Spontaneous Microguidewire Extrusion From the Foot Following Cerebral Aneurysm Treatment: First Case Report

2017 ◽  
Vol 15 (2) ◽  
pp. 213-216
Author(s):  
Kurdow Nader ◽  
Saleh Lamin ◽  
Joseph Leyon ◽  
Swarupsinh Chavda ◽  
Allan Thomas ◽  
...  
Keyword(s):  
Case Reports ◽  
Rare Complication ◽  
Family Doctor ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Her Family ◽  
First Case ◽  
Subsequent Fracture ◽  
Femoral Puncture ◽  
The Wire

Abstract BACKGROUND AND IMPORTANCE Microguidewire entrapment and failure related to endovascular therapy is a rare complication with limited case reports available, most of which are from cardiac endovascular intervention. Migration of the microguidewire has been reported in coronary intervention with some resulting in severe complications, but there are no reported cases of spontaneous extrusion of wire fragment following a neurointerventional procedure. We report the first case of a microguidewire entrapment with subsequent fracture, followed by spontaneous extrusion of the wire fragment. CLINICAL PRESENTATION A 40-yr-old woman was admitted for an elective flow-diversion stent treatment of an unruptured paraophthalamic aneurysm. Microguidewire entrapment occurred during an attempted balloon-aided dilatation of the partially opened stent. Careful attempts failed to retrieve the wire; hence, the decision was made to leave it behind. She presented to her family doctor 6 mo later with spontaneous extrusion of a 60-cm fragment of the retained wire, from her heel ipsilateral to the femoral puncture site. This had not resulted in any further vascular or non-vascular complications. CONCLUSION Fracture with extrusion is a potential consequence of a retained microguidewires. While this is an extremely rare complication, it is important to alert clinicians and patient about the possibility of wire migration and extrusion. Early follow-up with clinical assessment, and targeted imaging should lead to identification of this occurrence.

scholarly journals Two Case Reports of Varicocele Rupture during Sexual Intercourse and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Chalil Arif ◽  
Konstantinos Kotoulas ◽  
Chrysostomos Georgellis ◽  
Konstantinos Frigkas ◽  
Athanasios Bantis ◽  
...  
Keyword(s):  
Sexual Intercourse ◽  
Spermatic Cord ◽  
Case Reports ◽  
Rare Complication ◽  
Traumatic Rupture ◽  
Male Population ◽  
First Case ◽  
Key Points ◽  
General Male Population ◽  
Scrotal Hematoma

Varicocele is characterized by the dilatation of the veins of the spermatic cord. Its prevalence in general male population is 15% while in the infertile population the prevalence rises up to 25%. The varicocele is considered an etiological factor for male infertility. Although different pathophysiological patterns have been proposed, there is no consensus in the urological society to date. In most of the cases varicocele is asymptomatic but sometimes gives mild symptoms as dull pain at the scrotal region. A rare complication of this condition is the spontaneous or traumatic rupture and hematoma formation, either as spermatic cord hematoma or as scrotal hematoma. We are presenting two cases of varicocele rupture, presented with acute painful swelling of the left inguinal and scrotal region during sexual intercourse. Imaging studies revealed a scrotal hematoma in the first case and a spermatic cord hematoma in the second case, without signs of active bleeding. Both patients were treated conservatively and recovered uneventfully. Subsequently, we reviewed the literature in an effort to find the key points for the diagnosis and treatment of this condition.

scholarly journals Optical Coherence Tomographic Study of a Chronically Retained Coronary Guidewire

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Natasha Corballis ◽  
Sreekumar Sulfi ◽  
Alisdair Ryding
Keyword(s):  
Rare Complication ◽  
Coronary Intervention ◽  
Bare Metal Stent ◽  
Optical Coherence ◽  
Percutaneous Coronary Angioplasty ◽  
Subsequent Fracture ◽  
Percutaneous Coronary ◽  
The Individual

Guidewire entrapment is a rare complication of coronary intervention, and management depends on the individual circumstances. This is a case of an urgent percutaneous coronary angioplasty in which a guidewire became entrapped behind a bare metal stent with subsequent fracture of the core filament, which could not be retrieved. Using optical coherence tomography, our case demonstrates extensive tissue coverage of the retained guidewire at twelve months. Five-year follow-up suggests that retained guidewires can be managed without long-term anticoagulation, even when there is substantial intra-aortic material.

scholarly journals Capecitabine-Induced Hyperosmolar Hyperglycemic State

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A370-A371
Author(s):  
Carly Yim ◽  
Terra G Arnason ◽  
Nassrein Hussein
Keyword(s):  
Breast Cancer ◽  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Case Reports ◽  
Family Doctor ◽  
Metastatic Breast ◽  
Insulin Regimen ◽  
Her Family ◽  
Hyperglycemic Hyperosmolar State ◽  
History Of

Abstract Capecitabine is an orally administered prodrug of 5-fluorouracil (5-FU) which is often used for treatment of solid tumour cancers such as breast cancer and gastrointestinal tumours. Common adverse effects include nausea, diarrhea, anorexia and erythrodysthesia (hand-foot syndrome). However, there have been case reports of metabolic disturbances linked to capecitabine including hyperlipidemia, and less commonly, hyperglycemia. We report a case of a new diagnosis of persistent diabetes mellitus following an acute presentation of hyperosmolar hyperglycemic syndrome (HHS) subsequent to treatment with the chemotherapy agent, capecitabine. A 72 year old female with a history of metastatic breast cancer was admitted to hospital for management of hyperglycemic hyperosmolar state (HHS) after bloodwork from her family doctor revealed an elevated random blood glucose (40.2 mmol/L). Leading up to her presentation, the patient had completed 7 cycles of capecitabine treatment for her breast cancer. Prior to her capecitabine treatment, the patient did not have a history of diabetes mellitus. However, on admission, her hemoglobin A1C (HbA1C) was found to elevated into the diabetic range. Offending medications were considered and given the temporal dysglycemia following the patient’s chemotherapy regimen, capecitabine was thought to be a probable offending agent. The patient was acutely treated for HHS, and eventually transitioned to a basal-bolus insulin regimen at discharge. Her capecitabine was held pending review with her oncology team and she was closely followed up by her family doctor. The patient’s insulin regimen was ultimately titrated down to basal insulin only. Given the increasing use of capecitabine therapy in breast cancer, it is important to recognize the risk of hyperglycemia and hyperglycemic emergencies as a potential adverse effect of this treatment. It highlights the need to ensure that blood glucose is monitored throughout treatment to prevent hyperglycemic emergencies.

scholarly journals Spontaneous Renal Artery Dissection in COVID-19 Pneumonia: Potential Danger of Cytokine Storm

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Jitendra Parmar ◽  
Tapan Patel ◽  
Sandip Shah ◽  
Jay Kothari ◽  
Sameer Dani ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Renal Artery ◽  
Vascular Endothelial Cells ◽  
Case Reports ◽  
Vascular Complications ◽  
Artery Dissection ◽  
Vascular Endothelial ◽  
Cytokine Storm ◽  
Aged Patients ◽  
First Case

The coronavirus disease (COVID-19) pandemic has rapidly spread across the globe since its first detection in March 2020. Its widespread manifestations and vascular complications are increasingly being reported even in young and middle-aged patients. Hyperinflammation is a continuum of host’s exaggerated inflammatory response representing cytokine dysregulation/storm which produces coagulopathy and vascular endothelial dysfunction, apart from a prothrombotic state. Cytokine storm or direct viral invasion of the vascular endothelial cells through surface angiotensin-converting enzyme 2 receptors may result in endothelial dysfunction which can potentially result in dissection. Only a few case reports have been published in the literature describing vascular dissection without any inciting factors in COVID-19 patients. Herein, we present the first case report of bilateral renal artery dissection in a 41-year-old male patient who recently recovered from COVID-19 and was managed successfully in stages after many medical hurdles.

Abstract 1932: Bleeding and Vascular Complications Following Percutaneous Coronary Intervention can be Reduced with Multiple Practice Changes

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
John F Robb ◽  
Arvind K Sharma ◽  
David J Malenka ◽  
Winthrop D Piper ◽  
Sheila M Conley ◽  
...  
Keyword(s):  
Medical Center ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Odds Ratios ◽  
Patient Admissions ◽  
Recovery Unit ◽  
Time Period ◽  
Femoral Puncture ◽  
Changing Practices ◽  
Dartmouth Hitchcock Medical

Background : Bleeding (BC) and vascular complications (VC) remain an important cause of post-PCI morbidity and mortality that are potentially avoidable. We implemented a series of practice changes to reduce the risk of BC and VC and hypothesized they would be significantly associated with a decreased risk of these adverse events. Method s: Data were prospectively collected on 5916 consecutive patient admissions comprising 6019 PCIs from 1/2002–9/2006 at the Dartmouth-Hitchcock Medical Center. During that time period practice changes included routine fluoroscopy-guided femoral puncture, routine femoral angiography, selective use of closure devices, increased use of bivalirudin, decreased use of IIb/IIIa inhibitors, use of a dedicated recovery unit. Logistic regression was used to examine the relationship between changing practices, BC, and VC, controlling for case-mix, with results reported as adjusted odds ratios (OR) with 95% confidence intervals. Results: Between 2002 and 2006 BC rates decreased from 5.95% to 4.42% (p=0.006) and VC rates from 0.47% to 0.09% (p=0.070). The risk of BC decreased significantly with the use of bivalirudin, femoral angiography, suture-mediated closure, and use of a recovery unit (Table ). VC decreased significantly with the use of closure devices. Conclusions: Procedural and process changes made in the care of patients undergoing PCI were significantly associated with decreasing the risk of BC and VC. Adjusted * Odds Ratios for Bleeding and Vascular Complications: Treatment and Process Variables

scholarly journals Acute Complication Due to Impella 2.5 Device (Superficial Femoral Artery Thrombosis): Managed Successfully with Novel Aspiration Thrombectomy catheter (pronto V3)

2011 ◽  
Vol 5 ◽  
pp. CMC.S6157 ◽  
Author(s):  
Tariq M. Bhat ◽  
Alain Waked ◽  
Sumaya Teli ◽  
James Lafferty ◽  
Bhavesh Gala
Keyword(s):  
High Risk ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Thrombus Formation ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Vascular Complication ◽  
Aspiration Thrombectomy ◽  
First Case

The Impella recover LP 2.5 is a percutaneous left ventricular assist device (LVAD) recently approved for use in patients undergoing high risk percutaneous coronary intervention (PCI) and also in cases of cardiogenic shock. There is limited evidence available in literature about its safety, especially with regards to the incidence of local vascular complications, their management and long-term implications. We report here the first case of a serious local vascular complication—superficial femoral artery thrombus formation during Impella recover LP 2.5 use in a high risk PCI which was managed successfully with novel aspiration thrombectomy catheter (Pronto V3), which in itself is the first reported use of Pronto V3 in such a vascular complication.

Monoclonal antibody extravasations: Two case reports and literature review

2020 ◽  
pp. 107815522095000
Author(s):  
Alicia Rodríguez-Alarcón ◽  
David Conde-Estévez
Keyword(s):  
Monoclonal Antibody ◽  
Case Report ◽  
Literature Review ◽  
Case Reports ◽  
Rare Complication ◽  
Specific Treatment ◽  
Intravenous Chemotherapy ◽  
Chemotherapy Administration ◽  
First Case

Introduction Extravasation is a rare complication from intravenous chemotherapy administration. Literature about monoclonal antibody (MoAb) extravasations is scarce and also conflicting in how they are classified. Case report We reported two different cases of MoAb extravasations with cetuximab and nivolumab outcome respectively. The administration site appeared inflamed and patients did not report disturbances. Management and outcome: Both extravasations did not require specific treatment. General unspecific measures suffice to properly manage these extravasations and no sequels were observed after long follow-up. Both patients received all further courses of MoAb without any adverse events. Discussion To our knowledge, we reported the first case-report of nivolumab extravasation in the literature. In addition, the cetuximab extravasation management and outcome was in accordance with previously published reports. Both MoAb may be considered as non-aggressive or neutral. We reviewed published information about MoAb extravasations. In conclusion, not all MoAb should be classified in the same category when extravasated and special precautions are warranted with conjugated MoAb and bevacizumab.

Guillain–Barre syndrome: a rare complication of leptospirosis and scrub typhus co-infection

2019 ◽  
Vol 49 (3) ◽  
pp. 248-249 ◽  
Author(s):  
Nishant Dev ◽  
Rahul Kumar ◽  
Dilip Kumar
Keyword(s):  
Scrub Typhus ◽  
Case Reports ◽  
Rare Complication ◽  
Nerve Conduction Studies ◽  
Guillain Barre Syndrome ◽  
First Case ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Life Threatening ◽  
Guillain Barré

Guillain–Barré syndrome (GBS) is a potentially life-threatening immune-mediated acute inflammatory polyneuropathy associated with several antecedent infections. We report a 20-year-old man with GBS associated with concurrent leptospirosis and scrub typhus infection. GBS was confirmed with clinical examination and nerve conduction studies. There have been case reports of GBS in association with Leptospira and Orienta tsusugamushi separately. However, this may be the first case report of GBS associated with concurrent diseases.

scholarly journals Case series of iatrogenic coronary stent avulsion: a rare complication with varied management strategies

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Majd B Protty ◽  
Elinor H M O’Neill ◽  
Tim Kinnaird ◽  
Sean Gallagher
Keyword(s):  
Rare Complication ◽  
Management Strategies ◽  
Case Series ◽  
Coronary Stent ◽  
Management Options ◽  
Aortic Sinus ◽  
Coronary Syndrome ◽  
The Third ◽  
First Case ◽  
The Wire

Abstract Background Coronary stent avulsion is a rare, infrequently reported complication of percutaneous coronary intervention (PCI) with no consensus on management options. Case summary This case series presents three descriptions of iatrogenic coronary stent avulsions, and three different bailout management strategies. All patients presented with acute coronary syndrome and required PCI. In the first case, a freshly implanted stent was entrapped in a coronary guidewire and avulsed upon withdrawal of the wire into the aortic sinus. In the second case, a staged procedure to implant a new stent was complicated by stent dislodgement and entanglement with a recently implanted stent leading to avulsion of both stents into the aortic sinus and resultant dissection to the coronary arteries. In the third case, following a successful stent implantation, the tip of the coronary guidewire was bound to the proximal edge of the stent resulting in avulsion of the newly implanted stent into the ascending aorta upon retraction of the wire at the end of the procedure. The first two patients were managed percutaneously, and the third surgically. All patients have had acceptable technical and clinical outcomes. Discussion In the absence of a consensus on best bailout management strategy, we discuss the mechanisms of and the potential management options for this rare, but serious, complication.

scholarly journals Nontraumatic perforation of the small intestine caused by true primary enteroliths associated with radiation enteritis: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yusuke Hirakawa ◽  
Hirona Shigyo ◽  
Yuriko Katagiri ◽  
Kazuaki Hashimoto ◽  
Mitsuru Katsumoto ◽  
...  
Keyword(s):  
Small Intestine ◽  
Rare Complication ◽  
Fluid Collection ◽  
Family Doctor ◽  
Radiation Enteritis ◽  
Case Presentation ◽  
Her Family ◽  
Free Air ◽  
Uncommon Condition ◽  
Nontraumatic Perforation

Abstract Background True primary enterolithiasis is an uncommon condition, and nontraumatic perforation of the small intestine (NTPSI) is also an unusual entity. Therefore, NTPSI due to true primary enteroliths is an exceptionally rare complication. Moreover, enterolithiasis and radiation enteritis are also unique combinations. Herein, we present an exceedingly rare case of NTPSI induced by multiple true primary enteroliths associated with radiation enteritis. Case presentation A 92-year-old woman with acute abdominal pain was transferred to our hospital because a computed tomography (CT) scan performed by her family doctor revealed free air and fluid collection within her abdomen. Our initial diagnosis was upper gastrointestinal perforation, and we selected nonoperative management (NOM) with adnominal drainage. Although her general condition was stable, jejunal juice was drained continuously. Given that the CT performed 10 days after onset demonstrated perforation of the small intestine and adjacent concretion, we performed an emergency partial resection of the small intestine and jejunostomy. The resected bowel was 1 m in length and had many strictures that contained multiple enteroliths in their proximal lumens. The patient’s postoperative course was uneventful. The enteroliths were composed of deoxycholic acid (DCA). She was diagnosed with peritonitis due to NTPSI derived from multiple true primary enteroliths associated with radiation enteritis, as she had previously undergone hysterectomy and subsequent internal radiation therapy. Conclusions Clinicians should consider the rare entity of true primary enteroliths associated with radiation enteritis in NTPSI cases with unknown etiologies.

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