Jornal Vascular Brasileiro
https://app.periodikos.com.br/journal/jvb/article/doi/10.1590/S1677-54492008000300016
Jornal Vascular Brasileiro
Case Report

Endovascular treatment of a triple paraanastomotic aneurysm after aortobiiliac reconstruction

Tratamento endovascular de triplo aneurisma para-anastomótico após derivação aorto-biilíaca

Alexandre Campos Moraes Amato; Andrea Kahlberg; Luca Bertoglio; Germano Melissano; Roberto Chiesa

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Abstract

We report a case of a 72-year-old patient considered unfit for open surgery, presenting with paraanastomotic aneurysms of all three anastomoses, 13 years after an open aortobiiliac reconstruction for abdominal aortic aneurysm. This patient was successfully treated with an endovascular approach using a left aortouniiliac endograft and a right iliac tubular endograft, followed by crossover femorofemoral bypass. This report illustrates the usefulness of a minimally invasive approach for solving this complication of aortic open surgery and discusses technical issues related to endovascular devices in this particular setting.

Keywords

Pseudoaneurysm, aortic and iliac surgery, endovascular repair, endovascular treatment, anastomosis, postoperative complications

Resumo

Relatamos um caso de um paciente de 72 anos não considerado elegível para cirurgia aberta, apresentando aneurismas para-anastomóticos das três anastomoses, 13 anos após uma reconstrução aberta aorto-biilíaca para aneurisma aórtico abdominal. Este paciente foi tratado com sucesso através de abordagem endovascular usando uma endoprótese aorto-uniilíaca esquerda e uma endoprótese tubular ilíaca direita, seguida por derivação cruzada fêmoro-femoral. Este relato ilustra a utilidade de uma abordagem minimamente invasiva para o tratamento desta complicação da cirurgia aórtica aberta e discute questões técnicas relacionadas a dispositivos endovasculares neste contexto em especial.

Palavras-chave

Pseudo-aneurisma, cirurgia ilíaca e aórtica, reparo endovascular, tratamento endovascular, anastomose, complicações pós-operatórias

References

Mulder EJ, van Bockel JH, Maas J, van den Akker PJ, Hermans J. Morbidity and mortality of reconstructive surgery of noninfected false aneurysms detected long after aortic prosthetic reconstruction. Arch Surg. 1998;133:45-9.

Gawenda M, Zaehringer M, Brunkwall J. Open versus endovascular repair of para-anastomotic aneurysms in patients who were morphological candidates for endovascular treatment. J Endovasc Ther. 2003;10:745-51.

Pagni S, Halene S, Kwass W, Khachane V. Ruptured aortic pseudo-aneurysm: a rare presentation as aortocaval fistula. J Cardiovasc Surg (Torino). 1997;38:165-8.

Treiman GS, Weaver FA, Cossman DV. Anastomotic false aneurysms of the abdominal aorta and the iliac arteries. J Vasc Surg. 1988;8:268-73.

Gautier C, Borie H, Lagneau P. Aortic false aneurysms after prosthetic reconstruction of the infrarenal aorta. Ann Vasc Surg. 1992;6:413-7.

Nishibe T, Koizumi J, Kudo F. Repair of false para-anastomotic aortic aneurysms using an endovascular stent graft technique in a patient with severe pulmonary disease: report of a case. Surg Today. 2001;31:1110-2.

Morrissey NJ, Yano OJ, Soundararajan K. Endovascular repair of para-anastomotic aneurysms of the aorta and iliac arteries: preferred treatment for a complex problem. J Vasc Surg. 2001;34:503-12.

Brinster DR, McKee DM, Olsen DM, Berman SS, Rodriguez-Lopez JA. Endovascular treatment of a thoracic aortic pseudoaneurysm after previous open repair. Ann Thorac Surg. 2006;82:308-10.

Aun RASN, Lederman FTA, Waksman AA. Tratamento endoluminal de aneurismas anastomóticos na aorta abdominal: relato de dois casos. J Vasc Bras. 2006;5:58-62.

Melissano G, Civilini E, Marrocco-Trischitta MM, Chiesa R. Resolution of an anastomotic aortic pseudoaneurysm 4 years after endovascular treatment. Tex Heart Inst J. 2004;31:330-2.

Melissano G, Di Mario C, Tshomba Y. Endovascular treatment of a noninfected anastomotic juxtarenal aortic aneurysm. Tex Heart Inst J. 2000;27:408-11.

Lindblad B, Ivancev K, Chuter TA, Malina M, Brunkwall J, Risberg B. Endovascular exclusion of juxtarenal anastomotic pseudoaneurysm. Eur J Vasc Endovasc Surg. 1996;12:116-8.

van Herwaarden JA, Waasdorp EJ, Bendermacher BL, van den Berg JC, Teijink JA, Moll FL. Endovascular repair of paraanastomotic aneurysms after previous open aortic prosthetic reconstruction. Ann Vasc Surg. 2004;18:280-6.

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