VASA. Zeitschrift für Gefässkrankheiten
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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.
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Acute limb ischemia is still the most frequent cause of major limb loss. Timely and fast revascularization is the key for limb salvage and patient survival. ⋯ Recently, mechanical thrombectomy devices have become more widespread because intervention time and bleeding complications can be reduced. This review article summarizes the clinical presentation of and the treatment options for acute arterial occlusive disease caused either by embolism or local thrombosis.
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An amputation is a "tragic event" in someone's biography which causes a dramatic change in the outer appearance, the loss of mobility, independence and self esteem. The following article is about how people learn to cope with this difficult situation; with the practical problems of everyday life as well as their emotional problems. It is important for the amputees to go through the different stages of mourning: The first stage is the rejection of the situation. ⋯ During the process of coping with their amputation the patients often alternate between optimistic and pessimistic moods. Sometimes they fall back into a negative and resigned state of mind. This is natural and part of the process as long as they find their own way to a positive attitude and view of life.