Diagnosis and indications for revascularization in Takayasu’s Arteritis: Report of two cases and literature review |
Author : Magaye Gaye*, Adama Sawadogo, Papa Adama Dieng, Ndèye Fatou Sow, Souleymane Diatta, Momar Sokhna Diop, Papa Salmane Ba, Assane Ndiaye, Amadou Gabriel Ciss and Mouhamadou Ndiaye |
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Abstract :Takayasu’s arteritis (TA) is an inflammatory disease of large vessels that predominantly affects the aorta and its main branches such as supra-aortic trunks, renal and digestive arteries. The diagnosis is based on criteria proposed by the American College of Rheumatology and modifi ed by Sharma. These vascular lesions present a problem of surgical indications because of their pathogenic particularity. In this work, we report our experience on the diagnosis and management of two cases of TA. The case 1 was a 62-year-old female patient diagnosed with stenosis of the common carotid artery and the right subclavian artery. A bypass between the carotid artery and the subclavian artery was indicated but not performed. The second patient was a 23-year-old female patient diagnosed with renovascular hypertension. Investigations showed a significant stenosis of the left renal artery. She underwent angioplasty-stenting of the left renal artery and the result was good. Her echocardiography showed left ventricular and atrial hypertrophy and both. The two patients had no indirect signs of myocardial ischemia and arterial pulmonary injuries |
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19 Years old male with ST elevation myocardial infarction as an initial manifestation of primary antiphospoholipid syndrome |
Author : Lana Maricic* and Roberta Viševic |
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Abstract :Antiphospholipid antibody syndrome (APS) is a systemic, autoimmune, acquired disorder characterized by venous and/or arterial thrombosis and/or pregnancy morbidities [1]. Although detectable at 1-5% of asymptomatic subjects, persistent antiphospholipid antibodies (aPL) are significantly associated with recurrent arterial/venous thrombosis and pregnancy morbidity [2]. The 2006 International consensus Statement on an Update of the classification criteria recognize those antiphospholipid antibodies (aPLs): lupus anticoagulant (LA), anticardiolipin antibodies (ACA) IgM or IgG and antibody to ? 2 glycoprotein 1 (?-2-GP I) [3]. Those should be confirmed at least two occasions, 12 weeks apart [1]. Primary APS has generally been defined as the presence of aPL in patients with idiopathic thrombosis, but no evidence of autoimmune disease or other inciting factor, such as infection, malignancy, hemodialysis or drug-induced APL. |
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Right Iliofemoral Venous Thrombosis in a Prothrombin 20210GA carrier with Duplicated Inferior Vena Cava. An Unusual Case Report |
Author : Konstantinos Tigkiropoulos*, Emmanouil Papadakis, Ioannis Lazaridis and Nikolaos Saratzis |
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Abstract :Venous thromboembolism, presenting as deep vein thrombosis (DVT) is a disease affected by aging, with a low rate of about 1 per 10,000 annually before the fourth decade of life, rising rapidly after age 45 years, and approaching 5–6 per 1000 annually by age 80. We present the case of a 69-years old woman who presented to our emergency department with unilateral lower limb pain and swelling. Subsequent imaging revealed a right iliofemoral deep vein thrombosis, with associated duplication of her inferior vena cava. Thrombophilic screening revealed a prothrombin 20210A gene mutation. She was treated conservatively with Low Molecular Weight Heparin (LMWH) and elastic stockings. |
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Atraumatic Acute Limb Ischemia: Clinical Presentation, Classification, Assessment and Management- A Review |
Author : Nalaka Gunawansa* |
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Abstract :Acute Limb Ischaemia (ALI) can be a devastating clinical emergency with potentially life or limb threatening consequences. The commonest aetiologies of ALI are traumatic, embolic or thrombotic. While traumatic ALI is fairly obvious in the trauma victim, embolic and thrombotic ALI may mimic other clinical conditions such as neurological disease which may cause delays in diagnosis. Immediate diagnosis, accurate assessment of limb viability and urgent intervention when needed play a crucial role in salvaging the affected limb and preventing a major amputation. Delay in diagnosis and intervention causes irreversible muscle ischaemia leading to eventual limb loss and potential systemic organ dysfunction due to associated lactic acidosis and other toxins. |
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