- Isolated lower extremity vasculitis leading to progressive critical limb ischemia. [Journal Article]
- JVJ Vasc Surg Cases Innov Tech 2017; 3(3):119-122
- Giant cell arteritis is a large- and medium-vessel vasculitis that has been described as a systemic disease process with disseminated vessel involvement. Advances in vascular imaging techniques have ...
Giant cell arteritis is a large- and medium-vessel vasculitis that has been described as a systemic disease process with disseminated vessel involvement. Advances in vascular imaging techniques have demonstrated that involvement of the large vessels of the upper and lower limbs may be more prevalent than was once thought, although the clinical implications of this are unknown. Isolated lower extremity claudication without systemic or classic cranial symptoms, especially as a primary manifestation of giant cell arteritis, is rare. We present the case of a patient with isolated bilateral limb claudication that rapidly progressed to critical limb ischemia requiring urgent surgical intervention after steroid therapy. Our patient has consented to the publication of this report.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Clinical presentation of subclavian and innominate artery peripheral arterial disease (PAD) varies from hand claudication to cerebral hypoperfusion to distal embolization and digital ischemia. Upper ...
Clinical presentation of subclavian and innominate artery peripheral arterial disease (PAD) varies from hand claudication to cerebral hypoperfusion to distal embolization and digital ischemia. Upper extremity PAD could manifest as coronary steal or lower extremity claudication in patients who have had CABG or extra-anatomic axillary to femoral bypass. Physical examination is significant for weak pulses on an ipsilateral extremity, a systolic blood pressure difference of more than 10mmHg compared to contralateral extremity. Sometimes the affected hand may feel cool to touch, and in severe cases, digital ischemia has also been described. Often patients present during their sixth or seventh decades of life, and they have associated peripheral arterial disease risk factors such as smoking, diabetes mellitus, hyperlipidemia, hypertension, lower-extremity peripheral arterial artery disease, and less common inherited genetic disorders such as inflammatory or Takayasu arteritis.
- Extra-Anatomic Ascending Aorta to Abdominal Aorta Bypass in Takayasu Arteritis Patients with Mid-Aortic Syndrome. [Journal Article]
- KJKorean J Thorac Cardiovasc Surg 2017; 50(4):270-274
- CONCLUSIONS: An extra-anatomic ascending aorta to abdominal aorta bypass could be an effective treatment option for severe aortic steno-occlusive disease in patients with type II or III TA, with favorable early and long-term outcomes.
- Presentation, clinical features, and results of intervention in upper extremity fibromuscular dysplasia. [Multicenter Study]
- JVJ Vasc Surg 2017; 66(2):554-563
- CONCLUSIONS: Presenting symptoms for patients with UE FMD vary in severity from asymptomatic disease to digital ischemia. More than half of symptomatic limbs eventually require at least one invasive intervention for complete relief of symptoms.
- Factors Associated With Need for Revascularisation in Non-coronary Arterial Occlusive Lesions Secondary to Takayasu's Arteritis. [Journal Article]
- EJEur J Vasc Endovasc Surg 2017; 54(3):397-404
- CONCLUSIONS: Patients with TA who underwent interventions had higher ESR at the time of diagnosis; this factor and active smoking were associated with progression of the disease and worsening ischaemic symptoms despite medical therapy. Revascularisation procedures are effective at relieving symptoms; lifelong surveillance is necessary.
- Vascular TOS-Creating a Protocol and Sticking to It. [Review]
- DDiagnostics (Basel) 2017 Jun 10; 7(2)
- Thoracic Outlet Syndrome (TOS) describes a set of disorders that arise from compression of the neurovascular structures that exit the thorax and enter the upper extremity. This can present as one of ...
Thoracic Outlet Syndrome (TOS) describes a set of disorders that arise from compression of the neurovascular structures that exit the thorax and enter the upper extremity. This can present as one of three subtypes: neurogenic, venous, or arterial. The objective of this section is to outline our current practice at a single, high-volume institution for venous and arterial TOS. VTOS: Patients who present within two weeks of acute deep vein thrombosis (DVT) are treated with anticoagulation, venography, and thrombolysis. Those who present later are treated with a transaxillary first rib resection, then a two-week post-operative venoplasty. All patients are anticoagulated for 2 weeks after the post-operative venogram. Those with recurrent thrombosis or residual subclavian vein stenosis undergo repeat thrombolysis or venoplasty, respectively. ATOS: In patients with acute limb ischemia, we proceed with thrombolysis or open thrombectomy if there is evidence of prolonged ischemia. We then perform a staged transaxillary first rib resection followed by reconstruction of the subclavian artery. Patients who present with claudication undergo routine arterial duplex and CT angiogram to determine the pathology of the subclavian artery. They then undergo decompression and subclavian artery repair in a similar staged manner.
- [Efficacy of transforaminal endoscopic nerve root decompression in the treatment of degenerative lumbar spinal stenosis]. [Journal Article]
- BDBeijing Da Xue Xue Bao Yi Xue Ban 2017 Apr 18; 49(2):252-255
- CONCLUSIONS: We can apply transforaminal endoscopic decompression for the patients of lumbar spinal stenosis who have unilateral nerve root irritation. Patients with transforaminal endoscopic decompression can get less surgical trauma, quick recovery and obtain good short-term outcome.
- Type II Endoleaks, Left-Arm Complications, and Need of Revascularization after Left Subclavian Artery Coverage for Thoracic Aortic Aneurysms Endovascular Repair: A Systematic Review. [Review]
- AVAnn Vasc Surg 2017; 41:294-299
- CONCLUSIONS: Low-quality evidence suggests very low rates of arm complications with need of LSA revascularization and of type II endoleaks requiring embolization in elective endovascular treatment of thoracic aortic aneurysms with intentional coverage of LSA without prophylactic revascularization of LSA.
- Supersized Atheroma Causing Acquired Coarctation of Aorta Leading to Heart Failure. [Journal Article]
- JIJ Investig Med High Impact Case Rep 2017 Jan-Mar; 5(1):2324709616689477
- Calcified atheromatous aortic lesion causing significant narrowing of the aorta is an uncommon clinical entity. This calcified atheroma leads to obstruction of the lumen of the aorta simulating acqui...
Calcified atheromatous aortic lesion causing significant narrowing of the aorta is an uncommon clinical entity. This calcified atheroma leads to obstruction of the lumen of the aorta simulating acquired coarctation of aorta causing impaired perfusion of lower limbs, visceral ischemia, and hypertension. We report a case of 58-year-old patient who presented with dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, 25-lb weight gain, lower extremity edema, and chest pain. Extensive workup including computed tomography and magnetic resonance imaging revealed a large calcific mass in the aortic arch causing his presenting symptoms. After surgical correction his symptoms resolved. Any patient presenting with heart failure symptoms in the setting of uncontrolled renovascular hypertension, intermittent claudication symptoms, or visceral ischemia with normal ejection fraction but moderate to severe left ventricular hypertrophy should be in high suspicion for acquired coarctation of aorta. The routine thorough examination of pulses in bilateral upper and lower extremities in all hypertensive patients is a very simple and useful clinical tool to diagnose acquired aortic coarctation.
New Search Next
- Upper Limb Claudication From a Rare Congenital Vascular Anomaly. [Case Reports]
- EJEur J Vasc Endovasc Surg 2017; 53(3):353