Aged ; Diagnosis, Differential ; Humans ; Intermittent Claudication ; diagnosis ; etiology ; Male ; Middle Aged ; Nervous System Diseases ; complications ; diagnosis ; Vascular Diseases ; complications ; diagnosis

Cystic adventitial disease is rare, but it is one of the well-recognized causes of non-atherosclerotic arterial stenosis or obstruction. Despite one of its most common symptoms being chronic intermittent claudication, it may be misdiagnosed as arterial embolism when presented with acute ischemic symptoms. Surgical resection is recommended because of recurrence or a low success rate with aspiration or endovascular stent. We performed resection and repair with autologous vein patch for cystic adventitial disease of the popliteal artery of a 57-year-old man presenting with pain, pallor, and paresthesia, without any postoperative complications or recurrence.
Constriction, Pathologic ; Embolism ; Humans ; Intermittent Claudication ; Middle Aged ; Pallor ; Paresthesia ; Popliteal Artery ; Postoperative Complications ; Recurrence ; Stents ; Vascular Diseases ; Veins

Thirty-two consecutive patients with spondylolisthesis associated with displacement in varying degrees were operated by the Steffee procedure. Slippings more than Meyerding Grade III were reduced by modified Schollner technique:destabilization of the slipped segement, local distraction with spinal elevator and completion of reduction with a cork screw force pulling backward. Autogenous bone and Pyrost were added to get solid fusion. The authors reviewed thrity-two cases of symptomatic lumbar spondylolisthesis which were operated since March in 1987 at Kangnam Sacred Heart Hospital, Hallym University and the followings were obtained. 1. There were 17 males and 15 females, and the age of the patients was 44.2 years in average ranging from 19 to 66 years. 2. The types of spondylolisthesis were isthmic defect at 19 levels in 18 cases and degenerative in 14 cases. The level of the lesion was L5-Sl in 17 cases, L4-5 in 15 cases and L2-3 in 1 cases. 3. The clinical symptoms were low back pain, radiating pain, intermittent claudication, and motorsensory deficit in order of incidence. 4. Preoperatively, the degree of slinpping was Meyerding Grade I in 18, Grade III in 12 and Grade Ill in 3 cases. The slipping was reduced to nearly anatomic position in 13 cases and Grade I in 20 cases. The average slipping measured by Taillard method was changed from 23.4% preoperatively to 5% postoperatively. 5. Clinically, the results were judged as excellent in 13(13%) cases, good in 16(50%) cases and fair in 3(9%) cases according to Kim's criteria. 6. Postoperative complications were leg pain in 3 cases and "stress transfer" in 1 cases.
Elevators and Escalators ; Female ; Heart ; Humans ; Incidence ; Intermittent Claudication ; Leg ; Low Back Pain ; Male ; Methods ; Pedicle Screws ; Postoperative Complications ; Spine ; Spondylolisthesis

We report a case of erectile dysfunction caused by external iliac artery occlusion, associated with pelvic steal syndrome; bilateral internal iliac arteries were patent. The patient stated that he had experienced erectile dysfunction at similar times along with claudication, but he did not mention it before angiography. He expressed that the erectile dysfunction did not last long and that he felt completely okay after the interventional procedure, in addition to his claudication. Successful treatment of the occlusion, by percutaneous transluminal angioplasty and stent implantation, helped resolve erectile dysfunction completely and treat the steal syndrome.
*Angioplasty ; Arterial Occlusive Diseases/*complications/radiography/*therapy ; Erectile Dysfunction/*etiology/*therapy ; Humans ; Iliac Artery/pathology/*radiography ; Intermittent Claudication/complications ; Male ; Middle Aged ; *Stents ; Subclavian Steal Syndrome/*complications/*therapy

Atherosclerosis has more than 60% of the causes of arterial occlusive diseases. The abdominal aorta and lower extremity arteries are the most common sites of occlusion. We have treated surgically 2 cases who had intermittent claudication and were diagnosed as simultaneous aortobifemoral and bilateral femoropopliteal obstruction by angiography, but had ineffective results from medical treatment or angioplasty. Simultaneously aortobifemoral bypass using Hemashield Y graft and bilateral femoropopliteal bypass using autologous greater saphenous vein were done. After operations, the symptom disappeared and there were no specific postoperative complications except abdominal wound dehiscence. In postoperative angiography, we had obtained good patency of bypass graft. We are following up patients through the out patient department without recurrence up to 16 months.
Angiography ; Angioplasty ; Aorta, Abdominal ; Arterial Occlusive Diseases ; Arteries* ; Atherosclerosis ; Humans ; Intermittent Claudication ; Lower Extremity* ; Postoperative Complications ; Recurrence ; Saphenous Vein ; Transplants* ; Wounds and Injuries

PURPOSE: Popliteal artery entrapment syndrome (PAES) is rare but major cause of non-atheromatous popliteal arterial insufficiency in young. Because of its rareness, it is often neglected or misdiagnosed as thrombosis or embolism. Consequently surgeons would lose the appropriate time of treatment. METHOD: We reviewed 11 cases of PAES from 1994 to 2002 regarding to clinical characteristics, image findings, management and their results. RESULT: Two of 11 patients had bilateral involvement. All patients were male and aged 12 to 45 year old (mean; 32.1). Intermittent claudication was presented as initial symptom in all. One had toe gangrene. Conventional arteriography (11 cases) was used as initial diagnostic method. CT (7 cases) and MR (4 cases) angiography were also used to make diagnosis. Type II PAES were most common in 7 limbs. 11 limbs of 10 patients underwent operation. One was managed conservatively because of advanced liver cirrhosis. Resection of medial head of gastrocnemius and popliteal arterial bypass were performed in 7 limbs. One myectomy with femoroposterotibial bypass, one femoropopliteal bypass without myectomy, and myectomy with patch angioplasty were performed. Postoperative complication occurred in two limbs. One had occlusion of graft, another had occluded segment of endarterectomised popliteal artery. Primary graft patency at 6 mo, 1 yr and 3 yr were 81% 81%, 81% respectively. CONCLUSION: In young patients with claudication who have localized lesion at popliteal artery, clinicians should pay attention to rule out PAES. Accurate diagnosis can be achieved by CT or MR angiography. Early surgical correction is recommended to minimize surgical procedure and reduce complication of the disease.
Angiography ; Angioplasty ; Diagnosis ; Embolism ; Extremities ; Gangrene ; Head ; Humans ; Intermittent Claudication ; Liver Cirrhosis ; Male ; Middle Aged ; Popliteal Artery* ; Postoperative Complications ; Thrombosis ; Toes ; Transplants

The authors hypothesized that the placement of the interspinous implant would show a similar clinical outcome to the posterior lumbar interbody fusion (PLIF) in patients having spinal stenosis with mild segmental instability and that this method would be superior to PLIF without significantly affecting degeneration at the adjacent segments. Forty two adult patients having degenerative spinal stenosis with mild segmental instabilit who underwent implantation of Coflex(TM) (Spine motion, Germany) or PLIF at L4-5 between January 2000 and December 2003 were consecutively selected and studied for one-year clinical outcome. At 12 months after surgery, both groups showed a significant improvement in the visual analogue scale score and Oswestry disability index score for both lower extremity pain and low back pain. However, the range of motion at the upper adjacent segments (L3-4) increased significantly after surgery in the PLIF group, which was not manifested in the Coflex(TM) group during the follow-up. The authors assumed that interspinous implantation can be an alternative treatment for the spinal stenosis with segmental instability in selected conditions posing less stress on the superior adjacent level than PLIF.
Treatment Outcome ; Spinal Stenosis/complications/*surgery ; Spinal Fusion/*instrumentation/methods ; Prosthesis Design ; Pain Measurement ; Outcome Assessment (Health Care) ; Middle Aged ; Male ; Lumbar Vertebrae/*surgery ; Longitudinal Studies ; Joint Instability/complications/*prevention & control ; Intermittent Claudication/diagnosis/etiology/*prevention & control ; Humans ; Female ; Equipment Failure Analysis ; Back Pain/diagnosis/etiology/*prevention & control ; Aged ; Adult