Tratamento endovascular de pseudoaneurisma de aorta torácica: relato de caso / Endovascular treatment of thoracic aortic pseudoaneurysm: case report

RESUMO

Paciente de 31 anos vítima de acidente automobilístico apresentou falta de ar inspiratória progressiva acompanhada de dor dissecante no tórax, de forte intensidade, sem irradiação; Glasgow 15 e ISS 26 (16 + 9 + 1); exames laboratoriais e radiográficos compatíveis com a normalidade. Foi operado de fratura de tíbia 1 dia depois, tendo recebido alta 3 dias depois da entrada no serviço. No entanto, foi piorando da falta de ar e da dor torácica, retornando para nova consulta 2 dias após a alta hospitalar. Foi realizada tomografia computadorizada helicoidal que revelou pseudoaneurisma de aorta torácica. Optou-se por tratamento endovascular com implante de endoprótese.

ABSTRACT

A 31-year-old car accident victim was admitted with progressive inspiratory dyspnea, followed by intense dissecting thoracic pain, without any irradiation. The patient's Glasgow score was 15, while his ISS was 26 (16 + 9 + 1). Laboratory and radiographic results were normal. One day after hospital admission, the patient underwent surgery due to a fractured tibia, being discharged from hospital 3 days later. However, worsening shortness of breath and thoracic pain were observed and he returned to the hospital 2 days later. A helical computed tomography was done revealing a thoracic aortic pseudoaneurysm. Endovascular surgery with endoprosthesis implantation was the treatment of choice.