RESUMO
A 77-year-old man presented with an incidental finding of right renal artery aneurysm without symptoms. Computed tomography revealed a 22 mm saccular aneurysm with a wide neck at the main renal artery trunk. An 8 × 100 mm Viabahn stent graft (W. L. Gore, Flagstaff, AZ) was deployed by fully pulling back the guiding sheath. However, the deployment knob was not able to be pulled. We returned the guiding sheath to the original position and confirmed the cause was the bowstring phenomenon. Because avoidance of this phenomenon required straightening of the tortuous vessel, the stent graft was deployed by short pull-back of the guiding sheath. Computed tomography after a year revealed no opacification of the aneurysm and the patency of the stent graft.
Assuntos
Aneurisma/cirurgia , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Procedimentos Endovasculares/instrumentação , Artéria Renal/cirurgia , Stents , Idoso , Aneurisma/diagnóstico por imagem , Aneurisma/fisiopatologia , Humanos , Masculino , Desenho de Prótese , Artéria Renal/diagnóstico por imagem , Artéria Renal/fisiopatologia , Resultado do Tratamento , Grau de Desobstrução VascularRESUMO
Retroperitoneal hemorrhage due to iatrogenic rupture of the iliac artery is a life-threatening complication associated with endovascular intervention. We present a case of iatrogenic iliac rupture after insertion of a sheath into a severely tortuous iliac artery during coil embolization of a cerebral aneurysm. Bleeding was controlled by resuscitative endovascular balloon occlusion of the aorta followed by placement of a balloon-expandable stent graft into the iliac artery. This resulted in complete repair of the ruptured iliac artery. The patient recovered without any neurological complications.