Distal embolization as a presenting symptom of aortic aneurysms
Article Abstract:
An abdominal aortic aneurysm (AAA) is a lesion which carries a significant risk for the patient; it is a localized thinning of the wall of the abdominal aorta, the abdominal portion of the main trunk of the systemic arterial circulation. Patients are at risk for rupture of the AAA, which causes uncontrollable, and sometimes fatal, hemorrhage. A common manifestation of these aneurysms is the embolization (formation of a mobile clot) of debris, which circulates in the bloodstream until it becomes attached to the wall of a vessel. This study reviewed a series of patients with symptoms of distal embolization that originated from AAA. Records were reviewed of 302 patients who had repair of their AAAs. Asymptomatic patients represented 82 percent (248 patients) of operations, and 11 percent (32 patients) had rupture of the aneurysm. Distal embolization was the first symptom of AAA in 15 patients (5 percent). Thirteen patients had spontaneous embolization, and two patients developed embolism during or immediately following angiography. Of the 15 patients, 14 underwent computed tomographic (CT) scan which showed the clot within the AAA. Angiography showed occlusive lesions of the lower extremities in seven patients but was not diagnostic for embolism. The mortality rate was 13 percent (two patients died). Complications included renal failure in five patients (33 percent), below-knee leg amputations in three patients, and five minor amputations. The death rate may be compared with a mortality of 5 percent for elective aneurysm repair and 66 percent for ruptured aneurysm. It is concluded that CT scan is safer than angiography. Risk of embolus formation does not correlate with size of the aneurysm, and small AAAs are potentially dangerous. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Surgery
Subject: Health
ISSN: 0002-9610
Year: 1990
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Abdominal wall hernias after open abdominal aortic aneurysms repair: Prospective radiographic detection and clinical implications
Article Abstract:
The prevalence of radigraphically detected abdominal wall defects (AWD) after open abdominal aortic aneurysms (AAA) repair is evaluated. It is concluded that AWDs are radiographic findings occurring frequently after open AAA repair and that clinical observation to detect ventral hernia is not sensitive as radiographic evaluation, which is very sensitive.
Publication Name: Vascular and Endovascular Surgery
Subject: Health
ISSN: 1538-5744
Year: 2004
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