Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492006000400015
Jornal Vascular Brasileiro
Case Report

Tratamento endovascular do aneurisma da aorta abdominal em paciente com insuficiência renal crônica

Endovascular treatment of abdominal aortic aneurysm in a patient with chronic renal failure

Cleoni Pedron; Ana Carla M. Palis; Arno von Ristow; Alberto Vescovi; Bernardo Massière; José Mussa Cury Filho; Marcus Gress; Antonio Luiz de Medina

http://dx.doi.org/10.1590/S1677-54492006000400015 J Vasc Bras, vol.5, n4, p.325-330, 2006
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Resumo

A insuficiência renal crônica não-dialítica é uma contra-indicação relativa ao tratamento endovascular dos aneurismas da aorta abdominal. O uso de contrastes alternativos, como o gadolínio, além de fornecer imagens de baixa qualidade, está relacionado à nefrotoxicidade. Relatamos um caso de tratamento endovascular de aneurisma da aorta abdominal guiado por eco-Doppler colorido. Um paciente masculino de 82 anos, com aneurisma da aorta abdominal de 55 mm de diâmetro e clearance de creatinina de 17 ml/min, recebeu implante de endoprótese aórtica modular bifurcada, utilizando este método de imagem associado à radioscopia. Não foi empregado contraste iodado. O resultado imediato e os controles de 1 e 6 meses revelam completa exclusão do aneurisma. A função renal permanece inalterada. Concluímos que o implante de endoprótese guiado por eco-Doppler colorido em pacientes com insuficiência renal crônica não terminal e com anatomia favorável é um método factível e seguro.

Palavras-chave

Tratamento endovascular, aneurisma aórtico abdominal, insuficiência renal, eco-Doppler colorido, duplex scan

Abstract

Non-dialytic chronic renal failure is a contraindication related to the endovascular treatment of abdominal aortic aneurysms. The use of alternative contrast agents, such as gadolinium, provides good-quality images and is associated with nephrotoxicity. We report a case of endovascular treatment of an abdominal aortic aneurysm guided by color-flow Doppler ultrasonography. An 82-year-old male patient, with abdominal aortic aneurysm (55 mm in diameter) and creatinine clearance of 17 ml/min, underwent implantation of modular bifurcated aortic stent-graft, using that imaging method associated with radioscopy. Iodinated contrast was not used. The immediate result and 1- and 6-month controls showed complete aneurysm exclusion. Renal function is still unaltered. We conclude that the stent-graft implantation guided by color-flow Doppler ultrasonography in patients with nonterminal chronic renal failure and with favorable anatomy is a feasible and safe method.

Keywords

Endovascular treatment, abdominal aortic aneurysm, renal failure, color-flow Doppler ultrasonography, duplex scan

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