular number; trabecular separation; and anisotropy of bone and marrow phase. In addition, connectivity density was measured (ConnEulor method). The results showed that the age-related changes in the static histomorphometric measures are generally similar in the iliac crest and the vertebral body, and that these age-related changes are independent of gender. An exception, however, is connectivity density, where the age-related changes are similar for women and men in the vertebral body but significantly different in the iliac crest. Furthermore, the results showed that the histomorphometric measures were weakly intercorrelated between the iliac crest and the vertebral body, despite the generally similar pattern in age-related changes at these two skeletal sites. The highest correlation coefficient was found for trabecular separation (Tb.Sp; r = 0

  12. The influence of steroids on the vascular tension of isolated superficial nasal and facial veins in gilts during sexual maturation.

    PubMed

    Grzegorzewski, W J; Muszak, J; Tabecka-Łonczyńska, A; Stefańczyk-Krzymowska, S

    2010-01-01

    The arrangement of the superficial facial veins enables blood flow from the nasal cavity into the peripheral circulation by two pathways: through the facial vein into the external jugular vein and through the frontal vein into the cavernous sinus. The venous cavernous sinus is the site where hormones and pheromones permeate from venous blood into the arterial blood supplying the brain and hypophysis. The present study was designed to: (1) determine whether estradiol (E2) and progesterone (P4) affect the vascular tone of the superficial veins of the nose and face in maturating prepubertal gilts (PP) and in prepubertal gilts deprived of ovarian hormones (PPov), and (2) to analyze the immunolocalization of progesterone receptors (PR), and estradiol receptors alpha (ER alpha) and beta (ER beta) in these veins. The influence of hormones on the vascular tension differed depending on the type of vessel, the hormonal status and dose of hormone used. Estradiol decreased the vascular tension in the nasal and facial veins of PP gilts (P < 0.01). In PPov gilts, the effect of E2 was opposing, however it caused strong tension in the proximal and distal parts of the facial vein (P < 0.01 and P < 0.001, respectively). Progesterone increased the vascular tension in the proximal segment of the nasal vein and in the distal segment of the frontal and facial veins, and decreased the tension in the distal segment of the nasal and facial veins (P < 0.05) of PP gilts. In PPov gilts, P4 produced strong increase in the tension of distal and proximal segments of the nasal vein (P < 0.001 and P < 0.01, respectively) and of distal segment of the facial vein (P < 0.01), strong decrease in the tension of the distal part of the nasal vein (P < 0.01) and had limited effect on other veins. Expression of ER beta, but not of PR, was observed in the superficial nasal and facial veins. In conclusion, the ovarian steroid hormones that modulate the vascular tension of the nasal and facial veins in

  13. [Endarterectomy from the distal arterial bed in prosthetics of the aorta and iliac arteries].

    PubMed

    Koshelev, Iu M; Varnavskikh, V I; Dem'ianov, A M

    2005-01-01

    The work presents an experience with surgical treatment of 32 patients with critical ischemia of the lower extremities developed against the background of two-levels occlusive lesion of the arterial bed of the lower extremities. All the patients had atherosclerosis. Occlusion of the abdominal part of the aorta was the cause of reconstruction of the aorta and iliac arteries in 15 patients, occlusion of the iliac artery - in 14 patients, aneurysm of the abdominal aorta - in 3 patients. In all the patients the proximal lesion was associated with occlusion of the femoral arteries. In addition to proximal reconstruction, retrograde endarterectomy was made with a special instrument from the femoral arteries through the arteriotomy opening intended for distal anastomosis of a synthetic prosthesis. Complete revascularisation of the arterial bed of the lower extremities was obtained in all the patients. There were no lethal outcomes.

  14. Intravascular Ultrasound and Histology in In Vitro Assessment of Iliac Artery Angioplasty

    SciTech Connect

    Lankeren, Winnifred van; Gussenhoven, Elma J.; Qureshi, Akeel; Lugt, Aad van der

    1999-01-15

    Purpose: Intravascular ultrasound (IVUS) was used to assess in vitro the morphologic and quantitative effects of balloon angioplasty (PTA) of the iliac artery. Methods: Forty human iliac arteries ({>=} 30% area stenosis) were studied with IVUS in vitro before and after PTA and the findings were validated with histology. Results: The sensitivity of IVUS for dissection was 74% and for media rupture 59%. The incidence of vascular damage was higher when the whole segment was analyzed rather than the target site alone. Dissections occurred at the thinnest region of the plaque, unrelated to plaque calcification. Following PTA, quantitative changes at the target site were greater compared with the overall data derived from all cross-sections. The increase in lumen area was caused solely by an increase in vessel area. Conclusions: IVUS is sensitive in detecting dissections, which occurred irrespective of calcification at the thinnest region of the plaque. The increase in lumen area after PTA was caused by stretching of the vessel.

  15. Quantitative changes of calcium, phosphorus, and magnesium in common iliac arteries with aging.

    PubMed

    Tohno, S; Tohno, Y; Moriwake, Y; Azuma, C; Ohnishi, Y; Minami, T

    2001-01-01

    To elucidate the mechanism of element accumulations in the arteries with aging, the authors investigated the mass ratios among calcium, phosphorus, and magnesium in the common iliac arteries by inductively coupled plasma-atomic emission spectrometry. The subjects consisted of 16 men and 8 women, ranging in age from 65 to 93 yr. It was found that there were extremely significant correlations between calcium and phosphorus contents, between calcium and magnesium contents, and between phosphorus and magnesium contents in the common iliac arteries. In regard to the mass ratio, although the mass ratio of calcium to phosphorus was almost constant, the mass ratios of magnesium to calcium and phosphorus were different at early and advanced stages of the accumulation of calcium and phosphorus. It was found that both the mass ratios of magnesium to calcium and phosphorus were higher at an early stage of the accumulation of calcium and phosphorus in the arteries than at an advanced stage of the accumulation.

  16. Bilateral Distraction Osteogenesis of Vascularized Iliac Crest Free Flaps Used in Mandibular Reconstruction

    PubMed Central

    Subramaniam, Shiva S.; Vujcich, Nathan J.; Nastri, Alf L.

    2016-01-01

    Summary: Vascularized free flaps have become the gold standard in reconstructing large segmental mandibular defects; however, even when bony union and soft-tissue coverage is achieved, insufficient bone stock and altered facial contour can create functional and cosmetic problems for the patient. There have been limited case reports on the use of secondary distraction osteogenesis to address these issues. The authors report a case of bilateral mandibular distraction of deep circumflex iliac artery free flaps, used for mandibular reconstruction after total mandibulectomy for treatment of osteosarcoma. Performed for reasons of retrognathia and facilitation of dental prosthetic rehabilitation, this is the first case of bilateral horizontal distraction osteogenesis of deep circumflex iliac artery free flaps reported in the literature. PMID:27257565

  17. VIABILITY OF VASCULARIZED BONE GRAFT FROM THE ILIAC CREST USING THE ILIAC BRANCH OF THE ILIOLUMBAR ARTERY: EXPERIMENTAL STUDY ON RATS

    PubMed Central

    Peruchi, Fabian Maccarini; Sebben, Alessandra Deise; Lichtenfels, Martina; de Oliveira Jaeger, Marcos Ricardo; Silva, Jefferson Braga

    2015-01-01

    Objective: Through an experimental model, our aim was to create inferences about the viability of vascularized bone grafts from the iliac crest in rats and investigate their histological features. Methods: Twenty-one rats were used, divided into two groups: the first consisted of animals that were subjected to the technique of vascularized bone graft pedicled onto the iliac branch of the iliolumbar artery; the second (control group) underwent the same procedure as performed on the first group, with the addition of ligation of the vascular pedicle. The viability of the bone grafts was observed for three weeks, by means of direct observation of the graft, histology and immunohistochemistry. Results: All the vascularized grafts evaluated in the first week showed viability according to direct observation, histology and immunohistochemistry. However, in the second and third weeks, direct observation showed that 75% of the grafts were unviable, while histological analysis and immunohistochemistry showed that 50% were unviable. Conclusions: Some grafts that are designed to be vascularized became unviable and began to behave like non-vascularized grafts under direct observation and histology. Despite the possibility of failure, use of vascularized bone grafts should be encouraged, because descriptive histology shows greater cell density in the medullary bone portion, and osteocytes that function better regarding deposition of bone matrix, with preservation of the intraosseous vascular network. PMID:27042650

  18. Abdominal Aortic Aneurysm with a Dilated Common Iliac Artery: Treatment Using a Handmade Bifurcated Stent-Graft with a Wide Iliac Limb End

    SciTech Connect

    Miyayama, Shiro; Matsui, Osamu; Akakura, Yukari; Yamamoto, Toru; Nishida, Hiroto; Yoneda, Kenji; Kawai, Keiichi; Murakami, Shinya

    2003-11-15

    The purpose of this study was to evaluate the usefulness of a bifurcated stent-graft with a wide iliac limb end (WILE) in the treatment of abdominal aortic aneurysm (AAA) with a dilated common iliac artery (CIA) to avoid occlusion of the internaliliac artery (IIA). The WILE, covered with an expanded polytetrafluoroethylene graft which was constructed of large diameter stents according to the individual CIA diameter, was connected to a two-piece bifurcated stent-graft covering a polyester graft. The WILE was placed in eight dilated CIAs of six patients. All but one WILE fitted the dilated CIA well. One did not fit, and coil embolization of the leak was needed. All eight IIA derived from the dilated CIA avoided occlusion. Perigraft leak due to other causes was identified in another two patients. Limb kinking was observed in two patients. Our stent is useful in the treatment of AAA with dilated CIA to avoid occlusion of the IIA, and may extend the indication of endoluminal repair of AAA.

  19. Preclinical Feasibility of a Technology Framework for MRI-guided Iliac Angioplasty

    PubMed Central

    Rube, Martin A.; Fernandez-Gutierrez, Fabiola; Cox, Benjamin F.; Holbrook, Andrew B.; Houston, J. Graeme; White, Richard D.; McLeod, Helen; Fatahi, Mahsa; Melzer, Andreas

    2015-01-01

    Purpose Interventional MRI has significant potential for image guidance of iliac angioplasty and related vascular procedures. A technology framework with in-room image display, control, communication and MRI-guided intervention techniques was designed and tested for its potential to provide safe, fast and efficient MRI-guided angioplasty of the iliac arteries. Methods A 1.5T MRI scanner was adapted for interactive imaging during endovascular procedures using new or modified interventional devices such as guidewires and catheters. A perfused vascular phantom was used for testing. Pre-, intra- and post-procedural visualization and measurement of vascular morphology and flow was implemented. A detailed analysis of X-Ray fluoroscopic angiography workflow was conducted and applied. Two interventional radiologists and one physician in training performed 39 procedures. All procedures were timed and analyzed. Results MRI-guided iliac angioplasty procedures were successfully performed with progressive adaptation of techniques and workflow. The workflow, setup and protocol enabled a reduction in table time for a dedicated MRI-guided procedure to 6 min 33 s with a mean procedure time of 9 min 2 s, comparable to the mean procedure time of 8 min 42 s for the standard X-Ray guided procedure. Conclusions MRI-guided iliac vascular interventions were found to be feasible and practical using this framework and optimized workflow. In particular the real-time flow analysis was found to be helpful for pre- and post-interventional assessments. Design optimization of the catheters and in vivo experiments are required before clinical evaluation. PMID:25102933

  20. Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps

    PubMed Central

    Hansen, Keith S.; Hartman, Brett C.; Sood, Rajiv; Socas, Juan

    2016-01-01

    Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments. PMID:27689054

  1. Sacro-iliac osteomyelitis in a 13 year old boy following perforated appendicitis.

    PubMed

    Whelan-Johnson, Sophie; Isaacs, John; Pullan, Rupert D

    2013-05-01

    Appendicitis is a common cause of acute abdominal pain in children and is treated by an open or laparoscopic appendicectomy. Well documented post-operative complications include wound infection, intra-abdominal collection, and adhesional bowel obstruction. We present the rare case of right sacro-iliitis and iliac bone osteomyelitis in a 13 year old boy following an open appendicectomy for a perforated appendicitis.

  2. An anatomical ultrasound study of the long posterior sacro-iliac ligament.

    PubMed

    Moore, Abigail E; Jeffery, Ruth; Gray, Andrew; Stringer, Mark D

    2010-11-01

    The long posterior sacro-iliac ligament (LPSL) is directly posterior to the sacro-iliac joint and a potential source of lower back and pelvic pain. Its sonographic anatomy has not been described in detail. The aim of this study was to define and measure the ligament in healthy young women using ultrasound (US). The LPSL was scanned in 30 healthy women (median age, 22 years; range, 20-34) using a high-resolution linear transducer (7.5-10 MHz). The ligament was consistently visualized as a hyperechoic laminated linear structure between the posterior superior iliac spine and the lateral aspect of the third transverse sacral tubercle. Its length, thickness, and the angle between it and the posterior superior iliac spine were measured by an experienced sonographer bilaterally in both semiflexed standing and lateral decubitus positions. Four female cadaver pelves (age range, 57-93 years) were also scanned and dissected to validate US observations. In the semiflexed standing position, mean LPSL length was 37.9 ± 2.4 mm, mean thickness 1.57 ± 0.38mm, and median angle 18.5°. There was no statistically significant difference with equivalent values in the lateral decubitus position. Intrarater repeatability was fair to substantial in both positions (intraclass correlation coefficient, 0.39-0.66), improving to moderate to substantial (intraclass correlation coefficient, 0.57-0.80) using the mean of two measurements. There was good overall agreement between LPSL length and thickness in cadavers measured by US and dissection. These findings document the sonographic appearance, length, and thickness of the LPSL and provide useful normative data for understanding potential LPSL pathology, particularly in relation to pregnancy-related pelvic girdle pain.

  3. [Deviation of the abdominal aorta and common iliac arteries due to aging and kidney dystopia].

    PubMed

    Zhelobtsov, P M

    1982-12-01

    A specific peculiarity in the relief changeability and position of the abdominal aorta, the common iliac arteries is a segmentary deformity occurring in aged persons as a result of atherosclerotic alterations in their walls. A congenital homolateral dystopia, horseshoe and double kidney are rather seldom developmental anomalies in mature persons. In newborns, however, they are found 6-7 times more often and together with other congenital defects of the kidneys make evidently an often cause of the fetal and infantile death.

  4. The iliac crest in forensic age diagnostics: evaluation of the apophyseal ossification in conventional radiography.

    PubMed

    Wittschieber, Daniel; Vieth, Volker; Domnick, Christoph; Pfeiffer, Heidi; Schmeling, Andreas

    2013-03-01

    Due to the increasing significance of forensic age estimations in the age of globalisation, novel radiographic criteria besides clavicles and hand bones may provide additional certainty for forensic age expertises. The present study analyses the suitability of the iliac crest apophysis by means of 643 pelvic radiographs of patients between 10 and 30 years of age. Retrospective assessments were carried out according to the forensically established classification and sub-classification systems modified after Kreitner et al. (Rofo 166(6):481-486, 1997) and Kellinghaus et al. (Int J Legal Med 124(4):321-325, 2010). The basic ossification stages range from 1 to 4, and the sub-stages of stage 2 and 3 range from a to c. While stage 3c was first achieved at the age of 15 by both sexes, stage 4 was first observed in females at the age of 16 and in males at the age of 17. This indicates the possibility of a valid diagnosis of both the age of 14 and the age of 16 years which represent legally relevant age thresholds in numerous countries. Applied as targeted radiography on the iliac crest, the exposure to radiation would range between other radiographic techniques recently applied. Therefore, the iliac crest apophysis appears principally suitable as novel possible criterion for forensic age estimation in the living. However, for the establishment of the iliac crest apophysis in routine diagnostics, further studies are needed focussing on the comparison of different grading systems and different radiological techniques.

  5. Iliac crest autograft versus alternative constructs for anterior cervical spine surgery: Pros, cons, and costs

    PubMed Central

    Epstein, Nancy E.

    2012-01-01

    Background: Grafting choices available for performing anterior cervical diskectomy/fusion (ACDF) procedures have become a major concern for spinal surgeons, and their institutions. The “gold standard”, iliac crest autograft, may still be the best and least expensive grafting option; it deserves to be reassessed along with the pros, cons, and costs for alternative grafts/spacers. Methods: Although single or multilevel ACDF have utilized iliac crest autograft for decades, the implant industry now offers multiple alternative grafting and spacer devices; (allografts, cages, polyether-etherketone (PEEK) amongst others). While most studies have focused on fusion rates and clinical outcomes following ACDF, few have analyzed the “value-added” of these various constructs (e.g. safety/efficacy, risks/complications, costs). Results: The majority of studies document 95%-100% fusion rates when iliac crest autograft is utilized to perform single level ACDF (X-ray or CT confirmed at 6-12 postoperative months). Although many allograft studies similarly quote 90%-100% fusion rates (X-ray alone confirmed at 6-12 postoperative months), a recent “post hoc analysis of data from a prospective multicenter trial” (Riew KD et. al., CSRS Abstract Dec. 2011; unpublished) revealed a much higher delayed fusion rate using allografts at one year 55.7%, 2 years 87%, and four years 92%. Conclusion: Iliac crest autograft utilized for single or multilevel ACDF is associated with the highest fusion, lowest complication rates, and significantly lower costs compared with allograft, cages, PEEK, or other grafts. As spinal surgeons and institutions become more cost conscious, we will have to account for the “value added” of these increasingly expensive graft constructs. PMID:22905321

  6. Pseudoaneurysm of the internal iliac artery resulting in massive per-rectal bleeding

    PubMed Central

    Arthur, T.I.; Gillespie, C.J.; Butcher, W.; Lu, C.T.

    2013-01-01

    Rectal bleeding is a common reason for presentation to hospital, with large bleeds most commonly caused by diverticular disease and angiodysplasia. Here we present an unusual aetiology of massive per-rectal bleeding attributable to pseudoaneurysm of the internal iliac artery leading to an arterial fistula to the distal large bowel. It is hoped the case will serve as a reminder that rectal bleeding can have a less common aetiology. PMID:24964318

  7. Internal Iliac Artery Aneurysm Embolization with Fibrin Sealant: A Simple and Effective Solution

    SciTech Connect

    Brountzos, Elias N.; Malagari, Katerina; Papathanasiou, Mathildi A.; Gougoulakis, Alexandros; Kelekis, Dimitrios A.

    2003-02-15

    Endovascular treatment of internal iliac artery (IIA) aneurysms is an attractive alternative to surgical management, because the former is associated with less morbidity and mortality.Embolization with coils or exclusion of the IIA orifice with stent -grafts are the preferred techniques. Although uncommon, technical failures occur with reported aneurysm rupture. Two patients with IIA aneurysms are reported here, where we describe successful occlusion of their IIA aneurysms with the use of fibrin sealant, after initial failure of coil embolization.

  8. Contrast-enhanced harmonic ultrasonography of medial iliac lymph nodes in healthy dogs.

    PubMed

    Gaschen, Lorrie; Angelette, Nik; Stout, Rhett

    2010-01-01

    Herein, we describe the normal contrast-enhanced harmonic, color, and power Doppler ultrasonographic characteristics of the medial iliac lymph nodes in healthy dogs. Contrast-enhanced harmonic ultrasonography of the medial iliac lymph nodes was performed on 14 healthy dogs after intravenous administration of the lipoprotein-bound inert gas-filled microbubble contrast media Definity. Time-pixel intensity curves were generated for 1-min postinjection. Quantification of these curves was performed using Philips QLab software. Non-contrast-enhanced power and color Doppler examinations were performed in each node to assess vascular patterns subjectively. Normal lymph nodes exhibited a mean contrast wash-in phase beginning at 6.3 s from the time of injection with mean peak pixel intensity at 12.1s. Angioarchitecture was best visualized with contrast-enhanced harmonic ultrasound compared with power and color Doppler. Normal lymph nodes in dogs have a central artery with a centrifugal and uniform branching pattern. Contrast-enhanced harmonic ultrasonography is a noninvasive examination that demonstrates improved visibility of the intranodal architecture of healthy medial iliac lymph nodes in dogs compared with conventional, non-contrast-enhanced Doppler methods that may have future clinical applications.

  9. Embolization of the Internal Iliac Artery: Cost-Effectiveness of Two Different Techniques

    SciTech Connect

    Pellerin, Olivier; Caruba, Thibaud; Kandounakis, Yanis; Novelli, Luigi; Pineau, Judith; Prognon, Patrice; Sapoval, Marc

    2008-11-15

    The purpose of this study was to compare the cost-effectiveness of coils versus the Amplatzer Vascular Plug (AVP) for occlusion of the internal iliac artery (IAA). Between 2002 and January 2006, 13 patients (mean age 73 {+-} 13 years) were referred for stent-grafting of abdominal aortic aneurysm (n = 6); type I distal endoleak (n = 3), isolated iliac aneurysm (n = 3), or rupture of a common iliac aneurysm (n = 1). In all patients, extension of the stent-graft was needed because the distal neck was absent. Two different techniques were used to occlude the IIA: AVP in seven patients (group A) and coil embolization in six patients (group C). Immediate results and direct material costs were assessed retrospectively. Immediate success was achieved in all patients, and simultaneous stent-grafting was successfully performed in two of six patients in group C versus five of seven patients in group A. In all group A patients, a single AVP was sufficient to achieve occlusion of the IIA, accounting for a mean cost of 485 Euro , whereas in group C patients, an average of 7 {+-} 3 coils were used, accounting for a mean cost of 1,745 Euro . Mean average cost savings using the AVP was 1,239 Euro . When IIA occlusion is needed, the AVP allows a single-step procedure at significant cost savings.

  10. The sexual dimorphism of the sacro-iliac joint: an investigation using geometric morphometric techniques.

    PubMed

    Anastasiou, Evilena; Chamberlain, Andrew T

    2013-01-01

    The ability to correctly estimate the sex of skeletal remains is vital in forensic sciences. This article investigates the sexual dimorphism of the human sacro-iliac joint, using geometric morphometric techniques that assess morphological characters better than the traditional approaches for recording outline shapes, which are subject to quantification and inter-observer problems. Eight two-dimensional landmarks were recorded from digital images of 29 female and 35 male auricular surfaces of the ilium and sacrum. The specimens were analyzed using geometric morphometric methods (Generalized Procrustes analysis, relative warp analysis, Goodall's F) and multivariate statistics (ANOVA, MANCOVA, principal component analysis, discriminant function analysis [DFA]). Both the size and shape of the analyzed structures were found to be sexually dimorphic. The DFA illustrated that when the form of both the iliac and sacral articular surface is taken as a predictor variable, 94.5% of the individuals are assigned to the correct sex. The successful sex determination obtained by the DFA makes the further study of the sacro-iliac joint's sexual dimorphism promising.

  11. The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function

    SciTech Connect

    Gur, Serkan; Ozkan, Ugur; Onder, Hakan; Tekbas, Gueven; Oguzkurt, Levent

    2013-02-15

    To determine the incidence of erectile dysfunction in patients with common iliac artery (CIA) occlusive disease and the effect of revascularization on erectile function using the sexual health inventory for males (SHIM) questionnaire. All patients (35 men; mean age 57 {+-} 5 years; range 42-67 years) were asked to recall their sexual function before and 1 month after iliac recanalization. Univariate and multivariate analyses were performed to determine variables effecting improvement of impotence. The incidence of impotence in patients with CIA occlusion was 74% (26 of 35) preoperatively. Overall 16 (46%) of 35 patients reported improved erectile function after iliac recanalization. The rate of improvement of impotence was 61.5% (16 of 26 impotent patients). Sixteen patients (46%), including seven with normal erectile function before the procedure, had no change. Three patients (8%) reported deterioration of their sexual function, two of whom (6%) had normal erectile function before the procedure. The median SHIM score increased from 14 (range 4-25) before the procedure to 20 (range 1-25) after the procedure (P = 0.005). The type of recanalization, the age of the patients, and the length of occlusion were related to erectile function improvement in univariate analysis. However, these factors were not independent factors for improvement of erectile dysfunction in multivariate analysis (P > 0.05). Endovascular recanalization of CIA occlusions clearly improves sexual function. More than half of the patients with erectile dysfunction who underwent endovascular recanalization of the CIA experienced improvement.

  12. The Volume Behavior of Autogenous Iliac Bone Grafts After Sinus Floor Elevation: A Clinical Pilot Study.

    PubMed

    Gerressen, Marcus; Riediger, Dieter; Hilgers, Ralf-Dieter; Hölzle, Frank; Noroozi, Nelson; Ghassemi, Alireza

    2015-06-01

    Iliac crest is still regarded as one of the most viable source of autogenous graft materials for extensive sinus floor elevation. Three-dimensional resorption behavior has to be taken into account in anticipation of the subsequent insertion of dental implants. We performed 3-dimensional volume measurements of the inserted bone transplants in 11 patients (6 women and 5 men; mean age = 2.3 years) who underwent bilateral sinus floor elevation with autogenous iliac crest grafts. In order to determine the respective bone graft volumes, cone-beam computerized tomography studies of the maxillary sinuses were carried out directly after the operation (T0), as well as 3 months (T1) and 6 months (T2) postoperatively. The acquired DICOM (Digital Imaging and Communications in Medicine) data sets were evaluated using suitable analysis software. We evaluated statistical significance of graft volumes changes using a linear mixed model with the grouping factors for time, age, side, and sex with a significance level of P = .05. 38.9% of the initial bone graft volume, which amounted to 4.2 cm(3), was resorbed until T1. At T2, the average volume again decreased significantly by 18.9 % to finally reach 1.8 cm(3). The results show neither age nor side dependency and apply equally to both sexes. Without functional load, iliac bone grafts feature low-volume stability in sinus-augmentation surgery. Further clinical and animal studies should be done to detect the optimal timing for implant placement.

  13. Surgeon Custom-Made Iliac Branch Device to Salvage Hypogastric Artery during Endovascular Aneurysm Repair

    PubMed Central

    2014-01-01

    Endovascular salvage of the hypogastric artery using iliac branch device (IBD) during endovascular aortic aneurysm repair (EVAR), offers less invasive alternative solution to surgery to prevent pelvic ischemia. We have performed the first Korean surgeon custom-made IBD for this purpose to overcome the limitation of unavailability of the devices in Korea. Four patients with abdominal aortic aneurysm with bilateral common iliac artery aneurysm (CIAA) were treated using custom-made IBDs from October 2013 to December 2013. IBD was created in back table before EVAR operation using TFLE Zenith iliac limb stent graft (Cook Inc.). Three V12 (Atrium, Inc.) one Viabahn (Gore, Inc.) were used for bridging between IBD and target hypogastric artery. With this modification of IBD procedure, exteriorize the guide wire without snare device is possible which offers another benefit in terms of reducing medical costs comparing to commercial IBD. All operations were successful without any device related complications or postoperative endoleaks. During the mean follow up of 3 months, all IBD were patent without clinical complications. Surgeon custom made IBD is feasible and useful to preserve pelvic perfusion especially in the situation of limited commercial IBD availability in many countries. Long-term follow-up is needed to evaluate stent graft patency and IBD-related complications. PMID:25469069

  14. In vivo monitoring of blood oxygenation in large veins with a triple-wavelength optoacoustic system.

    PubMed

    Brecht, H P; Prough, D S; Petrov, Y Y; Patrikeev, I; Petrova, I Y; Deyo, D J; Cicenaite, I; Esenaliev, R O

    2007-11-26

    A noninvasive optoacoustic technique could be a clinically useful alternative to existing, invasive methods for cerebral oxygenation monitoring. Recently we proposed to use an optoacoustic technique for monitoring cerebral blood oxygenation by probing large cerebral and neck veins including the superior sagittal sinus and the internal jugular vein. In these studies we used a multi-wavelength optoacoustic system with a nanosecond optical parametric oscillator as a light source and a custom-made optoacoustic probe for the measurement of the optoacoustic signals in vivo from the area of the sheep neck overlying the external jugular vein, which is similar in diameter and depth to the human internal jugular vein. Optoacoustic signals induced in venous blood were measured with high resolution despite the presence of a thick layer of tissues (up to 10 mm) between the external jugular vein and the optoacoustic probe. Three wavelengths were chosen to provide accurate and stable measurements of blood oxygenation: signals at 700 nm and 1064 nm demonstrated high correlation with actual oxygenation measured invasively with CO-Oximeter ("gold standard"), while the signal at 800 nm (isosbestic point) was independent of blood oxygenation and was used for calibration.

  15. Preduodenal portal vein: its surgical significance.

    PubMed

    Makey, D A; Bowen, J C

    1978-11-01

    Preduodenal portal vein is a rare anatomical variant which may be one of many anomalies in the neonate with duodenal "atresia." Preduodenal portal vein also may be an occasional finding in an adult undergoing biliary, gastric, or pancreatic surgery. Awareness and recognition of the anomaly are essential for the avoidance of injury during such operations. We report here a symptomless patient whose preduodenal portal vein was discovered at cholecystectomy.

  16. The small saphenous vein and other 'neglected' veins of the popliteal fossa: a review.

    PubMed

    O'Donnell, T F; Iafrati, M D

    2007-01-01

    The small saphenous vein (SSV) and other veins in the popliteal fossa merit little discussion in the literature or in didactic programmes regarding their role in chronic venous insufficiency (CVI) and, in this sense, they are neglected. The purpose of this review is to present both duplex ultrasound findings and the associated clinical characteristics of patients with SSV reflux, from several large series. Both the anatomic variations and the epidemiology of the SSV, as well as other veins of the popliteal fossa, the gastrocnemius veins, Gocamini vein, popliteal area veins and popliteal vein, will be discussed. Findings from our review of the current available literature will demonstrate the important role that these veins play in association with CVI. The implications for open and endovenous surgery will be underlined.

  17. Tissue remodeling investigation in varicose veins

    PubMed Central

    Ghaderian, Sayyed Mohammad Hossein; Khodaii, Zohreh

    2012-01-01

    Although the etiology of varicose veins remains unknown, recent studies have focused on endothelial cell integrity and function because the endothelium regulates vessel tone and synthesizes many pro- and anti-inflammatory factors. The aim of this study was to investigate the evidence involving the endothelium in the development of varicose vein disease. In addition, tissue remodeling was investigated in varicose veins to determine the expression of different types of collagen. Tissue specimens of superficial varicose veins and control saphenous vein were used for immunohistochemical and transmission electron microscope (TEM). α-smooth muscle actin, and collagen I, III, IV antibodies were applied for immunohistochemical investigation. Findings of this study showed alterations of the intima, such as focal intimal discontinuity and denudation of endothelium; and the media, such as irregular arrangements of smooth muscle cells and collagen fibres in varicose veins. Our findings showed some changes in terms of distribution of types I, III and IV collagen in the intima and media of varicose vein walls compared with controls. These alterations to the media suggest that the pathological abnormality in varicose veins may be due to the loss of muscle tone as a result of the breakup of its regular structure by the collagen fibres. These findings only described some changes in terms of distribution of these types of collagen in the intima and media of varicose vein walls which may result in venous wall dysfunction in varicosis. PMID:24551759

  18. Small hepatic veins Budd-Chiari syndrome.

    PubMed

    Riggio, Oliviero; Marzano, Chiara; Papa, Alessia; Pasquale, Chiara; Gasperini, Maria Ludovica; Gigante, Antonietta; Valla, Dominique Charles; Plessier, Aurélie; Amoroso, Antonio

    2014-05-01

    Budd-Chiari syndrome is a rare disorder characterized by hepatic venous outflow obstruction at any level from the small hepatic veins to the atrio-caval junction, in the absence of heart failure or constrictive pericarditis. Various imaging modalities are available for investigating the gross hepatic vascular anatomy but there are rare forms of this disease where the obstruction is limited to the small intrahepatic veins, with normal appearance of the large hepatic veins at imaging. In this cases only a liver biopsy can demonstrate the presence of a small vessels outflow block. We report two cases of small hepatic veins Budd-Chiari syndrome.

  19. Remodelling of the Superior Caval Vein After Angioplasty in an Infant with Superior Caval Vein Syndrome

    SciTech Connect

    Mert, Murat Saltik, Levent; Gunay, Ilhan

    2004-08-15

    An 8-month old girl was presented with superior caval vein syndrome early after cardiac surgery. Angiography showed severe stenosis of the superior caval vein with 50 mmHg pressure gradient. Following balloon angioplasty, the pressure gradient was reduced to 7 mmHg with some residual stenosis of the superior caval vein. When the patient was reevaluated 5 months after the procedure, angiography revealed a normal diameter of the superior caval vein without a pressure gradient.

  20. The influence of steroids on vascular tension of isolated superficial veins of the nose and face during the estrous cycle of gilts.

    PubMed

    Grzegorzewski, W J; Chłopek, J; Tabecka-Łonczyńska, A; Stefańczyk-Krzymowska, S

    2010-01-15

    The arrangement of the superficial facial veins enables blood flow from the nasal cavity into the peripheral circulation by two pathways: through the frontal vein into the cavernous sinus and through the facial vein into the external jugular vein. The current study was designed to determine whether estradiol and progesterone affect the vascular tone of the superficial veins of the nose and face in cycling gilts (Sus scrofa f. domestica) and to analyze the immunolocalization of progesterone receptors and estradiol receptors in these veins. The influence of hormones on vascular tension differed depending on the type of vessel and the phase of the estrous cycle. Estradiol decreased vascular tension in the nasal vein during the follicular phase (P<0.05) and increased tension in the frontal vein during the luteal phase (P<0.05). Progesterone increased the vascular tension of the frontal vein (P<0.05) and decreased the tension of the other veins (P<0.05) in both phases of the cycle. Expression of estradiol receptor beta but not of progesterone receptor was observed in the superficial veins of the nose and face. In conclusion, the effect of ovarian steroid hormones on the vascular tension of the superficial veins of the nose and face in female pigs as well as the reactivity of these veins to steroid boar pheromones can affect the blood supply from the nasal cavity to the venous cavernous sinus. We propose that the ovarian steroid hormones that modulate the vascular tension of the nasal and facial veins may also influence the action of boar pheromones absorbed into the nasal mucosa in gilts and may reach the brain via local destination transfer.

  1. Biaxial mechanical properties of the human thoracic and abdominal aorta, common carotid, subclavian, renal and common iliac arteries.

    PubMed

    Kamenskiy, Alexey V; Dzenis, Yuris A; Kazmi, Syed A Jaffar; Pemberton, Mark A; Pipinos, Iraklis I; Phillips, Nick Y; Herber, Kyle; Woodford, Thomas; Bowen, Robert E; Lomneth, Carol S; MacTaggart, Jason N

    2014-11-01

    The biomechanics of large- and medium-sized arteries influence the pathophysiology of arterial disease and the response to therapeutic interventions. However, a comprehensive comparative analysis of human arterial biaxial mechanical properties has not yet been reported. Planar biaxial extension was used to establish the passive mechanical properties of human thoracic (TA, [Formula: see text]) and abdominal (AA, [Formula: see text]) aorta, common carotid (CCA, [Formula: see text]), subclavian (SA, [Formula: see text]), renal (RA, [Formula: see text]) and common iliac (CIA, [Formula: see text]) arteries from 11 deceased subjects ([Formula: see text] years old). Histological evaluation determined the structure of each specimen. Experimental data were used to determine constitutive parameters for a structurally motivated nonlinear anisotropic constitutive model. All arteries demonstrated appreciable anisotropy and large nonlinear deformations. Most CCA, SA, TA, AA and CIA specimens were stiffer longitudinally, while most RAs were stiffer circumferentially. A switch in anisotropy was occasionally demonstrated for all arteries. The CCA was the most compliant, least anisotropic and least frequently diseased of all arteries, while the CIA and AA were the stiffest and the most diseased. The severity of atherosclerosis correlated with age, but was not affected by laterality. Elastin fibers in the aorta, SA and CCA were uniformly and mostly circumferentially distributed throughout the media, while in the RA and CIA, elastin was primarily axially aligned and concentrated in the external elastic lamina. Constitutive modeling provided good fits to the experimental data for most arteries. Biomechanical and architectural features of major arteries differ depending on location and functional environment. A better understanding of localized arterial mechanical properties may support the development of site-specific treatment modalities for arterial disease.

  2. [Subclavian vein puncture as a primary approach for pacemaker lead implantation].

    PubMed

    Kronski, D; Haas, H

    2001-12-01

    In the beginning of transvenous pacemaker therapy, the external or alternatively internal jugular vein was commonly used for lead implantation. Due to frequent long-term complications both approaches are nowadays obsolete. In most pacemaker centers implantation via the cephalic vein has become standard. As an alternative, in 1975 Sterz et al. introduced puncture of the subclavian vein in the Seldinger technique as an approach for lead implantation. At this time, the commonly used introducers of pacemaker leads had to be cut for removal. No earlier than 1980 "peel away" introducers were commercially available. Since then, we consequently use this technique for implantation of single or dual chamber pacemaker devices. In the course of the last seven years merely 1.5-2% of implantations were performed via the cephalic vein; no jugular vein approach was performed. Due to a routinely performed subclavian vein puncture, we were able to optimize the procedure, proven by an enormous reduction in implantation time (local anesthesia - skin closure), x-ray time and complication rate. In the year 2000 we performed 52 implantations of a single chamber device with an average fluoroscopy time of 1.5 (0.3-9.3) minutes, radiation dose of 4.5 (0.1-47) Gycm(2) and implantation time of 17.6 (8-40) minutes and 144 implantations of a dual chamber device with an average fluoroscopy time of 2.86 (0.7-6.6) minutes, radiation dose of 8.31 (0.7-28) Gycm(2) and implantation time of 21.25 (10-45) minutes. Complications were rare, clinically irrelevant arterial punctures. Neither nerval damage nor pneumothoraces with the necessity for chest tube placement were seen in the above mentioned time frame. No early or late thrombosis of the subclavian vein was encountered.    The primary subclavian vein approach led to an enormous reduction in overall procedure time without significant morbidity.

  3. Magnetic Resonance Angiography of Nonferromagnetic Iliac Artery Stents and Stent-Grafts: A Comparative Study in Sheep

    SciTech Connect

    Schuermann, Karl; Vorwerk, Dierk; Buecker, Arno; Neuerburg, Joerg; Grosskortenhaus, Stefanie; Haage, Patrick; Piroth, Werner; Hunter, David W.; Guenther, Rolf W.

    1999-09-15

    Purpose: To compare nonferromagnetic iliac artery prostheses in their suitability for patency monitoring with magnetic resonance angiography (MRA) using conventional angiography as a reference. Methods: In experiment 1, three Memotherm stents were inserted into the iliac arteries of each of six sheep: two 'tandem' stents on one side and a single stent on the other side. In experiment 2, four prostheses (normal and low-porosity Corvita stent-grafts, Memotherm, ZA-stent) were inserted in each of 11 sheep. Patency was monitored before and 1, 3, and 6 months after insertion with 3D phase-contrast and two 2D time-of-flight sequences (TOF-1: TR/TE = 18/6.9, TOF-2: 13/2.5) with and without contrast at 1.5 T. On 206 coronal MIP images (72 pre-, 134 post-stenting), three readers analyzed 824 iliac segments (206 x 4) for patency and artifacts. Results: There was no difference in the number of artifacts between tandem and single iliac Memotherm stents. The ZA-stent induced significantly fewer artifacts than the other prostheses (p < 0.00001). With MRA, patency of the ZA-stent was correctly diagnosed in 88% of cases, which was almost comparable to nonstented iliac segments (95%), patency of the Memotherm stent in 59%, and of the Corvita stent-grafts in 57% and 55%. The TOF-2 sequence with contrast yielded the best images. Conclusion: MRA compatibility of nonferromagnetic prostheses depends strongly on the design of the device. MRA may be used to monitor the patency of iliac ZA-stents, whereas iliac Memotherm stents and Corvita stent-grafts appear to be less suited for follow-up with MRA.

  4. Epidemiology of Blackberry yellow vein associated virus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Blackberry yellow vein disease is one of the most important diseases of blackberry in the United States. Several viruses are found associated with the symptomology but Blackberry yellow vein associated virus (BYVaV) appears to be the most prevalent of all, leading to the need for a better understand...

  5. Element transport in veins during serpentinization

    NASA Astrophysics Data System (ADS)

    Schwarzenbach, E. M.; Beard, J. S.; Caddick, M. J.

    2013-12-01

    Serpentinization of ultramafic rocks has wide ranging implications for the petrology, rheology, and petrophysical properties of the oceanic lithosphere. During hydration of the peridotite, fluid-rock ratios and temperature control mineral formation in the veins. We studied a partly serpentinized peridotite from the Santa Elena ophiolite complex in Costa Rica and tracked element mobility during water-rock interaction. Serpentinization of the studied harzburgite is around 30 to 40%, with serpentinization of olivine being more advanced than serpentinization of orthopyroxene. Element mapping and point analyses show that the veins preserve characteristic element distributions within orthopyroxene and olivine, and with distance to orthopyroxene-hosted serpentine veins. With increasing distance from the orthopyroxene the following vein assemblages were observed in olivine: pure serpentine veins, serpentine + brucite veins, serpentine + brucite + magnetite veins. Veins are enriched in SiO2 in the proximity of orthopyroxene suggesting that a net transfer of SiO2 takes place from serpentinizing orthopyroxene to olivine. The magnetite-bearing serpentine veins mostly consist of Mg-rich serpentine (Mg# = 90 - 95) and Fe-rich brucite (Mg# = 70 - 75) finely intergrown. In contrast, the center of these veins contains a thin zone of high-Mg serpentine (Mg# 97), and high-Mg brucite (Mg# 92 - 94) next to magnetite. We infer from thermodynamic calculations that these mineral assemblages are controlled by H2O activity and low SiO2 activities. Within orthopyroxene, serpentine (Mg# = 84 - 89) with an elevated Al2O3 content (< 4.14wt.%) was detected, but talc was absent, indicating net loss of SiO2 from orthopyroxene during serpentinization. CaO and Al2O3 migrate from orthopyroxene, but occur only as trace components in serpentine at > 100 μm and > 200 μm, respectively, from the orthopyroxene. We infer that brucite is not stable in close proximity to orthopyroxene due to elevated SiO2

  6. [Preduodenal portal vein (author's transl)].

    PubMed

    Tovar, J A; Benavent, M; Bachiller, C; Díez-Pardo, J A

    1978-01-01

    Three cases of preduodenal portal vein (PDPV) observed in newborns and young infants are reported. In two patients the diagnosis was made during operations for duodenal stenosis and in the remaining one while operating for midgut volvulus and necrosis. In no case was the PDPV responsible for the clinical picture but in all three patients it was accompanied by other causes of obstruction: annular pancreas, extrinsic adhesive bands and malrotation. In one case there was also an asplenia, and polisplenia was present in another one. Both had malrotation and some degree of abnormal visceral asimmetry. The incidence of associated malformations in 52 previously reported cases is analyzed, and the more convincing embriological explanation for this anomaly is commented upon.

  7. Assessment and management of patients with varicose veins.

    PubMed

    Allen, Louise

    Varicose veins are enlarged superficial veins found in the legs. This article explores the anatomy and physiology of the venous system to assist nurses to assess, manage and treat patients with varicose veins.

  8. The External Degree.

    ERIC Educational Resources Information Center

    Houle, Cyril O.

    This book examines the external degree in relation to the extremes of attitudes, myths, and data. Emphasis is placed on the emergence of the American external degree, foreign external-degree programs, the purpose of the external degree, the current scene, institutional issues, and problems of general policy. (MJM)

  9. Lung Pathology in Pediatric Pulmonary Vein Stenosis.

    PubMed

    Pogoriler, Jennifer E; Kulik, Thomas J; Casey, Alicia M; Baird, Christopher W; Mullen, Mary P; Jenkins, Kathy J; Vargas, Sara O

    2016-01-01

    Pulmonary vein stenosis is a rare progressive narrowing of the extrapulmonary pulmonary veins, presenting predominantly in infancy and virtually always lethal. It typically arises following repair of congenital heart disease, particularly anomalous pulmonary venous return. Histologic characterization of pediatric pulmonary vein stenosis, not previously well described, may provide insight into the disease pathobiology. We retrieved archival lung specimens (biopsy, explant, or autopsy) from patients with pediatric pulmonary vein stenosis. Medical records were reviewed. Microscopic examination included hematoxylin and eosin (H&E)-stained slides, and for a subset of patients, elastic, trichrome, smooth-muscle actin, and D2-40. Groups with different clinical disease features were compared using Fisher's exact test. A total of 33 patients (median age, 7 months) had available tissue and 52% had congenital heart disease; 18% were premature. Within the lungs, interlobular septal veins showed thickened muscular coats (in 58%), proliferation/tortuosity (in 6%), and fibromyxoid intimal proliferation (in 3%). Associated arterial hypertensive changes were seen in 30 (91%). The one patient with intrapulmonary venous fibromyxoid intimal proliferation was the only patient with apparent primary familial disease. Lymphangiectasia and arterial medial hypertrophy were histologic features that correlated with clinical grouping. We conclude that in pediatric pulmonary vein stenosis, intrapulmonary pulmonary veins commonly show muscular thickening, best interpreted as venous hypertensive remodeling. Fibromyxoid intimal proliferation resembling that of the extrapulmonary pulmonary veins is uncommon. Awareness of intrapulmonary features in various clinical subtypes of pulmonary vein stenosis may be diagnostically and therapeutically informative considering that current catheter-based and surgical therapy is directed at the extrapulmonary component of pulmonary vein stenosis.

  10. The viability of cells obtained using the Reamer-Irrigator-Aspirator system and in bone graft from the iliac crest.

    PubMed

    Uppal, H S; Peterson, B E; Misfeldt, M L; Della Rocca, G J; Volgas, D A; Murtha, Y M; Stannard, J P; Choma, T J; Crist, B D

    2013-09-01

    We hypothesised that cells obtained via a Reamer-Irrigator-Aspirator (RIA) system retain substantial osteogenic potential and are at least equivalent to graft harvested from the iliac crest. Graft was harvested using the RIA in 25 patients (mean age 37.6 years (18 to 68)) and from the iliac crest in 21 patients (mean age 44.6 years (24 to 78)), after which ≥ 1 g of bony particulate graft material was processed from each. Initial cell viability was assessed using Trypan blue exclusion, and initial fluorescence-activated cell sorting (FACS) analysis for cell lineage was performed. After culturing the cells, repeat FACS analysis for cell lineage was performed and enzyme-linked immunosorbent assay (ELISA) for osteocalcin, and Alizarin red staining to determine osteogenic potential. Cells obtained via RIA or from the iliac crest were viable and matured into mesenchymal stem cells, as shown by staining for the specific mesenchymal antigens CD90 and CD105. For samples from both RIA and the iliac crest there was a statistically significant increase in bone production (both p < 0.001), as demonstrated by osteocalcin production after induction. Medullary autograft cells harvested using RIA are viable and osteogenic. Cell viability and osteogenic potential were similar between bone grafts obtained from both the RIA system and the iliac crest.

  11. Bilateral Subclavian Vein Occlusion in a SAPHO Syndrome Patient Who Needed an Implantable Cardioverter Defibrillator.

    PubMed

    Ishizuka, Masato; Yamamoto, Yuko; Yamada, Shintaro; Maemura, Sonoko; Nakata, Ryo; Motozawa, Yoshihiro; Yamamoto, Keisuke; Takizawa, Masataka; Uozumi, Hiroki; Ikenouchi, Hiroshi

    2016-05-25

    A 79-year-old Asian man was hospitalized because of progressive exertional dyspnea with decreasing left ventricular ejection fraction and frequent non-sustained ventricular tachycardia. Pre-procedure venography for implantable cardioverter defibrillator (ICD) implantation showed occlusion of the bilateral subclavian veins. In consideration of subcutaneous humps in the sterno-clavicular area and palmoplantar pustulosis, we diagnosed him as having synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome and speculated that it induced peri-osteal chronic inflammation in the sterno-clavicular area, resulting in occlusion of the adjacent bilateral subclavian veins. An automatic external defibrillator (AED) was installed in the patient's house and total subcutaneous ICD was considered. Venous thrombosis in SAPHO syndrome is not frequent but has been reported. To the best of our knowledge, this is the first case of bilateral subclavian vein occlusion in a SAPHO syndrome patient who needs ICD implantation.

  12. Usefulness of laboratory data in the management of right iliac fossa pain in adults

    PubMed Central

    Ortega-Deballon, Pablo; Ruiz De Adana-Belbel, Juan C; Hernández-Matías, Alberto; García-Septiem, Javier; Moreno-Azcoita, Mariano

    2008-01-01

    Background Inflammatory markers could be helpful in the management of patients with right iliac fossa pain, but the heterogeneity of designs and results precludes a definitive conclusion. A retrospective analysis of prospectively collected data was performed to assess the usefulness of laboratory data in the management of these patients. Patients and methods Patients with right iliac fossa pain referred to the surgeon were included. Blood samples were obtained for C-reactive protein, leukocyte, and granulocyte analysis. Clinical, surgical, and histopathologic data were collected. Analysis of inflammatory parameters was performed with logistic regression and areas under the receiver operating characteristic curve were compared. Results One hundred thirty-four patients were included. C-reactive protein increased with the severity of appendicitis and predicted accurately perforation (r2 = 0.613; P < 0.0005), showing the highest accuracy among inflammatory markers (areas under the ROC curve were 0.846, 0.753 and 0.685 for C-reactive protein, leukocyte and granulocytes, respectively; P < 0.001). Accuracy improved when C-reactive protein and leukocytes were combined (positive and negative predictive values were 93.2 percent and 92.3 percent, respectively). Conclusions C-reactive protein is a helpful marker in the management of patients with right iliac fossa pain. It increases with the evolution of the inflammatory process. Its predictive values improve in combination with the leukocyte count. A patient with normal C-reactive protein and leukocytes has a very low probability of appendicitis and should not undergo surgery. PMID:18484138

  13. Sphingosine-1-phosphate receptor 3 promotes neointimal hyperplasia in mouse iliac-femoral arteries

    PubMed Central

    Shimizu, Takuya; De Wispelaere, Allison; Winkler, Martin; D’Souza, Travis; Caylor, Jacob; Chen, Lihua; Dastvan, Frank; Deou, Jessie; Cho, Aesim; Larena-Avellaneda, Axel; Reidy, Michael; Daum, Guenter

    2012-01-01

    Objective The objective of this study is to define a role for S1PR3 in intimal hyperplasia. Methods and Results A denudation model of the iliac-femoral artery in wild-type and S1PR3-null mice was used to define a role for S1PR3 in the arterial injury response because we found in humans and mice that expression of S1PR3 is higher in these arteries when compared to carotid arteries. At 28 days after surgery, wild-type arteries form significantly larger lesions than S1PR3-null arteries. BrdU labeling experiments demonstrate that upon injury, wild-type arteries exhibit higher medial as well as intimal proliferation than S1PR3-null arteries. Because S1PR3 expression in vitro is low, we expressed S1PR3 in S1PR3-null SMCs using retroviral-mediated gene transfer to study S1PR3 effects on cell functions and signaling. SMCs expressing S1PR3, but not vector-transfected controls, respond to S1P stimulation with activation of Rac, Erk and Akt. SMCs expressing S1PR3 also grow migrate more. Conclusion In humans and mice, S1PR3 expression is higher in iliac-femoral arteries compared to carotid arteries. S1PR3 promotes neointimal hyperplasia upon denudation of iliac-femoral arteries in mice, likely by stimulating cell migration and proliferation through activation of signaling pathways involving Erk, Akt and Rac. PMID:22308044

  14. The Use of Iliac Stem Prosthesis for Acetabular Defects following Resections for Periacetabular Tumors

    PubMed Central

    De Paolis, Massimiliano; Romagnoli, Carlo; Alì, Nikolin; Giannini, Sandro; Donati, Davide Maria

    2013-01-01

    Introduction. The management of pelvic tumors is a challenge for orthopaedic oncologists due to the complex anatomy of the pelvis and the need to have extensive exposure. Various reconstructive techniques have been proposed with poor functional results and a high percentage of complications. Our purpose is to determine the functional results and the rate of complications of iliac stem prosthesis for acetabular defects following resections for periacetabular tumors. Materials and Methods. Between 1999 and 2012, 45 patients underwent pelvic resections for periacetabular bone tumors followed by reconstruction with stem cup prosthesis. The most common diagnosis was CS (chondrosarcoma, 29 cases), followed by OS (osteosarcoma, 9 cases) and metastasis (3 cases). In 33 cases, this implant was associated with massive bone allografts. Minimum follow-up required to evaluate functional outcome was 2 years. We classified pelvic resections according to Enneking and Dunham's classification and we used MSTS (musculoskeletal tumor system) score to evaluate functional outcomes. Results and Discussion. Sixteen patients died of their disease, three were lost to follow-up, four are alive with disease, and twenty-two are alive with no evidence of disease. Fifteen patients had local recurrence. Sixteen patients had bone or lung metastasis. We have had 6 infections, 2 aseptic loosening, and 2 cases of hip dislocation. Iliac sovracetabular osteotomy was fused in all cases at 10 months from surgery. Functional results were good or excellent in 25 of 31 patients with long-term follow-up (77%), with a percentage similar to that reported in the literature. Conclusion. The use of iliac stem prosthesis is a simple reconstructive technique that reduces operative times and risk of infection. It allows having good results and low rate of complications, but it should be performed in selected cases and centres of reference. PMID:24250275

  15. Backfill for iliac-crest donor sites: a prospective, randomized study of coralline hydroxyapatite.

    PubMed

    Bojescul, John A; Polly, David W; Kuklo, Timothy R; Allen, Thomas W; Wieand, Kay E

    2005-08-01

    We report on a prospective randomized study of coralline hydroxyapatite (CH) used as backfill for iliac-crest donor sites. Autogenous iliac-crest bone graft is routinely harvested for spinal fusion. Donor-site morbidity is underappreciated; the presumption is that donor sites regenerate. In this study, we assessed the biological viability of the backfill CH (Pro OsteonTM Implant 500 Hydroxyapatite Bone Void Filler; Interpore, Irvine, Calif) and compared donor-site morbidity after harvest. Twelve patients (11 men, 1 woman) were enrolled: 5 in the backfill group and 7 in the no-backfill group. As part of routine evaluations done preoperatively and 6 weeks, 3 months, 6 months, and 1 year postoperatively, plain radiographs and computed tomography (CT) scans were used to assess bone ingrowth, and technetium bone scans were used to assess biological activity. Postoperative pain analysis was also done. Ten patients (9 men, 1 woman) completed the study. Of the 4 completers in the backfill group, 3 (75%) showed bony ingrowth on plain radiographs and CT scans at 1 year; the fourth patient showed bony ingrowth only on plain radiographs. All 4 patients showed biological activity on bone scans and reported mild pain to no pain. Of the 6 completers in the no-backfill group, 1 (17%) showed bony ingrowth on plain radiographs and CT scans. No patient showed biological activity on bone scans at 1 year. CH aids in iliac-crest healing after bone-graft harvesting by acting as a biological osteoconductive matrix. Postoperative pain at the bone-graft site is potentially reduced. More studies of larger numbers of patients are needed to assess the true long-term benefits of this material in a clinical setting.

  16. Temporary extracorporeal axillo-iliac vascular prosthesis shunt in open repair of a pararenal aortic aneurysm

    PubMed Central

    Dregelid, Einar

    2013-01-01

    INTRODUCTION When a long aortic clamp time is expected or when upper body to lower body collateral arteries are sparse, temporary lower body perfusion may be needed to reduce ischemic injury during supraceliac clamping in open repair of pararenal aortic aneurysms. The use of conventional extracorporeal perfusion techniques carry extra risks and is not in the armamentarium of most vascular surgeons. An axillo-femoral or -iliac shunt using a vascular prosthesis does not require the same degree of anticoagulation and causes less activation of blood components. PRESENTATION OF CASE A patient, who had extensive vascular stenotic disease and large bowel ischemia, was operated on for a pararenal aortic aneurysm while the lower body was perfused via a temporary extracorporeal vascular prosthesis axillo-iliac shunt. Copious backbleeding encountered while suturing the proximal anastomosis testified to the efficacy of the temporary shunt. A left hemicolectomy had to be performed for gangrene of the sigmoid colon and he needed 2 days of respiratory support; otherwise the postoperative course was uneventful. DISCUSSION In our case more ischemic injury than that observed might have been expected without the temporary bypass but significant backbleeding may have negated some of the beneficial effect of the shunt. CONCLUSION A temporary axillo-femoral or -iliac shunt prevents lower limb ischemia and provides an ample amount of collateral blood flow to the torso. It does not need to be buried subcutaneously as previously described. Occlusive balloons should be used where possible to prevent backbleeding and to further increase available collateral blood supply. PMID:23500740

  17. Personal authentication through dorsal hand vein patterns

    NASA Astrophysics Data System (ADS)

    Hsu, Chih-Bin; Hao, Shu-Sheng; Lee, Jen-Chun

    2011-08-01

    Biometric identification is an emerging technology that can solve security problems in our networked society. A reliable and robust personal verification approach using dorsal hand vein patterns is proposed in this paper. The characteristic of the approach needs less computational and memory requirements and has a higher recognition accuracy. In our work, the near-infrared charge-coupled device (CCD) camera is adopted as an input device for capturing dorsal hand vein images, it has the advantages of the low-cost and noncontact imaging. In the proposed approach, two finger-peaks are automatically selected as the datum points to define the region of interest (ROI) in the dorsal hand vein images. The modified two-directional two-dimensional principal component analysis, which performs an alternate two-dimensional PCA (2DPCA) in the column direction of images in the 2DPCA subspace, is proposed to exploit the correlation of vein features inside the ROI between images. The major advantage of the proposed method is that it requires fewer coefficients for efficient dorsal hand vein image representation and recognition. The experimental results on our large dorsal hand vein database show that the presented schema achieves promising performance (false reject rate: 0.97% and false acceptance rate: 0.05%) and is feasible for dorsal hand vein recognition.

  18. Atypical tryptamine receptors in sheep pulmonary vein.

    PubMed Central

    Eyre, P

    1975-01-01

    Both the pulmonary artery and vein of the sheep contracted dose-dependently to histamine, carbamoylcholine, prostaglandin F2a, noradrenaline and bradykinin and relaxed in the presence of isoprenaline or prostaglandin E1. 2 The effect of 5-hydroxytryptamine (5-HT) on the artery was consistently to produce dose-dependent contractions without tachyphylaxis. The effect on the vein was biphasic. 5HT 5 X 10(-10) to 5 X 10(-8) M relaxed the partially constricted vein. 5-HT 10(-7) to 10(-6) m caused brief venoconstriction followed by relaxation. 5-HT greater than 10(-6) M caused dose-related contraction of the vein. 3 Methysergide effectively blocked the contractile response of the artery to 5-HT, but only weakly inhibited the contractions of the vein (dose-ratio less than 20). 4 Each of ten antagonists tested failed to inhibit the 5-HT-induced relaxation of the vein. Sheep pulmonary vein possesses tryptamine receptors which mediate relaxation and which are not of the classicl M- or D-type. These receptors appear not to be involved directly or indirectly with responses to acetylcholine, catecholamines, histamine or prostaglandins. PMID:1203621

  19. Preduodenal portal vein in the adult.

    PubMed

    Papaziogas, T; Papaziogas, B; Paraskevas, G; Lazaridis, C; Patsas, A

    2000-09-01

    We present three cases of preduodenal portal vein in adult people, which were diagnosed in our department. All of them were identified during elective operation for cholelithiasis, caused some technical difficulties to the performance of the operation, but led to no major intraoperative or postoperative complications. None of them had any preoperative symptoms, which could be related to this anomaly. The preduodenal portal vein is a rare congenital anomaly, which is usually discovered in infants or children due to the obstruction of the duodenum. In adults, it is often asymptomatic, and is usually discovered as an accidental finding during laparotomy for other reason. The postcontrast CT can set the diagnosis, when this anomaly is suspected. Despite its rarity, this anomaly is of great surgical importance, because it can predispose to intraoperative complications including hemorrhage from the abnormal vein, or damage to the biliary tract or the distented duodenum. The anterior position of the portal vein results from the persistence of the ventral anastomosis between the two vitelline veins and the distal portion of the right vitelline vein, with subsequent atrophy of the cranial part of the left vitelline and dorsal anastomotic vein.

  20. Radiological features of azygous vein aneurysm.

    PubMed

    Choudhary, Arabinda Kumar; Moore, Michael

    2014-04-01

    Mediastinal masses are most commonly associated with malignancy. Azygous vein aneurysm is a very rare differential diagnosis of mediastinal mass. We report here three cases of azygous vein aneurysm including children and adult patients. In the pediatric patient it was further complicated by thrombosis and secondary pulmonary embolism. We describe the radiological features on CXR, MRI, CT, PET-CT, US and angiogram and their differential diagnosis. Imaging findings of continuity with azygous vein, layering of contrast medium on enhanced CT and dynamic MRA showing filling of the mass at the same time as the azygous vein without prior enhancement will be strongly suggestive of azygous vein aneurysm with transtracheal ultrasound being the definitive test in these patients. It is important to keep a vascular origin mass in the differential diagnosis of mediastinal masses. Also, in young healthy patients with pulmonary embolism, a vascular etiology such as azygous vein aneurysm should be carefully evaluated. This article will help the clinicians to learn about the imaging features of azygous vein aneurysm on different imaging modalities.

  1. Graft necrosis occurred after iliac crest reconstruction after mandibular segmental resection of ameloblastoma.

    PubMed

    Bulut, Emel; Bekçioğlu, Burak; Baş, Burcu; Özden, Bora; Çelebi, Nükhet; Çelenk, Peruze; Külünk, Şafak

    2013-03-01

    Ameloblastoma is an uncommon benign odontogenic neoplasm of the maxillofacial region constituting less than 1% of tumors of the oral cavity. Ameloblastomas have been categorized broadly into 3 biologic variants: cystic (unicystic), solid, and peripheral. Unicystic ameloblastoma is a rare and less aggressive variant of ameloblastoma. The aim of this report is to describe a case of cystic ameloblastoma treated with segmental resection and iliac graft reconstruction. The possible reasons of graft failure seen in our patient at the early stage of the healing were also discussed.

  2. Unusual Presentation of Hepatocellular Carcinoma into Right iliac fossa: A Rare Entity

    PubMed Central

    Periyasamy, Karthikumaran

    2015-01-01

    Hepatocellular carcinoma (HCC) is the most common primary malignant hepatic tumour. Hepatocellular carcinoma presenting itself or extending into the right iliac fossa (RIF) is a very rare entity. We report on a rare case of hepatocellular carcinoma in a 60-year-old lady, presented with a mobile mass in the lower abdomen without cirrhosis, with normal α-feto protein levels (AFP) or any known risk factors for liver disease. HCC in this case was unusual in its presentation both in the patient as well as a disease. PMID:26672490

  3. [Iliac aneurysm rupture during preconditioning with levosimendan for coronary artery bypass graft].

    PubMed

    Román Fernández, A; López Álvarez, A; Corujeira Rivera, M C; Vilanova Vázquez, V; Carregal Rañó, A; Pereira Loureiro, M Á

    2014-03-01

    We present the case of a 77 year-old patient scheduled for coronary artery bypass. During the infusion of levosimendan as preconditioning for surgery, a rupture of right common iliac artery occurred. Surgery was delayed and an urgent aorto-bifemoral bypass was performed. We believe that the rupture of the artery was triggered by an increase in transmural pressure due to the inotropic effects of levosimendan in a dilated diseased vessel. To our knowledge, there are no cases of aneurysm rupture as a complication during levosimendan infusion, but the coincidence of events in time strongly suggests some kind of causal relationship.

  4. Dissection of left iliac artery during anterior lumbar interspace fusion: Report of a case.

    PubMed

    Fischer, Uwe M; Davies, Mark G; El Sayed, Hosam

    2015-04-01

    Vascular injury is an uncommon complication of spine surgery. Among the different approaches, anterior lumbar interbody fusion has increased potential for vascular injuries, since the great vessels and their branches overly the disc spaces to be operated on, and retraction of these vessels is necessary to gain adequate surgical exposure. The reported incidence for anterior lumbar interbody fusion-associated vascular injuries ranges from 0% to 18.1%, with venous laceration as the most common type. We report a case of anterior lumbar interbody fusion-associated left common iliac artery dissection leading to delayed acute limb ischemia developing in early post-operative period.

  5. [Iliac artery occlusion balloons for suspected placenta accreta during cesarean section].

    PubMed

    Burgos Frías, N; Gredilla, E; Guasch, E; Gilsanz, F

    2014-02-01

    Massive obstetric hemorrhage still remains a major cause of maternal mortality and morbidity. The risk factors associated with this pathology must be identified in order to schedule the appropriate delivery with the necessary resources. A case is presented of an iliac artery occlusion with intravascular balloons for suspected placenta accreta during cesarean section. The perioperative treatment, as well as an analysis of the treatment options is described, along with their advantages and disadvantages, from the use of postpartum hemorrhage protocols, blood transfusion and procoagulant factors, and other maneuvers to control bleeding, until the hysterectomy.

  6. Deep Circumflex Iliac Artery-Related Hemoperitoneum Formation After Surgical Drain Placement: Successful Transcatheter Embolization

    SciTech Connect

    Park, Sang Woo; Chang, Seong-Hwan Yun, Ik Jin; Lee, Hae Won

    2010-04-15

    A 53-year-old woman with liver cirrhosis and hepatocellular carcinoma underwent living donor liver transplantation. After transplantation, her hemoglobin and hematocrit levels decreased to 6.3 g/dl and 18.5%, respectively, during the course of 3 days. A contrast-enhanced abdominal computed axial tomography (CAT) scan showed a hemoperitoneum in the right perihepatic space with no evidence of abdominal wall hematoma or pseudoaneurysm formation. An angiogram of the deep circumflex iliac artery (DCIA) showed extravasation of contrast media along the surgical drain, which had been inserted during the transplantation procedure. Transcatheter embolization of the branches of the DCIA was successfully performed using N-butyl cyanoacrylate.

  7. Successful Recanalization of a Longstanding Right Common Iliac Artery Occlusion with a Radiofrequency Guidewire

    SciTech Connect

    Tapping, C. R.; Uri, I. F.; Dixon, S.; Bratby, M. J.; Anthony, S.; Uberoi, R.

    2012-10-15

    We describe a case of successful recanalization of a longstanding right common iliac occlusion with a radiofrequency (RF) guidewire. The patient had been symptomatic with claudication for 3 years, and a preliminary attempt to cross the lesion using conventional techniques proved unsuccessful. Using low and medium intensity RF pulses and a PowerWire, a tract through the occlusion was established, which allowed subsequent stenting with an excellent angiographic result and a good immediate clinical response. We propose this as a useful technique in the peripheral arterial system for occlusive lesions not amenable to traditional recanalization techniques.

  8. A Reappraisal of Saphenous Vein Grafting

    PubMed Central

    Yuan, Shi-Min; Jing, Hua

    2011-01-01

    Autologous saphenous vein grafting has been broadly used as a bypass conduit, interposition graft, and patch graft in a variety of operations in cardiac, thoracic, neurovascular, general vascular, vascular access, and urology surgeries, since they are superior to prosthetic veins. Modified saphenous vein grafts (SVG), including spiral and cylindrical grafts, and vein cuffs or patches, are employed in vascular revascularization to satisfy the large size of the receipt vessels or to obtain a better patency. A loop SVG helps flap survival in a muscle flap transfer in plastic and reconstructive surgery. For dialysis or transfusion purposes, a straight or loop arteriovenous fistula created in the forearm or the thigh with an SVG has acceptable patency. The saphenous vein has even been used as a stent cover to minimize the potential complications of standard angioplasty technique. However, the use of saphenous vein grafting is now largely diminished in treating cerebrovascular disorders, superior vena cava syndrome, and visceral revascularization due to the introduction of angioplasty and stenting techniques. The SVG remains the preferable biomaterial in coronary artery bypass, coronary ostioplasty, free flap transfer, and surgical treatment of Peyronie disease. Implications associated with saphenous vein grafting in vascular access surgery for the purpose of dialysis and chemotherapy are considerable. Vascular cuffs and patches have been developed as an important and effective means of enhancing the patency rates of the grafts by linking the synthetic material to the receipt vessel. In addition, saphenous veins can be a cell source for tissue engineering. We review the versatile roles that saphenous vein grafting has played as well as its current status in therapy. PMID:21245602

  9. Liquid chromatography-tandem mass spectrometry analysis of human adrenal vein corticosteroids before and after ACTH stimulation

    PubMed Central

    Nakamura, Yasuhiro; Rege, Juilee; Satoh, Fumitoshi; Morimoto, Ryo; Kennedy, Michael R; Ahlem, Clarence N; Honma, Seijiro; Sasano, Hironobu; Rainey, William E

    2014-01-01

    Context Although steroid hormones produced by the adrenal gland play critical roles in human physiology, a detailed quantitative analysis of the steroid products has not been reported. The current study uses a single methodology (liquid chromatography-tandem mass spectrometry, LC-MS/MS) to quantify ten corticosteroids in adrenal vein (AV) samples pre and post adrenocorticotropic hormone (ACTH) stimulation. Design/methods Three men and six women with a diagnosis of an adrenal aldosterone-producing adenoma (APA) were included in the study. Serum was collected from the iliac vein (IV) and the adrenal vein (AV) contralateral to the diseased adrenal. Samples were collected, before and after administration of ACTH. LC-MS/MS was then used to quantify serum concentrations of unconjugated corticosteroids and their precursors. Results Prior to ACTH stimulation the four most abundant steroids in AV were cortisol (90%), cortisone (4%), corticosterone (3%) and 11-deoxycortisol (0.8%). Post ACTH administration, cortisol remained the major adrenal product (79%), however, corticosterone became the second most abundantly produced adrenal steroid (11%) followed by pregnenolone (2.5%) and 17α-hydroxypregnenolone (2%). ACTH significantly increased the absolute adrenal output of all ten corticosteroids measured (P<0.05). The four largest post ACTH increases were pregnenolone (300-fold), progesterone (199-fold), 17α-hydroxypregnenolone (187-fold) and deoxycorticosterone (82-fold). Conclusion Using LC-MS/MS we successfully measured 10 corticosteroids in peripheral and adrenal vein serum samples under pre and post ACTH stimulation. This study demonstrates the primary adrenal steroid products and their response to ACTH. PMID:22150161

  10. Ultrasound strain elastography in assessment of cortical mechanical behavior in acute renal vein occlusion: in vivo animal model.

    PubMed

    Gao, Jing; He, Wen; Cheng, Ling-Gang; Li, Xiao-Ya; Zhang, Xiou-Ru; Juluru, Krishna; Al Khori, Noor; Coya, Adrienne; Min, Robert

    2015-01-01

    To assess the correlation of quantitative ultrasound strain parameters with the severity of cortical edema in renal vein occlusion, we prospectively performed ultrasound strain elastography on a canine acute renal vein occlusion model prior to and following 10, 20, and 40min of renal vein ligation. Strain and strain relaxation time representing the deformation and relaxation of the renal cortices and reference soft tissue were produced by the external compression with the ultrasound transducer and estimated using commercially available 2-D speckle tracking software. Cortical thickness was additionally measured. Repeated-measures analysis of variance was used to examine the difference in cortical thickness, strain ratio (mean cortical strain divided by mean reference tissue strain), and strain relaxation time ratio (cortical relaxation time divided by reference tissue relaxation time) prior to and after renal vein ligation. Pearson's correlation coefficient was applied to test the relationship between strain parameters and the time of the renal vein ligation. There was a strong positive correlation between the duration of renal vein ligation and strain (R(2)=0.97) and strain relaxation time (R(2)=0.98) ratios. Significant differences in strain and strain relaxation time ratios were found at all measured timepoints (all P≪.001). Cortical thickness, however, showed no significant difference between timepoints (P=.065). Our result suggest that strain and strain relaxation time ratios may be used as quantitative markers for the assessment of the renal cortical mechanical behavior in subclinical acute renal vein occlusion.

  11. Arteriovenous fistula of the superior gluteal artery as a complication of posterior iliac crest bone graft harvesting: 3D-CT angiography and arterial embolization

    PubMed Central

    Kong, Chae-Gwan; Won, Yoo-Dong; Riew, K. Daniel

    2009-01-01

    Superior gluteal artery injuries are rare, but potentially serious complications that occur during posterior iliac crest bone graft harvesting. The authors reported an arteriovenous fistula of the superior gluteal artery, which occurred as a complication during posterior iliac crest bone graft harvesting and was diagnosed with 3D-CT angiography, then treated with arterial embolization. PMID:19294431

  12. Progression of Thrombus in Portal Vein, Superior Mesenteric Vein, and Splenic Vein Even on Anticoagulation in a Patient with Ascending Colonic Malignancy with Liver Metastasis: Portal Vein Thrombosis versus Portal Vein Tumor Thrombosis.

    PubMed

    Sule, Ashish; Borja, Annamarie; Chin, Tay Jam

    2016-12-01

    Portal vein thrombosis (PVT) in a setting of liver metastasis is not easy to treat as it may be portal vein tumor thrombus (PVTT). A 77-year-old male patient was diagnosed as ascending colon carcinoma, underwent right hemicolectomy in 1991 with a recurrence in July 2009. In August 2009, he underwent computed tomography (CT) scan of the abdomen which showed evidence of superior mesenteric vein thrombosis with no liver metastasis. He was started with anticoagulation and decision was to treat long term. He was admitted with mesenteric artery ischemic symptoms in February 2012 on anticoagulation. CT scan abdomen and pelvis in February 2012 showed tumor thrombus involving the superior mesenteric vein, portal vein, and splenic vein with hepatic metastasis. His tumor marker chorioembryonic antigen was 34 µg/L. He was continued on anticoagulation. A repeat CT scan abdomen after 2 years (in January 2014) showed, increase in size of hepatic metastasis, extensive thrombus involving the superior mesenteric vein, portal vein, and splenic vein with collaterals. Mesentery was congested due to extensive superior mesenteric vein thrombus. He finally succumbed in June 2014. It is very important to differentiate PVT from PVTT as the prognosis is different. PVTT progresses despite of long-term anticoagulation with poor prognosis.

  13. A rare cause of ureteral injuries; simultaneous common iliac artery and ureter injury during posterior lumbar disc surgery

    PubMed Central

    Başer, Aykut; Alkış, Okan; Toktaş, Cihan; Zümrütbaş, Ali Ersin

    2016-01-01

    Major vascular injuries during lumbar disc surgery are rare but well-recognized complications. However, vascular injuries of the branches of the aorta and ureteral injuries are very rare. Although its incidence is not known definitely, it is estimated to be 1/1000. Ureteral injuries comprise less than 1% of all genitourinary traumas. In this article, we report clinical progress of a patient who had simultaneous internal iliac artery and ureteral injury during lumbar discectomy. The patient was managed with primary ureteroureterostomy. To our knowledge, this is the first case reported with simultaneous ureter and iliac artery trauma during lumbar disc surgery. PMID:27274898

  14. Covered stent in the superior gluteal artery in a hybrid approach to treat internal iliac artery aneurysm: a technical note.

    PubMed

    Noël-Lamy, Maxime; Teng Tan, Kong; Lindsay, Thomas

    2015-07-01

    This brief report describes a hybrid endovascular and open procedure to treat internal iliac artery (IIA) aneurysms and preserve pelvic blood flow. A covered stent was deployed before surgery in the superior gluteal artery, extending across the IIA aneurysm, with the proximal end in the common iliac artery lumen. During open aortoiliac aneurysm repair, the stent graft was anastomosed in an end-to-side manner to the surgical graft. Four aneurysms were treated in 3 patients. Technical success was achieved in all cases. There were no complications or repeat interventions. Stents were all patent at imaging follow-up (range, 6-25 mo). Patients were free from buttock claudication.

  15. Spontaneous ruptured dissection of the right common iliac artery in a patient with classic Ehlers-Danlos syndrome phenotype.

    PubMed

    Gaines, Rick; Tinkle, Brad T; Halandras, Pegge M; Al-Nouri, Omar; Crisostomo, Paul; Cho, Jae S

    2015-04-01

    Unlike vascular Ehlers-Danlos syndrome (EDS), classic EDS is rarely associated with vascular manifestation. We report the case of a 39-year-old man who presented with acute abdominal pain. At the time of presentation, the patient was in hypovolemic shock, and computed tomography angiogram demonstrated common iliac artery dissection with rupture. He underwent an attempted endovascular repair that was converted to an open repair of a ruptured right common iliac artery dissection. Subsequent genetic testing revealed a substitution of arginine for cysteine in type I collagen, COL1A1 exon 14 c.934C>T mutation, consistent with a rare variant of classic EDS.

  16. Who Is at Risk for Varicose Veins?

    MedlinePlus

    ... better within 3 to 12 months of delivery. Overweight or Obesity Being overweight or obese can put extra pressure on your ... lead to varicose veins. For more information about overweight and obesity, go to the Health Topics Overweight ...

  17. Varicose veins - what to ask your doctor

    MedlinePlus

    ... what to ask your doctor References Goldman MP, Weiss RA. Phleblogy and treatment of leg veins. In: ... and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the ...

  18. [Retinal vein occlusion in a young patient].

    PubMed

    Zemba, Mihail; Ochinciuc, Uliana; Sarbu, Laura; Avram, Corina; Camburu, Raluca; Stamate, Alina

    2013-01-01

    We present a case report of a 27 years old pacient with central retinal vein occlussion and macular edema. The pacient has a significant reduction of the macular aedema with complete recovery of vision after the treatment.

  19. Intraarterial Pressure Gradients After Randomized Angioplasty or Stenting of Iliac Artery Lesions

    SciTech Connect

    Tetteroo, Eric; Haaring, Cees; Graaf, Yolanda van der; Schaik, Jan P.J. van; Engelen, A.D. van; Mali, Willem P.T.M.

    1996-11-15

    Purpose: To determine initial technical results of percutaneous transluminal angioplasty (PTA) and stent procedures in the iliac artery, mean intraarterial pressure gradients were recorded before and after each procedure. Methods: We randomly assigned 213 patients with typical intermittent claudication to primary stent placement (n= 107) or primary PTA (n= 106), with subsequent stenting in the case of a residual mean pressure gradient of > 10 mmHg (n= 45). Eligibility criteria included angiographic iliac artery stenosis (> 50% diameter reduction) and/or a peak systolic velocity ratio > 2.5 on duplex examination. Mean intraarterial pressures were simultaneously recorded above and below the lesion, at rest and also during vasodilatation in the case of a resting gradient {<=} 10 mmHg. Results: Pressure gradients in the primary stent group were 14.9 {+-} 10.4 mmHg before and 2.9 {+-} 3.5 mmHg after stenting. Pressure gradients in the primary PTA group were 17.3 {+-} 11.3 mmHg pre-PTA, 4.2 {+-} 5.4 mmHg post-PTA, and 2.5 {+-} 2.8 mmHg after selective stenting. Compared with primary stent placement, PTA plus selective stent placement avoided application of a stent in 63% (86/137) of cases, resulting in a considerable cost saving. Conclusion: Technical results of primary stenting and PTA plus selective stenting are similar in terms of residual pressure gradients.

  20. One Year Experience of Iliac Bifurcated Device for Aortoiliac Aneurysm in a Korean Single Center

    PubMed Central

    Kim, Moon Hwan; Park, Keun-Myoung; Jeon, Yong Sun; Cho, Soon Gu; Hong, Kee Chun; Shin, Woo Young; Choe, Yun-Mee; Shin, Seok-Hwan; Kim, Kyung Rae

    2015-01-01

    One of the predominant methods for preserving the internal iliac artery (IIA) in aortoiliac aneurysms is to use an iliac bifurcated device (IBD). However, there are a few limitations to the use of IBD in Korea. Our study aims to present the technical aspects of these devices, and to provide a mid-term analysis of IBD. Since 2013, 4 IBDs were used in 4 patients, with a mean follow-up of 14 months (range, 6–22 months). A 100% technical success rate was achieved without mortality and morbidity in our cases. The mean procedural time was 176 min (range, 145–240 min), and the mean contrast dose used was 184 mL (range, 135–220 mL). Type I or III endoleaks and postoperative expansion of the aneurysms weren't observed. Our cases demonstrates that IBD is a relatively safe repair method of aortoiliac aneurysms with preservation of the IIAs. However, a longer follow-up is needed to review the midterm results. PMID:26719840

  1. Reperfusion and Compartment Syndrome After Flexible Ureteroscopy in a Patient with an Iliac Vascular Graft

    PubMed Central

    Emiliani, Esteban; Talso, Michele; Beltrán-Suárez, Edgar; Doizi, Steeve

    2016-01-01

    Abstract Background: Flexible ureteroscopy (fURS) is one of the main treatment options for urolithiasis less than 2 cm. Although fURS has no relative contraindication, some anatomical factors may need to be considered, as not all patients are suitable for the regular lithotomy position (LP). We report the case of a patient with a right iliac vascular graft that after an fURS without intraoperative incidences developed a reperfusion syndrome of the right lower limb. Case Presentation: A 46-year-old male patient was referred for treatment and follow-up in the cystinuric clinic after being found to have a 3 cm pelvic stone with a Double-J catheter in place after two failed sessions of shockwave lithotripsy. The patient was placed in the LP and a standard ureteroscopy was done with no intraoperative complications. During the first hour in the recovery room, the patient developed severe pain in the right calf muscle stiffness, edema, and increased volume. A postreperfusion and compartment syndrome diagnosis was made with emergency fasciotomy. Conclusion: To perform fURS, each case must be assessed individually. If a patient with an iliac vascular graft has to undergo fURS, the patient positioning must be modified by keeping the ipsilateral (or both) legs straight to avoid graft complications. PMID:27872901

  2. Comparison of the trabecular and cortical tissue moduli from human iliac crests.

    PubMed

    Kuhn, J L; Goldstein, S A; Choi, K; London, M; Feldkamp, L A; Matthews, L S

    1989-01-01

    The purpose of this study was to design a method to produce and test mechanically microspecimens of trabecular and cortical tissue from human iliac crests, and compare their measured moduli. Rectangular beam specimens were prepared on a low-speed diamond blade saw and a miniature milling machine. The final specimen dimensions ranged from approximately 50-200 microns for base and height. The modulus of each specimen was measured using three-point bending tests across a span length of 1.04 mm and performed at a constant rate of displacement. A subset of specimens was recovered for a radiographic estimation of degree of mineralization. The results showed the mean trabecular tissue modulus of all iliac crest specimens to be 3.81 GPa, whereas cortical tissue specimens averaged 4.89 GPa. This was a significant difference according to a two-way analysis of variance that controlled for differences between donors. No strong correlations were found between modulus and mineral density. Future investigations that consider other microstructural characteristics and their contributions to modulus, and specimen size effects, are indicated.

  3. Assessment of a Polyester-Covered Nitinol Stent in the Canine Aorta and Iliac Arteries

    SciTech Connect

    Castaneda, Flavio; Ball-Kell, Susan M.; Young, Kate; Li Ruizong

    2000-09-15

    Purpose: To evaluate the patency and healing characteristics of a woven polyester fabric-covered stent in the canine model.Methods: Twenty-four self-expanding covered stents were placed in the infrarenal aorta and bilateral common iliac arteries of eight dogs and evaluated at 1 (n = 2), 3 (n = 2), and 6 (n = 4) months. Stent assessment was done using angiography prior to euthanasia, and light and scanning electron microscopy.Results: Angiographically, just prior to euthanasia, 8 of 8 aortic and 14 of 16 iliac endovascular covered stents were patent. Histologically, the stented regions showed complete endothelialization 6 months after graft implantation. A neointima had formed inside the stented vessel regions resulting in complete encasement of the fabric-covered stent by 3 months after graft implantation. Medial compression with smooth muscle cell atrophy was present in all stented regions. Explanted stent wires, examined by scanning electron microscopy, showed pitting but no cracks or breakage.Conclusion: The covered stent demonstrated predictable healing and is effective in preventing stenosis in vessels 10.0 mm or greater in diameter but does not completely preclude stenosis in vessels 6.0 mm or less in diameter.

  4. Trace elements in the wall of abdominal aortic aneurysms with and without coexisting iliac artery aneurysms.

    PubMed

    Ziaja, Damian; Chudek, Jerzy; Sznapka, Mariola; Kita, Andrzej; Biolik, Grzegorz; Sieroń-Stołtny, Karolina; Pawlicki, Krzysztof; Domalik, Jolanta; Ziaja, Krzysztof

    2015-06-01

    Iliac artery aneurysms (IAA) and abdominal aortic aneurysms (AAA) frequently coexist. It remains unknown whether the content of trace elements in AAA walls depends on the coexistence of IAAs. The aim of this study was to compare the content of selected trace elements in AAA walls depending on the coexistence of IAAs. The content of trace elements was assessed in samples of AAA walls harvested intraoperatively in 19 consecutive patients. In the studied group, coexisting IAAs were diagnosed in 11 out of the 19 patients with AAA. The coexistence of IAAs was associated with a slightly lower content of nickel (0.28 (0.15-0.40) vs. 0.32 (0-0.85) mg/g; p = 0.09) and a significantly higher content of cadmium (0.71 (0.26-1.17) vs. 0.25 (0.20-0.31) mg/g; p = 0.04) in AAA walls. The levels of the remaining studied elements, copper, zinc, manganese, magnesium and calcium, were comparable. The elevated levels of cadmium in the walls of AAA coexisting with IAAs may suggest an impact of the accumulation of this trace element on the greater damage of the iliac artery wall.

  5. Bifurcated Endograft (Excluder) in the Treatment of Isolated Iliac Artery Aneurysm: Preliminary Report

    SciTech Connect

    Zander, Tobias Baldi, Sebastian; Rabellino, Martin; Kirsch, David; Llorens, Rafael; Zerolo, Ignacio; Qian, Zhong; Maynar, Manuel

    2009-09-15

    The aim of this study was to evaluate the effectiveness of endovascular repair in the treatment of isolated iliac artery aneurysm (IAA) using Excluder bifurcated endograft. Eight consecutive patients with IAA were treated during a period of 45 months using Excluder bifurcated endograft. Two patients presented with isolated IAA rupture and were treated emergently, whereas the other six patients underwent elective treatment. All aneurysms lacked sufficient proximal necks and therefore were not suitable for tubular-shaped endograft. Follow-up imaging was performed at 1 week, at every 3 months during the first year, semiannually until 2 years, and annually afterward using angio-computed axial tomography and plain films. Technical success was achieved in all patients. No mortality was seen despite two patients having IAA rupture. Follow-up (12 to 60 months) was done in all but one patient. During this period, complications were observed in three patients. One patient developed sexual impotence at 3-month follow up; one patient presented unilateral gluteal claudication after the procedure, which resolved at 3 months; and one patient developed a graft porosity-related endoleak, which was successfully managed with placement of an additional ipsilateral iliac extension. Endovascular treatment of isolated IAA using bifurcated endograft is safe and can be an alternative to surgical treatment. The benefits from decreased morbidity and mortality of endoluminal treatment of isolated IAA using bifurcated endograft outweigh the minor complications associated with this technique, which are mostly related to occlusion of hypogastric arteries.

  6. Percutaneous Treatment of Iliac Aneurysms and Pseudoaneurysms with Cragg Endopro System 1 Stent-Grafts

    SciTech Connect

    Gasparini, Daniele; Lovaria, Andrea; Saccheri, Silvia; Nicolini, Antonio; Favini, Giorgio; Inglese, Luigi; Giorgetti, Pier Luigi; Basadonna, Pier Tommaso

    1997-09-15

    Purpose: To evaluate the feasibility and short-term follow-up results of treating iliac aneurysms by the Cragg Endopro System 1 stent-graft. Methods: Nine lesions (two pseudoaneurysms and seven atherosclerotic aneurysms) were treated in eight patients by percutaneous implantation of a total of 10 stent-grafts. The procedure was followed by anticoagulation with heparin for 6 days, then antiplatelet therapy. Follow-up was by color Doppler ultrasound scan at 2 days and 3 months after the procedure for all patients, and by venous digital subtraction angiography and/or angio-CT up to 12 months later for four patients. Results: Initial clinical success rate was 100% and there were two minor complications. In one case the delivery system was faulty resulting in failure to deploy the stent-graft. An additional device had to be used. At 3-12 months all prostheses were patent but one patient (12.5%) had a minimal pergraft leak. Conclusion: Percutaneous stent-grafting with this device is a safe and efficacious treatment of iliac artery aneurysms.

  7. Gout in the spine and sacri-iliac joints: radiological manifestations

    SciTech Connect

    Jajic, I.

    1982-06-01

    It is well known that deposits of urates in soft tissues occur commonly in gout, particularly in para-articular areas and in articular cartilages of the limbs. Involvement of the spine and sacro-iliac joints by such deposits, however, has been regarded as being relatively unusual and has attracted little attention in the literature. As we were impressed by the frequency of episodes of acute back pain in our patients with gouty arthritis, established definitely on clinical and biochemical grounds, we undertook a radiological investigation of the spine and sacro-iliac joints in a series of 54 subjects. It was suspected that their episodes of pain were clinical manifestations of gout, and 12 of the group had suffered one or more attacks. Of these 12 subjects, eight were found to have radiological abnormalities. In six subjects, evidence of sacro-iliitis was demonstrated, which is comparable to the report of Resnick and Reinke (8), and in two patients vertebral lesions corresponded to those described by Jaffe (5). Hyperostotic spondylosis was present in no fewer than 29 of the series. Although lacking histological confirmation of the lesions demonstrated radiologically, we believe that our suspicions have been confirmed.

  8. Posterior iliac offset: description of a new radiological measurement of sacroiliac joint instability.

    PubMed

    Tonne, B M; Kempton, L B; Lack, W D; Karunakar, M A

    2014-11-01

    The purpose of this study was to describe the radiological characteristics of a previously unreported finding: posterior iliac offset at the sacroiliac joint and to assess its association with pelvic instability as measured by initial displacement and early implant loosening or failure. Radiographs from 42 consecutive patients with a mean age of 42 years (18 to 77; 38 men, four women) and mean follow-up of 38 months (3 to 96) with Anteroposterior Compression II injuries, were retrospectively reviewed. Standardised measurements were recorded for the extent of any diastasis of the pubic symphysis, widening of the sacroiliac joint, static vertical ramus offset and a novel measurement (posterior offset of the ilium at the sacroiliac joint identified on axial CT scan). Pelvic fractures with posterior iliac offset exhibited greater levels of initial displacement of the anterior pelvis (anterior sacroiliac widening, pubic symphysis diastasis and static vertical ramus offset, p < 0.001,0.034 and 0.028, respectively). Pelvic fractures with posterior ilium offset also demonstrated higher rates of implant loosening regardless of fixation method (p = 0.05). Posterior offset of the ilium was found to be a reliable and reproducible measurement with substantial inter-observer agreement (kappa = 0.70). Posterior offset of the ilium on axial CT scan is associated with greater levels of initial pelvic displacement and early implant loosening.

  9. Primary leiomyosarcoma of the innominate vein.

    PubMed

    Illuminati, Giulio; Miraldi, Fabio; Mazzesi, Giuseppe; D'urso, Antonio; Ceccanei, Gianluca; Bezzi, Marcello

    2007-01-01

    Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotomy prolonged into left cervicotomy. Primary venous sarcomas may be associated with prolonged survival in individual cases, with curative resection recommended as the standard treatment, in the absence of distant spread.

  10. Renal Vein Injury During Percutaneous Nephrolithotomy Procedure

    PubMed Central

    Toffeq, Hewa Mahmood

    2016-01-01

    Abstract Background: Percutaneous nephrostolithotomy is an important approach for removing kidney stones. Puncturing and dilatation are two mandatory steps in percutaneous nephrolithotomy (PCNL). Uncommonly, during dilatation, the dilators can cause direct injury to the main renal vein or to their tributaries. Case Presentation: A 75-year-old female underwent PCNL for partial staghorn stone in the left kidney. During puncturing and dilatation, renal vein tributary was injured, and the nephroscope entered the renal vein and inferior vena cava, which was clearly recognized. Injection of contrast material through the nephroscope confirms the false pathway to the great veins (renal vein and inferior vena cava). Bleeding was controlled intraoperatively by applying Amplatz sheath over the abnormal tract, the procedure was continued and stones were removed. At the end of the procedure, a Foley catheter was used as a nephrostomy tube and its balloon was inflated inside the renal pelvis and pulled back with light pressure to the lower calix, which was the site of injury to the renal vein tributaries, then the nephrostomy tube was closed; by this we effectively controlled the bleeding. The patient remained hemodynamically stable; antegrade pyelography was done on the second postoperative day, there was distally patent ureter with no extravasation, neither contrast leak to renal vein, and was discharged home at third postoperative day. After 2 weeks, the nephrostomy tube was gradually removed in the operative room, without bleeding, on the next day, Double-J stent was removed. Conclusion: Direct injury and false tract to the renal vein tributaries during PCNL can result in massive hemorrhage, and can be treated conservatively in hemodynamically stable patients, using a nephrostomy catheter as a tamponade. PMID:27704054

  11. Isolated inferior mesenteric portal hypertension with giant inferior mesenteric vein and anomalous inferior mesenteric vein insertion

    PubMed Central

    Prasad, G. Raghavendra; Billa, Srikar; Bhandari, Pavaneel; Hussain, Aijaz

    2013-01-01

    Extrahepatic portal hypertension is not an uncommon disease in childhood, but isolated inferior mesenteric portal varices and lower gastrointestinal (GI) bleed have not been reported till date. A 4-year-old girl presented with lower GI bleed. Surgical exploration revealed extrahepatic portal vein obstruction with giant inferior mesenteric vein and colonic varices. Inferior mesenteric vein was joining the superior mesenteric vein. The child was treated successfully with inferior mesenteric – inferior vena caval anastomosis. The child was relieved of GI bleed during the follow-up. PMID:23798814

  12. Improvements of deep vein reflux following radiofrequency ablation for saphenous vein incompetence.

    PubMed

    Kim, Suh Min; Jung, In Mok; Chung, Jung Kee

    2017-02-01

    Objectives The aim of this study was to describe the changes of deep vein reflux after radiofrequency ablation for great saphenous vein incompetence. Method The data on 139 limbs which were treated with radiofrequency ablation for great saphenous vein incompetence were prospectively collected and reviewed. Results Deep vein reflux was present in 43 of 139 limbs (30.9%). There were no significant differences in the rate of successful closure, the incidence of procedure-related complications, and the improvements of symptoms and quality of life between the limbs with or without deep vein reflux. With a mean follow-up of 5.9 months, the peak reflux velocity and duration of reflux were improved in all limbs with deep vein reflux and it was completely corrected in 13 limbs (30.2%) after radiofrequency ablation. Conclusions The presence of deep vein reflux does not affect the treatment outcomes of radiofrequency ablation for great saphenous vein incompetence and is improved in all patients. Deep vein reflux is not a barrier to performing radiofrequency ablation.

  13. Veins improve fracture toughness of insect wings.

    PubMed

    Dirks, Jan-Henning; Taylor, David

    2012-01-01

    During the lifetime of a flying insect, its wings are subjected to mechanical forces and deformations for millions of cycles. Defects in the micrometre thin membranes or veins may reduce the insect's flight performance. How do insects prevent crack related material failure in their wings and what role does the characteristic vein pattern play? Fracture toughness is a parameter, which characterises a material's resistance to crack propagation. Our results show that, compared to other body parts, the hind wing membrane of the migratory locust S. gregaria itself is not exceptionally tough (1.04±0.25 MPa√m). However, the cross veins increase the wing's toughness by 50% by acting as barriers to crack propagation. Using fracture mechanics, we show that the morphological spacing of most wing veins matches the critical crack length of the material (1132 µm). This finding directly demonstrates how the biomechanical properties and the morphology of locust wings are functionally correlated in locusts, providing a mechanically 'optimal' solution with high toughness and low weight. The vein pattern found in insect wings thus might inspire the design of more durable and lightweight artificial 'venous' wings for micro-air-vehicles. Using the vein spacing as indicator, our approach might also provide a basis to estimate the wing properties of endangered or extinct insect species.

  14. Subclavian vein thrombosis: A continuing challenge

    SciTech Connect

    Hill, S.L.; Berry, R.E. )

    1990-07-01

    Subclavian vein thrombosis is a relatively uncommon but potentially morbid disease entity. To determine the frequency, cause, and best mode of treatment of this problem, we performed a chart review of all patients with a diagnosis of subclavian vein thrombosis at two major metropolitan hospitals during a 6-year period. A total of 40 patients were identified with subclavian vein thrombosis, which represented 3.5% of all venous thromboses detected during the 6-year period. No side or sex predilection was noted and the majority of patients were outpatients. The cause was fairly evenly divided among intravenous catheters (32%), anatomic abnormalities (45%), and carcinoma with postoperative radiation (22.5%). Despite the increasing use of the subclavian veins for pacemaker leads, hyperalimentation, and permanent intravenous access for chemotherapy, there has not been an increase in diagnosed subclavian vein thrombosis. Anatomic abnormalities with compression of the vein respond well to either heparinization or lytic therapy but require surgery if the venous abnormality persists. Treatment consisted of lytic therapy in 20%, heparinization in 55%, and elevation with removal of the central line in 25% of patients. All patients responded well to treatment, with a decrease in swelling and symptoms; no patient progressed to venous gangrene and only one (2.5%) had a documented pulmonary embolus. Medical treatment provides excellent long-term benefit in most cases unless complicated by an anatomic abnormality.

  15. Scattering removal for finger-vein image restoration.

    PubMed

    Yang, Jinfeng; Zhang, Ben; Shi, Yihua

    2012-01-01

    Finger-vein recognition has received increased attention recently. However, the finger-vein images are always captured in poor quality. This certainly makes finger-vein feature representation unreliable, and further impairs the accuracy of finger-vein recognition. In this paper, we first give an analysis of the intrinsic factors causing finger-vein image degradation, and then propose a simple but effective image restoration method based on scattering removal. To give a proper description of finger-vein image degradation, a biological optical model (BOM) specific to finger-vein imaging is proposed according to the principle of light propagation in biological tissues. Based on BOM, the light scattering component is sensibly estimated and properly removed for finger-vein image restoration. Finally, experimental results demonstrate that the proposed method is powerful in enhancing the finger-vein image contrast and in improving the finger-vein image matching accuracy.

  16. External artery heat pipe

    NASA Technical Reports Server (NTRS)

    Gernert, Nelson J. (Inventor); Ernst, Donald M. (Inventor); Shaubach, Robert M. (Inventor)

    1989-01-01

    An improved heat pipe with an external artery. The longitudinal slot in the heat pipe wall which interconnects the heat pipe vapor space with the external artery is completely filled with sintered wick material and the wall of the external artery is also covered with sintered wick material. This added wick structure assures that the external artery will continue to feed liquid to the heat pipe evaporator even if a vapor bubble forms within and would otherwise block the liquid transport function of the external artery.

  17. Benign External Hydrocephalus in Infants

    PubMed Central

    Adele Marino, Maria; Morabito, Rosa; Vinci, Sergio; Germanò, Antonino; Briguglio, Marilena; Alafaci, Concetta; Mormina, Enricomaria; Longo, Marcello; Granata, Francesca

    2014-01-01

    Summary External hydrocephalus (EH) is a benign clinical entity in which macrocephaly is associated with an increase in volume of the subarachnoid space, especially overlying both frontal lobes, and a normal or only slight increase in volume of the lateral ventricles. Several pathogenic hypotheses have been proposed but the most accredited theory seems to be delayed maturation of the arachnoid villi. There is a consensus that this is a benign entity, correlated to a familial predisposition and, in some cases, inheritance. CT and MRI are very important to make a diagnosis but also to establish the prognosis in patients who encounter the rare complications such as subdural haematomas. In conclusion, CT and MRI can provide a highly accurate diagnosis in these patients, allowing a preliminary assessment of the prognosis, particularly regarding the enlarged subarachnoid space limits and the “cortical vein" sign which can predict a further complication. These results are obtained with the same examination performed in a standard CT or MRI study of the brain and no injection of contrast medium is needed. PMID:24750715

  18. An effective preprocessing method for finger vein recognition

    NASA Astrophysics Data System (ADS)

    Peng, JiaLiang; Li, Qiong; Wang, Ning; Abd El-Latif, Ahmed A.; Niu, Xiamu

    2013-07-01

    The image preprocessing plays an important role in finger vein recognition system. However, previous preprocessing schemes remind weakness to be resolved for the high finger vein recongtion performance. In this paper, we propose a new finger vein preprocessing that includes finger region localization, alignment, finger vein ROI segmentation and enhancement. The experimental results show that the proposed scheme is capable of enhancing the quality of finger vein image effectively and reliably.

  19. Corrosion cast study of the canine hepatic veins.

    PubMed

    Uršič, M; Vrecl, M; Fazarinc, G

    2014-11-01

    This study presents a detailed description of the distribution, diameters and drainage patterns of hepatic veins on the basis of the corrosion cast analysis in 18 dogs. We classified the hepatic veins in three main groups: the right hepatic veins of the caudate process and right lateral liver lobe, the middle hepatic veins of the right medial and quadrate lobes and the left hepatic veins of both left liver lobes and the papillary process. The corrosion cast study showed that the number of the veins in the Nomina Anatomica Veterinaria and most anatomical textbooks is underestimated. The number of various-sized hepatic veins of the right liver division ranged from 3 to 5 and included 1 to 4 veins from the caudate process and 2 to 4 veins from the right lateral liver lobe. Generally, in all corrosion casts, one middle-sized vein from the right part of the right medial lobe, which emptied separately in the caudal vena cava, was established. The other vein was a large-sized vein from the remainder of the central division, which frequently joined the common left hepatic vein from the left liver lobes. The common left hepatic vein was the largest of all the aforementioned hepatic veins.

  20. Dynamic coupling between fluid flow and vein growth in fractures: a 3D numerical model

    NASA Astrophysics Data System (ADS)

    Schwarz, J.-O.; Enzmann, F.

    2012-04-01

    Fluid flow is one of the main mass transport mechanisms in the Earth's crust and abundant mineral vein networks are important indicators for fluid flow and fluid rock interaction. These systems are dynamic and part of the so called RTM processes (reaction-transport-mechanics). Understanding of mineral vein systems requires coupling of these processes. Here we present a conceptional model for dynamic vein growth of syntaxial, posttectonic veins generated by advective fluid flow and show first results of a numerical model for this scenario. Vein generation requires three processes to occur: (i) fracture generation by mechanical stress e.g. hydro-fracturing, (ii) flow of a supersaturated fluid on that fracture and (iii) crystallization of phase(s) on or in the fracture. 3D synthetic fractures are generated with the SynFrac code (Ogilvie, et al. 2006). Subsequently solutions of the Navier-Stokes equation for this fracture are computed by a computational fluid dynamics code called GeoDict (Wiegmann 2007). Transport (advective and diffusive) of chemical species to growth sites in the fracture and vein growth are computed by a self-written MATLAB script. The numerical model discretizes the wall rock and fracture geometry by volumetric pixels (voxels). Based on this representation, the model computes the three basic functions for vein generation: (a) nucleation, (b) fluid flow with transport of chemical species and (c) growth. The following conditions were chosen for these three modules. Nucleation is heterogeneous and occurs instantaneously at the wall rock/fracture interface. Advective and diffusive flow of a supersaturated fluid and related transport of chemical species occurs according to the computed fluid flow field by GeoDict. Concentration of chemical species at the inflow is constant, representing external fluid buffering. Changes/decrease in the concentration of chemical species occurs only due to vein growth. Growth of nuclei is limited either by transport of

  1. Caloric restriction increases internal iliac artery and penil nitric oxide synthase expression in rat: comparison of aged and adult rats.

    PubMed

    Ozbek, Emin; Simsek, Abdulmuttalip; Ozbek, Mustafa; Somay, Adnan

    2013-09-26

    Because of the positive corelation between healthy cardiovascular system and sexual life we aimed to evaluate the effect of caloric restriction (CR) on endothelial and neuronal nitric oxide synthase (eNOS, nNOS) expression in cavernousal tissues and eNOS expression in the internal iliac artery in young and aged rats. Young (3 mo, n = 7) and aged (24 mo, n = 7) male Sprague-Dawley rats were subjected to 40% CR and were allowed free access to water for 3 months. Control rats (n = 14) fed ad libitum had free access to food and water at all times. On day 90, rats were sacrificed and internal iliac arteries and penis were removed and parafinized, eNOS and nNOS expression evaluated with immunohistochemistry. Results were evaluated semiquantitatively. eNOS and nNOS expression in cavernousal tis- sue in CR rats were more strong than in control group in both young and old rats. eNOS expression was also higher in the internal iliac arteries of CR rats than in control in young and old rats. As a result of our study we can say that there is a positive link between CR and neurotransmitter of erection in cavernousal tissues and internal iliac arteries. CR has beneficial effect to prevent sexual dysfunction in young and old animals and possible humans.

  2. Lumbar artery perforator (LAP) flap: a salvage tool for extended lumbo-sacral necrosis after bilateral internal iliac arteries embolization

    PubMed Central

    di Summa, Pietro Giovanni; Schaffer, Clara; Zaugg, Patrice; Bauquis, Olivier; Raffoul, Wassim

    2016-01-01

    Abstract We report the case of a 52-year-old man presenting an extensive lumbosacral necrosis after bilateral internal iliac arteries embolization following unstable pelvic fracture. Coverage of the defect was performed using two extended lumbar artery perforator flaps in a propeller fashion. Good functional and esthetic result was achieved at one-year follow-up. PMID:27583264

  3. Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis.

    PubMed

    Kim, Young-Kyun; Chun, Ho Jong; Hwang, Jeong Kye; Kim, Ji Il; Kim, Sang Dong; Park, Sun-Cheol; Moon, In Sung

    2016-07-01

    Adventitial cystic disease of the common femoral vein is a rare condition. We herein report the case of a 50-year-old woman who presented with painless swelling in her left lower leg that resembled deep vein thrombosis. She underwent femoral exploration and excision of the cystic wall. The presentation, investigation, treatment, and pathology of this condition are discussed with a literature review.

  4. Giacomini vein: thigh extension of the small saphenous vein - report of two cases and review of the literature

    PubMed Central

    Natsis, K; Paraskevas, G; Lazaridis, N; Sofidis, G; Piagkou, M

    2015-01-01

    Background Varicose vein surgery is very commonly performed. Also, it is very frequently employed for recurrent disease. The recognition of the normal or variant veins, inducing incompetency, is a prerequisite for effective treatment. The thigh extension of the small saphenous vein, the so-called Giacomini vein, was extensively described in 1873 by Carlo Giacomini in an incidence of 72%. However, such a vein is usually underestimated in classic surgical textbooks. Description of cases We present two cases of Giacomini vein found in two cadavers, dissected for academic purposes in the Department of Anatomy, where the small saphenous vein displayed a thigh extension without terminating into the popliteal vein. In one case Giacomini vein drained into the large saphenous vein, while in the other case the vein divided into two branches, separately draining into the large saphenous vein and the subcutaneous tissue of the gluteal region. Conclusion Due to the fact that Giacomini vein could be incompetent, associated with or without varicose saphenous vein trunks, the vascular surgeon should keep in mind that anatomical entity, to include it in preoperative ultrasound scanning control. Moreover, this vein could be utilized as an autologous graft, when the large saphenous is not available. Hippokratia 2015; 19 (3): 263-265. PMID:27418788

  5. Veining Failure and Hydraulic Fracturing in Shales

    NASA Astrophysics Data System (ADS)

    Mighani, S.; Sondergeld, C. H.; Rai, C. S.

    2014-12-01

    During the hydraulic fracturing, the pressurized fluid creates new fractures and reactivates existing natural fractures forming a highly conductive Stimulated Reservoir Volume (SRV) around the borehole. We extend the previous work on Lyons sandstone and pyrophyllite to anisotropic shale from the Wolfcamp formation. We divide the rock anisotropy into two groups: a) conventional and b) unconventional (shaly) anisotropy. X-ray Computed Tomography (CT), compressional velocity anisotropy, and SEM analysis are used to identify three causes of anisotropy: bedding planes, clay lamination, and calcite veins. Calcite vein is a subsequently filled with calcite bonded weakly to the matrix. Velocity anisotropy and visual observations demonstrate the calcite filled veins to be mostly subparallel to the fabric direction. Brazilian tests are carried out to observe the fracture initiation and propagation under tension. High speed photography (frame rate 300,000 frame/sec) was used to capture the failure. Strain gauges and Acoustic Emission (AE) sensors recorded the deformation leading up to and during failure. SEM imaging and surface profilometry were employed to study the post-failure fracture system and failed surface topology. Fracture permeability was measured as a function of effective stress. Brazilian tests on small disks containing a centered single vein revealed the shear strength of the veins. We interpret the strain data and number, frequency, and amplitude of AE events which are correlated well with the observed fracture process zone, surface roughness, and permeability. The unpropped fracture has enhanced permeability by two orders of magnitude. The observed anisotropic tensile failure seems to have a universal trend with a minimum strength occurring at 15o orientation with respect to the loading axis. The veins at 15o orientation with respect to the loading axis were easily activated at 30% of the original failure load. The measured strength of the vein is as low as 6

  6. Anatomically safe and minimally invasive transcrestal technique for procurement of autogenous cancellous bone graft from the mid-iliac crest

    PubMed Central

    Missiuna, Paul C.; Gandhi, Harjeet S.; Farrokhyar, Forough; Harnett, Barry E.; Dore, Edward M.G.; Roberts, Barbara

    2011-01-01

    Background Open iliac bone harvesting techniques can result in significant complications and residual morbidity. In reconstructive procedures where a small volume of autogenous cancellous bone graft is required, a minimally invasive technique for bone harvesting applied at the mid-iliac crest has been deemed satisfactory. We sought to assess the application of a well-established surgical technique to procure adequate volume of autogenous cancellous iliac bone graft with minimal trauma to adjacent structures. Methods We retrospectively reviewed the cases of patients who underwent a minimally invasive transcrestal mid-iliac bone graft procurement technique between May 2003 and December 2007. The technique was performed using a 3.5-mm Steinmann pin as a trocar and a 4.5-mm AO drill sleeve as a trephine. We administered a questionnaire, either in the clinic or by mail, to assess a number of parameters, including postoperative pain, dysthesia, parasthesia, status of the donor site wound and patient satisfaction. Results Of the 37 consecutive patients who underwent the procedure, data from 26 patients were available for assessment. Donor site pain resolved within a few days of the surgery, and none of the patients experienced symptoms of chronic pain. At the final review, none of the patients reported any unpleasant signs and symptoms related to the residual scar. Conclusion We recommend that the described minimally invasive trephine method be used when a small cancellous bone graft is needed. We found that patient morbidity was significantly lower with the trephine harvest technique than with open bone harvesting methods at the anterior iliac crest. PMID:21933526

  7. Biomorphometric analysis of ilio-sacro-iliacal corridors for an intra-osseous implant to fix posterior pelvic ring fractures.

    PubMed

    Gras, Florian; Hillmann, Sophia; Rausch, Sascha; Klos, Kajetan; Hofmann, Gunther O; Marintschev, Ivan

    2015-02-01

    It is hypothesized that ilio-sacro-iliacal corridors for a new envisioned pelvic ring implant (trans-sacral nail with two iliacal bolts = ISI-nail: ilio-sacro-iliacal nail) exists on the level of S1- or S2-vertebra in each patient. The corridors of 84 healthy human pelves (42x ♂; 42x ♀, 18-85 years) were measured in high resolution CT scans using the Merlin Diagnostic Workcenter Software. Trans-sacral corridors (≥ 9 mm diameter) on the level of S1 and S2 were found in 62% and 54% of pelves with a mean length [mm ± SD] of 164 ± 12.9 and 142 ± 10.2. Corresponding iliac corridors were present in all specimens in caudally tilted axial planes of 37.8 ± 0.67° and 53.7 ± 0.94° in relation to the operating table plane and divergent angulations of 69.0 ± 0.49° and 70.1 ± 0.32° in relation to the sagittal midline plane. Sacral dysmorphism, with compensatory larger S2 corridors were prevalent in 24% of pelves; ilio-sacro-iliacal osseous corridors for the envisioned implant were found in 88% of pelves on the level of S1 or S2. In the remaining 12% with too narrow corridors for any trans-sacral implant (screws, bars, ISI nail) alternative fixation methods have to be considered. Expected advantages of the envisioned ISI nail compared to available fixation devices are discussed.

  8. Portal vein aneurysm: What to know.

    PubMed

    Laurenzi, Andrea; Ettorre, Giuseppe Maria; Lionetti, Raffaella; Meniconi, Roberto Luca; Colasanti, Marco; Vennarecci, Giovanni

    2015-11-01

    Portal vein aneurysm is an unusual vascular dilatation of the portal vein, which was first described by Barzilai and Kleckner in 1956 and since then less than 200 cases have been reported. The aim of this article is to provide an overview of the international literature to better clarify various aspects of this rare nosological entity and provide clear evidence-based summary, when available, of the clinical and surgical management. A systematic literature search of the Pubmed database was performed for all articles related to portal vein aneurysm. All articles published from 1956 to 2014 were examined for a total of 96 reports, including 190 patients. Portal vein aneurysm is defined as a portal vein diameter exceeding 1.9 cm in cirrhotic patients and 1.5 cm in normal livers. It can be congenital or acquired and portal hypertension represents the main cause of the acquired version. Surgical indication is considered in case of rupture, thrombosis or symptomatic aneurysms. Aneurysmectomy and aneurysmorrhaphy are considered in patients with normal liver, while shunt procedures or liver transplantation are the treatment of choice in case of portal hypertension. Being such a rare vascular entity its management should be reserved to high-volume tertiary hepato-biliary centres.

  9. Robotic Assisted Cannulation of Occluded Retinal Veins

    PubMed Central

    Meenink, Thijs C. M.; Janssens, Tom; Vanheukelom, Valerie; Naus, Gerrit J. L.; Beelen, Maarten J.; Meers, Caroline; Jonckx, Bart; Stassen, Jean-Marie

    2016-01-01

    Purpose To develop a methodology for cannulating porcine retinal venules using a robotic assistive arm after inducing a retinal vein occlusion using the photosensitizer rose bengal. Methodology Retinal vein occlusions proximal to the first vascular branch point were induced following intravenous injection of rose bengal by exposure to 532nm laser light delivered by slit-lamp or endolaser probe. Retinal veins were cannulated by positioning a glass catheter tip using a robotically controlled micromanipulator above venules with an outer diameter of 80μm or more and performing a preset piercing maneuver, controlled robotically. The ability of a balanced salt (BSS) solution to remove an occlusion by repeat distention of the retinal vein was also assessed. Results Cannulation using the preset piercing program was successful in 9 of 9 eyes. Piercing using the micromanipulator under manual control was successful in only 24 of 52 attempts, with several attempts leading to double piercing. The best location for cannulation was directly proximal to the occlusion. Infusion of BSS did not result in the resolution of the occlusion. Conclusion Cannulation of venules using a robotic microassistive arm can be achieved with consistency, provided the piercing is robotically driven. The model appears robust enough to allow testing of therapeutic strategies aimed at eliminating a retinal vein thrombus and its evolution over time. PMID:27676261

  10. A new approach for sclera vein recognition

    NASA Astrophysics Data System (ADS)

    Thomas, N. L.; Du, Yingzi; Zhou, Zhi

    2010-04-01

    The vein structure in the sclera is stable over time, unique to each person, and well suited for human identification. A few researchers have performed sclera vein pattern recognition and reported promising initial results. Sclera recognition poses several challenges: the vein structure moves and deforms with the movement of the eye; images of sclera patterns are often defocused and/or saturated; and, most importantly, the vein structure in the sclera is multi-layered and has complex non-linear deformation. In this paper, we proposed a new method for sclera recognition: First, we developed a color-based sclera region estimation scheme for sclera segmentation. Second, we designed a Gabor wavelet-based sclera pattern enhancement method, and an adaptive thresholding method to emphasize and binarize the sclera vein patterns. Third, we proposed a line descriptor-based feature extraction, registration, and matching method that is illumination-, scale-, orientation-, and deformation-invariant, and can mitigate the multi-layered deformation effects exhibited in the sclera and tolerate segmentation error. It is empirically verified using the UBIRIS database that the proposed method can perform accurate sclera recognition.

  11. Ligation of superior mesenteric vein and portal to splenic vein anastomosis after superior mesenteric-portal vein confluence resection during pancreaticoduodenectomy – Case report

    PubMed Central

    Tang, Jianlin; Abbas, Jihad; Hoetzl, Katherine; Allison, David; Osman, Mahamed; Williams, Mallory; Zelenock, Gerald B.

    2014-01-01

    62 year old Caucasian female with pancreatic head mass abutting the superior mesenteric vein (SMV) presented with fine needle aspiration biopsy confirmed diagnosis of ductal adenocarcinoma. CT scan showed near complete obstruction of portal vein and large SMV collateral development. After 3 months of neoadjuvant therapy, her portal vein flow improved significantly, SMV collateral circulation was diminished. Pancreaticoduodenectomy (PD) and superior mesenteric portal vein (SMPV) confluence resection were performed; A saphenous vein interposition graft thrombosed immediately. The splenic vein remnant was distended and adjacent to the stump of the portal vein. Harvesting an internal jugular vein graft required extra time and using a synthetic graft posed a risk of graft thrombosis or infection. As a result, we chose to perform a direct anastomosis of the portal and splenic vein in a desperate situation. The anastomosis decompressed the mesenteric venous system, so we then ligated the SMV. The patient had an uneventful postoperative course, except transient ascites. She redeveloped ascites more than one year later. At that time a PET scan showed bilateral lung and right femur metastatic disease. She expired 15 months after PD. Conclusion The lessons we learned are (1) Before SMPV confluence resection, internal jugular vein graft should be ready for reconstruction. (2) Synthetic graft is an alternative for internal jugular vein graft. (3) Direct portal vein to SMV anastomosis can be achieved by mobilizing liver. (4) It is possible that venous collaterals secondary to SMV tumor obstruction may have allowed this patient's post-operative survival. PMID:25568802

  12. [Inflammatory granuloma of iliac bone harvest site: a rare complication of Horsley bone wax].

    PubMed

    Faghahati, S; Gleizal, A; Beziat, J-L

    2013-08-01

    Bone wax or Horsley wax, which is used very frequently in bone surgery, is a non-absorbable mixture of beeswax (70%) and Vaseline. It permits the haemostasis of bone gaps by mechanical obstruction of bone pores containing blood capillaries. Complications due to this product are rare but sometimes quoted in literature. We report the case of a 17-year-old patient who, 10 months after surgery and after an asymptomatic period, presented an inflammatory granuloma at the scar of iliac bone harvest, which had been used as a maxillary graft. This complication necessitated a first exploratory and cleansing surgery, as well as a second surgery, which clarified the origin of the inflammation and made it possible to eliminate the wax remains. We think that bone wax should be used sparingly and with caution, firmly applied to the bleeding site without leaving any free particles.

  13. Irreversible bone loss in osteomalacia. Comparison of radial photon absorptiometry with iliac bone histomorphometry during treatment.

    PubMed Central

    Parfitt, A M; Rao, D S; Stanciu, J; Villanueva, A R; Kleerekoper, M; Frame, B

    1985-01-01

    We examined the relationships between the changes in bone mineral deficit in the radius, determined by single-energy photon absorptiometry at standard proximal and distal sites, and in the ilium, determined by bone histomorphometry, during the treatment of osteomalacia of diverse etiology in 28 patients. In the ilium, relative osteoid volume decreased by 75-80% in both cortical bone (from 6.0% to 1.5%) and trabecular bone (from 30.1% to 6.6%) during a mean treatment duration of 2 yr. There was also a significant fall in iliac cortical porosity from 10.3% to 7.8%. As a result, mineralized bone volume increased by 7.5% in cortical and by 40.1% in trabecular bone; the cortical and trabecular increments were correlated (r = 0.69, P less than 0.001). The properly weighted increase for the entire tissue sample was 18.6%. By contrast, there was no change in bone mineral at either radial site, although there was a 2% increase at both sites when allowance was made for age-related bone loss during treatment. The proximal and distal age-adjusted increments was correlated (r = 0.76, P less than 0.001), but there was no correlation between the changes in any photon absorptiometric and any histomorphometric index. In that iliac cortical bone turnover in normal subjects was 7.2%/yr, we estimated the rate of bone turnover to be less than 2%/yr at both proximal and distal radial sites, including any trabecular bone present at the distal site. Compared to appropriate control subjects, the bone mineral deficits fell during treatment from 19.2% to 17.1% at the proximal radius (greater than 95% cortical bone) and from 20.5% to 18.5% at the distal radius (greater than 75% cortical bone). In the ilium the deficits, assuming attainment of normal values for osteoid volume and cortical porosity, fell from 41.7% to 36.1% in cortical and from 31.5% to 6.3% in trabecular bone, the properly weighted combined deficit falling from 38.6% to 27.7%. The irreversible iliac cortical deficit was

  14. Estimating the Radiation Dose to the Fetus in Prophylactic Internal Iliac Artery Balloon Occlusion: Three Cases

    PubMed Central

    Kai, Kentaro; Hamada, Tomohiro; Yuge, Akitoshi; Kiyosue, Hiro; Nishida, Yoshihiro; Nasu, Kaei; Narahara, Hisashi

    2015-01-01

    Background. Although radiation exposure is of great concern to expecting patients, little information is available on the fetal radiation dose associated with prophylactic internal iliac artery balloon occlusion (IIABO). Here we estimated the fetal radiation dose associated with prophylactic IIABO in Caesarean section (CS). Cases. We report our experience with the IIABO procedure in three consecutive patients with suspected placenta previa/accreta. Fetal radiation dose measurements were conducted prior to each CS by using an anthropomorphic phantom. Based on the simulated value, we calculated the fetal radiation dose as the absorbed dose. We found that the fetal radiation doses ranged from 12.88 to 31.6 mGy. The fetal radiation dose during the prophylactic IIABOs did not exceed 50 mGy. Conclusion. The IIABO procedure could result in a very small increase in the risk of harmful effects to the fetus. PMID:26180648

  15. Reliability of age estimation from iliac auricular surface in a subactual Chilean sample.

    PubMed

    Herrera, María José; Retamal, Rodrigo

    2017-02-14

    The aim of this study was to test the reliability of Osborne et al. (2004) [8] age estimation based on the iliac auricular surface of the ilium. We selected 172 skeletons with documented sex and age-at-death and established six uniformly distributed age intervals for analysis. ANOVA was employed to assess the association of the documented age with sex and the auricular surface classification. We employed Bonferroni post-hoc tests to find any statistical differences across documented ages within each phase of Osborne's criteria. While the ANOVA showed a significant association between the documented age and the auricular surface classification, post-hoc tests found that phases 2 and 3 were the only consecutive phases with significant differences. We argue that a lack of statistical significance between consecutive phases undermines the reliability of this method for forensic purposes especially in middle adults. It may be possible that the collapse of intermediate phases would increase the accuracy of this method.

  16. The reliability of palpating the posterior superior iliac spine: a systematic review

    PubMed Central

    Cooperstein, Robert; Hickey, Michael

    2016-01-01

    Introduction: Among pelvic landmarks routinely palpated by manual therapists, the posterior superior iliac spines (PSISs) are particularly important. In addition to serving as landmarks for identifying possible pelvic torsion, contacting the PSISs is integral to many other static and dynamic pelvic palpatory procedures. The primary study goal was to systematically review the literature on the intra- and interexaminer reliability of PSIS palpation. Methods: Electronic databases and secondary searches led to the retrieval of articles that satisfied inclusion criteria. Two investigators rated the quality of included articles using the QAREL instrument. Results: The search identified 13 articles, one judged high quality, satisfying the inclusion criteria. Intraexaminer exceeded interexaminer reliability. Among 8 studies that reported interexaminer agreement using kappa, mean ϰ=0.27 (adjusted for sample size). Discussion and Conclusion: Current methods of palpating for PSIS asymmetry do not result in levels of interexaminer reliability supporting clinical utility. Improved methods should be sought. PMID:27069265

  17. Late Thromboembolic Complication from a Palmaz Stent in the Common Iliac Artery

    SciTech Connect

    Stoeckelhuber, Beate M.; Szeimies, Ulrike; Spengel, Florentin A.; Kueffer, Georg

    1996-05-15

    A 56-year-old smoker presented with rest pain in his left leg and hyperfibrinogenemia. He was found to have a high-grade stenosing thrombus in a Palmaz stent which had been placed 4 years ago across a stenosing ulcerating plaque in the left common iliac artery. Systemic thrombolysis was successful but the patient refused long-term anticoagulation. He presented 2 months later with recurrent stent thrombosis and an embolus to the tibioperoneal trunk. Systemic lysis was successfully performed for the stent reobstruction but the distal embolic occlusion responded neither to systemic nor to local thrombolysis. This case suggests that patients with vascular stents and hyperfibrinogenemia and/or nicotine abuse should be considered candidates for long-term anticoagulation.

  18. Avulsion fracture of the anterior inferior iliac spine with abundant reactive ossification in the soft tissue.

    PubMed

    Resnick, J M; Carrasco, C H; Edeiken, J; Yasko, A W; Ro, J Y; Ayala, A G

    1996-08-01

    Patients who have sustained an avulsion fracture and present clinically during the healing phase of the injury may manifest a mass that clinically and radiographically mimics a malignant neoplasm. A 15-year-old male soccer goalkeeper presented with a large ossified mass in the soft tissues overlying the right hip 6 months after experiencing a popping sensation in his hip joint during a game. Although an osteosarcoma was suspected clinically and radiographically, a Tru-Cut needle biopsy of the lesion revealed reactive bone formation. Correlation of the clinical, radiographic, and pathologic findings indicated an avulsion fracture of the anterior inferior iliac spine with abundant reactive ossification in the soft tissues. The healing phase of an avulsion fracture may clinically and radiographically be mistaken for neoplasia. In such cases, a Tru-Cut needle biopsy may reveal the reactive nature of the process.

  19. Perforated sigmoid diverticulitis in a lumbar hernia after iliac crest bone graft - a case report

    PubMed Central

    2014-01-01

    Background The combination of perforated diverticulitis in a lumbar hernia constitutes an extremely rare condition. Case presentation We report a case of a 66 year old Caucasian woman presenting with perforated sigmoid diverticulitis localized in a lumbar hernia following iliac crest bone graft performed 18 years ago. Emergency treatment consisted of laparoscopic peritoneal lavage. Elective sigmoid resection was scheduled four months later. At the same time a laparoscopic hernia repair with a biologic mesh graft was performed. Conclusion This case shows a very seldom clinical presentation of lumbar hernia. Secondary colonic resection and concurrent hernia repair with a biologic implant have proven useful in treating this rare condition. PMID:25051974

  20. Percutaneous Vein Occlusion with Small Intestinal Submucosa: An Experimental Pilot Study in Swine and Sheep

    SciTech Connect

    Kim, Man Deuk; Hoppe, Hanno; Pavcnik, Dusan Kaufman, John A.; Uchida, Barry T.; Correa, Luiz O.; Timmermans, Hans A.; Park, Won Kyu; Corless, Christopher L.; Keller, Frederick S.; Roesch, Josef

    2007-07-15

    Purpose. The objective of this study was to investigate the feasibility, outcomes, and amount of small intestinal submucosa (SIS) material needed for embolization of jugular vein (JV) in a swine and sheep model. Our hypothesis was that SIS would cause vein occlusion. Materials and Methods. The external JVs (EJV) in swine (n = 6) and JVs in sheep (n = 6) were occluded with SIS fan-folded compressed strips. After percutaneous puncture of the peripheral portion of the EJV or JV, a TIPS set was used to exit their lumen centrally through the skin. The SIS strips were delivered into the isolated venous segment with a pull-through technique via a 10-Fr sheath. Follow-up venograms were done immediately after placement and at the time of sacrifice at 1 or 3 months. Gross examinations focused on the EJV or JV and their surrounding structures. Specimens were evaluated by histology. Results. SIS strip(s) placement was successful in all cases, with immediate vein occlusion seen in 23 of 24 veins (95.8%). All EJVs treated with two strips and all JVs treated with three or four strips remained closed on 1- and 3-month follow-up venograms. Two EJVs treated with one strip and one JV treated with two strips were partially patent on venograms at 1 and 3 months. There has been one skin inflammatory reaction. Necropsies revealed excluded EJV or JV segments with SIS incorporation into the vein wall. Histology demonstrated various stages of SIS remodeling with fibrocytes, fibroblasts, endothelial cells, capillaries, and inflammatory cells. Conclusion. We conclude that EJV and JV ablation with SIS strips using percutaneous exit catheterization is feasible and effective in animal models. Further exploration of SIS as vein ablation material is recommended.

  1. External radiation surveillance

    SciTech Connect

    Antonio, E.J.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site.

  2. Impact of Stent Design on In-Stent Stenosis in a Rabbit Iliac Artery Model

    SciTech Connect

    Sommer, C. M. Grenacher, L.; Stampfl, U.; Arnegger, F. U.; Rehnitz, C.; Thierjung, H.; Stampfl, S.; Berger, I.; Richter, G. M.; Kauczor, H. U.; Radeleff, B. A.

    2010-06-15

    The purpose of this study was to evaluate the impact of stent design on in-stent stenosis in rabbit iliac arteries. Four different types of stent were implanted in rabbit iliac arteries, being different in stent design (crown or wave) and strut thickness (50 or 100 {mu}m). Ten stents of each type were implanted. Each animal received one crown and one wave stent with the same strut thickness. Follow-up was either 12 weeks (n = 10 rabbits) or 24 weeks (n = 10 rabbits). Primary study end points were angiographic and microscopic in-stent stenosis. Secondary study end points were vessel injury, vascular inflammation, and stent endothelialization. Average stent diameter, relative stent overdilation, average and minimal luminal diameter, and relative average and maximum luminal loss were not significantly different. However, a trend to higher relative stent overdilation was recognized in crown stents compared to wave stents. A trend toward higher average and minimal luminal diameter and lower relative average and maximum luminal loss was recognized in crown stents compared to wave stents with a strut thickness of 100 {mu}m. Neointimal height, relative luminal area stenosis, injury score, inflammation score, and endothelialization score were not significantly different. However, a trend toward higher neointimal height was recognized in crown stents compared to wave stents with a strut thickness of 50 {mu}m and a follow-up of 24 weeks. In conclusion, in this study, crown stents seem to trigger neointima. However, the optimized radial force might equalize the theoretically higher tendency for restenosis in crown stents. In this context, also more favorable positive remodeling in crown stents could be important.

  3. Evidence of Altered Matrix Composition in Iliac Crest Biopsies from Patients with Idiopathic Juvenile Osteoporosis

    PubMed Central

    Garcia, IJ; Chiodo, V; Ma, Y; Boskey, AL

    2015-01-01

    Purpose Idiopathic juvenile osteoporosis (IJO) is a rare condition in children, characterized by bone pain, long bone and vertebral fractures. Previously, IJO bone was solely characterized by histomorphometry and quantitative computed tomography. The goal of this study is to describe IJO bone composition. Materials and Methods Fourier transform infrared imaging (FTIRI), a vibrational spectroscopic technique providing spatially resolved images of chemical composition, was used to determine whether iliac crest biopsies from children with IJO differed in composition from and age- and sex-matched controls, and, as a secondary analysis, whether IJO-bone showed the same disease dependent change in composition as do iliac crest bone biopsies from women with postmenopausal osteoporosis (PMO). Wilcoxon rank-tests and linear regressions were used to analyze FTIRI variables (mineral-to-matrix ratio, carbonate-to-phosphate ratio, crystallinity, acid-phosphate substitution, collagen maturity) and their individual pixel distributions (Heterogeneity). Results Mineral-to-matrix ratio was comparable in IJO and age-matched controls. Contrastingly, collagen maturity (also known as collagen cross-link ratio) was higher in cortical and cancellous IJO bone compared to juvenile controls. Acid-phosphate substitution was greater in IJO cancellous bone than in age-matched controls, suggesting IJO bone mineral is formed more recently, reflecting a slower mineralization process. This agrees with findings of increased heterogeneity for mineral-to-matrix and collagen maturity ratios in IJO cancellous bone. There were negative correlations between cancellous collagen maturity and previously reported histomorphometric bone formation markers. There were no correlations with indices of remodeling. Conclusions IJO bone, similar to PMO bone, had elevated collagen maturity relative to its age-matched controls. This emphasizes the importance of the collagen matrix for bone health. IJO bone differed

  4. Balloon-Assisted Occlusion of the Internal Iliac Arteries in Patients with Placenta Accreta/Percreta

    SciTech Connect

    Bodner, Leonard J.; Nosher, John L. Gribbin, Christopher; Siegel, Randall L.; Beale, Stephanie; Scorza, William

    2006-06-15

    Background. Placenta accreta/percreta is a leading cause of third trimester hemorrhage and postpartum maternal death. The current treatment for third trimester hemorrhage due to placenta accreta/percreta is cesarean hysterectomy, which may be complicated by large volume blood loss. Purpose. To determine what role, if any, prophylactic temporary balloon occlusion and transcatheter embolization of the anterior division of the internal iliac arteries plays in the management of patients with placenta accreta/percreta. Methods. The records of 28 consecutive patients with a diagnosis of placenta accreta/percreta were retrospectively reviewed. Patients were divided into two groups. Six patients underwent prophylactic temporary balloon occlusion, followed by cesarean section, transcatheter embolization of the anterior division of the internal iliac arteries and cesarean hysterectomy (n = 5) or uterine curettage (n = 1). Twenty-two patients underwent cesarean hysterectomy without endovascular intervention. The following parameters were compared in the two groups: patient age, gravidity, parity, gestational age at delivery, days in the intensive care unit after delivery, total hospital days, volume of transfused blood products, volume of fluid replacement intraoperatively, operating room time, estimated blood loss, and postoperative morbidity and mortality. Results. Patients in the embolization group had more frequent episodes of third trimester bleeding requiring admission and bedrest prior to delivery (16.7 days vs. 2.9 days), resulting in significantly more hospitalization time in the embolization group (23 days vs. 8.8 days) and delivery at an earlier gestational age than in those in the surgical group (32.5 weeks). There was no statistical difference in mean estimated blood loss, volume of replaced blood products, fluid replacement needs, operating room time or postoperative recovery time. Conclusion. Our findings do not support the contention that in patients with

  5. Trabecular bone microstructure and local gene expression in iliac crest biopsies of men with idiopathic osteoporosis.

    PubMed

    Patsch, Janina M; Kohler, Thomas; Berzlanovich, Andrea; Muschitz, Christian; Bieglmayr, Christian; Roschger, Paul; Resch, Heinrich; Pietschmann, Peter

    2011-07-01

    Male idiopathic osteoporosis (MIO) is a metabolic bone disease that is characterized by low bone mass, microstructural alterations, and increased fracture risk in otherwise healthy men. Although the detailed pathophysiology of MIO has yet to be clarified, evidence increasingly suggests an osteoblastic defect as the underlying cause. In this study we tested the hypothesis that the expression profile of certain osteoblastic or osteoblast-related genes (ie, WNT10B, RUNX2, Osterix, Osteocalcin, SOST, RANKL, and OPG) is different in iliac crest biopsies of MIO patients when compared with healthy controls. Furthermore, we investigated the relation of local gene expression characteristics with histomorphometric, microstructural, and clinical features. Following written informed consent and diligent clinical patient characterization, iliac crest biopsies were performed in nine men. While RNA extraction, reverse-transcription, and real-time polymerase chain reactions (PCRs) were performed on one biopsy, a second biopsy of each patient was submitted for histomorphometry and micro-computed tomography (µCT). Age-matched bone samples from forensic autopsies served as controls. MIO patients displayed significantly reduced WNT10B, RUNX2, RANKL, and SOST expression. Performing µCT for the first time in MIO biopsies, we found significant decreases in trabecular number and connectivity density. Trabecular separation was increased significantly, but trabecular thickness was similar in both groups. Histomorphometry revealed decreased BV/TV and osteoid volume and fewer osteoclasts in MIO. By providing evidence for reduced local WNT10B, RUNX2, and RANKL gene expression and histomorphometric low turnover, our data support the osteoblast dysfunction model discussed for MIO. Further, MIO seems to lead to a different microstructural pathology than age-related bone loss.

  6. Endovascular Treatment of Anastomotic Pseudoaneurysms after Aorto-iliac Surgical Reconstruction

    SciTech Connect

    Lagana, Domenico Carrafiello, Gianpaolo; Mangini, Monica Recaldini, Chiara; Lumia, Domenico; Cuffari, Salvatore; Caronno, Roberto; Castelli, Patrizio; Fugazzola, Carlo

    2007-11-15

    Purpose. To assess the effectiveness of endovascular treatment of anastomotic pseudoaneurysms (APAs) following aorto-iliac surgical reconstruction. Materials. We retrospectively evaluated 21 men who, between July 2000 and March 2006, were observed with 30 APAs, 13 to the proximal anastomosis and 17 to the distal anastomosis. The patients had had previous aorto-iliac reconstructive surgery with a bypass due to aneurysm (15/21) or obstructive disease (6/21). The following devices were used: 12 bifurcated endoprostheses, 2 aorto-monoiliac, 4 aortic extenders, 1 stent-graft leg, and 2 covered stents. Follow-up was performed with CT angiography at 1, 3, and 6 months after the procedure and yearly thereafter. Results. Immediate technical success was 100%. No periprocedural complications occurred. Four patients died during follow-up from causes not related to APA, and 1 (treated for prosthetic-enteric fistula) from sepsis 3 months after the procedure. During a mean follow-up of 19.7 months (range 1-72 months), 2 of 21 occlusions of stent-graft legs occurred 3 and 24 months after the procedure (treated with thrombolysis and percutaneous transluminal angioplasty and femorofemoral bypass, respectively) and 1 type I endoleak. Primary clinical success rate was 81% and secondary clinical success was 91%. Conclusion. Endovascular treatment is a valid alternative to open surgery and can be proposed as the treatment of choice for APAs, especially in patients who are a high surgical risk. Further studies with larger series and longer follow-up are necessary to confirm the long-term effectiveness of this approach.

  7. How Safe is Bilateral Internal Iliac Artery Embolization Prior to EVAR?

    SciTech Connect

    Bratby, M. J. Munneke, G. M.; Belli, A.-M.; Loosemore, T. M.; Loftus, I.; Thompson, M. M.; Morgan, R. A.

    2008-03-15

    Purpose. To assess the outcomes of patients after bilateral internal iliac artery (IIA) embolization prior to endovascular aneurysm repair (EVAR). Methods. Thirty-nine patients (age range 55-88 years, mean 72.5 years; 2 women) underwent IIA embolization/occlusion before EVAR. There were 28 patients with aorto-biiliac aneurysms and 6 with bilateral common iliac artery (CIA) aneurysms. Five patients with unilateral CIA aneurysms had previous surgical ligation of the contralateral IIA or inadvertent covering by the stent-graft of the contralateral IIA origin. Outcomes were assessed by clinical follow-up. Results. Severe ischemic complications were limited to spinal cord ischemia in 1 patient (3%) who developed paraparesis following EVAR. No other severe ischemic complications such as buttock necrosis, or bowel or bladder ischemia, occurred. Buttock and/or thigh claudication occurred in 12 patients (31%) and persisted beyond 1 year in 3 patients (9%). Sexual dysfunction occurred in 2 patients (5%). Patients who underwent simultaneous embolization had a 25% (3/12) ischemic complication rate versus 41% (11/27) in those with sequential embolization (p = 0.48). Embolization limited to the main trunk of the IIA resulted in a significantly reduced ischemic complication rate of 16% (3/19) versus 55% (11/20) of patients who had a more distal embolization of the IIA (p = 0.019, Fisher's exact test). Conclusion. Severe complications after bilateral IIA embolization are uncommon. Although buttock/thigh claudication occurs in around 30% of patients soon after the procedure, this resolves in the majority after 1 year. There is no obvious benefit for sequential versus simultaneous IIA embolization in our series. Occlusion of the proximal IIA trunk is associated with reduced complications compared with occlusion of the distal IIA.

  8. Endovascular Tubular Stent-Graft Placement for Isolated Iliac Artery Aneurysms

    SciTech Connect

    Okada, Takuya Yamaguchi, Masato; Kitagawa, Atsushi; Kawasaki, Ryota; Nomura, Yoshikatsu; Okita, Yutaka; Sugimura, Kazuro; Sugimoto, Koji

    2012-02-15

    Purpose: To evaluate the safety, efficacy, and mid-term outcomes of endovascular tubular stent-graft placement for repair of isolated iliac artery aneurysms (IAAs). Materials and Methods: Between January 2002 and March 2010, 20 patients (7 women and 13 men; mean age 74 years) underwent endovascular repair of 22 isolated IAAs. Two patients underwent endovascular repair for bilateral aneurysms. Ten para-anastomotic aneurysms (45%) developed after open abdominal aortic aneurysm (AAA) repair with an aorto-iliac graft, and 12 were true aneurysms (55%). Eleven straight and 11 tapered stent-grafts were placed. Contrast-enhanced computed tomography (CT) was performed to detect complications and evaluate aneurysmal shrinkage at week 1, 3, 6, and 12 months and once every year thereafter. Non-contrast-enhanced CT was performed in seven patients with chronic kidney disease. Results: All procedures were successful, without serious complications, during the mean (range) follow-up period of 746 days (47-2651). Type II endoleak not requiring treatment was noted in one patient. The mean (SD) diameters of the true and para-anastomotic aneurysms significantly (p < 0.05) decreased from 42.0 (9.3) to 36.9 (13.6) mm and from 40.1 (13.0) to 33.6 (15.8) mm, respectively; the mean (SD) shrinkage rates were 15.1% (20.2%) and 18.9% (22.4%), respectively. The primary patency rate was 100%, and no secondary interventions were required. Four patients (21%) developed transient buttock claudication, and one patient (5%) developed colorectal ischaemia, which was treated conservatively. Conclusion: Endovascular tubular stent-graft placement for the repair of isolated IAAs is safe and efficacious. Tapered stent-grafts of various sizes are required for accurate placement.

  9. Predictors of Reintervention After Endovascular Repair of Isolated Iliac Artery Aneurysm

    SciTech Connect

    Zayed, Hany A. Attia, Rizwan; Modarai, Bijan; Clough, Rachel E.; Bell, Rachel E.; Carrell, Tom; Sabharwal, Tarun; Reidy, John; Taylor, Peter R.

    2011-02-15

    The objective of this study was to identify factors predicting the need for reintervention after endovascular repair of isolated iliac artery aneurysm (IIAA). We reviewed prospectively collected database records of all patients who underwent endovascular repair of IIAA between 1999 and 2008. Detailed assessment of the aneurysms was performed using computed tomography angiography (CTA). Follow-up protocol included CTA at 3 months. If this showed no complication, then annual duplex scan was arranged. Multivariate analysis and analysis of patient survival and freedom from reintervention were performed using Kaplan-Meier life tables. Forty IIAAs (median diameter 44 mm) in 38 patients were treated (all men; median age 75 years), and median follow-up was 27 months. Endovascular repair of IIAA was required in 14 of 40 aneurysms (35%). The rate of type I endoleak was significantly higher with proximal landing zone (PLZ) diameter >30 mm in the aorta or >24 mm in the common iliac artery or distal landing zone (DLZ) diameter >24 mm (P = 0.03, 0.03, and 0.0014, respectively). Reintervention rate (RR) increased significantly with increased diameter or decreased length of PLZ; increased DLZ diameter; and endovascular IIAA repair (P = 0.005, 0.005, 0.02, and 0.02 respectively); however, RR was not significantly affected by length of PLZ or DLZ. Freedom-from-reintervention was 97, 93, and 86% at 12, 24, and 108 months. There was no in-hospital or aneurysm-related mortality. Endovascular IIAA repair is a safe treatment option. Proper patient selection is essential to decrease the RR.

  10. PROXIMAL TIBIAL OSTEOTOMY: STABILIZATION OF THE MEDIAL OPENING WITH A TRICORTICAL ILIAC BONE GRAFT

    PubMed Central

    da Cunha Luciano, Roberto; de Moura Souza, Getúlio Danival; Rispoli, Juliano; Cardoso, Rodrigo Galvão; do Nascimento, Marcus Vinícius Martins; Domingos, Gustavo Gontijo; Luciano, Dyego Vilela

    2015-01-01

    Objective: Radiographic assessment of lower limb alignment, in the frontal and sagittal planes, after high tibial osteotomy. To stabilize the osteotomy, a tricortical iliac graft was used, along with a positioning screw. Methods: Prospective study on 46 patients with ages ranging from 17 to 61 years. Among them, 42 patients presented genu varum secondary to knee osteoarthritis and four from other causes. Teleradiography was performed for surgical planning, using the Frank Noyes method, as modified by Fugizawa. A conventional surgical access of 3 cm was made to harvest a tricortical iliac graft. Osteotomy was performed under radioscopic control, by means of an anteromedial incision of 3 cm with release of the superficial portion of the medial collateral ligament. The graft was placed in the posterior portion of the osteotomy, to maintain an unaltered tibial slope. The screw crossed the osteotomy orthogonally to protect the lateral cortex. Pre and postoperative radiographic criteria were established to assess the results. Results: There was consolidation in 100% of the cases and maintenance of the mechanical axis, obtained intraoperatively, in 94% of the cases. The posterior slope of the tibial plateau in the sagittal plane ranged from 7° to 12°. Joint mobility was restored in all the patients. Eleven patients presented temporary pain at the site of graft harvesting, but none had paresthesia. The incidence of complications was 8% (infection, loss of correction and joint fracture). Conclusion: The technique was shown to be reproducible, simple, biological, accurate and low-cost, and it may be an alternative to the existing techniques. PMID:27026961

  11. Fractal properties of cancellous bone of the iliac crest in vertebral crush fracture.

    PubMed

    Fazzalari, N L; Parkinson, I H

    1998-07-01

    Fractal analysis is a method for describing complex shapes, including the cancellous structure of bone. It describes the surface texture and form of individual trabecular profiles and the overall cancellous structure. Sixty-four postmenopausal women with symptoms of back pain were referred for investigation for osteoporosis. The patients were divided into two groups for comparison: vertebral crush fracture (n = 31, mean age 68.58 +/- 6.47 years), and no vertebral crush fracture (n = 33, mean age 63.36 +/- 7.21 years). Cores of cancellous bone, 3 mm in diameter, were taken from the iliac crest and sectioned. A box-counting method implemented on an image analyzer was used to measure the fractal dimension. Three fractal dimensions describing trabecular surface texture (fractal 1), trabecular shape (fractal 2), and trabecular arrangement (fractal 3) were measured, indicating that cancellous bone has sectional self-similarity. Conventional histomorphometry was also performed on the samples. The results show that fractal 2 is significantly lower in the vertebral crush fracture group than in the nonfracture group (1.15 +/- 0.10 < 1.23 +/- 0.090, p < 0.0013). The histomorphometric analysis shows that bone surface total volume (p < 0.0002), trabecular number (p < 0.0001), and osteoid surface bone surface (p < 0.028) are significantly lower in the fracture group than the nonfracture group. Eroded surface/bone surface (p < 0.056) follows this trend, whereas trabecular separation (p < 0.001) is significantly higher in the fracture group than in the nonfracture group. Fractal 1 and fractal 3 were not significantly different between study groups. The fractal dimension detects changes in the cancellous architecture and gives information about iliac bone transformation in postmenopausal women with vertebral fracture.

  12. Flank Hernia Repair with Suture Anchor Mesh Fixation to the Iliac Crest.

    PubMed

    Mukherjee, Kaushik; Miller, Richard S

    2017-03-01

    Traumatic or postsurgical flank hernias are complex and prone to recurrence, particularly at the border of the iliac crest. We reviewed our experience using suture anchors drilled into the iliac crest to fixate the mesh to bone. Our study of 10 repairs in eight patients was Institutional Review Board exempt. We obtained demographics, body mass index, diabetes, methicillin-resistant Staphylococcus aureus (MRSA) history, smoking status, steroid use, number of prior repairs, defect size, mesh size, number of anchors, and recurrence and infection at follow-up. We performed Kaplan-Meier analysis using a composite of recurrence or infection. Three of eight (interquartile range, 37.5%) patients were male. Median age and body mass index were 47.5 years (31.0, 54.7) and 32.2 (29.0, 36.0), respectively. Three patients had prior repairs, one each with two, three, and five prior attempts at fixation. One of eight patients (12.5%) had a history of MRSA infection. One of eight patients (12.5%) had a history of intermittent steroid use for sarcoidosis. Defect size was 90 cm2 (62.2, 165) and mesh size was 155 cm2 (150, 232) with four anchors (4, 5.5). Procedural complications included 2/10 (20%) with recurrence and 1/10 (10%) with postoperative MRSA infection. Follow-up was 12 months (3.0, 25.0). Mean freedom from recurrence and mesh infection (Kaplan-Meier) was 43.5 months (95%confidence interval = 24.2, 62.8). In conclusion, our series is one of the largest in the literature involving the suture anchor technique. Despite a high-risk patient population due to trauma, obesity, and prior smoking and MRSA history, we achieved an acceptable recurrence rate. Further study may benefit from a randomized trial design.

  13. Oversized vein grafts develop advanced atherosclerosis in hypercholesterolemic minipigs

    PubMed Central

    2012-01-01

    Background Accelerated atherosclerosis is the main cause of late aortocoronary vein graft failure. We aimed to develop a large animal model for the study of pathogenesis and treatment of vein graft atherosclerosis. Methods An autologous reversed jugular vein graft was inserted end-to-end into the transected common carotid artery of ten hypercholesteroemic minipigs. The vein grafts were investigated 12-14 weeks later with ultrasound and angiograpy in vivo and microscopy post mortem. Results One minipig died during follow up (patent vein graft at autopsy), and one vein graft thrombosed early. In the remaining eight patent vein grafts, the mean (standard deviation) intima-media thickness was 712 μm (276 μm) versus 204 μm (74 μm) in the contralateral control internal jugular veins (P < .01). Advanced atherosclerotic plaques were found in three of four oversized vein grafts (diameter of graft > diameter of artery). No plaques were found in four non-oversized vein grafts (P < .05). Conclusions Our model of jugular vein graft in the common carotid artery of hypercholesterolemic minipigs displayed the components of human vein graft disease, i.e. thrombosis, intimal hyperplasia, and atherosclerosis. Advanced atherosclerosis, the main cause of late failure of human aortocoronary vein grafts was only seen in oversized grafts. This finding suggests that oversized vein grafts may have detrimental effects on patient outcome. PMID:22463679

  14. Can tuffisite veins help dictate eruption styles?

    NASA Astrophysics Data System (ADS)

    Kolzenburg, S.; Heap, M. J.; Lavallee, Y.; Russell, J. K.; Meredith, P. G.; Dingwell, D. B.

    2010-12-01

    The ability of magmas to degas during ascent may affect eruption style. The permeability of the magma and/or the conduit wall rocks may therefore dictate whether an eruption will be explosive or effusive. Fractures increase permeability. Fractures filled by veins of autoclastic, cataclastic and tuffisitic glass shards and crystal fragments are common in shallow conduit systems. These veins have the potential to dramatically increase permeability and provide pathways for gas loss. Here we present the first study on the porosity, permeability, strength, P-and S-wave and dynamic elastic moduli of andesite containing tuffisite veins at Volcán de Colima, Mexico. Porosity was measured via pycnometry. The strength and mechanisms of deformation were investigated on tuffisite-bearing and tuffisite-free samples in a uniaxial press at 940°C by loading at 2 MPa/min until failure. The permeability, P- and S-wave velocity, and dynamic elastic moduli were measured in a high-pressure permeameter/pore volumometer up to effective confining pressures of 50 MPa (ca. 2km depth). Measurements were made on cylindrical samples prepared as: (1) without tuffisite veins and with tuffisite veins (2) perpendicular and (3) sub-parallel to flow (i.e., the samples’ axial direction). Petrographic analysis reveals that the tuffisites are comprised almost exclusively of micron-size crystal fragments. Dilatometric measurements of tuffisite (10°C/min up to 1000°C), failed to reveal a Tg, indicating the absence of interstitial glass. In contrast, the dome rocks exhibits viscous relaxation between 770 and 885 °C, indicating glass. The high-temperature (940°C) deformation experiments on samples containing tuffisite veins showed an absence of ductile deformation and a uniaxial strength of 116 MPa; i.e, slightly weaker than tuffisite-free rock (~130 MPa) and stronger than erupted dome lavas (~30 MPa). The presence of tuffisite increases the porosity. Permeability measurements show that tuffisite

  15. Pathogenesis of varicose veins - lessons from biomechanics.

    PubMed

    Pfisterer, Larissa; König, Gerd; Hecker, Markus; Korff, Thomas

    2014-03-01

    The development of varicose veins or chronic venous insufficiency is preceded by and associated with the pathophysiological remodelling of the venous wall. Recent work suggests that an increase in venous filling pressure is sufficient to promote varicose remodelling of veins by augmenting wall stress and activating venous endothelial and smooth muscle cells. In line with this, known risk factors such as prolonged standing or an obesity-induced increase in venous filling pressure may contribute to varicosis. This review focuses on biomechanically mediated mechanisms such as an increase in wall stress caused by venous hypertension or alterations in blood flow, which may be involved in the onset of varicose vein development. Finally, possible therapeutic options to counteract or delay the progress of this venous disease are discussed.

  16. Isolated Cortical Vein Thrombosis - The Cord Sign

    PubMed Central

    Sharma, Vijay K.; Teoh, Hock L

    2009-01-01

    Isolated cortical vein thrombosis is an uncommon condition and often difficult to diagnose, both clinically and radiologically. We report a case of a 38 years old man who presented with headache of new onset and clinical examination was unremarkable. The unenhanced brain CT did not reveal any abnormality. In view of unrelenting headache and partial seizures, we performed magnetic resonance imaging (with axial T1, T2 and gradient echo sequences, coronal FLAIR, diffusion weighted imaging as well as Gadolinium contrast-enhanced images) and magnetic resonance venography of the brain that revealed an isolated parietal cortical vein thrombosis with the rarely reported 'cord sign'. We report the clinical and radiological findings in our patient with isolated parietal cortical vein thrombosis. PMID:22470649

  17. Common Iliac Artery Thrombosis following Pelvic Surgery Resulting in Kidney Allograft Failure Successfully Treated by Percutaneous Transluminal Angioplasty with Balloon-Expandable Covered Stent

    PubMed Central

    Golla, Maheswara S.; Acharjee, Subasit; Jaber, Bertrand L.; Garcia, Lawrence A.

    2015-01-01

    We report the case of a 66-year-old woman who developed acute kidney allograft failure due to thrombotic occlusion of the common iliac artery after hysterectomy requiring emergent allograft rescue. She underwent percutaneous transluminal angioplasty with endovascular balloon expandable covered stent graft placement in the right common iliac artery. Although there are a handful of case reports of acute limb ischemia secondary to acute common iliac artery thrombosis, this is the first case reported in the literature resulting in successful kidney allograft rescue following pelvic surgery. PMID:26355669

  18. Successful liver allograft inflow reconstruction with the right gastroepiploic vein.

    PubMed

    Pinheiro, Rafael S; Cruz, Ruy J; Nacif, Lucas S; Vane, Matheus F; D'Albuquerque, Luiz A C

    2016-02-01

    Portal vein thrombosis is a common complication in cirrhotic patients. When portal vein thrombectomy is not a suitable option, a large collateral vessel can be used for allograft venous inflow reconstruction. We describe an unusual case of successful portal revascularization using the right gastroepiploic vein. The patient underwent a cadaveric orthotopic liver transplantation with end-to-end anastomosis of the portal vein to the right gastroepiploic vein. Six months after liver transplantation the patient is well with good liver function. The use of the right gastroepiploic vein for allograft venous reconstruction is feasible and safe, with a great advantage of avoiding the need of venous jump graft.

  19. How Vein Sealing Boosts Fracture Opening

    NASA Astrophysics Data System (ADS)

    Nüchter, Jens-Alexander

    2015-04-01

    Veins from from cracks. As such, a stage of brittle failure and fracturing is to be set apart from a stage of opening and sealing. The process of fracture opening requires distortion of the host rocks to create space for the evolving vein. To keep a crack arrested and, at the same time, to widen or stabilize the cavity, the stress intensity factor K_I=(P-S3)(πa) must remain below the fracture toughness K_IC of the host rock, and P-S3 >0 (P and S3 denote pore fluid pressure and absolute minimum principal stress, respectively and 'a' refers to the half-length of the fracture). For purely elastic distortion of the host rocks, maximum aperture W0=K_IC (1-ν^2)/(E(π/8)^1/2))(2a)^1/2 depends on on K_IC, Poisson's ratio ν, and Young's modulus E of the host rocks. Owing to the low values for rock K_IC typically ranging between 0.1 and 1 MPa m^1/2, veins formed by purely elastic distortion of the host rocks are restricted to high aspect ratios 2a/W. In metamorphic rocks, veins with low aspect ratios are common; inelastic deformation and viscous creep in the host rocks must have contributed to final vein shapes. In the present study, I use finite element models to simulate fracture opening and cavity formation supported by viscous creep distributed in the host rock. Simulations are carried out on 2D plate models containing elliptical fractures. The walls of the fractures are coated by thin layers simulating incipient sealing; a residual cavity prevails in the centre of the model veins. Constant displacement is applied to the plate boundaries oriented normal to the cracks. I run a series of models with various viscosity contrasts between the rocks and the sealing. The results of these models indicate the following. (1) Fracture opening is most effective when the viscosity of the sealing ηs exceeds the viscosity of the host rocks ηr (2) The rate of fracture opening increases with increasing values for ηs/ηr . (3) An increase in the thickness of the sealing layer causes

  20. Conduits for Coronary Bypass: Vein Grafts

    PubMed Central

    Farkas, Emily A

    2012-01-01

    The saphenous vein has been the principal conduit for coronary bypass grafting from the beginning, circa 1970. This report briefly traces this history and concomitantly presents one surgeons experience and personal views on use of the vein graft. As such it is not exhaustive but meant to be practical with a modest number of references. The focus is that of providing guidance and perspective which may be at variance with that of others and recognizing that there may be many ways to accomplish the task at hand. Hopefully the surgeon in training/early career may find this instructive on the journey to surgical maturity. PMID:23130300

  1. Postpartum Ovarian Vein Thrombophlebitis with Staphylococcal Bacteremia

    PubMed Central

    Parino, Eduardo; Mulinaris, Eric; Saccomano, Edgardo; Gallo, Juan Cruz; Kohan, Gabriel

    2015-01-01

    A 34-year-old female patient presented with fever and right flank pain ten days after uncomplicated vaginal delivery. CT examination revealed right ovarian vein thrombosis and methicillin-resistant Staphylococcus aureus (MRSA) was isolated from blood cultures. No other source of bacteremia was found. Antibiotic therapy and anticoagulation with enoxaparin were instituted. Fourteen days after admission, she was discharged in good condition. Although a very uncommon complication after spontaneous vaginal delivery, septic ovarian vein thrombophlebitis should be suspected in cases of persistent puerperal fever when other diagnostic possibilities have been excluded. PMID:26221549

  2. External approach to rhinoplasty.

    PubMed

    Goodman, Wilfred S; Charbonneau, Paul A

    2015-07-01

    The technique of external rhinoplasty is outlined. Having reviewed 74 cases, its advantages and disadvantages are discussed. Reluctance to use this external approach seems to be based on emotional rather than radical grounds, for its seems to be the procedure of choice for many problems.

  3. Infraclavicular access to the axillary vein - new possibilities for the catheterization of the central veins in the intensive care unit.

    PubMed

    Gawda, Ryszard; Czarnik, Tomasz; Łysenko, Lidia

    2016-01-01

    Central vein cannulation is one of the most commonly performed procedures in intensive care. Traditionally, the jugular and subclavian vein are recommended as the first choice option. Nevertheless, these attempts are not always obtainable for critically ill patients. For this reason, the axillary vein seems to be a rational alternative approach. In this narrative review, we evaluate the usefulness of the infraclavicular access to the axillary vein. The existing evidence suggests that infraclavicular approach to the axillary vein is a reliable method of central vein catheterization, especially when performed with ultrasound guidance.

  4. [Anatomicosurgical study of the superior mesenteric vein].

    PubMed

    Dell'Isola, C; Tucci, G F

    1991-01-01

    Results of an autoptic study of the superior mesenteric vein in thirty cadavers are reported. The anatomo-surgical patterns of the venous axis are emphasized. In fact, a better knowledge of this vessel allows an easier and safer surgical approach during pancreatic resections.

  5. Duodenal web with preduodenal portal vein.

    PubMed

    Golombek, S; Bilgi, J; Ukabiala, O

    1995-06-01

    This article described an unusual case of an infant with duodenal atresia and preduodenal portal vein without Down's syndrome or other anatomical anomalies associated with this condition. Duodenoduodenostomy was effective. Enteral feeding was re-established 72 hours post-operatively and the patient was discharged home one day later.

  6. 21 CFR 880.6980 - Vein stabilizer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Vein stabilizer. 880.6980 Section 880.6980 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Miscellaneous...

  7. Puzzles in practice: splenic vein thrombosis.

    PubMed

    McIntyre, Brittany; Marsh, Melanie; Walden, Jeffrey

    2016-06-01

    This report details a 58-year-old gentleman who presented to his outpatient primary care physician's clinic several times over four weeks for ongoing epigastric pain radiating into his left flank, dry heaving, and constipation. He was presumed to have gastritis at each visit and prescribed escalating doses of proton pump inhibitors. Due to the unrelenting pain, he eventually was admitted to the hospital and diagnosed with splenic vein thrombosis after computed tomography imaging of the abdomen. Our literature search revealed that pancreatic pathology is overwhelmingly the contributing factor to splenic vein thrombosis. Our patient had prominent collateral vasculature, suggesting that his splenic vein thrombosis was chronic in nature and likely the cause of his ongoing abdominal pain. Splenic vein thrombosis is an uncommon cause of abdominal pain, but one that should be included in the treating physician's differential diagnoses when abdominal pain is ongoing despite medical therapy. Although he had no evidence of initial findings on radiography, our patient was eventually diagnosed with biopsy-proven pancreatic cancer. Our case report demonstrates how patients presenting with persistent or worsening abdominal pain despite the use of proton pump inhibitors or other acid reducing agents and potential 'red flag' findings such as decreased appetite and weight loss should be worked up for other potential sources of abdominal pathology.

  8. Hepatic vein obstruction (Budd-Chiari)

    MedlinePlus

    ... your provider if: You have symptoms of hepatic vein obstruction You are being treated for this condition and you develop new symptoms Alternative Names Budd-Chiari syndrome; Hepatic veno-occlusive disease Images Digestive system Digestive system organs Blood clot formation ...

  9. What Are the Signs and Symptoms of Varicose Veins?

    MedlinePlus

    ... around the varicose vein. Signs of telangiectasias are clusters of red veins that you can see just under the surface of your skin. These clusters usually are found on the upper body, including ...

  10. The effects of crystalloid potassium cardioplegic solution on arterialized canine vein grafts. Assessment of chronic prostacyclin production and histopathologic alterations.

    PubMed

    Hoover, E L; Pett, S B; Eldor, A; Alonso, D; Subramanian, V A; Weksler, B; Gay, W A

    1981-08-01

    Efforts to improve myocardial preservation during aortocoronary bypass procedures have led to the perfusion of saphenous vein segments with potassium cardioplegic (KCP) solutions after completion of the distal anastomosis. Recent reports show that the procurement of veins leads to varying degrees of damage, particularly to the endothelial surface, as a result of the dissection itself, the hydrostatic pressure required to distend the veins in obtaining hemostasis and the composition of the solutions used to irrigate the harvested segments. The biologic activity of arterialized vein segments is largely unknown. We tested the hypothesis that the degree of venous injury inherent in vein harvesting may be compounded by perfusion with a potassium-rich solution, a known vascular irritant. The external jugular vein was removed from 18 dogs. Half of the vein was perfused with 300 ml of a KCP solution at 4 degrees C (40 mEq/l KCl, 10 ml sodium bicarbonate, pH 7.6, osmolarity 340 mosmol) and the other half with lactated Ringer's solution (LR). The treated vein was reversed and interposed into the excluded internal carotid circulation. A sham dissection was done on the opposite jugular vein. The veins were harvested after 6 weeks and assayed for spontaneous and arachidonate-stimulated (AS) prostacyclin activity as well as light microscopic analysis of morphologic changes. Spontaneous and AS production of prostacyclin did not differ significantly in the sham, LR and KCP groups: 1539 +/- 709 and 4166 +/- 1802, 1569 +/- 763 and 3767 +/- 2706, 1860 +/- 1233 and 3947 +/- 3347 pg/ml). Light microscopic analysis revealed an intense adventitial fibrotic reaction in the KCP group and the appearance of fibroblast-like cells in the outer layer of the vein wall. The intima was intact in all three groups. We conclude that intimal damage sustained during harvesting is repaired within 6 weeks, and there is no impairment to surface production of prostacyclin. The intense adventitial fibrotic

  11. External carotid artery pseudoaneurysm with arteriovenous fistula: A rare complication of glass shrapnel injury

    PubMed Central

    Saraf, Rashmi; Sharma, Rajaram; Jaini, Lodha V; Mhashal, Shashikant

    2016-01-01

    Posttraumatic external carotid artery pseudoaneurysm with arteriovenous fistula is a rare condition. An 8-year-old child presented with painful pulsatile swelling in the preauricular region following a penetrating glass shrapnel injury. Detailed evaluation showed distal external carotid artery pseudoaneurysm with fistula, which was draining into the retromandibular vein. Endovascular treatment was performed. This case highlights the role of endovascular intervention for such rare complicated vascular pathologies. PMID:28104948

  12. Omental vein catheter thrombolysis for acute porto-mesenteric vein thrombosis.

    PubMed

    Fonseca, Annabelle L; Cleary, Muriel A; Cholewczynski, Walter; Sumpio, Bauer E; Atweh, Nabil A

    2013-05-01

    Mesenteric venous thrombosis (MVT) is an uncommon clinical condition with potential high morbidity. We report here a patient who presented with acute-onset MVT and bowel infarction, which was successfully ameliorated with intramesenteric vein thrombolytic therapy.

  13. A Finger Vein Identification Method Based on Template Matching

    NASA Astrophysics Data System (ADS)

    Zou, Hui; Zhang, Bing; Tao, Zhigang; Wang, Xiaoping

    2016-01-01

    New methods for extracting vein features from finger vein image and generating templates for matching are proposed. In the algorithm for generating templates, we proposed a parameter-templates quality factor (TQF) - to measure the quality of generated templates. So that we can use fewer finger vein samples to generate templates that meet the quality requirement of identification. The recognition accuracy of using proposed methods of finger vein feature extraction and template generation strategy for identification is 97.14%.

  14. Endovascular aneurysm repair in emergent ruptured abdominal aortic aneurysm with a ‘real’ hostile neck and severely tortuous iliac artery of an elderly patient

    PubMed Central

    2014-01-01

    Background Endovascular aneurysm repair (EVAR) has been a revolutionary development in the treatment of abdominal aortic aneurysms (AAAs). Meanwhile, unfavorable anatomy of the aneurysm has always been a challenge to vascular surgeons, and the application of EVAR in emergent and elderly patients are still in dispute. Case presentation A 79-year-old woman presented as an emergency of abdominal pain with acute hypotension, heart rate elevation and a rapid decrease of hemoglobin. Emergent computed tomographic angiography (CTA) showed a ruptured AAA (rAAA) extending from below the opening of bilateral renal arteries down to the celiac artery and elongated to both common iliac arteries. The hostile neck and severely tortuous iliac artery made the following procedure a great challenge. An emergent endovascular approach was performed in which an excluder aortic main body was deployed below the origin of the bilateral renal arteries covering the ruptured aortic segment. Two iliac legs were placed superior to the opening of the right hypogastric respectively. In order to avoid the type Ib endoleak, we tried to deploy another cuff above the bifurcation of the iliac artery. However, the severely tortuous right iliac artery made this procedure extremely difficult, and a balloon-assisted technique was used in order to keep the stiff wire stable. Another iliac leg was placed above the bifurcation of the left iliac artery. The following angiography showed a severe Ia endoleak in the proximal neck and therefore, a cuff was deployed distal to opening of the left renal artery with off-the-shelf solution. The patient had an uneventful recovery with a resolution of the rAAA. She is well and symptom-free 6 months later. Conclusion Endovascular aneurysm repair (EVAR) in emergent elderly rAAA with hostile neck and severe tortuous iliac artery is extremely challenging, and endovascular management with integrated technique is feasible and may achieve a satisfactory early result. PMID

  15. Fracture and Collapse of Balloon-Expandable Stents in the Bilateral Common Iliac Arteries Due to Shiatsu Massage

    SciTech Connect

    Ichihashi, Shigeo Higashiura, Wataru; Itoh, Hirofumi; Sakaguchi, Shoji; Kichikawa, Kimihiko

    2012-12-15

    We report a case of stent fracture and collapse of balloon-expandable stents caused by shiatsu massage. A 76-year-old man presented with complaints of intermittent claudication of the right lower extremity. Stenoses of the bilateral common iliac arteries (CIAs) were detected. Balloon-expandable stents were deployed in both CIAs, resulting in resolution of symptoms. Five months later, pelvis x-ray showed collapse of both stents. Despite the stent collapse, the patient was asymptomatic, and his ankle brachial index values were within the normal range. Further history showed that the patient underwent daily shiatsu therapy in the umbilical region, which may have triggered collapse of the stent. Physicians should advise patients to avoid compression of the abdominal wall after implantation of a stent in the iliac artery.

  16. A case of donor-site lymphoedema after lymph node-superficial circumflex iliac artery perforator flap transfer.

    PubMed

    Pons, Gemma; Masia, Jaume; Loschi, Pietro; Nardulli, Maria Luisa; Duch, Joan

    2014-01-01

    Vascularised lymph node transfer is a promising technique to treat limb lymphoedema, especially when caused by lymph node dissection. The most common approach is the transfer of superficial inguinal lymph nodes using groin flaps or superficial circumflex iliac artery perforator flaps. Lower-limb lymphatic sequelae are unexpected as these lymph nodes should drain lymph from the lower abdominal wall. Recently, Vignes et al. described two cases out of 26 cases of chronic lymphoedema after superficial inguinal lymph node harvest. From a series of 42 vascularised lymph node transfers performed at our centre, only one patient developed swelling in the donor thigh. The features of this patient who underwent a lymph node-containing superficial circumflex iliac artery perforator flap are reported herein. We recommend maximal accuracy in selecting the appropriate lymph nodes for transfer and provide some tips from our experience.

  17. Spontaneous Subcapsular Renal Hematoma: Strange Case in an Anticoagulated Patient with HWMH after Aortic and Iliac Endovascular Stenting Procedure

    PubMed Central

    Greco, Michele; Benedetto, Filippo; Spinelli, Francesco; Traxer, Olivier; Tefik, Tzevat; Pappalardo, Rosa

    2016-01-01

    Spontaneous subcapsular renal hematoma is a rare condition in clinical practice. It is caused by renal cysts, benign and malignant renal tumors, vascular lesions, and antiplatelet or anticoagulant therapy. In this paper we report an unusual case of rupture of a renal cyst of a 66-year-old male patient during an aortic and iliac endovascular procedure for a massive calcified atheroma above the iliac bifurcation. We suspected that the bolus of high weight molecular heparin given during the procedure caused the rupture of the cyst. According to the literature, this is the first case of renal cyst rupture during an endovascular aortic procedure after administering a high weight molecular heparin bolus. PMID:27579210

  18. An unusual complication of femoral vein catheterisation: pneumoperitoneum.

    PubMed

    Yildizdas, D; Tepe, T; Parlak, M; Akcali, M

    2007-12-01

    A 2-month-old girl with severe pneumonia required a central venous line. Femoral vein catheterisation was attempted but insertion was difficult. Pneumoperitoneum developed, which is a rare complication of femoral vein catheterisation. It is important when undertaking femoral vein catheterisation to use the correct landmarks in the femoral triangle below the inguinal ligament and an appropriate size of catheter.

  19. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  20. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  1. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  2. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  3. 21 CFR 880.6970 - Liquid crystal vein locator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters)....

  4. Who Is at Risk for Deep Vein Thrombosis?

    MedlinePlus

    ... on Twitter. Who Is at Risk for Deep Vein Thrombosis? The risk factors for deep vein thrombosis (DVT) include: A history of DVT. Conditions or factors that make your blood thicker or more likely to clot than normal. Some inherited ... to a deep vein from surgery, a broken bone, or other trauma. ...

  5. Preduodenal portal vein in an adult--angiography and CT.

    PubMed

    Sasai, K; Sano, A; Nishizawa, S; Imanaka, K; Kuroda, Y

    1985-01-01

    We report on an adult case of preduodenal portal vein illustrated by computed tomography (CT) and angiography. These diagnostic modalities were initially performed to evaluate a coexisting pancreatic cancer. Contrast-enhanced CT demonstrated unusual positioning of the portal vein ventral to the duodenum. The superior mesenteric-portal vein, which was L-shaped and convexly caudad, strongly suggested this anomalous condition.

  6. Venous thrombosis in subclavian, axillary, brachial veins with extension to internal jugular vein, right sigmoid sinus and simultaneous pulmonary embolism

    PubMed Central

    Tamizifar, Babak; Beigi, Arash; Rismankarzadeh, Maryam

    2013-01-01

    We present a rare case of Venous Thrombosis in Subclavian, Axillary, Brachial Veins with extension to Internal Jugular vein, right sigmoid sinus and simultaneous Pulmonary embolism during the treatment with low molecular weight heparin. PMID:23901341

  7. Modified Iliac Crest Reconstruction with Bone Cement for Reduction of Donor Site Pain and Morbidity after Open Wedge High Tibial Osteotomy: A Prospective Study

    PubMed Central

    Lee, Jong Seong; Park, Yong Jee; Wang, Lih; Chang, Yong Suk; Shetty, Gautam M.; Nha, Kyung Wook

    2016-01-01

    Purpose This study was to determine the efficacy of iliac crest reconstruction using bone cement in reducing pain and morbidity at the donor site in patients undergoing open wedge high tibial osteotomy (OWHTO) with tricortical iliac crest autologous graft. Materials and Methods Thirty-three patients who underwent iliac crest reconstruction using polymethyl methacrylate (PMMA) bone cement (group A) and thirty patients who had no iliac crest reconstruction (group B) were enrolled in this study. All patients were evaluated for pain and functional disability related to graft harvesting using the pain and functional visual analogue scale (VAS) score during hospital stay and at 6 weeks, 3 months, and 6 months postoperatively. Results There was significant difference between the two groups in terms of pain and function. The pain VAS score was significantly lower in group A than group B during the first 2 weeks postoperatively (p=0.04) and the functional VAS score was also significantly lower in group A during the first 2 weeks postoperatively (p<0.001) in terms of breathing, sitting up from the supine position, and standing up with crutches from the sitting position. Conclusions Iliac crest donor site reconstruction using PMMA bone cement in patients undergoing OWHTO significantly decreased pain and improved function during the first 2 weeks postoperatively when compared to patients who underwent OWHTO without iliac crest reconstruction. PMID:27894174

  8. Validation of a Method to Accurately Correct Anterior Superior Iliac Spine Marker Occlusion

    PubMed Central

    Hoffman, Joshua T.; McNally, Michael P.; Wordeman, Samuel C.; Hewett, Timothy E.

    2015-01-01

    Anterior superior iliac spine (ASIS) marker occlusion commonly occurs during three-dimensional (3-D) motion capture of dynamic tasks with deep hip flexion. The purpose of this study was to validate a universal technique to correct ASIS occlusion. 420ms of bilateral ASIS marker occlusion was simulated in fourteen drop vertical jump (DVJ) trials (n=14). Kinematic and kinetic hip data calculated for pelvic segments based on iliac crest (IC) marker and virtual ASIS (produced by our algorithm and a commercial virtual join) trajectories was compared to true ASIS marker tracking data. Root mean squared errors (RMSEs; mean ± standard deviation) and intra-class correlations (ICCs) between pelvic tracking based on virtual ASIS trajectories filled by our algorithm and true ASIS position were 2.3±0.9° (ICC=0.982) flexion/extension, 0.8±0.2° (ICC=0.954) abduction/adduction for hip angles, and 0.40±0.17N-m (ICC=1.000) and 1.05±0.36N-m (ICC=0,998) for sagittal and frontal plane moments. RMSEs for IC pelvic tracking were 6.9±1.8° (ICC=0.888) flexion/extension, 0.8±0.3° (ICC=0.949) abduction/adduction for hip angles, and 0.31±0.13N-m (ICC=1.00) and 1.48±0.69N-m (ICC=0.996) for sagittal and frontal plane moments. Finally, the commercially-available virtual join demonstrated RMSEs of 4.4±1.5° (ICC=0.945) flexion/extension, 0.7±0.2° (ICC=0.972) abduction/adduction for hip angles, and 0.97±0.62N-m (ICC=1.000) and 1.49±0.67N-m (ICC=0.996) for sagittal and frontal plane moments. The presented algorithm exceeded the a priori ICC cutoff of 0.95 for excellent validity and is an acceptable tracking alternative. While ICCs for the commercially available virtual join did not exhibit excellent correlation, good validity was observed for all kinematics and kinetics. IC marker pelvic tracking is not a valid alternative. PMID:25704531

  9. A rare presentation of locally re-recurrent colon cancer involving the iliac bone and a review of the literature.

    PubMed

    Schumacher, Andrew; Babikir, Osman Mahdi; Abboud, Amer; Theodorakis, Spyridon

    2014-10-29

    Colorectal cancer is a leading cause of cancer death in the USA. While locally advanced rectal cancer involving bone has been described extensively, colon cancer locally involving bone has only been described, to our knowledge, in a single case report. In this case report, we describe the presentation and treatment of locally advanced re-recurrent colon cancer involving the iliac bone. We also discuss the available literature on treatment for recurrent and re-recurrent colorectal cancer.

  10. A rare presentation of locally re-recurrent colon cancer involving the iliac bone and a review of the literature

    PubMed Central

    Schumacher, Andrew; Mahdi Babikir, Osman; Abboud, Amer; Theodorakis, Spyridon

    2014-01-01

    Colorectal cancer is a leading cause of cancer death in the USA. While locally advanced rectal cancer involving bone has been described extensively, colon cancer locally involving bone has only been described, to our knowledge, in a single case report. In this case report, we describe the presentation and treatment of locally advanced re-recurrent colon cancer involving the iliac bone. We also discuss the available literature on treatment for recurrent and re-recurrent colorectal cancer. PMID:25355743

  11. Future of External Reporting

    ERIC Educational Resources Information Center

    Powers, Kristina

    2015-01-01

    This chapter builds on prior chapters and focuses on higher education trends on the horizon and the resulting impact on external reporting for institutional researchers. Three practical recommendations and examples for institutional researchers are also presented.

  12. Enhanced External Counterpulsation (EECP)

    PubMed Central

    2006-01-01

    class I; 35% are in class II; 25%, class III; and 5%, class IV. Surveys (8) suggest that from 5% to 15% of patients with HF have persistent severe symptoms, and that the remainder of patients with HF is evenly divided between those with mild and moderately severe symptoms. To date, the diagnosis and management of chronic HF has concentrated on patients with the clinical syndrome of HF accompanied by severe left ventricular systolic dysfunction. Major changes in treatment have resulted from a better understanding of the pathophysiology of HF and the results of large clinical trials. Treatment for chronic HF includes lifestyle management, drugs, cardiac surgery, or implantable pacemakers and defibrillators. Despite pharmacologic advances, which include diuretics, angiotensin-converting enzyme inhibitors, beta-blockers, spironolactone, and digoxin, many patients remain symptomatic on maximally tolerated doses. (6) The Technology Patients are typically treated by a trained technician in a medically supervised environment for 1 hour daily for a total of 35 hours over 7 weeks. The procedure involves sequential inflation and deflation of compressible cuffs wrapped around the patient’s calves, lower thighs and upper thighs. In addition to 3 sets of cuffs, the patient has finger plethysmogram and electrocardiogram (ECG) attachments that are connected to a control and display console. External counterpulsation was used in the United States to treat cardiogenic shock after acute myocardial infarction. (9;10) More recently, an enhanced version namely “enhanced external counterpulsation” (EECP) was introduced as a noninvasive procedure for outpatient treatment of patients with severe, uncontrollable cardiac ischemia. EECP is said to increase coronary perfusion pressure and reduce the myocardial oxygen demand. Currently, EECP is not applicable for all patients with refractory angina pectoris. For example, many patients are considered ineligible for therapy due to co

  13. Externally modulated theranostic nanoparticles.

    PubMed

    Urban, Cordula; Urban, Alexander S; Charron, Heather; Joshi, Amit

    2013-08-01

    Externally modulated nanoparticles comprise a rapidly advancing class of cancer nanotherapeutics, which combine the favorable tumor accumulation of nanoparticles, with external spatio-temporal control on therapy delivery via optical, magnetic, or ultrasound modalities. The local control on therapy enables higher tumor treatment efficacy, while simultaneously reducing off-target effects. The nanoparticle interactions with external fields have an additional advantage of frequently generating an imaging signal, and thus such agents provide theranostic (both diagnostic and therapeutic) capabilities. In this review, we classify the emerging externally modulated theranostic nanoparticles according to the mode of external control and describe the physiochemical mechanisms underlying the external control of therapy, and illustrate the major embodiments of nanoparticles in each class with proven biological efficacy: (I) electromagnetic radiation in visible and near-infrared range is being exploited for gold based and carbon nanostructures with tunable surface plasmon resonance (SPR) for imaging and photothermal therapy (PTT) of cancer, photochemistry based manipulations are employed for light sensitive liposomes and porphyrin based nanoparticles; (II) Magnetic field based manipulations are being developed for iron-oxide based nanostructures for magnetic resonance imaging (MRI) and magnetothermal therapy; (III) ultrasound based methods are primarily being employed to increase delivery of conventional drugs and nanotherapeutics to tumor sites.

  14. Externally modulated theranostic nanoparticles

    PubMed Central

    Urban, Cordula; Urban, Alexander S.; Charron, Heather; Joshi, Amit

    2013-01-01

    Externally modulated nanoparticles comprise a rapidly advancing class of cancer nanotherapeutics, which combine the favorable tumor accumulation of nanoparticles, with external spatio-temporal control on therapy delivery via optical, magnetic, or ultrasound modalities. The local control on therapy enables higher tumor treatment efficacy, while simultaneously reducing off-target effects. The nanoparticle interactions with external fields have an additional advantage of frequently generating an imaging signal, and thus such agents provide theranostic (both diagnostic and therapeutic) capabilities. In this review, we classify the emerging externally modulated theranostic nanoparticles according to the mode of external control and describe the physiochemical mechanisms underlying the external control of therapy, and illustrate the major embodiments of nanoparticles in each class with proven biological efficacy: (I) electromagnetic radiation in visible and near-infrared range is being exploited for gold based and carbon nanostructures with tunable surface plasmon resonance (SPR) for imaging and photothermal therapy (PTT) of cancer, photochemistry based manipulations are employed for light sensitive liposomes and porphyrin based nanoparticles; (II) Magnetic field based manipulations are being developed for iron-oxide based nanostructures for magnetic resonance imaging (MRI) and magnetothermal therapy; (III) ultrasound based methods are primarily being employed to increase delivery of conventional drugs and nanotherapeutics to tumor sites. PMID:24834381

  15. Internal iliac and uterine arteries Doppler ultrasound in the assessment of normotensive and chronic hypertensive pregnant women

    PubMed Central

    Guedes-Martins, L.; Cunha, A.; Saraiva, J.; Gaio, R.; Macedo, F.; Almeida, H.

    2014-01-01

    The objective of this work was to compare Doppler flows pulsatility index (PI) and resistance indexes (RI) of uterine and internal iliac arteries during pregnancy in low risk women and in those with stage-1 essential hypertension. From January 2010 and December 2012, a longitudinal and prospective study was carried out in 103 singleton uneventful pregnancies (72 low-risk pregnancies and 31 with stage 1 essential hypertension)at the 1st, 2nd and 3rd trimesters. Multiple linear regression models, fitted using generalized least squares and whose errors were allowed to be correlated and/or have unequal variances, were employed; a model for the relative differences of both arteries impedance was utilized. In both groups, uterine artery PI and RI exhibited a gestational age related decreasing trend whereas internal iliac artery PI and RI increased. The model testing the hemodynamic adaptation in women with and without hypertension showed similar trend. Irrespective of blood pressure conditions, the internal iliac artery resistance pattern contrasts with the capacitance pattern of its immediate pelvic division, suggesting a pregnancy-related regulatory mechanism in the pelvic circulation. PMID:24445576

  16. Sacro-Iliac Joint Sensory Block and Radiofrequency Ablation: Assessment of Bony Landmarks Relevant for Image-Guided Procedures.

    PubMed

    Robinson, Trevor J G; Roberts, Shannon L; Burnham, Robert S; Loh, Eldon; Agur, Anne M

    2016-01-01

    Image-guided sensory block and radiofrequency ablation of the nerves innervating the sacro-iliac joint require readily identifiable bony landmarks for accurate needle/electrode placement. Understanding the relative locations of the transverse sacral tubercles along the lateral sacral crest is important for ultrasound guidance, as they demarcate the position of the posterior sacral network (S1-S3 ± L5/S4) innervating the posterior sacro-iliac joint. No studies were found that investigated the spatial relationships of these bony landmarks. The purpose of this study was to visualize and quantify the interrelationships of the transverse sacral tubercles and posterior sacral foramina to inform image-guided block and radiofrequency ablation of the sacro-iliac joint. The posterior and lateral surfaces of 30 dry sacra (15 M/15 F) were digitized and modeled in 3D and the distances between bony landmarks quantified. The relationships of bony landmarks (S1-S4) were not uniform. The mean intertubercular and interforaminal distances decreased from S1 to S4, whereas the distance from the lateral margin of the posterior sacral foramina to the transverse sacral tubercles increased from S1 to S3. The mean intertubercular distance from S1 to S3 was significantly (p < 0.05) larger in males. The interrelationships of the sacral bony landmarks should be taken into consideration when estimating the site and length of an image-guided strip lesion targeting the posterior sacral network.

  17. Fulminant Necrotizing Fasciitis of the Thigh, Following an Infection of the Sacro-iliac Joint in an Immunosuppressed, Young Woman.

    PubMed

    Gothner, Martin; Dudda, Marcel; Kruppa, Christiane; Schildhauer, Thomas A; Swol, Justyna

    2015-09-28

    Necrotizing soft tissue infection of an extremity is a rare but life-threatening disease. The disease is an infection that involves the soft tissue layer and is characterized by rapidly spreading inflammation (especially of the fascial planes and the surrounding tissues) with a high mortality. Early diagnosis is essential for the outcome of the patients. Radical surgical debridement is the treatment of choice. The predisposing factors are immunosuppression, diabetes mellitus and drug abuse. This report presents a case of necrotizing fasciitis in the thigh, following an abscess of the sacro-iliac joint, as a rare complication in a young, immunosuppressed woman. The patient's history revealed intravenous drug abuse and hepatitis C. After immediate diagnosis by magnetic resonance imaging, radical surgical debridement was required and performed. Prior to soft tissue coverage with a split skin graft, five additional sequential debridements were necessary. During her hospital stay, the patient experienced further cerebral and pulmonary septic embolisms and an infection of the elbow. Six months after admission, the patient was discharged in good condition to a rehabilitation center. Necrotizing fasciitis is a life-threatening complication following an abscess of the sacro-iliac joint. Physicians must be vigilant to inflammatory signs and pain in immunosuppressed patients. An abscess of the sacro-iliac joint is rare, but complications of an untreated abscess can be fatal in these patients.

  18. Improving the accuracy of mandibular reconstruction with vascularized iliac crest flap: Role of computer-assisted techniques.

    PubMed

    Zhang, Wen-Bo; Yu, Yao; Wang, Yang; Mao, Chi; Liu, Xiao-Jing; Guo, Chuan-Bin; Yu, Guang-Yan; Peng, Xin

    2016-11-01

    While vascularized iliac crest flap is widely used for mandibular reconstruction, it is often challenging to predict the clinical outcome in a conventional operation based solely on the surgeon's experience. Herein, we aimed to improve this procedure by using computer-assisted techniques. We retrospectively reviewed records of 45 patients with mandibular tumor who underwent mandibulectomy and reconstruction with vascularized iliac crest flap from January 2008 to June 2015. Computer-assisted techniques including virtual plan, stereomodel, pre-bending individual reconstruction plate, and surgical navigation were used in 15 patients. The other 30 patients underwent conventional surgery based on the surgeon's experience. Condyle position and reconstructed mandible contour were evaluated based on post-operative computed tomography. Complications were also evaluated during the follow-up. Flap success rate of the patients was 95.6% (43/45). Those in the computer-assisted group presented with better outcomes of the mandibular contour (p = 0.001) and condyle position (p = 0.026). Further, they also experienced beneficial dental restoration (p = 0.011) and postoperative appearance (p = 0.028). The difference between postoperative effect and virtual plan was within the acceptable error margin. There is no significant difference in the incidence of post-operative complications. Thus, computer-assisted techniques can improve the clinical outcomes of mandibular reconstruction with vascularized iliac crest flap.

  19. ACUTE TEARING OF THE OBLIQUE ABDOMINAL WALL INSERTION ONTO THE ILIAC CREST IN AN AUSTRALIAN FOOTBALL PLAYER: A CASE REPORT

    PubMed Central

    Stockden, Marshall; Breidahl, Bill

    2016-01-01

    Background Tears of the abdominal obliques have previously been reported in the vicinity of the lower ribs but they have not been reported in the vicinity of the iliac crest. The purpose of this case report is to describe the mechanism of injury and diagnosis of a distal abdominal oblique tear and subsequent rehabilitation programming. Case Description A 21-year-old male Australian football player experienced acute right-sided abdominal pain during a game while performing a commonly executed rotation skill. He was assessed clinically before being further examined with ultrasound and magnetic resonance imaging which revealed a rupture of the abdominal oblique wall at its insertion onto the iliac crest. The player then underwent a structured and graduated rehabilitation program with clear key performance indicators to optimize return to play and prevent recurrence. Outcomes The player was able to return to play at 35 days post injury and had no recurrence or complications at 12 month follow up post injury. Discussion This is the first time an abdominal oblique wall rupture at its insertion onto the iliac crest has been reported. In players with acute abdominal pain following twisting an insertional oblique tear should be considered as a differential diagnosis. A structured rehabilitation program may also help optimize an athlete's return to play after distal abdominal oblique rupture. PMID:27999726

  20. Segmentation and reconstruction of hepatic veins and intrahepatic portal vein based on the coronal sectional anatomic dataset.

    PubMed

    Lou, Li; Liu, Shu Wei; Zhao, Zhen Mei; Heng, Pheng Ann; Tang, Yu Chun; Li, Zheng Ping; Xie, Yong Ming; Chui, Yim Pan

    2009-12-01

    Three-dimensional (3D) reconstruction of intrahepatic vessels is very useful in visualizing the complex anatomy of hepatic veins and intrahepatic portal vein. It also provides a 3D anatomic basis for diagnostic imaging and surgical operation on the liver. In the present study, we built a 3D digitized model of hepatic veins and intrahepatic portal vein based on the coronal sectional anatomic dataset of the liver. The dataset was obtained using the digital freezing milling technique. The pre-reconstructed structures were identified and extracted, and then were segmented by the method of manual intervention. The digitized model of hepatic veins and intrahepatic portal vein was established using 3D medical visualization software. This model facilitated a continuous and dynamic displaying of the hepatic veins and intrahepatic portal vein at different orientations, which demonstrated the complicated relationship of adjacent hepatic veins and intrahepatic portal vein realistically in the 3D space. This study indicated that high-quality 2D images, precise data segmentation, and suitable 3D reconstruction methods ensured the reality and accuracy of the digital visualized model of hepatic veins and intrahepatic portal vein.

  1. Transcutaneous laser treatment of leg veins.

    PubMed

    Meesters, Arne A; Pitassi, Luiza H U; Campos, Valeria; Wolkerstorfer, Albert; Dierickx, Christine C

    2014-03-01

    Leg telangiectasias and reticular veins are a common complaint affecting more than 80% of the population to some extent. To date, the gold standard remains sclerotherapy for most patients. However, there may be some specific situations, where sclerotherapy is contraindicated such as needle phobia, allergy to certain sclerosing agents, and the presence of vessels smaller than the diameter of a 30-gauge needle (including telangiectatic matting). In these cases, transcutaneous laser therapy is a valuable alternative. Currently, different laser modalities have been proposed for the management of leg veins. The aim of this article is to present an overview of the basic principles of transcutaneous laser therapy of leg veins and to review the existing literature on this subject, including the most recent developments. The 532-nm potassium titanyl phosphate (KTP) laser, the 585-600-nm pulsed dye laser, the 755-nm alexandrite laser, various 800-983-nm diode lasers, and the 1,064-nm neodymium yttrium-aluminum-garnet (Nd:YAG) laser and various intense pulsed light sources have been investigated for this indication. The KTP and pulsed dye laser are an effective treatment option for small vessels (<1 mm). The side effect profile is usually favorable to that of longer wavelength modalities. For larger veins, the use of a longer wavelength is required. According to the scarce evidence available, the Nd:YAG laser produces better clinical results than the alexandrite and diode laser. Penetration depth is high, whereas absorption by melanin is low, making the Nd:YAG laser suitable for the treatment of larger and deeply located veins and for the treatment of patients with dark skin types. Clinical outcome of Nd:YAG laser therapy approximates that of sclerotherapy, although the latter is associated with less pain. New developments include (1) the use of a nonuniform pulse sequence or a dual-wavelength modality, inducing methemoglobin formation and enhancing the optical absorption

  2. Aorto-coronary vein graft 'Y' anastomosis made easy.

    PubMed

    Jarvis, Martin Amadee

    2011-10-01

    Vein graft-to-vein graft anastomosis, creating a 'Y' graft, is a useful technique when there is a lack of good-quality autologous vein to perform individual aorto-coronary bypass grafts or when the ascending aorta is short or atheromatous, limiting the space for proximal graft anastomosis. Unlike artery-to-artery composite grafts, which are resistant to flow-limiting technique-based distortions, the accurate construction of vein-to-vein anastomoses is critical. A technique is described that facilitates accurate placement of the anastomosis that prevents kinking, twisting or displacement.

  3. [Clinical estimation of the central vein catheterization in phthysiosurgical patients].

    PubMed

    Opanasenko, M S; Levanda, L I; Kononenko, V A; Klymenko, V I; Tereshkovych, O V; Kalenychenko, M I; Konik, B M; Obrems'ka, O K; Demus, R S; Kshanovs'kyĭ, O E

    2013-04-01

    The issue of actuality of the central veins catheterization application was studied in phthysiosurgical patients. The author's view, concerning indications and choosing of the central vein catheterization side, was presented. The data, concerning frequency of the certain veins catheterization, were adduced. General succeeding in performing central veins catheterization have had constituted 96%. While having complications rate of 11.8%, this included mechanical--8.2%, thrombotic--2.3%, infective--1.3%. There was substantiated one of the most optimal and secure procedure among central accesses--the internal jugular vein catheterization.

  4. Internal vein texture and vein evolution of the epithermal Shila-Paula district, southern Peru

    NASA Astrophysics Data System (ADS)

    Chauvet, Alain; Bailly, Laurent; André, Anne-Sylvie; Monié, Patrick; Cassard, Daniel; Tajada, Fernando Llosa; Vargas, Juan Rosas; Tuduri, Johann

    2006-07-01

    The epithermal Shila-Paula Au-Ag district is characterized by numerous veins hosted in Tertiary volcanic rocks of the Western Cordillera (southern Peru). Field studies of the ore bodies reveal a systematic association of a main E-W vein with secondary N55-60°W veins—two directions that are also reflected by the orientation of fluid-inclusion planes in quartz crystals of the host rock. In areas where this pattern is not recognized, such as the Apacheta sector, vein emplacement seems to have been guided by regional N40°E and N40°W fractures. Two main vein-filling stages are identified. stage 1 is a quartz-adularia-pyrite-galena-sphalerite-chalcopyrite-electrum-Mn silicate-carbonate assemblage that fills the main E-W veins. stage 2, which contains most of the precious-metal mineralization, is divided into pre-bonanza and bonanza substages. The pre-bonanza substage consists of a quartz-adularia-carbonate assemblage that is observed within the secondary N45-60°W veins, in veinlets that cut the stage 1 assemblage, and in final open-space fillings. The two latter structures are finally filled by the bonanza substage characterized by a Fe-poor sphalerite-chalcopyrite-pyrite-galena-tennantite-tetrahedrite-polybasite-pearceite-electrum assemblage. The ore in the main veins is systematically brecciated, whereas the ore in the secondary veins and geodes is characteristic of open-space crystallization. Microthermometric measurements on sphalerite from both stages and on quartz and calcite from stage 2 indicate a salinity range of 0 to 15.5 wt% NaCl equivalent and homogenization temperatures bracketed between 200 and 330°C. Secondary CO2-, N2- and H2S-bearing fluid inclusions are also identified. The age of vein emplacement, based on 40Ar/39Ar ages obtained on adularia of different veins, is estimated at around 11 Ma, with some overlap between adularia of stage 1 (11.4±0.4 Ma) and of stage 2 (10.8±0.3 Ma). A three-phase tectonic model has been constructed to explain the

  5. Can serum interleukin-6 levels predict the outcome of patients with right iliac fossa pain?

    PubMed Central

    Goodwin, A. T.; Swift, R. I.; Bartlett, M. J.; Fernando, B. S.; Chadwick, S. J.

    1997-01-01

    In patients with right iliac fossa (RIF) pain it can be difficult to distinguish between appendicitis and nonspecific abdominal pain (NSAP). In this study we sought to determine whether serum interleukin-6 (IL-6) levels, an early marker of acute inflammation, taken at the time of admission could predict the outcome of patients admitted with RIF pain. Data were collected in a prospective manner on 53 consecutive patients (23 male, 30 female), mean age 22.1 years (range 10-79 years). Nineteen (36%) patients underwent surgery, of whom 16 had appendicitis (histologically proven). The mean (SEM) IL-6 levels (pg/ml) in patients undergoing operation vs those receiving non-operative management were 270.8 (106.3) vs 265.0 (80.4) (P = NS). The mean white blood cell (WBC) counts (x10(9)/l) in these patients were 14.28 (0.81) vs 9.66 (0.67), respectively (P = 0.0002). When patients with a confirmed diagnosis of appendicitis were compared with patients with a diagnosis of NSAP, the IL-6 levels were 149.4 (69.1) vs 363.6 (113.2), respectively (P = NS). In the same groups of patients, the WBC counts were 14.21 (0.81) vs 9.51 (0.68) (P = 0.004). We conclude that IL-6 levels taken at the time of admission are not useful in predicting the outcome of RIF pain. PMID:9135242

  6. Can serum interleukin-6 levels predict the outcome of patients with right iliac fossa pain?

    PubMed

    Goodwin, A T; Swift, R I; Bartlett, M J; Fernando, B S; Chadwick, S J

    1997-03-01

    In patients with right iliac fossa (RIF) pain it can be difficult to distinguish between appendicitis and nonspecific abdominal pain (NSAP). In this study we sought to determine whether serum interleukin-6 (IL-6) levels, an early marker of acute inflammation, taken at the time of admission could predict the outcome of patients admitted with RIF pain. Data were collected in a prospective manner on 53 consecutive patients (23 male, 30 female), mean age 22.1 years (range 10-79 years). Nineteen (36%) patients underwent surgery, of whom 16 had appendicitis (histologically proven). The mean (SEM) IL-6 levels (pg/ml) in patients undergoing operation vs those receiving non-operative management were 270.8 (106.3) vs 265.0 (80.4) (P = NS). The mean white blood cell (WBC) counts (x10(9)/l) in these patients were 14.28 (0.81) vs 9.66 (0.67), respectively (P = 0.0002). When patients with a confirmed diagnosis of appendicitis were compared with patients with a diagnosis of NSAP, the IL-6 levels were 149.4 (69.1) vs 363.6 (113.2), respectively (P = NS). In the same groups of patients, the WBC counts were 14.21 (0.81) vs 9.51 (0.68) (P = 0.004). We conclude that IL-6 levels taken at the time of admission are not useful in predicting the outcome of RIF pain.

  7. Effect of hydroxyapatite nanoparticles on osmotic responses of pig iliac endothelial cells.

    PubMed

    Yue, Cui; Zhao, Gang; Yi, Jingru; Gao, Cai; Shen, Lingxiao; Zhang, Yuntian; Wang, Zhen; Liu, Wei

    2014-10-01

    In order to fully explore the potential applications of nanoparticles in biopreservation, it is necessary to study the effect of nanoparticles on cell membrane permeabilities. The aim of this study is therefore to comparatively evaluate the osmotic responses of pig iliac endothelial cells in the absence and presence of commercially available hydroxyapatite nanoparticles. The results indicate that, after the introduction of 0.0 1 wt% hydroxyapatite nanoparticles, the dependence of cell membrane hydraulic conductivity (Lp) on temperature still obeys the Arrhenius relationship, while the reference value of the hydraulic conductivity of the cell membrane at 273.15K (Lpg) and the activation energy for water transport across cell membrane (ELp) change from 0.77 × 10(-14)m/Pa/s and 15.65 kJ/mol to 0.65 × 10(-14)m/Pa/s and 26.14 kJ/mol. That is to say, the reference value of the hydraulic conductivity of the cell membrane has been slightly decreased while the activation energy for water transport across cell membrane has been greatly enhanced, and thus it implies that the hydraulic conductivity of cell membrane are more sensitive to temperature in the presence of nanoparticles. These findings are of potential significance to the optimization of nanoparticles-aided cryopreservation.

  8. [Internal Fixation of Sacro-iliac Joint in Unstable Fractures of the Pelvic Ring.].

    PubMed

    Soukup, B

    1999-01-01

    Unstable fractures of the pelvic ring are always serious injuries posing problems from many aspects. Among the most serious are definitely unstable fractures of the pelvic ring with both vertical and rotational instability, i. e. type C fractures according to AO classification scheme. The recent therapeutic concept recommends in case of these fractures an active reconstruction on the dorsal SI complex which evidently improves the final perspective of patients with such a severe injury. The author presents his own clinical experience and literary data relating to the treatment of 11 patients who underwent reconstruction in the region of dorsal sacro-iliac complex due to type C unstable fracture. Clinical results achieved on the basis of the evaluation of a group of 11 patients are favourable and promising despite a significant complexity of the problems of unstable pelvic fractures. In 9 patients the anatomical result on radiograph was excellent, 9 patients regained full mobility after the proper physiotherapy, 10 patients resumed their work and 6 patients resumed even professional sports activity. In the conclusion the author states that in suitable, mainly young and fully stabilized patients the reconstruction surgery on the dorsal pelvic SI segment is fully justified which is documented both by the literary data and his own experience. Key words: unstable pelvic fractures.

  9. Comparison of Self-Expanding Polyethylene Terephthalate and Metallic Stents Implanted in Porcine Iliac Arteries

    SciTech Connect

    Wilczek, Krzysztof; Scheerder, Ivan de; Wang Kai; Verbeken, Eric; Piessens, Jan

    1996-05-15

    Purpose: Comparison of the biocompatibility of self-expanding polyethylene terephthalate (PET) stents with self-expanding metallic stents (Wallstents). Methods: Diameter- and length-matched PET stents and Wallstents were symmetrically implanted in the paired iliac arteries of 13 crossbred domestic swine. Stent deployment was studied angiographically and with intravascular ultrasound immediately after stent implantation. The angiographic stented lumen diameter was measured using quantitative vessel analysis before, immediately after stenting, and at 6-week follow-up. Cross-section histopathology and area morphometry were performed. Results: Immediately poststenting, intravascular ultrasound revealed proximal dislocation of 5 of the 13 PET stents, whereas all metal stents were firmly embedded at the implantation site. At 6-week follow-up, three of the remaining PET stents were totally or subtotally occluded by organized thrombus, whereas all metal stents were patent. Compared with immediately poststenting, the angiographic lumen diameter within the five remaining PET stents was reduced by 30%, and that of the metallic stents was virtually unaltered (p < 0.02). This observation was confirmed by postmortem morphometry, wherein the PET-stented vessel segments a diameter stenosis of 40% was measured vs only 9% in the metallic stents (p < 0.0001). Conclusion: PET-stent deployment is difficult to control due to the lack of radiopacity of this stent. PET stents seem to be more thrombogenic and lead to significantly more neointimal proliferation than metallic stents.

  10. Endovascular Treatment of Infrarenal Abdominal Aortic Lesions With or Without Common Iliac Artery Involvement

    SciTech Connect

    Oender, Hakan; Oguzkurt, Levent; Guer, Serkan; Tekbas, Gueven; Guerel, Kamil; Coskun, Isa; Oezkan, Ugur

    2013-02-15

    To evaluate the results of stent placement for obstructive atherosclerotic aortic disease with or without involvement of the common iliac artery. Forty patients had self-expanding stents primarily or after balloon dilatation in the abdominal aorta between January 2005 and May 2011. All patients had trouble walking. Follow-up examinations were performed with clinical visits; these included color Doppler ultrasonography and computed tomographic angiography. Technical, clinical, and hemodynamic success was achieved in all patients. None of the patients underwent reintervention during the follow-up period, which ranged from 3 months to 6 years (median 24 months). Nine complications occurred in six patients. Of the nine complications, four were distal thromboembolisms, which were successfully treated with catheter-directed thrombolysis or anticoagulation therapy. Endovascular treatment of the obstructive aortic disease using self-expanding stents was safe and effective, with high technical success and long-term patency. Thromboembolic complications were high even though direct stenting was considered protective for thromboembolism formation. Particularly for infrarenal aortic stenosis, it can be recommended as the first-line treatment option for patients with obstructive atherosclerotic aortic disease.

  11. Embolization of an Internal Iliac Artery Aneurysm after Image-Guided Direct Puncture

    SciTech Connect

    Heye, S. Vaninbroukx, J.; Daenens, K.; Houthoofd, S.; Maleux, G.

    2012-08-15

    Objective: To evaluate the feasibility, safety, and efficacy of embolization of internal iliac artery aneurysm (IIAA) after percutaneous direct puncture under (cone-beam) computed tomography (CT) guidance. Methods: A retrospective case series of three patients, in whom IIAA not accessible by way of the transarterial route, was reviewed. CT-guided puncture of the IIAA sac was performed in one patient. Two patients underwent puncture of the IIAA under cone-beam CT guidance. Results: Access to the IIAA sac was successful in all three patients. In two of the three patients, the posterior and/or anterior division was first embolized using platinum microcoils. The aneurysm sac was embolized with thrombin in one patient and with a mixture of glue and Lipiodol in two patients. No complications were seen. On follow-up CT, no opacification of the aneurysm sac was seen. The volume of one IIAA remained stable at follow-up, and the remaining two IIAAs decreased in size. Conclusion: Embolization of IIAA after direct percutaneous puncture under cone-beam CT/CT-guidance is feasible and safe and results in good short-term outcome.

  12. Sectioned images and surface models of a cadaver for understanding the deep circumflex iliac artery flap.

    PubMed

    Kim, Bong Chul; Chung, Min Suk; Kim, Hyung Jun; Park, Jin Seo; Shin, Dong Sun

    2014-03-01

    The aim of this study was to describe the deep circumflex iliac artery (DCIA) flap from sectioned images and stereoscopic anatomic models using Visible Korean, for the benefit of medical education and clinical training in the field of oromandibular reconstructive surgery. Serially sectioned images of the pelvic area were obtained from a cadaver. Outlines of significant structures in the sectioned images were drawn and stacked to build surface models. The PDF (portable document format) file (size, 30 MB) of the constructed models is available for free download on the Web site of the Department of Anatomy at Ajou University School of Medicine (http://anatomy.co.kr). In the PDF file, the relevant structures of the DCIA flap can be seen in the sectioned images. All surface models and stereoscopic structures associated with the DCIA flap are displayed in real time. We hope that these state-of-the-art sectioned images, outlined images, and surface models will help students and trainees better understand the anatomy associated with DCIA flap.

  13. Myxofibroma of the maxilla. Reconstruction with iliac crest graft and dental implants after tumor resection.

    PubMed

    Infante-Cossío, Pedro; Martínez-de-Fuentes, Rafael; García-Perla-García, Alberto; Jiménez-Castellanos, Emilio; Gómez-Izquierdo, Lourdes

    2011-07-01

    Odontogenic fibromyxomas are benign odontogenic tumors of mesenchymal origin of rare presentation in the oral cavity, which exhibit locally aggressive behavior and are prone to local recurrence. The controversy has mainly been on therapeutic management with recommendations varying, depending on the clinical cases, from simple curettage of lesion to segmental bone resection. We present a case report describing the reconstruction of an osseous defect in the maxilla and the restoration with dental implants in a 32 year old female patient after radical surgical excision due to an odontogenic fibromyxoma with locally aggressive behavior. The primary reconstruction of maxillary discontinuity defect was carried out by an immediate non-vascularized cortico-cancellous iliac crest graft. Using a computer-guided system for the implant treatment-planning, three dental implants were secondary placed in the bone graft by means of flapless implant surgery. The patient was subsequently restored with an implant-supported fixed prosthesis that has remained in continuous function for a period of three years. The surgical, reconstructive and restorative treatment sequence and techniques are discussed.

  14. Thin superficial circumflex iliac artery perforator flap and supermicrosurgery technique for face reconstruction.

    PubMed

    Choi, Dong Hoon; Goh, Terence; Cho, Jae Young; Hong, Joon Pio

    2014-11-01

    Distant free flaps have become a routine option for reconstruction of large, complicated facial soft tissue defects. The challenge is to find a flap that is pliable to provide good contour and function. The purpose of this paper was to evaluate the use of superficial circumflex iliac artery perforator (SCIP) flaps for facial defects. From November 2010 to June 2013, facial reconstruction was performed on 6 patients (age range, 15-79 years). The harvesting technique was modified to elevate above the deep fat, and the pedicles were taken above or just below the deep fascia. The mean size of the flap was 75.6 cm2, with a thickness of 7 mm; the mean pedicle length was 4.9 cm; and the mean artery caliber was 0.7 mm. The supermicrosurgery technique was used successfully in all 6 cases. Donor sites were all closed primarily. The mean follow-up was 16.7 months. All flaps survived without flap loss, and the donor sites healed without complications including lymphorrhea. The patients were satisfied with contour and function after reconstruction. The result of these 6 cases suggested that the SCIP flap can be a reliable flap for moderate-sized to large defects in the face. The use of new instrumentation and supermicrosurgical techniques allows use of the SCIP flap reliably while providing patients with a good contour, function, and minimal donor site morbidity.

  15. Successful Portal Vein Stent Placement in a Child with Cavernomatous Replacement of the Portal Vein After Partial Liver Transplantation: The Importance of a Recognizable Portal Vein Remnant.

    PubMed

    Miraglia, Roberto; Maruzzelli, Luigi; Caruso, Settimo; Ricotta, Calogero; Riva, Silvia; Burgio, Gaetano; Spada, Marco; Luca, Angelo

    2015-12-01

    Late portal vein thrombosis with cavernomatous replacement has been reported in 4.5% of pediatric patients who have undergone partial liver transplantation. In such cases, minimally invasive radiological treatments have a high failure rate. We report a successful case of percutaneous recanalization of the portal vein remnant, and subsequent stent placement, in a pediatric patient who underwent left lateral split liver transplantation with cavernomatous replacement of the portal vein.

  16. Augmented reality based real-time subcutaneous vein imaging system

    PubMed Central

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-01-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed. PMID:27446690

  17. Augmented reality based real-time subcutaneous vein imaging system.

    PubMed

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-07-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed.

  18. Finger vein extraction using gradient normalization and principal curvature

    NASA Astrophysics Data System (ADS)

    Choi, Joon Hwan; Song, Wonseok; Kim, Taejeong; Lee, Seung-Rae; Kim, Hee Chan

    2009-02-01

    Finger vein authentication is a personal identification technology using finger vein images acquired by infrared imaging. It is one of the newest technologies in biometrics. Its main advantage over other biometrics is the low risk of forgery or theft, due to the fact that finger veins are not normally visible to others. Extracting finger vein patterns from infrared images is the most difficult part in finger vein authentication. Uneven illumination, varying tissues and bones, and changes in the physical conditions and the blood flow make the thickness and brightness of the same vein different in each acquisition. Accordingly, extracting finger veins at their accurate positions regardless of their thickness and brightness is necessary for accurate personal identification. For this purpose, we propose a new finger vein extraction method which is composed of gradient normalization, principal curvature calculation, and binarization. As local brightness variation has little effect on the curvature and as gradient normalization makes the curvature fairly uniform at vein pixels, our method effectively extracts finger vein patterns regardless of the vein thickness or brightness. In our experiment, the proposed method showed notable improvement as compared with the existing methods.

  19. Differential changes in vascular mRNA levels between rat iliac and renal arteries produced by cessation of voluntary running.

    PubMed

    Padilla, Jaume; Jenkins, Nathan T; Roberts, Michael D; Arce-Esquivel, Arturo A; Martin, Jeffrey S; Laughlin, M Harold; Booth, Frank W

    2013-01-01

    Early vascular changes at the molecular level caused by adoption of a sedentary lifestyle are incompletely characterized. Herein, we employed the rodent wheel-lock model to identify mRNAs in the arterial wall that are responsive to the acute transition from higher to lower levels of daily physical activity. Specifically, we evaluated whether short-term cessation of voluntary wheel running alters vascular mRNA levels in rat conduit arteries previously reported to have marked increases (i.e. iliac artery) versus marked decreases (i.e. renal artery) in blood flow during running. We used young female Wistar rats with free access to voluntary running wheels. Following 23 days of voluntary running (average distance of ∼15 km per night; ∼4.4 h per night), rats in one group were rapidly transitioned to a sedentary state by locking the wheels for 7 days (n = 9; wheel-lock 7 day rats) or remained active in a second group for an additional 7 days (n = 9; wheel-lock 0 day rats). Real-time PCR was conducted on total RNA isolated from iliac and renal arteries to evaluate expression of 25 pro-atherogenic and anti-atherogenic genes. Compared with the iliac arteries of wheel-lock 0 day rats, iliac arteries of wheel-lock 7 day rats exhibited increased expression of TNFR1 (+19%), ET1 (+59%) and LOX-1 (+31%; all P < 0.05). Moreover, compared with renal arteries of wheel-lock 0 day rats, renal arteries of wheel-lock 7 day rats exhibited decreased expression of ETb (-23%), p47phox (-32%) and p67phox (-19%; all P < 0.05). These data demonstrate that cessation of voluntary wheel running for 7 days produces modest, but differential changes in mRNA levels between the iliac and renal arteries of healthy rats. This heterogeneous influence of short-term physical inactivity could be attributed to the distinct alteration in haemodynamic forces between arteries.

  20. Endovascular Radiofrequency Ablation for Varicose Veins

    PubMed Central

    2011-01-01

    Executive Summary Objective The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and cost–effectiveness of endovascular radiofrequency ablation (RFA) for the treatment of primary symptomatic varicose veins. Background The Ontario Health Technology Advisory Committee (OHTAC) met on August 26th, 2010 to review the safety, effectiveness, durability, and cost-effectiveness of RFA for the treatment of primary symptomatic varicose veins based on an evidence-based review by the Medical Advisory Secretariat (MAS). Clinical Condition Varicose veins (VV) are tortuous, twisted, or elongated veins. This can be due to existing (inherited) valve dysfunction or decreased vein elasticity (primary venous reflux) or valve damage from prior thrombotic events (secondary venous reflux). The end result is pooling of blood in the veins, increased venous pressure and subsequent vein enlargement. As a result of high venous pressure, branch vessels balloon out leading to varicosities (varicose veins). Symptoms typically affect the lower extremities and include (but are not limited to): aching, swelling, throbbing, night cramps, restless legs, leg fatigue, itching and burning. Left untreated, venous reflux tends to be progressive, often leading to chronic venous insufficiency (CVI). A number of complications are associated with untreated venous reflux: including superficial thrombophlebitis as well as variceal rupture and haemorrhage. CVI often results in chronic skin changes referred to as stasis dermatitis. Stasis dermatitis is comprised of a spectrum of cutaneous abnormalities including edema, hyperpigmentation, eczema, lipodermatosclerosis and stasis ulceration. Ulceration represents the disease end point for severe CVI. CVI is associated with a reduced quality of life particularly in relation to pain, physical function and mobility. In severe cases, VV with ulcers, QOL has been rated to be as bad

  1. Pulmonary vein stenosis: Etiology, diagnosis and management.

    PubMed

    Pazos-López, Pablo; García-Rodríguez, Cristina; Guitián-González, Alba; Paredes-Galán, Emilio; Álvarez-Moure, María Ángel De La Guarda; Rodríguez-Álvarez, Marta; Baz-Alonso, José Antonio; Teijeira-Fernández, Elvis; Calvo-Iglesias, Francisco Eugenio; Íñiguez-Romo, Andrés

    2016-01-26

    Pulmonary vein stenosis (PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques (transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS.

  2. Leuprolide acetate and central retinal vein occlusion.

    PubMed

    Federici, Thomas J

    2007-01-01

    A 63-year-old man suffered a central retinal vein occlusion 2 months after he began taking leuprolide acetate for prostate cancer. Despite control for possible systemic hypertension (126/90 mm Hg) and mild hypercholesterolemia (total cholesterol level =246 mg/dL [range: 16 to 200 mg/dL], high-density lipoprotein level =67 mg/dL [range: 40 to 59 mg/dL], and low-density lipoprotein level =144 mg/dL [range: 0 to 130 mg/dL]), progression of the venous occlusive disease occurred. Leuprolide acetate, which is associated with thromboembolic events and diffuse intravascular coagulation, may be implicated in central retinal vein occlusion.

  3. Leiomyosarcoma arising from the inferior mesenteric vein

    PubMed Central

    Clemente, Gennaro; Sarno, Gerardo; Barbaro, Brunella; Nuzzo, Gennaro

    2009-01-01

    Leyomiosarcomas arising from the portal/mesenteric venous system are very rare tumours, and only a few cases have been reported in the global literature. As the other leyomiosarcomas of vascular origin, they are associated with a poor prognosis. The present report describes the case of a 66-year-old woman with a leyomiosarcoma of the inferior mesenteric vein, unexpectedly found during a CT scan performed for another indication. A brief review of the literature is also given. The patient underwent radical surgical excision and enjoys a good health, without radiological signs of recurrence, 24 months after surgery. In this case, an early incidental diagnosis determined an early treatment and, probably, a favourable prognosis. This is the second case of leyomiosarcoma of the inferior mesenteric vein reported in the literature. PMID:21686492

  4. Varicose vein therapy and nerve lesions.

    PubMed

    Hirsch, Tobias

    2017-03-01

    Treating varicose veins using endovenous thermal techniques - especially laser and radio frequency ablation - has emerged as an effective alternative to open surgery with stripping and high ligation. Even though these methods are very gentle and patient-friendly, they are nevertheless accompanied by risks and side effects. Compared to open surgical therapy, the risk of damage to peripheral and motor nerves is reduced; however, it still exists as a result of heat exposure and tumescent anaesthesia. Non-thermal methods that can be applied without tumescent anaesthesia have been introduced to the market. They pose a considerably lower risk of nerve lesions while proving to be much more effective. This paper investigates data on postoperative nerve damage and paraesthesia using internet research (PubMed). It analyses the current state of knowledge regarding non-thermal treatment methods and takes into account the latest developments in the use of cyanoacrylate to close insufficient saphenous veins.

  5. The great brain versus vein debate.

    PubMed

    Menon, Ravi S

    2012-08-15

    From the earliest fMRI experiments, it was quickly appreciated by those working with BOLD at high field that the signal change originated from visible veins whose spatial localization was relatively coarse ("the macrovasculature"), and smaller vessels ("the microvasculature") that were not individually visible in BOLD images. It was expected that a functional brain imaging technique that was predominantly sensitive to the macrovasculature would not have the same effective resolution as one sensitive to the microvasculature. Elimination of the venous signal and enhancement of the microvascular one offered the tantalizing ability to image columnar and lamellar structures in the brain and distinguished fMRI from its predecessor techniques. This article reviews a brief history of how these signal sources were first identified and separated and some of the controversy associated with the "brain versus vein" debate.

  6. Pulmonary vein stenosis: Etiology, diagnosis and management

    PubMed Central

    Pazos-López, Pablo; García-Rodríguez, Cristina; Guitián-González, Alba; Paredes-Galán, Emilio; Álvarez-Moure, María Ángel De La Guarda; Rodríguez-Álvarez, Marta; Baz-Alonso, José Antonio; Teijeira-Fernández, Elvis; Calvo-Iglesias, Francisco Eugenio; Íñiguez-Romo, Andrés

    2016-01-01

    Pulmonary vein stenosis (PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques (transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS. PMID:26839659

  7. A pilot/introducer needle for central vein cannulation.

    PubMed

    Suzuki, T; Kanazawa, M; Kinefuchi, Y; Fukuyama, H; Takiguchi, M; Yamamoto, M; Abe, K; Okuda, Y

    1995-12-01

    A kit for safe and easy insertion of a central vein cannula was devised. A small gauge (22 gauge) metal pilot needle was equipped with a Y-shaped hub which had a side-port to accept a small gauge (0.46 mm) Seldinger guide wire. Once the needle reached the vein, guidewire was threaded in through the side-port. There was no need to remove the pilot needle and no need to repeat vein puncture with a larger-bore needle. Three puncture methods were used with the kit: (1) the central approach via the internal jugular vein, (2) the supraclavicular approach via the junction of the internal jugular vein and subclavian vein, and (3) the infraclavicular approach via the subclavian vein. Each method was used on 20 patients, for total of 60 patients, with a high success rate. Less than 3 minutes were required from puncture to catheter insertion. No serious complications were encountered.

  8. Asymptomatic Pulmonary Vein Stenosis: Hemodynamic Adaptation and Successful Ablation

    PubMed Central

    Weinberg, Denis

    2016-01-01

    Pulmonary vein stenosis is a well-established possible complication following an atrial fibrillation ablation of pulmonary veins. Symptoms of pulmonary vein stenosis range from asymptomatic to severe exertional dyspnea. The number of asymptomatic patients with pulmonary vein stenosis is greater than originally estimated; moreover, only about 22% of severe pulmonary vein stenosis requires intervention. We present a patient with severe postatrial fibrillation (AF) ablation pulmonary vein (PV) stenosis, which was seen on multiple imaging modalities including cardiac computed tomography (CT) angiogram, lung perfusion scan, and pulmonary angiogram. This patient did not have any pulmonary symptoms. Hemodynamic changes within a stenosed pulmonary vein might not reflect the clinical severity of the obstruction if redistribution of pulmonary artery flow occurs. Our patient had an abnormal lung perfusion and ventilation (V/Q) scan, suggesting pulmonary artery blood flow redistribution. The patient ultimately underwent safe repeat atrial fibrillation ablation with successful elimination of arrhythmia. PMID:28105376

  9. Spontaneous thrombosis of vein of Galen malformation

    PubMed Central

    Kariyappa, Kalpana Devi; Krishnaswami, Murali; Gnanaprakasam, Francis; Ramachandran, Madan; Krishnaswamy, Visvanathan

    2016-01-01

    Vein of Galen malformation (VOGM) is a rare intracranial vascular malformation. Before the advent and advancement of various endovascular techniques, there was dismal prognosis. Rarely, this condition may spontaneously thrombose without the need for surgical or endovascular treatment with good prognosis. We report a case of an 8-month-old infant who had serial imaging, suggestive of VOGM and presented to us for further management, wherein the imaging revealed spontaneous thrombosis. PMID:27857804

  10. Different influences of extracellular and intracellular superoxide on relaxation through the NO/sGC/cGMP pathway in isolated rat iliac arteries.

    PubMed

    Tawa, Masashi; Shimosato, Takashi; Iwasaki, Hirotaka; Imamura, Takeshi; Okamura, Tomio

    2015-02-01

    Superoxide production is increased in diseased blood vessels, which is considered to lead to impairment of the nitric oxide (NO)/soluble guanylate cyclase (sGC)/cGMP pathway. To investigate the respective influence of extracellular and intracellular superoxide on vascular function through the NO/sGC/cGMP pathway, mechanical responses of rat external iliac arteries without endothelium were studied under exposure to a superoxide-generating agent, pyrogallol, or menadione. Exposure to pyrogallol impaired the relaxation induced by acidified NaNO2 (exogenous NO) but not that by nitroglycerin (organic nitrate), BAY 41-2272 (sGC stimulator), BAY 60-2770 (sGC activator), or 8-Br-cGMP (cGMP analog). Superoxide dismutase (SOD) and tempol restored the impaired relaxation by acidified NaNO2. Superoxide production in the bathing solution, but not in artery segments, was significantly increased by exposure to pyrogallol, which was abolished in the presence of SOD or tempol. However, exposure to menadione impaired the relaxant response to acidified NaNO2, nitroglycerin, or BAY 41-2272, whereas it augmented that to BAY 60-2770. Also, this exposure had no effect on the 8-Br-cGMP-induced vasorelxation. Superoxide production in artery segments was dramatically enhanced by exposure to menadione, whereas that in the bathing solution was not affected. This increase in vascular superoxide production was normalized by tempol but not by SOD. These findings suggest that extracellular superoxide reacts with NO only outside the cell, whereas intracellular superoxide not only scavenges NO inside the cell but also shifts the sGC redox equilibrium.

  11. Percutaneous Transumbilical Portal Vein Embolization in a Patient with a Ruptured Hepatocellular Carcinoma Supplied by the Portal Vein

    SciTech Connect

    Kim, Soo Chin; Kim, Hyo-Cheol Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung

    2011-02-15

    We describe a case of a ruptured hepatocellular carcinoma supplied by the portal vein that was successfully treated with portal vein embolization via a percutaneous transumbilical approach. A contrast material-enhanced computed tomographic (CT) scan showed the presence of a large hypervascular tumor on portal venous phase as well as right hepatic vein thrombosis and hemoperitoneum that prevented portal vein embolization by the use of the percutaneous and transjugular transhepatic approach. The use of percutaneous transumbilical portal vein embolization can be an alternative option in this situation.

  12. Central Vein Preservation in Critical Venous Access.

    PubMed

    Davidson, J; Paul, A; Patel, S; Davenport, M; Ade-Ajayi, N

    2016-08-01

    Introduction The lack of suitable veins in children with critical central venous access requirements is a major obstacle to optimal care and is potentially life-threatening. We present outcomes following the use of vein-preserving (VP) surgical techniques, notably the sheath exchange for tunneled lines (SETL). Materials and Methods A retrospective, single observer analysis of a prospectively maintained departmental logbook as well as the medical records of patients. Two broad groups of central line replacements were identified; those inserted following removal of a previous line and a traditional "plastic-free" (PF) period and those exchanged without such an interval. Results Overall, 19 lines were directly exchanged during the study period and compared with 34 inserted after a PF period. Similar catheter life spans and infection rates were demonstrated in each group; 125 (range, 78-173) days in VP exchanges versus 122 (range, 70-175) days in PF replacements (p = 0.41). Line Sepsis resulting in removal or change of line occurred at 103 (range, 60-147) days in VP group versus 104 (range, 45-164) days in PF (p = 0.73). Conclusion For children with critical venous access requirements, direct line exchange procedures are a robust and reproducible means of vein preservation. The outcomes compare favorably with those following the more traditional removal, a PF period and reinsertion.

  13. Varicose veins and chronic venous insufficiency.

    PubMed

    Partsch, H

    2009-11-01

    Varicose veins are a very frequent disorder with prevalence in our adult population between 14% for large varices and 59% for small teleangiectasias. Subjective symptoms may be very non-specific. The term "chronic venous insufficiency (CVI)" defines functional abnormalities of the venous system producing advanced symptoms like oedema, skin changes or leg ulcers. Both entities, varicose veins and CVI, may be summarized under the term "chronic venous disorders" which includes the full spectrum of morphological and functional abnormalities of the venous system. A classification system to describe chronic venous disorders regarding clinical appearance, etiology, anatomical distribution and pathophysiology has been proposed under the acronym of CEAP. The revised version of the CEAP classification contains also definitions of clinical signs and suggests three levels of apparative investigations adjusted to the clinical stage. Concerning the etiology of venous disorders controversial theories exist leading to different therapeutic concepts. As a matter of fact there is a vicious circle between structural changes in valves and venous wall and hemodynamic forces leading to reflux and venous hypertension. Different methods for treating varicose veins are available producing satisfactory early outcome in most cases, but followed by a high recurrence rate after years. Chronic venous insufficiency requires "chronic management". Compression therapy by bandages for initial treatment of severe stages and maintenance therapy using medical compression stockings is essential. In addition correction of venous refluxes by surgery or endovenous procedures including echo-guided foam sclerotherapy should be considered in every single case.

  14. Patterning of leaf vein networks by convergent auxin transport pathways.

    PubMed

    Sawchuk, Megan G; Edgar, Alexander; Scarpella, Enrico

    2013-01-01

    The formation of leaf vein patterns has fascinated biologists for centuries. Transport of the plant signal auxin has long been implicated in vein patterning, but molecular details have remained unclear. Varied evidence suggests a central role for the plasma-membrane (PM)-localized PIN-FORMED1 (PIN1) intercellular auxin transporter of Arabidopsis thaliana in auxin-transport-dependent vein patterning. However, in contrast to the severe vein-pattern defects induced by auxin transport inhibitors, pin1 mutant leaves have only mild vein-pattern defects. These defects have been interpreted as evidence of redundancy between PIN1 and the other four PM-localized PIN proteins in vein patterning, redundancy that underlies many developmental processes. By contrast, we show here that vein patterning in the Arabidopsis leaf is controlled by two distinct and convergent auxin-transport pathways: intercellular auxin transport mediated by PM-localized PIN1 and intracellular auxin transport mediated by the evolutionarily older, endoplasmic-reticulum-localized PIN6, PIN8, and PIN5. PIN6 and PIN8 are expressed, as PIN1 and PIN5, at sites of vein formation. pin6 synthetically enhances pin1 vein-pattern defects, and pin8 quantitatively enhances pin1pin6 vein-pattern defects. Function of PIN6 is necessary, redundantly with that of PIN8, and sufficient to control auxin response levels, PIN1 expression, and vein network formation; and the vein pattern defects induced by ectopic PIN6 expression are mimicked by ectopic PIN8 expression. Finally, vein patterning functions of PIN6 and PIN8 are antagonized by PIN5 function. Our data define a new level of control of vein patterning, one with repercussions on other patterning processes in the plant, and suggest a mechanism to select cell files specialized for vascular function that predates evolution of PM-localized PIN proteins.

  15. Surgical Marking Pen Dye Inhibits Saphenous Vein Cell Proliferation and Migration in Saphenous Vein Graft Tissue

    PubMed Central

    Kikuchi, Shinsuke; Kenagy, Richard D; Gao, Lu; Wight, Thomas N; Azuma, Nobuyoshi; Sobel, Michael; Clowes, Alexander W

    2014-01-01

    Objective Markers containing dyes such as crystal violet (CAS 548-62-9) are routinely used on the adventitia of vein bypass grafts to avoid twisting during placement. Since little is known about how these dyes affect vein graft healing and function, we determined the effect of crystal violet on cell migration and proliferation, which are responses to injury after grafting. Methods Fresh human saphenous veins were obtained as residual specimens from leg bypass surgeries. Portions of the vein that had been surgically marked with crystal violet were analyzed separately from those that had no dye marking. In the laboratory, they were split into easily dissected inner and outer layers after removal of endothelium. This f cleavage plane was within the circular muscle layer of the media. Cell migration from explants was measured daily as either 1) % migration positive explants, which exclusively measures migration, or 2) the number of cells on the plastic surrounding each explant, which measures migration plus proliferation. Cell proliferation and apoptosis (Ki67 and TUNEL staining, respectively) were determined in dye-marked and unmarked areas of cultured vein rings. The dose-dependent effects of crystal violet were measured for cell migration from explants as well as proliferation, migration, and death of cultured outer layer cells. Dye was extracted from explants with ethanol and quantified by spectrophotometry. Results There was significantly less cell migration from visibly blue, compared to unstained, outer layer explants by both methods. There was no significant difference in migration from inner layer explants adjacent to blue-stained or unstained sections of vein, because dye did not penetrate to the inner layer. Ki67 staining of vein in organ culture, which is a measure of proliferation, progressively increased up to 6 days in non-blue outer layer and was abolished in the blue outer layer. Evidence of apoptosis (TUNEL staining) was present throughout the wall

  16. Metasurface external cavity laser

    SciTech Connect

    Xu, Luyao Curwen, Christopher A.; Williams, Benjamin S.; Hon, Philip W. C.; Itoh, Tatsuo; Chen, Qi-Sheng

    2015-11-30

    A vertical-external-cavity surface-emitting-laser is demonstrated in the terahertz range, which is based upon an amplifying metasurface reflector composed of a sub-wavelength array of antenna-coupled quantum-cascade sub-cavities. Lasing is possible when the metasurface reflector is placed into a low-loss external cavity such that the external cavity—not the sub-cavities—determines the beam properties. A near-Gaussian beam of 4.3° × 5.1° divergence is observed and an output power level >5 mW is achieved. The polarized response of the metasurface allows the use of a wire-grid polarizer as an output coupler that is continuously tunable.

  17. Absence of Middle Hepatic Vein Combined with Retro-Aortic Left Renal Vein: a Very Rare Case Report

    PubMed Central

    Turamanlar, Ozan; Kırpıko, Oğuz; Özen, Oğuz Aslan; Değirmenci, Bumin; Akçer, Sezer; Uygur, Ramazan

    2012-01-01

    The hepatic and renal veins drain into the inferior vena cava. The upper group of hepatic veins consists of three veins which extend to the posterior face of the liver to join the inferior cava. The left renal vein passes anterior to the aorta just below the origin of the superior mesenteric artery. We detected a variation in the hepatic and renal veins in a multislice CT angiogram of a nine-year-old male patient in the Radiology Department of Afyon Kocatepe University Medical School. The upper group hepatic veins normally drains into the inferior vena cava as three separate trunks, namely the right, left and middle. In our case, we found that only the right and left hepatic veins existed and the middle hepatic vein was absent. Furthermore, the left renal vein, which normally passes anterior to the abdominal aorta, was retro-aortic. Left renal vein variations are of great importance in planning retroperitoneal surgery and vascular interventions. Knowledge of a patient’s hepatic vein and renovascular anatomy and determining their variations and anomalies are of critical importance to abdominal operations, transplantations and preoperative evaluation of endovascular interventions. PMID:25206997

  18. [Endovascular laser ablation of the greater saphenous vein for varicose veins: our initial experience].

    PubMed

    Bronzino, P; Abbo, L; Bagnasco, F; Barisone, P; Dezzani, C; Genovese, A M; Iannucci, P; Ippoliti, M; Sacchi, M; Aimo, I

    2005-01-01

    Laser treatment of primary varicose veins of the legs is a new mini-invasive technique which represent an alternative to the safenectomy. Endovascular laser treatment is based on the employ of laser to destroying the vascular wall and inducing fibrosis. This technique is not without complications: burns, paraesthesias, haematomas, but most of all disappear in few days. Encouraged by the promising results reported in literature, we have performed 18 laser ablation of greater saphenous vein since 2003 till today. Our patients had a good post-operative course and a follow up without troubles (3-17 months). We think that laser treatment is effective in the treatment of the primary varicose veins of the legs. It requests attention and experience in dosing the laser energy for minimizing the complications. Today there isn't long term follow up in literature.

  19. Development of HIFU Therapy System for Lower Extremity Varicose Veins

    NASA Astrophysics Data System (ADS)

    Ota, Ryuhei; Suzuki, Jun; Yoshinaka, Kiyoshi; Deguchi, Juno; Takagi, Shu; Miyata, Tetsuro; Matsumoto, Yoichiro

    2009-04-01

    High-intensity focused ultrasound (HIFU) treatment utilizing microbubbles was investigated in the present study. It is known that microbubbles have the potential to enhance the heating effects of an ultrasound field. In this study, the heat accompanying microbubble oscillation was used to occlude varicose veins. Alteration of veins was observed after ultrasound irradiation. Veins were resected by stripping. In this study, two vein conditions were adopted during HIFU irradiation; non-compressed and compressed. Compressing the vein was expected to improve occlusion by rubbing the altered intima under compressed conditions. The frequency of the ultrasound was 1.7 MHz, the intensity at the focus was 2800 W/cm2, and the irradiation time was 20 s. In this study, the contrast agent Levovist® was chosen as a microbubble source, and the void fraction (ratio of total gas volume to liquid) in the vein was fixed at 10-5. Under non-compressed conditions, changes were observed only at the adventitia of the vein anterior wall. In contrast, under compressed conditions, changes were observed from the intima to the adventitia of both the anterior and posterior walls, and they were partly stuck together. In addition, more experiments with hematoxylin-eosin staining suggested that the changes in the vein were more substantial under the latter conditions. From these results, it was confirmed that the vein was occluded more easily with vein compression.

  20. Automated detection of periventricular veins on 7 T brain MRI

    NASA Astrophysics Data System (ADS)

    Kuijf, Hugo J.; Bouvy, Willem H.; Zwanenburg, Jaco J. M.; Viergever, Max A.; Biessels, Geert Jan; Vincken, Koen L.

    2015-03-01

    Cerebral small vessel disease is common in elderly persons and a leading cause of cognitive decline, dementia, and acute stroke. With the introduction of ultra-high field strength 7.0T MRI, it is possible to visualize small vessels in the brain. In this work, a proof-of-principle study is conducted to assess the feasibility of automatically detecting periventricular veins. Periventricular veins are organized in a fan-pattern and drain venous blood from the brain towards the caudate vein of Schlesinger, which is situated along the lateral ventricles. Just outside this vein, a region-of- interest (ROI) through which all periventricular veins must cross is defined. Within this ROI, a combination of the vesselness filter, tubular tracking, and hysteresis thresholding is applied to locate periventricular veins. All detected locations were evaluated by an expert human observer. The results showed a positive predictive value of 88% and a sensitivity of 95% for detecting periventricular veins. The proposed method shows good results in detecting periventricular veins in the brain on 7.0T MR images. Compared to previous works, that only use a 1D or 2D ROI and limited image processing, our work presents a more comprehensive definition of the ROI, advanced image processing techniques to detect periventricular veins, and a quantitative analysis of the performance. The results of this proof-of-principle study are promising and will be used to assess periventricular veins on 7.0T brain MRI.

  1. Working with External Evaluators

    ERIC Educational Resources Information Center

    Silver, Lauren; Burg, Scott

    2015-01-01

    Hiring an external evaluator is not right for every museum or every project. Evaluations are highly situational, grounded in specific times and places; each one is unique. The museum and the evaluator share equal responsibility in an evaluation's success, so it is worth investing time and effort to ensure that both are clear about the goals,…

  2. External College Survey.

    ERIC Educational Resources Information Center

    Gold, Ben K.

    This report presents the results of a community survey which attempted to determine the demand for another college in the Los Angeles Community College District. The function of this "community campus" or "external college" would be to serve members of the community who are not already served by the eight existing colleges. Questionnaires received…

  3. External Interest Group Impingements.

    ERIC Educational Resources Information Center

    Millard, Richard M.

    The history of the interrelation among state approval, accreditation, and institutional eligibility is considered. It is suggested that faculty and college administrators can be either an internal or external group in relationship to the planning process. The federal government, or the state government, passes legislation that may have both…

  4. Endovascular Laser Therapy for Varicose Veins

    PubMed Central

    2010-01-01

    Executive Summary Objective The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and cost–effectiveness of endovascular laser therapy (ELT) for the treatment of primary symptomatic varicose veins (VV). Background The Ontario Health Technology Advisory Committee (OHTAC) met on November 27, 2009 to review the safety, effectiveness, durability and cost-effectiveness of ELT for the treatment of primary VV based on an evidence-based review by the Medical Advisory Secretariat (MAS). Clinical Condition VV are tortuous, twisted, or elongated veins. This can be due to existing (inherited) valve dysfunction or decreased vein elasticity (primary venous reflux) or valve damage from prior thrombotic events (secondary venous reflux). The end result is pooling of blood in the veins, increased venous pressure and subsequent vein enlargement. As a result of high venous pressure, branch vessels balloon out leading to varicosities (varicose veins). Symptoms typically affect the lower extremities and include (but are not limited to): aching, swelling, throbbing, night cramps, restless legs, leg fatigue, itching and burning. Left untreated, venous reflux tends to be progressive, often leading to chronic venous insufficiency (CVI). A number of complications are associated with untreated venous reflux: including superficial thrombophlebitis as well as variceal rupture and haemorrhage. CVI often results in chronic skin changes referred to as stasis dermatitis. Stasis dermatitis is comprised of a spectrum of cutaneous abnormalities including edema, hyperpigmentation, eczema, lipodermatosclerosis and stasis ulceration. Ulceration represents the disease end point for severe CVI. CVI is associated with a reduced quality of life particularly in relation to pain, physical function and mobility. In severe cases, VV with ulcers, QOL has been rated to be as bad or worse as other chronic diseases such as

  5. Sartorius muscle pedicle iliac bone graft for the treatment of avascular necrosis of femur head.

    PubMed

    Vaishya, Raju; Agarwal, Amit Kumar; Gupta, Nishint; Vijay, Vipul

    2016-08-01

    Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks. All the patients were followed clinically and radiologically at regular intervals. The operated femoral heads, were grouped according to Ficat's staging: 24 in stage IIA (45.3%), 22 in stage IIB (41.5%) and 07 in stage III (13.2%). The average duration of surgery was 85 min (range: 55-130 min). The total duration of follow-up was average 4.2 years (range: 2.2-15 years).The Harris hip score was excellent (>90) in 18 hips (33.96%), good (80-89) in 24 hips (45.28%), fair (70-79) in 9 hips (17%) and poor (<70) in 2 hips (3.7%). AVN of the femoral head is a painful and disabling condition in young adults. Sartorius muscle pedicle bone graft technique allows adequate decompression, re vascularization and osteogenesis of the femur head in Ficat's stage IIa, IIb and III, in young adults. This is an effective and easy technique to adopt with excellent to good results in 80% cases and is associated with only minimal complications.

  6. Characteristics of the response of the iliac artery to wall shear stress in the anaesthetized pig.

    PubMed

    Kelly, R F; Snow, H M

    2007-07-15

    The functional significance of shear stress-induced vasodilatation in large conduit arteries is unclear since changes in the diameter have little effect on the resistance to blood flow. However, changes in diameter have a relatively large effect on wall shear stress which suggests that the function of flow-mediated dilatation is to reduce wall shear stress. The mean and pulsatile components of shear stress vary widely throughout the arterial system and areas of low mean and high amplitude of wall shear stress are prone to the development of atheroma. In this study, using an in vivo model with the ability to control flow rate and amplitude of flow independently, we investigated the characteristics of the response of the iliac artery to variations in both the mean and amplitude of wall shear stress. The results of this study confirm that increases in mean wall shear stress are an important stimulus for the release of nitric oxide by the endothelium as indicated by changes in arterial diameter and show for the first time, in vivo, that increases in the amplitude of the pulsatile component of shear stress have a small but significant inhibitory effect on this response. A negative feedback mechanism was identified whereby increases in shear stress brought about by increases in blood flow are reduced by the release of nitric oxide from the endothelium causing dilatation of the artery, thus decreasing the stimulus to cell adhesion and, through a direct action of nitric oxide, inhibiting the process of cell adhesion. The results also provide an explanation for the uneven distribution of atheroma throughout the arterial system, which is related to the ratio of pulsatile to mean shear stress and consequent variability in the production of NO.

  7. A biomimetic growth factor delivery strategy for enhanced regeneration of iliac crest defects.

    PubMed

    Huri, Pinar Yilgor; Huri, Gazi; Yasar, Umit; Ucar, Yurdanur; Dikmen, Nurten; Hasirci, Nesrin; Hasirci, Vasif

    2013-08-01

    The importance of provision of growth factors in the engineering of tissues has long been shown to control the behavior of the cells within the construct and several approaches were applied toward this end. In nature, more than one type of growth factor is known to be effective during the healing of tissue defects and their peak concentrations are not always simultaneous. One of the most recent strategies includes the delivery of a combination of growth factors with the dose and timing to mimic the natural regeneration cascade. The sequential delivery of bone morphogenetic proteins BMP-2 and BMP-7 which are early and late appearing factors during bone regeneration, respectively, was shown in vitro to enhance osteoblastic differentiation of bone marrow derived mesenchymal stem cells. In the present study, the aim was to study the effectiveness of this delivery strategy in a rabbit iliac crest model. 3D plotted poly(ε-caprolactone) scaffolds were loaded with BMP carrying nanoparticles to achieve: (a) single BMP-2 or BMP-7 delivery, and (b) their combined delivery in a simultaneous or (c) sequential (biomimetic) fashion. After eight weeks of implantation, computed tomography and biomechanical tests showed better mineralized matrix formation and bone-implant union strength at the defect site in the case of sequential delivery compared to single or simultaneous delivery modes. Bone mineral density (BMD) and push-out stress were: 33.65±2.25 g cm(-3) and 14.5±2.28 MPa, respectively, and almost 2.5 fold higher in comparison to those without growth factors (BMD: 14.14±1.21 g cm(-3); PS: 6.59±0.65 MPa). This study, therefore, supports those obtained in vitro and emphasizes the importance of mimicking the natural timing of bioavailability of osteogenic factors in improving the regeneration of critical-sized bone defects.

  8. Iliac Crest Bone Graft versus Local Autograft or Allograft for Lumbar Spinal Fusion: A Systematic Review

    PubMed Central

    Tuchman, Alexander; Brodke, Darrel S.; Youssef, Jim A.; Meisel, Hans-Jörg; Dettori, Joseph R.; Park, Jong-Beom; Yoon, S. Tim; Wang, Jeffrey C.

    2016-01-01

    Study Design  Systematic review. Objective  To compare the effectiveness and safety between iliac crest bone graft (ICBG) and local autologous bone and allograft in the lumbar spine. Methods  A systematic search of multiple major medical reference databases identified studies evaluating spinal fusion in patients with degenerative joint disease using ICBG, local autograft, or allograft in the thoracolumbar spine. Results  Six comparative studies met our inclusion criteria. A “low” strength of the overall body of evidence suggested no difference in fusion percentages in the lumbar spine between local autograft and ICBG. We found no difference in fusion percentages based on low evidence comparing allograft with ICBG autograft. There were no differences in pain or functional results comparing local autograft or allograft with ICBG autograft. Donor site pain and hematoma/seroma occurred more frequently in ICBG autograft group for lumbar fusion procedures. There was low evidence around the estimate of patients with donor site pain following ICBG harvesting, ranging from 16.7 to 20%. With respect to revision, low evidence demonstrated no difference between allograft and ICBG autograft. There was no evidence comparing patients receiving allograft with local autograft for fusion, pain, functional, and safety outcomes. Conclusion  In the lumbar spine, ICBG, local autograft, and allograft have similar effectiveness in terms of fusion rates, pain scores, and functional outcomes. However, ICBG is associated with an increased risk for donor site-related complications. Significant limitations exist in the available literature when comparing ICBG, local autograft, and allograft for lumbar fusion, and thus ICBG versus other fusion methods necessitates further investigation. PMID:27556001

  9. Sartorius muscle pedicle iliac bone graft for the treatment of avascular necrosis of femur head

    PubMed Central

    Vaishya, Raju; Agarwal, Amit Kumar; Gupta, Nishint; Vijay, Vipul

    2016-01-01

    Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks. All the patients were followed clinically and radiologically at regular intervals. The operated femoral heads, were grouped according to Ficat’s staging: 24 in stage IIA (45.3%), 22 in stage IIB (41.5%) and 07 in stage III (13.2%). The average duration of surgery was 85 min (range: 55–130 min). The total duration of follow-up was average 4.2 years (range: 2.2–15 years).The Harris hip score was excellent (>90) in 18 hips (33.96%), good (80–89) in 24 hips (45.28%), fair (70–79) in 9 hips (17%) and poor (<70) in 2 hips (3.7%). AVN of the femoral head is a painful and disabling condition in young adults. Sartorius muscle pedicle bone graft technique allows adequate decompression, re vascularization and osteogenesis of the femur head in Ficat’s stage IIa, IIb and III, in young adults. This is an effective and easy technique to adopt with excellent to good results in 80% cases and is associated with only minimal complications. PMID:27583161

  10. Interventional Exclusion of Iliac Artery Aneurysms Using the Flow-Diverting Multilayer Stent

    SciTech Connect

    Pieper, Claus Christian Meyer, Carsten; Rudolph, Jens Verrel, Frauke; Schild, Hans Heinz Wilhelm, Kai E.

    2013-08-01

    PurposeThis study was designed to evaluate retrospectively the results of complex iliac artery aneurysm (IAA) exclusion using the Cardiatis-Multilayer-Stent.MethodsBetween October 2010 and August 2012, ten IAAs were treated in eight males (mean age 75 (59-91) years) using the Multilayer Stent. All IAA exceeded a diameter of 3 cm or were symptomatic. Follow-up (FU) examinations included CT or MR angiography, sonography, and clinical assessment up to 2 years.ResultsPrimary stent placement was technically successful in eight of ten cases. In two cases, severe stent retraction during deployment necessitated placement of an additional stent. Immediately after stent placement, a marked reduction of flow within the sac was observed in all cases (peri-interventional mortality 0 %). During FU, there were two thrombotic stent occlusions, making reintervention necessary (primary patency rate 80 %, secondary patency 100 %). Four IAA were completely occluded at FU, whereas the original vessel and covered branches (n = 8) were patent. In four IAA, there was still residual perfusion. In one patient, IAA diameter decreased slightly, while it remained constant in seven (mean imaging FU 195 (range 1-695) days). There were no adverse events on clinical FU (mean FU 467 (range 101-695) days).ConclusionsOther studies showed the Cardiatis-Multilayer-Stent to be a technically relatively simple treatment option for complex IAA with inadequate landing zones, especially in patients with multiple comorbidities to avoid ipsilateral IIA obstruction. However, in our series complication rate was high. Incomplete sac exclusion, stent-shortening, and thrombotic occlusion can complicate treatment, making meticulous patient selection necessary. Close imaging surveillance is mandatory especially in the early postinterventional period.

  11. Chemical gradients and progressive veining in a partly serpentinized harzburgite

    NASA Astrophysics Data System (ADS)

    Schwarzenbach, Esther; Caddick, Mark; Beard, James; Bodnar, Robert

    2016-04-01

    Serpentinized ultramafic rocks constitute a major part of the oceanic lithosphere. They form when water interacts with olivine and pyroxene to produce a dense network of veins comprised of secondary minerals: Serpentine + brucite ± magnetite veins occur in olivine, Al-rich serpentine + talc veins occur in orthopyroxene, and Al-rich serpentine ± talc ± brucite veins occur at the boundary between orthopyroxene and olivine. Here, we present a detailed study on a harzburgite from the Santa Elena Ophiolite in Costa Rica that is ~30% serpentinized in order to provide new constraints on the effect of variable water (H2O) and silica (SiO2) activities on vein formation in peridotites. The studied sample records 1) mineralogical and chemical zonations in olivine-hosted veins that show a distinct pattern with increasing width of the veins (consumption of olivine), 2) varying brucite composition depending on whether or not it is associated with magnetite, and 3) chemical gradients in Si, Al, Cr, and Ca at the boundary between orthopyroxene- and olivine-hosted veins. These observed chemical variations suggest fluid mediated mass transport within and between orthopyroxene- and olivine-hosted veins. We use thermodynamic models to show that an increase in vein width and progressive evolution of olivine-hosted veins is accompanied by an increase in water-rock ratios. This is associated with the development of chemical gradients (e.g. gradients in water and silica activity) between the fluid-rich center of serpentine veins and the olivine grain boundaries as typically expressed by the abundance of brucite in the vein center and a dominance of serpentine at the boundary with olivine. The increase in water-rock ratios within the vein center also leads to the formation of magnetite from Fe-rich brucite ± Fe-rich serpentine. Mass transfer between vein core and vein rim may exist on the submicron-scale along grain boundaries of the finely intergrown serpentine-brucite mixture. We

  12. Bilateral Leg Ischemia due to Descending Aortic Dissection: Combined Treatment with Femoro-femoral Cross-over Bypass and Unilateral Aorto-iliac stenting

    SciTech Connect

    Frahm, Christian; Widmer, Matthias K.; Do, Dai-Do

    2002-10-15

    We report a case of aorto-iliac occlusion due to descending aortic dissection treated initially with femoro-femoral cross-over bypass and secondarily with unilateral aorto-iliac stenting because of progression of the dissection. A 75-year-old man presented with acute ischemia of the right leg. CT revealed occlusion of the right iliac artery due to descending aortic dissection with a clotted false lumen. Three days after femoro-femoral cross-over bypass,ischemia of both legs developed and angiography demonstrated occlusion of the infrarenal aorta and left common iliac artery. Two overlapping stents were deployed in these vessel segments. Completion angiography confirmed successful recanalization with adequate distal flow and good patency of the cross-over bypass. Peripheral pulses were restored and the patient's symptoms were alleviated. Combined treatment with cross-over bypass and endovascular recanalization may be considered as a viable alternative to open aortic surgery in selected cases of complicated aorto-iliac dissection with bilateral leg ischemia.

  13. The effects of hindlimb unweighting on the capacitance of rat small mesenteric veins

    NASA Technical Reports Server (NTRS)

    Dunbar, S. L.; Berkowitz, D. E.; Brooks-Asplund, E. M.; Shoukas, A. A.

    2000-01-01

    Microgravity is associated with an impaired cardiac output response to orthostatic stress. Mesenteric veins are critical in modulating cardiac filling through venoconstriction. The purpose of this study was to determine the effects of simulated microgravity on the capacitance of rat mesenteric small veins. We constructed pressure-diameter relationships from vessels of 21-day hindlimb-unweighted (HLU) rats and control rats by changing the internal pressure and measuring the external diameter. Pressure-diameter relationships were obtained both before and after stimulation with norepinephrine (NE). The pressure-diameter curves of HLU vessels were shifted to larger diameters than control vessels. NE (10(-4) M) constricted veins from control animals such that the pressure-diameter relationship was significantly shifted downward (i.e., to smaller diameters at equal pressure). NE had no effect on vessels from HLU animals. These results indicate that, after HLU, unstressed vascular volume may be increased and can no longer decrease in response to sympathetic stimulation. This may partially underlie the mechanism leading to the exaggerated fall in cardiac output and stroke volume seen in astronauts during an orthostatic stress after exposure to microgravity.

  14. Multifocal Signal Loss at Bridging Veins on Susceptibility-Weighted Imaging in Abusive Head Trauma.

    PubMed

    Yilmaz, U; Körner, H; Meyer, S; Reith, W

    2015-06-01

    Identifying abusive head trauma (AHT) in infants is difficult because often there are no externally visible injuries and symptoms are nonspecific. The radiological finding that usually raises suspicion of AHT--especially when found with retinal hemorrhage and inappropriate history--is subdural hematoma (SDH). In addition to that, bridging vein thrombosis, assessed by imaging or autopsy, has been reported as a sign of the traumatic cause of SDH. Here we present two cases of AHT-associated SDH in infants, in which multifocal signal loss at bridging veins was present on susceptibility-weighted imaging without signs of venous infarction. As susceptibility-weighted imaging has been reported to be more sensitive for blood products than gradient-echo T2-weighted imaging, we propose that it might help to identify clot formation on injured bridging veins and therefore increase the sensitivity of imaging studies for a traumatic cause of SDH, helping to identify AHT that is considered to be caused by violent shaking.

  15. Reproducibility of dorsal hand vein responses to phenylephrine and prostaglandin F2 alpha using the dorsal hand vein compliance method.

    PubMed

    Schindler, C; Grossmann, M; Dobrev, D; Francke, K; Ravens, U; Kirch, W

    2003-03-01

    Assessment of drug-induced venodilation by the dorsal hand vein compliance method requires stable constriction of the vein. This study was designed to investigate intra- and intersubject reproducibility of the venous preconstriction technique in response to phenylephrine and prostaglandin F2 alpha and to determine the influence of basal vein size. Twelve healthy male nonsmokers participated in a prospective cross-over study. Inter- and intrasubject variability was tested in response to phenylephrine and PGF2 alpha on different study days in the same hand vein. The dose of the respective constrictor causing approximately 80% constriction of the vein (ED80) was determined and infused for another 100 minutes. Actual vein size was measured every 5 minutes. Coefficient of variation and regression analyses were performed to analyze influence of vessel size on ED80 of the respective constrictor. Adjusted constriction levels were stable and well reproducible in all subjects. The intersubject coefficient of variation of ED80 ranged from 0.9% to 6.7% for phenylephrine and from 0.9% to 6.9% for PGF2 alpha. Whereas responses to phenylephrine were independent of basal vein diameter, there was a positive correlation between ED80 of PGF2 alpha and basal vein size. Thus, the hand vein compliance method is a suitable method to study dilatory responses in phenylephrine- or PGF2 alpha-constricted veins with considerable interindividual but small intraindividual variability. However, in such studies, phenylephrine appears to be a more reliable tool than PGF2 alpha.

  16. Preduodenal portal vein in the adult.

    PubMed

    Ooshima, I; Maruyama, T; Ootsuki, K; Ozaki, M

    1998-01-01

    Preduodenal portal vein (PDPV) is a rare developmental anomaly. We recently encountered this anomaly in a 73-year-old woman who had gastric cancer and colonic cancer with liver metastasis. The PDPV was diagnosed preoperatively by computed tomography and angiography. To the best of our knowledge, there are only 19 adult cases reported in the world literature, with this additional case being reported here. In infants the anomaly has often been associated with duodenal obstruction, but in adults it is often symptomless. We discuss the disease process, embryology, diagnosis, association with other anomalies, and surgical treatment.

  17. Science Linking Pulmonary Veins and Atrial Fibrillation

    PubMed Central

    Mahida, Saagar; Sacher, Frederic; Derval, Nicolas; Berte, Benjamin; Yamashita, Seigo; Hooks, Darren; Denis, Arnaud; Amraoui, Sana; Hocini, Meleze; Haissaguerre, Michel; Jais, Pierre

    2015-01-01

    Over the past few decades, significant progress has been made in understanding the mechanistic basis of atrial fibrillation (AF). One of the most important discoveries in this context has been that pulmonary veins (PV) play a prominent role in the pathogenesis of AF. PV isolation has since become the most widely used technique for treatment of paroxysmal AF. Multiple studies have demonstrated that the electrophysiological and anatomical characteristics of PVs create a proarrhythmogenic substrate. The following review discusses the mechanistic links between PVs and AF. PMID:26835098

  18. Massive hydrothorax following subclavian vein catheterization

    PubMed Central

    2010-01-01

    Since the introduction of central venous catheterization for monitoring of the venous pressure, fluid infusion and hyperalimentation, the literature has been full of serious life-threatening complications. Of these complications is the false positioning of the central venous catheter and subsequent development of pleural effusion. In this report we are describing a case of iatrogenic massive pleural effusion following subclavian vein catheterization necessitating intercostal tube drainage and mechanical ventilation. The case highlights the importance of ensuring adequate positioning of the catheter after insertion through aspiration of venous blood, immediate post insertion X-ray and the utilization of ultrasound guidance in cases with expected difficult catheterization. PMID:21073758

  19. Azygous Vein Aneurysm (AVA): A Case Report

    PubMed Central

    Tujo, Charles Albert

    2017-01-01

    Azygous Vein Aneurysm (AVAs) is an uncommon cause of mediastinal mass. They are typically asymptomatic and do not commonly require treatment. They may mimic mediastinal adenopathy on chest radiographs. We present a case of AVAs found during evaluation of chest pain in a patient who was also found to have pulmonary thromboembolism. The mass was worked up with cross-sectional imaging techniques using both Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI) and ultimately Positron Emission Tomography (PET). Due to recurrent symptomatology, the aneurysm was coiled.

  20. Predictors of Long-Term Results After Treatment of Iliac Artery Obliteration by Transluminal Angioplasty and Stent Deployment

    SciTech Connect

    Funovics, M.A.; Lackner, B.; Cejna, M.; Peloschek, P.; Sailer, J.; Philipp, M.O.; Maca, T.; Ahmadi, A.; Minar, E.; Lammer, J.

    2002-10-15

    Purpose: To investigate initial and long-term success rate after percutaneous treatment of iliac artery occlusion with angioplasty and stent deployment. To investigate the influence of vascular comorbidity, lesion length, stent placement and lesion coverage as possible predictors of outcome. Methods: Between January 1994 and December 1999, 80 iliac recanalizations were performed on 78 patients, median age 61.1 {+-}11.5 (SD) years. All patients were followed up by clinical examinations, duplex ultrasound and intravenous digital subtraction angiography. Mean follow-up time was 2.0 {+-} 1.53 (SD) years.Multivariate Cox regression analysis was used to determine the influence of cofactors on patency. Results: One, 2 and 4 years after recanalization, primary patency was 78.1%, 74.5% and 64.0%; secondary patency was 88.8%, 88.8% and 77.9%, respectively.Patients with shorter occlusions, complete lesion coverage and patent ipsilateral femoral arteries had significantly longer patency rates.Complications included inguinal hematoma (n=1), technical failure (n=3) aortic dissection (n=1), embolic occlusions (n=7), gluteal claudication (n=1) and genital necrosis after subsequent urethral surgery in one patient with contralateral occlusion and ipsilateral overstenting of the internal iliac artery with subsequent stenosis. Complications were of permanent clinical significance in seven of 78 (9%) of the patients. In 17 (22%) cases, percutaneous reintervention was performed with angioplasty in the stent (n=16) or deployment of a new stent (n=1). Conclusion: Endoluminal stent placement has its place in an interdisciplinary therapeutic approach as a viable therapeutic alternative to major transabdominal bypass surgery and can be performed with comparable complication rates. Patients with short occlusions, patent femoral arteries, and stents covering the entire occlusion have significant longer patency.