RESUMEN
Actinic vascular lesions tend to be stenotic-occlusive lesions. In this article, we present 2 exceptional cases of pseudoaneurysms caused by radionecrosis of the supra-aortic trunks. Both patients were treated by a retrograde carotid approach and deployment of a self-expanding covered stent. Proper exclusion of the pseudoaneurysm was attained in both cases; the first patient remained asymptomatic 12 months later; the second patient died of mediastinitis. Compared with conventional surgery, endovascular management is a viable, less invasive alternative in select patients, especially in life-threatening cases.
Asunto(s)
Aneurisma Falso/terapia , Tronco Braquiocefálico , Procedimientos Endovasculares/instrumentación , Traumatismos por Radiación/terapia , Stents , Lesiones del Sistema Vascular/terapia , Anciano , Aneurisma Falso/diagnóstico , Aneurisma Falso/etiología , Tronco Braquiocefálico/diagnóstico por imagen , Tronco Braquiocefálico/lesiones , Tronco Braquiocefálico/efectos de la radiación , Procedimientos Endovasculares/efectos adversos , Resultado Fatal , Femenino , Humanos , Mediastinitis/microbiología , Necrosis , Selección de Paciente , Diseño de Prótesis , Traumatismos por Radiación/diagnóstico , Traumatismos por Radiación/etiología , Radioterapia/efectos adversos , Factores de Riesgo , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Lesiones del Sistema Vascular/diagnóstico , Lesiones del Sistema Vascular/etiologíaRESUMEN
Endovascular treatment through femoropopliteal and infragenicular percutaneous transluminal angioplasty, both in native vessels and in bypass salvage, has been an emerging technique in recent years. However, in some cases, a difficult anterograde access in distal occlusions has limited the technical success of this procedure. Combined subintimal arterial flossing with antegrade-retrograde intervention is used as a resource technique to obtain precise recanalization in these cases. Here, we present the case of a retromalleolar access of the posterior tibial artery, based on subintimal arterial flossing with antegrade-retrograde intervention technique, to achieve femoral-posterior tibial bypass salvage.