Papel del cirujano vascular en la fijación anterior de columna / Role of the vascular surgeon in anterior spine fixation

La fijación anterior de columna es una técnica bien implantada en la cirugía espinal. La presencia y necesidad de manipular los vasos principales, la aorta y las ilíacas y el riesgo hemorrágico que ello presenta hacen recomendable la colaboración de un cirujano vascular como cirujano de abordaje durante los procedimientos. Presentamos la experiencia de nuestro hospital en el tratamiento de fijación anterior de columna entre los servicios de traumatología y de cirugía vascular con una serie de 28 casos comprendidos entre el 2017 y el 2021.(AU)

Anterior spinal fixation is a well-established technique in spinal surgery: The presence and need for manipulation of the main vessels, aorta and iliac, and the risk of bleeding that presents, makes it advisable to have a Vascular Surgeon as an approach surgeon during the procedures. We present the experience of our Hospital in the treatment of anterior fixation of the experience of our Hospital in the treatment of anterior of the spine with the traumatology and vascular surgery service with a series of 28 cases between 2017 and 2021.(AU)

Aortic polyaneurysmal disease: case report.

We report a 78-year-old man who presents progression of his aneurysmatic pathology with previous abdominal infrarenal aortic surgery 20 years later. The computed tomography (CT) scan showed proximal degeneration of the infrarenal aorta, left iliac aneurysm and a new descending thoracic aneurysm close to the aortic arch. The surgical treatment was staged in two times due to the evolution of the aneurysm measures. First, the thoracic and the infrarenal aneurysms were covered each one with endoprosthesis. Four years later the iliac disease was solved with a branched specific iliac endograft.

Usefulness of aneurysm sac angiography in therapeutic management of an endoleak after endovascular aneurysm repair.

Endoleak treatment after endovascular aneurysm repair (EVAR) can be difficult and complex. The key to success lies mostly in the accurate interpretation of imaging tests. We describe the case of a patient who was urgently operated on due to an episode of acute arterial ischemia in the left lower limb for stent-graft iliac limb thrombosis and a proximal type I endoleak. We highlight the importance of performing aneurysm sac angiography as part of an effective therapeutic strategy.

Pseudoaneurismas de la arteria glútea superior. A propósito de un caso y revisión de la bibliografía / Pseudoaneurysms of the superior gluteal artery. A case report and review of the literature

Introducción. Los aneurismas, verdaderos o falsos, de la arteria glútea superior e inferior son muy raros, y la mayoría se relaciona con traumatismos pélvicos o heridas penetrantes en la región glútea. Caso clínico. Varón de 70 años con una fístula persistente en la región glútea derecha de seis meses de evolución tras el drenaje de un absceso glúteo. La resonancia magnética informa de la existencia de un aneurisma de la arteria ilíaca interna derecha. Con este diagnóstico, es remitido a nuestro Servicio de Angiología y Cirugía Vascular donde, mediante una angiotomografía computarizada (angio-TC), se objetiva la presencia de un pseudoaneurisma dependiente de la arteria glútea superior derecha. Durante el estudio arteriográfico se decide realizar un tratamiento endovascular con embolización intraarterial selectiva de la arteria glútea superior, para conseguir la trombosis-exclusión del aneurisma. En la angio-TC de control de los tres meses se observa la trombosis del pseudoaneurisma y en la angio-TC de control a los nueve meses se constata una reducción de su tamaño. Conclusión. Se discute la incidencia, las formas de presentación y la estrategia quirúrgica de esta patología infrecuente y se revisa la bibliografía actual

Introduction. Aneurysms, either true or false, of the superior and inferior gluteal artery are very rare and most of the cases that are seen are related to traumatic injury to the pelvis or stab wounds in the gluteal region. Case report. A 70-year-old male who had had a persistent fistula in the right-hand gluteal region for six months following the drainage of a gluteal abscess. Magnetic resonance imaging showed the existence of an aneurysm in the right internal iliac artery. With this diagnosis, the patient was referred to our Angiology and Vascular Surgery Service, where a pseudoaneurysm was detected in the right superior gluteal artery by means of computerised tomographic angiography (CT-angiography). During the arteriographic study it was decided that endovascular treatment with selective intraarterial embolisation of the superior gluteal artery should be carried out in order to achieve thrombosis-exclusion of the aneurysm. Thrombosis of the pseudoaneurysm was observed in the follow-up CT-angiography carried out at three months and the follow-up CT-angiography study performed at nine months showed that it had got smaller. Conclusions. The incidence, presenting symptoms and surgical strategy of this infrequent pathology are discussed and the current literature on the subject is reviewed