RESUMO
Vascular involvement is one of the major causes of mortality and morbidity in Behçet's disease (BD). Aneurysm or pseudoaneurysm formation is one of the vascular complications, and the aorta is the most common site. Currently, there is no definitive therapeutic modality. Both open surgery and endovascular repair are safe and effective options. However, the recurrence rate over the anastomotic sites is a major concern. We report a case of BD in a patient with recurrent abdominal aorta pseudoaneurysm 10 months after the first surgery. Preoperative corticosteroids followed by open repair were performed with good outcomes.
Assuntos
Falso Aneurisma , Aneurisma da Aorta Abdominal , Síndrome de Behçet , Implante de Prótese Vascular , Humanos , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/etiologia , Aneurisma da Aorta Abdominal/cirurgia , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/cirurgia , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Implante de Prótese Vascular/efeitos adversos , Síndrome de Behçet/complicações , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/tratamento farmacológico , Resultado do Tratamento , Imunossupressores/uso terapêuticoRESUMO
The occurrence of arterial and venous thrombosis during coronavirus infection has been widely reported since the beginning of the epidemic. Floating carotid thrombus (FCT) in the common carotid artery is exceptional and its main known cause is atherosclerosis. We describe the case of a 54-year-old man who developed, one week after the onset symptomatology of related to COVID-19 infection, an ischemic stroke, complicating a large intraluminal floating thrombus in the left common carotid artery. Despite surgery and anticoagulation, a local recurrence with other thrombotic complications occurred and the patient died.
Assuntos
COVID-19 , Trombose , Masculino , Humanos , Pessoa de Meia-Idade , COVID-19/complicações , Artéria Carótida Primitiva/diagnóstico por imagem , Artéria Carótida Primitiva/cirurgia , Trombose/diagnóstico por imagem , Trombose/tratamento farmacológico , Trombose/etiologia , Artérias Carótidas , Coagulação SanguíneaRESUMO
Arteriovenous fistula (AVF) are the preferred hemodialysis vascular access. However, central venous catheter (CVC) placement rates remain very high in patients initiating hemodialysis and/or in whom with a fistula dysfunction. Several complications are associated with the insertion of these catheters, including infection, thrombosis and arterial injuries. Iatrogenic AVF are uncommon complications. Herein, we report the case of a 53-year-old female with an iatrogenic right subclavian artery - internal jugular vein fistula secondary to a right internal jugular catheter malposition. Through a median sternotomy combined with supraclavicular approach, AVF exclusion with direct suture of subclavian artery and the internal jugular vein was performed. The patient was discharged without any complications.
Assuntos
Fístula Arteriovenosa , Cateterismo Venoso Central , Trombose , Feminino , Humanos , Pessoa de Meia-Idade , Cateterismo Venoso Central/efeitos adversos , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/cirurgia , Diálise Renal/efeitos adversos , Doença IatrogênicaRESUMO
Post-traumatic pseudoaneurysm of branches of external carotid artery is very rare and is at high risk of engaging vital prognosis by a rupture, even more in child. So, it must be evoked in emergency in front of any beating mass after a local trauma. We report the case of a 14-year-old child with a pseudoaneurysm of the temporo-maxillary trunk that occurred after a local trauma. The diagnosis was based on clinical examination and angio-MRI. The treatment was hybrid. After an embolization of the arterial trunk we performed a surgical flattering of the pseudoaneurysm and suture of maxillary and temporal orifices.
Assuntos
Falso Aneurisma , Embolização Terapêutica , Criança , Humanos , Adolescente , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgiaRESUMO
Iliac arteriovenous (AV) fistula after lumbar disc surgery are uncommon entities with limited reported cases. This report describes a 44-year-old man with history of L4-L5 spinal discectomy who complained of congestive heart failure symptoms four years later. Computed tomography angiography (CTA) revealed an AV fistula connecting the right common iliac artery and vein. AV closure with lateral suturing of common iliac artery and vein was performed through transperitoneal aorto-iliac approach. Postoperatively, the patient's symptoms of orthopnea resolved. Follow-up at six years was uneventful.
Assuntos
Fístula Arteriovenosa , Vértebras Lombares , Masculino , Humanos , Adulto , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/cirurgia , Artéria Ilíaca/diagnóstico por imagem , Artéria Ilíaca/cirurgia , Discotomia/efeitos adversos , Tomografia Computadorizada por Raios X/efeitos adversosRESUMO
Vascular involvement is one of the major causes of mortality and morbidity in Behçet's disease (BD). Vasculo-Behçet patients are at risk for multiple vessel-related complications including thromboses, stenoses, occlusions, and aneurysms. In this report, we describe the case of a young woman admitted in our department for management of a concomitant common iliac and common femoral artery pseudoaneurysms revealing Behçet's disease.
Assuntos
Falso Aneurisma , Aneurisma , Síndrome de Behçet , Trombose , Feminino , Humanos , Síndrome de Behçet/complicações , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/tratamento farmacológico , Falso Aneurisma/etiologia , Falso Aneurisma/complicações , Artéria Femoral/diagnóstico por imagem , Aneurisma/etiologiaRESUMO
Behçet's disease (BD) is a multisystem chronic autoimmune inflammatory disorder that involves multiple organs. Arterial involvements in BD are rare. One of severe manifestation is the aortic aneurysm which can lead to a rupture. Aorto-duodenal fistulas (ADFs) are the most frequent aorto-digestive fistulas. In this article we will describe and discuss primary and secondary ADFs which occurred in a same patient.
Assuntos
Aneurisma Aórtico , Síndrome de Behçet , Fístula , Aorta , Síndrome de Behçet/complicações , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/tratamento farmacológico , Fístula/complicações , HumanosAssuntos
Aneurisma da Aorta Abdominal/etiologia , Ruptura Aórtica/etiologia , Síndrome de Behçet/complicações , Corticosteroides/uso terapêutico , Adulto , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/diagnóstico por imagem , Ruptura Aórtica/cirurgia , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/tratamento farmacológico , Implante de Prótese Vascular , Humanos , Imunossupressores/uso terapêutico , Masculino , Resultado do TratamentoRESUMO
Isolated aneurysms of the common iliac artery are rare, affecting less than 0.01% of the general adult population. Most of these aneurysms are asymptomatic and are discovered as an incidental finding. We describe an elderly patient presented with a urinary retention, which the investigations had led to the diagnosis of a large left common iliac artery aneurysm.
Assuntos
Aneurisma Ilíaco/complicações , Retenção Urinária/etiologia , Idoso , Implante de Prótese Vascular , Humanos , Aneurisma Ilíaco/diagnóstico por imagem , Aneurisma Ilíaco/cirurgia , Masculino , Recuperação de Função Fisiológica , Resultado do Tratamento , Retenção Urinária/diagnóstico por imagem , Retenção Urinária/fisiopatologia , UrodinâmicaRESUMO
BACKGROUND: Behçet's disease (BD) is a multisystem chronic autoimmune inflammatory disorder that involves multiple organs. Arterial involvement in BD is rare. Aortic involvement is one of the most severe manifestations and is associated with a much higher mortality. In this article, we will present our experience in open surgical repair of abdominal aortic aneurysm combined with immunosuppressive therapy. METHODS: Between January 2010 and December 2017, 7 patients were treated for abdominal aortic aneurysms (5 infra-renal and 2 supra-renal, in 1 woman and 6 men). All patients were Moroccan, the age range being 25-59 years, mean age 43.2 years. Three Dacron tube grafts, two Dacron aortobiiliac grafts and two patch closures were used. All 7 patients received immunosuppresive therapy after surgery. RESULTS: All patients underwent successful open surgical repair without major complications during the 30 days immediately after the procedure. During a mean follow-up of 36 months, there was no recurrent aneurysmal localization, but one patient had lost their sight. Until now, we have been following 6 patients and they continue to receive immunosuppressive therapy. CONCLUSION: Long-term immunosuppressive therapy after aneurysm repair is important to limit pseudoaneurysm recurrence. Through our serie, we describe the results of the combination of surgical treatment and adjunctive immunosuppressive therapy, with a literature review.
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Síndrome de Behçet/complicações , Implante de Prótese Vascular , Adulto , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/etiologia , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/tratamento farmacológico , Prótese Vascular , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/instrumentação , Feminino , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Marrocos , Desenho de Prótese , Estudos Retrospectivos , Fatores de Tempo , Resultado do TratamentoRESUMO
Popliteal injuries are well known to be serious with a high rate of mortality due to damage caused to popliteal vessels. Pseudoaneurysm formation and arteriovenous fistulas are well-known complications of arterial injury, but are rarely concomitant. Diagnosis is usually done by computed tomography (CT) angiography. Treatment strategies consist of surgery or endovascular management. We report the surgical treatment of two cases of popliteal arteriovenous fistula associated with pseudoaneurysm complicating stab wounds.
Assuntos
Falso Aneurisma/etiologia , Fístula Arteriovenosa/etiologia , Artéria Poplítea/lesões , Veia Poplítea/lesões , Ferimentos Perfurantes/complicações , Adolescente , Falso Aneurisma/cirurgia , Fístula Arteriovenosa/cirurgia , Humanos , Masculino , Artéria Poplítea/cirurgia , Veia Poplítea/cirurgia , Ferimentos Perfurantes/cirurgiaRESUMO
Axillary artery injury from humeral neck fracture is an uncommon event. Vascular damage due to these injuries may threaten limb loss. In some cases, the signs of ischemia may not be evident just after the injury and may only appear later on. Therefore, a high index of suspicion is essential. It is important to bear this association in mind, so as to make an early diagnosis and avoid serious complications. We are describing the case of a young patient involved in a motor vehicle crash with an axillary artery trauma due to the surgical neck of humerus fracture. The patient underwent a basilic vein grafting, the postoperative course was good.
Assuntos
Acidentes de Trânsito , Artéria Axilar/lesões , Fraturas do Ombro/complicações , Fraturas do Ombro/diagnóstico , Artéria Axilar/cirurgia , Angiografia por Tomografia Computadorizada , Humanos , Masculino , Fraturas do Ombro/cirurgia , Adulto JovemRESUMO
True atherosclerotic aneurysms of superficial femoral artery (SFA) are rare and often associated with other peripheral or aortic aneurysms. We are reporting the case of a 78-year-old man who has been admitted with a ruptured superficial femoral artery aneurysm associated with bilateral popliteal artery aneurysm. The patient underwent successful aneurysm resection and bypass grafting.
Assuntos
Aneurisma Roto/etiologia , Arteriosclerose/complicações , Artéria Femoral/patologia , Idoso , Aneurisma/diagnóstico por imagem , Aneurisma Roto/diagnóstico por imagem , Aneurisma Roto/cirurgia , Angiografia , Implante de Prótese Vascular , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/cirurgia , Humanos , Hipertensão/complicações , Masculino , Artéria Poplítea/patologia , Ruptura Espontânea , Tomografia Computadorizada por Raios XRESUMO
Pseudoaneurysms of the deep femoral artery are uncommon and occur as a late complication of various traumas. Usually associated with femoral fractures, We report two cases of profunda femoris artery injury which presented as false aneurysm secondary to penetrating trauma. Because of its insidious onset, awareness and careful follow-up are the key issues for the early diagnosis.
RESUMO
Behçet's disease is a vasculitis of unknown origin. Vascular lesions predominantly affect veins. Arterial involvement is rare but usually associated with poor prognosis. Aortic syndromes are usually aneurysmal and occasionally reveal Behçet's disease. We report the case of a 46-year-old man whose Behçet's disease was revealed by a sub-renal abdominal aortic aneurysm in pre-rupture state. The diagnosis of this disease was retained based on clinical, biological and radiological criteria. The surgical procedure consisted in the resection of the aneurysmal sac and the interposition of a prosthetic PTFE tube.