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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2019, Número 1

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Rev Mex Angiol 2019; 47 (1)


Manejo endovascular de pseudoaneurisma aórtico torácico secundario a úlcera ateroesclerótica penetrante

Silva-González M, Lecuona-Huet NE, Regalado-Solís F, Nieto-Zepeda D, López-Valdivia J, Farro-Moreno A, Ziga-Martínez A

Idioma: Español
Referencias bibliográficas: 31
Paginas: 43-46
Archivo PDF: 302.99 Kb.


RESUMEN

Los síndromes aórticos agudos (SAA) engloban tres entidades: Disección aórtica, hematoma intramural y úlcera aórtica penetrante (UAP), las cuales pareciera que una envuelve a la otra y pueden coexistir. En la UAP hay una alteración focal de la capa íntima y la lámina elástica que se extiende hacia la capa media y habitualmente se presenta con una enfermedad ateroesclerótica más extensa y difusa que envuelve la aorta y las arterias coronarias. La extensión de la úlcera a la lámina media puede favorecer la formación de un hematoma (disección localizada), pseudoaneurisma o ruptura transmural. Se presenta el caso clínico de un paciente masculino de 65 años de edad con UAP que tuvo como complicación un pseudoaneurisma sacular en aorta descendente al cual se le realizó manejo endovascular de manera satisfactoria con endoprótesis Zenith TX2. La terapia endovascular se considera especialmente efectiva para las UAP tipo B cuando el dolor y la hipertensión son difíciles de controlar o cuando se observan signos de propagación o expansión temprana. El manejo endovascular se ha convertido en el tratamiento de elección para las UAP con buenos resultados a mediano plazo.


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