Assuntos
Derivação Axilofemoral/efeitos adversos , Prótese Vascular/efeitos adversos , Fístula Cutânea/etiologia , Oclusão de Enxerto Vascular/etiologia , Infecções Relacionadas à Prótese/etiologia , Sepse/etiologia , Antibacterianos/uso terapêutico , Aorta/cirurgia , Derivação Axilofemoral/instrumentação , Angiografia por Tomografia Computadorizada , Fístula Cutânea/diagnóstico , Fístula Cutânea/terapia , Remoção de Dispositivo , Oclusão de Enxerto Vascular/diagnóstico , Oclusão de Enxerto Vascular/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/terapia , Sepse/diagnóstico , Sepse/terapia , Trombose/cirurgiaRESUMO
BACKGROUND: A traumatic non-anastomotic pseudoaneurysm is a rare complication of an axillofemoral bypass graft. Fewer than 20 cases have been reported in the literature. Our case is unusual in that we report a double localization of this complication. CASE PRESENTATION: We report the case of a 60-year-old Arabic male patient who was diagnosed with two hematomas in the trajectory of his axillofemoral bypass secondary to a traumatism. The diagnosis of a non-anastomotic pseudoaneurysm was retained considering the results of a computed tomography angiography scan, which showed the double localization of the pseudoaneurysm. Surgical management consisted of flattening the pseudoaneurysm along with the interposition of a prosthetic segment. There were no postoperative complications and our patient was well 3 years after discharge. CONCLUSIONS: Non-anastomotic pseudoaneurysm is a rarely described complication of a axillofemoral bypass graft. To the best of our knowledge, a double localization has not been described in the literature before. Minimally invasive techniques as a treatment option are being widely used as an alternative to open repair.
Assuntos
Falso Aneurisma/diagnóstico por imagem , Arteriopatias Oclusivas/diagnóstico por imagem , Artéria Axilar/diagnóstico por imagem , Derivação Axilofemoral/efeitos adversos , Artéria Femoral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Falso Aneurisma/fisiopatologia , Falso Aneurisma/cirurgia , Arteriopatias Oclusivas/fisiopatologia , Arteriopatias Oclusivas/cirurgia , Artéria Axilar/patologia , Artéria Axilar/cirurgia , Artéria Femoral/patologia , Artéria Femoral/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Resultado do TratamentoAssuntos
Falso Aneurisma/diagnóstico por imagem , Artéria Axilar/cirurgia , Derivação Axilofemoral/efeitos adversos , Implante de Prótese Vascular/efeitos adversos , Prótese Vascular/efeitos adversos , Artéria Femoral/cirurgia , Falha de Prótese/efeitos adversos , Idoso , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Artéria Axilar/diagnóstico por imagem , Derivação Axilofemoral/métodos , Implante de Prótese Vascular/métodos , Doença Crônica , Artéria Femoral/diagnóstico por imagem , Humanos , Masculino , Politetrafluoretileno , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Although endovascular therapy (EVT) has advanced, few reports have compared EVT and bypass surgery in claudication patients with femoropopliteal disease. The present study used data from a multicenter registry in Japan to analyze outcomes of EVT and bypass surgery for claudication patients with Trans-Atlantic Inter-Society Consensus (TASC)-II C and D femoropopliteal lesions. METHODS AND RESULTS: Of 1,156 patients who underwent revascularization, 696 patients were treated for intermittent claudication. A total of 263 patients with femoropopliteal lesion were classified into TASC-II C and D. The primary and secondary patency rates of the EVT and bypass surgery groups were analyzed. The overall complication rate was 14.4% in the bypass surgery group and 3.5% in the EVT group (P<0.01). The 1- and 5-year primary patency rates were 82.1% and 69.4% in the bypass surgery group and 67.8% and 45.2% in the EVT group, respectively. Although the bypass surgery group had a higher primary patency rate than the EVT group (P<0.01, log-rank test), secondary patency rates did not differ significantly between the two groups. CONCLUSIONS: Although bypass surgery is clearly feasible for claudication patients with TASC-II C and D femoropopliteal disease, EVT is also a good option because of its lower complication rate and good secondary patency rate in patients in poor condition for bypass.
