Successful endovascular coil embolization of large pseudoaneurysm of ductus arteriosus diverticulum.
Identifieur interne : 000698 ( Main/Exploration ); précédent : 000697; suivant : 000699Successful endovascular coil embolization of large pseudoaneurysm of ductus arteriosus diverticulum.
Auteurs : David Buechner [États-Unis] ; Veronica Lippuner [États-Unis] ; Kristine Demaio [États-Unis] ; F Daniel Donovan [États-Unis] ; Philip R. Weber [États-Unis] ; G Phillip Schoettle [États-Unis]Source :
- CVIR endovascular [ 2520-8934 ] ; 2019.
Abstract
BACKGROUND
Pseudoaneurysm of the ductus arteriosus diverticulum, although rare in adults, may have catastrophic consequences if left untreated due to erosion and rupture of the pseudoaneurysm into adjacent thoracic structures. Although thoracic endovascular aortic repair (TEVAR) is the standard treatment method for aneurysm closure of the ductus arteriosus diverticulum, it was not possible in our patient secondary to marked aortoiliac access vessel tortuosity, significant vascular calcific burden, and an abdominal aortic aneurysm. We describe the first reported case of endovascular coil embolization being successfully used as the definite repair of a ductus arteriosus diverticulum pseudoaneurysm.
CASE PRESENTATION
An 85-year-old man with history of severe coronary arterial disease presented with an enlarging pseudoaneurysm of a ductus arteriosus diverticulum. The diverticulum and thoracic aortic junction demonstrated the typical obtuse angles and wide neck, differentiating it from otherwise similar-appearing diagnostic considerations. Repair was attempted with conventional aortic stent graft but the patient's infrarenal abdominal aortic aneurysm and his heavily calcified, tortuous iliac vessels could not accommodate the 24Fr introducer sheath necessary for stent graft placement. Therefore, endovascular coil embolization was successfully completed through a 4Fr directional catheter. The patient tolerated the procedure well and was discharged from the hospital in good condition on post-embolization day six.
CONCLUSIONS
Endovascular coil embolization is an alternative treatment for ductus arteriosus diverticulum pseudoaneurysm closure in cases where the standard TEVAR method is unsuccessful. Instead of the wide entry point at the aorta we used the junction of the diverticulum and pseudoaneurysm as the "neck" for satisfactory and stable coil placement. Endovascular coil embolization alone may be a viable definitive therapy for occlusion of the ductus pseudoaneurysm component of the diverticulum in cases where complex anatomy or extensive vascular disease makes stent graft repair impractical if not impossible.
DOI: 10.1186/s42155-019-0053-5
PubMed: 32026144
PubMed Central: PMC6966358
Affiliations:
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embolization of large pseudoaneurysm of ductus arteriosus diverticulum.</title><author><name sortKey="Buechner, David" sort="Buechner, David" uniqKey="Buechner D" first="David" last="Buechner">David Buechner</name><affiliation wicri:level="1"><nlm:affiliation>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138, USA. dbuechner64@gmail.com.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138</wicri:regionArea><wicri:noRegion>38138</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA. dbuechner64@gmail.com.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation></author><author><name sortKey="Lippuner, Veronica" sort="Lippuner, Veronica" uniqKey="Lippuner V" first="Veronica" last="Lippuner">Veronica Lippuner</name><affiliation wicri:level="1"><nlm:affiliation>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138, USA. lippunerv@memrad.net.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138</wicri:regionArea><wicri:noRegion>38138</wicri:noRegion></affiliation></author><author><name sortKey="Demaio, Kristine" sort="Demaio, Kristine" uniqKey="Demaio K" first="Kristine" last="Demaio">Kristine Demaio</name><affiliation wicri:level="2"><nlm:affiliation>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation></author><author><name sortKey="Donovan, F Daniel" sort="Donovan, F Daniel" uniqKey="Donovan F" first="F Daniel" last="Donovan">F Daniel Donovan</name><affiliation wicri:level="1"><nlm:affiliation>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138</wicri:regionArea><wicri:noRegion>38138</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation></author><author><name sortKey="Weber, Philip R" sort="Weber, Philip R" uniqKey="Weber P" first="Philip R" last="Weber">Philip R. Weber</name><affiliation wicri:level="1"><nlm:affiliation>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138</wicri:regionArea><wicri:noRegion>38138</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation></author><author><name sortKey="Schoettle, G Phillip" sort="Schoettle, G Phillip" uniqKey="Schoettle G" first="G Phillip" last="Schoettle">G Phillip Schoettle</name><affiliation wicri:level="2"><nlm:affiliation>Thoracic and Cardiovascular Surgery, Methodist Le Bonheur Healthcare, Memphis, TN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Thoracic and Cardiovascular Surgery, Methodist Le Bonheur Healthcare, Memphis, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation></author></analytic><series><title level="j">CVIR endovascular</title><idno type="eISSN">2520-8934</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Pseudoaneurysm of the ductus arteriosus diverticulum, although rare in adults, may have catastrophic consequences if left untreated due to erosion and rupture of the pseudoaneurysm into adjacent thoracic structures. Although thoracic endovascular aortic repair (TEVAR) is the standard treatment method for aneurysm closure of the ductus arteriosus diverticulum, it was not possible in our patient secondary to marked aortoiliac access vessel tortuosity, significant vascular calcific burden, and an abdominal aortic aneurysm. We describe the first reported case of endovascular coil embolization being successfully used as the definite repair of a ductus arteriosus diverticulum pseudoaneurysm.</p></div><div type="abstract" xml:lang="en"><p><b>CASE PRESENTATION</b></p><p>An 85-year-old man with history of severe coronary arterial disease presented with an enlarging pseudoaneurysm of a ductus arteriosus diverticulum. The diverticulum and thoracic aortic junction demonstrated the typical obtuse angles and wide neck, differentiating it from otherwise similar-appearing diagnostic considerations. Repair was attempted with conventional aortic stent graft but the patient's infrarenal abdominal aortic aneurysm and his heavily calcified, tortuous iliac vessels could not accommodate the 24Fr introducer sheath necessary for stent graft placement. Therefore, endovascular coil embolization was successfully completed through a 4Fr directional catheter. The patient tolerated the procedure well and was discharged from the hospital in good condition on post-embolization day six.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Endovascular coil embolization is an alternative treatment for ductus arteriosus diverticulum pseudoaneurysm closure in cases where the standard TEVAR method is unsuccessful. Instead of the wide entry point at the aorta we used the junction of the diverticulum and pseudoaneurysm as the "neck" for satisfactory and stable coil placement. Endovascular coil embolization alone may be a viable definitive therapy for occlusion of the ductus pseudoaneurysm component of the diverticulum in cases where complex anatomy or extensive vascular disease makes stent graft repair impractical if not impossible.</p></div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">32026144</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>28</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">2520-8934</ISSN><JournalIssue CitedMedium="Internet"><Volume>2</Volume><Issue>1</Issue><PubDate><Year>2019</Year><Month>Mar</Month><Day>30</Day></PubDate></JournalIssue><Title>CVIR endovascular</Title><ISOAbbreviation>CVIR Endovasc</ISOAbbreviation></Journal><ArticleTitle>Successful endovascular coil embolization of large pseudoaneurysm of ductus arteriosus diverticulum.</ArticleTitle><Pagination><MedlinePgn>12</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s42155-019-0053-5</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Pseudoaneurysm of the ductus arteriosus diverticulum, although rare in adults, may have catastrophic consequences if left untreated due to erosion and rupture of the pseudoaneurysm into adjacent thoracic structures. Although thoracic endovascular aortic repair (TEVAR) is the standard treatment method for aneurysm closure of the ductus arteriosus diverticulum, it was not possible in our patient secondary to marked aortoiliac access vessel tortuosity, significant vascular calcific burden, and an abdominal aortic aneurysm. We describe the first reported case of endovascular coil embolization being successfully used as the definite repair of a ductus arteriosus diverticulum pseudoaneurysm.</AbstractText><AbstractText Label="CASE PRESENTATION" NlmCategory="METHODS">An 85-year-old man with history of severe coronary arterial disease presented with an enlarging pseudoaneurysm of a ductus arteriosus diverticulum. The diverticulum and thoracic aortic junction demonstrated the typical obtuse angles and wide neck, differentiating it from otherwise similar-appearing diagnostic considerations. Repair was attempted with conventional aortic stent graft but the patient's infrarenal abdominal aortic aneurysm and his heavily calcified, tortuous iliac vessels could not accommodate the 24Fr introducer sheath necessary for stent graft placement. Therefore, endovascular coil embolization was successfully completed through a 4Fr directional catheter. The patient tolerated the procedure well and was discharged from the hospital in good condition on post-embolization day six.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Endovascular coil embolization is an alternative treatment for ductus arteriosus diverticulum pseudoaneurysm closure in cases where the standard TEVAR method is unsuccessful. Instead of the wide entry point at the aorta we used the junction of the diverticulum and pseudoaneurysm as the "neck" for satisfactory and stable coil placement. Endovascular coil embolization alone may be a viable definitive therapy for occlusion of the ductus pseudoaneurysm component of the diverticulum in cases where complex anatomy or extensive vascular disease makes stent graft repair impractical if not impossible.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Buechner</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138, USA. dbuechner64@gmail.com.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA. dbuechner64@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lippuner</LastName><ForeName>Veronica</ForeName><Initials>V</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-2835-5773</Identifier><AffiliationInfo><Affiliation>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138, USA. lippunerv@memrad.net.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>DeMaio</LastName><ForeName>Kristine</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Donovan</LastName><ForeName>F Daniel</ForeName><Initials>FD</Initials><Suffix>Jr</Suffix><AffiliationInfo><Affiliation>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weber</LastName><ForeName>Philip R</ForeName><Initials>PR</Initials><AffiliationInfo><Affiliation>Memphis Radiological PC, 7695 Poplar Pike, Germantown, TN, 38138, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schoettle</LastName><ForeName>G Phillip</ForeName><Initials>GP</Initials><AffiliationInfo><Affiliation>Thoracic and Cardiovascular Surgery, Methodist Le Bonheur Healthcare, Memphis, TN, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>03</Month><Day>30</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>CVIR Endovasc</MedlineTA><NlmUniqueID>101738484</NlmUniqueID><ISSNLinking>2520-8934</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Ductus arteriosus pseudoaneurysm</Keyword><Keyword MajorTopicYN="N">Endovascular coil embolization</Keyword><Keyword MajorTopicYN="N">TEVAR</Keyword><Keyword MajorTopicYN="N">Thoracic aneurysm</Keyword><Keyword MajorTopicYN="N">Thoracic aortic repair</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>11</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>02</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>2</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>2</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>2</Month><Day>7</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32026144</ArticleId><ArticleId IdType="doi">10.1186/s42155-019-0053-5</ArticleId><ArticleId IdType="pii">10.1186/s42155-019-0053-5</ArticleId><ArticleId IdType="pmc">PMC6966358</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Eur J Cardiothorac Surg. 1991;5(11):566-70</Citation><ArticleIdList><ArticleId IdType="pubmed">1772665</ArticleId></ArticleIdList></Reference><Reference><Citation>Ann Thorac Surg. 1987 Dec;44(6):656-7</Citation><ArticleIdList><ArticleId IdType="pubmed">3318741</ArticleId></ArticleIdList></Reference><Reference><Citation>Can Assoc Radiol J. 1986 Sep;37(3):195-7</Citation><ArticleIdList><ArticleId IdType="pubmed">2944898</ArticleId></ArticleIdList></Reference><Reference><Citation>AJR Am J Roentgenol. 1988 Apr;150(4):793-6</Citation><ArticleIdList><ArticleId IdType="pubmed">3258092</ArticleId></ArticleIdList></Reference><Reference><Citation>Chirurg. 2007 Jan;78(1):47-51</Citation><ArticleIdList><ArticleId 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Buechner</name><name sortKey="Demaio, Kristine" sort="Demaio, Kristine" uniqKey="Demaio K" first="Kristine" last="Demaio">Kristine Demaio</name><name sortKey="Donovan, F Daniel" sort="Donovan, F Daniel" uniqKey="Donovan F" first="F Daniel" last="Donovan">F Daniel Donovan</name><name sortKey="Donovan, F Daniel" sort="Donovan, F Daniel" uniqKey="Donovan F" first="F Daniel" last="Donovan">F Daniel Donovan</name><name sortKey="Lippuner, Veronica" sort="Lippuner, Veronica" uniqKey="Lippuner V" first="Veronica" last="Lippuner">Veronica Lippuner</name><name sortKey="Schoettle, G Phillip" sort="Schoettle, G Phillip" uniqKey="Schoettle G" first="G Phillip" last="Schoettle">G Phillip Schoettle</name><name sortKey="Weber, Philip R" sort="Weber, Philip R" uniqKey="Weber P" first="Philip R" last="Weber">Philip R. Weber</name><name sortKey="Weber, Philip R" sort="Weber, Philip R" uniqKey="Weber P" first="Philip R" last="Weber">Philip R. Weber</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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