SOMATOM Definition Flash Follow-up Examination after Stent Implantation for Ruptured Aneurysm
Author: Sebastian Leschka, MD
Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland | 2009-10-05
An 81-year-old male patient presented at the radiology department for follow-up examination. Six weeks before the patient had been delivered to the hospital for coiling and stent implantation because of a ruptured aneurysm of arteria iliaca interna. Previous to implantation, the patient complained over pain in the lower abdominal region. One day after stent implantation a type II endoleakage appeared. Four days after implantation, an acute bleeding of the urethra had been found after removal of permanent catheter.
The scheduled follow-up exam was requested to indicate progress of convalescence.
During examination with SOMATOM Definition Flash scanner, supra-aortic vessels were shown to be normal. No pathologically increased lymph nodes could be found. There were no findings regarding pleural contusion or pneumothorax. Moderately decreased dorso-basal left-sided lung-ventilation was noted but no pathological pulmonary or mediastinal lesions could be detected.
The abdomen was found to be adequately perfused and the previously coiled right arteria iliaca interna was retrogradely supplied with blood. In the right-sided pelvis minor, the known Iliaca interna aneurysm, a non-perfused sack-like aneurysm with maximum dimension of 6.9 cm X 7.2 cm, was visible. Additionally, an arising, cyst-like hematoma (max. 6.4 cm X 3.3 cm) was detected. The boundary area of the hematoma showed increased contrast media uptake. The implanted stent in the right arteria iliaca communis showed a regular position not indicating any endoleak. No intraperitoneal fluid was visible. No pathologically increased lymph nodes were found in the abdomen.
The follow-up could be conducted quickly and progress of the patient´s convalescence indicated with reliable image results. Regular follow-up investigations for monitoring future recovery have been recommended.
For the scan, only a dose of 3.01 mSv was necessary. With the very same single scan, substantial coronary artery stenosis could be excluded.
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