Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.20210223
Jornal Vascular Brasileiro
Case Report

Successful endovascular repair with coil embolization of ruptured right internal thoracic artery aneurysm

Reparo endovascular bem-sucedido de aneurisma da artéria torácica interna direita roto com embolização com molas

Yamasandi Siddegowda Shrimanth; Atit A. Gawalkar; Parag Barwad; Soumitra Ghosh; Samman Verma; Arun Sharma; Sanjeev Naganur

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Abstract

Abstract: Internal thoracic artery aneurysms (ITAAs) are rare with wide variation in clinical presentation and a high risk of rupture. Endovascular techniques are increasingly being used for treatment of such aneurysms over surgical repair in recent times. A 34-year-old male presented with progressive swelling of the right anterior chest wall for 2 weeks and was diagnosed with right internal thoracic artery aneurysm with contained rupture. He underwent successful endovascular repair with coil embolization of ruptured right ITAA. Post intervention computed tomography (CT) angiography confirmed sealing of the ruptured aneurysm with no residual filling of the sac. At six months follow-up he is doing well with complete resolution of hematoma. This case demonstrates that an endovascular approach with coil embolization is a feasible and safe option for treating the rare ruptured ITAAs.

Keywords

internal thoracic artery aneurysm, aneurysm rupture, coil embolization, endovascular repair, CT angiography, percutaneous repair

Resumo

Resumo: Os aneurismas da artéria torácica interna (ITAAs) são raros, com ampla variação na apresentação clínica e alto risco de ruptura. As técnicas endovasculares têm sido cada vez mais utilizadas para o tratamento desses aneurismas em relação ao reparo cirúrgico. Um homem de 34 anos de idade apresentou edema progressivo da parede torácica anterior direita por 2 semanas e foi diagnosticado com aneurisma da artéria mamária interna direita com ruptura contida. Ele foi submetido a reparo endovascular bem-sucedido, com embolização de ITAA direito roto. A angiotomografia computadorizada (angioTC) pós-intervenção confirmou o selamento do aneurisma rompido, sem enchimento residual do saco. No seguimento de 6 meses, ele estava bem, com resolução completa do hematoma. Este caso demonstra que a abordagem endovascular com embolização com molas é uma opção viável e segura no tratamento dos raros ITAAs rotos.
 

Palavras-chave

aneurisma da artéria torácica interna, ruptura do aneurisma, embolização com molas, reparo endovascular, angiotomografia, reparo percutâneo

References

1 Lawani O, Ganim J, Ganim R. Incidental finding and endovascular repair of a left internal mammary artery aneurysm following a multivessel coronary artery bypass graft. Case Rep Cardiol. 2021;2021:e8831235. http://dx.doi.org/10.1155/2021/8831235. PMid:33680518.

2 Heyn J, Zimmermann H, Klose A, Luchting B, Hinske C, Sadeghi-Azandaryani M. Idiopathic internal mammary artery aneurysm. J Surg Case Rep. 2014;2014(12):rju125. http://dx.doi.org/10.1093/jscr/rju125. PMid:25452261.

3 Piffaretti G, Carrafiello G, Franchin M, et al. Stent-graft repair of a true internal thoracic artery aneurysm. Ann Vasc Surg. 2015;29(7):1452.e11-5. http://dx.doi.org/10.1016/j.avsg.2015.04.072. PMid:26164363.

4 Almerey T, Paz-Fumagalli R, Farres H, Oldenburg WA, Hakaim AG. Idiopathic internal mammary artery aneurysm in the setting of aberrant right subclavian artery. J Vasc Surg Cases Innov Tech. 2017;3(4):251-3. http://dx.doi.org/10.1016/j.jvscit.2017.10.006. PMid:29349438.

5 San Norberto EM, Cilleruelo A, Martin-Pedrosa M, Taylor J, Garcia-Yuste M, Vaquero C. Endovascular treatment of posttraumatic pseudoaneurysm of the internal mammary artery. Ann Vasc Surg. 2014;28(3):743.e1-5. http://dx.doi.org/10.1016/j.avsg.2013.06.034. PMid:24556180.

6 Bohatch MS Jr, Tanure T, Oliveira AL, Ribeiro MS, Joviliano EE. Endovascular treatment of left internal thoracic artery aneurysm. J Vasc Bras. 2020;19:e20200042. http://dx.doi.org/10.1590/1677-5449.200042. PMid:34178077.

7 Alhawasli H, Darki A, Lewis BE. Endovascular repair of bilateral internal mammary artery aneurysms in a patient with Marfan syndrome: a case report. Int J Angiol. 2016;25(5):e39-42. PMid:28031650.

8 Miyazaki M, Nagamine H, Hara H, Sugita H, Kawase Y. Successful treatment of a right internal mammary artery aneurysm with thoracoscopic surgery. J Vasc Surg Cases Innov Tech. 2019;5(3):269-72. http://dx.doi.org/10.1016/j.jvscit.2019.03.006. PMid:31304439.
 

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