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Bohatch Júnior MS, Tanure Júnior T, Oliveira ALD, Ribeiro MS, Joviliano EE. Tratamento endovascular de aneurisma de artéria torácica interna esquerda. J Vasc Bras 2020; 19:e20200042. [PMID: 34178077 PMCID: PMC8202176 DOI: 10.1590/1677-5449.200042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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.
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Chen JF, Papanikolaou D, Fereydooni A, Mojibian H, Dardik A, Nassiri N. Coil embolization of bilateral internal mammary artery aneurysms in the setting of a heterozygous missense variant of unknown significance in COL5A1 and fibromuscular dysplasia. J Vasc Surg Cases Innov Tech 2019; 5:410-414. [PMID: 31660461 PMCID: PMC6806644 DOI: 10.1016/j.jvscit.2019.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 07/11/2019] [Indexed: 11/29/2022]
Abstract
Internal mammary artery aneurysms are rare but serious clinical entities. Rupture results in hemothorax and can be life threatening. Most reported cases are pseudoaneurysms secondary to iatrogenic or traumatic causes. Noniatrogenic, nontraumatic, true internal mammary artery aneurysms have most commonly been associated with vasculitides or connective tissue disorders; rare cases have been deemed idiopathic. We describe a rare case of bilateral internal mammary artery aneurysms—successfully treated with coil embolization—in the setting of heterozygosity for a missense variant of unknown significance in the COL5A1 gene and multifocal fibrodysplastic changes on angiography.
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Affiliation(s)
- Julia Fayanne Chen
- Division of Vascular and Endovascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Dimitra Papanikolaou
- Division of Cardiac Surgery and The Yale Aortic Institute, Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Arash Fereydooni
- Division of Vascular and Endovascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Hamid Mojibian
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn
| | - Alan Dardik
- Division of Vascular and Endovascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Naiem Nassiri
- Division of Vascular and Endovascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn
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Ho K, Joshi P, Wong D, Brusch A, Hockley J, Jansen S. Hybrid treatment of an isolated immunoglobulin G4-related internal thoracic artery aneurysm. J Vasc Surg Cases Innov Tech 2018; 4:331-334. [PMID: 30761381 PMCID: PMC6298933 DOI: 10.1016/j.jvscit.2018.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/27/2018] [Indexed: 12/25/2022]
Abstract
True aneurysms of the internal thoracic artery (ITA) are rare and are associated with vasculitides, connective tissue diseases, and infections. We report a case of a 3-cm immunoglobulin G4-positive ITA aneurysm that was excised by a hybrid approach involving open ligation of the ITA origin and video-assisted thoracoscopic aneurysmectomy. This novel technique was able to acquire tissue for histopathologic diagnosis through a minimally invasive means.
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Affiliation(s)
- Kelvin Ho
- Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Pragnesh Joshi
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Daniel Wong
- PathWest Laboratory Medicine, Perth, Western Australia, Australia
| | - Anna Brusch
- PathWest Laboratory Medicine, Perth, Western Australia, Australia.,Department of Clinical Immunology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Joseph Hockley
- Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Shirley Jansen
- Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia.,School of Public Health, Curtin University, Perth, Western Australia, Australia.,Heart Research Institute, Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia
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