PubMed · 5471654
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R T McDonald, D Behnam. 1970. Intestinal ischemia, a continuing problem.. https://pubmed.ncbi.nlm.nih.gov/5471654/
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An unusual course of the right testicular artery was observed during routine dissection of the posterior abdominal wall of a 60-year-old male cadaver. It arose from the abdominal aorta, inferior and posterior to the origin of the right renal artery, and passed posterior to the inferior vena cava and right renal vein; it then arched anterior to the inferior pole of the right kidney and descended anterior to the psoas major muscle, crossing anterior to the genitofemoral nerve, ureter and the proximal part of the external iliac artery. Finally, it passed to the deep inguinal ring and through the inguinal canal to enter the spermatic cord with the other constituents. The left testicular artery arose from the abdominal aorta about 1 cm higher than the right testicular artery and followed a normal course. The embryologic basis and clinical importance of this case are discussed.
Mobile luminal thrombus of the descending thoracic aorta is an unusual finding in patients with peripheral embolization. The diagnosis is best made with transesophageal echography (TEE). Traditionally, systemic anticoagulation and selective surgical thrombectomy are standard treatment. We present a case report of recurrent mobile thrombus despite surgical thrombectomy and systemic anticoagulation. We treated it with endovascular exclusion of a descending thoracic aorta emboligenic lesion with an endoluminal stent graft, using simultaneous TEE and fluoroscopic intraoperative guidance. The patient remains symptom-free 9 months after stent-graft implantation. TEE-guided endoluminal exclusion should be considered in treatment of descending thoracic aorta emboligenic lesions.
Segmental arterial mediolysis is an unusual arterial lesion for which pathogenesis has remained controversial. We report on a 47-year-old Japanese woman who underwent surgery for an abdominal aortic aneurysm that was 10.5 cm in diameter and contiguous with a left common iliac aneurysm that was 2.3 cm in diameter; the aneurysms were considered to have progressed rapidly in size. Pathologic examinations of the respective aneurysms showed cystic medial necrosis in the aortic and segmental arterial mediolysis in the iliac aneurysm. Coexistence of these two pathologic findings indicates that there may be a strong relation between these two disease entities.