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Frontiers in Radiology 2024Aortofemoral bypass surgery is a common procedure for treating aortoiliac occlusive disease, also known as Leriche syndrome, which can cause lower extremity ischemic...
Aortofemoral bypass surgery is a common procedure for treating aortoiliac occlusive disease, also known as Leriche syndrome, which can cause lower extremity ischemic symptoms. Diagnostic imaging techniques play a crucial role in managing pseudoaneurysms (PSAs), with Duplex ultrasound and Computed Tomography-angiography (CTA) being effective tools for early diagnosis. Pseudoaneurysms (PSAs) present as pulsating masses with various symptoms, and prompt intervention is essential to avoid complications. A case report is presented involving an 82-year-old male who underwent aorto-bifemoral bypass surgery and later developed a pseudoaneurysm (PSA) of the left branch. Surgical treatment involved the removal of the pseudoaneurysm (PSA) and graft replacement. Other cases from the literature are also described, emphasizing the rarity and potential severity of non-anastomotic pseudoaneurysms (PSAs) in reconstructive vascular surgery. Periodic screening of patients who undergo reconstructive vascular surgery is crucial to detect pseudoaneurysms (PSAs) early and prevent complications. Asymptomatic pseudoaneurysms (PSAs) can grow significantly and become life-threatening if not identified in a timely manner. Regular post-operative imaging, such as annual Computed Tomography-angiography (CTA) and/or Duplex ultrasound, is recommended to ensure early diagnosis and appropriate management of complications.
PubMed: 38751596
DOI: 10.3389/fradi.2024.1327050 -
JAMA Cardiology Apr 2024
PubMed: 38630495
DOI: 10.1001/jamacardio.2024.0530 -
Journal of Vascular and Interventional... Apr 2024
Topics: Male; Humans; Fournier Gangrene; Leriche Syndrome; Stents
PubMed: 38521565
DOI: 10.1016/j.jvir.2023.11.013 -
Gan To Kagaku Ryoho. Cancer &... Dec 2023We report a case of robotic abdominoperineal resection for rectal cancer with Leriche syndrome. Case: A 75-year-old male. Colonoscopy, which was performed due to...
We report a case of robotic abdominoperineal resection for rectal cancer with Leriche syndrome. Case: A 75-year-old male. Colonoscopy, which was performed due to persistent diarrhea, revealed type 2 lower rectal circumferential tumor. Pathological examination revealed adenocarcinoma. Computed tomography revealed no distant metastasis, and incidentally complete occlusion from the abdominal aorta to both common iliac arteries. He was diagnosed to rectal cancer(RbRaP, cT3N0M0, cStage Ⅱa)with Leriche syndrome. Therefore, robotic abdominoperineal resection(D3 dissection)was performed. There was no complication, and he was discharged 15 days after surgery. Postoperative pathological examination revealed pT3N1asM0, pStage Ⅲb.
Topics: Male; Humans; Aged; Robotic Surgical Procedures; Leriche Syndrome; Treatment Outcome; Rectal Neoplasms; Proctectomy
PubMed: 38303235
DOI: No ID Found -
Clinical Journal of Gastroenterology Apr 2024The incidence of esophagogastric junction cancer has been increasing, leading to growing interest in surgical treatment. Leriche syndrome, characterized by occlusion...
The incidence of esophagogastric junction cancer has been increasing, leading to growing interest in surgical treatment. Leriche syndrome, characterized by occlusion limited to the infrarenal aorta, has not been reported to be associated with ischemic enteritis, and there are no previous reports on the surgical approaches for esophagogastric junction cancer in this disease.We describe the case of a male patient in his fifties with lower abdominal pain and melena who was diagnosed with esophagogastric junction cancer, Leriche syndrome, and ischemic enteritis. Contrast-enhanced computed tomography (CT) showed a hemorrhage from the cancer, occlusion of the abdominal aorta beyond the renal artery branches, and rectal contrast deficiency. Three-dimensional (3D)-CT angiography revealed occlusion from the lumbar artery bifurcation to the distal portions of both common iliac arteries plus numerous collateral pathways, indicating a precarious rectal blood supply. Based on 3D-CT angiography, minimally invasive surgery (MIS) using laparoscopy and thoracoscopy for esophagogastric junction cancer was performed after whole-body control. The patient was discharged without any postoperative complications.Esophagogastric junction cancer with Leriche syndrome can be complicated by ischemic enteritis due to tumor bleeding and fragile collateral pathways. MIS using laparoscopy and thoracoscopy guided by 3D-CT angiography can be safely performed for this disease.
Topics: Humans; Male; Leriche Syndrome; Rectum; Esophagogastric Junction; Ischemia; Minimally Invasive Surgical Procedures; Neoplasms; Enteritis
PubMed: 38281289
DOI: 10.1007/s12328-023-01911-w -
Cureus Nov 2023Aortoiliac occlusive disease (AIOD), also known as Leriche syndrome, is a form of peripheral artery disease (PAD) that involves narrowing, and in severe cases, complete...
Aortoiliac occlusive disease (AIOD), also known as Leriche syndrome, is a form of peripheral artery disease (PAD) that involves narrowing, and in severe cases, complete occlusion, of infrarenal abdominal aorta and/or iliac and femoropopliteal arteries. It classically presents as a triad of symptoms, i.e., leg pain, erectile dysfunction, and abnormally weak or absent femoral pulses. If untreated, it can progress to ischemia and gangrene of the affected regions of pelvis and lower extremities. Like any other PAD, AIOD is most commonly caused by atherosclerosis and usually occurs in strong association with severe cardiovascular diseases. Due to the rarity of this disease, its incidence and prevalence are still unknown making it harder to diagnose especially in patients without the classic risk factors and typical presentation. We report a case of AIOD in a 65-year-old woman who presented with atypical symptoms. She was diagnosed with AIOD type I upon further investigation, which was managed successfully.
PubMed: 38106757
DOI: 10.7759/cureus.48858 -
Journal of Vascular Nursing : Official... Dec 2023Aortoiliac arterial disease is a chronic progressive disease which is characterized by steno-occlusive changes in the aorta and iliac arteries. The gold standard for the...
INTRODUCTION
Aortoiliac arterial disease is a chronic progressive disease which is characterized by steno-occlusive changes in the aorta and iliac arteries. The gold standard for the treatment of patients with the advanced stage of the disease is aorto-bifemoral reconstruction. Patients with circumferential juxtarenal calcifications of the aorta bear a high risk of intraoperative complications, due to difficult cross-clamping in such zones.
CASE REPORT
We present a case of a 73-year-old patient who has been admitted due to left leg rest pain and second toe ulceration. Multislice computed tomography showed significant stenosis of the aortoiliac segment with a circumferentially calcified abdominal aorta. Aortobifemoral reconstruction was performed featuring endoluminal occlusion of the aorta using a balloon catheter which was placed through the left brachial artery. The procedure and the postoperative course were uneventful, and the patient was discharged on the sixth postoperative day.
CONCLUSION
The hybrid endovascular and open surgery technique presented emerged as a valid alternative for selected high-risk patients. Scrub nurses should be familiarized with endovascular techniques and tools and be aware of the measures to be protected from the harmful effects of ionizing radiation.
Topics: Humans; Aged; Arterial Occlusive Diseases; Nurse's Role; Blood Vessel Prosthesis Implantation; Treatment Outcome; Aorta, Abdominal
PubMed: 38072574
DOI: 10.1016/j.jvn.2023.07.002 -
Radiology Case Reports Feb 2024Leriche syndrome is an aortoiliac occlusive arterial disease comprising decreased peripheral pulses, claudication, and erectile dysfunction. We present a case of a...
Leriche syndrome is an aortoiliac occlusive arterial disease comprising decreased peripheral pulses, claudication, and erectile dysfunction. We present a case of a 60-year-old male with abdominal pain and hematochezia who was diagnosed with hemorrhoids. The patient also had associated leg cramps on both sides and lower limb weakness. Further evaluation of the patient with imaging revealed occlusion of the distal descending abdominal aorta below the level of renal arteries and the iliac arteries. An incidental finding of Leriche syndrome was evident. This case report contributes to the current literature when any patient with abdominal pain and bilateral lower limb weakness, Leriche syndrome should be considered to avoid complications as it has high morbidity and mortality.
PubMed: 38044901
DOI: 10.1016/j.radcr.2023.10.077 -
Joint Bone Spine Mar 2024
Topics: Humans; Calcinosis; Knee Joint; Osteoarthritis, Knee
PubMed: 37977525
DOI: 10.1016/j.jbspin.2023.105660 -
Respiratory Medicine and Research Nov 2023Management of severe COVID-19 patients admitted to ICU considerably evolved during the first months of the pandemic. It is unclear, however, whether these changes...
BACKGROUD
Management of severe COVID-19 patients admitted to ICU considerably evolved during the first months of the pandemic. It is unclear, however, whether these changes improved long-term survival of these critically ill patients.
METHODS
We conducted a retrospective cohort study in adults with COVID-19 pneumonia admitted to a French ICU between February 2020 and January 2021, a timeframe that covered the first two waves of the pandemic. Primary outcome was to compare long-term survival between the first and second waves. Survival predictor were identified using a Cox proportional-hazards model.
RESULTS
We included 265 patients in the cohort: 140 (52.8 %) and 125 (47.2 %) belonging to the first and second waves, respectively. Baseline characteristics of the patients were similar between the two waves. During W2, use of early corticotherapy increased (86.4% vs. 17.8 %; p <0.001), as well as high-flow oxygen therapy use (68.5% vs. 37.4 %; p<0.001). Need for invasive mechanical ventilation decreased (49.6% vs. 72.9 %; p <0.001) and ICU length of stay was shorter (11 [6-22] vs 19 [8-32]days; p = 0.008). ICU mortality was 32.8 % without significant difference between waves. Survival analysis revealed that 3 variables were independently associated with a worse long-term prognosis: a higher SAPS II score (1.05 [1.04-1.06]; p<0.001), a higher age (1.05 [1.01-1.08]; p = 0.005) and admission during W2 (2.22 [1.15-4.28]; p = 0.017).
DISCUSSION
Despite substantial changes on management of severe COVID-19 patients, we observed a decreased long-term survival among patients admitted during the second wave. We also noted a shorter ICU length of stay.
Topics: Adult; Humans; COVID-19; Retrospective Studies; Intensive Care Units; Hospitalization; Respiration, Artificial
PubMed: 37918184
DOI: 10.1016/j.resmer.2023.101057