The Experts below are selected from a list of 7290 Experts worldwide ranked by ideXlab platform
Shin Ishimaru - One of the best experts on this subject based on the ideXlab platform.
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abdominal aortic aneurysm associated with crossed renal ectopia without fusion case report and literature review
Journal of Vascular Surgery, 2003Co-Authors: Hiromi Yano, Naoki Konagai, Mitsunori Maeda, Mikihiko Itoh, Atsushi Kuwabara, Tatsuhiko Kudou, Shin IshimaruAbstract:Genitourinary anomalies can present a formidable challenge to the Vascular Surgeon at abdominal aortic reconstruction. We saw a case of crossed renal ectopia without fusion, a rare anomaly, associated with abdominal aortic aneurysm. Because of risk for injury to the kidney during surgery, preoperative evaluation of this anomaly must include computed tomography, angiography, and intravenous pyelography. Preoperative placement of a ureteral catheter may prevent injury to the anomalous ureter. Renal failure of the ectopic kidney during aortic reconstruction can be a serious problem. We used in situ hypothermic perfusion with cold (4°C) Ringer solution for renal protection, and reimplanted the aberrant renal artery. The postoperative course was good, without major complications. The procedure for renal preservation must be selected on the basis of anatomic findings. We review the literature and present the first case of crossed renal ectopia. (J Vasc Surg 2003;37:1098-102.) Crossed renal ectopia is an uncommon genitourinary anomaly, detected in 1 of 7000 autopsies. 1 The ectopic kidney crosses the midline and lies contralateral to its normal position, 2 and may be fused to the normal kidney. The ureter of the ectopic kidney crosses the midline to enter the bladder at its normal position. The blood supply to the kidneys is from the aorta or the iliac arteries, and the number of renal arteries varies. 3,4 Such aberrations may provide a significant challenge to the Vascular Surgeon if aortic reconstruction is required. The English literature includes only been a few reports of abdominal aneurysm repair complicated by crossed fused ectopic kidney, 5-10 and no reports of this operation without fusion. We report successful aneurysm reconstruction in a patient with crossed ectopic kidney without fusion. CASE REPORT
Ralph B Dilley - One of the best experts on this subject based on the ideXlab platform.
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Vascular complications of exposure for anterior lumbar interbody fusion
Journal of Vascular Surgery, 2010Co-Authors: Joy Garg, Karen Woo, Jodi Hirsch, James D Bruffey, Ralph B DilleyAbstract:Objective The purpose of this study is to document the incidence of Vascular complications during anterior lumbar interbody fusion (ALIF) in 212 consecutive patients treated at the Scripps Clinic and determine what factors adversely affected outcome. Methods We reviewed the prospectively maintained database of all ALIF procedures performed at Scripps Clinic between August 2004 and June 2009. All procedures were performed by a spine Surgeon in conjunction with a Vascular Surgeon who performed the exposure portion of the operation, and protected the vessels from injury during the instrumentation phase of the operation. Results Two hundred twelve ALIF operations were identified. The mean age of the patients was 53.8 years, and 120 (56.6%) were female. The mean body mass index (BMI) was 29.6 (range, 18.1 to 47.8). Twenty-two (10.4%) operations were performed at the L4-5 disc space, 149 (70.3%) at L5-S1, and 41 (19.3%) involved L4-L5 with L5-S1. The mean estimated blood loss (EBL) was 143 milliliters. There was a significant direct correlation between increasing BMI and EBL (P = .018). Thirteen (6.1%) Vascular injuries occurred of which five were major (38.5%). One major arterial injury (0.5%) occurred and required arterial thrombectomy and stent placement. Four of the major Vascular injuries were venous in nature and required a multi-suture repair. The remaining eight injuries (61.5%) were venous, the majority of which required a suture repair. There were no mortalities. There was an increase risk of Vascular injury when both L4-L5 and L5-S1 were exposed (P = .003) and with the male gender (P = .013). Calcification of the aorto-iliac system did not exert an effect on EBL or Vascular injury. In four cases, the Surgeon was unable to expose the appropriate disc levels. Conclusions Anterior exposure of the spine for ALIF can be performed safely with a team approach that includes a Vascular Surgeon. Preoperative evaluation by a Vascular Surgeon is advisable. Patients with increased BMI and bi-level exposures should be approached with caution.
Aziz Maged - One of the best experts on this subject based on the ideXlab platform.
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Crossed renal ectopia and aorto-occlusive disease: a management strategy
'Korean Society for Thoracic and Cardiovascular Surgery', 2015Co-Authors: Ng Eugene, Campbell Ian, Choong, Andrew M. T. L., Dunglison Nigel, Aziz MagedAbstract:We present a rare case of a patient with aortoiliac occlusive disease on the background of type A crossed renal ectopia, for whom open surgical intervention was required. Aortic exposure in patients with concomitant crossed renal ectopia can present technical challenges to the Vascular Surgeon. The knowledge of variations in the ectopic renal blood supply is of paramount importance when performing surgery to treat this condition and affects the choice of surgical exposure. We present and discuss the operative details of our patient and outline an approach to this subset of patients
F Postacchini - One of the best experts on this subject based on the ideXlab platform.
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injury to major abdominal vessels during posterior lumbar interbody fusion a case report and review of the literature
The Spine Journal, 2013Co-Authors: Roberto Postacchini, Gianluca Cinotti, F PostacchiniAbstract:Abstract Background context Numerous cases of injury to major abdominal vessels during the excision of a lumbar herniated disc have been reported, but no cases of injury during interbody fusion by a posterior approach have been described. Purpose To report on an injury to common iliac vessels during a posterior lumbar interbody fusion (PLIF) and discuss the causes and possible preventive measures. Study design A unique case report and a review of the literature. Methods The hospital chart and autopsy report of a single patient were analyzed. Results A 52-year-old woman with L4–L5 disc degeneration underwent PLIF. During scraping of the vertebral end plates, there was a sudden increase in blood flow from the disc space, however not copious, with no changes of vital parameters. When the patient was placed supine, severe hypotension and abdominal distension led to strongly suspect a lesion to abdominal vessels. At laparotomy, carried out by a Vascular Surgeon, a vast retroperitoneal hematoma was evacuated and the Vascular lesions were repaired. Postoperatively, the patient continued to lose blood from the abdominal drains and after 4 hours, she was reoperated by another Vascular Surgeon, who found a diffuse hemorrhage from the small vessels in the surgical field. Soon after the surgery the patient died. Conclusions The lesions were produced by a shaver used for scraping the vertebral end plates. The absence of abundant bleeding from the disc space was possibly because of the compression of the iliac vessels by the pads of the frame on which the patient was lying. The causes of the lesions and possible prevention of similar injuries are analyzed.
Perditer Okyere - One of the best experts on this subject based on the ideXlab platform.
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reVascularization of post traumatic leg amputation a case report
Ghana Medical Journal, 2020Co-Authors: Isaac Okyere, Vincent Ativor, Perditer OkyereAbstract:There are few reports on lower extremity reVascularization because of its high risks of general and local complications as well as poor functional prognosis. However, reVascularization of the traumatically amputated lower extremity is a technically feasible surgical undertaking if there can be effective collaboration between the orthopaedic Surgeon and the Vascular Surgeon. Successful outcome is usually judged by functional achievements of the patient toward returning to the preinjury level. Appropriate patient selection significantly increases the potential for obtaining a satisfactory outcome. We report the successful reVascularization of a near amputation of the right leg of a young man who wasknocked down accidentally by a speeding taxi leading to mangled and near amputation of his right leg. He underwent successful reVascularization and currently doing well, one year after the surgery. Successful reVascularization is possible if indicated in less resource countries especially if there is an experienced team of Vascular and orthopaedic Surgeons.Keywords: ReVascularization, leg, trauma, amputation, repairFunding: None
