A rare case of thoracic-abdominal aortic aneurysm in conjunction with bilateral superficial femoral artery occlusion, documented with computed tomography angiography

Lavdim Ymeri, MD; Flaka Pasha, MD; Valon Zejnullahu, MDPhD; Edona Leci Desku, MD; Bujar Gjikolli, MD; Dardan Dreshaj, MD

Radiology Case Reports (Mar 2022)

A rare case of thoracic-abdominal aortic aneurysm in conjunction with bilateral superficial femoral artery occlusion, documented with computed tomography angiography

Lavdim Ymeri, MD,
Flaka Pasha, MD,
Valon Zejnullahu, MDPhD,
Edona Leci Desku, MD,
Bujar Gjikolli, MD,
Dardan Dreshaj, MD

Affiliations

Lavdim Ymeri, MD: Clinic of Radiology, University Clinical Center of Kosovo, Kosovo; Alma Mater Europaea Campus College “Rezonanca,” Kosovo
Flaka Pasha, MD: Clinic of Radiology, University Clinical Center of Kosovo, Kosovo; Department of Pharmacology and Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Prishtina “Hasan Prishtina,” Kosovo; Corresponding author.
Valon Zejnullahu, MDPhD: Alma Mater Europaea Campus College “Rezonanca,” Kosovo; Clinic of General Surgery, University Clinical Center of Kosovo, Kosovo
Edona Leci Desku, MD: Clinic of Radiology, Sheikh Zayed Hospital at Vushtri, Kosovo
Bujar Gjikolli, MD: Clinic of Radiology, University Clinical Center of Kosovo, Kosovo; Department of Radiology, AAB College, Kosovo
Dardan Dreshaj, MD: Head and Neck Surgery Clinic, University Clinical Center of Kosovo, Kosovo

Journal volume & issue: Vol. 17, no. 3
pp. 505 – 510

Abstract

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Aneurysms represent bulging of the weakened blood vessel area, as a result of cystic medial degeneration. Aneurysms chance of rupturing increases over time, resulting in bleeding and death. Therefore, patients with aortic aneurysms require frequent monitoring with magnetic resonance and computed tomography angiography, as well as undergoing open repair surgery and endovascular aneurysm repair.We present a case of ruptured thoracic aortic aneurysm in conjunction with bilateral superficial femoral occlusion, as incidental findings in Covid-19 positive patient.The patient, a 62-years-old female, presented with cough, shortness of breath, fever and leg claudication. Doppler ultrasonography of the lower limbs was conducted to rule out thromboembolism, revealing bilateral superficial femoral arteries occlusion. The patient was administered high doses of parenteral anticoagulants.Hemoptysis ensued, prompting an MSCT scan, that showed right pleural effusion, atelectasis, and right active perihilar infiltrates with inter-lobar pleurisy. Due to inflammatory changes on the lung parenchyma, the patient got tested for Sars-Cov-2, and resulted positive.Contrast-enhanced MSCT also revealed thoracic-abdominal aortic aneurysm with its highest diameter measuring 10 cm, and massive per-aortal thrombus and/or hematoma of 5 cm, which was further ruptured and patient died untreated in the fourth day of hospitalization.Questions arise whether Covid-19 was the primary cause of bilateral superficial femoral artery occlusion and whether high doses of parenteral anticoagulants were the primary cause of thoracic aortic aneurysm rupture.Thus, a careful balance must be made between the detrimental and protective contributions of anticoagulants in the patients presenting with Covid-19 and thoracic-abdominal aortic aneurysm.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: http://www.journals.elsevier.com/radiology-case-reports/

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