Bilateral giant femoropopliteal artery aneurysms: a case report

<p>Abstract</p> <p>Introduction</p> <p>Popliteal artery aneurysms are the most common peripheral arterial aneurysms, and are frequently bilateral. Acute limb ischemia, rupture and compression phenomena can complicate these aneurysms when the diameter exceeds 2 cm.</p> <p>Case Presentation</p> <p>We report an 82-year-old male patient with two giant femoropopliteal aneurysms, 10.5 and 8.5 cm diameters, managed in our institution. Both aneurysms were resected and a polytetrafluoroethylene (PTFE) femoropopliteal interposition graft was placed successfully. Management and literature review are discussed.</p> <p>Conclusion</p> <p>We believe this is the first report in the medical literature of bilateral giant femoropopliteal aneurysms.</p

Hepatic abscess in a pre-existed simple hepatic cyst as a late complication of sigmoid colon ruptured diverticula: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hepatic abscesses have been reported as a rare complication of diverticulitis of the bowel. This complication is recognized more commonly at the time of the diagnosis of diverticulitis, or ruptured diverticula, but also can be diagnosed prior to surgery, or postoperatively.</p> <p>Case presentation</p> <p>This report describes a man who developed an hepatic abscess within a simple hepatic cyst, two months after operation for ruptured diverticula of the sigmoid colon. The abscess was drained surgically and the patient made a complete recovery.</p> <p>Conclusion</p> <p>The development of an hepatic abscess in a pre-existing hepatic cyst, secondary to diverticulitis, is a rare complication. A high degree of clinical suspicion is required for immediate diagnosis and treatment.</p

The Hypothesis Regarding the Benefit of Carotid Endarterectomy Under Locoregional Anesthesia in Prevention of Stroke May be Unanswered

A recent trial attempted to investigate the role of locoregional anesthesia (LA) in carotid endarterectomy (CEA) compared with general anesthesia. The hypothesis regarding the advantage of LA is based on the intraprocedural neurologic evaluation and the early identification of neurologic deficit. The trial has not demonstrated the superiority of the rocoregional anesthesia versus general anesthesia and revealed equal results concerning the prevention of stroke. We analyze the reasons which explain why the hypothesis regarding the advantage of LA in CEA, in comparison to general anesthesia cannot be answered

An update on markers of carotid atherosclerosis in patients with Type 2 diabetes

Carotid atherosclerosis constitutes an important cause of ischemic brain attack and stroke, accounting for up to 40% of cases of ischemic cerebrovascular disease. Type 2 diabetes mellitus is an independent risk factor for stroke and its recurrence. Thus, identifying diabetic patients who are at high risk of developing stroke is of great clinical importance. Noninvasive measurements of surrogate markers of atherosclerosis, such as novel serum biomarkers, can be helpful in detecting subclinical carotid disease, especially among individuals at the highest cardio-/cerebro-vascular risk. Previous studies have proposed an expanding body of serum biomarkers, such as C-reactive protein, fibrinogen, adipokines, cytokines and growth factors, as novel indicators of carotid atherosclerosis development that predict carotid-related clinical outcomes. Furthermore, those biomarkers are expected to assess the efficacy of both pharmaceutical and interventional strategies. Accordingly, it is increasingly clear that measuring biomarkers may improve the definition of cerebrovascular risk profile in patients with Type 2 diabetes mellitus

What a vascular surgeon should know and do about atherosclerotic risk factors

Atherosclerosis is a systematic disease presenting with a significant overlapping of cardiovascular disorders implicating coronary heart disease and its equivalents, peripheral arterial disease, carotid arterial disease, and aneurysm disease. Evaluating patient’s atherosclerotic risk profile is essential to guide primary and secondary prevention. Atherosclerotic risk factor modifications reduce, significantly, cardiovascular disease mortality and morbidity, particularly in high-risk patients. This article provides a reference guide for all conventional (eg, smoking, dyslipidemia, hypertension) and evolving (eg, homocysteine, C-reactive protein, fibrinogen, inflammatory markers) risk factors of atherosclerosis and recommends the currently effective strategies for an overall cardiovascular risk reduction. As vascular surgeons, by definition, conduct the overall management of patients with vascular disease understanding of the development, assessment, and management of atherosclerotic risk factors should remain among their highest priorities. (J Vasc Surg 2009;49:1348-54.