RESUMO
Giant cell arteritis, Takayasu arteritis, and Horton disease are rare, idiopathic diseases that cause chronic inflammation and obliteration of large arteries, mainly the aorta and its major branches. Histological examination reveals multinucleated giants cells and clinical presentation is characterized by general symptoms and/or symptoms related to stenosis or occlusion of vessels. A case of a 50-year-old woman with neurological symptoms, cervicothoracic tumour with severe stenosis of the right subclavian artery and complete occlusion of common carotid artery is presented.
Assuntos
Tronco Braquiocefálico/patologia , Disartria/etiologia , Arterite de Células Gigantes/diagnóstico , Neoplasias do Mediastino/etiologia , Neoplasias Vasculares/etiologia , Implante de Prótese Vascular , Tronco Braquiocefálico/cirurgia , Estenose das Carótidas/etiologia , Disartria/cirurgia , Feminino , Arterite de Células Gigantes/complicações , Arterite de Células Gigantes/cirurgia , Humanos , Neoplasias do Mediastino/patologia , Neoplasias do Mediastino/cirurgia , Pessoa de Meia-Idade , Esternotomia , Síndrome do Roubo Subclávio/etiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Neoplasias Vasculares/patologia , Neoplasias Vasculares/cirurgiaRESUMO
BACKGROUND: Aortic stent-graft infections (ASGIs) are associated with significant mortality. We report our experience of two cases of ASGI treated differently and successfully. METHODS: Two patients presented with constitutional symptoms some months after scheduled endovascular repair of aortic aneurysm (EVAR). Patient 1 had an abscess formation around the endograft in continuity with the right groin. Due to patient comorbidities, a conservative treatment was performed. Patient 2 had an abscess formation with air surrounding the stent graft. The patient was treated successfully by endograft removal. RESULTS: Computed tomographic scan follow-up at 6 months from surgery showed no evidence of recurrent infection. CONCLUSION: Despite the recommended treatment of ASGI being surgery, conservative treatment can be performed successfully in patients with high surgical risk, avoiding aortic clamping. We present the first reported case of ASGI due to Streptococcus haemolyticus, the second case due to a fungus, and the second reported case of spondylodiscitis after EVAR.
Assuntos
Abscesso Abdominal/terapia , Antibacterianos/uso terapêutico , Aneurisma Aórtico/cirurgia , Implante de Prótese Vascular/efeitos adversos , Prótese Vascular/efeitos adversos , Desbridamento , Remoção de Dispositivo , Infecções Relacionadas à Prótese/terapia , Stents/efeitos adversos , Abscesso Abdominal/diagnóstico por imagem , Abscesso Abdominal/microbiologia , Idoso , Aortografia/métodos , Implante de Prótese Vascular/instrumentação , Candida albicans/isolamento & purificação , Discite/etiologia , Enterobacter cloacae/isolamento & purificação , Humanos , Masculino , Propionibacterium/isolamento & purificação , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/microbiologia , Streptococcus/isolamento & purificação , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Massive and/or recurrent hemoptysis is a clear indication for surgical treatment of pleuropulmonary aspergilloma, despite the incidence of postoperative morbidity and mortality. Thoracoplasty has been widely used for 20 years and is still indicated in these cases, following lobectomy, even though the procedure is not free of complications. We report the case of a patient who required thoracoplasty to treat a pleuropulmonary aspergilloma invading the chest wall. Subsequent placement of an aortic stent-graft was required due to tearing of the left subclavian artery.
Assuntos
Angioscopia , Aspergilose/complicações , Aspergilose/cirurgia , Aspergillus fumigatus , Fístula Brônquica/microbiologia , Fístula Brônquica/cirurgia , Empiema Pleural/microbiologia , Empiema Pleural/cirurgia , Complicações Intraoperatórias/cirurgia , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/cirurgia , Fístula do Sistema Respiratório/microbiologia , Fístula do Sistema Respiratório/cirurgia , Artéria Subclávia/lesões , Toracoplastia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
La hemoptisis masiva y/o repetitiva es una indicación clara de tratamiento quirúrgico del aspergiloma pleuropulmonar, a pesar de la morbimortalidad posquirúrgica existente. La toracoplastia, muy utilizada hace 2 décadas, todavía tiene su indicación aquí, tras lobectomía, aunque no está exenta de complicaciones. Presentamos un caso de aspergiloma pleuropulmonar con invasión de pared torácica que requirió toracoplastia y posteriormente técnicas endovasculares aórticas por desgarro de la arteria subclavia izquierda
Massive and/or recurrent hemoptysis is a clear indication for surgical treatment of pleuropulmonary aspergilloma, despite the incidence of postoperative morbidity and mortality. Thoracoplasty has been widely used for 20 years and is still indicated in these cases, following lobectomy, even though the procedure is not free of complications. We report the case of a patient who required thoracoplasty to treat a pleuropulmonary aspergilloma invading the chest wall. Subsequent placement of an aortic stent-graft was required due to tearing of the left subclavian artery