Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/916
Título: Terapêutica Endovascular de Pseudoaneurisma e Fístula Arteriovenosa em Enxerto Renal
Outros títulos: Endovascular Therapy of Pseudoaneurysm and Arteriovenous Fistula in a Renal Graft
Autor: Teixeira e Costa, F
Pisco, JM
Neto, AP
Reimão Pinto, J
Palavras-chave: Falso Aneurisma
Terapêutica
Fístula Arteriovenosa
Data: 2004
Editora: Sociedade Portuguesa de Nefrologia e Hipertensão
Citação: Rev Port Nefrol Hipert 2004; 18 (1): 53-56
Resumo: A 31 year old male Caucasian received a renal cadaveric allograft. Reconstruction of an inferior polar artery was corrected pre-implantation. Delayed graft function occurred leading to dialysis support for one month. Graft biopsies(days 7, 15) showed acute tubular necrosis(ATN) and no rejection. Serial ultrasound (US), performed on average weekly, were compatible with ATN. On day 31, Doppler US and a CAT scan suggested for the first time a pseudoaneurysm adjacent to the implantation of the graft artery on the external iliac artery. For clinical and technical reasons, arteriography was only performed on day 67, when serum creatinine was 3.3 mg/dl. It showed a large pseudoaneurysm with an arteriovenous fistula to the right common iliac vein. Compression of the right external iliac artery was clear. In an attempt to close the arteriovenous fistula, the communication with the pseudoaneurysm was embolised with gelfoam and metallic coils with partial success. One week later, by right femoral approach a covered wallstent was placed immediately below the origin of the graft artery.Subsequent Doppler US and arteriography con-firmed closure of the communication with thepseudoaneurysm and of the arteriovenous fistula. The calibre of the right external iliac artery was then normal. By month 18, serum creatinine is stable at 2.1 mg/dl. We can only speculate on the origin of thepseudoaneurysm and of the AV fistula, whichwere not evident until one month post-transplantation. Backtable surgery was performed on thepolar not the main graft artery. Invasive angiography was irreplaceable in this unusual clinical situation.
Peer review: yes
URI: http://hdl.handle.net/10400.17/916
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