[Acute post-trauma dissection of the descending thoracic aorta]. / Dissection aiguë post-traumatique de l'aorte thoracique descendante.

BACKGROUND: Traumatic injury to the descending thoracic aorta other than the isthmus is rare, and little known. Acute post-trauma rupture may occur in a context of multiple or rarely unique localizations. CASE REPORT: We report the case of a young man who was the victim of multiple injuries with an isolated rupture of the descending thoracic aorta. Early diagnosis and adapted endovascular treatment led to favorable outcome. CONCLUSION: In 90% of cases, acute post-trauma rupture of the aorta in a single localization involve the isthmus. Rupture of the descending aorta is more exceptional but must not be missed. The pathophysiological mechanism and appropriate management are discussed in light of a review of the literature.

[Emergency endovascular treatment for ruptured post-traumatic pseudoaneurysm of the superior gluteal artery]. / Traitement endovasculaire en urgence d'un faux anévrisme post-traumatique rompu de l'artère glutéale supérieure.

Pseudoaneurysms of the gluteal arteries are rare, often secondary to blunt or penetrating pelvic trauma. These pseudoaneurysms are initially asymptomatic and manifest after a variable delay ranging from a few weeks to many years after the initial trauma. The spontaneous outcome can be fatal in case of rupture. Previously, treatment of gluteal pseudoaneurysms was exclusively surgical, but the advent of endovascular techniques revolutionized management practices by decreasing perioperative morbidity and offering results comparable to those of surgery. We report the case of a patient admitted for emergency management of a ruptured post-traumatic pseudoaneurysm of the superior gluteal artery that had occurred 20 days after penetrating buttock trauma. Selective embolization was successful.

[Treatment of a complex renal artery aneurysm by renal autotransplantation]. / Traitement d'un anévrisme complexe de l'artère rénale par autotransplantation rénale.

Renal artery aneurysm (AAR) is rare and usually asymptomatic; rupture, thromboembolism are aneurysmal complications that can then lead to renal infarction. AAR is often found fortuitously when exploring other diseases. Renal autotransplantation (RAT) is an alternative treatment for complex AAR, with satisfactory outcomes described in the literature.

[Spontaneous false aneurysm of the extracranial internal carotid artery - during pregnancy]. / Faux anévrisme spontané de l'artère carotide interne extracrânienne - pendant la grossesse.

Extracranial carotid false aneurysms are rare but serious because of the high risk of rupture and thromboembolic ischemic strokes. Although hemodynamic and hormonal physiological changes in pregnant women may favor arterial rupture and the development of false aneurysms, only one case of extracranial carotid false aneurysm related to pregnancy has been reported in the literature. Surgical repair is still the treatment of choice of these lesions. We report a case of spontaneous false aneurysm of the extracranial internal carotid artery occurring at the end of pregnancy. The surgical procedure consisted in resection of the false aneurysm with interposition of a prosthetic graft. The follow-up was uneventful.

[An axillary-subclavian artery aneurysm in pre-rupture revealing Marfan syndrome]. / Un anévrisme de l'artère axillo-sous-clavière en pré-rupture révélant un syndrome de Marfan.

Marfan syndrome is an autosomal dominant disorder of connective tissue which has many clinical symptoms and whose prognosis depends on associated cardiovascular complications, dominated by proximal aortic disorders. Peripheral arterial aneurysms are rare during Marfan syndrome and are exceptionally indicative of the disease. We report the case of a large aneurysm of the axillary-subclavian artery in pre-rupture revealing a new case of Marfan syndrome. Treatment consisted in surgical repair by resection of the aneurysm and performing a venous bypass graft; the postoperative course was uneventful.

[Traumatic dissection of the left renal pedicle in a young adult]. / Dissection traumatique de l'artère rénale gauche chez un adulte jeune.

Blunt trauma rarely causes renal pedicle dissection. Clinical signs are minimal and inconsistently reported. The diagnosis is based on computed tomographic angiography; arteriography is still useful when revascularization is considered. We report here a case of traumatic dissection with thrombosis of a juxta-aortic renal pedicle monitored in the intensive care unit. An endovascular procedure could not be proposed because of the juxta-aortic localization.

[Claude Bernard-Horner syndrome revealing spontaneous aneurysm of the vertebral artery]. / Syndrome de Claude Bernard-Horner révélant un faux anévrisme spontané de l'artère vertébrale.

False aneurysms of the extracranial vertebral artery (FAVA) are rare because of the path of the artery at the level of the transverse holes. They can be secondary to penetrating cervical trauma, spontaneous in the course of an angiopathy such as Ehlers-Danlos syndrome, or iatrogenic. We report the case of a 31-year-old woman who presented a syndrome of Claude Bernard-Horner related to a spontaneous FAVA. The angioscanner confirmed the diagnosis and the patient underwent successful surgical treatment of the false aneurysm with ligature of the vertebral artery. Outcome was favorable.

[Peripheral arterial pseudo-aneurysm in Behçet's disease: Report of two cases]. / Pseudo-anévrisme artériel périphérique dans la maladie de Behçet : à propos de deux cas.

Behçet's disease is a systemic vasculitis of unknown etiopathogenesis. Arterial events such as pseudo-aneurysms are rare and may be the mode of occurrence of the disease. These pseudo-aneurysms tend, regardless of size, to progress rapidly to life-threatening rupture. We report two cases of arterial pseudo-aneurysms that ruptured. Treatment consisted of surgical repair in one case and arterial ligation in the other; the postoperative course was uneventful in both cases.

[Coil embolization therapy in post-traumatic pseudoaneurysms and arteriovenous fistula of knee and leg arteries]. / Embolisation par coil des pseudoanévrysmes et fistules artério-veineuses post-traumatiques des artères gonales et jambières.

Pseudoaneurysms remain a rare complication of knee and leg trauma. They may go unnoticed and manifest late after the initial trauma; they are often associated with arteriovenous fistula. No standard treatment is recognized. We report a case of post-traumatic pseudoaneurysm of the inferior articular artery of the knee, treated by coil embolization and a case of post-traumatic pseudoaneurysm of the anterior tibial artery associated with an arteriovenous fistula, treated with coil embolization and decompression surgery. Follow-up in both patients was satisfactory.

[Endovascular treatment of acute limb ischemia occurred after popliteal stent fracture]. / Traitement endovasculaire d'une ischémie aiguë survenue après fracture d'un stent poplité.

Angioplasty stenting of popliteal artery lesions is a common procedure in endovascular surgery. Stent fractures in popliteal artery maybe asymptomatic or cause restenosis, false-aneurysm or acute thrombosis. We report one case of acute limb ischemia occurred after a popliteal stent fracture placed four months earlier. The patient underwent an angioplasty stenting, completed with thrombolysis and thrombectomy. This case-report aims to illustrate complications of stent fracture in popliteal artery and possibility's to manage it by endovascular approach.

[An aortic and femoral aneurysm revealing Behçet's disease]. / Une maladie de Behçet révélée par un anévrisme aortique et fémoral.

Vascular involvement in Behçet's disease is rare, but may be inaugural in many cases. We report a case of Behçet's disease revealed by two pre-rupture aneurysms - a subrenal abdominal aortic aneurysm and a femoral aneurysm. This patient had only one of the International Study Group for Behçet's disease diagnostic criteria: pseudofolliculitis. Behçet's disease must be considered as a possible diagnosis in patients with unexplained inflammatory arteriopathy.

[Endovascular treatment of intra-thoracic left subclavian artery aneurysm]. / Traitement endovasculaire d'un anévrisme de l'artère sous-clavière gauche intrathoracique.

Aneurysms of the subclavian artery are rare, and remain asymptomatic until complications. We report one case of atherosclerotic aneurysm of the proximal portion of the left subclavian artery fortuitously discovered and successfully treated by endovascular stent graft. This case report aims to illustrate endovascular procedures in the management of difficult access lesions or in high-risk surgical patients.

[The aneurysms of digestive system arteries: three cases]. / Les anévrysmes des artères digestives. À propos de trois cas.

The aneurysms of digestive arteries are a rare pathological entity, with a risk of rupture associated to a high mortality rate, often asymptomatic, then they are discovered incidentally during a exam for other diagnostic purposes. We report three cases of digestive aneurysms, one of celiac trunk, one of mesenteric artery on behçet disease, and one of splenic artery, which were treated surgically with success.

[Exceptional association of bilateral popliteal aneurysm with an abdominal aortic aneurysm in Marfan syndrome]. / Association exceptionnelle d'un anévrysme poplité bilatéral et d'un anévrysme de l'aorte abdominale au cours d'un syndrome de Marfan.

Marfan syndrome is an autosomal dominant disorder with rheumatoid, ophthalmological, neurological, cutaneous and cardiovascular manifestations. Aneurysmal lesions affecting both the abdominal aorta and the peripheral arteries are not often described in the literature. We report a case associating a bilateral popliteal aneurysm and an aneurysm of the infra-renal abdominal aorta.

[Infected aneurysm of a branch of the superior mesenteric artery]. / Anévrysme infectieux d'une branche de l'artère mésentérique supérieure.

Aneurysm of the superior mesenteric artery is a rare finding. The risk of rupture is difficult to predict and manage. We report the case of a young woman who developed an aneurysm of the superior mesenteric artery in a context of bacterial endocarditis. Surgical resection without revascularization was successful.

[Cervical paragangliomas: surgical experience with 12 cases]. / Les paragangliomes cervicaux. Une expérience chirurgicale à propos de 12 cas.

We report a retrospective analysis of 12 patients who underwent vascular surgery for cervical paraganglioma at the Mohammed V Military Hospital at Rabat from 1996 to 2011. There were seven women and five men, mean age 46 years. All patients presented a tumor syndrome. At surgery, the diameter of the lesion measured 3 to 6 cm. There were no bilateral cases in this series. Symptoms had been noted on average for 66 months. Hospital stay after surgery and postoperative complications are reported.