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Endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR) are minimally invasive procedures to treat abdominal, and many thoracic, aortic aneurysms. An aneurysm, an abnormal bulge or ballooning in the wall of a blood vessel, can burst which causes bleeding inside the body and often leads to death. [1]
BackgroundPatent foramen ovale (PFO) is causally associated with stroke in some patients younger than 60 years, especially when it is large or associated with an atrial septal aneurysm (ASA). After 60 years of age, this association is less well understood. versus 17.5%;P<0.0001). P<0.0001). versus 14.5%,P=0.002).ConclusionsPFO
ObjectiveSpinal cord ischemia due to damage or occlusion of the orifices of aortic segmental arteries (ASA) is a serious complication of open and endovascular aortic repair.
IntroductionBasilar‐tip aneurysm (BTA) is the most common aneurysm found in the posterior circulation, representing 5–8% of total intracranial aneurysms. For ruptured aneurysms, Adjuvant therapy (BAC or SAC) was used to treat larger dimension aneurysms compared to CE (p = 0.046). vs. 10.7%).
Repeat CT angio chest (not CT coronary, unclear what protocol) showed possible LAD aneurysm and thrombus. Finally, coronary angiography was performed (at least 5 days after presentation) which confirmed LAD aneurysm with large thrombus burden, TIMI 0 flow, thrombectomy performed. No further cath details available.
Here are his repeat ECGs after intervention: This shows new Q-waves in V4-V6, with persistent STE and positive T-waves in the anterolateral leads which matches left ventricular aneurysm morphology. because if it does, then urgent cath to define the anatomy is clearly indicated. Similar findings.
Mid cavity obstruction in HCM is associated with apical aneurysm, systemic embolism, and arrhythmias. Evaluation of diastolic characteristics of LV and LV and coronary anatomy evaluation are other diagnostic uses of cath in HCM. LVOTO is due to septal hypertrophy, SAM, and anterior displacement of mitral valve apparatus.
Compare to the anatomy after stenting: The lower of the 2 now easily seen branches is the circumflex, now with excellent flow. Post-myocardial infarction (MI) ventricular septal defects are frequently seen in mid-anteroseptal and apical septal segments, whereas apex and the basal inferior segment are prone to aneurysm formation.
It is consistent with an inferior LV aneurysm. LAO cranial shot of the RCA Here is an annotated still showing anatomy: Dotted black lines indicate filling defects due to thrombus: The cath report described mostly organized thrombus and heavy thrombotic burden. It is almost certainly not acute. No repeat ECGs were obtained.
His initial high sensitivity troponin I returned at 1300 ng/L and given that his cardiac workup was otherwise unremarkable, a CT was obtained to evaluate for pulmonary embolism and aortic aneurysm or dissection but this too was unrevealing. Another EKG was also obtained. ECG at time 82 minutes: What do you think?
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