Ruptured arterial aneurysm in Wegener’s granulomatosis: a case report

Abstract

Background Aneurysm formation is a possible, but rare, complication of granulomatosis with polyangiitis, known as Wegener’s granulomatosis. Urgent diagnosis and therapy is very important because a ruptured aneurysm could be life threatening. Case presentation We, therefore, present the case of a 63-year-old Greek man who was diagnosed with granulomatosis with polyangiitis and retroperitoneal hematoma due to ruptured aneurysm in renal artery and upper pancreaticoduodenal artery. His clinical course was complicated by acute renal failure and acute respiratory failure due to alveolar hemorrhage. Emergency coil embolization was performed. Postembolization recovery was uneventful; no bleeding occurred. The patient underwent mechanical ventilation and continuous veno-venous hemofiltration and received combined immunosuppression and supportive therapy, but eventually died 30 days after admission to hospital from severe septic shock and multiple organ failure. Conclusion Endovascular treatment is the therapy of choice, especially for patients with ruptured aneurysms that are hemodynamically stable. Early diagnosis is very important, as urgent embolization and early initiation of immunosuppression therapy are the treatment of choice.

Spontaneous brachial artery pseudoaneurysm secondary to vasculitis

“…In the setting of major vascular involvement, interventions may be necessary to treat symptomatic stenosis or in the setting of rupture of aneurysm or pseudoaneurysms. 2,3 Both endovascular and open interventions have historically been preferred only in the quiescent phase. In the active phase of disease, endovascular intervention can serve as a bridge to definitive open reconstruction.…”