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Diagnóstico y tratamiento de un hemotórax causado por un seudoaneurisma de arteria intercostal
Diagnosis and treatment of hemothorax caused by intercostal artery pseudoaneurysm
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Aumento de densidad en ambos vértices pulmonares, secundario a oleotórax bilateral como tratamiento de la tuberculosis pulmonar.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cristina López Riolobos, Enrique Zamora García, Elena García Castillo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Cristina" "apellidos" => "López Riolobos" ] 1 => array:2 [ "nombre" => "Enrique" "apellidos" => "Zamora García" ] 2 => array:2 [ "nombre" => "Elena" "apellidos" => "García Castillo" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212916000264" "doi" => "10.1016/j.arbr.2016.02.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916000264?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028961500054X?idApp=UINPBA00003Z" "url" => "/03002896/0000005200000004/v1_201603270531/S030028961500054X/v1_201603270531/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen clínica</span>" "titulo" => "Diagnóstico y tratamiento de un hemotórax causado por un seudoaneurisma de arteria intercostal" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "219" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "María Rodríguez, Teresa González de la Huebra Labrador, Jose L. Aranda" "autores" => array:3 [ 0 => array:4 [ "nombre" => "María" "apellidos" => "Rodríguez" "email" => array:1 [ 0 => "mery.rodriguez.perez@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Teresa" "apellidos" => "González de la Huebra Labrador" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Jose L." "apellidos" => "Aranda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Radiología Vascular e Intervencionista, Hospital Universitario de Salamanca, Salamanca, España" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Diagnosis and treatment of hemothorax caused by intercostal artery pseudoaneurysm" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 406 "Ancho" => 1950 "Tamanyo" => 78720 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Angiografía de la décima arteria intercostal. B) Embolización distal y proximal del seudoaneurisma. C) Preservación de la vascularización vertebral tras la embolización.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Los seudoaneurismas de las arterias intercostales (SAI) son raros y difíciles de diagnosticar, y pueden surgir como complicación de cualquier intervención realizada a través de los espacios intercostales. Por lo general son asintomáticos hasta que su apertura hacia la cavidad pleural produce un hemotórax. Presentamos el caso de un paciente con un SAI después de una resección pulmonar a través de una toracotomía. Como el seudoaneurisma no se sospechaba, el paciente se reoperó por hemotórax a los 21 días de la primera cirugía, sin que se observara ningún punto de sangrado dentro de la cavidad pleural. Diez días después de la segunda cirugía el paciente presentó un nuevo episodio de hemotórax. Mediante la realización de una angiografía se le detectó el SAI. La angiografía selectiva de la décima arteria intercostal se llevó a cabo utilizando un catéter tipo cobra. La embolización del SAI se realizó utilizando un microcatéter, a través del cual se liberaron <span class="elsevierStyleItalic">microcoils</span> en la arteria afectada, primero distalmente y después proximalmente al SAI, hasta su oclusión completa<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a> (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>). Un drenaje pleural fue suficiente para evacuar el hemotórax del paciente.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Este caso muestra la importancia de sospechar la presencia de un SAI ante episodios de hemotórax no justificados por otras causas, con el fin de llevar a cabo un diagnóstico y un tratamiento apropiados (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 406 "Ancho" => 1950 "Tamanyo" => 78720 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Angiografía de la décima arteria intercostal. B) Embolización distal y proximal del seudoaneurisma. C) Preservación de la vascularización vertebral tras la embolización.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intercostal artery pseudoaneurysm due to stab wound" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Sekino" 1 => "H. Takagi" 2 => "H. Kubota" 3 => "T. Kato" 4 => "Y. Matsuno" 5 => "T. Umemoto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jvs.2005.03.058" "Revista" => array:6 [ "tituloSerie" => "J Vasc Surg" "fecha" => "2005" "volumen" => "42" "paginaInicial" => "352" "paginaFinal" => "356" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16102639" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pseudoaneurysms and the role of minimally invasive techniques in their management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N.E. Saad" 1 => "W.E. Saad" 2 => "M.G. Davies" 3 => "D.L. Waldman" 4 => "P.J. Fultz" 5 => "D.J. Rubens" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "RG" "fecha" => "2005" "volumen" => "25" "numero" => "Suppl 1" "paginaInicial" => "S173" "paginaFinal" => "S189" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005200000004/v1_201603270531/S0300289615003646/v1_201603270531/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005200000004/v1_201603270531/S0300289615003646/v1_201603270531/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615003646?idApp=UINPBA00003Z" ]
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