EURORAD ESR

Case 13435

A rare complication of vertebral metastasis surgery

Author(s)
de la Vía Oraá, E. Lonjedo Vicent, E. Gómez Valdés, J. Ruiz Guanter, A. Casula, E. Alandete Germán.

Valencia, Spain;
Email:esviao82@gmail.com
 
Patient
male, 71 year(s)
 
 
  • Figure 1
    Axial views of contrast computed tomography of the thorax.

    A large haematoma located in the posterior mediastinum, paravertebral region, left pleural space, dorsal and cervical musculature, reaching the subcutaneous tissue was observed. Note the presence of aberrant right...

     
    Area of Interest: Vascular; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemorrhage;
     
     
  • Figure 2
    Axial and sagittal views. CT scan of the chest.

    Active extravasation of contrast into the posterior mediastinum and paravertebral region is observed posterior to the right subclavian artery but the originating point of the bleeding vessel is not identified.

     
    Area of Interest: Vascular; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haemorrhage;
     
     
  • Figure 3
    Selective aortography image. CT chest scan (axial and coronal reconstructions)

    Selective aortography image shows aberrant right subclavian artery with high caliber, identifying an image of active bleeding high flow at its source. CT shows aberrant subclavian artery with Kommerell´s diverticulum.

     
    Area of Interest: Vascular; Imaging Technique: Catheter arteriography; CT; Procedure: Contrast agent-intravenous; Special Focus: Acute; Blood;
     
     
  • Figure 4
    Selective aortography images.

    Selective aortography images show the placement of an occlusion balloon to stabilize the patient.

     
    Area of Interest: Vascular; Imaging Technique: Catheter arteriography; Procedure: Balloon occlusion; Special Focus: Acute; Blood;
     
     
  • Figure 5
    Selective aortography images.

    Embolization of the proximal right SCA by double approach (right brachial-red arrow). The Amplatzer and coil in the origin of the aberrant right SCA. Good flow compensation of the right upper limb (white arrow).

     
    Area of Interest: Vascular; Imaging Technique: Catheter arteriography; Procedure: Embolisation; Special Focus: Acute; Blood;
     
     
  • Figure 6
    Sagittal view. CT chest scan.

    Sagittal view of CT scan after endovascular treatment. Drainage of haematoma is performed and Goretex® mesh is placed in front of the osteosynthesis material to protect the subclavian artery to new injuries.

     
    Area of Interest: Vascular; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Blood;
     
     
A large haematoma located in the posterior mediastinum, paravertebral region, left pleural space, dorsal and cervical musculature, reaching the subcutaneous tissue was observed. Note the presence of aberrant right subclavian artery.
 
Active extravasation of contrast into the posterior mediastinum and paravertebral region is observed posterior to the right subclavian artery but the originating point of the bleeding vessel is not identified.
 
Selective aortography image shows aberrant right subclavian artery with high caliber, identifying an image of active bleeding high flow at its source. CT shows aberrant subclavian artery with Kommerell´s diverticulum.
 
Selective aortography images show the placement of an occlusion balloon to stabilize the patient.
 
Embolization of the proximal right SCA by double approach (right brachial-red arrow). The Amplatzer and coil in the origin of the aberrant right SCA. Good flow compensation of the right upper limb (white arrow).
 
Sagittal view of CT scan after endovascular treatment. Drainage of haematoma is performed and Goretex® mesh is placed in front of the osteosynthesis material to protect the subclavian artery to new injuries.
 
 
 
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