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Sepsis and bleeding can lead to life-threatening complications, such as stent-graft infection and pseudoaneurysm, after stent-graft implantation. An 83 year-old woman was admitted to our hospital for sepsis 14 months after treatment with a balloon-expandable stent-graft for an arterio-ureteral fistula (AUF) between the right external iliac artery and the right ureter. Blood cultures were positive for methicillin-resistant Staphylococcus aureus and Candida tropicalis. A giant infectious pseudoaneurysm (44 × 70 mm) at the distal edge of the stent-graft was suspected of having caused the sepsis. Although endovascular therapy (EVT) was planned to correct the pseudoaneurysm, the right iliac artery spontaneously became occluded from the ostium of the right common iliac artery to the common femoral artery 5 days after diagnosing the pseudoaneurysm; hence, EVT was not performed. Antibiotic administration was continued, and blood culture results were negative. Although EVT using a stent graft for AUFs is effective, data on the chronic phase outcomes are limited. Therefore, patients with AUFs treated using stent-grafts should be carefully followed up.

This is the first report of a resuscitated adult with left main coronary artery ostial atresia (LMCAOA), with long-term follow-up for 10 years. A 57-year-old woman with untreated Graves' disease presented with resuscitated cardiac arrest, and her computed tomography coronary angiography showed a string-like left main without significant atherosclerosis, which led to the diagnosis of LMCAOA. Noninvasive and invasive testing revealed extensive myocardial ischemia because of LMCAOA with concomitant coronary spasm. After successful revascularization with coronary artery bypass grafting, the patient has remained stable for 10 years, which highlights this treatment as being highly effective and durable in patients with LMCAOA and cardiac arrest. Résumé: Il s'agit du premier rapport d'un adulte réanimé présentant une atrésie ostiale de l'artère coronaire principale gauche (atrésie ostiale de l'ACPG), comportant un suivi à long terme sur une période de 10 ans. Une femme de 57 ans atteinte de la maladie de Basedow non traitée a subi un arrêt cardiaque en réanimation. La coronarographie par tomodensitométrie a montré une artère principale gauche en forme de cordon sans athérosclérose importante, ce qui a conduit au diagnostic d'atrésie ostiale de l'ACPG. Des tests non invasifs et invasifs ont révélé une ischémie myocardique étendue due à l'atrésie ostiale de l'ACPG avec spasme coronaire concomitant. Après une revascularisation réussie par pontage aorto-coronarien, la patiente est restée stable pendant 10 ans, ce qui montre que ce traitement est très efficace et durable chez les patients atteints d'atrésie ostiale de l'ACPG et d'arrêt cardiaque.

Background: “Frailty” is associated with poor prognosis in ST-elevated myocardial infarction (STEMI). However, there is little data regarding the impact of the Canadian Study of Health and Aging Clinical Frailty Scale (CFS), a simple and semiquantitative tool for assessing frailty, on mid-term mortality in STEMI patients. Methods: A total of 354 consecutive STEMI patients (mean age 69.8 ± 12.4 years; male 76.6%) who underwent percutaneous intervention between July 2014 and March 2017 were retrospectively reviewed. The study endpoint was mid-term mortality according to the CFS classification. Furthermore, in order to clarify the impact of CFS upon admission on mid-term mortality, the independent predictors of all-cause death were evaluated. Results: Patients were categorized into three groups (CFS 1–3, n = 281; CFS 4–5, n = 62; and CFS 6–7, n = 11). During the study period (median 474 days), all-cause death was observed in 39 patients. After multivariate Cox regression analysis, higher CFS (adjusted hazard ratio [HR] 2.34, 95% confidence interval [CI] 1.43–3.85, p

Objectives: To clarify the prevalence and characteristics of pain associated with sarcopenia and to verify the usefulness of evaluation of pain for sarcopenia. Methods: In total, 759 community-dwelling people (aged 65–79 years) with or without sarcopenia and lower limb pain were classified into 4 groups (NSp, nonsarcopenia; NSpP, nonsarcopenia with pain; Sp, sarcopenia; and SpP, sarcopenia with pain). Body composition, motor function, history of fractures since age 50 years, and number of falls in the past 1 year were compared between the groups. Results: Participant proportions by group were: NSp, 53.9%; NSpP, 42.8%; Sp, 1.3%; and SpP, 2.0%. Participants with lower limb pain showed low single leg standing, walking speed, and 2-step value scores and high 25-question Geriatric Locomotive Functional Scale (GLFS-25) score after adjusting for age, sex, body mass index, and presence of sarcopenia. The SpP group showed lower functional reach test and higher GLFS-25 scores than the Sp group. Regarding the history of fractures since 50 years of age and falls in past 1 year, a high retention rate of fracture was noted in the NSpP group. They also experienced significantly more falls in the past 1 year than those in the NSp group. The SpP group noted more falls and fractures although it was insignificant. Conclusions: The results indicate that participants with lower limb pain showed declining motor function and a high risk for falls and fractures. Sarcopenia could escalate this risk. Therefore, evaluating patients for both pain and sarcopenia may be useful for risk assessment and treatment. Keywords: Sarcopenia, Pain, Community elderly