Belmir Hicham, Azghari Amine, Sedki Nabil
Department of Vascular Surgery, Mohammed VI University of Health Sciences, Casablanca, Morocco.
Department of Vascular Surgery, Mohammed V University, Rabat, Morocco.
J Vasc Surg Cases Innov Tech. 2020 Jul 28;6(3):473-477. doi: 10.1016/j.jvscit.2020.07.003. eCollection 2020 Sep.
Extracorporeal shock wave lithotripsy (ESWL) can lead to rare but severe arterial complications. The causal relationship of ESWL with arterial pseudoaneurysm formation in a patient with Behçet disease is discussed. A 35-year-old man presented with acute recrudescence of right flank pain caused by ureteral lithiasis immediately after having undergone a last session of ESWL. Abdominal examination revealed a painful pulsatile mass in the right iliac region. Contrast-enhanced computed tomography identified a pseudoaneurysm of the right external iliac artery in a patient with a medical history of Behçet disease. The pseudoaneurysm was treated endovascularly, including the use of a covered stent with intensive immunosuppressive therapy. We obtained successful exclusion of the pseudoaneurysm. This case highlights that arterial pseudoaneurysm may occur after ESWL in patients with Behçet disease. Strict follow-up after ESWL sessions is necessary.
体外冲击波碎石术(ESWL)可导致罕见但严重的动脉并发症。本文讨论了白塞病患者中ESWL与动脉假性动脉瘤形成之间的因果关系。一名35岁男性在接受最后一次ESWL治疗后,因输尿管结石立即出现右胁腹疼痛急性复发。腹部检查发现右髂区有一个疼痛性搏动性肿块。对比增强计算机断层扫描在一名有白塞病病史的患者中发现右髂外动脉假性动脉瘤。该假性动脉瘤采用血管内治疗,包括使用覆膜支架并强化免疫抑制治疗。我们成功排除了假性动脉瘤。该病例强调白塞病患者ESWL后可能发生动脉假性动脉瘤。ESWL治疗后进行严格随访是必要的。