Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492010005000002
Jornal Vascular Brasileiro
Relato de Caso

Tratamento endovascular de pseudoaneurisma de aorta torácica: relato de caso

Endovascular treatment of thoracic aortic pseudoaneurysm: case report

Luis Carlos Mendes de Brito; João de Toledo Martins; Ovanil Furlani Júnior; Sérgio Penteado de Camargo Oliveira Júnior; Azis Arruda Chagury; Karina Ribeiro Cavalcante Tavares

Downloads: 0
Views: 1189

Resumo

Paciente de 31 anos vítima de acidente automobilístico apresentou falta de ar inspiratória progressiva acompanhada de dor dissecante no tórax, de forte intensidade, sem irradiação; Glasgow 15 e ISS 26 (16 + 9 + 1); exames laboratoriais e radiográficos compatíveis com a normalidade. Foi operado de fratura de tíbia 1 dia depois, tendo recebido alta 3 dias depois da entrada no serviço. No entanto, foi piorando da falta de ar e da dor torácica, retornando para nova consulta 2 dias após a alta hospitalar. Foi realizada tomografia computadorizada helicoidal que revelou pseudoaneurisma de aorta torácica. Optou-se por tratamento endovascular com implante de endoprótese.

Palavras-chave

Pseudoaneurisma, aorta torácica, traumatismos torácicos

Abstract

A 31-year-old car accident victim was admitted with progressive inspiratory dyspnea, followed by intense dissecting thoracic pain, without any irradiation. The patient’s Glasgow score was 15, while his ISS was 26 (16 + 9 + 1). Laboratory and radiographic results were normal. One day after hospital admission, the patient underwent surgery due to a fractured tibia, being discharged from hospital 3 days later. However, worsening shortness of breath and thoracic pain were observed and he returned to the hospital 2 days later. A helical computed tomography was done revealing a thoracic aortic pseudoaneurysm. Endovascular surgery with endoprosthesis implantation was the treatment of choice.

Keywords

Pseudoaneurysm, thoracic aorta, thoracic injuries

Referências

Giannini JÁ, Soldá SC, Saad Júnior R. Trauma de tórax. Emergências traumáticas e não traumáticas. 2001:57-69.

LoCicero J 3rd, Mattox KL. Epidemiology of chest trauma. Surg Clin North Am.. 1989;69:15-9.

Calhoon JH, Trinkle JK. Pathophysiology of chest trauma. Chest Surg Clin N Am.. 1997;7:199-211.

Cuba RM, Bezerra JA. Traumatismo torácico: estudo retrospectivo de 168 casos. Rev Col Bras Cir.. 2005;32:57-9.

Bansal V, Lee J, Coimbra R. Current diagnosis and management of blunt traumatic rupture of the thoracic aorta. J Vasc Bras.. 2007;6:64-73.

Buz S, Zipfel B, Mulahasanovic S, Pasic M, Weng Y, Hetzer R. Conventional surgical repair and endovascular treatment of acute traumatic aortic rupture. Eur J Cardiothorac Surg.. 2008;33:143-9.

Tang GL, Tehrani HY, Usman A. Reduced mortality, paraplegia, and stroke with stent graft repair of blunt aortic transections: a modern meta-analysis. J Vasc Surg. 2008;47:671-5.

Walsh SR, Tang TY, Sadat U, et al. Endovascular stenting versus open surgery for thoracic aortic disease: systematic review and meta-analysis of perioperative results. J Vasc Surg.. 2008;47:1094-8.

Moainie SL, Neschis DG, Gammie JS. Endovascular stenting for traumatic aortic injury: an emerging new standard of care. Ann Thorac Surg.. 2008;85:1625-9.

Orend KH, Zarbis N, Schelzig H, Halter G, Lang G, Sunder-Plassmann L. Endovascular treatment (EVT) of acute traumatic lesions of the descending thoracic aorta: 7 years’ experience. Eur J Vasc Endovasc Surg.. 2007;34:666-72.

EVAR Trial Participants. Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysms (EVAR 1 Trial): Randomized controlled trial. Lancet.. 2005;365:2179-86.

Blankensteijn JD, de Jong SE, Prinssen M. Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. N Engl J Med.. 2005;352:2398-405.

Ott MC, Stewart TC, Lawlor DK, Gray DK, Forbes TL. Management of blunt thoracic aortic injuries: endovascular stents versus open repair. J Trauma.. 2004;56:565-70.

Bown MJ, Sutton AJ, Bell PR, Sayers RD. A meta-analysis of 50 years of ruptured abdominal aortic aneurysm repair. Br J Surg.. 2002;89:714-30.

Aun R. Ruptura traumática da aorta por traumatismo torácico fechado. J Vasc Bras.. 2007;6:5-6.

Mioto Neto B, Aun R, Estenssoro AE, Puech-Leão P. Tratamento das lesões de aorta nos traumatismos torácicos fechados.. J Vasc Bras.. 2005;4:217-26.

Bush RL, Johnson ML, Collins TC. Open versus endovascular abdominal aortic aneurysm repair in VA hospitals. J Am Coll Surg. Apr. 2006;202:577-87.

Saratzis N, Melas N, Saratzis A, Lazaridis J, Kiskinis D. Minimally invasive endovascular intervention in emergent and urgent thoracic aortic pathologies: single center experience. Hellenic J Cardiol.. 2008;49:312-9.

Dick F, Hinder D, Immer FF. Outcome and quality of life after surgical and endovascular treatment of descending aortic lesions. Ann Thorac Surg.. 2008;85:1605-12.

Mohan IV, Hitos K, White GH. Improved outcomes with endovascular stent grafts for thoracic aorta transections. Eur J Vasc Endovasc Surg.. 2008;36:152-7.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5de15d080e88257f514ce1d5 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections