Isolated giant true intercostal artery aneurysm with arteriovenous fistula: A case report

Vascular ◽  
2021 ◽  
pp. 170853812110413
Author(s):  
Kenichi Honma ◽  
Terutoshi Yamaoka ◽  
Daisuke Matsuda
Keyword(s):  
Minimally Invasive ◽  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Artery Aneurysm ◽  
Rare Condition ◽  
Intercostal Artery ◽  
Spinal Cord Infarction ◽  
Invasive Treatment ◽  
Intercostal Artery Aneurysm ◽  
The Right

Objectives Intercostal artery aneurysm (IAA) is a very rare condition. Interestingly, only one study reported a case of intercostal aneurysm caused by an arteriovenous fistula (AVF). Here, we report the case of a patient with non-ruptured isolated giant true IAA caused by an AVF (size, 28 × 41 mm). Methods Treatment options for IAA include open surgery and endovascular treatment (EVT). We chose EVT, as it is minimally invasive. The right 11th intercostal artery and aneurysm diverged from the aorta. Two outflow arteries, one inflow artery, and an AVF from the aneurysm were confirmed, and coil embolization was performed. The artery of Adamkiewicz did not communicate with the right 11th intercostal artery. We performed angiography and confirmed occlusion of IAA with endoleak. Results There were no clinical findings indicative of spinal cord infarction after treatment. The patient did not develop complications and was discharged the day after treatment. Endoleak was not observed on computed tomography angiography findings at 1 month after treatment. Conclusions In our patient, an AVF might have caused IAA. Endovascular treatment for non-ruptured isolated giant IAA is a safe and minimally-invasive treatment. We found that performing EVT is beneficial when the size of the IAA exceeds 30 mm.

scholarly journals Endovascular Treatment of Intercostal Artery Aneurysm Associated With Aortic Coarctation

2019 ◽  
Vol 108 (1) ◽  
pp. e51-e52
Author(s):  
Ryo Suzuki ◽  
Akihito Mikamo ◽  
Yuutaro Matsuno ◽  
Akira Fujita ◽  
Hiroshi Kurazumi ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Aortic Coarctation ◽  
Artery Aneurysm ◽  
Intercostal Artery ◽  
Intercostal Artery Aneurysm

scholarly journals Anterior Spinal Cord Syndrome is a Complication Following Embolisation of Bleeding Intercostal Artery in Penetrating Trauma: A Case Report

2020 ◽  
Author(s):  
Tovi Vo ◽  
Daniel Harris ◽  
Ngee Foo ◽  
Daniel Eillis
Keyword(s):  
Spinal Cord ◽  
Trauma Patient ◽  
Penetrating Trauma ◽  
Intercostal Artery ◽  
Spinal Cord Infarction ◽  
Contrast Extravasation ◽  
Transcatheter Arterial Embolisation ◽  
Arterial Embolisation ◽  
Artery Of Adamkiewicz ◽  
The Right

Abstract Background:Transcatheter arterial embolisation of intercostal vessels is a minimally invasive procedure that is increasingly being used in the management of haemothorax in the trauma patient, however significant complications – such as spinal ischaemia can occur. We present a rare case of paralysis in a patient following embolisation of the intercostal arteries due to bleeding from penetrating trauma.Case presentation:A 46-year-old male presented to the Emergency department with two stab wounds to the right posterior chest. Computed tomography scan of the chest revealed active contrast extravasation from the right 9th intercostal artery. Selective embolisation of the right 9th intercostal artery using Gelfoam® and coils as well as further embolisation of the 7th, 8th and 10th intercostal arteries was performed. Unfortunately due to ongoing bleeding and hypotension, the patient subsequently required emergency surgery that revealed two penetrating injuries to the right inferior lobe of the lung. After the patient was extubated, he was found to have bilateral motor from the level of L4 and below and sensory deficits from L2 and below. Magnetic resonance imaging of the spine showed spinal cord infarction at the level of T11 and T12 that was thought to be secondary to the embolisation of the intercostal arteries inadvertently affecting the artery of Adamkiewicz.Conclusions:Transcatheter arterial embolisation has an established roll in haemostasis of the trauma patient – particularly in intercostal arteries for the management of haemothorax. Although extremely rare, spinal complications from this procedure can be significantly life changing for the patient. The variable anatomy of the artery of Adamkiewicz should be carefully considered on a case-by-base basis in the stable trauma patient and balance of risk versus benefit be determined if the artery is unable to be identified on pre-procedure angiography.

scholarly journals Successful Endovascular Treatment for Aortic Thrombosis Due to Primary Antiphospholipid Syndrome: A Case Report and Literature Review

2018 ◽  
Vol 53 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Yoshito Kadoya ◽  
Kan Zen ◽  
Yohei Oda ◽  
Satoaki Matoba
Keyword(s):  
Endovascular Treatment ◽  
Antiphospholipid Syndrome ◽  
Laboratory Data ◽  
Ankle Brachial Index ◽  
Rare Condition ◽  
Final Diagnosis ◽  
Primary Antiphospholipid Syndrome ◽  
Aortic Thrombosis ◽  
Good Treatment Option ◽  
The Right

A 60-year-old man with a history of Raynaud’s phenomenon presented with bilateral intermittent claudication and an ulcer on his right toe. The ankle–brachial index of the right and left legs was 0.77 and 0.75, respectively. Laboratory data showed prolongation of the activated partial thromboplastin time and a positive result on the lupus anticoagulant test. Computed tomography angiography revealed isolated infrarenal aortic stenosis with irregular surface and noncalcified plaques. Intravascular ultrasonography examination demonstrated a noncalcified, irregular, and mobile plaque, suggestive of abdominal aortic thrombosis. In addition to anticoagulant and dual antiplatelet therapy, endovascular treatment was performed. A total of three 40-mm-long balloon-expandable stents were successfully implanted on a 15-mm balloon. The final angiography showed good results except for minimal plaque shifting in the terminal aorta. Three months later, the ulcer resolved and a final diagnosis of primary antiphospholipid syndrome (APS) was made. Clinicians should recognize that APS can affect the abdominal aorta, leading to aortic thrombosis. Endovascular treatment may be the one good treatment option for this rare condition.

Iliofemoral Venous Thrombosis Caused by Compression of an Internal Iliac Artery Aneurysm: A Minimally Invasive Treatment

1998 ◽  
Vol 5 (2) ◽  
pp. 142-145 ◽  
Author(s):  
David Rosenthal ◽  
John H. Matsuura ◽  
Hilde Jerius ◽  
Michael D. Clark
Keyword(s):  
Minimally Invasive ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Artery Aneurysm ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Iliac Artery Aneurysm ◽  
Venous Thrombectomy ◽  
Internal Iliac Artery Aneurysm ◽  
Internal Iliac

Purpose: To report the success of a minimally invasive treatment for phlegmasia cerulea dolens without gangrene caused by compression from an internal iliac artery aneurysm. Methods and Results: An 81-year-old male with a 1-month history of paralysis owing to a hemorrhagic stroke presented with massive edema and skin mottling of the right lower extremity. Imaging confirmed right iliofemoral deep vein thrombosis caused by compression from a 4-cm internal iliac artery aneurysm. With thrombolysis ruled out, a minimally invasive treatment plan was undertaken, featuring percutaneous coil embolization of the aneurysm and surgical venous thrombectomy with proximal arteriovenous fistula creation and iliac vein stent placement. Failure of the coils to embolize the iliac aneurysm prompted the use of an endovascular graft to exclude the aneurysm. The patient's symptoms subsided, and he has a patent right iliofemoral venous system and internal iliac artery at his latest (16-month) follow-up. Conclusions: This case demonstrates that minimally invasive endovascular and open techniques can be combined to achieve an optimum outcome in patients at high risk for standard surgical approaches.

Endovascular Therapy of a Ruptured Intercostal Artery Aneurysm

2004 ◽  
Vol 11 (2) ◽  
pp. 219-221 ◽  
Author(s):  
Ingolf Töpel ◽  
Markus Steinbauer ◽  
Christian Paetzel ◽  
Piotr M. Kasprzak
Keyword(s):  
Endovascular Therapy ◽  
Artery Aneurysm ◽  
Intercostal Artery ◽  
Intercostal Artery Aneurysm

Recurrent Massive Bleeding from an Intercostal Artery Aneurysm Through an Empyema Chest Tube

CHEST Journal ◽  
1993 ◽  
Vol 104 (2) ◽  
pp. 637-639 ◽  
Author(s):  
Petham Muthuswamy ◽  
Jacob Samuel ◽  
Barry Mizock ◽  
Patrick Dunne
Keyword(s):  
Chest Tube ◽  
Artery Aneurysm ◽  
Massive Bleeding ◽  
Intercostal Artery ◽  
Intercostal Artery Aneurysm

scholarly journals Minimally invasive treatment of spinal dural arteriovenous fistula with the use of intraoperative indocyanine green angiography

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video5 ◽  
Author(s):  
Ricardo B. Fontes ◽  
Lee A. Tan ◽  
John E. O'Toole
Keyword(s):  
Minimally Invasive ◽  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Early Mobilization ◽  
Open Approach ◽  
Minimally Invasive Approach ◽  
Invasive Treatment ◽  
Spinal Dural Arteriovenous Fistula ◽  
Invasive Approach

Spinal dural arteriovenous fistula (dAVF) is the most common vascular malformation of the spinal cord. Traditionally it is treated by the standard muscle-splitting midline approach with bilateral laminectomies extending from one level above to one level below the dAVF. We present a minimally invasive approach for ligation of dAVF with concurrent use of intraoperative indocyanine green (ICG) angiography. Minimally invasive watertight dural closure technique is also demonstrated and discussed. The minimally invasive approach with intraoperative ICG results in quicker recovery, early mobilization and shorter hospital stay compared to traditional open approach.The video can be found here: http://youtu.be/mNUeJKLxL3Q.

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