RESUMO
Dorsalis pedis artery (DPA) aneurysms are very rare and fewer than 60 cases have been reported in the literature. Most affected patients present with false aneurysms after orthopedic surgery or trauma. Here we report an unusual case of a giant DPA pseudoaneurysm after cannulation for arterial line placement in a patient newly diagnosed with systemic lupus erythematosus (SLE). A diagnostic delay resulted in necrosis of the overlying skin. Excision of the pseudoaneurysm, ligation of the DPA, and debridement of the foot dorsum were performed, followed by a second flap coverage surgery. Although a DPA false aneurysm is rare after arterial line removal, it can cause the serious complications of skin necrosis, rupture and toe necrosis. Arterial puncture sites should be carefully monitored, especially in patients with SLE or other vasculitis.
Assuntos
Humanos , Aneurisma , Falso Aneurisma , Artérias , Cateterismo , Desbridamento , Diagnóstico Tardio , Pé , Ligadura , Lúpus Eritematoso Sistêmico , Necrose , Ortopedia , Punções , Ruptura , Pele , Dedos do Pé , Dispositivos de Acesso Vascular , VasculiteRESUMO
We report an unusual case of an 83-year-old man who was admitted with dizziness and repeated drop attacks. He was diagnosed with bilateral carotid artery occlusion and he underwent a left subclavian to left carotid bypass with ringed polytetrafluoroethylene graft. The patient's postoperative course was uneventful and no symptoms presented during a 6-month follow-up. Finally, we discuss on proper management of such patients.
Assuntos
Idoso de 80 Anos ou mais , Humanos , Artérias Carótidas , Doenças das Artérias Carótidas , Artéria Carótida Primitiva , Artéria Carótida Interna , Tontura , Seguimentos , Patologia , Politetrafluoretileno , Síncope , Transplantes , Insuficiência VertebrobasilarRESUMO
A 75-year-old patient with severe comorbidities was treated with an Endurant® (Medtronic, USA) II endograft due to a ruptured abdominal aortic aneurysm (AAA). After four years of unremarkable follow-up, bilateral limb separation was detected. The patient underwent endovascular bridging without any complication. Although rarely detected in newer grafts, late bilateral type IIIa endoleaks can present and should be promptly repaired. Complex or ruptured AAAs treated with off-label use of endografts should be under closer surveillance using imaging tools for potential endoleaks or aneurysm sac growth.