Bir Hemodiyaliz Hastasında Endovasküler Greftleme ile Tedavi Edilen Spontan Torasik Aort Yalancı Anevrizması
Spontaneous Thoracic Aortic Pseudoaneurysm Treated with Endovascular Grafting in a Hemodialysis Patient
limited with specific anatomical considerations and complications. Particularly in high risk patients, endovascular approach offers lower morbidity and mortality(2,3). A 51 year-old male patient with renal failure experienced dyspnea during dialysis. Chest radiogram revealed massive left-sided pleural effusion. Thoracic computerized tomography documented pseudoaneurysm in thoracic aorta distal to left subclavian artery (48.5x29.1 mm) (Figures 1, 2). There was no history of trauma or percutaneous/ surgical intervention; possibly the atherosclerotic plaque weakened the wall and lead to aortic rupture during a hypertensive attack and pseudoaneurysm developed. Successful endovascular treatment was performed (Figure 3). Left hemithorax was tube-drained after the procedure (defibrinated blood), because preceding intervention could decompress the pseudoaneurysm sac and lead to rupture. The postoperative course was uneventful
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- Yilmaz O, Arbatli H, Sirin G, Arpaz M, Yagan NE, Numan F, et al. Endovascular treatment of traumatic thoracic aortic aneurysms: Report of five cases and review of the literature. Ulus Travma Acil Cerrahi Derg 2010;16:575-8.
- Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, et al; American Association for the Surgery of Trauma Thoracic Aortic Injury Study Group. Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma Multicenter Study. J Trauma 2008;64:561-70.
- Yaşa H, Bayrak S, Ali Gürbüz A. Abdominal Aort Anevrizmalarında Hibrid Girişimler. Turkiye Klinikleri J Cardiovasc Surg-Special Topics 2011;3:52-60.
- Figure 2. Three dimensional reconstruction
- of thoracic aorta clearly demonstrated the
- pseudoaneurysm formation (arrow).
- Figure 3. Intraoperative angiography showed
- successful exclusion of the pseudoaneurysm sac by
- endovascular stent grafting.