Bozzani Antonio, Bobbio Pallavicini Francesca, Arici Vittorio, Quaretti Pietro, Rossi Mauro, Ticozzelli Giulia, Ragni Franco
Vascular Surgery Unit, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
Reumathology Unit, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
Ann Vasc Surg. 2020 Jan;62:496.e9-496.e13. doi: 10.1016/j.avsg.2019.06.003. Epub 2019 Aug 5.
Large artery stenosis of the arm or leg arteries or the cervical arteries has been described in giant cell arteritis (GCA); aortic involvement, nevertheless, is less frequent, even if imaging tools such as positron emission tomography (PET) computed tomography have increased the frequency in the observation of aortic involvement. A 56-year-old female with a medical history of GCA presented to our emergency department with an unruptured voluminous thoracoabdominal aortic aneurysm (TAAA). The fluorodeoxyglucose PET demonstrated the presence of high inflammatory activity. The patient underwent endovascular correction using a "sandwich technique." The 3-month control CT scan shows complete aneurysm exclusion. In high risk for surgery patients with GCA, the endovascular treatment with parallel stent graft of TAAA is safe and feasible.
巨细胞动脉炎(GCA)中曾有关于手臂或腿部动脉以及颈动脉的大动脉狭窄的描述;然而,主动脉受累情况较少见,即便正电子发射断层扫描(PET)计算机断层扫描等成像工具增加了主动脉受累的观察频率。一名有GCA病史的56岁女性因未破裂的巨大胸腹主动脉瘤(TAAA)就诊于我们的急诊科。氟脱氧葡萄糖PET显示存在高炎症活性。该患者采用“三明治技术”进行了血管内矫正。3个月后的对照CT扫描显示动脉瘤完全隔绝。对于手术高危的GCA患者,采用平行支架移植物对TAAA进行血管内治疗是安全可行的。