Acute aortic syndromes.

[Acute aortic syndromes]. Presse Med. 2018 Mar 08;: Authors: Cochennec F, Marzelle J Abstract Acute aortic syndromes include aortic dissections, intramural hematomas, penetrating ulcers, ruptured or contained ruptured aortic aneurysms. In presence of acute thoracic or dorsal pain, elevated D-Dimers and if acute coronary artery syndrome has been ruled out, additional imaging should be performed to detect acute aortic pathologies. Acute type A dissections involve the ascending aorta. Emergent open repair is the preferred treatment. Acute type B dissections involve the thoracic descending aorta. Endovascular treatment using thoracic stent grafts is indicated in complicated cases (malperfusion, rupture, uncontrolled hypertension) or in cases where risk factors of aortic degeneration are identified. Regarding ruptured abdominal aortic aneurysms, optimization techniques recently led to a reduced postoperative mortality. They include adequate treatment of abdominal compartment syndrome, use of aortic stent grafts, endovascular balloon occlusion and permissive hypotension. Symptomatic complex aneurysms encompass renal and visceral arteries. Nowadays, they can be treated in an urgent setting using new endovascular techniques, such as "off-the shelf" branched stent grafts, parallel techniques, home made or in situ fenestrations of standard stent grafts. PMID: 29526427 [PubMed - as supplied by publisher]
Source: Presse Medicale - Category: General Medicine Authors: Tags: Presse Med Source Type: research

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CONCLUSION: ACUTE ABDOMEN sonographic approach in acute abdomen can play an important role in ruling out critical diagnosis, and can guide emergency physician or any critical care physician in patient management. PMID: 31544223 [PubMed]
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Ultrasound J Source Type: research
ConclusionACUTE ABDOMEN sonographic approach in acute abdomen can play an important role in ruling out critical diagnosis, and can guide emergency physician or any critical care physician in patient management.
Source: Critical Ultrasound Journal - Category: Radiology Source Type: research
Zhong-Yan Zhou1,2†, Wai-Rong Zhao1†, Wen-Ting Shi1†, Ying Xiao1, Zi-Lin Ma1, Jin-Gui Xue3, Lun-Qing Zhang4, Qing Ye1, Xin-Lin Chen1* and Jing-Yi Tang1,5* 1Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China 2State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, China 3Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China 4Faculty of Health Sciences, University of Macau, Macau, China 5Cardiac Rehabilitation Center of Longhua Hospital, Shanghai Univers...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
A 74-year-old man (height 168 cm; weight 74 kg) with a history of diabetes mellitus and hypertension presented with lower abdominal pain of 4 weeks ’ duration. He had undergone off-pump coronary artery bypass grafting surgery 2 months before the current admission. A computed tomography scan of the abdomen revealed a large infrarenal abdominal aortic aneurysm (diameter 6.4 cm). The patient was scheduled for abdominal aortic aneurysm repair. Af ter placing a right radial arterial catheter under local anesthesia, anesthesia was induced with intravenous midazolam, etomidate, fentanyl, and rocuronium.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Diagnostic Dilemma Source Type: research
Authors: Kim IH, Min HK, Kim JY, Kim DK, Kang DK, Jun HJ, Hwang YH Abstract Aortocaval fistula (ACF) occurs in
Source: Korean Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Korean J Thorac Cardiovasc Surg Source Type: research
We report a rare case of delayed removal of an epidural hematoma that resulted in good patient outcomes. Patient concerns: A 69-year-old woman weighing 58 kg presented with back pain that had persisted for 12 years. Her medical history was notable for hypertension. Cervical computed tomography angiography indicated a giant abdominal aortic aneurysm measuring 11.58 × 17.34 × 13.00 cm in her abdominal cavity. Stent graft implantation was scheduled by the interventional therapy group to treat her abdominal aortic aneurysm under single-dose spinal anesthesia. Postoperatively, the patient complained of ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusion: ACS was occurred with a severe complication (acute intestinal necrosis) in a very short period, which is very rare regarding to this condition after EVAR, it reminds us the severe result of ACS and more methods to prevent it happened after surgical management.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
CLINICAL INTRODUCTION A 76-year-old woman with a history of hypertension and diabetes mellitus presented to the ED with abdominal pain for 1 week. On physical examination, the patient was found to have epigastric and bilateral costovertebral angle tenderness. Laboratory tests reported elevations of white blood cell count, creatinine and serum lipase. A chest radiograph was obtained (figure 1). Question What is the most likely diagnosis?Abdominal aortic aneurysm Hepatic abscess Pneumoperitoneum Pneumoretroperitoneum Answer: D The chest radiograph showed mottled air in the subphrenic area (figure 2). The non-contrast-en...
Source: Emergency Medicine Journal - Category: Emergency Medicine Authors: Tags: EMJ Image Challenge Source Type: research
In this study, cangrelor was discontinued 1-6 hours prior to surgery, while aspirin was continued throughout the perioperative period. Bridging with cangrelor did not increase major bleeds prior to surgery, though minor bleeds, mostly ecchymosis at venipuncture site, was higher. P2Y12 assay documented sufficient platelet inhibition corresponding to levels required for anti thrombotic effect [1]. Cangrelor is awaiting approval and more large scale trials regarding the use of bridging are needed. Reference 1. Angiolillo DJ et al; BRIDGE Investigators. Bridging antiplatelet therapy with cangrelor in patients undergoing ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
A 71-year-old man with hypertension presented with abdominal pain and dyspnoea; he had an 8-cm juxtarenal abdominal aortic aneurysm (unsuitable for standard endovascular aneurysm repair, owing to saccular outpouching of the immediate infrarenal area; arrow in [A]). Physical examination revealed signs of right heart failure: bilateral ankle oedema, hepatomegaly and right pleural effusion. An aortocaval fistula was noticed on computed tomographic angiography. Following suprarenal aortic clamping and distal inferior vena cava balloon control, an aorto-bi-iliac Dacron graft was implanted with primary closure of the fistula (B)...
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Tags: Coup D'Oeil Source Type: research
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