Volume 9 / Número 3 ANGIOLOGIA • ARTIGO DE ...SETEMBRO 2013 ISSN 1646-706X • ARTIGO DE REVISÃO...
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1646-706X/$ - see front matter © 2013 Sociedade Portuguesa de Angiologia e Cirurgia Vascular. Publicado por Elsevier España, S.L. Todos os direitos reservados. Volume 9 / Número 3 SETEMBRO 2013 ISSN 1646-706X •ARTIGO DE REVISÃO Estenose intra-stent na artéria femoral superÀcial: soluções actuais para um problema crescente H. Rodrigues, F. Bastos Gonçalves, G. Alves, C. Amaral, G. Rodrigues, R. Abreu, A. Quintas, N. Oliveira, M.E. Ferreira, J. Albuquerque Castro e L. Mota Capitão •ARTIGO ORIGINAL Risco da exposição à radiação ionizante durante procedimentos endovasculares S. Eufrásio, P. Sousa, N. Oliveira, F. Gonçalves, G. Alves, H. Rodrigues, G. Rodrigues, A. Quintas, R. Abreu, J. Aragão Morais, J. Albuquerque e Castro, M.E. Ferreira, M.J. Manzano e L. Mota Capitão •CASOS CLÍNICOS Acute critical hand ischemia secondary to iatrogenic intrarterial injection of dexchlorfeniramine and prednisone F. Rielo, A. Toledo, C. Pineiro, J.M.G. Colodro Método combinado de embolização da artéria esplénica e esplenectomia laparoscópica — caso clínico L. Borges, E. Dias e I. Cássio •IMAGEM VASCULAR Bilateral isolated aneurysms of profunda femoris artery J. Tiago, P. Martins, V. Manuel, C. Martins, J. Fernandes e Fernandes •XIII Congresso da SPACV www.elsevier.pt/acv ANGIOLOGIA E CIRURGIA VASCULAR Angiol Cir Vasc. 2013;9(3):97-98 VASCULAR IMAGES Bilateral isolated aneurysms of profunda femoris artery Aneurismas isolados da artéria femoral profunda José Tiago*, Pedro Martins, Viviana Manuel, Carlos Martins, José Fernandes e Fernandes Department of Angiology and Vascular Surgery, Hospital Universitário de Santa Maria, Lisbon, Portugal Recebido a 1 de maio de 2013; aceite a 15 de junho de 2013 * Corresponding author. E-mail address: [email protected] Introduction First described by Pappas et al. 1 arteriosclerotic aneurysms of profunda femoris are very rare entities. 1-5 Because of its anatomical position in the muscular fascia and wall characteristics the profunda artery is less affected by aneurismal disease than other peripheral arteries and true aneurysms account for less than 0.5% 2 of all peripheral aneurysms and 1-6,6% 3,4 of all femoral arteries aneurysms. Bilateral profunda femoris artery aneurysms (BPFAA) are even rarer and without a context of polianeurysmatic disease few cases are described in literature. 5 Case report A 72 years old man presented with complaints of acute swelling and pulsatile mass in the proximal left thigh (Fig. 1). On past medical history the patient was a former smoker, had a bilateral inguinal hernia repair, open prostatectomy for benign prostatic hyperplasia and was being treated for arterial hypertension and atrial fibrillation. He denied other comorbidities, history of trauma or needle use in the left groin. On physical examination there was a large pulsatile and expansible mass in the left medial thigh region. The duplex scan examination showed BPFAA with a large left profunda femoris artery aneurysm (PFAA) CT scan revealed a 6 cm diameter PFAA in the left tight and a right 1.7 cm PFAA (Figs. 2 and 3). No other aneurysms were present at the CT screening. The patient underwent successful surgical repair with open aneurysmectomyand graft repair with polytetrafluoro- ethylene (PTFE) interposition on the left side. The right PFAA was maintained in close surveillance (Figs. 4 and 5). Figure 1 Left femoral pulsatile and expansible mass (red arrow).
Transcript of Volume 9 / Número 3 ANGIOLOGIA • ARTIGO DE ...SETEMBRO 2013 ISSN 1646-706X • ARTIGO DE REVISÃO...
1646-706X/$ - see front matter © 2013 Sociedade Portuguesa de Angiologia e Cirurgia Vascular. Publicado por Elsevier España, S.L. Todos os direitos reservados.
Volume 9 / Número 3 SETEMBRO 2013
ISSN 1646-706X
• ARTIGO DE REVISÃO
Estenose intra-stent na artéria femoral super cial: soluções actuais para um problema crescenteH. Rodrigues, F. Bastos Gonçalves, G. Alves, C. Amaral, G. Rodrigues, R. Abreu, A. Quintas, N. Oliveira, M.E. Ferreira, J. Albuquerque Castro e L. Mota Capitão
• ARTIGO ORIGINAL
Risco da exposição à radiação ionizante durante procedimentos endovascularesS. Eufrásio, P. Sousa, N. Oliveira, F. Gonçalves, G. Alves, H. Rodrigues, G. Rodrigues, A. Quintas, R. Abreu, J. Aragão Morais, J. Albuquerque e Castro, M.E. Ferreira, M.J. Manzano e L. Mota Capitão
• CASOS CLÍNICOS
Acute critical hand ischemia secondary to iatrogenic intrarterial injection of dexchlorfeniramine and prednisoneF. Rielo, A. Toledo, C. Pineiro, J.M.G. Colodro
Método combinado de embolização da artéria esplénica e esplenectomia laparoscópica — caso clínicoL. Borges, E. Dias e I. Cássio
• IMAGEM VASCULAR
Bilateral isolated aneurysms of profunda femoris arteryJ. Tiago, P. Martins, V. Manuel, C. Martins, J. Fernandes e Fernandes
• XIII Congresso da SPACV
(www.elsevier.pt/acv)
www.elsevier.pt/acv
ANGIOLOGIAE CIRURGIA VASCULAR
Angiol Cir Vasc. 2013;9(3):97-98
VASCULAR IMAGES
Bilateral isolated aneurysms of profunda femoris artery
Aneurismas isolados da artéria femoral profunda
José Tiago*, Pedro Martins, Viviana Manuel, Carlos Martins, José Fernandes e Fernandes
Department of Angiology and Vascular Surgery, Hospital Universitário de Santa Maria, Lisbon, Portugal
Recebido a 1 de maio de 2013; aceite a 15 de junho de 2013
* Corresponding author.E-mail address: [email protected]
Introduction
First described by Pappas et al.1 arteriosclerotic aneurysms of profunda femoris are very rare entities.1-5 Because of its anatomical position in the muscular fascia and wall characteristics the profunda artery is less affected by aneurismal disease than other peripheral arteries and true aneurysms account for less than 0.5%2 of all peripheral aneurysms and 1-6,6%3,4 of all femoral arteries aneurysms.
Bilateral profunda femoris artery aneurysms (BPFAA) are even rarer and without a context of polianeurysmatic disease few cases are described in literature.5
Case report
A 72 years old man presented with complaints of acute swelling and pulsatile mass in the proximal left thigh (Fig. 1). On past medical history the patient was a former smoker, had a bilateral inguinal hernia repair, open prostatectomy for benign prostatic hyperplasia and was being treated for arterial hypertension and atrial fibrillation. He denied other comorbidities, history of trauma or needle use in the left groin.
On physical examination there was a large pulsatile and expansible mass in the left medial thigh region. The duplex scan examination showed BPFAA with a large left profunda femoris artery aneurysm (PFAA)
CT scan revealed a 6 cm diameter PFAA in the left tight and a right 1.7 cm PFAA (Figs. 2 and 3). No other aneurysms were present at the CT screening.
The patient underwent successful surgical repair with open aneurysmectomyand graft repair with polytetra fluoro-ethylene (PTFE) interposition on the left side. The right PFAA was maintained in close surveillance (Figs. 4 and 5).
Figure 1 Left femoral pulsatile and expansible mass (red arrow).
98 J. Tiago et al.
Conclusion
Isolated BPFAA are extremely rare and asymptomatic most of the time, when symptoms are present, surgical repair is prompt recommended to prevent complications such as femoral nerve and veins compression and aneurysm rupture with great risk of limb loss. Treatment of PFAA is safe maintains profunda artery function, eliminates the presence of compressive neurologic signs and reduces deep venous thrombosis risk.
References
1. Pappas G, Janes J, Bernatz P, Schriger A. Femoral aneurysms. JAMA. 1964;190:489-93.
Figure 2 Computed tomography scan showing bilateral profunda femoris artery aneurysm, including a 6 cm diameter aneurysm on the left side (red arrow).
Figure 3 Three-dimensional computed tomography scan reconstruction showing the 6 cm diameter left bilateral profunda femoris artery aneurysm.
Figure 4 Left bilateral profunda femoris artery aneurysm exposed through a longitudinal groin incision. Inflow and out ow vessels are encircled with blue tape and the femoral nerve with red tape.
Figure 5 Open aneurysmectomy and polytetra uoroethylene (PTFE) graft interposition.
2. Rich PB, Wolk SW, Sarosi MJ, Shanley CJ. Endovascular manage-ment of a true aneurysm of the profunda femoris artery: a case report. Vasc Endovascular Surg. 2000;34:467-70.
3. Posner SR,Wilensky J, Dimick J, Henke PK. A true aneurysm of the profunda femoris artery: a case report and review of the English language literature. Ann Vasc Surg. 2004;18:740-6.
4. Cutler BS, Darling RC. Surgical management of arteriosclerotic femoral aneurysms. Surgery. 1973;74:764-73.
5. Gemayel G, Mugnai D, Khabiri E, Sierra J, Murith N, Kalangos A. Isolated bilateral profunda femoris artery aneurysm. Ann Vasc Surg. 2010;24:824.e11-824.e13.
