Tratamento endovascular de aneurisma renal sacular com colo largo com técnica do waffle-cone

No passado, o tratamento de aneurismas da artéria visceral (VAAs) era exclusivamente cirúrgico e raramente diagnosticado em casos eletivos ou de emergência. O desenvolvimento de técnicas de imagem e procedimentos endovasculares mudou a história das opções terapêuticas dessa patologia. O manejo endovascular de VAAs surgiu devido ao avanço das técnicas endovasculares, o qual apresentou uma alta eficácia.

Palavras-chave:
aneurisma; endovascular; procedimento endovascular; stent

Autoria

Paulo Eduardo Ocke Reis

Universidade Federal Fluminense – UFF, Niterói, RJ, Brasil.Universidade Federal FluminenseBrasilNiterói, RJ, BrasilUniversidade Federal Fluminense – UFF, Niterói, RJ, Brasil.

http://orcid.org/0000-0001-5450-6806

Guilherme de Palma Abrão

Universidade Federal Fluminense – UFF, Niterói, RJ, Brasil.Universidade Federal FluminenseBrasilNiterói, RJ, BrasilUniversidade Federal Fluminense – UFF, Niterói, RJ, Brasil.

Leonardo Roever

Universidade Federal de Uberlândia – UFU, Uberlândia, MG, Brasil.Universidade Federal de UberlândiaBrasilUberlândia, MG, BrasilUniversidade Federal de Uberlândia – UFU, Uberlândia, MG, Brasil.

http://orcid.org/0000-0002-7517-5548

Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Correspondence Paulo Eduardo Ocke Reis Universidade Federal Fluminense – UFF, Hospital Universitário Antonio Pedro, Departamento de Cirurgia Geral e Especializada Rua Marquês do Paraná, 303 - Centro CEP 24033-900 - Niterói (RJ), Brasil Tel.: +55 (21) 2629-5000 E-mail: ockereis@yahoo.com

Author information PEOR - Specialist in vascular and endovascular surgery; Adjunct professor of vascular surgery, Universidade Federal Fluminense (UFF). GPA - Specialist in interventional neuroradiology; Adjunct professor of radiology, Universidade Federal Fluminense (UFF). LR - Centro de Pesquisa Clínica, Universidade Federal de Uberlândia (UFU).

Author contributions Conception and design: PEOR, GPA, LR Analysis and interpretation: PEOR, GPA, LR Data collection: PEOR, GPA, LR Writing the article: PEOR, GPA, LR Critical revision of the article: PEOR, GPA Final approval of the article*: PEOR, GPA, LR Statistical analysis: GPA, LR Overall responsibility: PEOR, GPA, LR *All authors have read and approved of the final version of the article submitted to J Vasc Bras.

SCIMAGO INSTITUTIONS RANKINGS

Universidade Federal Fluminense – UFF, Niterói, RJ, Brasil.Universidade Federal FluminenseBrasilNiterói, RJ, BrasilUniversidade Federal Fluminense – UFF, Niterói, RJ, Brasil.

Figuras

Figuras (6)

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Figure 1
Schematic diagram illustrating a wide-necked saccular aneurysm treated with a Waffle-Cone Technique. Modified from Khattak et al.¹¹11 Khattak YJ, Sibaie AA, Anwar M, Sayani R. Stents and stent mimickers in endovascular management of wide-neck intracranial aneurysms. Cureus. 2018;10(10):e3420. http://dx.doi.org/10.7759/cureus.3420. PMid:30542634.
http://dx.doi.org/10.7759/cureus.3420...

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Figure 2
Microcatheter positioned inside the aneurysm sac, so we deployed the micro coils. Stent already deployed (red arrow).

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Figure 3
Final control arteriography. The red arrow indicates the radiopaque marking on the stent.

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Figure 4
Late phase control arteriography showing complete exclusion of the aneurysm.

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Figure 5
Coronal angiotomography with an algorithm to reduce metallic artifacts showing successful exclusion of an intraparenchymal renal saccular aneurysm. ARE = renal artery.

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Figure 6
Coronal reconstruction of angiotomography with an algorithm to reduce metallic artifacts, showing complete exclusion of a 2.7 x 2.0 mm aneurysm sac using stent-assisted coil embolization. ARE = renal artery.

Figure 1 Schematic diagram illustrating a wide-necked saccular aneurysm treated with a Waffle-Cone Technique. Modified from Khattak et al.¹¹11 Khattak YJ, Sibaie AA, Anwar M, Sayani R. Stents and stent mimickers in endovascular management of wide-neck intracranial aneurysms. Cureus. 2018;10(10):e3420. http://dx.doi.org/10.7759/cureus.3420. PMid:30542634.
http://dx.doi.org/10.7759/cureus.3420...

Figure 2 Microcatheter positioned inside the aneurysm sac, so we deployed the micro coils. Stent already deployed (red arrow).

Figure 3 Final control arteriography. The red arrow indicates the radiopaque marking on the stent.

Figure 4 Late phase control arteriography showing complete exclusion of the aneurysm.

Figure 5 Coronal angiotomography with an algorithm to reduce metallic artifacts showing successful exclusion of an intraparenchymal renal saccular aneurysm. ARE = renal artery.

Figure 6 Coronal reconstruction of angiotomography with an algorithm to reduce metallic artifacts, showing complete exclusion of a 2.7 x 2.0 mm aneurysm sac using stent-assisted coil embolization. ARE = renal artery.

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Tratamento endovascular de aneurisma renal sacular com colo largo com técnica do waffle-cone

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[1] Conflicts of interest: No conflicts of interest declared concerning the publication of this article.