Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgery
ABSTRACT Spontaneous non-aneurysmal aortic rupture is rare and is usually attributed to penetrating aortic ulcers, infections, tumor infiltrations, or inflammatory and collagen diseases. Chronic rupture is infrequent but extremely rare in non-aneurysmal aortas, which makes diagnosis difficult becaus...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Instituto Israelita de Ensino e Pesquisa Albert Einstein
2024-12-01
|
| Series: | Einstein (São Paulo) |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082024000100512&lng=en&tlng=en |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846119045378605056 |
|---|---|
| author | Bruno Jeronimo Ponte Viviane Galli Dib Andressa Cristina Sposato Louzada Júlia Freire Castanheiras de Paiva Ferreira Lucas Lembrança Pinheiro Cynthia de Almeida Mendes Nelson Wolosker |
| author_facet | Bruno Jeronimo Ponte Viviane Galli Dib Andressa Cristina Sposato Louzada Júlia Freire Castanheiras de Paiva Ferreira Lucas Lembrança Pinheiro Cynthia de Almeida Mendes Nelson Wolosker |
| author_sort | Bruno Jeronimo Ponte |
| collection | DOAJ |
| description | ABSTRACT Spontaneous non-aneurysmal aortic rupture is rare and is usually attributed to penetrating aortic ulcers, infections, tumor infiltrations, or inflammatory and collagen diseases. Chronic rupture is infrequent but extremely rare in non-aneurysmal aortas, which makes diagnosis difficult because the absence of an aneurysm can mislead the physician to rule out rupture. Here, we describe the case of an 85-year-old male, who was undergoing oncological investigation for weight loss, inappetence, and back pain. Computed tomography and magnetic resonance imaging performed 3 months before admission showed a contained pseudoaneurysm of the infrarenal aorta associated with significant aortoiliac calcification and images suggestive of peritoneal implants. The patient was referred to our oncological center and underwent abdominal computed tomography for oncological investigation and staging. The patient was urgently admitted to the intensive care unit after a critical finding of contained rupture of the infrarenal aorta during the scan. Endovascular repair was indicated, and the patient was successfully treated with implantation of an Endurant IIs 25 × 25 × 70 mm endoprosthesis. No procedural complications were observed. Postoperative course was uneventful, and the patient was discharged on the fifth postoperative day. Control computed tomography performed 1 and 6 months after surgery showed no leaks. This case emphasizes the importance of communication between the radiologists and attending physicians. As the rupture was punctual and well defined in the computed tomography and angiography images, endovascular repair with an aortic cuff was safely performed, and the procedure time was reduced. |
| format | Article |
| id | doaj-art-9953d6c5b4a048a0a79bc4468f0fb63b |
| institution | Kabale University |
| issn | 2317-6385 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Instituto Israelita de Ensino e Pesquisa Albert Einstein |
| record_format | Article |
| series | Einstein (São Paulo) |
| spelling | doaj-art-9953d6c5b4a048a0a79bc4468f0fb63b2024-12-17T07:59:05ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)2317-63852024-12-012210.31744/einstein_journal/2024rc1113Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgeryBruno Jeronimo Pontehttps://orcid.org/0000-0002-7272-7423Viviane Galli Dibhttps://orcid.org/0009-0007-2080-4486Andressa Cristina Sposato Louzadahttps://orcid.org/0000-0002-4133-3798Júlia Freire Castanheiras de Paiva Ferreirahttps://orcid.org/0009-0006-3090-5902Lucas Lembrança Pinheirohttps://orcid.org/0000-0001-5203-9896Cynthia de Almeida Mendeshttps://orcid.org/0000-0001-9266-8144Nelson Woloskerhttps://orcid.org/0000-0003-1991-3507ABSTRACT Spontaneous non-aneurysmal aortic rupture is rare and is usually attributed to penetrating aortic ulcers, infections, tumor infiltrations, or inflammatory and collagen diseases. Chronic rupture is infrequent but extremely rare in non-aneurysmal aortas, which makes diagnosis difficult because the absence of an aneurysm can mislead the physician to rule out rupture. Here, we describe the case of an 85-year-old male, who was undergoing oncological investigation for weight loss, inappetence, and back pain. Computed tomography and magnetic resonance imaging performed 3 months before admission showed a contained pseudoaneurysm of the infrarenal aorta associated with significant aortoiliac calcification and images suggestive of peritoneal implants. The patient was referred to our oncological center and underwent abdominal computed tomography for oncological investigation and staging. The patient was urgently admitted to the intensive care unit after a critical finding of contained rupture of the infrarenal aorta during the scan. Endovascular repair was indicated, and the patient was successfully treated with implantation of an Endurant IIs 25 × 25 × 70 mm endoprosthesis. No procedural complications were observed. Postoperative course was uneventful, and the patient was discharged on the fifth postoperative day. Control computed tomography performed 1 and 6 months after surgery showed no leaks. This case emphasizes the importance of communication between the radiologists and attending physicians. As the rupture was punctual and well defined in the computed tomography and angiography images, endovascular repair with an aortic cuff was safely performed, and the procedure time was reduced.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082024000100512&lng=en&tlng=enRupturespontaneousAneurysm, falsePatient dischargePenetrating atherosclerotic ulcerAorta, abdominalAneurysmProstheses and implantsAngiographyEndovascular proceduresTomography, X-ray computedMagnetic resonance imagingAged, 80 and overIntensive care units |
| spellingShingle | Bruno Jeronimo Ponte Viviane Galli Dib Andressa Cristina Sposato Louzada Júlia Freire Castanheiras de Paiva Ferreira Lucas Lembrança Pinheiro Cynthia de Almeida Mendes Nelson Wolosker Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgery Einstein (São Paulo) Rupture spontaneous Aneurysm, false Patient discharge Penetrating atherosclerotic ulcer Aorta, abdominal Aneurysm Prostheses and implants Angiography Endovascular procedures Tomography, X-ray computed Magnetic resonance imaging Aged, 80 and over Intensive care units |
| title | Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgery |
| title_full | Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgery |
| title_fullStr | Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgery |
| title_full_unstemmed | Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgery |
| title_short | Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgery |
| title_sort | chronic spontaneous non aneurysmal aortic rupture treated with endovascular surgery |
| topic | Rupture spontaneous Aneurysm, false Patient discharge Penetrating atherosclerotic ulcer Aorta, abdominal Aneurysm Prostheses and implants Angiography Endovascular procedures Tomography, X-ray computed Magnetic resonance imaging Aged, 80 and over Intensive care units |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082024000100512&lng=en&tlng=en |
| work_keys_str_mv | AT brunojeronimoponte chronicspontaneousnonaneurysmalaorticrupturetreatedwithendovascularsurgery AT vivianegallidib chronicspontaneousnonaneurysmalaorticrupturetreatedwithendovascularsurgery AT andressacristinasposatolouzada chronicspontaneousnonaneurysmalaorticrupturetreatedwithendovascularsurgery AT juliafreirecastanheirasdepaivaferreira chronicspontaneousnonaneurysmalaorticrupturetreatedwithendovascularsurgery AT lucaslembrancapinheiro chronicspontaneousnonaneurysmalaorticrupturetreatedwithendovascularsurgery AT cynthiadealmeidamendes chronicspontaneousnonaneurysmalaorticrupturetreatedwithendovascularsurgery AT nelsonwolosker chronicspontaneousnonaneurysmalaorticrupturetreatedwithendovascularsurgery |