RESUMO
A dissecting aneurysm of the vertebral artery in the extracranial portion is a rare pathology. It may either have a symptom-free course or induce a clinical picture of vertebrobasilar insufficiency. To the main methods of surgical treatment belong endovascular techniques and resection of an aneurysm with shunting of the V3 segment of the vertebral artery. Presented in the article is a clinical case report regarding successful surgical management of a dissecting aneurysm of the extracranial portion in a young woman presenting with a clinical course of vertebrobasilar insufficiency and treated by means of ligation of the vertebral artery in the V1 segment and autovenous shunting from the external carotid artery to the V3 segment of the vertebral artery.
Assuntos
Falso Aneurisma , Dissecção Aórtica , Procedimentos Endovasculares/métodos , Artéria Vertebral , Insuficiência Vertebrobasilar , Adulto , Anastomose Cirúrgica/métodos , Dissecção Aórtica/diagnóstico , Dissecção Aórtica/cirurgia , Falso Aneurisma/diagnóstico , Falso Aneurisma/fisiopatologia , Falso Aneurisma/cirurgia , Angiografia por Tomografia Computadorizada/métodos , Feminino , Humanos , Procedimentos de Cirurgia Plástica/métodos , Resultado do Tratamento , Artéria Vertebral/diagnóstico por imagem , Artéria Vertebral/patologia , Artéria Vertebral/cirurgia , Insuficiência Vertebrobasilar/diagnóstico , Insuficiência Vertebrobasilar/etiologia , Insuficiência Vertebrobasilar/fisiopatologia , Insuficiência Vertebrobasilar/cirurgiaRESUMO
Presented in the article are the results of treating a total of 108 patients with chronic critical lower limb ischaemia (CCLLI) confirmed according to the recommendations of the Transatlantic Inter-Society Consensus (TASC) 2007 [1]. All patients were diagnosed as having combined lesions of the aortoiliac and femoropopliteal segments of the arterial bed of the lower limbs. All patients underwent simultaneous hybrid operations: open reconstructive interventions in the infrarenal zone and stenting of iliac arteries. In the comparison group (n=14) the first stage consisted of restoration of the inflow pathways followed by open reconstruction of the femoropopliteal segment. In the Study Group (n=94) the first stage was infrainguinal reconstruction by the open technique followed by stenting of the arteries of the aortoiliac segment. It was shown that restoration the outflow pathways as the first stage was associated with a considerable decrease in the risk of intraoperative complications.
Assuntos
Cuidados Intraoperatórios/métodos , Isquemia , Síndrome de Leriche/cirurgia , Salvamento de Membro , Procedimentos Cirúrgicos Vasculares , Idoso , Feminino , Artéria Femoral/patologia , Artéria Femoral/cirurgia , Humanos , Artéria Ilíaca/patologia , Artéria Ilíaca/cirurgia , Isquemia/etiologia , Isquemia/fisiopatologia , Isquemia/cirurgia , Síndrome de Leriche/complicações , Síndrome de Leriche/diagnóstico , Síndrome de Leriche/fisiopatologia , Salvamento de Membro/efeitos adversos , Salvamento de Membro/métodos , Extremidade Inferior/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Artéria Poplítea/patologia , Artéria Poplítea/cirurgia , Stents , Resultado do Tratamento , Grau de Desobstrução Vascular , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Procedimentos Cirúrgicos Vasculares/métodosRESUMO
The article deals with outcomes of managing a total of twenty-nine patients of high operational risk with TASK II type С and D lesions of the aortoiliac segment. All patients were subjected to single-stage hybrid operations: open reconstructive interventions on the infrainguinal zone and stenting of iliac arteries. High risk of coronary complications these patients were running was confirmed in accordance with the European guidelines on perioperative assessment of the patients being elected for extracardiac operative treatment. Critical ischaemia was in all cases reliably relieved. Two patients during predilatation developed haemorrhage due to iliac artery rupture which was the cause of changing over to open operation. No lethal outcomes were observed.
Assuntos
Aorta Abdominal , Aterosclerose , Doença das Coronárias , Artéria Ilíaca , Salvamento de Membro/métodos , Extremidade Inferior/irrigação sanguínea , Complicações Pós-Operatórias/prevenção & controle , Idoso , Angiografia/métodos , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/cirurgia , Aterosclerose/complicações , Aterosclerose/diagnóstico , Aterosclerose/fisiopatologia , Aterosclerose/cirurgia , Constrição Patológica/etiologia , Constrição Patológica/fisiopatologia , Constrição Patológica/cirurgia , Doença das Coronárias/etiologia , Doença das Coronárias/prevenção & controle , Feminino , Humanos , Artéria Ilíaca/diagnóstico por imagem , Artéria Ilíaca/cirurgia , Isquemia/etiologia , Isquemia/fisiopatologia , Isquemia/cirurgia , Salvamento de Membro/efeitos adversos , Masculino , Risco Ajustado , Índice de Gravidade de Doença , Stents , Resultado do TratamentoRESUMO
Described herein is a successful therapeutic outcome in a female patient presenting with resistant arterial hypertension secondary to a gigantic intraorganic aneurysm of the right renal artery. Treatment consisted of intravascular prosthetic repair of the parenchymatous portion of the renal artery, eventually making itpossible to entirely bypass the aneurysmatic sac and to restore the lumen of the renal artery, followed by normalization of arterial pressure.
