Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.20190001
Jornal Vascular Brasileiro
Case Report

Pseudoaneurisma e fístula arteriovenosa da artéria femoral profunda após rotura completa do músculo vasto medial: tratamento endovascular

Pseudoaneurysm and arteriovenous fistula of the deep femoral artery after complete rupture of the vastus medialis muscle: endovascular treatment

Valter Castelli Jr; Carolina Brito Faustino; Alexandre Fioranelli; Giuliano Volpiani; Jong Hun Park; Vanessa Prado Santos; Nelson Wolosker

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Resumo

Resumo: A artéria femoral profunda, devido às suas características anatômicas, se encontra protegida da maioria dos traumatismos vasculares. Relatamos um caso de pseudoaneurisma de ramo perfurante da artéria femoral profunda, associado à fístula arteriovenosa, secundário a rotura completa do músculo vasto medial em paciente jogador de futebol. A ressonância magnética demonstrou lesão muscular associada a pseudoaneurisma, e a angiotomografia confirmou a presença de pseudoaneurisma associado a fístula arteriovenosa de ramo da artéria femoral profunda. Foi realizado tratamento endovascular da fístula através da embolização com micromolas fibradas e drenagem cirúrgica do hematoma muscular. O paciente evoluiu bem, sem queixas clínicas no 30º dia de pós-operatório e também após 1 ano.

Palavras-chave

falso aneurisma, fístula arteriovenosa, artéria femoral, embolização terapêutica

Abstract

Due to its anatomical characteristics, the deep femoral artery is protected from most vascular injuries. We report a case of a soccer player with pseudoaneurysm of a perforating branch of the deep femoral artery, associated with an arteriovenous fistula and secondary to complete rupture of the vastus medialis muscle. Magnetic resonance imaging showed muscle damage associated with a pseudoaneurysm and angiotomography confirmed the presence of a pseudoaneurysm associated with a deep arteriovenous fistula of a branch of the deep femoral artery. Endovascular treatment of the fistula was performed by embolization with fibrous microcoils and surgical drainage of the muscle hematoma. The patient recovered well, was free from clinical complaints on the 30th postoperative day and also after 1 year.

Keywords

pseudoaneurysm, A-V fistula, arteriovenous fistula, deep femoral artery, microcoil embolization.

References

1 Raherinantenaina F, Rajaonanahary TMA, Rakoto Ratsimba HN. Management of traumatic arterial pseudoaneurysms as a result of limb trauma. Formosan J Surg. 2016;49(3):89-100. http://dx.doi.org/10.1016/j.fjs.2016.04.001.

2 Naouli H, Jiber H, Bouarhroum A. False aneurysm of perforating branch of the deep femoral artery – Report of two cases. Int J Surg Case Rep. 2015;14:36-9. http://dx.doi.org/10.1016/j.ijscr.2015.07.001. PMid:26217914.

3 Hadzimehmedagic A, Vranic H, Gavrankapetanovic I, et al. Treatment of rare posttraumatic false aneurism and A-V fistula of the deep femoral artery and vein. Med Arh. 2010;64(1):53-4. PMid:20422829.

4 Mahadevan V. Cíngulo do membro inferior e membros inferiores. In: Standring S. Gray’s Anatomia. 40th ed. Rio de Janeiro: Elsevier; 2010. p. 1329-410.

5 Roy KD, Aggarwal RA, Purohit S, Bandagi G, Marathe N. Iatrogenic Pseudo-aneurysm of profunda femoris artery following fixation of intertrochanteric femur fracture – A case report and review of literature. J Clin Diagn Res. 2016;10(3):RD01-03. http://dx.doi.org/10.7860/JCDR/2016/17818.7437. PMid:27134957.

6 Neubauer T, Grechenig S, Leitner L, Auffarth A, Plecko M. Vascular complications in plating of the proximal femur. Arch Orthop Trauma Surg. 2016;136(4):539-51. http://dx.doi.org/10.1007/s00402-015-2406-4. PMid:26762137.

7 Hamaguchi S, Ogawa Y, Arai Y, Hashimoto K, Nakajima Y. A case of pseudoaneurysm of the deep femoral artery sucessfully treated by NBCA embolization under oclusion. Jpn J Radiol. 2013;31(8):538-41. http://dx.doi.org/10.1007/s11604-013-0207-7. PMid:23605126.

8 Kim JW, Lee JI, Park KC. Pseudoaneurysm of the deep femoral artery caused by a guide wire following femur intertrochanteric fracture with a hip nail: a case report. Acta Orthop Traumatol Turc. 2017;51(3):266-9. http://dx.doi.org/10.1016/j.aott.2017.03.011. PMid:28457795.

9 Khoshnevis J, Sobhiyeh MR, Fallah Zavareh M. Deep femoral artery branch pseudoaneurysm after orthopedic procedure requiring surgical treatment: a case report. Trauma Mon. 2012;17(2):305-8. http://dx.doi.org/10.5812/traumamon.5181. PMid:24350112.

10 Ocke Reis PE, Roever L, Ocke Reis IF, et al. Endovascular stent grafting of a deep femoral artery pseudoaneurysm. EJVES Short Rep. 2016;33:5-8. http://dx.doi.org/10.1016/j.ejvssr.2016.07.004. PMid:28856315.

11 Piolanti N, Giuntoli M, Nucci AM, Battistini P, Lisanti M, Andreani L. Profunda femoris artery pseudoaneurysm after intramedullary fixation for a pertrochanteric hip fracture. J Orthop Case Rep. 2017;7(2):74-7. PMid:28819608.

12 Cavalcante LP, Scarpari R, Queiróz TM, et al. Embolização de pseudoaneurisma com fístula arteriovenosa de artéria femoral profunda decorrente de ferimento por arma branca: relato de caso. J Vasc Bras. 2015;14(2):182-5. http://dx.doi.org/10.1590/1677-5449.0081.

13 How MI, Lee PK, Wei TS, Chong CT. Delayed presentation of compartment síndrome of the thigh secondary to quadriceps trauma and vascular injury in a soccer athlete. Int J Surg Case Rep. 2015;11:56-8. http://dx.doi.org/10.1016/j.ijscr.2015.04.003. PMid:25931302.
 


Submitted date:
10/13/2019

Accepted date:
05/14/2020

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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