1.Popliteal artery pseudoaneurysm successfully treated with amplatzer vascular plug
Liew Kah Weng ; Benjamin Leong Dak Keung
The Medical Journal of Malaysia 2016;71(5):302-303
Popliteal artery pseudoaneurysm is uncommon. They
usually result from penetrating or blunt trauma, arterial
reconstructive surgery, invasive diagnostic or surgical
orthopedic procedures. They can cause arterial thrombosis
and limb ischeamia. We report a 53 year old Chinese
gentleman with popliteal artery pseudoaneurysm who
presented with right lower limb numbness and paralysis in
toes extension. He gave a history of acupuncture treatment
around the popliteal fossa of the affected limb. Clinical
examination revealed a pulsatile mass in the popliteal fossa.
Computed tomography angiography showed a large, 5 cm,
pseudoaneurysm arising from the popliteal artery. A
diagnostic angiogram was performed and revealed that
there is no run off from the popliteal artery and the tibial
vessels were reconstructed from collaterals. Endovascular
intervention was carried out with an Amplatzer Vascular
Plug to embolise the pseudoaneurysm. The
pseudoaneurysm was successfully excluded and post-op
follow up revealed no more pulsatile mass and improving
lower limb function. To the best of our knowledge this is first
reported case of pseudoaneurysm of the popliteal artery
secondary to acupuncture in Malaysia.
2.Management of concurrent thoracic and abdominal aortic aneurysms
Saw Siong Teng ; Feona S. Jospeh ; Benjamin Leong Dak Keung
The Medical Journal of Malaysia 2017;72(5):321-323
Concurrent thoracic and abdominal aortic aneurysm is
uncommon. It remains a formidable surgical challenge to
vascular surgeons, as decision to treat in staged or
simultaneous setting still debatable. We present, here, a
case of a 62-year-old-man with asymptomatic concurrent
thoracic and abdominal aortic aneurysms, which was
successfully treated with two-stage hybrid endovascular
repair. The aim of this case report is to discuss the
treatment options available, possible associated
complications and measures to prevent them.
Aortic Aneurysm, Abdominal
;
Aortic Aneurysm, Thoracic
3.Prevalence of Peripheral Arterial Disease and Abdominal Aortic Aneurysm among Patients with Acute Coronary Syndrome
Benjamin Dak Keung Leong ; Ariffin Azizi Zainal ; Jitt Aun Chuah ; Sook Yee Voo
The Medical Journal of Malaysia 2013;68(1):10-12
Introduction: Peripheral arterial disease(PAD) and
abdominal aortic aneurysm(AAA) are two important underdiagnosed vascular pathologies. As they share common risk factors with coronary arterial disease, we conducted a study to look at their prevalence among patients with acute coronary syndrome(ACS).
Materials and Methods: Patients with ACS admitted to
Queen Elizabeth Hospital, Malaysia, from February 2009 till
August 2009 were screened prospectively for PVD and AAA.
Patients’ data and clinical findings were gathered and
analyzed. Measurements of ankle brachial index (ABI) and
abdominal aortic diameter were performed by a single
assessor. PAD was defined as ABI ≤ 0.9 or diabetic patients
with signs and symptoms of PAD and absence of pedal
pulses. AAA was defined as abdominal aortic diameter ≥
3cm.
Results: 102 patients were recruited with mean age of 59.5
years old. Male: female ratio was 6:1. 40.2% of patients had NSTEMI; 45.1%, STEMI and 14.7%, unstable angina. Risk
factors profile is as follows: hypertension- 68.6%, smoking-56.9%, hypercholesterolemia- 52.9%, diabetes mellitus-35.3% and history of stroke- 5.9%. Median ABI was 1.1 with lowest reading of 0.4. Mean abdominal aortic size was 2.0cm with largest diameter of 3.3cm. PAD was present in 24.5% of patients and AAA in 2.0%. 68.0% of patients with PAD were asymptomatic. Smoking and age more than 60 years were independent predictors for PAD among ACS patients.
Conclusions: PAD is strongly correlated with CAD with old
age and smoker as independent predictors. However,
association between AAA and ACS could not be established.