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1.
Vasc Endovascular Surg ; 56(1): 107-111, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34549640

RESUMO

Acquired arteriovenous fistulas involving the carotid artery are most frequently the result of trauma and iatrogenic causes such as central venous catheterisation. Occasionally, they may develop spontaneously due to erosion of an aneurysm into an adjacent vein. We report a rare case of an acquired carotid-jugular fistula secondary to a pseudoaneurysm that occurred four months following carotid endarterectomy.


Assuntos
Falso Aneurisma , Fístula Arteriovenosa , Endarterectomia das Carótidas , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/cirurgia , Artéria Carótida Primitiva , Endarterectomia das Carótidas/efeitos adversos , Humanos , Veias Jugulares/diagnóstico por imagem , Veias Jugulares/cirurgia , Resultado do Tratamento
3.
Vasc Endovascular Surg ; 56(1): 95-97, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34474621

RESUMO

Case presentation: We present a case of a patient with a syphilitic popliteal pseudoaneurysm who developed acute lower-limb ischemia secondary to thromboembolism related to the pseudoaneurysm. The diagnosis of a syphilitic popliteal aneurysm was made due to positive syphilitic serological testing and with exclusion of all other potential causes. The pseudoaneurysm was surgically repaired using a great saphenous vein patch angioplasty, which was done without delay to prevent further thromboembolic complications. This was then followed by a course of intravenous benzyl penicillin. Discussion: Peripheral arterial involvement of tertiary syphilis remains exceedingly rare, with the vast majority of reported cases of vascular syphilis relating to aortic involvement. Given the paucity of literature on this condition, there is no good evidence to guide current management. Conclusion: With the globally increasing rates of syphilis, more cases of peripheral arterial involvement may become apparent, as was the case in the early 20th century.


Assuntos
Falso Aneurisma , Aneurisma , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Humanos , Isquemia/diagnóstico por imagem , Isquemia/etiologia , Isquemia/terapia , Artéria Poplítea/diagnóstico por imagem , Artéria Poplítea/cirurgia , Resultado do Tratamento
4.
Acta Ortop Mex ; 35(3): 290-293, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34921541

RESUMO

INTRODUCTION: Aneurysms and pseudoaneurysms of the arteries of the foot and ankle are rare clinical entities. In most cases occur within months or years of the initial trauma, complications in the aforementioned situations are very uncommon, however, they should be ruled out at medical check-ups. We will present a clinical case in which pseudoaneurysm of the Distal Peroneal Artery occurred as a result of a fracture- dislocation of the ankle. CLINICAL CASE: Patient of 60 years of age with trauma in right ankle, his radiographic study of the right ankle evidencing fracture- dislocation of the same. Surgical treatment is decided four days after the injury. In the postoperative course with edema, circulatory changes of abnormal form that merited imaging complement and arteriography was performed which indicates the presence of pseudoaneurysm of approximately 28 × 30 mm in distal peroneal artery meriting specific treatment with adequate control of symptoms. CONCLUSION: We believe that it is of the utmost importance the correct assessment and physical examination of patients undergoing ankle surgery in successive post-surgical controls to detect these types of complications early and treat them in time.


INTRODUCCIÓN: Los aneurismas y seudoaneurismas de las arterias del pie y tobillo son entidades clínicas poco frecuentes. En la mayoría de los casos ocurren a los meses o años del trauma inicial, las complicaciones en las situaciones antes mencionadas son muy infrecuentes; sin embargo, deben descartarse en los controles médicos. Presentaremos un caso clínico en el cual se produjo seudoaneurisma de la arteria peronea distal como consecuencia de una luxofractura de tobillo. CASO CLÍNICO: Paciente de 60 años de edad con trauma en tobillo derecho, su estudio radiográfico de tobillo derecho evidenció luxofractura del mismo. Se decide tratamiento quirúrgico cuatro días después de la lesión. En el postoperatorio padeció edema, ambos circulatorios de forma anormal que ameritó complemento imagenológico y se realizó arteriografía, la cual indica presencia de seudoaneurisma de 28 × 30 mm aproximadamente en arteria peronea distal ameritando tratamiento específico con adecuado control de síntomas. CONCLUSIÓN: Creemos que es de suma importancia la correcta valoración y examen físico de los pacientes sometidos a cirugía de tobillo en los controles postquirúrgicos sucesivos para detectar de manera precoz este tipo de complicaciones y tratarlos a tiempo.


Assuntos
Falso Aneurisma , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Articulação do Tornozelo , Humanos , Extremidade Inferior , Artérias da Tíbia
5.
Ann Card Anaesth ; 24(4): 500-502, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34747766

RESUMO

A 69-year-old patient underwent an urgent aortic valve replacement because of Streptococcus agalactiae endocarditis of his native aortic valve. Since a rapid progression of the former abscess cavity into an aortic root pseudoaneurysm with increasing paravalvular regurgitation during postoperative follow-up, reoperation was performed. In the preoperative transesophageal echocardiography (TEE) images the pseudoaneurysm completely surrounds the left coronary artery (LCA) without any signs of myocardial ischemia.


Assuntos
Falso Aneurisma , Endocardite Bacteriana , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Idoso , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Humanos , Reoperação
6.
Ann Card Anaesth ; 24(4): 473-475, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34747757

RESUMO

Left ventricular (LV) pseudoaneurysm is a rare complication following free wall rupture post transmural myocardial infarction or left ventricular surgery. A lot of imaging modalities like echocardiography, computerised tomography and cardiac magnetic resonance imaging are available to diagnose it. Echocardiography plays a significant role in delineating the cavity, orifice and impact on the surrounding structures. We present a case of LV pseudoaneurysm recurrence following surgical repair.


Assuntos
Falso Aneurisma , Aneurisma Cardíaco , Infarto do Miocárdio , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Ecocardiografia , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/etiologia , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos
8.
J Card Surg ; 36(12): 4762-4765, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34541714

RESUMO

Pulmonary artery (PA) pseudoaneurysms are a rare but potentially lethal diagnosis. They can be further categorized by etiology or location and are typically successfully treated with endovascular therapies. However, they occasionally require operative intervention. Here, we present a case of a patient who presented with a central PA pseudoaneurysm on computed tomography scan with unclear etiology that was initially treated with conservative management. However, this was noted to have rapid enlargement on interval imaging necessitating urgent surgical intervention. The patient underwent a median sternotomy, anterior PA arteriotomy for exposure, exclusion of the posterior artery pseudoaneurysm with a bovine pericardial patch, and closure of the anterior arteriotomy with a bovine pericardial patch. The patient did well and was discharged on postoperative day 11 with repeat imaging showing resolution.


Assuntos
Falso Aneurisma , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Animais , Bovinos , Humanos , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Esternotomia , Tomografia Computadorizada por Raios X , Procedimentos Cirúrgicos Vasculares
9.
J Card Surg ; 36(11): 4423-4426, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34477257

RESUMO

We report a rare case of a ruptured giant left anterior descending coronary artery pseudoaneurysm that necessitated salvage operative repair. This case affirms the life-threatening nature of this clinically significant pathology, as well as the need for emergent repair before pseudoaneurysm rupture to maximize the likelihood of patient survival.


Assuntos
Falso Aneurisma , Vasos Coronários , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Humanos , Ruptura
10.
Hinyokika Kiyo ; 67(7): 297-301, 2021 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-34353009

RESUMO

Partial nephrectomy (PN) for small renal tumors has become increasingly common. Complications of PN include renal artery pseudoaneurysm (PA), a potentially life-threatening condition. However, the true incidence and natural history of PA after PN remain unclear. Therefore, we conducted a retrospective study of the radiographic characteristics of robotic-assisted partial nephrectomy (RAPN) observed during the postoperative period. We selected 36 consecutive patients with renal carcinoma who underwent RAPN at our institution between December 2016 and May 2019. Patients with contraindications for the use of contrast medium were excluded. A total of 31 eligible patients underwent computed tomography angiography (CTA) during the early postoperative period after RAPN and the incidence of PA was evaluated. Among the patients with PASs, asymptomatic PAs were followed without intervention and their clinical course was assessed using CTA at 1 to 3 months postoperatively. PA was identified in 5 out of 31 (16.1%) patients after RAPN. Median duration between PN and the first CTA was 6 days (range, 1-8). Median PA size was 13 mm (range, 8-17). All (100%) PAs were asymptomatic and resolved spontaneously, as verified by CTA during the late postoperative period. Median duration between identification of PA on early postoperative CTA and subsequent resolution was 92 days (range, 35-106). Our findings indicated that asymptomatic PA after PN can be followed without intervention.


Assuntos
Falso Aneurisma , Neoplasias Renais , Procedimentos Cirúrgicos Robóticos , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Humanos , Neoplasias Renais/cirurgia , Nefrectomia/efeitos adversos , Artéria Renal/diagnóstico por imagem , Artéria Renal/cirurgia , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Resultado do Tratamento
11.
BMC Surg ; 21(1): 318, 2021 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-34353316

RESUMO

BACKGROUND: Hemobilia refers to bleeding into the biliary tract. Hepatic artery pseudoaneurysm (HAP) rupture is an uncommon cause of hemobilia, and cases of HAP associated with Mirizzi syndrome are extremely rare. Although transarterial embolization is recommended as the first-line treatment for hemobilia, surgery is sometimes required. CASE PRESENTATION: A 76-year-old woman was referred to our hospital with epigastric pain. She was febrile and had conjunctival icterus and epigastric tenderness. Laboratory tests revealed abnormal white blood cell count and liver function. An abdominal computed tomography (CT) revealed multiple calculi in the gallbladder, an incarcerated calculus in the cystic duct, and a slightly dilated common hepatic duct. Based on examination findings, she was diagnosed with Mirizzi syndrome type I, complicated by cholangitis. Intravenous antibiotics were administered, and we performed endoscopic retrograde cholangiopancreatography (ERCP) to place a drainage tube. The fever persisted; therefore, contrast-enhanced CT (CECT) was performed. This revealed portal vein thrombosis and hepatic abscesses; therefore, heparin infusion was administered. The following day, she complained of melena, and laboratory tests showed that she was anemic. ERCP was performed to change the drainage tube in the bile duct; however, bleeding from the papilla of Vater was observed. CECT demonstrated a right HAP with high-density fluid in the gallbladder and gallbladder perforation. Finally, she was diagnosed with hemobilia caused by HAP rupture, and emergency surgery was performed to secure hemostasis and control the infection. During laparotomy, we found that a right HAP had ruptured into the gallbladder. The gallbladder made a cholecystobiliary fistula, which indicated Mirizzi syndrome type II. Although we tried to repair the right hepatic artery, we later ligated it due to arterial wall vulnerability. Then, we performed subtotal cholecystectomy and inserted a T-tube into the common bile duct. There were no postoperative complications except for minor leakage from the T-tube insertion site. The patient was discharged after a total hospital stay of 7 weeks. CONCLUSIONS: We experienced an extremely rare case of emergency definitive surgery for hemobilia due to HAP rupture complicated by Mirizzi syndrome type II. Surgery might be indicated when controlling underlying infections was required.


Assuntos
Falso Aneurisma , Hemobilia , Síndrome de Mirizzi , Idoso , Falso Aneurisma/complicações , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Feminino , Hemobilia/etiologia , Hemobilia/cirurgia , Artéria Hepática/diagnóstico por imagem , Artéria Hepática/cirurgia , Ducto Hepático Comum , Humanos , Fígado , Síndrome de Mirizzi/cirurgia
13.
BMC Womens Health ; 21(1): 298, 2021 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-34399742

RESUMO

BACKGROUND: The formation of a uterine artery pseudoaneurysm is rare and isolated cases have been reported in the existing literature following caesarean sections, curettages and cone biopsies. There has been no report of pseudoaneurysm formation following a loop electrosurgical excision procedure. Vaginal bleeding could potentially be life threatening if this diagnosis is not considered following cervical instrumentation or surgery. Management options range from haemostatic sutures, image-guided embolisation to surgical repair. We report the diagnosis and management of a case of uterine artery pseudoaneurysm after a loop electrosurgical excision procedure. CASE PRESENTATION: A 37-year-old woman was diagnosed with cervical intraepithelial neoplasia grade 3 (CIN3) and underwent a therapeutic loop electrosurgical excision procedure. One month after the procedure, the patient presented to the emergency department with repeated episodes of sudden-onset heavy vaginal bleeding associated with hypotension and syncope. A computed tomography angiogram was performed, which demonstrated a pseudoaneurysm of the right uterine artery. Following the diagnosis, image-guided embolisation was performed successfully. Post-embolisation angiograms showed successful embolisation of the pseudoaneurysm and the patient had no further episodes of bleeding. CONCLUSIONS: Loop electrosurgical excision procedures are generally safe but rarely, can be complicated by the formation of uterine artery pseudoaneurysms. The depth of the loop electrosurgical excision procedure and vascular anatomy should be considered to prevent such complications. A computed tomography angiogram appears to be ideal for diagnosis. Image-guided embolisation is safe and effective as a therapeutic measure, with minimal morbidity.


Assuntos
Falso Aneurisma , Neoplasias do Colo do Útero , Adulto , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Eletrocirurgia/efeitos adversos , Feminino , Humanos , Gravidez , Artéria Uterina/diagnóstico por imagem , Artéria Uterina/cirurgia , Neoplasias do Colo do Útero/cirurgia , Hemorragia Uterina/etiologia
14.
BMJ Case Rep ; 14(8)2021 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-34429290

RESUMO

Penetrating trauma due to nail gun is an uncommon yet important clinical entity. There are numerous case reports describing these injuries, yet few describe those resulting in cerebrovascular injury. Laceration of cerebral blood vessels may result in significant intracranial haemorrhage and cerebral ischaemia, with catastrophic consequences. In the present study, we report a female patient who was shot in the face with a nail gun in a domestic assault. The nail entered her right cavernous sinus and lacerated her right internal carotid artery causing a pseudoaneurysm and a caroticocavernous fistula. This report details the approach to, and pitfalls of, managing a cerebrovascular injury due to penetrating intracranial nail. Catheter cerebral angiography is essential in the diagnosis and treatment of these injuries. Best treatment and outcomes require clinicians with expertise in endovascular and surgical repair strategies.


Assuntos
Falso Aneurisma , Fístula Carotidocavernosa , Traumatismos Craniocerebrais , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/cirurgia , Fístula Carotidocavernosa/diagnóstico por imagem , Fístula Carotidocavernosa/etiologia , Fístula Carotidocavernosa/cirurgia , Angiografia Cerebral , Feminino , Humanos
15.
Kyobu Geka ; 74(9): 697-700, 2021 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-34446625

RESUMO

A 71-year-old woman was admitted for cardiac tamponade due to left ventricular free wall rupture after acute myocardial infarction. Sutureless repair was performed for bleeding from the inferior wall. Fifteen days later, computed tomography demonstrated enlargement of a left ventricular pseudoaneurysm. Patch closure using a vascular prosthesis was performed through left thoracotomy. No recurrence of the left ventricular aneurysm has been observed since.


Assuntos
Falso Aneurisma , Aneurisma Cardíaco , Ruptura Cardíaca Pós-Infarto , Procedimentos Cirúrgicos sem Sutura , Idoso , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Feminino , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/etiologia , Aneurisma Cardíaco/cirurgia , Ruptura Cardíaca Pós-Infarto/diagnóstico por imagem , Ruptura Cardíaca Pós-Infarto/cirurgia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos
17.
J Card Surg ; 36(10): 3910-3912, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34251061

RESUMO

Infectious complications after percutaneous transluminal coronary angioplasty are uncommon and can occur at any point of time leading to high morbidity and mortality. We report a case of delayed coronary artery stent infection and rupture, with epicardial infected false aneurysm formation, and right coronary artery to right atrium fistula formation, presenting after 1 month of pyrexia.


Assuntos
Falso Aneurisma , Aneurisma Infectado , Aneurisma Coronário , Fístula , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Aneurisma Infectado/diagnóstico por imagem , Aneurisma Infectado/etiologia , Aneurisma Infectado/cirurgia , Aneurisma Coronário/diagnóstico por imagem , Aneurisma Coronário/etiologia , Aneurisma Coronário/cirurgia , Fístula/diagnóstico por imagem , Fístula/etiologia , Fístula/cirurgia , Átrios do Coração/diagnóstico por imagem , Humanos , Stents/efeitos adversos
18.
Medicine (Baltimore) ; 100(27): e26612, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34232217

RESUMO

RATIONALE: Endovascular treatment (EVT) is considered a preferred procedure of superficial femoral artery (SFA) pseudoaneurysm in recent years. However, heterotopic ossification (HO) after SFA pseudoaneurysm is a rare occurrence, that may cause late stent-graft fracture. PATIENT CONCERNS: A 58-year-old male who underwent EVT for SFA pseudoaneurysm 8 years ago presented with a progressive mass at the right thigh and claudication. Computed tomography angiography (CTA) showed fracture and occlusion of stent-graft, which was compressed by the deep femoral artery (DFA) pseudoaneurysm and a bone-like body. DIAGNOSIS: According to the CTA images, the stent-graft was fractured and occluded, accompanied by DFA pseudoaneurysm. INTERVENTIONS AND OUTCOMES: Debridement and arterial reconstruction were performed. Pathological analysis showed that the bone-like body was derived from HO. CTA at one-year follow-up showed that the prosthetic vessel was patent and previous hematoma disappeared. CONCLUSIONS: This report demonstrates that residual hematoma can induce HO, which may result in late stent fracture, and it should thus be removed timely. Patients with SFA pseudoaneurysm who have undergone EVT should be followed up regularly.


Assuntos
Falso Aneurisma/cirurgia , Prótese Vascular/efeitos adversos , Procedimentos Endovasculares/efeitos adversos , Artéria Femoral , Hematoma/etiologia , Ossificação Heterotópica/complicações , Stents/efeitos adversos , Falso Aneurisma/diagnóstico , Angiografia por Tomografia Computadorizada , Hematoma/diagnóstico , Hematoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Ossificação Heterotópica/diagnóstico
19.
BMJ Case Rep ; 14(7)2021 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-34233867

RESUMO

A 43-year-old man with a history of double sleeve right upper lobectomy for pulmonary sarcoma, presented with worsening haemoptysis. Bronchoscopic and positron emission tomography (PET)CT appearances were suspicious for disease recurrence; however, on attending for CT-guided biopsy, he was found to have a large pseudoaneurysm of his right pulmonary artery. The patient underwent placement of endovascular covered stent with fluoroscopic confirmation of pseudoaneurysm occlusion, and was discharged home on lifelong antiplatelet therapy. To our knowledge, this is the first reported case of pulmonary artery pseudoaneurysm following double (bronchovascular) sleeve resection of the lung, successfully treated by endovascular stenting.


Assuntos
Falso Aneurisma , Adulto , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Humanos , Pulmão , Masculino , Recidiva Local de Neoplasia , Pneumonectomia , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia
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