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Aortic nonanastomotic pseudoaneurysm eroding lumbar vertebra--a case report.
1Department of Surgery, State University of New York at Buffalo, KALEIDA Health System, Millard Fillmore Gates Hospital, 3 Gates Circle, Buffalo, NY 14209, USA.
Vascular Surgery
|July 14, 2001
Summary
Nonanastomotic pseudoaneurysms are rare complications of prosthetic grafts, often presenting with atypical symptoms like back pain. Prompt surgical repair is crucial to prevent rupture and resolve symptoms in patients with prior aortic reconstructions.
Area of Science:
- Vascular Surgery
- Medical Imaging
- Aortic Aneurysm Research
Background:
- Nonanastomotic pseudoaneurysms are uncommon complications following prosthetic graft placement, particularly axillofemoral grafts.
- This case highlights a pseudoaneurysm arising from a prior end-to-side aortobifemoral bypass, presenting years after the initial surgery.
Observation:
- The patient presented with severe back pain, weight loss, night sweats, and leg claudication, initially misdiagnosed as a spinal tumor.
- Advanced imaging revealed a pseudoaneurysm eroding vertebral bodies, necessitating a thorough vascular and oncologic workup.
Findings:
- Surgical exploration identified a defect in the native aorta proximal to the anastomosis, not a malignancy.
- The pseudoaneurysm was successfully repaired by reconfiguring the aortic anastomosis to an end-to-end configuration, restoring blood flow.
Implications:
- Atypical back pain in patients with a history of aortic reconstruction warrants high suspicion for vascular complications like pseudoaneurysms.
- Early diagnosis and surgical intervention are critical for managing aortic pseudoaneurysms and preventing life-threatening rupture.