Polyneurysmal dystrophy is defined as the clinical entity characterized by the presence of multiple arterial lesions in different sections of the arterial tree in a simultaneous or sequential manner, excluding uniquely bilateral and multilobulated aneurysms [1, 2]. The incidence of multiple aneurysms in the United States is 0.01% [3] to 3.9% [4]. These aneurysms are caused by: atherosclerosis [4, 5], changes in elastic fibers (ectasic medial dystrophy) [6], Polyarteritis Nodosa, Takayasu's arteritis, Behçet's disease, Marfan's syndrome, trauma and infection [7]. We performed a search on the PubMed and Bireme databases, where we found 17 articles from 1963 to 2017. This work is a case report. A 79-year-old male, a former smoker, hypertensive. He was undergoing colored arterial Doppler ultrasonography that revealed fusiform aneurysms in popliteal arteries (AAP) and femoral arteries (AAF) bilaterally. A Computed tomography angiography (CTA) showed Abdominal Aortic Aneurysm (AAA) type IV (Crawford) of 4.5 cm in diameter, iliac arteries and common femoral arteries enlarged. Fifteen days before the starting of studies of this case, the patient presented fungal lesion in right foot evolving with critical ischemia. We opted for conventional surgery. A femoral-pedal bypass with ex-vivo saphenous vein without valves, in the right lower limb, with the exclusion of AAF and AAP, was also performed, in addition to amputation of the 5th right toe. The colored arterial Doppler ultrasonography of the RLL at the 30th day after the surgery evidenced exclusion of AAF, patent bypass, AAP with low flow and thrombi in it. Forty days after the surgery in RLL, he evolved with pain, pallor and hypothermia in Left Lower Limb (LLL). A colored arterial Doppler ultrasonography of the LLL revealed acute occlusion of the left popliteal artery and a Left Femoral Artery Aneurysm. We have performed a femoral-pedal bypass in Left Lower Limb, with exclusion of AAF and left AAP. About 3 (three) months after the last surgery, the patient evolved well, with peripheral pulses preserved. But during preparation for the correction of the thoracic aneurysm the patient developed mesenteric thrombosis due to the mural thrombi of the abdominal aortic aneurysm; he was submitted to exploratory laparotomy and resection of 70 cm of small intestine. During waiting for customized endoprosthesis to treat abdominal aortic aneurysm, the patient had passed away. We cannot waste time in the treatment of this disease, and it is extremely difficult to predict which of the aneurysms needs to be treated first.
| Published in | Journal of Surgery (Volume 6, Issue 2) |
| DOI | 10.11648/j.js.20180602.15 |
| Page(s) | 53-57 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2018. Published by Science Publishing Group |
Polyaneurysmal, Polyianeurysmatic, Multiple Aneurysms, Ectasic Medial Dystrophy
| [1] | Martínez Pérez M. Distrofia polianeurismática. En: Estevan Solano JM. Tratado de aneurismas. Barcelona: Uriach, 1997. p. 497-507. |
| [2] | Mesh LC, Graham ML. Aortic aneurysm, arteriomegaly, and aneurysmosis. En: Ernest BC, Stanley CJ. Mosby Current Therapy in Vascular Surgery (3ra Ed). St. Louis: editorial; 1995:292-96. |
| [3] | Mei F, Yu M, Li Y, Jin B, Ouyang C. Treatment of multiple aneurysms. Ann Vasc Surg. 2014; 28 (8):1937 e13-7. |
| [4] | Dent TL, Lindenauer SM, Ernst CB, Fry WJ. Multiple arteriosclerotic arterial aneurysms. Arch Surg. 1972; 105 (2):338-44. |
| [5] | Pelissier P. Les dolichomega arteres (à propos de 28 observations). Lyon1975. |
| [6] | Loire R, Descotes J. [Polyaneurysmal dystrophy (ectatic medial dystrophy)]. Ann Cardiol Angeiol (Paris). 1992; 41 (8):443-8. |
| [7] | Becker F. Anévrisme, artériomégalie, dolichoartère, dysplasie artérielle... de quoi parle-t-on? Journal des Maladies Vasculaires. 2015; 40 (2):70-1. |
| [8] | Sugiura H, Hosoda Y. [Histopathological and immunohistochemical diagnosis of intractable vasculitis syndromes]. Nihon Rinsho. 1994; 52 (8):2034-40. |
| [9] | Alvarez Garcia L, Vidal Fernandez P, Garcia Gimeno MF, Gonzalez Arranz MA, Gonzalez Gonzalez ME, Lopez Garcia D, et al. Aortic polyaneurysmal disease: case report. J Thorac Dis. 2017; 9 (Suppl 6):S544-S6. |
| [10] | Chen JY, Tsai YS, Li YH. Multiple arterial aneurysms in a patient with Behcet's disease. Eur Heart J Cardiovasc Imaging. 2016; 17 (5):587. |
| [11] | Defraigne JO, Vasquez C, Limet R. Ruptured aneurysm of the profunda femoral artery associated with polyaneurysmal disease. Acta Chir Belg. 1997; 97 (2):93-6. |
| [12] | English WP, Edwards MS, Pearce JD, Mondi MM, Hundley JC, Hansen KJ. Multiple aneurysms in childhood. J Vasc Surg. 2004; 39 (1):254-9. |
| [13] | Harbuzariu C, Duncan AA, Bower TC, Kalra M, Gloviczki P. Profunda femoris artery aneurysms: association with aneurysmal disease and limb ischemia. J Vasc Surg. 2008; 47 (1):31-4; discussion 4-5. |
| [14] | Henry WJ. Multiple Aneurysm Formation in a Young Man: A Case Report. Ann Surg. 1963; 158:1043-6. |
| [15] | Lizame MLG, Musenden OE, Brínguez YP, Torres DC, Valadez MH. Distrofia polianeurismática: presentacíon de un caso. Rev cuba angiol y cir vasc. 2007; 8 (1):1-3. |
| [16] | Schiller M, Gordon R, Shifrin E, Abu-Dalu K. Multiple arterial aneurysms. J Pediatr Surg. 1983; 18 (1):27-9. |
| [17] | Takagi H, Mori Y, Manabe H, Hirose H. Multiple arterial aneurysms. J Vasc Surg. 2003; 38 (6):1440. |
APA Style
Kimã Barbosa Monteiro Meira, Rodrigo Nóbrega Bandeira, Tainá Louise Dantas Barreto, Ranieri Dutra Nogueira, Felipe Ramalho de Morais, et al. (2018). Treatment of Multiple Arterial Aneurysms in Patient with Polyaneurysmal Disease: Case Report. Journal of Surgery, 6(2), 53-57. https://doi.org/10.11648/j.js.20180602.15
ACS Style
Kimã Barbosa Monteiro Meira; Rodrigo Nóbrega Bandeira; Tainá Louise Dantas Barreto; Ranieri Dutra Nogueira; Felipe Ramalho de Morais, et al. Treatment of Multiple Arterial Aneurysms in Patient with Polyaneurysmal Disease: Case Report. J. Surg. 2018, 6(2), 53-57. doi: 10.11648/j.js.20180602.15
AMA Style
Kimã Barbosa Monteiro Meira, Rodrigo Nóbrega Bandeira, Tainá Louise Dantas Barreto, Ranieri Dutra Nogueira, Felipe Ramalho de Morais, et al. Treatment of Multiple Arterial Aneurysms in Patient with Polyaneurysmal Disease: Case Report. J Surg. 2018;6(2):53-57. doi: 10.11648/j.js.20180602.15
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author = {Kimã Barbosa Monteiro Meira and Rodrigo Nóbrega Bandeira and Tainá Louise Dantas Barreto and Ranieri Dutra Nogueira and Felipe Ramalho de Morais and Caio César Vaz Lacet Gondim and Amanda Morimitsu and Sérgio Ricardo Ferreira Vieira and Francisco Chavier Vieira Bandeira and Paulo Roberto da Silva Lima},
title = {Treatment of Multiple Arterial Aneurysms in Patient with Polyaneurysmal Disease: Case Report},
journal = {Journal of Surgery},
volume = {6},
number = {2},
pages = {53-57},
doi = {10.11648/j.js.20180602.15},
url = {https://doi.org/10.11648/j.js.20180602.15},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20180602.15},
abstract = {Polyneurysmal dystrophy is defined as the clinical entity characterized by the presence of multiple arterial lesions in different sections of the arterial tree in a simultaneous or sequential manner, excluding uniquely bilateral and multilobulated aneurysms [1, 2]. The incidence of multiple aneurysms in the United States is 0.01% [3] to 3.9% [4]. These aneurysms are caused by: atherosclerosis [4, 5], changes in elastic fibers (ectasic medial dystrophy) [6], Polyarteritis Nodosa, Takayasu's arteritis, Behçet's disease, Marfan's syndrome, trauma and infection [7]. We performed a search on the PubMed and Bireme databases, where we found 17 articles from 1963 to 2017. This work is a case report. A 79-year-old male, a former smoker, hypertensive. He was undergoing colored arterial Doppler ultrasonography that revealed fusiform aneurysms in popliteal arteries (AAP) and femoral arteries (AAF) bilaterally. A Computed tomography angiography (CTA) showed Abdominal Aortic Aneurysm (AAA) type IV (Crawford) of 4.5 cm in diameter, iliac arteries and common femoral arteries enlarged. Fifteen days before the starting of studies of this case, the patient presented fungal lesion in right foot evolving with critical ischemia. We opted for conventional surgery. A femoral-pedal bypass with ex-vivo saphenous vein without valves, in the right lower limb, with the exclusion of AAF and AAP, was also performed, in addition to amputation of the 5th right toe. The colored arterial Doppler ultrasonography of the RLL at the 30th day after the surgery evidenced exclusion of AAF, patent bypass, AAP with low flow and thrombi in it. Forty days after the surgery in RLL, he evolved with pain, pallor and hypothermia in Left Lower Limb (LLL). A colored arterial Doppler ultrasonography of the LLL revealed acute occlusion of the left popliteal artery and a Left Femoral Artery Aneurysm. We have performed a femoral-pedal bypass in Left Lower Limb, with exclusion of AAF and left AAP. About 3 (three) months after the last surgery, the patient evolved well, with peripheral pulses preserved. But during preparation for the correction of the thoracic aneurysm the patient developed mesenteric thrombosis due to the mural thrombi of the abdominal aortic aneurysm; he was submitted to exploratory laparotomy and resection of 70 cm of small intestine. During waiting for customized endoprosthesis to treat abdominal aortic aneurysm, the patient had passed away. We cannot waste time in the treatment of this disease, and it is extremely difficult to predict which of the aneurysms needs to be treated first.},
year = {2018}
}
TY - JOUR T1 - Treatment of Multiple Arterial Aneurysms in Patient with Polyaneurysmal Disease: Case Report AU - Kimã Barbosa Monteiro Meira AU - Rodrigo Nóbrega Bandeira AU - Tainá Louise Dantas Barreto AU - Ranieri Dutra Nogueira AU - Felipe Ramalho de Morais AU - Caio César Vaz Lacet Gondim AU - Amanda Morimitsu AU - Sérgio Ricardo Ferreira Vieira AU - Francisco Chavier Vieira Bandeira AU - Paulo Roberto da Silva Lima Y1 - 2018/04/03 PY - 2018 N1 - https://doi.org/10.11648/j.js.20180602.15 DO - 10.11648/j.js.20180602.15 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 53 EP - 57 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20180602.15 AB - Polyneurysmal dystrophy is defined as the clinical entity characterized by the presence of multiple arterial lesions in different sections of the arterial tree in a simultaneous or sequential manner, excluding uniquely bilateral and multilobulated aneurysms [1, 2]. The incidence of multiple aneurysms in the United States is 0.01% [3] to 3.9% [4]. These aneurysms are caused by: atherosclerosis [4, 5], changes in elastic fibers (ectasic medial dystrophy) [6], Polyarteritis Nodosa, Takayasu's arteritis, Behçet's disease, Marfan's syndrome, trauma and infection [7]. We performed a search on the PubMed and Bireme databases, where we found 17 articles from 1963 to 2017. This work is a case report. A 79-year-old male, a former smoker, hypertensive. He was undergoing colored arterial Doppler ultrasonography that revealed fusiform aneurysms in popliteal arteries (AAP) and femoral arteries (AAF) bilaterally. A Computed tomography angiography (CTA) showed Abdominal Aortic Aneurysm (AAA) type IV (Crawford) of 4.5 cm in diameter, iliac arteries and common femoral arteries enlarged. Fifteen days before the starting of studies of this case, the patient presented fungal lesion in right foot evolving with critical ischemia. We opted for conventional surgery. A femoral-pedal bypass with ex-vivo saphenous vein without valves, in the right lower limb, with the exclusion of AAF and AAP, was also performed, in addition to amputation of the 5th right toe. The colored arterial Doppler ultrasonography of the RLL at the 30th day after the surgery evidenced exclusion of AAF, patent bypass, AAP with low flow and thrombi in it. Forty days after the surgery in RLL, he evolved with pain, pallor and hypothermia in Left Lower Limb (LLL). A colored arterial Doppler ultrasonography of the LLL revealed acute occlusion of the left popliteal artery and a Left Femoral Artery Aneurysm. We have performed a femoral-pedal bypass in Left Lower Limb, with exclusion of AAF and left AAP. About 3 (three) months after the last surgery, the patient evolved well, with peripheral pulses preserved. But during preparation for the correction of the thoracic aneurysm the patient developed mesenteric thrombosis due to the mural thrombi of the abdominal aortic aneurysm; he was submitted to exploratory laparotomy and resection of 70 cm of small intestine. During waiting for customized endoprosthesis to treat abdominal aortic aneurysm, the patient had passed away. We cannot waste time in the treatment of this disease, and it is extremely difficult to predict which of the aneurysms needs to be treated first. VL - 6 IS - 2 ER -
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