RESUMO
Se presenta el caso de una paciente de 77 años, en quien, durante una cirugía de resección de tumor cutáneo, se observa incidentalmente aumento de volumen cervical derecho de características dinámicas. El hallazgo corresponde a un aneurisma de la vena yugular interna derecha, diagnóstico de mayor frecuencia en población pediátrica, habitualmente de curso benigno.
A 77-year-old woman in whom, during a skin tumor resection surgery, a right cervical swelling with dynamic characteristics was observed. The finding is compatible with an aneurysm of the right internal jugular vein, more commonly obsered in children, usually with a benign course.
Assuntos
Humanos , Feminino , Idoso , Veias Jugulares/diagnóstico por imagem , Aneurisma/diagnóstico por imagemRESUMO
An iliac vein aneurysm is a rare vascular anomaly, scarcely reported in the vascular literature. We present the case of a 72-year-old man with a history of a remote heart transplant complicated by severe tricuspid regurgitation and traumatic abdominal injury, who was incidentally found to have a 10-cm right common iliac vein aneurysm. Because of the size and risk of rupture, we elected to treat him with surgical iliac vein aneurysmorrhaphy. His iliac venous diameter and flow continued to be stable at subsequent follow-up.
RESUMO
Popliteal arteriovenous fistulae (PAF) are anomalous communications between the arterial and venous systems of the lower extremity. They are usually secondary to trauma and are rarely associated with additional vascular defects. The coexistence of a PAF and a venous aneurysm is rare and usually occurs in patients with connective tissue disorders. Evidence regarding the management of this type of anomaly is scarce. However, both open and endovascular approaches seem feasible alternatives for treating this condition. Here, we describe a spontaneous popliteal arteriovenous fistula associated with a venous aneurysm in a 42-year-old male patient who presented with a popliteal mass. Satisfactory endovascular closure of the fistula and exclusion of the venous aneurysm were achieved using an Amplatzer™ Vascular Plug II.
Assuntos
Aneurisma , Fístula Arteriovenosa , Procedimentos Endovasculares , Adulto , Aneurisma/diagnóstico por imagem , Aneurisma/etiologia , Aneurisma/cirurgia , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/cirurgia , Humanos , Masculino , Resultado do TratamentoRESUMO
RESUMEN Introducción: dos complicaciones frecuentes que presentan mal función de las fístulas arteriovenosas internas son la trombosis y la estenosis. Otras complicaciones como los aneurismas, aunque de menor frecuencia, no dejan de ser importantes. Estas requieren una intervención a tiempo para evitar el fracaso de dicho acceso. Presentación del caso: paciente que es intervenido por aneurisma venoso de fístula arteriovenosa interna y tratado con aneurismectomía total. No se preservó el acceso vascular. Se colocó catéter temporal en yugular interna derecha en espera de la realización de un nuevo acceso vascular, sin complicaciones. Conclusiones: el tratamiento es a criterio del cirujano vascular debido a los elementos clínicos encontrados, así como a los cambios degenerativos a consecuencia del proceso inflamatorio local. Los aneurismas de las fístulas arteriovenosas constituyen una complicación con frecuencia baja, pero que no están exentos de la ruptura. Se observa tanto en fístulas arteriovenosas autólogas como en injertos autólogos y heterólogos. El peligro de rotura espontánea en un sitio de afinamiento marcado de la piel a consecuencia de punciones repetidas, constituye una indicación para tomar una conducta quirúrgica con prontitud. Además, es importante que el equipo multidisciplinario esté al cuidado de la fistula durante todo el tiempo de vida útil.
ABSTRACT Introduction: two frequent complications that present a poor function of the internal arteriovenous fistulas are thrombosis and stenosis. Other complications such as aneurysms, although less frequent, are not unimportant; they require a timely intervention to avoid the failure of such approach. Case report: a patient who is intervened due to a venous aneurysm of internal arteriovenous fistula and treated with total aneurysmectomy. Vascular approach was not preserved; a temporary catheter was placed in the right internal jugular vein while waiting for a new vascular approach to be made, and there were no complications. Conclusions: the treatment is at the discretion of the vascular surgeon; due to the clinical elements found, as well as the degenerative changes as a result of the local inflammatory process. The aneurysms of the arteriovenous fistulas constitute a complication of low frequency, but they are not exempt from rupture. It is observed both in autologous arteriovenous fistulas and in autologous and heterologous grafts. The danger of spontaneous rupture at a marked skin-toning site as a result of repeated punctures is an indication for prompt surgical procedure. The treatment is at the discretion of the vascular surgeon and it is important the multidisciplinary team cares for the fistula during its projected lifespan.
RESUMO
BACKGROUND: Isolated giant cerebral varix (IGV) is an uncommon vascular lesion that represents a diagnostic challenge and requires dynamic vascular studies for its characterization. The IGV is considered a benign, low-flow venous lesion with very low risk of bleeding that might cause secondary symptoms mainly due to compression of the adjacent parenchyma. CASE DESCRIPTION: A 12-year-old female patient with non-contributory medical history presented with headache for the last 2 months. Upon admission, her neurological examination was unremarkable. Magnetic resonance imaging (MRI) and computed tomography angiography (CTA) images demonstrated a large varicose dilation of the superficial Sylvian vein, located anterior to the left temporal pole, with no evidence of abnormal arteriovenous connections or tumoral lesions. This finding was considered incidental and unrelated to her symptoms. In this case, we considered that the combination of CTA and MRIs was enough to establish an accurate diagnosis, excluding the need to perform invasive imaging studies. Taking into account these considerations, the patient was managed with conservative treatment and has been followed up for 1 year, remaining asymptomatic. CONCLUSION: Cerebral IGVs are rare vascular lesions that are treated conservatively when asymptomatic and surgically in the case of rupture or compression of adjacent structures. Given our observation of a high unlikelihood of vascular connections to arteries, and the information obtained with non-invasive imaging techniques such as CTA and MRI was enough to make a clinical decision and avoid the evaluation with invasive procedures.
RESUMO
Background: Aneurysm is a vascular disease that causes the partial rupture of arteries and veins and subsequent blood leakage due to the weakening of the vessels elastic middle layer. Venous aneurysms in horses are rare, but the arterial aneurysms are commonly reported. The aim of this paper is to report a rare occurrence of jugular external aneurysm in a horse and propose the inclusion this disease as a differential diagnosis, both because it is rare in this specie and invariably fatal. The medical examination showed a firm well-defined mass, painless, nonpulsatile on palpation and with no changed in the local temperature. Case: The horse was referred to the Veterinarian Hospital of the Federal University of Pelotas (UFPel, RS-Brazil. It was a male, Crioulo breed, 10 years old, used as stallion. The owner reported a swelling in the pectoral region that occurred after a trauma episode that had gradually grown for two years. The patient was clinically stable, and would undergo surgery extirpation for aesthetic matters. Clinical examination showed the swelling was circumscribed and centralized and it presented about 20 centimeters in diameter. The ultrasound of the pectoral area showed an anechoic structure with hyperechoic spots inside limited by an hyperechoic layer similar to a fibrous capsule. Presumptive diagnostics were of: hematoma, subcutaneous abscess, neoplasia, and [...](AU)
Assuntos
Animais , Cavalos , Aneurisma/veterinária , Veias Jugulares , Doenças Vasculares/veterináriaRESUMO
Background: Aneurysm is a vascular disease that causes the partial rupture of arteries and veins and subsequent blood leakage due to the weakening of the vessels elastic middle layer. Venous aneurysms in horses are rare, but the arterial aneurysms are commonly reported. The aim of this paper is to report a rare occurrence of jugular external aneurysm in a horse and propose the inclusion this disease as a differential diagnosis, both because it is rare in this specie and invariably fatal. The medical examination showed a firm well-defined mass, painless, nonpulsatile on palpation and with no changed in the local temperature. Case: The horse was referred to the Veterinarian Hospital of the Federal University of Pelotas (UFPel, RS-Brazil. It was a male, Crioulo breed, 10 years old, used as stallion. The owner reported a swelling in the pectoral region that occurred after a trauma episode that had gradually grown for two years. The patient was clinically stable, and would undergo surgery extirpation for aesthetic matters. Clinical examination showed the swelling was circumscribed and centralized and it presented about 20 centimeters in diameter. The ultrasound of the pectoral area showed an anechoic structure with hyperechoic spots inside limited by an hyperechoic layer similar to a fibrous capsule. Presumptive diagnostics were of: hematoma, subcutaneous abscess, neoplasia, and [...]