Endovascular Treatment of Late Aortic Erosive Lesion by Pedicle Screw without Screw Removal: Case Report and Literature Review.
BACKGROUND
Aortic lesions are uncommon complications in spine surgery, but potentially fatal, because they can cause massive bleeding and hemodynamic instability. We report the endovascular treatment of late aortic erosive lesion by pedicle screw without screw removal.


METHODS
A breast cancer patient had a pathological fracture on T10, with spinal cord compression, and a pseudoaneurysm of the aorta in contact with an anterolateral pedicle screw. Endovascular surgery corrected the aortic lesion and allowed decompression, a week later, by posterior arthrodesis (T7-L1), with screw maintenance.


RESULTS
There was no contrast leakage at thorax angiotomography in 2 years, and she died of meningeal carcinomatosis.


CONCLUSIONS
Screw maintenance was safe in the endovascular treatment of aortic lesion by erosion.
Endovascular and Vascular Surgery, Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Antonio Eduardo
AE
Zerati
Endovascular and Vascular Surgery, Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Dafne Braga Diamante
DB
Leiderman
Spine Surgery Division, Spinal Tumors, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
William Gemio Jacobsen
WG
Teixeira
Spine Surgery Division, Spinal Tumors, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Douglas Kenji
DK
Narazaki
Spine Surgery Division, Laboratory of Medical Investigation, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Electronic address: aacristante@uol.com.br.
Alexandre Fogaça
AF
Cristante
Vascular Surgery, Faculdade de Medicina da Universidade de São Paulo and Hospital Israelita Albert Einstein, São Paulo, Brazil.
Nelson
N
Wolosker
Vascular Surgery Department, Faculdade de Medicina da la Universidade de São Paulo, São Paulo, Brazil.
Nelson
N
de Luccia
Spine Surgery Division, Laboratory of Medical Investigation, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Tarcísio Eloy Pessoa
TE
Barros Filho
D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D001863:Bone Screws; D001943:Breast Neoplasms / Q000556:secondary* / Q000628:therapy; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*