Román D. Rostagno

Oclusión de una fístula arteriovenosa pulmonar con el tapón vascular Amplatzer

Las malformaciones arteriovenosas pulmonares son anomalias poco frecuentes del pulmon, que entranan un riesgo considerable de complicaciones graves como la tromboembolia cerebral, el absceso cerebral y la hemorragia pulmonar. La embolizacion con coils o con balones desprendibles es el tratamiento de eleccion. Sin embargo, estos pueden migrar y producir embolia paradojica, especialmente en las malformaciones con comunicaciones arteriovenosas grandes. Presentamos un caso en el que utilizamos un nuevo dispositivo de oclusion vascular (Tapon Vascular Amplatzer) para ocluir una fistula arteriovenosa pulmonar en un paciente con sindrome de Rendu-Osler-Weber.

Occlusion of a pulmonary arteriovenous fistula with an amplatzer vascular plug

Pulmonary arteriovenous malformations are rare anomalies that carry a considerable risk of serious complications such as cerebral thromboembolism or abscess and pulmonary hemorrhage. The first-line treatment of such malformations is detachable coil or balloon embolotherapy. However, coils and balloons may migrate and cause paradoxical embolism especially in malformations with large arteriovenous shunts. We report a case in which we used a new vascular occlusion device (amplatzer vascular plug), to occlude a pulmonary arteriovenous fistula in a patient with Rendu-Osler-Weber syndrome.

Endovascular Treatment of Extracranial Internal Carotid Aneurysms Using Endografts

Aneurysms of the extracranial internal carotid artery (EICA) are infrequent. They are difficult to treat with conventional surgery because of their distal extension into the skull base. We report three cases of EICA aneurysms in two symptomatic patients successfully treated with polytetrafluoroethylene self-expanding endografts using an endovascular approach. The aneurysms were located distal to the carotid bifurcation and extended to the subpetrous portion of the internal carotid artery.

Endovascular treatment of iatrogenic aortic injury after spinal surgery

Abstract A 59-year-old female presented to our institution with paraparesis caused by medullar compression secondary to multiple myeloma. Spinal cord decompression and transpedicular spine fixation were performed. A month later, the patient complained of sudden pain in her middle back. A CT scan revealed screw impingement on the aortic wall at T8 level. A thoracic stent-graft was deployed before removing the fixation. The patient had an uneventful postoperative course, without complications during the four-year follow-up. In this case report, stent-graft placement proved to be safe and effective in avoiding bleeding during screw removal.