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Idiopathic multiple systemic aneurysms in a child
Insights
A child experienced limb ischemia due to artery aneurysms. Surgical repair was successful, but the cause of the idiopathic aneurysms remains unknown, highlighting a rare pediatric vascular condition.
Area of Science:
- Vascular Surgery
- Pediatric Cardiology
- Radiology
Background:
- A 3-year-old child presented with left upper extremity ischemia.
- The condition was attributed to embolic disease originating from multiple idiopathic saccular aneurysms.
Observation:
- Arteriography revealed aneurysms in the left subclavian, splenic, and phrenic arteries, along with right common carotid artery ectasia.
- Coronary arteriograms were normal.
- Microscopic and electron microscopy analyses ruled out inflammatory processes and rickettsial infections.
Findings:
- The patient underwent successful surgical intervention including brachial artery embolectomy, aneurysm ligation, and bypass grafting.
- Histopathology showed intimal proliferation without signs of inflammation.
Implications:
- This case highlights a rare pediatric vascular disorder with idiopathic aneurysms.
- The etiology remains undetermined, necessitating further research into pediatric vasculopathies.
Abstract:
A 3-year-old child had ischemia of the left-sided upper extremity secondary to embolic disease. Arteriography showed multiple idiopathic saccular aneurysms of the left subclavian artery. Coronary arteriograms were normal. Cerebral arteriography showed ectasia of the right common carotid artery, and abdominal aortography, aneurysms of the splenic and phrenic arteries. The patient underwent brachial artery embolectomy, proximal and distal aneurysm ligation, and placement of a carotid to axillary artery polytef bypass graft. Microscopic analysis indicated intimal proliferation, normal elastic tunica media vasorum, and no evidence of an inflammatory process. Electron microscopy showed no evidence of rickettsiae. The patient's clinical appearance was similar but not identical to that of Kawasaki disease, Takayasu's disease, or periarteritis nodosa. Workup of the patient and subsequent surgical exploration failed to demonstrate a definitive cause.