Abstract
History and clinical findings:
A 27-year-old man had been admitted to hospital with acute neurological defects involving his legs and urinary system. An intervertebral disk was removed surgically, because a herniation had been suspected. But symptoms increased postoperatively. Further imaging showed a ruptured aneurysm of the internal iliac artery which was treated with coil embolization.
Investigations:
Further diagnostic tests excluded hematological, rheumatic and endocrinological causes for the development of the aneurysm. Genetic differentiation was normal. Imaging then demonstrated "string of beads" small aneurysms of intra- and extracerebral, renal, visceral and peripheral arteries.
Treatment and course:
During the past three years the patient had repeated ruptures of the intra-abdominal arterial aneurysms for which coil embolization and bypass grafting were performed, also to prevent further ruptures.
Conclusions:
Segmental mediolytic arteriopathy is a rare condition requiring careful imaging and histological tests for its diagnosis and acute surgical treatment.
Publication types
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Case Reports
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English Abstract
MeSH terms
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Adult
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Aneurysm, Ruptured / diagnosis*
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Aneurysm, Ruptured / pathology
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Aneurysm, Ruptured / therapy
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Angiography
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Aortic Aneurysm, Abdominal / diagnosis
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Aortic Aneurysm, Abdominal / pathology
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Aortic Aneurysm, Abdominal / therapy
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Cerebral Arterial Diseases / diagnosis*
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Cerebral Arterial Diseases / pathology
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Cerebral Arterial Diseases / therapy
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Diagnosis, Differential
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Embolization, Therapeutic
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Humans
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Iliac Artery / pathology
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Image Processing, Computer-Assisted
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Imaging, Three-Dimensional
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Intervertebral Disc Displacement / diagnosis
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Intervertebral Disc Displacement / surgery
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Intracranial Aneurysm / diagnosis*
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Intracranial Aneurysm / pathology
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Intracranial Aneurysm / therapy
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Ischemia / diagnosis*
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Ischemia / pathology
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Ischemia / therapy
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Kidney / blood supply*
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Laparoscopy
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Leg / blood supply
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Lumbar Vertebrae / surgery
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Magnetic Resonance Angiography
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Male
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Necrosis
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Peripheral Vascular Diseases / diagnosis*
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Peripheral Vascular Diseases / pathology
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Peripheral Vascular Diseases / therapy
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Polyradiculopathy / diagnosis
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Polyradiculopathy / surgery
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Postoperative Complications / diagnosis
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Postoperative Complications / pathology
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Postoperative Complications / therapy
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Renal Artery / pathology
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Tibial Arteries / pathology
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Tomography, X-Ray Computed
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Tunica Media* / pathology