[Renal pseudoaneurysm--a complication of nephrostomy]. / Renalt pseudoaneurisme--komplikation til nefrostomi.

Renal artery aneurysms are rare. These aneurysms have a potential for rupture, resulting in high mortality rates. Percutaneous renal procedures may lead to renovascular injury such as pseudoaneurysms. Regardless of the kidney region, puncture through a fornix of a calyx is relatively safe and only causes injury to an intrarenal vessel in a few percent of the cases. Renal pseudoaneurysm is usually diagnosed by renal angiography or computed tomography. Selective renal embolization is currently considered the most appropriate technique in the treatment for this complication.

[Endovascular treatment of ruptured splenic artery aneurysm]. / Endovaskulaert behandlet rumperet aneurisme på arteria lienalis.

Splenic artery aneurysms (SAA) are traditionally treated surgically, but endovascular techniques are becoming increasingly popular. A 64 year-old male with chest pain and low blood pressure was admitted under suspicion of AMI. A CT scan showed a 56 mm SAA with signs of rupture. The patient was treated with endovascular embolisation of the SAA with coils. Blood pressure and haemoglobin levels were stabilized and the patient was discharged. In the case of rupture the treatment of choice seems to be endovascular.

[Endovascular treatment of diseases of the descending thoracic aorta]. / Endovaskulaer behandling af sygdom i aorta descendens.

INTRODUCTION: Endovascular repair as treatment of aortic diseases seems promising. We report the first Danish results of endografting of the descending thoracic aorta. MATERIALS AND METHODS: Nineteen patients (median age 68 years, range 22-78 years) underwent endovascular treatment of diseases in the descending thoracic aorta: atherosclerotic aneurysm (n = 7), ruptured aneurysm (n = 3), Type B dissection (n = 3), traumatic rupture (n = 3), pseudoaneurysm (n = 2) and a defective aortic prosthesis (n = 1). The patients were followed with chest CT scans and clinically. RESULTS: In all cases the endograft was successfully deployed in the intended positions. Median total hospital stay was 5 days, range 2-21 days. Eight patients had post-implantation syndrome. No deaths occurred within the first post-operative month. During the follow-up period (median 12 months, range 1-56 months) five deaths were observed. One of the patients died from aortobronchial fistula related to the endograft. One patient had an endoleak, and two had expanded aneurysm. None of these patients was treated. CONCLUSION: In selected patients, endoluminal grafting of the descending thoracic aortic is a safe and successful alternative to open graft repair in treating aneurysm, ruptured aneurysm, traumatic rupture and dissection. However, long-term evaluation is still required.

[Endovascular treatment of abdominal aortic aneurysms]. / Endovaskulaer behandling af abdominale aortaaneurismer.

INTRODUCTION: The endovascular method of treating abdominal aortic aneurysms was introduced as an alternative to conventional surgical repair in the hope of reducing the operative mortality and morbidity. MATERIAL AND METHODS: Thirty patients were selected for endovascular aneurysm repair on the basis of anatomical criteria. The result of the treatment was evaluated by angiography on completion of surgery and by contrast-enhanced CT scans at 1, 3, 6, and 12 months, and annually thereafter. RESULTS: Exclusion of the aneurysm sac was achieved in 27 patients. Acute conversion to open surgical repair was necessary in one patient, owing to arterial damage. Two patients had primary endoleak. In one patient the endoleak disappeared spontaneously, in the second patient conversion to open repair was performed during follow up. The operative mortality was 0%, and the incidence of early complications requiring treatment was 13%. During a median follow-up period of 22 months, secondary endoleaks were detected in five patients and graft-limb occlusion occurred in three patients. Secondary intervention was performed in eight patients (29%). DISCUSSION: In selected patients, endovascular repair is feasible and associated with few major perioperative complications. The observed rate of secondary intervention emphasises the need for continued surveillance.