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Iliac Artery (iliac + artery)
Kinds of Iliac Artery Terms modified by Iliac Artery Selected AbstractsEndovascular stent implantation for treatment of peripheral artery diseaseEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 3 2007M. Schillinger Endovascular stent implantation is a rapidly emerging technology for treatment of arterial obstructions in the entire circulation. During recent years, several randomized studies evaluated the effects of stenting in lower limb arteries. We herein provide an overview on data of trials in the iliac and femoropopliteal vessel area discussing the benefits and limitations of endovascular stents. In the iliac arteries, midterm and long-term data from one randomized trial including analysis on patency, clinical outcomes, cost-effectiveness and quality of life indicate that balloon angioplasty with selective stenting remains the therapy of choice for endovascular revascularization. In the femoropopliteal arteries, balloon-expanding stents were not superior to balloon angioplasty for treatment of short lesions, and self-expanding nitinol stents also failed to show a beneficial effect in short lesions below 5 cm. However, including longer lesions, one randomized trial indicated a beneficial effect of nitinol stents in lesions with a median length around 10,12 cm. Further studies and longer follow-up intervals are needed to confirm these data. Meanwhile, balloon angioplasty with optional stenting also remains the recommended endovascular approach for the femoropopliteal segment. [source] Mycotic aneurysm of the renal transplant arteryINTERNATIONAL JOURNAL OF UROLOGY, Issue 6 2006SHIRO FUJIKATA Abstract, A case of mycotic aneurysm secondary to septicemia is reported. A 59-year-old man with end-stage renal failure underwent renal transplantation from a living donor. On the fifteenth postoperative day, he was febrile and his arm around an entry wound of the drip infusion had infectious signs. Cultures of the blood and pus discharge grew Methicillin-resistant Staphylococcus aureus. Vancomycin was administered intravenously for 30 days. Then the existence of a mycotic aneurysm on the transplant artery was not suspected by computed tomography. After his infectious signs disappeared, examinations revealed a pseudoaneurysm measuring 4 cm in diameter at the site of anastomosis between the renal transplant and external iliac arteries by computed tomography. He has been carefully followed up with a conservative management. This is the first case of a mycotic aneurysm treated conservatively and displaying an uneventful course without rupture. [source] Duplex Doppler sonography of transplant renal artery stenosisJOURNAL OF CLINICAL ULTRASOUND, Issue 3 2003Ruth Helena de Morais MD Abstract Purpose The aim of this study was to evaluate the accuracy of duplex Doppler sonography in diagnosing transplant renal artery stenosis (TRAS) and to determine which parameter is the most reliable for making that diagnosis. Methods Over a 3-year period, we sonographically evaluated patients who were referred for investigation of possible TRAS. We investigated the following parameters: peak systolic velocity (PSV) in the external iliac and renal arteries, acceleration time and acceleration in the intrarenal arteries, acceleration time in the renal artery, resistance index, and the ratio of the PSVs in the renal and external iliac arteries. We also used MR angiography and digital subtraction arteriography to verify the degree of stenosis. After the evaluations, the patients were classified into 2 groups, 1 with and the other without significant stenosis (> 50% narrowing of the lumen) on digital subtraction arteriography. We also included a control group of patients who had undergone renal transplantation at least 6 months before, had had a good course after transplantation, had a diastolic blood pressure of 90 mm Hg or less, and were taking a maximum of 1 antihypertensive drug. Results Our study population consisted of 22 patients suspected to have TRAS (10 without and 12 with confirmed significant stenosis) and 19 control patients. We found statistically significant differences between the mean values of these 3 groups except for the PSV in the iliac artery and the resistance index in the intrarenal arteries. The most accurate parameters to use in diagnosing TRAS were an acceleration time of 0.1 second or higher in the renal and intrarenal arteries, a PSV of greater than 200 cm/second in the renal artery, and a ratio of PSVs in the renal and external iliac arteries of greater than 1.8. Conclusions Duplex Doppler sonography is an excellent method for screening patients suspected to have TRAS and can help select which of those patients should undergo digital subtraction arteriography. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:135,141, 2003 [source] Endovascular Interventions in Iliac and Infrainguinal Occlusive Artery DiseaseJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 6 2004JOHANNES RUEF M.D., M.Sc. Percutaneous endovascular procedures are increasingly applied to treat symptomatic peripheral occlusive artery disease. While the primary technical success and recanalization rates in iliac and infrainguinal interventions are high, differences in the long-term patency rates exist with respect to the anatomic localization, separating the iliac, femoropopliteal, and infrapopliteal arterial regions. In iliac arteries, even complex lesions can be recanalized with good long-term patency rates, especially when using self-expanding nitinol stents. In the infrainguinal arteries the method of choice is still under debate (e.g., balloon angioplasty vs stent implantation). A high restenosis rate represents one of the major limitations in femoropopliteal and infrapopliteal interventions. Therefore, additional methods and treatment strategies for peripheral interventions with the potential for future applications are under investigation and will be discussed such as drug-eluting stents, brachytherapy, subintimal angioplasty, laser angioplasty, atherectomy/thrombectomy, cutting balloon, polytetrafluoroethylene (PTFE)-covered stent grafts, biodegradable stents, and cryoplasty. The increasing amount of data on successful peripheral interventions supports the necessity to adapt and reevaluate the current consensus guidelines that were put together in 2000. [source] Successful management of uterine arteriovenous malformation by ligation of feeding artery after unsuccessful uterine artery embolizationJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2009Daisaku Yokomine Abstract Uterine arteriovenous malformation (AVM) is a rare and potentially life-threatening disease. The present report describes a postmenopausal patient with uterine AVM manifesting recurrent, massive genital bleeding. Uterine artery embolization (UAE) was scheduled before hysterectomy, but UAE was unsuccessful due to the dilated, tortuous internal iliac arteries, and extremely rapid arterial blood flow. Hysterectomy appeared to carry a potential risk of massive blood loss due to multiple dilated vessels around the uterine corpus and cervix. Therefore, six arteries feeding the uterus were surgically ligated. At 10 months after the operation there have been no episodes of atypical genital bleeding. [source] Alteration of urothelial-mediated tone in the ischemic bladder: Role of eicosanoids,NEUROUROLOGY AND URODYNAMICS, Issue 3 2004Kazem M. Azadzoi Abstract Aims Previously we showed that ischemia alters bladder smooth muscle contractility in the rabbit. This study investigates the role of urothelium and eicosanoid-release in ischemic bladder smooth muscle instability. Materials and Methods Male New Zealand white rabbits were divided into treated (n,=,12) and age-matched control (n,=,10) groups. The treated group underwent balloon endothelial injury of the iliac arteries, and then received 4 weeks of cholesterol diet, followed by 4 weeks of regular diet. The control group received a regular diet for 8 weeks. After 8 weeks, blood flow for both the iliac arteries and the bladder as well as bladder oxygen tension were recorded. In one-half of each ischemic and control bladder, the urothelium was removed. Bladder tissues were processed for organ bath and enzyme-immunoassay (EIA) of prostaglandins (PGs) and leukotrienes (LTs). Results A significant decrease in iliac arterial blood flow, bladder wall blood flow, and bladder oxygen tension was found in the treated group. Bladder ischemia increased the frequency and amplitude of baseline spontaneous smooth muscle contractility. Ischemic tissues with urothelium (Uro+) demonstrated significant increases in the contractile response to electrical field stimulation (EFS) and carbachol relative to control Uro+ tissues. Urothelial removal increased smooth muscle contraction in the control tissues but had no significant effect in the ischemic/hypoxic tissues. Contraction of control tissues without urothelium (Uro,) was similar to contraction of ischemic Uro+ tissues. Contractions of ischemic Uro+ and control Uro, tissues were unchanged after treatment with the cyclooxygenase (COX) inhibitor indomethacin, while they were significantly reduced by the 5-lipoxygenase (5-LO) inhibitor NDGA. EIA showed no change in PGs release from the ischemic urothelium, but significant increase in PGF2-, and thromboxane A2 release from the ischemic suburothelial tissue. Ischemia increased the release of LTB4, LTC4, and LTE4 from both urothelium and suburothelial tissue. Conclusions Our studies suggest loss of urothelial-mediated tone and LTs-mediated smooth muscle instability in the chronically ischemic/hypoxic bladder. Neurourol. Urodynam. 23:258,264, 2004. Published 2004 Wiley-Liss, Inc. [source] Mycotic pseudoaneurysm following a kidney transplant: A case report and review of the literaturePEDIATRIC TRANSPLANTATION, Issue 5 2009Ignacio Osmán Abstract:, Vascular complications represent a significant cause of morbidity and mortality following a kidney transplant. Pseudoaneurysms are rare, occurring in approximately 1% of cases. We present a 15-yr-old patient who received a kidney transplant in the right iliac fossa. Thirty-six days following the transplant, the patient was admitted to the hospital because of a marked increase in serum creatinine levels, arterial hypertension, scrotal edema, and lower right limb pain. The patient did not present fever or raised inflammatory markers. A pseudoaneurysm was diagnosed by means of a Doppler echography and a CT. By a selective arteriography of the right iliac artery, we placed a 8 × 5 cm stent to isolate the pseudoaneurysm, due to the high risk of an extensive defect occurring in the arterial wall. Forty-eight h later the patient underwent transplant nephrectomy. Seven days following surgery, the patient experienced febrile syndrome and therefore another CT was carried out which showed a large abscess around the stent. So we decided to perform another intervention in order to drain this abscess. Due to the extensive loss of the arterial wall where the prosthesis was largely exposed, we ligated the common iliac and external iliac arteries, removed the prosthesis and performed a femoro-femoral bypass with the usual subcutaneous positioning of the prosthesis (separate from surgical site). The stent and mural thrombus were sent for culture analysis and Candida albicans was observed. The diagnosis of a pseudoaneurysm in these types of patients continues to be considered as a surgical emergency by the majority of authors. Transplantectomy is the most frequently used treatment technique. Positioning a stent prior to transplantectomy avoids ligature of the iliac artery in the majority of cases. [source] Macroscopic Features of the Arterial Supply to the Reproductive System of the Male Ostrich (Struthio camelus)ANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 4 2007M. Z. J. Elias Summary The macroscopic features of the arterial supply to the reproductive system of the male ostrich was studied in 16 pre-pubertal and eight sexually mature and active birds. The left and right cranial renal arteries arise from the aorta, between the cranial divisions of the kidneys. These vessels supply the cranial divisions of the kidneys, the testes, the epididymides and the cranial segments of the ducti deferentia. Accessory testicular arteries which arise directly from the aorta are present in 45.8% of the specimens. They supply the testes and cranial parts of the ducti deferentia. They are variable in number and origin, and four variants are identified. A cranial ureterodeferential branch originates from the cranial renal artery, supplies the cranial portion of the ductus deferens and ureter, and runs caudally to anastomose with the middle renal artery. The sciatic artery arises laterally from the aorta, just caudal to the acetabulum, and gives rise, ventrally, to a common trunk, the common renal artery, which divides into the middle and caudal renal arteries. The middle renal artery gives rise to the middle ureterodeferential branch which supplies the middle part of the ductus deferens and ureter. A few centimetres caudal to the kidney, the aorta terminates in three branches, namely, the left and right internal iliac arteries and the median caudal artery. The internal iliac artery divides into the lateral caudal artery and the pudendal artery; the latter gives off caudal ureterodeferential branches that supply the caudal segments of the ductus deferens and ureter. In addition, the pudendal artery gives off vessels that supply the cloaca, some of which continue to the base of the phallus, where they form an arterial network. In conclusion, the pattern of the blood supply to the reproductive organs of the male ostrich is, in general, similar to that of the domestic fowl and pigeon, although there are a few highlighted distinctive features. [source] Dilatation in the femoral vascular bed does not cause retrograde relaxation of the iliac artery in the anaesthetized pigACTA PHYSIOLOGICA, Issue 3 2008Julian P.J. Halcox No abstract is available for this article. [source] Pathology of lethal peripartum broad ligament haematoma in 31 Thoroughbred maresEQUINE VETERINARY JOURNAL, Issue 6 2010T. UENO Summary Reasons for performing study: Broad ligament haemorrhage in peripartum mares is a life-threatening disease and there are few reports on the aetiology and pathogenesis of broad ligament haematoma. Objectives: To obtain information regarding the sites for the early diagnosis and pathogenesis of broad ligament haematoma of mares. Methods: Thirty-one mares that died of broad ligament haematoma peripartum were examined pathologically for bleeding sites. The arterial distribution of 5 young mares with several parities served as negative controls. Results: Age and/or multiparity were the predisposing factors for the disease. Arterial injuries were most commonly observed in the uterine artery (24 of 31 mares). Among these, the proximal uterine artery that lies within 15 cm of the bifurcation of the iliac artery was the most frequent site for rupture (18 mares). The lesions occurred preferentially at the bifurcations, lateral part of curvatures and abrupt flexures of the artery. The morphology of the injuries was classified into 3 types: ruptures with and without longitudinal fissures, and transections. Histologically, the arterial wall adjacent to the rupture showed atrophy of smooth muscle cells with fibrosis of the tunica media and disruption and/or calcification of the internal elastic lamina. Conclusions: Arterial injuries that led to broad ligament haematoma in peripartum mares occurred most frequently in the proximal uterine artery, and atrophy of smooth muscle cells with fibrosis of the arterial wall was as one of the predisposing factors in aged and multiparous mares. Potential relevance: Monitoring small aneurysms, mural tearing, medial fibrosis at the proximal uterine artery by transrectal echography could provide useful information for the early diagnosis and possible prevention of broad ligament haematoma of peripartum mares. [source] Endoluminal repair of distal aortic arch aneurysms causing aorto-vocal syndromeINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2008J. P. Morales Summary Purpose:, We have evaluated the efficacy of endovascular repair of distal aortic arch aneurysms (DAAA) causing recurrent laryngeal nerve palsy. Material and methods:, Eight patients (five male and three female) with median age of 72 years (range: 59,80) presented with left recurrent laryngeal nerve palsy associated with DAAA. All patients were considered unfit for open surgery. The median aneurysm size was 5.9 cm (range: 5,7.3). Thirteen stents were deployed: eight Gore, four Endofit and one Talent. Epidural anaesthesia was used in all patients. The left subclavian artery was covered in all and the left common carotid in three who had a preliminary right to left carotid,carotid bypass. Routine follow-up (FU) was with computed tomography (CT) at 3,6 months and yearly thereafter. Results:, Exclusion of the aneurysm sac was achieved in all patients. Thirty-day mortality was 0%, with no paraplegia or stroke. Early complications included: rupture of the external iliac artery (one) and common femoral artery thrombectomy (one). One patient died of unknown cause at 17 months. The mean FU in the remaining seven patients was 21 months (range: 6,51). Aneurysm size decreased in five, was unchanged in one and increased in one. Three patients had improvement in voice quality postoperatively. One patient had a recurrent type 1 endoleak which was restented twice. No late deaths have occurred. Conclusion:, Though technically the procedures involved were more complicated, endovascular repair of DAAA causing aorto-vocal syndrome is safe and offers a realistic alternative to open surgery. Hoarseness of the voice can improve postoperatively and is associated with reduction in aortic sac diameter. [source] Duplex Doppler sonography of transplant renal artery stenosisJOURNAL OF CLINICAL ULTRASOUND, Issue 3 2003Ruth Helena de Morais MD Abstract Purpose The aim of this study was to evaluate the accuracy of duplex Doppler sonography in diagnosing transplant renal artery stenosis (TRAS) and to determine which parameter is the most reliable for making that diagnosis. Methods Over a 3-year period, we sonographically evaluated patients who were referred for investigation of possible TRAS. We investigated the following parameters: peak systolic velocity (PSV) in the external iliac and renal arteries, acceleration time and acceleration in the intrarenal arteries, acceleration time in the renal artery, resistance index, and the ratio of the PSVs in the renal and external iliac arteries. We also used MR angiography and digital subtraction arteriography to verify the degree of stenosis. After the evaluations, the patients were classified into 2 groups, 1 with and the other without significant stenosis (> 50% narrowing of the lumen) on digital subtraction arteriography. We also included a control group of patients who had undergone renal transplantation at least 6 months before, had had a good course after transplantation, had a diastolic blood pressure of 90 mm Hg or less, and were taking a maximum of 1 antihypertensive drug. Results Our study population consisted of 22 patients suspected to have TRAS (10 without and 12 with confirmed significant stenosis) and 19 control patients. We found statistically significant differences between the mean values of these 3 groups except for the PSV in the iliac artery and the resistance index in the intrarenal arteries. The most accurate parameters to use in diagnosing TRAS were an acceleration time of 0.1 second or higher in the renal and intrarenal arteries, a PSV of greater than 200 cm/second in the renal artery, and a ratio of PSVs in the renal and external iliac arteries of greater than 1.8. Conclusions Duplex Doppler sonography is an excellent method for screening patients suspected to have TRAS and can help select which of those patients should undergo digital subtraction arteriography. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:135,141, 2003 [source] Iliac vein compression syndrome: An underdiagnosed cause of lower extremity deep venous thrombosis,JOURNAL OF HOSPITAL MEDICINE, Issue 7 2010Ami Naik BS Abstract Iliac vein compression syndrome (CS) is a rare cause of deep venous thrombosis. It is caused by an anatomic anomaly in which the right common iliac artery overlies the left common iliac vein causing mechanical compression. Subsequent endothelial changes within the vessels have the potential to spur thrombus formation. Aggressive diagnostic and therapeutic interventions must be implemented upon suspicion to avoid long-term complications. We report on a 19 year old male who presented with ICS. We discuss the clinical presentation, diagnosis, and current treatment options. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine. [source] Incidence and Treatment of Arterial Access Dissections Occurring during Cardiac CatheterizationJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 1 2008AMIT PRASAD M.D. Background: Arterial access dissections may complicate cardiac catheterization and can often be treated percutaneously. The goal of this study was to examine the incidence, consequences, and the treatment of arterial access dissections at a tertiary referral hospital with an active training program. Methods: Patients experiencing arterial access dissection during coronary angiography or intervention at our institution between October 1, 2004, and January 31, 2007, were identified and their records were retrospectively reviewed. Results: Thirteen of the 3,062 consecutive patients (0.42%) had arterial access dissection during the study period. The location of the dissection was in the common femoral artery (CFA) (n = 6), the external iliac artery (EIA) (n = 6), or in an aortobifemoral graft (n = 1). Three of the six patients with CFA dissection were diagnosed during coronary angiography, and because of significant comorbidities were treated with self-expanding stents. After a mean follow-up of 7 months, they experienced no stent fracture or other complication. Six patients had EIA dissections. In one such patient, the dissection was not flow limiting and was treated conservatively. The remaining five patients underwent successful implantation of self-expanding stents, and during a mean follow-up of 9.6 months, no patient had any symptoms or events related to lower extremity ischemia. Finally, one patient had an aortobifemoral graft dissection. Due to the patient's critical condition, secondary to sepsis, his family elected to withdraw care, and he subsequently expired. Conclusions: Arterial access dissections occur infrequently during cardiac catheterization. Routine femoral artery angiography may help identify vascular access complications, often allowing simultaneous endovascular treatment, with excellent short-term outcomes. [source] Antagonistic effects of selective ,1 -adrenoceptor antagonists MDL73005EF and tamsulosin and partial agonists clonidine and tizanidine in rat thoracic aorta and rabbit iliac arteryJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 1 2001Mitsutoshi Satoh The antagonistic effects of MDL73005EF and tamsulosin and partial agonists clonidine and tizanidineat rat thoracic aorta and rabbit iliac artery ,1 -adrenoceptors were investigated in this study. Selective ,1 -adrenoceptor antagonists MDL73005EF and tamsulosin dose-dependently shifted the concentration-response curves for noradrenaline to the right. Schild plots of the results obtained from the inhibition by MDL73005EF (pA2 8.30 ± 0.04) and tamsulosin (pA2 10.51 ± 0.06) of noradrenaline yielded a straight line with a slope of unity in rat thoracic aorta. The slopes of Schild plots obtained from the inhibition by MDL73005EF and tamsulosin of noradrenaline were significantly different from unity in rabbit iliac artery. Schild plots of the results obtained from the inhibition by clonidine and tizanidine of noradrenaline yielded a straight line with a slope of unity in rat thoracic aorta (pA2 7.08 ± 0.04 and 7.32 ± 0.04, respectively). These results suggest that ,1D -adrenoceptors play a significant role in the ,1 -adrenoceptor-agonist-induced contraction of rat thoracic aorta and rabbit iliac artery, and that clonidine and tizanidine interact with the ,1D -adrenoceptor subtype as competitive antagonists in rat thoracic aorta. [source] Canine leishmaniasis with nephrotic syndrome and aortic and caudal vena cava thromboembolismJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 5 2008Nuno Félix DVM Abstract Objective , To describe a case of leishmaniasis associated with nephrotic syndrome and aortic and caudal vena cava thrombosis in a dog. Case Summary , A 3-year-old male Boxer was referred to the Faculty of Veterinary Medicine, Lisbon, with vomiting, polyuria, polydipsia, lethargy, anorexia, and weight loss. On admission, the dog was thin, quiet, and dehydrated. Initial laboratory abnormalities were compatible with a diagnosis of leishmaniasis (confirmed by serology and bone marrow aspirate), and nephrotic syndrome. Three days later, the animal developed lumbar pain, paraparesis, and absent femoral pulses. Coagulation tests showed a marked reduction in antithrombin (AT) and a mild increase in serum fibrinogen concentration. A diagnosis of thromboembolism was made. In spite of treatment aimed at controlling the primary condition and decreasing further thrombus formation, necrosis developed in the distal right pelvic limb and the nail beds of the left pelvic limb. Against medical advice, medication was stopped and, 15 days later, the dog returned to the hospital, showing extensive necrosis of both pelvic limb extremities. Euthanasia was performed at the owner's request. Necropsy showed a thrombus localized at the distal aorta and extending into the right iliac artery, and an additional thrombus extending from both femoral veins onto the caudal vena cava. New or Unique Information Provided , Thromboembolic disease is rare in dogs with leishmaniasis with nephrotic syndrome. This case suggests that a marked decrease in AT and a mild increase in serum fibrinogen may elicit a hypercoagulable state in these patients. [source] Cryopreserved iliac artery is indispensable interposition graft material for middle hepatic vein reconstruction of right liver graftsLIVER TRANSPLANTATION, Issue 6 2005Shin Hwang Cryopreserved iliac vein grafts (IVGs) have often been used for reconstruction of middle hepatic vein (MHV) branches in right liver grafts, but their storage pool has often been exhausted in our institution due to the low incidence of deceased donor organ procurement. To overcome this shortage of IVG, we started to use cryopreserved iliac artery graft (IAG). During September and October 2004, we carried out 41 cases of adult living donor liver transplantation, including 29 right lobe grafts with MHV reconstruction. Interposition vessel grafts were autologous vein (n = 6), IVG (n = 13), and IAG (n = 10). IAG was used in 3 (21%) of 13 cases during the first month. For the next month, it was more frequently used (7 [44%] of 16) because handling of cryopreserved IAG was not difficult and its outcome was favorable. On follow-up with computed tomography for 3 months, outflow disturbance occurred in 1 (17%) of 6 autologous vein cases, in 2 (15%) of 13 IVG cases, and in 1 (10%) of 10 IAG cases. Two-month patency rate of IAG was not lower than that of IVG. In conclusion, we feel that cryopreserved IAG can be used as an interposition vessel graft for MHV reconstruction of right liver graft when cryopreserved IVG is not available. (Liver Transpl 2005;11:644,649.) [source] Mycotic pseudoaneurysm following a kidney transplant: A case report and review of the literaturePEDIATRIC TRANSPLANTATION, Issue 5 2009Ignacio Osmán Abstract:, Vascular complications represent a significant cause of morbidity and mortality following a kidney transplant. Pseudoaneurysms are rare, occurring in approximately 1% of cases. We present a 15-yr-old patient who received a kidney transplant in the right iliac fossa. Thirty-six days following the transplant, the patient was admitted to the hospital because of a marked increase in serum creatinine levels, arterial hypertension, scrotal edema, and lower right limb pain. The patient did not present fever or raised inflammatory markers. A pseudoaneurysm was diagnosed by means of a Doppler echography and a CT. By a selective arteriography of the right iliac artery, we placed a 8 × 5 cm stent to isolate the pseudoaneurysm, due to the high risk of an extensive defect occurring in the arterial wall. Forty-eight h later the patient underwent transplant nephrectomy. Seven days following surgery, the patient experienced febrile syndrome and therefore another CT was carried out which showed a large abscess around the stent. So we decided to perform another intervention in order to drain this abscess. Due to the extensive loss of the arterial wall where the prosthesis was largely exposed, we ligated the common iliac and external iliac arteries, removed the prosthesis and performed a femoro-femoral bypass with the usual subcutaneous positioning of the prosthesis (separate from surgical site). The stent and mural thrombus were sent for culture analysis and Candida albicans was observed. The diagnosis of a pseudoaneurysm in these types of patients continues to be considered as a surgical emergency by the majority of authors. Transplantectomy is the most frequently used treatment technique. Positioning a stent prior to transplantectomy avoids ligature of the iliac artery in the majority of cases. [source] Aortic aneurysm repair with a functioning renal transplant: therapeutic optionsANZ JOURNAL OF SURGERY, Issue 1-2 2004Denise M. Roach Background: Aortic aneurysm repair in the presence of a functioning renal transplant carries significant risks of renal ischaemia. We describe the management of patients undergoing this treatment by using a temporary, externally sited axillofemoral bypass and discuss other treatment options. Methods: Three patients underwent a temporary, externally sited axillary artery to common femoral artery bypass. The aneurysm was then dissected via a transperitoneal incision. When the aneurysm was clamped, the axillofemoral graft was opened allowing retrograde perfusion to the renal transplant. Results: All three patients made a good recovery without postoperative deterioration of renal function. Conclusion: Numerous methods of protecting the transplanted kidney have been described, including expeditious surgery with no renal protection or some form of temporary shunt to perfuse the donor iliac artery. Temporary insertion of an axillofemoral bypass adds 45,60 min of extra operating time if two surgeons are present. However, this technique should completely avoid transplant ischaemia and is an excellent technique for dealing with abdominal aneurysms in patients with functioning transplants. [source] Percutaneous intervention for chronic total occlusion of the internal iliac artery for unrelenting buttock claudication,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2009Satjit Adlakha DO Abstract Internal iliac artery stenosis or occlusion has been documented to cause hip pain, erectile dysfunction, and buttock claudication. Endovascular repair for patients with significant stenosis has been well documented, but chronic total occlusion revascularizations have not been reported in the literature. The reluctance to attempt percutaneous intervention may be in part due to the extensive collateralization that forms to this vessel, or fear of complications such as wire perforation in a vessel that has a tortuous route with multiple bifurcations. This report describes two cases of patients with unrelenting buttock claudication that completely resolved after percutaneous intervention of unilateral chronic total occlusions of the internal iliac artery. © 2008 Wiley-Liss, Inc. [source] Pulmonary arterial hypertension and right heart failure,A late-onset complication after cardiac catheterization,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 7 2009Beate Koch MD Abstract Arteriovenous fistula is a possible complication of diagnostic procedures requiring arterial femoral catheterization. Late onset manifestation is reported rarely. An impressive case of severe pulmonary arterial hypertension and consecutive right heart failure caused by an arteriovenous fistula between the common iliac artery and the distal inferior caval vein manifesting four years after cardiac catheterization in described. © 2009 Wiley-Liss, Inc. [source] The iliolumbar artery,Anatomic considerations and details on the common iliac artery trifurcationCLINICAL ANATOMY, Issue 1 2010M.C. Rusu Abstract The iliolumbar artery (ILA) of Haller is the largest nutrient pedicle of the ilium and its detailed knowledge is important for various surgical procedures that approach the lumbosacral junction, the L4/L5 disk space, the sacroiliac joint, the iliac and psoas muscles, or the lumbar spine. Also the ILA is relevant for various techniques of embolization. We aimed to evaluate the anatomic and topographic features of the ILA, by dissection on 30 human adult pelvic halves and on 50 angiograms. ILA was a constant presence and it emerged at Level A (from the common iliac artery (CIA), 8.75%), Level B (from the CIA bifurcation, 2.5%), Level C (from the internal iliac artery (IIA), 52.5%), Level D (from the IIA bifurcation, 3.75%), and Level E (from the posterior trunk of the IIA, 32.5%). Level B of origin of the ILA corresponds to a trifurcated CIA (morphology previously unreported), while Level D corresponds to a trifurcated IIA. A higher origin of the ILA corresponds to a more transversal course of it. A descending lumbar branch that leaves the iliac arterial system independently to enter the psoas major muscle, as seen in 48% of cases, may be misdiagnosed as ILA. Surgical interventions in the lumbar, sacral, and pelvic regions must take into account the variable origins of the ILA from the iliac system that can modify the expected topographical relations and may lead to undesired hemorrhagic accidents. Clin. Anat. 23:93,100, 2010. © 2009 Wiley-Liss, Inc. [source] The applied anatomy of anterior approach for minimally invasive hip joint surgeryCLINICAL ANATOMY, Issue 2 2009Li Hua Chen Abstract The anterior approach for minimally invasive hip joint surgery is one of the common approaches utilized in hip joint surgery. Here, we report the results of dissections in 60 sides of human adult cadavers. We observed and measured the branches of the superficial circumflex iliac artery, the lateral femoral cutaneous nerves, the lateral circumflex femoral artery, and the superior gluteal nerves in the experiment via the anterior approach for minimally invasive hip joint surgery. The relationship between these structures and the anterior approach was studied. The present study provides important data demonstrating the location, path of dominant structures that might be encountered during the surgery and their relationships with the surgical incision. These data may allow surgeons performing the anterior approach for hip joint surgery to minimize the risk of neurovascular injury. Clin. Anat. 22:250,255, 2009. © 2008 Wiley-Liss, Inc. [source] Altered course of the right testicular arteryCLINICAL ANATOMY, Issue 1 2004M. Bülent Özdemir Abstract An unusual course of the right testicular artery was observed during routine dissection of the posterior abdominal wall of a 60-year-old male cadaver. It arose from the abdominal aorta, inferior and posterior to the origin of the right renal artery, and passed posterior to the inferior vena cava and right renal vein; it then arched anterior to the inferior pole of the right kidney and descended anterior to the psoas major muscle, crossing anterior to the genitofemoral nerve, ureter and the proximal part of the external iliac artery. Finally, it passed to the deep inguinal ring and through the inguinal canal to enter the spermatic cord with the other constituents. The left testicular artery arose from the abdominal aorta about 1 cm higher than the right testicular artery and followed a normal course. The embryologic basis and clinical importance of this case are discussed. Clin. Anat. 17:67,69, 2004. © 2003 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||||||||