Adult ; Arterial Occlusive Diseases ; diagnosis ; Constriction, Pathologic ; diagnosis ; Humans ; Male ; Martial Arts ; Muscle, Skeletal ; pathology ; Pain ; diagnosis ; Peripheral Vascular Diseases ; diagnosis ; Popliteal Artery ; physiopathology ; Singapore

A 72-year-old woman presented with recurrent painful erythematous nodules and ulcers on both legs. Latent tuberculosis was proven by a positive interferon-gamma release assay, and a histopathology examination revealed septolobular panniculitis with vasculitis. The initial diagnosis was erythema induratum associated with tuberculosis, but the leg ulcers became worse despite anti-tuberculosis medication and wound dressing. Computed tomography angiography showed occlusion of the superficial femoral and popliteal arteries bilaterally, supporting that the vascular event contributes to the ulcers according to the vascular territories. Under the diagnosis of peripheral arterial occlusive disease, she was treated with percutaneous transluminal angioplasty and antiplatelet medication. The skin ulcers were resolved. Elderly patients with erythema induratum have a risk of coincidental peripheral arterial occlusive disease, therefore dermatologists should be aware of the possibility of underlying vascular disease, so even minor trauma like skin biopsy can evoke serious condition shown in this patient. Here, we report a case of drastically aggravated erythema induratum due to co-existing peripheral arterial occlusive disease, which resolved with vascular intervention after not responding to antituberculosis medication.
Aged ; Angiography ; Angioplasty ; Arterial Occlusive Diseases* ; Bandages ; Biopsy ; Diagnosis ; Erythema Induratum* ; Erythema* ; Female ; Humans ; Interferon-gamma Release Tests ; Latent Tuberculosis ; Leg ; Leg Ulcer ; Panniculitis ; Popliteal Artery ; Skin ; Skin Ulcer ; Tuberculosis ; Ulcer ; Vascular Diseases ; Vasculitis ; Wounds and Injuries

Acute arterial occlusion is a rare complication following total knee arthroplasty (TKA). The incidence as reported previously is from 0.03% to 0.17%; however, the sequelae can be disastrous because of its potential threat to limb loss.We report a case of acute arterial occlusion in the midpiece of femoral artery following TKA occurred 40 min postoperatively. The occlusion site existed at the midpiece of femoral artery is uncommon. Arterial circulation of the lower limb could not be restored by the thrombolysis and thrombectomy treatments performed within 11 h after TKA. In the end, amputation had to be carried out. In the treatment of acute arterial occlusion following TKA with a tourniquet, it is important to fully consider that arteriosclerosis may induce atheromatous plaque disruption, which might be the reason for acute arterial occlusion.
Amputation ; methods ; Angiography ; methods ; Arterial Occlusive Diseases ; etiology ; surgery ; Arthroplasty, Replacement, Knee ; adverse effects ; methods ; Disease Progression ; Female ; Femoral Artery ; diagnostic imaging ; surgery ; Follow-Up Studies ; Humans ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; surgery ; Postoperative Complications ; diagnosis ; surgery ; Severity of Illness Index ; Thrombectomy ; methods ; Thrombosis ; diagnostic imaging ; etiology ; surgery

Angiography, Digital Subtraction ; Arterial Occlusive Diseases ; diagnosis ; Carotid Artery Diseases ; diagnosis ; Carotid Artery, Internal ; pathology ; Carotid Artery, Internal, Dissection ; diagnosis ; Humans ; Male ; Middle Aged

Myotonic dystrophy (MD) is the most common adult muscular dystrophy characterized by multi-systemic clinical manifestations involving the brain, smooth muscle, cardiovascular and endocrine systems. However, peripheral arterial occlusive disease (PAOD) is an uncommon presentation of MD type 1 (DM1), which has not been reported in recent literature. A 53-year-old female, previously confirmed as DM1, presented with vague claudication of both lower limbs. The diagnosis of PAOD based on results of ankle-brachial index, ultrasonography, and abdominal computed tomography angiography studies was followed by aortobifemoral artery bypass surgery. Although the arterial patency was restored after the operation, she did not recover from post-operative respiratory complications. Screening of PAOD is necessary for DM1 with general risk factors of occlusive arteriopathy. However, surgery should be reserved for the most severe cases.
Adult ; Angiography ; Ankle Brachial Index ; Arterial Occlusive Diseases* ; Arteries ; Brain ; Diagnosis ; Endocrine System ; Female ; Humans ; Lower Extremity ; Mass Screening ; Middle Aged ; Muscle, Smooth ; Muscular Dystrophies ; Myotonic Dystrophy* ; Risk Factors ; Ultrasonography

No abstract available.
Arterial Occlusive Diseases/complications/*diagnosis/radiography ; Hemorrhage ; Humans ; Ileal Diseases/radiography/surgery ; Ileocecal Valve/blood supply ; Infarction/pathology/*surgery ; Male ; Mesenteric Artery, Superior/*radiography ; Middle Aged ; Thromboangiitis Obliterans/complications/*diagnosis ; Tomography, X-Ray Computed

INTRODUCTIONThe gold standard for evaluation of the lower extremity arterial tree is catheter angiography. Duplex arterial-occlusive imaging or duplex ultrasonography arteriography, a noninvasive technique, is used as the first-line investigation in patients with peripheral vascular disease at our centre. Based on the results of duplex imaging, patients who require angiographic intervention then proceed with simultaneous catheter arteriography and intervention. This study aimed to compare the results of duplex imaging alone as the first-line investigation against the eventual results of catheter angiography, and to assess the impact of the former on patients' clinical outcomes.

METHODSAll cases involving patients who underwent duplex imaging followed by angiographic intervention, from May 2008 to February 2009, were discussed at weekly interdisciplinary meetings. Only patients who underwent lower limb imaging were included in the study. Those who were involved in grafts and stent surveillance studies, as well as those with incomplete duplex images were excluded.

RESULTSDuring the study period, 113 duplex imaging studies of the lower limb followed by percutaneous transluminal angioplasty were performed at our hospital for peripheral vascular disease. The iliac artery was visualised in 40 images, but could not be visualised in 73 images. There was a potential change in management in three cases due to radiological differences between the duplex images and angiography films.

CONCLUSIONIn our series, duplex imaging was found to be accurate enough to guide initial clinical management of patients with peripheral vascular disease. This modality is the preferred first-line investigation for such patients at our centre.

Angiography ; methods ; Angioplasty ; methods ; Arterial Occlusive Diseases ; diagnosis ; diagnostic imaging ; Humans ; Leg ; blood supply ; diagnostic imaging ; Peripheral Vascular Diseases ; diagnosis ; diagnostic imaging ; Predictive Value of Tests ; Reproducibility of Results ; Ultrasonography ; methods ; Ultrasonography, Doppler, Duplex ; methods

Adult ; Arterial Occlusive Diseases ; diagnosis ; Celiac Artery ; Crohn Disease ; diagnosis ; Humans ; Ligaments ; Male ; Syndrome

We report a case of ophthalmic artery obstruction combined with brain infarction following periocular autologous fat injection. The patient, a 44-year-old woman, visited our hospital for decreased visual acuity in her left eye and dysarthria one hour after receiving an autologous fat injection in the periocular area. Her best corrected visual acuity for the concerned eye was no light perception. Also, a relative afferent pupillary defect was detected in this eye. The left fundus exhibited widespread retinal whitening with visible emboli in several retinal arterioles. Diffusion-weighted magnetic resonance imaging of the brain showed a hyperintense lesion at the left insular cortex. Therefore, we diagnosed ophthalmic artery obstruction and left middle cerebral artery infarction due to fat emboli. The patient was managed with immediate ocular massage, carbon dioxide, and oxygen therapy. Following treatment, dysarthria improved considerably but there was no improvement in visual acuity.
Adult ; Arterial Occlusive Diseases/diagnosis/*etiology ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Infarction, Middle Cerebral Artery/*complications/diagnosis ; Magnetic Resonance Imaging ; *Ophthalmic Artery ; Orbit ; Subcutaneous Fat/*transplantation ; Transplantation, Autologous/adverse effects ; Visual Acuity

Arterial Occlusive Diseases ; diagnosis ; etiology ; Coronary Disease ; complications ; diagnosis ; Humans ; Lower Extremity ; blood supply ; Male ; Middle Aged