Tratamento endovascular de pseudo-aneurisma de carótida interna em criança

Abstract

Relato de um caso de paciente feminina, com 6 anos de idade, que apresentou uma massa cervical, dolorosa e com características de processo infeccioso, que revelou ser um pseudo-aneurisma de carótida interna. Foi realizado o tratamento endovascular, com o uso de um balão destacável que determinou a oclusão e conseqüente trombose do pseudo-aneurisma, com excelente resultado.

Pseudoaneurisma de carótida comum secundário a trauma contuso: opção de tratamento por cirurgia a céu aberto

“…Patients with extracranial carotid pseudoanerysms present variable clinical pictures: from a palpable and pulsatile cervical mass to strokes with definitive neurological deficits 5 . Ischemic symptoms are caused by impaired carotid artery flow or by distal embolism 3 . Dysphagia and respiratory distress can also be observed 1,5 , as in the case reported.…”

“…Cervical trauma is the leading cause of carotid artery pseudoanerysms (PA) 3 . The mechanism of injury is rupture of the arterial wall, leading to local hemorrhage that is contained by adjacent structures, forming a pulsatile hematoma, or pseudoaneurysmal sac.…”

“…Traditionally, the treatment of choice is open surgical repair 3 . Nevertheless, endovascular techniques, such as stenting, endografting, and balloon angioplasty have been increasingly used to repair the carotid lesions, making it possible to treat those lesions with a lesser risk of complications 3,4 .…”

Correction of carotid-jugular traumatic fistula using a bovine pericardial patch

“…15 Possible options include vascular echography, angiotomography, magnetic resonance angiography or arteriography, and all of them could be used to plan conventional or endovascular surgery. 6 The importance of angiotomography for managing these cases should not be underestimated, since it is a less invasive method than arteriography and offers satisfactory accuracy.…”

“…5 Definitive diagnosis is not generally a challenge, using color Doppler ultrasonography, angiotomography, magnetic resonance angiography or even arteriography. 6,7 Patients with traumatic cervical contusions who are at risk of traumatic cerebrovascular injury should undergo cerebral and cervical angiotomography. When necessary, digital arteriography can be used to provide a clearer picture of the extent of arterial injury.…”