Background: Thrombosis following stenosis of arteriovenous fistulae resulting in the loss of vascular access for hemodialysis is an important complication in patients with chronic renal failure. Percutaneous transluminal angioplasty is being used more frequently in the treatment of stenosis aiming at increasing the patency of arteriovenous fistulae.
-Context -Transjugular intrahepatic portosystemic shunt (TIPS) is the non-surgical treatment option with low level of morbi-mortality and possibility of accomplishment in patients with severe hepatic dysfunction which aims at decompressing the portal system treating or reducing the portal hypertension complications. ). Global mortality occurred in 41 (60.3%). Conclusions -Mortality is directly related to clinical factors of patients, being Child-Pugh and MELD classifications predictors of mortality, with more impact in patients with Child-Pugh class C and MELD > 15. The complications found were similar to those described in the literature, although the dysfunction by stent stenosis (26.4%) was lower than in the most of the studies and the encephalopathy incidence (58.3%) was higher. Probably, the high incidence of encephalopathy is explained by the low incidence of stenosis. HEADINGS -Portasystemic shunt, transjugular intrahepatic. Hypertension, portal.Estudo não apresenta conflito de interesses.
The splenic artery is the visceral vessel that is most often affected by aneurysmal disease. Occasionally, gastrointestinal bleeding may signify that the aneurysm is in communication with the digestive tract. We report on the case of a 64-year-old multiparous patient with intermittent digestive bleeding caused by a splenic artery aneurysm who was successfully treated with endovascular embolization.Keywords: Splenic artery; aneurysm; hemorrhage gastrointestinal; embolization therapeutic.
ResumoA artéria esplênica é o vaso visceral mais acometido pela doença aneurismática. Ocasionalmente, um sangramento gastrointestinal pode refletir uma comunicação entre o aneurisma de artéria esplênica e o trato digestivo. Relatamos o caso de uma paciente de 64 anos com hemorragia digestiva intermitente devida a aneurisma de artéria esplênica, a qual foi submetida ao tratamento endovascular por embolização com sucesso.
A taxa de mortalidade cirúrgica do aneurisma de ilíaca roto é similar à do aneurisma de aorta abdominal roto, devido à sua localização profunda na pelve, dificuldade de exposição distal da ilíaca decorrente do hematoma, bridas devido a laparotomia prévia e proximidade com ureter e estruturas venosas. O objetivo do presente estudo é enfatizar o procedimento endovascular como mais uma opção na correção dessas lesões. Relata-se o caso de um paciente de 60 anos de idade, submetido a derivação com enxerto aorto-biilíaco prévio com prótese há 5 anos, por aneurisma de aorta abdominal infra-renal, apresentando rotura de aneurisma em segmento remanescente da ilíaca comum esquerda. Estava hemodinamicamente estável após ressuscitação com fluidos e foi submetido ao tratamento endovascular de urgência, com a exclusão do aneurisma e ausência de vazamentos.
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