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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
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Repeated Peripheral Embolisms associated with Chronic Aortic Dissection.

Shigeaki Aoyagi1, Mau Amako1, Kumiko Wada1

  • 1Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan.

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|September 9, 2020
PubMed
Summary
This summary is machine-generated.

Embolism from aortic dissection (AD) can cause organ ischemia. This case highlights a second embolism event in chronic AD leading to leg claudication, treated successfully with bypass surgery.

Keywords:
aortic dissectionfragmentation of a mural thrombusischemic complicationlimb ischemiaperipheral vascular embolismrenal embolismtype B aortic dissection

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Area of Science:

  • Vascular Surgery
  • Cardiovascular Medicine
  • Interventional Radiology

Background:

  • Type B aortic dissection (AD) can lead to systemic complications.
  • Embolism from aortic mural thrombi is a known risk in AD.
  • Chronic AD poses unique challenges for diagnosis and management.

Observation:

  • A 63-year-old male with chronic type B AD presented with acute limb ischemia.
  • CT revealed occlusion of the right external iliac artery, suggesting a second embolic event.
  • Initial catheter embolectomy provided insufficient blood flow restoration.

Findings:

  • Femorofemoral bypass surgery successfully restored antegrade blood flow to the right leg.
  • Postoperative ankle-brachial index (ABI) normalized, resolving ischemic symptoms.
  • This case underscores embolism as a potential cause of acute organ ischemia in chronic AD.

Implications:

  • Embolism should be considered in patients with acute organ ischemia, even with chronic aortic dissection.
  • Vascular imaging is crucial for identifying embolic sources in AD patients.
  • Surgical intervention, like bypass grafting, can effectively manage limb ischemia secondary to AD complications.