Tratamento endovascular de pseudoaneurisma de artéria mesentérica superior: relato de caso

Abstract

O pseudoaneurisma de artéria mesentérica superior é uma doença rara, porém com alta taxa de ruptura e mortalidade. Sua etiologia geralmente é infecciosa e comumente o diagnóstico é feito por meio de achado nos exames de imagem. Historicamente, seu tratamento de eleição tem sido o reparo cirúrgico aberto; entretanto, é associado a inúmeras complicações e dificuldades técnicas. Relatamos um caso de pseudoaneurisma de artéria mesentérica superior em um paciente portador de abscesso hepático no qual, após resolução do processo infeccioso, foi empregado, com sucesso, um tratamento minimamente invasivo endovascular, com implante de micromolas e stent não-recoberto.

Dissecção espontânea isolada da artéria mesentérica superior: qual a melhor abordagem terapêutica?

“…In endovascular repair, the aim of placing stents in the SMA is covering the intimal detachment and preventing blood flow through the false lumen, which could lead to obliteration of the false lumen by thrombosis. The stent should undergo minimal shortening, present good flexibility, adequate radial force, to ensure that it will not migrate as a result of the continuous displacement of the SMA 3,8,9 . The use of self-expanding stents is recommended in these cases, as their radial force is enough to stand the pressure of the false lumen, which is usually filled with fresh thrombus, and also because these stents adequately accommodate to the diameter of the true lumen.…”

Duplo aneurisma de artéria mesentérica superior: relato de caso

“…Aneurysms of the superior mesenteric artery (SMA) were first described by Koch in 1951 and are rare, accounting for 5.5 to 8% of cases of visceral aneurysms and less than 0.5% of all intra-abdominal aneurysms. 1,2 They occur in similar proportions of men and women and the majority of patients are in the age range of 45 to 55 years. 1,3 Reported incidence based on autopsy studies is from 1 in 12,000 to 1 in 19,000 cadavers.…”

“…1,2 They occur in similar proportions of men and women and the majority of patients are in the age range of 45 to 55 years. 1,3 Reported incidence based on autopsy studies is from 1 in 12,000 to 1 in 19,000 cadavers. 3 In addition to the possibility of hemorrhagic shock in the event of rupture, SMA aneurysms can involve risk of ischemia of the intestine, which must be treated because of its lethal nature.…”

Embolização de pseudoaneurisma com fístula arteriovenosa de artéria femoral profunda decorrente de ferimento por arma branca: relato de caso

“…1,3,7 Recently, endovascular treatment has emerged as an alternative option to open surgery, even in victims of traumatic arterial injuries, being particularly useful for injuries in which it is anticipated that intraoperative proximal and/or distal arterial control may prove difficult, and in cases of damage to both arteries and veins. 7,8 Another advantage is the shorter length of hospital stay and the earlier return to daily activities. [7][8][9] Endovascular treatment options for PSAs include embolization with cyanoacrylate (glue) or coils (with fibers or in platinum) and placement of stents (covered or not).…”

“…7,8 Another advantage is the shorter length of hospital stay and the earlier return to daily activities. [7][8][9] Endovascular treatment options for PSAs include embolization with cyanoacrylate (glue) or coils (with fibers or in platinum) and placement of stents (covered or not).…”