Aneurisma Isolado de Artérias Ilíacas - Relato de Caso / Isolated Iliac Artery Aneurysm - Case Report
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Abstract
RESUMO
Introdução: Os aneurismas de artérias ilíacas (AAI) isolados são condições raras, ocorrendo em somente 1% dos aneurismas periféricos. O tratamento endovascular é atualmente a opção de escolha à cirurgia aberta, porém ainda é sujeito a complicações no intra e pós-procedimento. Relato: Sexo masculino, 77 anos, hipertenso, portador de AAI comuns simultâneos foi submetido à correção endovascular através de implante de extensões ilíacas de endopróteses de aorta abdominal e embolização da artéria ilíaca interna esquerda. Após 50 dias houve trombose de todo o segmento ilíaco esquerdo e embolização distal. Realizada fibrinólise intra-arterial (sem sucesso), implante de stents auto expansíveis no segmento ilíaco esquerdo e trombectomia através de acesso femoral superficial. O paciente manteve-se assintomático, sem sequelas neurológicas, com pulso distal presente após um ano de acompanhamento. Conclusão: O tratamento endovascular dos AAI e a correção de suas complicações através de técnicas híbridas são opções factíveis, com bons resultados a curto e médio prazo.
Palavras-chave: Aneurisma ilíaco, Angiografia digital, Implante de prótese vascular.
ABSTRACT
Introduction: Isolated iliac arteries aneurysms (IAA) are rare conditions, occurring in only 1% of all peripheral aneurysms. Endovascular treatment is currently the preferred method compared to open surgery, but it is still prone to intra- and post-procedure complications. Case report: Male, 77 years, hypertension, with simultaneous common isolated IAA, underwent endovascular repair through implantation of two iliac extensions of abdominal aortic stent graft, and coil embolization of the left internal iliac artery. After 50 days thrombosis of the entire left iliac segment and distal embolization was observed. Intra-arterial fibrinolysis was performed (unsuccessfully), followed by implantation of self-expanding stents in the left iliac segment and thrombectomy through superficial femoral access. The patient remained asymptomatic without neurological sequelae, with palpable distal pulses after one year of follow-up. Conclusion: Endovascular treatment of IAA and treatment of its complications through hybrid techniques are feasible options, with good results in the short and medium-term.
Keywords: Iliac aneurysm, Digital subtraction angiography, Blood vessel prosthesis implantation
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