RESUMO
We present a case of a lumbar pseudoaneurysm in a 62-year-old patient with myelofibrosis (agnogenic myeloid metaplasia). The patient was submitted to two anesthetic infiltrations for lumbar pain and one biopsy of a suspected hematopoietic site. Subsequently, a 4.5 cm lumbar pseudoaneurysm was diagnosed. The pseudoaneurysm was thrombosed with 1 ml (500 IU) thrombin injection with a successful clinical result. We discuss different treatment options along with several issues related to the most frequent complication of this technique, namely, native artery thrombosis.
Assuntos
Falso Aneurisma/etiologia , Hemostáticos/administração & dosagem , Trombina/administração & dosagem , Falso Aneurisma/diagnóstico por imagem , Biópsia por Agulha/efeitos adversos , Hemostáticos/uso terapêutico , Humanos , Injeções , Região Lombossacral , Masculino , Pessoa de Meia-Idade , Trombina/uso terapêutico , Ultrassonografia de IntervençãoRESUMO
The management of primary subclavian-axillary vein thrombosis is controversial. Indications and time of operative or endovascular intervention after successful thrombolysis remain unresolved. To improve the long-term functional outcomes in patients with primary subclavian-axillary vein thrombosis, early reestablishment of venous patency and prevention of recurrent thrombosis are required. We present a case in which, after catheter-directed thrombolysis, positional venography showed costoclavicular compression of the subclavian vein. At the time of surgical thoracic outlet decompression, transluminal venous angioplasty was performed.
Assuntos
Angioplastia com Balão/métodos , Cuidados Intraoperatórios/métodos , Síndrome do Desfiladeiro Torácico/cirurgia , Trombose Venosa/terapia , Adulto , Veia Axilar/diagnóstico por imagem , Humanos , Masculino , Radiografia , Veia Subclávia/diagnóstico por imagem , Terapia Trombolítica , Trombose Venosa/diagnóstico por imagemRESUMO
Antiphospholipid syndrome is accepted as one of the most important causes of hypercoagulable states. Thrombotic events in patients with antiphospholipid syndrome, predominantly women, occur at a younger age than in those suffering from atherosclerotic disease. The majority of the thrombotic events affect the deep venous system of the lower limbs and arterial thrombosis predominates in the cerebral territory. The use of anticoagulant therapy prevents recurrent thrombosis but the duration and intensity of treatment remain controversial. Aortic disease is an anecdotal fact in the literature. A case of infrarenal aortic occlusion involving both iliac arteries associated with primary antiphospholipid syndrome is presented.