RESUMEN
Context: Spinal cord infarction is a rare condition that develops as a result of insufficient vascular perfusion, sometimes related to procedures involving the aorta and vertebral arteries.Findings: We present the case of a 66-year-old woman who developed weakness on all four extremities and thermalgesic sensory deficit following an elective endovascular embolization of an incidentally diagnosed aneurysm in the posterior circulation. The procedure involved the cathetherization of both vertebral arteries, but was unremarkable and the flow into the anterior spinal artery was preserved. Radiological findings highly suggested a spinal cord infarction. She was started on corticosteroids and showed a significant neurological improvement.Clinical relevance: The present case illustrates that spinal cord infarction is a typical - but uncommon - complication that has to be suspected after vertebral artery endovascular procedures. It can result from hypoperfusion of smaller branches that irrigate the cervical spinal cord, and patients can make remarkable recoveries despite severe initial deficits.
Asunto(s)
Traumatismos de la Médula Espinal , Isquemia de la Médula Espinal , Anciano , Femenino , Hemodinámica , Humanos , Infarto/etiología , Médula Espinal/irrigación sanguínea , Médula Espinal/diagnóstico por imagen , Isquemia de la Médula Espinal/diagnóstico por imagen , Isquemia de la Médula Espinal/etiología , Arteria Vertebral/diagnóstico por imagenRESUMEN
PURPOSE: To report our initial experience using a patient-specific 3D-printed renal tumor model for the surgical planning of a complex heminephrectomy in a horseshoe kidney. MATERIALS AND METHODS: We selected a clinical case for a complex laparoscopic surgery consisting in a 53 year-old male presenting a local recurrence of a renal tumor in a horseshoe kidney with aberrant vascularisation previously treated with a laparoscopic partial nephrectomy. He is now proposed for a laparoscopic left heminephrectomy. Along with conventional imaging, a real-size 3D-printed renal model was used to plan de surgical approach. The perioperative experience of the surgical team was recorded. RESULTS: The surgical team found the patient-specifi c 3D printed model useful for a better understanding of the anatomy and an easier surgical planning. CONCLUSION: The use of patient-specifi c 3D-printed renal models seem to be helpful for the surgical planning in complex renal tumors.
Asunto(s)
Carcinoma de Células Renales/cirugía , Riñón Fusionado/cirugía , Neoplasias Renales/cirugía , Laparoscopía/métodos , Modelos Anatómicos , Impresión Tridimensional , Carcinoma de Células Renales/diagnóstico por imagen , Angiografía por Tomografía Computarizada , Humanos , Imagenología Tridimensional/métodos , Neoplasias Renales/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Nefrectomía/métodos , Reproducibilidad de los Resultados , Resultado del TratamientoRESUMEN
ABSTRACT Purpose: To report our initial experience using a patient-specific 3D-printed renal tumor model for the surgical planning of a complex heminephrectomy in a horseshoe kidney. Materials and Methods: We selected a clinical case for a complex laparoscopic surgery consisting in a 53 year-old male presenting a local recurrence of a renal tumor in a horseshoe kidney with aberrant vascularisation previously treated with a laparoscopic partial nephrectomy. He is now proposed for a laparoscopic left heminephrectomy. Along with conventional imaging, a real-size 3D-printed renal model was used to plan de surgical approach. The perioperative experience of the surgical team was recorded. Results: The surgical team found the patient-specific 3D printed model useful for a better understanding of the anatomy and an easier surgical planning. Conclusion: The use of patient-specific 3D-printed renal models seem to be helpful for the surgical planning in complex renal tumors.