VASA. Zeitschrift für Gefässkrankheiten
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Comparative Study
Outcome of carotid endarterectomy under local anaesthesia with respect to the patients' risk profile.
In the present study the perioperative complication rate is compared between high- and low-risk patients when carotid endarterectomy (CEA) is routinely performed under local anaesthesia (LA). ⋯ With the routine use of LA, CEA was not associated with worse outcome in high-risk patients. Considering the data reported in the literature, it does not appear justified to refer high-risk patients principally to carotid angioplasty and stenting (CAS) when LA can be chosen to perform CEA.
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Case Reports
Salvage of a dialysis angioaccess by bypassing a central venous obstruction to the common femoral vein.
We describe the case of a 71 year-old male patient undergoing haemodialysis who presented with severe symptoms of venous hypertension at the left upper extremity due to subclavian and innominate vein obstruction. The patient had a well functioning ispilateral angioaccess. ⋯ The postoperative recovery was regular and the patient was discharged 6 days after surgery with a functioning bypass and relief from the venous hypertension symptoms. In this case, surgical bypassing of a central venous obstruction through an extra-anatomical pathway relieved the symptoms of venous hypertension and prolonged the use of the haemodialysis access.
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Case Reports
Left cervical aortic arch in conjunction with a complex arch aneurysm and subaortic left innominate vein.
We present a patient with left cervical aortic arch who had a complex aortic arch aneurysm consisting of multiple saccular aneurysmatic excavations, proximal aortic arch narrowing, a right subclavian artery aneurysm and subaortic left innominate vein diagnosed by computed tomographic angiography.
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We report a case with spinal cord ischemia and consecutive paraplegia following spontaneous isolated abdominal aortic dissection (IAAD). A 63-year-old female was admitted to the surgical emergency room with severe lumbar back pain and accompanying paresthesia of both legs. Contrast enhanced computed tomograpy (CT) of the abdomen showed an infrarenal IAAD in a normal size aorta with patent lumbar arteries. ⋯ IAAD is a rare differential diagnosis of lumbar back pain and can be associated with paraplegia as the leading symptom. Individualized treatment is indicated. Surgical treatment options concerning paraplegia are limited.