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1.
Heart Lung ; 49(6): 779-782, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32980627

RESUMO

COVID-19 pandemic triggered in many patients the fear to go to the emergency rooms in order to avoid a possible infection. This phenomenon caused a significant reduction in acute coronary syndrome-related interventional procedures with a subsequent increase in critical hospitalizations and post-infarction mechanical complications. A case series of cardiac ruptures during the COVID-19 lockdown and the surgical treatment of a huge post-ischemic cardiac pseudoaneurysm complicated by a "contained" free wall rupture are presented.


Assuntos
Infarto do Miocárdio , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Falso Aneurisma/terapia , Infecções por Coronavirus , Feminino , Humanos , Itália , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/terapia , Pandemias , Pneumonia Viral
6.
Am J Emerg Med ; 38(9): 1966.e1-1966.e3, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32444291

RESUMO

A 53-year-old woman was admitted to the emergency department with sudden onset of massive hemoptysis. She had previous history of dyspnea and cough for two months. She had no history of chronic disease, smoking, or use of anticoagulant and antiplatelet drugs. On arrival, she was tachycardic and tachypneic, but her body temperature was normal. Chest X-ray showed enlarged right hilus and multiple nodular opacities predominantly in the left lung basis. Computed tomography (CT) scan of the chest demonstrated massive intraluminal filling defect extending from the right pulmonary artery through the main and left pulmonary arteries. Pulmonary artery sarcoma (PAS) was the preliminary imaging-based diagnosis. However, CT also revealed presence of several pseudoaneurysms arising from the distal branches of the left pulmonary artery encased by metastatic nodules. Although hemoptysis is an uncommon presentation for patients with PAS, accompanied pseudoaneurysms were the main reason for massive hemoptysis. Differentiation of PAS from bland thromboembolism could be challenging on CT. Herein reported case provides an additional imaging feature that may utilize differentiating pulmonary artery sarcoma from bland thrombus.


Assuntos
Falso Aneurisma/etiologia , Hemoptise/etiologia , Neoplasias de Tecido Vascular/complicações , Artéria Pulmonar , Sarcoma/complicações , Falso Aneurisma/diagnóstico , Serviço Hospitalar de Emergência , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias de Tecido Vascular/diagnóstico , Neoplasias de Tecido Vascular/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Artéria Pulmonar/diagnóstico por imagem , Radiografia Torácica , Sarcoma/diagnóstico , Sarcoma/diagnóstico por imagem , Tomografia Computadorizada por Raios X
7.
J Minim Invasive Gynecol ; 27(5): 1209-1213, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32259651

RESUMO

A pseudoaneurysm of the uterine artery or its branches is usually a result of vascular trauma during invasive procedures such as a cesarean section, vaginal delivery, myomectomy, hysterotomy, or dilatation and curettage. A uterine artery pseudoaneurysm rupture is a rare, yet life-threatening event. Deep infiltrating endometriosis usually involves a decrease in symptoms and imaging findings throughout pregnancy, with the notable exception of the phenomenon of decidualization. We present the case of a pregnant woman with a recent diagnosis of endometriosis, who conceived spontaneously and presented with disabling pain at 13 weeks' gestation. She was diagnosed with a left, huge (and rapidly growing) retrocervical endometriosis nodule encompassing a uterine artery pseudoaneurysm. Selective transarterial embolization was performed at 22 weeks' gestation owing to enlargement of the pseudoaneurysm sac, and the pseudoaneurysm was obliterated successfully. The patient was followed intensively throughout the pregnancy and the baby was delivered at term by cesarean section. After delivery, the nodule returned to the pregestational size.


Assuntos
Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Endometriose/complicações , Doenças Retais/complicações , Artéria Uterina/patologia , Doenças do Colo do Útero/complicações , Adulto , Falso Aneurisma/terapia , Colo do Útero/patologia , Endometriose/diagnóstico , Endometriose/terapia , Feminino , Humanos , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico , Complicações Cardiovasculares na Gravidez/etiologia , Complicações Cardiovasculares na Gravidez/terapia , Primeiro Trimestre da Gravidez , Doenças Retais/diagnóstico , Doenças Retais/terapia , Artéria Uterina/diagnóstico por imagem , Artéria Uterina/cirurgia , Embolização da Artéria Uterina , Doenças do Colo do Útero/diagnóstico , Doenças do Colo do Útero/terapia
8.
Angiol Sosud Khir ; 26(1): 138-142, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32240149

RESUMO

Aneurysms and pseudoaneurysms of visceral arteries are relatively rare clinical entities and their pathogenesis has not yet been fully understood. Aneurysmal rupture appears to be a complication leading to life-threatening internal haemorrhage and is a cause of high mortality. However, advances in endovascular surgery techniques have extended the capabilities of treating aneurysms, allowing microemboli to be delivered even to the hard-to-reach portions of the vascular bed with complicated anatomy. Presented in the article is a clinical case report regarding embolization of a false aneurysm of the inferior gastrointestinal artery, separated by a microcoil, and demonstrating possibilities of endovascular superselective embolization of the target vessel.


Assuntos
Falso Aneurisma/diagnóstico , Embolização Terapêutica , Procedimentos Endovasculares , Artéria Hepática , Humanos , Resultado do Tratamento
13.
No Shinkei Geka ; 48(1): 25-32, 2020 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-31983685

RESUMO

Intracranial pseudoaneurysms arising after radiotherapy for brain tumors are a relatively rare occurrence and associated with high-volume radiotherapy such as stereotactic radiosurgery. Herein, the authors report a rare case of intracranial pseudoaneurysm after conventional radiotherapy for oligodendroglioma. Case:A 46-year-old female incidentally presented with an intracranial hemorrhage from a middle temporal artery aneurysm. Four years earlier, she underwent surgical resection and conventional radiation therapy for oligodendroglioma. The aneurysm was successfully treated with middle cerebral artery(MCA)aneurysm trapping, in conjunction with a parietal branch superficial temporal artery-MCA bypass, to prevent re-rupture. Formation of intracranial pseudoaneurysm after conventional radiotherapy is extremely rare. However, the occurrence of cerebral aneurysm(s), as well as vascular stenosis during follow-up for brain tumors treated with radiotherapy, should be considered.


Assuntos
Falso Aneurisma , Neoplasias Encefálicas , Aneurisma Intracraniano , Oligodendroglioma , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Neoplasias Encefálicas/radioterapia , Angiografia Cerebral , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico , Aneurisma Intracraniano/etiologia , Pessoa de Meia-Idade , Artéria Cerebral Média , Oligodendroglioma/radioterapia , Artérias Temporais
14.
No Shinkei Geka ; 48(1): 39-45, 2020 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-31983687

RESUMO

We herein report a case of ruptured arterio-venous malformation(AVM)detected using three-dimensional digital subtraction angiography(3DDSA)fusion images and successfully treated with target embolization for pseudoaneurysm. A 50-year-old man with a history of AVM was admitted to our department for the treatment of ruptured high-grade AVM in the right parietal lobe. Although a bleeding point was not evident on DSA, the patient had re-rupture in the right ventricle, one month after admission. Chronological 3DDSA fusion images generated from 3DDSA images taken on admission and after re-rupture revealed a newly visualized intranidal pseudoaneurysm near a hematoma. Contrast-enhanced magnetic resonance imaging showed vessel wall enhancement along the posterior horn of the right ventricle;this enhancement corresponded to the location of the pseudoaneurysm. We planned target embolization for the intranidal pseudoaneurysm to prevent re-bleeding. The origin of the feeder was so steep that a microcatheter could not be advanced deeply, and embolization with 20% n-butyl-2-cyanoacrylate resulted in proximal occlusion. Follow-up angiography 1 week after embolization showed complete disappearance of the pseudoaneurysm, and the patient had no recurrence of aneurysm until one year.


Assuntos
Falso Aneurisma , Aneurisma Roto , Embolização Terapêutica , Malformações Arteriovenosas Intracranianas , Falso Aneurisma/diagnóstico , Falso Aneurisma/terapia , Aneurisma Roto/diagnóstico , Aneurisma Roto/terapia , Angiografia Digital , Humanos , Imageamento Tridimensional , Malformações Arteriovenosas Intracranianas/diagnóstico , Malformações Arteriovenosas Intracranianas/terapia , Masculino , Pessoa de Meia-Idade
17.
Ann Thorac Surg ; 109(6): e429-e430, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31689408

RESUMO

This report describes a complication after stent grafting of the aortic arch for residual dissection after ascending aorta and aortic arch replacement for acute type A dissection. One year later, a pseudoaneurysm originating from the proximal suture line and therefore far from the stent graft landing zone developed and fistulized into the pulmonary artery. Possible causes were suture damage during stent deployment and change of system forces after stent placement leading to high tension on the suture line. Emergency surgery was performed. Aortic arch stent grafting is a new and promising technique, but its complications are still not completely known.


Assuntos
Aneurisma Dissecante/cirurgia , Falso Aneurisma/etiologia , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/efeitos adversos , Procedimentos Endovasculares/efeitos adversos , Complicações Pós-Operatórias/etiologia , Stents/efeitos adversos , Doença Aguda , Idoso , Falso Aneurisma/diagnóstico , Falso Aneurisma/cirurgia , Aorta Torácica/cirurgia , Humanos , Imageamento Tridimensional , Masculino , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/cirurgia , Reoperação
19.
Ann Thorac Surg ; 109(5): 1611-1613, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31586613

RESUMO

This case demonstrates successful surgical management of a 6-cm-long aortoesophageal fistula from an infected stent graft. A 69-year-old woman with a penetrating descending thoracic aortic ulcer underwent endovascular aortic repair. Two weeks later, she presented with nausea and melena, and she was found to have an infected stent graft on imaging. She underwent a two-stage procedure encompassing aortic arch debranching and extra-anatomic aortic bypass in stage 1, and stent graft resection, primary esophageal repair, intercostal and omental flap, and jejunostomy tube placement in stage 2. She was discharged 1 month later and is doing well 1.5 years after the operation.


Assuntos
Aorta Torácica/cirurgia , Doenças da Aorta/cirurgia , Implante de Prótese Vascular/métodos , Fístula Esofágica/cirurgia , Laparotomia/métodos , Complicações Pós-Operatórias , Fístula Vascular/cirurgia , Idoso , Falso Aneurisma/complicações , Falso Aneurisma/diagnóstico , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/cirurgia , Doenças da Aorta/diagnóstico , Doenças da Aorta/etiologia , Angiografia por Tomografia Computadorizada , Fístula Esofágica/diagnóstico , Fístula Esofágica/etiologia , Feminino , Humanos , Reoperação , Fístula Vascular/diagnóstico , Fístula Vascular/etiologia
20.
Ann Vasc Surg ; 65: 160-165, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31669482

RESUMO

BACKGROUND: Vascular graft infection with anastomotic dehiscence requires immediate surgical intervention to preserve life and limb. We present our experience of using the Omniflow® II biosynthetic vascular prosthesis (LeMaitre Vascular) in the emergency repair of vascular graft dehiscence at the femoral anastomosis. METHODS: A retrospective review of consecutive patients presenting with femoral anastomotic dehiscence in a single centre was conducted. All patients were revascularized using an in situ Omniflow II graft. Patient demographics, affected graft type, microbiology, and antibiotic regimes were documented. Primary outcome measures were limb salvage, patency rates, and mortality. RESULTS: Five patients presented with acute femoral false aneurysm and four of five with significant hemorrhage. Infected grafts included one aortobifemoral, two femoral crossover, one axillobifemoral, and one infrainguinal reversed vein graft. All were revascularized with an in situ Omniflow II graft following the excision of the infected graft material. The median followup was 50 months. Limb salvage was achieved in 8 of 9 threatened limbs, and none required further intervention for re-infection. One graft occluded at 5 months. Two of five patients died during followup (one at 12 months, one at 50 months). CONCLUSIONS: Omniflow II provides a useful "off-the-shelf" conduit for the urgent revascularization of infected femoral dehiscence.


Assuntos
Falso Aneurisma/cirurgia , Aneurisma Infectado/cirurgia , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/instrumentação , Prótese Vascular/efeitos adversos , Remoção de Dispositivo , Artéria Femoral/cirurgia , Infecções Relacionadas à Prótese/cirurgia , Idoso , Anastomose Cirúrgica , Falso Aneurisma/diagnóstico , Falso Aneurisma/microbiologia , Falso Aneurisma/mortalidade , Aneurisma Infectado/diagnóstico , Aneurisma Infectado/microbiologia , Aneurisma Infectado/mortalidade , Implante de Prótese Vascular/mortalidade , Bases de Dados Factuais , Remoção de Dispositivo/efeitos adversos , Remoção de Dispositivo/mortalidade , Feminino , Artéria Femoral/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/microbiologia , Infecções Relacionadas à Prótese/mortalidade , Estudos Retrospectivos , Fatores de Risco , Deiscência da Ferida Operatória , Fatores de Tempo , Resultado do Tratamento , Grau de Desobstrução Vascular
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