[Acute post-trauma dissection of the descending thoracic aorta]. / Dissection aiguë post-traumatique de l'aorte thoracique descendante.

BACKGROUND: Traumatic injury to the descending thoracic aorta other than the isthmus is rare, and little known. Acute post-trauma rupture may occur in a context of multiple or rarely unique localizations. CASE REPORT: We report the case of a young man who was the victim of multiple injuries with an isolated rupture of the descending thoracic aorta. Early diagnosis and adapted endovascular treatment led to favorable outcome. CONCLUSION: In 90% of cases, acute post-trauma rupture of the aorta in a single localization involve the isthmus. Rupture of the descending aorta is more exceptional but must not be missed. The pathophysiological mechanism and appropriate management are discussed in light of a review of the literature.

[Emergency endovascular treatment for ruptured post-traumatic pseudoaneurysm of the superior gluteal artery]. / Traitement endovasculaire en urgence d'un faux anévrisme post-traumatique rompu de l'artère glutéale supérieure.

Pseudoaneurysms of the gluteal arteries are rare, often secondary to blunt or penetrating pelvic trauma. These pseudoaneurysms are initially asymptomatic and manifest after a variable delay ranging from a few weeks to many years after the initial trauma. The spontaneous outcome can be fatal in case of rupture. Previously, treatment of gluteal pseudoaneurysms was exclusively surgical, but the advent of endovascular techniques revolutionized management practices by decreasing perioperative morbidity and offering results comparable to those of surgery. We report the case of a patient admitted for emergency management of a ruptured post-traumatic pseudoaneurysm of the superior gluteal artery that had occurred 20 days after penetrating buttock trauma. Selective embolization was successful.

[Treatment of a complex renal artery aneurysm by renal autotransplantation]. / Traitement d'un anévrisme complexe de l'artère rénale par autotransplantation rénale.

Renal artery aneurysm (AAR) is rare and usually asymptomatic; rupture, thromboembolism are aneurysmal complications that can then lead to renal infarction. AAR is often found fortuitously when exploring other diseases. Renal autotransplantation (RAT) is an alternative treatment for complex AAR, with satisfactory outcomes described in the literature.

[Spontaneous false aneurysm of the extracranial internal carotid artery - during pregnancy]. / Faux anévrisme spontané de l'artère carotide interne extracrânienne - pendant la grossesse.

Extracranial carotid false aneurysms are rare but serious because of the high risk of rupture and thromboembolic ischemic strokes. Although hemodynamic and hormonal physiological changes in pregnant women may favor arterial rupture and the development of false aneurysms, only one case of extracranial carotid false aneurysm related to pregnancy has been reported in the literature. Surgical repair is still the treatment of choice of these lesions. We report a case of spontaneous false aneurysm of the extracranial internal carotid artery occurring at the end of pregnancy. The surgical procedure consisted in resection of the false aneurysm with interposition of a prosthetic graft. The follow-up was uneventful.

[An axillary-subclavian artery aneurysm in pre-rupture revealing Marfan syndrome]. / Un anévrisme de l'artère axillo-sous-clavière en pré-rupture révélant un syndrome de Marfan.

Marfan syndrome is an autosomal dominant disorder of connective tissue which has many clinical symptoms and whose prognosis depends on associated cardiovascular complications, dominated by proximal aortic disorders. Peripheral arterial aneurysms are rare during Marfan syndrome and are exceptionally indicative of the disease. We report the case of a large aneurysm of the axillary-subclavian artery in pre-rupture revealing a new case of Marfan syndrome. Treatment consisted in surgical repair by resection of the aneurysm and performing a venous bypass graft; the postoperative course was uneventful.

[False aneurysm of the external iliac artery revealing Behçet's disease]. / Faux anévrysme de l'artère iliaque externe révélant une maladie de Behçet.

Behçet's disease is a vasculitis of unknown etiology. Vascular involvement is rare, but may be inaugural in many cases. We report a case of Behçet's disease revealed by a symptomatic pseudo-aneurysm of the external iliac artery. The symptomatology was non-specific. Ultrasound Doppler and computed tomographic angiography were essential for diagnosis. The pseudo-aneurysm was managed by endovascular treatment. Corticosteroid and immunosuppressant therapy were administrated after surgery.

[Traumatic dissection of the left renal pedicle in a young adult]. / Dissection traumatique de l'artère rénale gauche chez un adulte jeune.

Blunt trauma rarely causes renal pedicle dissection. Clinical signs are minimal and inconsistently reported. The diagnosis is based on computed tomographic angiography; arteriography is still useful when revascularization is considered. We report here a case of traumatic dissection with thrombosis of a juxta-aortic renal pedicle monitored in the intensive care unit. An endovascular procedure could not be proposed because of the juxta-aortic localization.

[Claude Bernard-Horner syndrome revealing spontaneous aneurysm of the vertebral artery]. / Syndrome de Claude Bernard-Horner révélant un faux anévrisme spontané de l'artère vertébrale.

False aneurysms of the extracranial vertebral artery (FAVA) are rare because of the path of the artery at the level of the transverse holes. They can be secondary to penetrating cervical trauma, spontaneous in the course of an angiopathy such as Ehlers-Danlos syndrome, or iatrogenic. We report the case of a 31-year-old woman who presented a syndrome of Claude Bernard-Horner related to a spontaneous FAVA. The angioscanner confirmed the diagnosis and the patient underwent successful surgical treatment of the false aneurysm with ligature of the vertebral artery. Outcome was favorable.

[False aneurysm of the carotid artery revealing Behçet disease]. / Faux anévrysme de l'artère carotide révélant une maladie de Behçet.

Vascular involvement in Behçet's disease often present as venous thrombosis. Arterial damage is rare. We report a case of Behçet's disease occurring in a 40-year-old woman revealed by a false aneurysm of the left common carotid artery. The intervention consisted in a prosthetic graft after endovascular control. After a 2-year follow-up period, the patient did not develop any postoperative complication.