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Behcet's disease is a multisystem inflammatory disorder, whose vascular involvement is very rare. Aneurysmal arterial involvement is the severe form of the disease, it constitutes a therapeutic challenge given its severity, and frequent secondary complications. Profunda femoral artery aneurysms (PFAAs) are extremely rare. The systematic immunosuppressive drug treatment and endovascular or surgical technique thoroughness can reduce relapse rate. We report the case of a young man in whom a false aneurysm of the profunda femoral artery revealed Behcet's disease. He underwent an endovascular treatment by embolization using coils; with good control after 3 months.
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INTRODUCTION: Psoriasis, a chronic inflammatory skin condition, affects 4 % of the population and is associated with various comorbidities, making it a public health concern. CASE REPORT: We discuss the case of a 50-year-old man with severe erythrodermic psoriasis who presented with a ruptured saccular abdominal aortic aneurysm (AAA), requiring emergency surgery with good postoperative follow-up. shedding light on the link between psoriasis and cardiovascular complications. DISCUSSION: Psoriasis severity correlates with cardiovascular risk and shares common development pathways with aortic aneurysms such as systemic and aortic inflammation, and arterial stiffness, emphasizing the importance of managing both skin symptoms and systemic inflammation to reduce vascular comorbidities. Psoriasis patients have a higher risk of AAA, warranting consideration for AAA screening. Controversies exist regarding corticosteroid therapy and choice of surgical intervention for AAA in psoriatic patients. CONCLUSION: Psoriasis patients face an increased risk of AAA, highlighting the need for vigilant screening and comprehensive management. Further research is essential to understanding the pathophysiological connections between psoriasis and arterial diseases, guiding preventive strategies and optimal medical treatments for these high-risk patients.
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Mycotic pseudoaneurysms of the iliac arteries are extremely rare and are caused by infection of the artery wall. It is difficult to diagnose early due to its silent manifestation. We present a case of a 64-year-old man with an isolated left common iliac artery pseudoaneurysm caused by Candida albicans who presented with thrombophlebitis, abdominal pain, nausea and vomiting associated with fever, which was successfully treated with interposition grafting and antibiotic therapy. We present this case to highlight that aneurysms and other vascular lesions can affect different arteries in the body and may therefore only be discovered during routine investigations of non-specific symptoms.
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INTRODUCTION AND IMPORTANCE: Intraparenchymal renal artery aneurysms are a really rare condition that represents <10 % of all renal artery aneurysms. They are more often caused by trauma or iatrogenic injury and their rupture can lead to life-threatening hemorrhage. CASE PRESENTATION: We report the case of a 25-year-old male with history of back stab wound three months before being admitted to our unity. The patient presented a macroscopic hematuria three days after the injury. An abdominal CT angiography revealed an intraparenchymal renal artery aneurysm, and it was successfully treated with super selective endovascular coil embolization, achieving both pseudoaneurysm exclusion and renal preservation. CLINICAL DISCUSSION: Intraparenchymal renal artery aneurysms are rare. They are more often caused by trauma or iatrogenic injury. Renal artery pseudoaneurysms are mainly asymptomatic. Renal pseudoaneurysms can be diagnosed through contrast enhanced CT, renal Doppler ultrasound, or MRI. Super selective embolization of the feeding artery of the pseudoaneurysm using endovascular techniques is the treatment of choice. CONCLUSION: The management of patients with renal pseudo aneurysms should allow to achieve two main goals: Preserving Renal function, and excluding the pseudoaneurysm.
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INTRODUCTION: Subclavian steal syndrome (SSS) is the hemodynamic phenomenon of blood flow reversal in the vertebral artery due to significant stenosis or occlusion of the proximal ipsilateral subclavian artery. MATERIALS AND METHODS: Four patients with subclavian steal syndrome were treated in our center. Percutaneous radial approach was used for angioplasty, primary stenting of subclavian artery was performed, surgical techniques in particular carotid-subclavian bypass and carotid-subclavian transposition were used. RESULTS: We report the cases of four patients, three of which are male, with an average age of 60 years. All of them were symptomatic. Diagnosis was made by duplex ultrasound, supplemented by CT-angiography and arteriography. Endovascular treatment was attempted in all four patients, which was successful in two patients, who underwent primary stenting, and failed for the two others, for whom surgical treatment was considered. One had a subclavio-carotid bypass graft with a polytetrafluorethylene (PTFE) prosthesis and the other had a subclavio-carotid transposition. The technical results were satisfactory in all patients with symptoms resolution. The postoperative evolution was without notable complications and the postoperative checkups were satisfactory. DISCUSSION: There are excellent screening tools and effective medical therapies which can be instituted if the SSS is diagnosed early. When the need for revascularization arises, percutaneous modalities are favored given their proven long-term efficacy, decreased morbidity and mortality, and cost-effectiveness. Nevertheless, large, prospective, randomized and controlled trials are needed to compare the long-term patency rates between the endovascular and surgical techniques.
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INTRODUCTION: Mycobacterium tuberculosis is a cause of mycotic aortic pseudoaneurysms, wich are a rare case with high mortality rates. Three types of dissemination hematogenous by contiguity and direct to the aortic wall are possibles. PRESENTATION OF CASE: We report a rare case of tuberculous thoracic aortic pseudo aneurysm, successfully treated endovascularly associated to antituberculosis drugs. DISCUSSION: Classically TB pseudoaneurisms have been treated with open surgical therapy.however, they are associated to high morbidity and mortaity with increased lenghts of hospital stay. Due to advancements of endovascular technology, it be cames a good and successful alternative as a treatment, with a background of medical treatment. CONCLUSION: Thoracic endovascular aneurysm repair (TEVAR) associated to anti-tuberculosis medication have revolutionized the management and improved the prognosis of this pathology.
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INTRODUCTION: Traumatic Arteriovenous Fistulas (AVFs) are a rare complication of vascular injuries and pose a problem of topographic diagnosis and therapeutic management. Delayed treatment may cause cardiac and trophic complications. PRESENTATION OF CASES: We describe 4 cases of AVFs complicating stab wounds of the lower limb, associated in 2 cases with pseudoaneurysms. DISCUSSION: In two cases we performed a surgical repair, whereas in the other 2 patients we choose an endovascular treatment with wall graft stent placement. CONCLUSION: All traumatic AVFs must be treated to avoid vascular, local and general complications. Using both techniques, we had great results with no complications.
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INTRODUCTION: The occurrence of synchronous abdominal aorta aneurysms and colorectal cancer represents a real management challenge. Up till now, there is no evidence-based consensus recommendation in the surgical management of such patients. Herein we reported the clinical management challenge of synchronous abdominal aorta aneurysms (AAA) and colorectal cancer (CRC). PRESENTATION OF CASE: 78-year-old man was admitted in our structure for acute abdominal pain, vomiting and constipation. His past medical history included type 2 diabetes, arterial hypertension and a stable infra-renal aortic aneurysm documented 2 years ago. Physical examination found a stable patient with blood pressure and heart rate within normal range, pulsatile mass along with abdominal distension with vital signs within normal limits. Abdominal CT scan and subsequent CT angiogram confirmed an 88 × 75 mm infra-renal aortic aneurysm concomitant with considerable lumen reduction due to asymmetric wall thickening of the sigmoid. Colonoscopy combined with biopsy examination confirmed structuring irregular sigmoid adenocarcinoma Therefore we report a case of a large AAA and concomitant sigmoid adenocarcinoma tumor causing stricture. DISCUSSION: In such situation, the main controversy is the necessity of treating the diseases simultaneouslor in two stages favoring the AAA management first. To our best knowledge, we report the first case published in literature in which the patient was treated for colorectal cancer first by laparoscopic surgery followed by AAA management with EVAR. CONCLUSION: In this case report, we highlight some tricks required in performing laparoscopic sigmoid colectomy for patient with large AAA to prevent per-operative pitfalls. Evidence-based consensus is required to determine the optimal surgical treatment.
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INTRODUCTION: Horseshoe Kidney (HSK) is probably the most common of all renal fusion abnormalities. However the association of Abdominal aortic aneurism (AAA) and HSK is rare, and occurred in 0,12% of patient affected by AAA. PRESENTATION OF CASE: We present a patient with the concomitant presence of AAA and HSK treated by open surgical repair with a transperitoneal approach without section of the isthmus with great outcomes after surgery. DISCUSSION: The management of AAA associated with HSK presents a special challenge during vascular surgery, given the close spatial relationship and the frequent renal arterial variations that accompanies HSK. CONCLUSION: Diagnosis and a well designed surgical strategy are required to avoid surgical post operative complications.
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Exostoses or osteochondromas are benign osseous tumors that develop on the bone surface and can be sporadic or hereditary. Their evolution is generally benign, but they may be complicated in some patients by conflicts with the surrounding nervous or vascular structures, in particular arteries. We report a case of false aneurysm of the popliteal artery secondary to an isolated exostosis of the left femur in a 20-year-old woman. A delay in the diagnosis allowed the development of the false aneurysm, which was at the origin of a major venous compression. The surgical treatment consisted in aneurysmectomy and reconstruction by end-to-end anastomosis associated with the resection of the osseous tumor, and the deep venous thrombosis was treated medically.