Gas gangrene complicating limb trauma.

A consecutive series of 18 patients with clostridial myonecrosis has been reviewed. The two deaths were attributed to other causes. A treatment regimen including repeated debridement and excision of all non-viable tissue, and therapeutic antibiotics is outlined. Hyperbaric oxygenation has been omitted from our treatment program.     

De Bakey type I aortic dissection complicating systemic lupus erythematosus; report of a case

We report a 43-year-old patient of De Bakey type I aortic dissection [DA (I)] with a 2-year-history of systemic lupus erythematosus (SLE). He had had no treatment for SLE before the onset of dissection. Computed tomography (CT) on admission revealed DA (I), and he underwent emergency operation. Since the aortic valve and the left main coronary artery were severely damaged, aortic root replacement was performed. Coronary buttons were prepared in Carrel method and coronary reconstruction was performed in Piehler modification. After surgery, he suffered from repetitive hemolytic anemia. Corticosteroid therapy and rinsed blood transfusion were very effective for anemia. The combination with SLE and DA (I) was rare and this report of successful aortic root replacement is the second literature among English and Japanese papers.     

Vascular injury complicating meniscectomy. Report of a case

Severe haemorrhage occurred from the posterior wall of the capsule during meniscectomy in a 17-year-old girl. Arteriography showed an aneurysm originating from a larger branch of the popliteal artery, and the aneurysm was extirpated. Exploration of the blood vessels (or arteriography) is advisable, should severe bleeding occur during meniscectomy or postoperatively.     

A bidirectional closing aortic dissection from an atherosclerotic distal aortic arch aneurysm: Report of a case

(Received for publication on May 8, 1998; accepted on Jan. 7, 1999)     

Primary aortoenteric fistula with a chronic isolated abdominal aortic dissection: Report of a case

(Received for publication on Sept. 19, 1996; accepted on May 12, 1997)     

Spontaneous abdominal aortic dissection treated by endovascular stent grafting: Report of a case

A spontaneous abdominal aortic dissection is very rare. We experienced this rare entity in a 37-year-old man. He was successfully treated by endovascular stent grafting, including coil embolization of the inferior mesenteric artery. The pseudolumen was completely thrombosed and it shrank without any endoleak 3 months later. This modality is thus considered to be a good alternative to open surgical repair, even though a long-term follow-up is mandatory.     

A case with four-channel aortic dissection.

A 65-year-old male with four-channel aortic dissection successfully underwent replacement of the thoracoabdominal aorta, reconstruction of the celiac, superior mesenteric artery, renal arteries, and 5 pairs of intercostals or lumbar arteries using deep hypothermic technique.     

A combination of preductal aortic coarctation and type B dissection: Report of a case

(Received for publication on Sept. 12, 1996; accepted on May 12, 1997)     

Right axillary arterial perfusion for a ruptured type B aortic dissection: Report of a case

The results of surgical treatment for a ruptured type B aortic dissection remain far from satisfactory. It is believed that additional perfusion from the right axillary artery might be more beneficial than perfusion from only the femoral artery during surgery for a ruptured thoracic aneurysm. The right axillary perfusion is more likely to perfuse the vital organs proximal to the ruptured area, and thus avoid retrograde emboli. In addition, if the open proximal method is performed, then the right axillary perfusion is able to facilitate the evacuation of air from the aortic lumen. We present herein the case of a patient in whom a ruptured type B acute aortic dissection was successfully treated by applying right axillary perfusion through a left thoracotomy.