Jornal Vascular Brasileiro
http://www.jvb.periodikos.com.br/article/doi/10.1590/1677-5449.200042
Jornal Vascular Brasileiro
Case Report

Tratamento endovascular de aneurisma de artéria torácica interna esquerda

Endovascular treatment of left internal thoracic artery aneurysm

Milton Sérgio Bohatch Júnior; Tércio Tanure Júnior; André Luiz de Oliveira; Maurício Serra Ribeiro; Edwaldo Edner Joviliano

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Resumo

Resumo: O aneurisma da artéria torácica interna é uma entidade rara, com apresentação variável e risco potencial de ruptura e de morte. A angiotomografia é o exame diagnóstico de escolha, sendo útil para o planejamento terapêutico. Considerando morbidade do acesso torácico para abordagem direta e o risco imprevisível de ruptura, o procedimento endovascular se apresenta como modalidade terapêutica de escolha para tratamento desse tipo de aneurisma. Descrevemos um caso de aneurisma de artéria torácica interna, com descoberta incidental na investigação de síncope tratado com embolização com micromolas de baixo perfil e de liberação controlada.

Palavras-chave

aneurisma, artéria torácica interna, procedimentos endovasculares

Abstract

Aneurysm of the internal thoracic artery is a rare entity, with variable presentation and a potential risk of fatal rupture. Angiotomography is the diagnostic test of choice and is useful for planning treatment. Considering the morbidity of thoracic access for a direct approach and the unpredictable risk of rupture, an endovascular procedure is the treatment modality of choice for this type of aneurysm. We describe the case of an internal thoracic artery aneurysm discovered incidentally during investigation of syncope and treated by embolization with low-profile and controlled-release microcoils.

Keywords

aneurism; mammary arteries; endovascular procedures.

References

1 Piffaretti G, Carrafiello G, Franchin M, et al. Stent-graft repair of a true internal thoracic artery aneurysm. Ann Vasc Surg. 2015;29(7):1452.e11-5. http://dx.doi.org/10.1016/j.avsg.2015.04.072. PMid:26164363.

2 Martin A, Ross BA, Braimbridge MV. Peristernal wiring in closure of median sternotomy. False aneurysm of the internal mammary artery. J Thorac Cardiovasc Surg. 1973;66(1):145-6. http://dx.doi.org/10.1016/S0022-5223(19)40667-3. PMid:4577107.

3 Fujiyoshi T, Nishibe T, Koizumi N, Ogino H. Coil embolization of bilateral internal mammary artery aneurysms is durable in a patient with Marfan syndrome. J Vasc Surg Cases Innov Tech. 2018;4(3):216-9. http://dx.doi.org/10.1016/j.jvscit.2018.04.007. PMid:30148242.

4 Khorasani H, Eiberg J, Bigaard J. Idiopathic pseudoaneurysm in a patient with breast implants. J Surg Case Rep. 2016;2016(7):1-3. http://dx.doi.org/10.1093/jscr/rjw128. PMid:27470014.

5 Nevidomskyte D, Shalhub S, Aldea GS, et al. Endovascular repair of internal mammary artery aneurysms in two sisters with SMAD3 mutation. Ann Vasc Surg. 2017;41:283.e5-280. http://dx.doi.org/10.1016/j.avsg.2016.10.048. PMid:28286188.

6 Almerey T, Paz-Fumagalli R, Farres H, Oldenburg WA, Hakaim AG. Idiopathic internal mammary artery aneurysm in the setting of aberrant right subclavian artery. J Vasc Surg Cases Innov Tech. 2017;3(4):251-3. http://dx.doi.org/10.1016/j.jvscit.2017.10.006. PMid:29349438.

7 Okura Y, Kawasaki T, Hiura T, Seki H, Saito H. Aneurysm of the internal mammary artery with cystic medial degeneration. Intern Med. 2012;51(17):2355-9. http://dx.doi.org/10.2169/internalmedicine.51.8139. PMid:22975548.

8 Alhawasli H, Darki A, Lewis BE. Endovascular repair of bilateral internal mammary artery aneurysms in a patient with Marfan Syndrome - a case report. Int J Angiol. 2016;25(5):e39-42. PMid:28031650.

9 Heyn J, Zimmermann H, Klose A, Luchting B, Hinske C, Sadeghi-Azandaryani M. Idiopathic internal mammary artery aneurysm. J Surg Case Rep. 2014;2014(12):1-3. http://dx.doi.org/10.1093/jscr/rju125. PMid:25452261.

10 Bhat D, Hufford T, Peckler S. Left internal mammary artery aneurysm presenting as a pulsatile breast mass: a case report. Breast Dis. 2016;36(4):153-5. http://dx.doi.org/10.3233/BD-160229. PMid:27589502.

11 San Norberto EM, Cilleruelo A, Martin-Pedrosa M, Taylor J, Garcia-Yuste M, Vaquero C. Endovascular Treatment of posttraumatic pseudoaneurysm of the internal mammary artery. Ann Vasc Surg. 2014;28(3):743.e1-5. http://dx.doi.org/10.1016/j.avsg.2013.06.034. PMid:24556180.

12 Lindblom RPF, Zemgulis V, Lilieqvist A, Nyman A. Even small aneurysms can bleed: a ruptured small idiopathic aneurysm of the internal thoracic artery. Interact Cardiovasc Thorac Surg. 2013;17(3):583-5. http://dx.doi.org/10.1093/icvts/ivt248. PMid:23736660.

13 Datta S, Manoly I, Karangelis D, Hasan R. Pseudoaneurysm of the right internal mammary artery post vacuum-assisted closure therapy: a rare complication and literature review. Ann Vasc Surg. 2016;31:207.e1-10. http://dx.doi.org/10.1016/j.avsg.2015.08.010. PMid:26597235.

14 Wani NA, Rawa IA, Pala NA, Kosar T. Pseudoaneurysm of internal mammary artery caused by pulmonary actinomycosis. Br J Radiol. 2010;83(995):e235-8. http://dx.doi.org/10.1259/bjr/69723351. PMid:20965895.

15 Kwon OY, Kim GJ, Oh TH, Lee YO, Lee SC, Cho JY. Staged management of a ruptured internal mammary artery aneurysm. Korean J Thorac Cardiovasc Surg. 2016;49(2):130-3. http://dx.doi.org/10.5090/kjtcs.2016.49.2.130. PMid:27066438.

16 Miura H, Taira O, Uchida O, Usuda J, Hirai S, Kato H. Spontaneous haemothorax associated with von Recklinghausen’s disease: review of occurrence in Japan. Thorax. 1997;52(6):577-8, discussion 575-6. http://dx.doi.org/10.1136/thx.52.6.577. PMid:9227730.

17 Kim DW, Jeong IS, Na KJ, Oh SB, Ahn BH, Song SY. Successful treatment of a ruptured left internal mammary artery aneurysm with a delayed diagnosis of type I neurofibromatosis. J Thorac Dis. 2017;9(9):E739-42. http://dx.doi.org/10.21037/jtd.2017.08.08. PMid:29221333.

18 Piffaretti G, Carrafiello G, Franchin M, et al. Stent-graft repair of a true internal thoracic artery aneurysm. Ann Vasc Surg. 2015;29(7):1452.e11-6. http://dx.doi.org/10.1016/j.avsg.2015.04.072. PMid:26164363.

19 Alhawasli H, Darki A, Lewis BE. Endovascular repair of bilateral internal mammary artery aneurysms in a patient with Marfan Syndrome - a case report. Int J Angiol. 2016;25(5):e39-42. PMid:28031650.
 

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