Arc of Buhler: A lifesaving anatomic variation. A case report.

Autor:	Nikolaos S; Evangelismos General Hospital of Athens, Department of Cardio Thoracic and Vascular Surgery, Athens, Greece., Vasilios P; Evangelismos General Hospital of Athens, Department of Cardio Thoracic and Vascular Surgery, Athens, Greece., Niki L; Kapodistrian University of Athens, Research Unit of Radiology and Medical Imaging, Greece., Argyriou EO; Whipps Cross University Hospital, Barts Health NHS Trust, Departement of Colorectal Surgery, London, UK., Theodoros K; Evangelismos General Hospital of Athens, Interventional Radiology Unit, Department of Radiology, Athens, Greece., Mihalis A; Evangelismos General Hospital of Athens, Department of Cardio Thoracic and Vascular Surgery, Athens, Greece.
Jazyk:	angličtina
Zdroj:	Jornal vascular brasileiro [J Vasc Bras] 2020 Nov 23; Vol. 19, pp. e20200045. Date of Electronic Publication: 2020 Nov 23.
DOI:	10.1590/1677-5449.200045
Abstrakt:	The presence of malperfusion syndrome in cases of complicated acute type B aortic dissection is a negative predictive factor and urgent intervention is indicated. Anatomic variations, such as the Arc of Buhler, contribute anastomotic channels and can preserve the visceral blood supply. In this case report, we describe the overall management of a 54-year-old man who presented with a type B aortic dissection. Initially, conservative management was chosen, as indicated for an uncomplicated type B dissection, but the dissection deteriorated. Despite the fact that severe occlusion of the celiac artery was detected on Computed Tomography (CT) angiography, the Arc of Buhler anatomical variation was present, contributing adequate visceral blood supply. After considering this finding, the patient was treated effectively with thoracic endovascular aortic repair (TEVAR). Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article.
Databáze:	MEDLINE
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