ABSTRACT
An 85-year-old patient presented with a giant pseudo-aneurysm in the groin fifteen years after placement of an aortobifemoral graft (ABG). The pseudo-aneurysm was expanding rapidly. To prevent massive haemorrhage an inflatable balloon was inserted into the native distal aorta. The balloon was inserted via the contralateral groin. After inflation, the pseudo-aneurysm was safely excluded by the interposition of a new prosthetic segment between the left prosthetic branch of the ABG and the common femoral artery. This technique, which has been used for more than 50 years in several other indications, is an elegant method to minimise blood loss in the treatment of large pseudoaneurysms of the groin.
Subject(s)
Aneurysm, False/surgery , Aneurysm, Ruptured/surgery , Aortic Diseases/surgery , Balloon Occlusion , Blood Vessel Prosthesis Implantation/adverse effects , Aged, 80 and over , Aneurysm, False/diagnosis , Aneurysm, Ruptured/diagnostic imaging , Aortic Aneurysm, Abdominal/surgery , Aortic Diseases/diagnosis , Emergency Medical Services , Female , Femoral Artery/surgery , Groin , Humans , Time Factors , Tomography, X-Ray Computed , Vascular Surgical ProceduresABSTRACT
Two cases of symptomatic fibromuscular dysplasia of the internal carotid artery treated with intraoperative balloon-dilatation and semi-rigid metal dilators are presented. Fibromuscular dysplasia (FMD) is a segmental, non atheromatous disease of small and medium sized arteries. Mainly the renal arteries are affected. Involvement of the internal carotid artery is more frequently, than generally appreciated, associated with definite cerebrovascular symptomatology. Symptomatic FMD of the internal carotid artery requires surgical treatment. Histological findings, pathogenesis, clinical manifestations, diagnosis and therapeutic modalities are discussed.
