Journal of Yeungnam Medical Science

Case report

Endovascular treatment of Takayasu arteritis in a middle-aged woman with syncope and limb claudication: a case report: Ha-Young Choi, Sunggun Lee, Jino Park, Yeo-Jeong Song, Dong-Kie Kim, Ki-Hun Kim, Sang-Hoon Seol, Doo-Il Kim, Seunghwan Kim; J Yeungnam Med Sci. 2023;40(4):448-453. Published online April 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.00122

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Abstract PDF: Takayasu arteritis (TA) is a disease that causes inflammation and stenosis of medium to large blood vessels. We report a case of a 50-year-old female patient with newly developed hypertension, syncope, and claudication of the extremities. Total occlusion of the left subclavian artery at the origin was found and significant stenosis of the right common iliac artery was revealed by hemodynamic analysis. She was successfully treated with percutaneous angioplasty for multiple peripheral arterial diseases and was finally diagnosed with TA. In consultation with a rheumatologist, medical treatment for TA was initiated, the patient’s hypertension disappeared, and her claudication symptoms improved.

Case Reports

Acute upper limb ischemia in a patient with newly diagnosed paroxysmal atrial fibrillation: Dong Shin Kim, Seunghwan Kim, Hyang Ki Min, Chiwoo Song, Young Bin Kim, Sae Jong Kim, Ji Young Park, Sung Kee Ryu, Jae Woong Choi; Yeungnam Univ J Med. 2017;34(2):242-246. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.242

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Abstract PDF: Acute limb ischemia (ALI) due to an embolism is associated with high mortality rate and poor prognosis, and early diagnosis with prompt revascularization is required to reduce the risk of limb amputation or even death. The etiologies of ALI are diverse, and it includes an embolism from the heart and thrombotic occlusion of the atherosclerotic native vessels, stents, or grafts. An uncommon cause of ALI is acute arterial thromboembolism, and atrial fibrillation (AF) is the single most important risk factors for systemic thromboembolism. It is important to correctly identify the source of ALI for secondary prevention, as it depends on the underlying cause. Percutaneous transluminal angioplasty (PTA) has been proven to be a safe and effective treatment for focal atherosclerotic and thrombotic occlusive diseases of the aorta and its major extremity branches. Herein, we report on a 77-year-old female patient with acute upper limb ischemia, treated by PTA using a catheter-guided thrombectomy. He was newly diagnosed with paroxysmal AF (PAF) while evaluation the cause of his acute arterial thromboembolism. We recommend that cardiologists always consider PAF as a possible diagnosis even in patients without any history of AF under ALI because it is possible to develop thromboembolism in clinical practice.

Lower limb ischemia after bee sting.: Hee Yun Ryu, Min Seok Yoo, Ji Young Park, Jae Woong Choi, Sung Kee Ryu, Seunghwan Kim, Se Jin Lee, Young Bin Kim; Yeungnam Univ J Med. 2016;33(2):134-137. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.134

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Abstract PDF

Bee sting causes mild symptoms such as urticaria and localized pain, and severe symptoms including anaphylaxis, cardiovascular collapse, and death. We reported on a patient with arterial thrombotic occlusion and severe ischemia in the lower limb after multiple bee stings. The patient was stung 5 times and complained of pallor, pain, and coldness in the left toe, and did not have dorsalis pedis pulsation. Computed tomography angiography showed multiple thrombotic occlusion of the anterior and posterial tibial artery below the knee. Local thrombolytic therapy using urokinase was administered and the occluded arteries were successfully recanalized.

Citations

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A Rare Case of Acute Lower Limb Ischemia following Bee Sting
Jayesh Patel, Arya Patel, Shivangi Jha, Ketul S Barot, Pratiksha Patel, Dwisha Poptani
Indian Journal of Vascular and Endovascular Surgery.2023; 10(3): 231. CrossRef

Deep Vein Thrombosis Due to Hematoma as a Rare Complication after Femoral Arterial Catheterization.: Minsoo Kim, Jong Young Lee, Cheol Whan Lee, Seung Whan Lee, Soo Jin Kang, Yong Hoon Yoon, Sang Yong Om, Young Hak Kim; Yeungnam Univ J Med. 2013;30(1):31-35. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.31

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Abstract PDF

Hematoma is quite a common complication of femoral arterial catheterization. However, to the best of our knowledge, there have been no previous studies regarding deep vein thrombosis (DVT) caused by compression of a vein due to a hematoma. We report a case of a hematoma developing after femoral arterial catheterization and causing extensive symptomatic DVT. A 59-year-old male was seen in our Emergency Department with right lower leg swelling 15 days after coronary stent implantation performed using right femoral artery access. Computed tomographic (CT) scanning revealed a large hematoma (45 mm in its longest diameter) compressing the common femoral vein and with DVT from the right external iliac vein to the popliteal vein. Due to the extensive DVT involvement, we decided to release the compressed common femoral vein by surgical evacuation of the large hematoma. However, even following evacuation of the hematoma, as the DVT did not resolve soon, further mechanical thrombectomy and catheter-directed thrombolysis were performed. Angiography then showed nearly resolved DVT, and the leg swelling was improved. The patient was discharged with the anticoagulation medication, warfarin.

Citations

Citations to this article as recorded by

Femoral Vein Thrombosis Following Femoral Access Cardiac Catheterisation – A Rare Complication
Laurence Disler, Mathew Disler, Dayle Disler Biddle, Camilla Friedman, Janet Couper-Smith
Cardiovascular Revascularization Medicine.2023; 53: S224. CrossRef
A Case of Puncture-Site Giant Pseudoaneurysm Following Recanalization Therapy for Acute Ischemic Stroke: Marked Growth and Rupture of a Femoral Artery Pseudoaneurysm
Noriaki Matsubara, Yusuke Fukuo, Kohei Yoshimura, Hideki Kashiwagi, Gen Futamura, Yangtae Park, Toshihiko Kuroiwa, Masahiko Wanibuchi
Journal of Neuroendovascular Therapy.2021; 15(6): 366. CrossRef
Deep Vein Thrombosis after Femoral Arterial Access: Pathophysiologic and Therapeutic Challenges
Evan Harmon, Yoo Jin Lee, Sula Mazimba, Kanwar Singh, Aditya Sharma, Younghoon Kwon
Case Reports in Cardiology.2019; 2019: 1. CrossRef
Treatment of pulmonary thromboembolism using Arrow-Trerotola percutaneous thrombolytic device
Tae Kyun Kim, Ji Young Park, Jun Ho Bae, Jae Woong Choi, Sung Kee Ryu, Min-Jung Kim, Jun Bong Kim, Jang Won Sohn
Yeungnam University Journal of Medicine.2014; 31(1): 28. CrossRef

Treatment of Coronary Artery Perforation and Tamponade Complicating Balloon Angioplasty by PTFE-Covered Stent. A Case Report.: Jong Seon Park, Gu Ru Hong, Jun Ho Bae, Ihn Ho Cho, Bong Sup Shim, Young Jo Kim, Dong Gu Shin; Yeungnam Univ J Med. 2005;22(1):90-95. Published online June 30, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.1.90

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Abstract PDF: A coronary artery perforation is a rare but often fatal complication of angioplasty. We experienced a coronary artery perforation and cardiac tamponade during balloon angioplasty. A polytetrafluorethylene (PTFE) -covered stent was used to successfully close the perforation.

Original Article

Change of Serum Levels of C-Reactive Protein After Coronary Angioplasty and Its Effects on Clinical Restenosis.: Jong Seon Park, Gu Ru Hong, Chae Hoon Lee, Dong Gu Shin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 2001;18(2):215-225. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.215

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Abstract PDF: BACKGROUND
There are many evidences that inflammation is an important determinant of the development of atherosclerosis and one of the systemic markers of inflammation, C-reactive protein(CRP), is associated with extent of coronary artery disease and risk of coronary events. We assessed the time response of CRP response after coronary angioplasty and it's influence on the clinical restenosis in angina patients. MATERIALS AND METHODS: Patients included 36 angina patients undergoing single vessel angioplasty. Levels of CRP were measured before and 12, 24, 48, and 72 hours after angioplasty. Clinical restenosis was assessed at 6 months after procedure. RESULTS: Baseline CRP level was 0.30+/-0.01 mg/dL in stable and 0.46+/-0.28 mg/dL in unstable angina patients(p<0.05). After angioplasty, CRP level was increased with peak at 24 hour and persisted to 72 hours after angioplasty. At 24 hour after angioplasty, the magnitude of CRP change was 0.32+/-0.31 mg/dL in stable and 0.79+/-0.73 mg/dL in unstable angina patient(p<0.05). The change of CRP level was not associated with troponin-T after angioplasty. In unstable angina patients, clinical restenosis was developed in 8% of patients with low baseline CRP levels and in 50% of those with high baseline CRP levels more than 0.6 mg/dL(p<0.05). CONCLUSION: In unstable angina patients, inflammatory response is more increased than stable angina patients, and increased inflammatory response effects on the restenosis after coronary angioplasty.

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