Tratamento de aneurismas de artéria esplênica e renal no mesmo tempo operatório: relato de caso e revisão
Treatment of aneurysms in the splenic and renal arteries in a single operation: case report and review
Sergio Quilici Belczak
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Abstract
Visceral and renal artery aneurysms are rare (0.01 to 2%) and their risk of rupture varies between different types and depending on their anatomy and patient context (comorbidities, pregnancy, and liver transplant history). Mortality due to rupture of these aneurysms is around 25%. New techniques and materials derived from neurointervention seem to be promising options for treatment of these aneurysms. In this context, we report the case of a patient undergoing endovascular treatment of both splenic artery and renal artery aneurysms during the same procedure, using Solitaire stents and controlled release coils in both repairs. The patient recovered well with both aneurysms adequately treated. In conclusion, endovascular treatment of splenic and renal artery aneurysms during the same operation is feasible and has proved safe and effective in the case reported
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References
1 Pasha SF, Gloviczki P, Stanson AW, Kamath PS. Splanchnic artery aneurysms. Mayo Clin Proc. 2007;82(4):472-9.
2 Bedford PD, Lodge B. Aneurysm of the splenic artery. Gut. 1960;1(4):312-20.
3 Pulli R, Dorigo W, Troisi N, Pratesi G, Innocenti AA, Pratesi C. Surgical treatment of visceral artery aneurysms: a 25-year experience. J Vasc Surg. 2008;48(2):334-42.
4 Stanley JC, Wakefield TW, Graham LM, Whitehouse WM Jr, Zelenock GB, Lindenauer SM. Clinical importance and management of splanchnic artery aneurysms. J Vasc Surg. 1986;3(5):836-40.
5 Shukla AJ, Eid R, Fish L, et al. Contemporary outcomes of intact and ruptured visceral artery aneurysms. J Vasc Surg. 2015;61(6):1442-8.
6 Abbas MA, Stone WM, Fowl RJ, et al. Splenic artery aneurysms: two decades experience at Mayo clinic. Ann Vasc Surg. 2002;16(4):442-9.
7 Bracale UM, Narese D, Ficarelli I, et al. Stent-assisted detachable coil embolization of wide-necked renal artery aneurysms. Diagn Interv Radiol. 2017;23(1):77-80.
8 Nosher JL, Chung J, Brevetti LS, Graham AM, Siegel RL. Visceral and renal artery aneurysms: a pictorial essay on endovascular therapy. Radiographics. 2006;26(6):1687-704, quiz 1687.
9 Etezadi V, Gandhi RT, Benenati JF, et al. Endovascular treatment of visceral and renal artery aneurysms. J Vasc Interv Radiol. 2011;22(9):1246-53.
10 Elaassar O, Auriol J, Marquez R, Tall P, Rousseau H, Joffre F. Endovascular techniques for the treatment of renal artery aneurysms. Cardiovasc Intervent Radiol. 2011;34(5):926-35.
11 Dorigo W, Pulli R, Azas L, et al. Early and intermediate results of elective endovascular treatment of true visceral artery aneurysms. Ann Vasc Surg. 2016;30:211-8.
12 Ferrero E, Ferri M, Viazzo A, et al. Visceral artery aneurysms, an experience on 32 cases in a single center: treatment from surgery to multilayer stent. Ann Vasc Surg. 2011;25(7):923-35.
13 Künzle S, Glenck M, Puippe G, Schadde E, Mayer D, Pfammatter T. Stent-graft repairs of visceral and renal artery aneurysms are effective and result in long-term patency. J Vasc Interv Radiol. 2013;24(7):989-96.
14 Ierardi AM, Kehagias E, Piffaretti G, et al. ePTFE stent graft in non-steno-occlusive arterial disease: 2 centers retrospective study. Radiol Med. 2016;121(6):482-93.
15 Meyer C, Verrel F, Weyer G, Wilhelm K. Endovascular management of complex renal artery aneurysms using the multilayer stent. Cardiovasc Intervent Radiol. 2011;34(3):637-41.
16 Henry M, Polydorou A, Frid N, et al. Treatment of renal artery aneurysm with the multilayer stent. J Endovasc Ther. 2008;15(2):231-6.
17 Wojtassek M. Managing visceral artery aneurysms. Endovascular Today; Wayne, PA; october 2013. p. 77-81.
18 Stelzner C, Abolmaali N, Hecker U, Schellong S. Imaging of visceral vessels. Internist. 2017;58(8):775-86.
19 Ghariani MZ, Georg Y, Ramirez C, et al. Long-term results of surgical treatment of aneurysms of digestive arteries. Ann Vasc Surg. 2013;27(7):954-8.