BACKGROUND Surgery,which is a major risk factor for venous thrombosis,has rarely been considered a risk factor for arterial thrombosis.Recent studies have suggested that venous and arterial thromboses share common ris...BACKGROUND Surgery,which is a major risk factor for venous thrombosis,has rarely been considered a risk factor for arterial thrombosis.Recent studies have suggested that venous and arterial thromboses share common risk factors and have a bidirectional relationship.Accordingly,there is a growing interest in the risk of arterial thrombosis after surgery.We report a case of acute bilateral lower extremity arterial thromboses that developed after a prolonged surgery.CASE SUMMARY A 59-year-old man was hospitalized for intraocular foreign body removal surgery.He was a heavy-drinking smoker and had untreated hypertension and varicose veins in both legs.The operation was unexpectedly prolonged,lasting 4 h and 45 min.Immediately after emergence from general anesthesia,the patient complained of extreme pain in both legs.After the surgical drape was removed,cyanosis was evident in both feet of the patient.The pulse was not palpable,and continuous-wave Doppler signals were inaudible in the bilateral dorsalis pedis and posterior tibial arteries.Computed tomography angiography confirmed acute bilateral thrombotic occlusion of the popliteal arteries,proximal anterior tibial arteries,and tibioperoneal trunks.Arterial pulse returned in both lower limbs after 6 h of heparin initiation.The patient was discharged on postoperative day 26 without any sequelae.CONCLUSION Acute lower extremity arterial thrombosis can occur after surgery.Anesthesiologists should pay particular attention to patients with risk factors for thrombosis.展开更多
BACKGROUND Eisenmenger syndrome(ES)is an uncorrected congenital cardiac defect with a left-to-right shunt,leading to pulmonary arterial hypertension.Patients with ES are susceptible to hemodynamic alterations during n...BACKGROUND Eisenmenger syndrome(ES)is an uncorrected congenital cardiac defect with a left-to-right shunt,leading to pulmonary arterial hypertension.Patients with ES are susceptible to hemodynamic alterations during noncardiac surgery with general anesthesia,which increases perioperative morbidity and mortality.Monitored anesthesia care(MAC)is often used during minor procedures in patients with cardiac disease.However,few reports on MAC in patients with ES exist.CASE SUMMARY A 49-year-old man was admitted for a severe headache lasting 30 d.He had been diagnosed with a large perimembranous ventricular septal defect(VSD)with bidirectional shunt flow and pulmonary arterial hypertension 10 years ago.A round mass in the right frontal lobe was revealed by Magnetic resonance imaging.Stereotactic aspiration using a neuronavigation system was performed under MAC.The patient was stayed in the hospital for 5 d,and discharged without complications.CONCLUSION MAC may be effective for craniotomy in patients with ES.展开更多
文摘BACKGROUND Surgery,which is a major risk factor for venous thrombosis,has rarely been considered a risk factor for arterial thrombosis.Recent studies have suggested that venous and arterial thromboses share common risk factors and have a bidirectional relationship.Accordingly,there is a growing interest in the risk of arterial thrombosis after surgery.We report a case of acute bilateral lower extremity arterial thromboses that developed after a prolonged surgery.CASE SUMMARY A 59-year-old man was hospitalized for intraocular foreign body removal surgery.He was a heavy-drinking smoker and had untreated hypertension and varicose veins in both legs.The operation was unexpectedly prolonged,lasting 4 h and 45 min.Immediately after emergence from general anesthesia,the patient complained of extreme pain in both legs.After the surgical drape was removed,cyanosis was evident in both feet of the patient.The pulse was not palpable,and continuous-wave Doppler signals were inaudible in the bilateral dorsalis pedis and posterior tibial arteries.Computed tomography angiography confirmed acute bilateral thrombotic occlusion of the popliteal arteries,proximal anterior tibial arteries,and tibioperoneal trunks.Arterial pulse returned in both lower limbs after 6 h of heparin initiation.The patient was discharged on postoperative day 26 without any sequelae.CONCLUSION Acute lower extremity arterial thrombosis can occur after surgery.Anesthesiologists should pay particular attention to patients with risk factors for thrombosis.
文摘BACKGROUND Eisenmenger syndrome(ES)is an uncorrected congenital cardiac defect with a left-to-right shunt,leading to pulmonary arterial hypertension.Patients with ES are susceptible to hemodynamic alterations during noncardiac surgery with general anesthesia,which increases perioperative morbidity and mortality.Monitored anesthesia care(MAC)is often used during minor procedures in patients with cardiac disease.However,few reports on MAC in patients with ES exist.CASE SUMMARY A 49-year-old man was admitted for a severe headache lasting 30 d.He had been diagnosed with a large perimembranous ventricular septal defect(VSD)with bidirectional shunt flow and pulmonary arterial hypertension 10 years ago.A round mass in the right frontal lobe was revealed by Magnetic resonance imaging.Stereotactic aspiration using a neuronavigation system was performed under MAC.The patient was stayed in the hospital for 5 d,and discharged without complications.CONCLUSION MAC may be effective for craniotomy in patients with ES.
