RESUMO
Aortic arch aneurysms involving the major vessels of the neck pose great challenges in their repair. Open repair of these aneurysms are associated with a significant morbidity and mortality. The major challenge for endovascular repair of these complex aneurysms is the maintenance of cerebral perfusion during stent implantation and long-term durability. This paper discusses preoperative planning and technical aspects to successful endovascular repair of a large aortic arch aneurysm involving the distal take-off of the left subclavian artery.
Assuntos
Aorta Torácica/cirurgia , Aneurisma Aórtico/cirurgia , Artéria Subclávia/cirurgia , Idoso , Aorta Torácica/diagnóstico por imagem , Aneurisma Aórtico/complicações , Aneurisma Aórtico/diagnóstico por imagem , Prótese Vascular , Implante de Prótese Vascular , Procedimentos Endovasculares , Hemoptise/etiologia , Humanos , Masculino , Stents , Artéria Subclávia/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
An 80-year-old man presented with painful leg ulceration due to steal phenomenon from a groin arteriovenous fistula (AVF) 10 years following a coronary angiogram. The diagnosis of the AVF was confirmed by duplex examination of the groin vessels which demonstrated characteristic flow pattern in the femoral arterial and venous system. Angiography further confirmed the site of the fistulous communication and this was managed by a covered stent graft. We discuss the incidence of AVF, risk factors for its development, relevant diagnostic investigations and management options along with strategies to reduce the incidence of AVF following percutaneous punctures.
