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A case of endovascular therapy for treating idiopathic arterial deteriorations of unknown etiology

INTRODUCTION: Peripheral artery pseudoaneurysm as a consequence of arterial deterioration is relatively rare in young populations, who typically lack an atherosclerotic background. Such pseudoaneurysms are known to pose a risk of rupture, which is correlated with high mortality and morbidity rates....

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Autores principales: Matsuura, Sohei, Takayama, Toshio, Endo, Takashi, Akai, Takafumi, Isaji, Toshihiko, Hoshina, Katsuyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560634/
https://www.ncbi.nlm.nih.gov/pubmed/33039783
http://dx.doi.org/10.1016/j.ijscr.2020.09.178
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author Matsuura, Sohei
Takayama, Toshio
Endo, Takashi
Akai, Takafumi
Isaji, Toshihiko
Hoshina, Katsuyuki
author_facet Matsuura, Sohei
Takayama, Toshio
Endo, Takashi
Akai, Takafumi
Isaji, Toshihiko
Hoshina, Katsuyuki
author_sort Matsuura, Sohei
collection PubMed
description INTRODUCTION: Peripheral artery pseudoaneurysm as a consequence of arterial deterioration is relatively rare in young populations, who typically lack an atherosclerotic background. Such pseudoaneurysms are known to pose a risk of rupture, which is correlated with high mortality and morbidity rates. Pseudoaneurysms are more prone to rupture than true aneurysms are, as their vessel walls tear more easily. We present the case of a 50-year-old patient who had multiple arterial deteriorations. CASE PRESENTATION: The patient experienced backache, and computed tomography revealed a tear of the right renal artery, and a pseudoaneurysm of the left internal iliac artery. He had a history of graft replacement for the right superficial artery pseudoaneurysm, which had been occluded. Although various tests were performed for differential diagnosis, the etiology was unidentified. Considering the suspected vascular fragility and failure of previous direct intervention, these 2 lesions were treated by placing endografts simultaneously. DISCUSSION: We investigated various diseases causing vascular fragility in the reported case, such as vascular Behçet disease, vascular Ehlers-Danlos syndrome, fibromuscular dysplasia, and segmental arterial mediolysis. However, these were all excluded and the etiology remains unclear. Progress in endovascular techniques enables the use of minimally invasive treatment in patients with vascular fragility. CONCLUSION: When vascular fragility may exist, endovascular treatment is a desirable option, as it can be performed repetitively and is less invasive.
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spelling pubmed-75606342020-10-20 A case of endovascular therapy for treating idiopathic arterial deteriorations of unknown etiology Matsuura, Sohei Takayama, Toshio Endo, Takashi Akai, Takafumi Isaji, Toshihiko Hoshina, Katsuyuki Int J Surg Case Rep Case Report INTRODUCTION: Peripheral artery pseudoaneurysm as a consequence of arterial deterioration is relatively rare in young populations, who typically lack an atherosclerotic background. Such pseudoaneurysms are known to pose a risk of rupture, which is correlated with high mortality and morbidity rates. Pseudoaneurysms are more prone to rupture than true aneurysms are, as their vessel walls tear more easily. We present the case of a 50-year-old patient who had multiple arterial deteriorations. CASE PRESENTATION: The patient experienced backache, and computed tomography revealed a tear of the right renal artery, and a pseudoaneurysm of the left internal iliac artery. He had a history of graft replacement for the right superficial artery pseudoaneurysm, which had been occluded. Although various tests were performed for differential diagnosis, the etiology was unidentified. Considering the suspected vascular fragility and failure of previous direct intervention, these 2 lesions were treated by placing endografts simultaneously. DISCUSSION: We investigated various diseases causing vascular fragility in the reported case, such as vascular Behçet disease, vascular Ehlers-Danlos syndrome, fibromuscular dysplasia, and segmental arterial mediolysis. However, these were all excluded and the etiology remains unclear. Progress in endovascular techniques enables the use of minimally invasive treatment in patients with vascular fragility. CONCLUSION: When vascular fragility may exist, endovascular treatment is a desirable option, as it can be performed repetitively and is less invasive. Elsevier 2020-09-30 /pmc/articles/PMC7560634/ /pubmed/33039783 http://dx.doi.org/10.1016/j.ijscr.2020.09.178 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Matsuura, Sohei
Takayama, Toshio
Endo, Takashi
Akai, Takafumi
Isaji, Toshihiko
Hoshina, Katsuyuki
A case of endovascular therapy for treating idiopathic arterial deteriorations of unknown etiology
title A case of endovascular therapy for treating idiopathic arterial deteriorations of unknown etiology
title_full A case of endovascular therapy for treating idiopathic arterial deteriorations of unknown etiology
title_fullStr A case of endovascular therapy for treating idiopathic arterial deteriorations of unknown etiology
title_full_unstemmed A case of endovascular therapy for treating idiopathic arterial deteriorations of unknown etiology
title_short A case of endovascular therapy for treating idiopathic arterial deteriorations of unknown etiology
title_sort case of endovascular therapy for treating idiopathic arterial deteriorations of unknown etiology
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560634/
https://www.ncbi.nlm.nih.gov/pubmed/33039783
http://dx.doi.org/10.1016/j.ijscr.2020.09.178
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