RESUMEN
Giant cell arteritis, Takayasu arteritis, and Horton disease are rare, idiopathic diseases that cause chronic inflammation and obliteration of large arteries, mainly the aorta and its major branches. Histological examination reveals multinucleated giants cells and clinical presentation is characterized by general symptoms and/or symptoms related to stenosis or occlusion of vessels. A case of a 50-year-old woman with neurological symptoms, cervicothoracic tumour with severe stenosis of the right subclavian artery and complete occlusion of common carotid artery is presented.
Asunto(s)
Tronco Braquiocefálico/patología , Disartria/etiología , Arteritis de Células Gigantes/diagnóstico , Neoplasias del Mediastino/etiología , Neoplasias Vasculares/etiología , Implantación de Prótesis Vascular , Tronco Braquiocefálico/cirugía , Estenosis Carotídea/etiología , Disartria/cirugía , Femenino , Arteritis de Células Gigantes/complicaciones , Arteritis de Células Gigantes/cirugía , Humanos , Neoplasias del Mediastino/patología , Neoplasias del Mediastino/cirugía , Persona de Mediana Edad , Esternotomía , Síndrome del Robo de la Subclavia/etiología , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Neoplasias Vasculares/patología , Neoplasias Vasculares/cirugíaRESUMEN
BACKGROUND: Aortic stent-graft infections (ASGIs) are associated with significant mortality. We report our experience of two cases of ASGI treated differently and successfully. METHODS: Two patients presented with constitutional symptoms some months after scheduled endovascular repair of aortic aneurysm (EVAR). Patient 1 had an abscess formation around the endograft in continuity with the right groin. Due to patient comorbidities, a conservative treatment was performed. Patient 2 had an abscess formation with air surrounding the stent graft. The patient was treated successfully by endograft removal. RESULTS: Computed tomographic scan follow-up at 6 months from surgery showed no evidence of recurrent infection. CONCLUSION: Despite the recommended treatment of ASGI being surgery, conservative treatment can be performed successfully in patients with high surgical risk, avoiding aortic clamping. We present the first reported case of ASGI due to Streptococcus haemolyticus, the second case due to a fungus, and the second reported case of spondylodiscitis after EVAR.
Asunto(s)
Absceso Abdominal/terapia , Antibacterianos/uso terapéutico , Aneurisma de la Aorta/cirugía , Implantación de Prótesis Vascular/efectos adversos , Prótesis Vascular/efectos adversos , Desbridamiento , Remoción de Dispositivos , Infecciones Relacionadas con Prótesis/terapia , Stents/efectos adversos , Absceso Abdominal/diagnóstico por imagen , Absceso Abdominal/microbiología , Anciano , Aortografía/métodos , Implantación de Prótesis Vascular/instrumentación , Candida albicans/aislamiento & purificación , Discitis/etiología , Enterobacter cloacae/aislamiento & purificación , Humanos , Masculino , Propionibacterium/aislamiento & purificación , Infecciones Relacionadas con Prótesis/diagnóstico por imagen , Infecciones Relacionadas con Prótesis/microbiología , Streptococcus/aislamiento & purificación , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Massive and/or recurrent hemoptysis is a clear indication for surgical treatment of pleuropulmonary aspergilloma, despite the incidence of postoperative morbidity and mortality. Thoracoplasty has been widely used for 20 years and is still indicated in these cases, following lobectomy, even though the procedure is not free of complications. We report the case of a patient who required thoracoplasty to treat a pleuropulmonary aspergilloma invading the chest wall. Subsequent placement of an aortic stent-graft was required due to tearing of the left subclavian artery.
Asunto(s)
Angioscopía , Aspergilosis/complicaciones , Aspergilosis/cirugía , Aspergillus fumigatus , Fístula Bronquial/microbiología , Fístula Bronquial/cirugía , Empiema Pleural/microbiología , Empiema Pleural/cirugía , Complicaciones Intraoperatorias/cirugía , Enfermedades Pulmonares Fúngicas/complicaciones , Enfermedades Pulmonares Fúngicas/cirugía , Fístula del Sistema Respiratorio/microbiología , Fístula del Sistema Respiratorio/cirugía , Arteria Subclavia/lesiones , Toracoplastia , Humanos , Masculino , Persona de Mediana EdadRESUMEN
La hemoptisis masiva y/o repetitiva es una indicación clara de tratamiento quirúrgico del aspergiloma pleuropulmonar, a pesar de la morbimortalidad posquirúrgica existente. La toracoplastia, muy utilizada hace 2 décadas, todavía tiene su indicación aquí, tras lobectomía, aunque no está exenta de complicaciones. Presentamos un caso de aspergiloma pleuropulmonar con invasión de pared torácica que requirió toracoplastia y posteriormente técnicas endovasculares aórticas por desgarro de la arteria subclavia izquierda
Massive and/or recurrent hemoptysis is a clear indication for surgical treatment of pleuropulmonary aspergilloma, despite the incidence of postoperative morbidity and mortality. Thoracoplasty has been widely used for 20 years and is still indicated in these cases, following lobectomy, even though the procedure is not free of complications. We report the case of a patient who required thoracoplasty to treat a pleuropulmonary aspergilloma invading the chest wall. Subsequent placement of an aortic stent-graft was required due to tearing of the left subclavian artery