Pseudo-aneurismas: relato de dois casos e revisão da literatura

Abstract

Pseudo-aneurismas são uma afecção arterial rara. Os autores destacam a raridade da ocorrência de pseudo-aneurisma da artéria carótida comum pós-traumático e a associação de pseudo-aneurisma com osteocondroma femoral. Enfatizam a importância dos métodos por imagem, em especial a angiotomografia, no diagnóstico de afecções vasculares, como na ocorrência de pseudo-aneurismas. Realizam, ainda, revisão bibliográfica pertinente ao assunto.

Fístula arteriovenosa traumática em região temporal: um desafio terapêutico

“…There are some possible differential diagnoses for traumatic AVF, such as arterial occlusion, dissection, and formation of pseudoaneurysms or true aneurysms. 8 Arteriovenous fistulas of the superficial temporal artery have an estimated incidence 9 of 0.5 to 2.0% of cases; while incidence of traumatic pseudoaneurysms varies 10 from 4 to 13%. In the present case, although the trauma was blunt and the incidence of pseudoaneurysms exceeds that of AVF, angiotomography confirmed the diagnosis of AVF.…”

“…Existem possíveis diagnósticos diferenciais para a FAV traumática, como oclusão arterial, dissecção e formação de pseudoaneurisma ou aneurismas verdadeiros 8 . As FAV da artéria temporal superficial apresentam incidência estimada 9 entre 0,5 a 2,0% dos casos; já a incidência de pseudoaneurisma traumático varia 10 de 4 a 13%. No presente caso, apesar de o trauma ser contuso e de a incidência de pseudoaneurismas ser superior à FAV, a angiotomografia confirmou o diagnóstico.…”

Pseudoaneurisma de carótida comum secundário a trauma contuso: opção de tratamento por cirurgia a céu aberto

“…It is a fast, non-invasive, and low-cost method that has high-spatial-resolution and is not operator-dependent. It can be performed in critically ill patients, such as those with multiple trauma with vascular involvement 5,7 .…”

“…Conventional angiography is the classic method for diagnosis of pseudoaneurysms 8 . However, some authors question this statement, and state that conventional angiography may fail and is not indispensable, for it is invasive and has the limitation of not evaluating bones and adjacent tissues 7 .…”

“…Historically, the treatment of pseudoaneurysm has been quite discussed. Some studies have described open repair as the treatment of choice for traumatic carotid pseudoaneurysms, especially extracranial ones, because they present low rates of spontaneous resolution, when treated medically 7,9 . Extracranial pseudoaneurysms, when are small, inaccessible or located distally to the origins of brain vessels, may be treated with anticoagulation and medical follow-up.…”