RESUMO
Atherosclerotic lesions of the hypogastric artery have been recognized as a cause of buttock claudication, thigh claudication, and impotence, and usually treated by endovascular procedures and in some instances with open surgery. We report an unusual case of a total occlusion of the left external iliac artery, severe stenosis of the left hypogastric artery with rest pain, and ischemic lesion in the left foot that was successfully treated with hypogastric angioplasty and covered self-expanding stent implant. The patient recovered distal pulses, rest pain disappeared, and the ischemic lesion healed; currently the patient walks without intermittent claudication, and the lesion of the toe has healed.
Assuntos
Arteriopatias Oclusivas/complicações , Pé/irrigação sanguínea , Isquemia/etiologia , Pelve/irrigação sanguínea , Idoso , Angioplastia com Balão/instrumentação , Índice Tornozelo-Braço , Arteriopatias Oclusivas/diagnóstico , Arteriopatias Oclusivas/fisiopatologia , Arteriopatias Oclusivas/terapia , Doença Crônica , Circulação Colateral , Constrição Patológica , Humanos , Claudicação Intermitente/etiologia , Claudicação Intermitente/terapia , Isquemia/diagnóstico , Isquemia/fisiopatologia , Isquemia/terapia , Masculino , Recuperação de Função Fisiológica , Fluxo Sanguíneo Regional , Índice de Gravidade de Doença , Stents , Resultado do Tratamento , Caminhada , CicatrizaçãoRESUMO
Los tumores del glomus carotídeo se caracterizan por su vascularización importante y su manejo preoperatorio puede incluir la embolización percutánea previa a la resección quirúrgica. Esta técnica disminuye la hemorragia y el tamaño del tumor y hace menos riesgosa la disección, con reducción de la morbimortalidad. Una técnica alternativa es la interrupción de la irrigación del tumor mediante la colocación de un stent cubierto en la carótida externa, que es la vía principal de irrigación. Esta técnica es útil en especial en tumores grandes y evita el riesgo de embolia intracraneal cuando se emplean coils para realizar la embolización. En esta presentación se describe el caso de una paciente de 31 años tratada de esta manera; se le colocó el stent y 24 horas después se realizó la resección del tumor.
Glomus tumors are hypervascularized neoplasms which may require preoperative percutaneous embolization. This technique reduces the incidence of bleeding, the tumor size, the risk of resection-related complications, and morbidity and mortality. The interruption of the tumor blood supply placing a covered stent in the external carotid artery, the main tumor-supplying vessel, is an alternative option. This technique is especially useful in large tumors and prevents the risk of intracranial embolism when coils are used during embolization. We describe the case of a 31 year-old female patient who underwent stent placement 48 hours before tumor resection.