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1.
PLoS One ; 15(1): e0226681, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31971937

RESUMO

BACKGROUND: Splenic artery aneurysm (SAA) is a rare but potentially fatal condition. Rupture results in 25% mortality up to 75% in pregnant women with 95% fetal mortality. Brief reports suggest an increased risk of developing SAA in patients with HHT. METHODS: We analyzed enhanced multidetector CT data in 186 HHT patients matched (gender and ± 5 year old) with 186 controls. We screened for SAA and recorded diameter of splenic and hepatic arteries and hepatic, pancreatic and splenic parenchymal involvements. We determined by univariate and multivariate analysis, the relationship with age, sex, genetic status, cardiovascular risk factors (CVRF) and visceral involvement. RESULTS: SAA concerned 24.7% of HHT patients and 5.4% of controls, p<0.001. Factors associated with increased risk of SAA in HHT were female gender (p = 0.04, OR = 2.12, IC 95% = 1.03-4.50), age (p = 0.0003, OR = 1.04, 95% CI = 1.02-1.06) and pancreatic parenchymal involvement (p = 0.04, OR = 2.13, 95% CI = 1.01-4.49), but not type of mutation, hepatic or splenic parenchymal involvements, splenic size or splenic artery diameter or CVRF. CONCLUSIONS: We found a 4.57 higher rate of SAA in HHT patients without evidence of splenic high output related disease or increased CVRF. These results suggest the presence of a vascular intrinsic involvement. It should lead to screening all HHT patients for SAA. The vasculopathy hypothesis could require a change in management as screening of all systemic arteries and even the aorta and to further research in the field.


Assuntos
Aneurisma/epidemiologia , Artéria Esplênica/patologia , Telangiectasia Hemorrágica Hereditária/complicações , Doenças Vasculares/epidemiologia , Adulto , Idoso , Aneurisma/diagnóstico por imagem , Aneurisma/etiologia , Aneurisma/patologia , Estudos de Casos e Controles , Feminino , Seguimentos , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Prevalência , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Doenças Vasculares/diagnóstico por imagem , Doenças Vasculares/etiologia , Doenças Vasculares/patologia
2.
Vasc Endovascular Surg ; 54(3): 254-263, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31894734

RESUMO

OBJECTIVE: Both true and false extracranial carotid artery aneurysms (ECAA) are a potential source of morbidity and mortality. While ECAA have historically been treated surgically, endovascular reconstruction with stenting is an emerging treatment option. The aim of our study was to report clinical/radiologic outcomes following endovascular repair of ECAAs. METHODS: A comprehensive systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. RESULTS: A total of 68 case reports and case series, comprising 162 patients, were included. Most patients presented with at least one symptom or sign related to the ECAA (89.5%; N = 145/162). In 42.6% (N = 69/162) and 46.3% (N = 75/162) of the cases polytetrafluoroethylene covered and uncovered stents were deployed respectively. Immediate post-procedural imaging demonstrated complete aneurysm exclusion in 86.4% (N = 140/162) of the cases and minimal filling of the aneurysm sack in 10.5% (N = 17/162) of all cases. Perioperative adverse event rates were 3.1% for stroke, 1.2% for transient ischemic attack (TIA) and 4.3% for mortality. During a mean follow-up of 21.8months, there were additionally observed one stroke, two TIAs and three deaths. Overall 88.6 % of the patients (N = 117/132) remained asymptomatic, partially recovered or at least did not suffer from new neurologic deficits during follow up, with no signs of stenosis or occlusion of the carotid artery. CONCLUSIONS: Endovascular stenting for the treatment of ECAAs is feasible with acceptable short- and long-term clinical and radiologic outcomes. Prospective real-world studies are needed to further validate the safety and the long-term patency of endovascular repair.


Assuntos
Aneurisma/terapia , Doenças das Artérias Carótidas/terapia , Procedimentos Endovasculares , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Aneurisma/diagnóstico por imagem , Aneurisma/mortalidade , Aneurisma/fisiopatologia , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/mortalidade , Doenças das Artérias Carótidas/fisiopatologia , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Procedimentos Endovasculares/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Stents , Fatores de Tempo , Resultado do Tratamento , Grau de Desobstrução Vascular , Adulto Jovem
3.
J Vasc Access ; 21(1): 120-124, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31244374

RESUMO

INTRODUCTION: Plasmablastic lymphoma is a rare and aggressive neoplasm, generally associated with immunodeficiencies and related to latent Epstein-Barr virus infection. This case is the first reported case of plasmablastic lymphoma relapse in aneurysmatic brachial artery wall. CASE DESCRIPTION: We describe the case of male patient who underwent cadaveric donor kidney transplant when he was 61 years old and radio-cephalic distal arteriovenous fistula ligation 8 months later. After 8 years, he developed gingival plasmablastic lymphoma treated with cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone regimen with subsequent remission. During follow-up, a mid-forearm vascular access was created because of the worsening of renal function. Twenty-two months later, the patient showed a symptomatic 20 mm brachial artery aneurysm with radiological signs of imminent rupture, for which he was surgically treated. The histological evaluation of the brachial artery specimen revealed a relapse of plasmablastic lymphoma in the arterial wall and in an adjacent lymph node. CONCLUSION: Brachial artery aneurysms are a rare complication in kidney transplant recipients after ligation of arteriovenous access for haemodialysis. Here, we report a case in which this condition is associated with an even rarer plasmablastic lymphoma. A common aetiology, due to immunosuppressive therapy, is postulated for the two coexisting diseases.


Assuntos
Aneurisma/imunologia , Derivação Arteriovenosa Cirúrgica , Artéria Braquial/imunologia , Neoplasias Gengivais/imunologia , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Falência Renal Crônica/terapia , Transplante de Rim/efeitos adversos , Linfoma Plasmablástico/imunologia , Diálise Renal , Idoso , Aneurisma/diagnóstico por imagem , Aneurisma/patologia , Aneurisma/cirurgia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/patologia , Progressão da Doença , Evolução Fatal , Neoplasias Gengivais/tratamento farmacológico , Neoplasias Gengivais/patologia , Humanos , Falência Renal Crônica/diagnóstico , Ligadura , Masculino , Linfoma Plasmablástico/tratamento farmacológico , Linfoma Plasmablástico/patologia , Fatores de Risco , Resultado do Tratamento
4.
Vasc Endovascular Surg ; 54(1): 75-79, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31506016

RESUMO

Brachial artery aneurysms and arteriovenous malformations (AVM) are limb-threatening vascular anomalies. This patient presented with a bilobed brachial artery aneurysm in the antecubital fossa proximally to an AVM arising from the dorsal interosseous and ulnar arteries that had been treated with endovascular embolization, leaving the hand solely supplied by the radial artery. The aneurysm continued to increase in size and imaging revealed concomitant thrombus. A femoral vein interposition graft was used to repair the aneurysm, and postoperatively, the patient retained full left arm function.


Assuntos
Aneurisma/cirurgia , Malformações Arteriovenosas/complicações , Artéria Braquial/cirurgia , Veia Femoral/transplante , Artéria Ulnar/anormalidades , Adolescente , Aneurisma/complicações , Aneurisma/diagnóstico por imagem , Aneurisma/fisiopatologia , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/terapia , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/fisiopatologia , Embolização Terapêutica , Feminino , Humanos , Resultado do Tratamento , Artéria Ulnar/diagnóstico por imagem , Grau de Desobstrução Vascular
5.
Ann Vasc Surg ; 62: 497.e7-497.e12, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31449937

RESUMO

BACKGROUND: The aneurysms of internal jugular vein (IJV) are very rare and hence scarcely described in the literature. Owing to the lack of guidelines on the treatment paradigm of this condition, management strategies vary. METHODS: Six patients presenting in our institution with internal jugular venous aneurysms from September 2007 to August 2017 were retrospectively analyzed. RESULTS: IJV aneurysms were confirmed in all 6 patients. For 3 of them, a surgical treatment was deemed necessary. These were 2 patients with intravenous thrombosis and 1 patient with progressive aneurysmal enlargement during the initial monitoring period. The choice of surgical technique was based on aneurysm morphology: 2 patients with saccular aneurysms underwent tangential aneurysmectomy with lateral venorrhaphy, and a patient presenting a fusiform aneurysm underwent its total excision followed by IJV ligation. Three remaining patients were managed conservatively, with one of them fully regressing and the other 2 remaining asymptomatic. CONCLUSIONS: IJV aneurysms are very rare and usually of benign natural history. For asymptomatic patients, conservative treatment with close follow-up is generally recommended. If any accompanying signs or symptoms are present, such as pain, swelling, evidence of thrombosis, progressive enlargement, or severe psychological stress, timely and appropriate surgical intervention should ensue.


Assuntos
Aneurisma/terapia , Tratamento Conservador , Veias Jugulares/cirurgia , Procedimentos Cirúrgicos Vasculares , Adulto , Aneurisma/diagnóstico por imagem , Criança , Pré-Escolar , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Veias Jugulares/diagnóstico por imagem , Ligadura , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Flebografia/métodos , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia
6.
Ann Vasc Surg ; 62: 498.e7-498.e10, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31449942

RESUMO

Popliteal artery aneurysms (PAAs) are the most common peripheral arterial aneurysms and develop almost exclusively (>90%) in men who have a history of tobacco abuse at an average age of 65 years. Most PAAs are caused by chronic inflammation secondary to atherosclerotic disease; other nondegenerative causes of PAAs include arterial trauma, infection, Behçet's disease, medial fibromuscular dysplasia, or popliteal artery entrapment. Few case reports have been published on idiopathic congenital PAAs. We report a case of a 26-year-old man who presented with progressive claudication and subsequent acute limb ischemia due to the thrombosis of a large idiopathic PAA. Our case demonstrates that the differential diagnosis of young adult or pediatric patients presenting with signs of acute limb ischemia or claudication should include a symptomatic PAA.


Assuntos
Aneurisma/complicações , Claudicação Intermitente/etiologia , Isquemia/etiologia , Doença Arterial Periférica/etiologia , Artéria Poplítea , Trombose/etiologia , Doença Aguda , Adulto , Aneurisma/diagnóstico por imagem , Aneurisma/fisiopatologia , Aneurisma/cirurgia , Fasciotomia , Humanos , Claudicação Intermitente/diagnóstico por imagem , Claudicação Intermitente/fisiopatologia , Claudicação Intermitente/cirurgia , Isquemia/diagnóstico por imagem , Isquemia/fisiopatologia , Isquemia/cirurgia , Ligadura , Masculino , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/fisiopatologia , Doença Arterial Periférica/cirurgia , Artéria Poplítea/diagnóstico por imagem , Artéria Poplítea/fisiopatologia , Artéria Poplítea/cirurgia , Veia Safena/transplante , Trombose/diagnóstico por imagem , Trombose/fisiopatologia , Trombose/cirurgia , Resultado do Tratamento , Enxerto Vascular
7.
Ann Vasc Surg ; 62: 497.e1-497.e5, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31449949

RESUMO

Celiac axis (CA) aneurysm is a rare vascular condition, consisting of only 3.6-4% of visceral artery aneurysms but is frequently life threatening and can result in death. A celiomesenteric trunk (CMT) is an anatomic anomaly in which the celiac and superior mesenteric arteries arise from a common trunk. This structure accounts for only 1% of visceral artery variation, and a celiac artery aneurysm at a CMT is exceptionally rare. Here, we report the case of a 62-year-old woman with a celiac artery aneurysm at a CMT. Endovascular repair was completed using a bare metal stent-assisted coil. Satisfactory results were observed at the 10-month follow-up. To our knowledge, this is the first case reported of bare metal stent-assisted coil repair of a CA aneurysm at a CMT.


Assuntos
Aneurisma/terapia , Angioplastia com Balão , Artéria Celíaca , Embolização Terapêutica , Artéria Mesentérica Superior , Aneurisma/diagnóstico por imagem , Aneurisma/fisiopatologia , Angioplastia com Balão/instrumentação , Artéria Celíaca/diagnóstico por imagem , Artéria Celíaca/fisiopatologia , Embolização Terapêutica/instrumentação , Feminino , Humanos , Artéria Mesentérica Superior/diagnóstico por imagem , Artéria Mesentérica Superior/fisiopatologia , Pessoa de Meia-Idade , Circulação Esplâncnica , Stents , Resultado do Tratamento
8.
Ann Vasc Surg ; 62: 499.e1-499.e4, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31449957

RESUMO

We report a rare case of 4 cm true aneurysm of left axillary artery in a 3-year-old girl. Computed tomography angiography confirmed the diagnosis. Open surgical repair with resection and primary end-to-end anastomosis was performed. The patient did not have any complication after 1-year follow-up. Axillary artery aneurysm is extremely rare in pediatric population. Previous reports of this rare entity are discussed comprehensively.


Assuntos
Aneurisma/cirurgia , Artéria Axilar/cirurgia , Procedimentos Cirúrgicos Vasculares , Aneurisma/diagnóstico por imagem , Aortografia/métodos , Artéria Axilar/diagnóstico por imagem , Pré-Escolar , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Resultado do Tratamento
9.
Vasc Endovascular Surg ; 54(3): 272-277, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31858897

RESUMO

INTRODUCTION: The optimal method of operative management of complex renal artery aneurysms (RAAs) involving distal branches (BRAAs) remains unclear. When more than 1 artery is involved within the BRAA, endovascular techniques are not advisable and an ex vivo approach is often preferred. In this study, we introduce an alternative surgical in situ technique to treat BRAAs. METHODS AND SURGICAL TECHNIQUE: Five aneurysms involving the main or second-order bifurcation of the renal artery (RA) were treated in 4 patients at our institute between November 2012 and January 2017. The treatment of the BRAAs was based on resection of the aneurysm wall and reconstruction with autologous Pantaloon vein graft (PVG): a "Y-shaped" bypass created on-bench with autogenous great saphenous vein. Sequential clamping/reperfusion of the kidney allows to reduce renal function impairment. RESULTS: No perioperative mortality or morbidity was observed, including none nephrectomy. In all the cases, aneurysms were treated with an in situ technique as previously planned. All the grafts were patent at the follow-up time (mean 64.1 ± 11.7 months). Renal function was preserved in all the cases. Vascularization of the renal parenchyma was satisfactory both on arterial echo Doppler and contrast-medium ultrasound in all the cases. Average cross-clamping times of the main RA and of a single branch RA were 15.8 ± 1.7 and 17.7 ± 4.6 minutes, respectively. Mean total operating time was 266.3 ± 18.9 minutes. CONCLUSION: The PVG with sequential clamping applied in the surgical treatment of BRAAs permits to reduce the ischemic effects to the renal parenchyma. To our knowledge, these are the first cases described in which BRAAs are treated with a PVG and our experience suggests that it is a feasible technique, with good long-term results and without severe adverse events recorded.


Assuntos
Aneurisma/cirurgia , Artéria Renal/cirurgia , Veia Safena/transplante , Enxerto Vascular/métodos , Idoso , Aneurisma/diagnóstico por imagem , Aneurisma/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Artéria Renal/diagnóstico por imagem , Artéria Renal/fisiopatologia , Veia Safena/diagnóstico por imagem , Veia Safena/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Grau de Desobstrução Vascular
10.
Vasc Endovascular Surg ; 54(3): 214-219, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31878841

RESUMO

OBJECTIVES: This study aimed to assess the feasibility and results of double-lumen balloon-assisted embolization of visceral artery aneurysms (VAAs). METHODS: Nine patients (mean age, 55.3 ± 10.8 years) diagnosed with VAA (superior mesenteric, n = 5; splenic, n = 2; renal, n = 2) and undergoing double-lumen balloon-assisted embolization were included in this study. Magnetic resonance angiogram (MRA) was used in the 6-month follow-up to assess the aneurysms and patency of the parent arteries. RESULTS: All patients were successfully treated with no reports of morbidity or mortality. Residual filling of the aneurysm neck was detected in 2 patients at the end of the procedure, but those parts were found to be stable in the sixth-month MRA. In 1 patient with renal aneurysm, a stent had to be deployed using a double-lumen balloon catheter because of the prolapse of the coil into the main artery. In another patient with a very large-necked superior mesenteric artery aneurysm, additional coils could be used at the same time thanks to the double-lumen balloon as the coils were not stabilized enough during embolization with the microcatheter coils. Liquid embolic agent was also used in this patient from the same lumen because of the large diameter of the aneurysm. CONCLUSIONS: Double-lumen balloons, which are mostly used in neurointerventional procedures, can be efficiently used as in the treatment of VAAs due to their ability to deploy stent and perform coil-liquid embolization through 1 lumen.


Assuntos
Aneurisma/terapia , Oclusão com Balão/instrumentação , Dispositivos de Acesso Vascular , Vísceras/irrigação sanguínea , Idoso , Aneurisma/diagnóstico por imagem , Aneurisma/fisiopatologia , Oclusão com Balão/efeitos adversos , Desenho de Equipamento , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
11.
BMJ Case Rep ; 12(12)2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-31843769

RESUMO

Renal artery aneurysms are rare and typically found incidentally. Risk of rupture drives the incentive for repair, which can be achieved by both open and endovascular techniques. Ex vivo repair with renal auto-transplantation is recommended for complex aneurysms involving distal or multiple arteries. Here we describe a successful treatment of a renal artery aneurysm after previous endovascular treatment failure. A multi-layered stent was left misplaced inside of the aneurysm. Ex vivo repair with renal auto-transplantation allowed for complete aneurysm exclusion. With increasing use of endovascular techniques, failure of endovascular treatment might become a common indication for ex vivo repair in renal artery aneurysms.


Assuntos
Aneurisma/cirurgia , Rim/cirurgia , Artéria Renal/cirurgia , Reimplante/métodos , Adulto , Aneurisma/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Procedimentos Endovasculares/efeitos adversos , Feminino , Humanos , Rim/patologia , Laparoscopia , Nefrectomia/métodos , Artéria Renal/diagnóstico por imagem
12.
Medicine (Baltimore) ; 98(48): e18203, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770276

RESUMO

The aim of this study was to evaluate the safety and clinical effectiveness of endovascular stent repair of celiac arterial aneurysm (CAA).From January 2015 to December 2018, 11 patients (7 males, 4 females with a mean age of 52.2 ±â€Š7.9 years) underwent endovascular stent repair of CAA in our center. A covered stent was used to occlude the CAA neck. Follow-up was performed 2 weeks and 1, 3, 6, and 12 months following surgery and yearly thereafter. Rates of technical success, treatment-related complications, and long-term outcome were analyzed.Each patient was placed with 1 stent for repair of CAA. Stent was placed in the celiac and common hepatic arteries for 10 patients and was placed in the celiac artery for 1 patient. The duration of the procedure ranged from 50 to 75 minutes (mean 63.2 ±â€Š7.2 minutes). The rate of technical success of the endovascular stent repair was 100%. No patient experienced CAA rupture or instant endoleak during or after stent insertion. Abdominal pain was relieved progressively after stent insertion. All patients were followed-up for 6 to 48 months (mean 22.4 ±â€Š10.8 months). All patients were alive during the follow-up. No endoleaks were experienced during follow-up with 100% stent patency rate. No patient suffered splenic, hepatic, or bowel infarction during follow-up.Endovascular stent repair is a safe, simple, and effective treatment for patients with CAA.


Assuntos
Aneurisma , Implante de Prótese Vascular , Artéria Celíaca , Procedimentos Endovasculares , Complicações Pós-Operatórias/epidemiologia , Stents , Aneurisma/diagnóstico por imagem , Aneurisma/fisiopatologia , Aneurisma/cirurgia , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/instrumentação , Implante de Prótese Vascular/métodos , Artéria Celíaca/diagnóstico por imagem , Artéria Celíaca/patologia , Artéria Celíaca/cirurgia , China/epidemiologia , Procedimentos Endovasculares/instrumentação , Procedimentos Endovasculares/métodos , Procedimentos Endovasculares/estatística & dados numéricos , Feminino , Humanos , Efeitos Adversos de Longa Duração/epidemiologia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia
14.
J Med Vasc ; 44(6): 380-386, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31761305

RESUMO

The aim of this study was to evaluate the results of conservative surgical treatment of the aneurysmal complications of arteriovenous hemodialysis fistulae and to determine the factors predictive of long- and mid-term patency of treated fistulae. The surgical treatment was mainly based on caliber reduction and reconstruction. METHODS: This was a descriptive retrospective study with a five-year duration, going from January 2013 to December 2018. This study included 40 patients presenting aneurysmal complications of their hemodialysis vascular access who were treated with aneurysmorrhaphy. RESULTS: The mean age of the aneurysmal-complicated hemodialysis vascular access was 42 months. The indications for treatment were puncture-related difficulties in 42.5% of cases, rapid increase of the aneurysmal diameter in 27.5%, skin thinning in 25% and aneurysmal rupture in 5%. The mean aneurysmal course was 6.6 months with an average diameter of 3.25cm at the moment of management. The initial technical success rate was 100%. Twenty patients had complications in the postoperative period. Patency rates at 3, 6, 12 and 24 months were 89.5%, 81.6%, 71% and 63.1%, respectively. Factors predictive of thrombosis were diabetes (P=0.001), peripheral arterial disease (P=0.003), number of punctures per week (P=0.003) and context of emergency presentation (P=0.001). CONCLUSION: Aneurysmorrhaphy seems to be the best conservative surgical treatment for aneurysmal complications of hemodialysis vascular access fistulae. This surgical approach allows us to conserve the native autologous vascular access and spare the patient's venous network.


Assuntos
Aneurisma/cirurgia , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Tratamento Conservador , Diálise Renal , Aneurisma/diagnóstico por imagem , Aneurisma/etiologia , Aneurisma/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Grau de Desobstrução Vascular
15.
J Med Vasc ; 44(6): 432-435, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31761310

RESUMO

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.


Assuntos
Aneurisma/cirurgia , Transplante de Rim , Artéria Renal/transplante , Aneurisma/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Renal/diagnóstico por imagem , Transplante Autólogo , Resultado do Tratamento
16.
Cancer Radiother ; 23(8): 926-929, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31611052

RESUMO

Stereotactic body radiation therapy is still controversial for inoperable patients with central lung lesion. We report the case of a 59-year-old woman with previous history of head and neck squamous cell carcinoma who was treated by lung stereotactic body irradiation for an inoperable lymph node in station 10R. One year after, a fibroscopy showed a necrosis of the right main bronchus mucosae and the CT showed a radio-induced aneurysm protruding into the right inferior lobular bronchus. The patient eventually died a few hours later with a massive haemoptysis. This case highlights the potential toxicity of central lung stereotactic body radiation therapy and raises the question of its legitimacy.


Assuntos
Aneurisma/etiologia , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Neoplasias Pulmonares/radioterapia , Irradiação Linfática/efeitos adversos , Artéria Pulmonar/efeitos da radiação , Radiocirurgia/efeitos adversos , Aneurisma/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/terapia , Fracionamento da Dose de Radiação , Feminino , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Neoplasias Pulmonares/patologia , Irradiação Linfática/métodos , Pessoa de Meia-Idade , Neoplasias Primárias Desconhecidas/terapia , Artéria Pulmonar/diagnóstico por imagem , Radiocirurgia/métodos
17.
Heart Surg Forum ; 22(5): E357-E359, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31596711

RESUMO

Brachiocephalic vein aneurysm is an extremely rare condition of unknown origin. It may be asymptomatic, presenting as an incidental finding or as a result of complications it causes. We report a case of a 54-year-old man who was asymptomatic and diagnosed with an isolated saccular aneurysm of the left brachiocephalic vein using contrast-enhanced computed tomography. The patient underwent aneurysmectomy through a median sternotomy with no requirement for a vascular graft or cardiopulmonary bypass. The patient had an uneventful postoperative course and remained well two months after the surgery.


Assuntos
Aneurisma/cirurgia , Doenças Assintomáticas , Veias Braquiocefálicas/cirurgia , Aneurisma/diagnóstico por imagem , Veias Braquiocefálicas/diagnóstico por imagem , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Esternotomia , Tomografia Computadorizada por Raios X
18.
Zentralbl Chir ; 144(5): 488-498, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31634974

RESUMO

Peripheral arterial aneurysms are rare vascular pathologies characterised by focal dilatation of at least 1.5-fold relative to the diameter of the native vessel. Primary arterial aneurysms can affect any segment of the arterial trunk. Diagnostic tests include duplex sonography, CT and MR angiography, and digital subtraction angiography. It is essential that the influx and efflux to the aneurysm should be mapped as precisely as possible. The most common type of peripheral arterial aneurysms are popliteal artery aneurysms, which frequently occur with aorta aneurysms. Peripheral arterial aneurysms are more common in patients with connective tissue disease or autoimmune disease (Ehlers-Danlos syndrome, Marfan syndrome, Behçet's disease). The current gold standard for therapy is surgery, although endovascular therapies have also been described. As the condition is rare, there is insufficient evidence to compare these approaches. Results from several register studies and single centre studies in patients with popliteal aneurysms indicate that endovascular therapy can give similar outcomes to open therapy if patients are carefully selected. Nevertheless, open surgery remains the gold standard. Therapy of aneurysms of the extremities must consider individual treatment criteria, such as the morphology of the aneurysm, its anatomical localisation - particularly with respect to mobilise segments, vascular efflux and the patient's general condition.


Assuntos
Aneurisma , Síndrome de Behçet , Implante de Prótese Vascular , Aneurisma/diagnóstico por imagem , Aneurisma/cirurgia , Angiografia Digital , Artérias , Síndrome de Behçet/cirurgia , Humanos , Artéria Poplítea
19.
Biomed Mater Eng ; 30(4): 427-438, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31561321

RESUMO

BACKGROUND: The development of any disturbance in the Circle of Willis (COW) can change the hemodynamics of blood flow and result in damage to the vascular system. Clinical methods such as TCD for diagnosing an aneurysm or growth factors and rupture can measure blood velocity. Several factors influence the accuracy of TCD that can lead to wrong evaluations and affect the treatment planning. OBJECTIVE: In this study, the conformity between CFD and TCD was accomplished for investigating the accuracy of the clinical method (TCD) in different vessels of the Circle of Willis. METHODS: The realistic three-dimensional models have been produced from angiography images. Considering fluid-structure interaction, a domain of the blood flow and vessel wall has been simulated by the ANSYS.CFX software. The velocity in the cerebral arteries has been calculated and compared with the velocity acquired from TCD. RESULTS: According to the findings, there were significant differences between the results obtained from computational fluid dynamics and Doppler test in different vessels of the Circle of Willis. In some areas, differences close to 80 cm/s were also reported. CONCLUSION: According to the results, there are possibilities of errors in carrying out a Doppler test in some arteries and can lead to wrong estimates and ultimately incorrect decisions.


Assuntos
Aneurisma/diagnóstico por imagem , Círculo Arterial do Cérebro/diagnóstico por imagem , Idoso , Aneurisma/patologia , Aneurisma/fisiopatologia , Velocidade do Fluxo Sanguíneo , Angiografia Cerebral , Artérias Cerebrais/diagnóstico por imagem , Artérias Cerebrais/patologia , Artérias Cerebrais/fisiopatologia , Circulação Cerebrovascular , Criança , Círculo Arterial do Cérebro/patologia , Círculo Arterial do Cérebro/fisiopatologia , Humanos , Masculino , Modelos Anatômicos , Software , Ultrassonografia Doppler Transcraniana
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