Incidental Finding of Intercostal Artery Aneurysm During Coarctation Surgery
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Abstract
Intercostal artery aneurysms (ICAA) are very rare vascular complication of coarctation. The most cases are asymptomatic and could be found incidentally during thoracotomy for others vascular pathology or may present with fatal problems such as rupture that is leading to bleeding and hypovolemic shock. Intercostal artery aneurysm most commonly accompanies with neurofibromatosis, aortic coarctation, or in chest trauma. We report a 10-year-old girl who complained of lower extremities pain and hypertension for a few months. His final diagnosis was coarctation of the aorta. She was scheduled for thoracotomy and coarctation repair by resection and end to end anastomosis. During thoracotomy at lateral side of coarctation, an ICAA distal to coarctation site was seen that by a collateral artery connects to its upper intercostals artery. The patient was treated by ligation and resection of the affected intercostal artery and subsequent coarctation repair. The postoperative course was uneventful and, she was discharged on 7th postoperative day.
Sekino S, Takagi H, Kubota H, Kato T, Matsuno Y, Umemoto T. Intercostal artery pseudoaneurysm due to stab wound. J Vasc Surg 2005;42:352–6.
Maltz SB, Fantus RJ, Mellett MM, Kirby JP. Surgical complications of Ehlers-Danlos syndrome type IV: case report and review of the literature. J Trauma 2001;51: 387–90.
Wallace RB, Nast EP. Postcoarctation mycotic intercostal arterial pseudoaneurysm. Am J Cardiol 1987;59:1014–5.
Seishiro, S., Hisato, T., Hajime, K., Takayoshi, K., Yukihiro, M., and Takuya, U. Intercostal artery pseudoaneurysm due to stab wound. J Vasc Surg. 2005; 2: 352–356.
Aoki, T., Okada, A., Tsuchida, M., and Hayashi, J. Ruptured intercostal artery pseudoaneurysm after blunt thoracic trauma. Thorac Cardiovasc Surg. 2003; 51: 346–347
Neuwirth, C.A. and Singh, H. Intercostal artery aneurysm in a child with Kawasaki disease and known coronary artery aneurysms. J Vasc Interv Radiol. 2010; 21: 952–953
Carr, J.A., Vadlamudi, V., and Azher, Q.S. Intercostal artery aneurysmosis. Ann Thorac Surg. 2013; 96: 1870–1873
Aizawa K, Iwashita C, Saito T, Misawa Y. Spontaneous rupture of an intercostal artery in a patient with neurofibromatosis type 1. Interact Cardiovasc Thorac Surg. 2010;10:128–130. doi: 10.1510/icvts.2009.222125. [PubMed
Lu, C.C., Chen, C.H., Yeh, S.F., Lai, J.H., and Chang, D.M. A spontaneous intercostal artery hemorrhge in systemic lupus erythematosus. Rheumatol Int. 2012; 32: 829–831
Luo, Z.Q., Lai, Y.Q., Zhu, J.M., Li, K.Y., Liu, K.Y., and Zhou, Q.W. Intercostal artery aneurysm associated with coarctation of aorta in an adult. J Card Surg. 2010; 25: 719–720
Alonso, S.F, Azcona, C.M, Heredero, A.F, and de Cubas., L.R. Post-sternotomy intercostal artery pseudoaneurysm. Sonographic diagnosis and thrombosis by ultrasound-guided percutaneous thrombin injection. Interact Cardiovasc Thorac Surg. 2009; 9: 722–724
Mathew, R., Abdullah, S., and Renfrew, I. Massive abdominal wall haematoma and haemothorax due to spontaneous rupture of an intercostal artery. Emerg Med J. 2008; 25: 608
Sundram-Novelend, S.Y., Appleton, D.S., Screaton, N.J., Davies, R.J., and Chilvers, E.R. Spontaneous rupture of an intercostal artery aneurysm during air flight. Thorax. 2008; 63: 294.
Carr, J.A., Vadlamudi, V., and Azher, Q.S. Intercostal artery aneurysmosis. Ann Thorac Surg. 2013; 96: 1870–1873
Arai K, Sanada J, Kurozumi A, Watanabe T, Matsui O. Spontaneous hemothorax in neurofibromatosis treated with percutaneous embolization. Cardiovasc Intervent Radiol 2007;30:477–9.
Topel I, Steinbauer M, Paetzel C, Kasprzak PM. Endovas cular therapy of a ruptured intercostal artery aneurysm. J Endovasc Ther 2004;11:219–21.
Muthuswamy P, Samuel J, Mizock B, Dunne P. Recurrent massive bleeding from an intercostal artery aneurysm through an empyema chest tube. Chest 1993;104:637–9.
Yamaguchi T, Standford W, Lang EV. Intercostal artery
aneurysm associated with coarctation of the aorta:specific finding on MR imaging. Int J Card Imaging.1997;13:357-8.
| Files | ||
| Issue | Vol 55, No 6 (2017) | |
| Section | Case Report(s) | |
| Keywords | ||
| Congenital heart disease Coarctation Intercostal artery aneurysm | ||
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