Aneurysm Of Left Femoral Artery Research Articles

Treatment of Multiple Arterial Aneurysms in Patient with Polyaneurysmal Disease: Case Report

Polyneurysmal dystrophy is defined as the clinical entity characterized by the presence of multiple arterial lesions in different sections of the arterial tree in a simultaneous or sequential manner, excluding uniquely bilateral and multilobulated aneurysms [1, 2]. The incidence of multiple aneurysms in the United States is 0.01% [3] to 3.9% [4]. These aneurysms are caused by: atherosclerosis [4, 5], changes in elastic fibers (ectasic medial dystrophy) [6], Polyarteritis Nodosa, Takayasu's arteritis, Behcet's disease, Marfan's syndrome, trauma and infection [7]. We performed a search on the PubMed and Bireme databases, where we found 17 articles from 1963 to 2017. This work is a case report. A 79-year-old male, a former smoker, hypertensive. He was undergoing colored arterial Doppler ultrasonography that revealed fusiform aneurysms in popliteal arteries (AAP) and femoral arteries (AAF) bilaterally. A Computed tomography angiography (CTA) showed Abdominal Aortic Aneurysm (AAA) type IV (Crawford) of 4.5 cm in diameter, iliac arteries and common femoral arteries enlarged. Fifteen days before the starting of studies of this case, the patient presented fungal lesion in right foot evolving with critical ischemia. We opted for conventional surgery. A femoral-pedal bypass with ex-vivo saphenous vein without valves, in the right lower limb, with the exclusion of AAF and AAP, was also performed, in addition to amputation of the 5th right toe. The colored arterial Doppler ultrasonography of the RLL at the 30th day after the surgery evidenced exclusion of AAF, patent bypass, AAP with low flow and thrombi in it. Forty days after the surgery in RLL, he evolved with pain, pallor and hypothermia in Left Lower Limb (LLL). A colored arterial Doppler ultrasonography of the LLL revealed acute occlusion of the left popliteal artery and a Left Femoral Artery Aneurysm. We have performed a femoral-pedal bypass in Left Lower Limb, with exclusion of AAF and left AAP. About 3 (three) months after the last surgery, the patient evolved well, with peripheral pulses preserved. But during preparation for the correction of the thoracic aneurysm the patient developed mesenteric thrombosis due to the mural thrombi of the abdominal aortic aneurysm; he was submitted to exploratory laparotomy and resection of 70 cm of small intestine. During waiting for customized endoprosthesis to treat abdominal aortic aneurysm, the patient had passed away. We cannot waste time in the treatment of this disease, and it is extremely difficult to predict which of the aneurysms needs to be treated first.

An Asymptomatic Hemorrhagic Hepatic Cyst with Solid Contents

We describe a patient who had an asymptomatic hemorrhagic hepatic cyst with solid contents that mimicked a malignancy. An 85-year-old woman was referred to our hospital because a hypoechoic mass was detected. She had no complications. The past medical history included hypertension and left femoral artery aneurysm. The results of initial laboratory tests were as follows: serum aspartate aminotransferase, 28 IU/L; serum alanine aminotransferase, 23 IU/L; serum C-reactive protein, 0.11 mg/dL; and serum hemoglobin concentration, 13.1 g/dL. The serum platelet count (17.3×104/μL) was slightly decreased. The serum concentration of carcinoembryonic antigen was 3.0 ng/mL, that of CA19-9 was 12.2 u/ml, and that of AFP was 3.8 ng/ml. The serum concentration of hyaluronic acid (147 ng/mL) was elevated. Hepatitis B virus antigen and hepatitis C virus antibody were negative. Ultrasonography revealed a protruding hypoechoic mass, 6 cm in diameter, with a central isoechoic structure in segment 7, accompanied by multiple hepatic cysts. The edge of the liver was dull, and the liver parenchymal echo was mildly rough. Computed tomography (CT) showed a slightly high-density area with calcification of the margin. Magnetic resonance imaging revealed a hypointense lesion with central hyperintensity on T1- weighted sequences and hyperintensity on T2-weighted sequences. On positron emission tomography- CT, there was no uptake of fluorodeoxyglucose in the liver. We diagnosed an old hemorrhagic cyst or abscess, but could not rule out a malignant neoplasm because of the damaged liver. A right lateral sectionectomy was therefore performed. The resected specimen had black solid contents, and the capsule lacked fluid. Pathological examination revealed an old hemorrhage with a thick fibrous capsule without epithelial components. The liver showed mild fibrosis with fatty changes. The lesion was considered an old hemorrhagic hepatic cyst because a nearby hepatic cyst had simple columnar epithelium.

Extended pedicle rectus abdominis myocutaneous flap for groin reconstruction: Case report

Reconstruction of left groin defect following a failed left femoral aneurysm bypass procedure. The defect was occasioned by excision of a saccular aneurysm of left femoral artery, and repair with PTFE graft for an ilio femoral bypass. On the second postoperative day, the wound became septic and the graft extruded with a resultant wound defect of about 20 x 10 cm. The graft was later removed and wound coverage achieved by an extended contralateral pedicled rectus abdominis myocutaneous flap.

Fever, backache, and groin pain

A 44-year-old Nigerian, living in the UK, presented with a 5-week history of groin discomfort, back pain, and fever. He was hypertensive, smoked marijuana, but denied intravenous drug use. Examination revealed a low-grade fever (38°C) and raised blood pressure (200/120 mmHg), but was otherwise normal. A left femoral artery aneurysm was noted on ultrasound scan of his groin. A blood culture, taken on admission, grew a fully sensitive Streptococcus pneumoniae. 24 hours later, two further blood cultures were taken and, once again, S pneumoniae was isolated. He was treated with intravenous benzylpenicillin (1·2 g four times daily), and within 7 days his temperature had returned to normal. A transfemoral angiogram revealed multiple aneurysms at the aortic bifurcation, the right common iliac artery, and left femoral artery (figure). A computerised tomography scan of his chest and a transthoracic echocardiogram were normal. After 4 weeks of antimicrobial treatment he was apyrexial and his back pain had resolved.