An Idiopathic Pulmonary Artery Aneurysm, Treated by Aneurysmectomy and Graft Replacement / 日本心臓血管外科学会雑誌

<p>A 61-year old man was referred to our institute under a diagnosis of pulmonary aneurysm. Contrast computed tomography revealed a huge pulmonary aneurysm of 70 mm in maximal dimension at the main pulmonary trunk. No congenital heart disorders were identified on trans-thoracic or trans-esophageal echocardiography. No significant signs of pulmonary hypertension were demonstrated on right heart catheterization. Laboratory findings on admission included positive results for syphilitic antibodies. T-shaped graft replacement of the pulmonary arteries using a cardiopulmonary bypass was scheduled. The main and left pulmonary arteries were replaced with a J-Graft 26 mm in size (Japan Lifeline, Tokyo, Japan). Then, the right pulmonary artery was reconstructed with the rest of the J-Graft, and anastomosed to the side of the newly reconstructed main and left pulmonary arteries. His postoperative course was generally uneventful. Pathological findings of the excised aneurysmal walls revealed true aneurysmal formation with no specific inflammatory changes. This case was considered to be an idiopathic pulmonary aneurysm without congenital heart disorders, pulmonary hypertension, and pathologically inflammatory reactions of aneurysmal walls.</p>

Aneurisma poplíteo en niño / Aneurysm of the popliteal artery in a boy

Aim: To present a true aneurysm in childhood, an uncommon pathology, even more those who affect the popliteal artery. case report: We present the case of a boy 3 years old with a true aneurysm with popliteal location. conclusion: Because of its possible complications, the treatment is surgery.

Objetivo: Presentar un caso de aneurisma verdadero en niños, patología poco frecuente, más aún aquellos que afectan a la arteria poplítea. caso clínico: Se presenta el caso de un niño de 3 años con un aneurisma verdadero de localización poplítea. conclusión: Debido a sus posibles complicaciones, el tratamiento es quirúrgico.

Aneurisma del tronco tirocervical / Thyrocervical trunk aneurysm

El aneurisma de la arteria subclavia es una entidad extremadamente rara que no sobrepasa el 1 % del total de los aneurismas periféricos y pueden situarse en diferentes sectores de la arteria. El objetivo de este trabajo es describir el diagnóstico y tratamiento empleado en un paciente portador de un aneurisma verdadero del tronco tirocervical derecho, rama de la arteria subclavia, considerado como infrecuente. Se trata de una paciente femenina de 48 años de edad, con antecedentes de aumento de volumen en la zona supraclavicular derecha, tumoración que late y se expande sin trauma previo en dicha zona. Las manifestaciones clínicas consistieron en dolor y parestesias que se irradiaban al miembro superior derecho. A través de estudios ultrasonográficos (ecodoppler y angioTac) se le diagnosticó un aneurisma del tronco tirocervical derecho, rama de la primera porción de la arteria subclavia. Fue intervenida quirúrgicamente en el Instituto Nacional de Angiología y Cirugía Vascular. Se realizó una aneurismectomía y ligadura proximal y distal utilizando un abordaje supraclavicular. Se encontró un aneurisma verdadero de la arteria señalada. Los estudios ultrasonográficos permitieron un diagnóstico certero del problema. La técnica quirúrgica utilizada fue exitosa y la paciente mostró una evolución satisfactoria, sin complicaciones hasta el momento actual con regresión de sus síntomas clínicos(AU)

The subclavian artery aneurysm is an extremely rare disease that barely accounts for 1 % of all peripheral aneurysms and may be located in different sectors of the aorta. The objective of this paper was to describe the diagnosis and treatment used in a patient carrying an unusual true aneurysm of the right thyrocervical trunk, the subclavian artery branch. The case of 48 years-old woman, with a history of raised volume of the right supraclavicular area, beating tumor that expands, and no previous trauma in the area. The clinical symptoms were pain and parestesias irradiating to the right upper member. Through the ultrasonographic studies (Ecodoppler and AngioTac), she was diagnosed a right thyrocervical trunk aneurysm, branch of the first portion of the subclavian artery. She was operated on at the National Institute of Angiology and Vascular Surgery. She underwent aneurysmectomy and proximal and distal ligature by using supraclavicular approach. A true aneurysm of the referred artery was found. The ultrasonographic studies allowed a precise diagnosis of the problem and the surgical procedure was successful. The patient recovered satisfactorily with no complications up to the present and regression of her clinical symptoms(AU)

True Aneurysm of the Common Digital Artery: Case Report

PURPOSE: An aneurysm is defined as a permanent, localized dilation of an artery with a 50% increase in diameter over its expected normal diameter. Aneurysms can be classified by cause as traumatic and nontraumatic. Traumatic aneurysms can be divided into true and false aneurysms. Nontraumatic causes of peripheral artery aneurysms include mycotic, atherosclerotic, inflammatory, and idiopathic. In the hand, true aneurysms occurring at the common digital artery have been rarely reported. We present a rare case of a true aneurysm of the common digital artery that was resected and reconstructed using a reversed vein graft. METHODS: A 49-year-old male patient was refered to our institution with a 0.73x0.44x1.37cm sized pulsating mass between 2nd and 3rd flexor digitorum tendons on Lt. palm area. The mass had been present for 5 years and had increased in size over the previous year. No history of trauma was reported. After a physical examination and ultrasound sonography review, a diagnosis of aneurismal dilatation of common digital artery was made. Surgical treatment by excision of the aneurysm, and a reversed vein graft was performed. RESULTS: Histologic examination of the specimen(3.4x0.7cm) showed aneurismal dilatation, with elastin fibers present in the arterial wall. The lesions were healed without any complications and there were no evidence of recurrence. Doppler examination of the reconstruction showed good perfusion. CONCLUSION: Early excision is recommended to relieve symptoms and avoid neurologic damage. Also, artery reconstruction can be performed by primary end-to-end anastomosis or the placement of a reversed interposition vein graft. Micro surgical repair was the only possible treatment in this case. The authors believe that the vascular anatomy should always be restored as natural as possible.

A Rare Case of Spontaneous True Aneurysm of the Occipital Artery

A 51-year-old man presented with a pulsatile scalp mass over the right occipital region, which had increased in size over the previous 1 month. He had no previous history of head trauma. Three-dimensional computed tomography (3D-CT) angiography of the brain revealed a 3.0 x 1.5 cm occipital artery aneurysm arising from the occipital artery. The occipital artery aneurysm was removed following the ligation of the proximal and distal portion of the occipital artery aneurysm. The histological diagnosis was true aneurysm. To the best of our knowledge, this is the first reported case in the literature.

Transcatheter arterial embolization for the treatment of splenic artery aneurysms: clinical results in eight cases / 介入放射学杂志

Objective To assess the feasibility and effectiveness of transcatheter arterial embolization for the treatment of splenic artery aneurysms (SAAs). Methods Transcatheter splenic arterial embolization with coils was performed in eight cases of SAAs. The patients were followed for 3-36 months. The follow-up examinations with CT or color Doppler ultrasonic angiography were made. Results Technical success was achieved in all eight cases with no severe complications. During the follow-up period, one patient died of severe abdominal bleeding 10 months after the operation and the other seven patients remained in good condition with no occurrence of re-canalization of the lesions. Conclusion Transeatheter arterial embolization is a safe and effective treatment for splenic artery aneurysms. It is necessary to make a regular follow-up imaging study.

Multiple Aneurysms of the Radial Artery: a Case Report

True aneurysm of the radial artery is very rare, and the false aneurysms are more common. True aneurysms of the radial artery are usually secondary to trauma or iatrogenic injury. A 71-year-old male presented with a several year history of a left forearm-pulsating mass. He suffered from a brain infarct and had received acupuncture for his hemiplegia for the previous year. The physical examination revealed two pulsating masses on the left forearm. The left ulnar and radial arteries were palpable. The laboratory values were normal. Computerized tomography showed two 40x25 and 37x20 mm-sized saccular true aneuryms containing mural thrombosis in the left proximal radial artery with atherosclerotic change. The aneurysms were resected with reconstruction by using the cephalic vein. Distal flow was reestablished by using end-to-end anastomosis. No complications have been observed during the 4 weeks of follow-up.

Isolated True Aneurysm of Deep Femoral Artery

Aneurysm of deep femoral artery rarely occurs as an isolated lesion because of the anatomical position and characteristics of wall tissue. Early surgery is mandatory because the aneurysm has a tendency to become large and to rupture. We report herein a case of an isolated true deep femoral artery aneurysm in a 67-year-old female, who presented with a pulsatile mass in the groin showing rapid enlargement. CT angiography followed by conventional angiography confirmed the diagnosis and revealed no evidence of aneurysm or occlusive disease in the other arteries. Endo-aneurysmectomy with 6 mm PTFE graft interposition was performed. Acute deep vein thrombosis was developed postoperatively but was cured by short-term anticoagulation therapy. At ten-months follow-up, she resumed her normal activity with no ischemic or thrombotic symptoms.

A Successful Case of Surgical Repair for a True Aneurysm of the Brachial Artery Caused by Blunt Injury / 日本心臓血管外科学会雑誌

We present one case of true aneurysm of the branchial artery which is very rare among peripheral aneurysms. A 52-year-old woman developed a bruise on the right upper arm around June 1993, but did nothing about it because she felt no symptoms. A pulsating mass became palpable at this site around the following month. Digital subtraction angiography revealed an aneurysm formation of 1.5×1.5cm in size in the right brachial artery. Operative findings showed that the wall of the aneurysm joined the normal region and all the vascular layers in the aneurysm were maintained. After resection of the aneurysm, end-to-end anastomosis was carried out. A diagnosis of true aneurysm was confirmed by the pathohistological findings that the vascular three-layer structure was maintained, with few arteriosclerotic changes.

Aneurysm of the Main Pulmonary Artery-Report of a case and review of the literature

Pulmonary artery aneurysms are extremely rate and are seldom diagnosed during life. In true aneurysms, dilatation tends to be confined to the main trunk of the artery and degenerative changes in the wall are found. In 1971, Williams et al reported the first successful excision and replacement of the main pulmonary artery, including the bifurcation, with a dacron graft. Since then there have been few cases of main pulmonary artery aneurysm treated surgically. However, aneurysm of the main pulmonary artery treated surgically was not reported in our country till now. Recently we have experienced a case of the mainpulmonary artery aneurysm in a 10 years old boy and it was confirmed by echocardiogram, ultrasonogram of the chest, computed tomogram of the chest, radioisotope heart scan, cardiac catheterization and cine-angiogram of main pulmonary artery, aorta & right ventricle etc and patent ductus arteriosus was noted at the indifferent site from aneurysmal sac. Thereafter he underwent surgical correction at our hospital with the aid of total cardiopulmonary by-pass.