prikaz prve stranice dokumenta Combined endovascular repair of aorta and removal of penetrating pedicle screw after posterior instrumentation: a case report and literature review
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Scientific paper - Case study
Combined endovascular repair of aorta and removal of penetrating pedicle screw after posterior instrumentation: a case report and literature review
Acta clinica Croatica, 63. (2024), 2; 422-430. https://doi.org/10.20471/acc.2024.63.02.20
Girotto, Dean Girotto; Burić, Josip; Šimić, Hrvoje; Tomulić, Vjekoslav; Jakljević, Tomislav; Kvas, Zvonimir

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Girotto, D. G., Burić, J., Šimić, H., Tomulić, V., Jakljević, T. & Kvas, Z. (2024). Combined endovascular repair of aorta and removal of penetrating pedicle screw after posterior instrumentation: a case report and literature review. Acta clinica Croatica, 63.. (2), 422-430. doi: 10.20471/acc.2024.63.02.20

Girotto, Dean Girotto, et al. "Combined endovascular repair of aorta and removal of penetrating pedicle screw after posterior instrumentation: a case report and literature review." Acta clinica Croatica, vol. 63., no. 2, 2024, pp. 422-430. https://doi.org/10.20471/acc.2024.63.02.20

Girotto, Dean Girotto, Josip Burić, Hrvoje Šimić, Vjekoslav Tomulić, Tomislav Jakljević and Zvonimir Kvas. "Combined endovascular repair of aorta and removal of penetrating pedicle screw after posterior instrumentation: a case report and literature review." Acta clinica Croatica 63., no. 2 (2024): 422-430. https://doi.org/10.20471/acc.2024.63.02.20

Girotto, D. G., et al. (2024) 'Combined endovascular repair of aorta and removal of penetrating pedicle screw after posterior instrumentation: a case report and literature review', Acta clinica Croatica, 63.(2), pp. 422-430. doi: 10.20471/acc.2024.63.02.20

Girotto DG, Burić J, Šimić H, Tomulić V, Jakljević T, Kvas Z. Combined endovascular repair of aorta and removal of penetrating pedicle screw after posterior instrumentation: a case report and literature review. Acta clinica Croatica [Internet]. 2024 [cited 2025 February 27];63.(2):422-430. doi: 10.20471/acc.2024.63.02.20

D. G. Girotto, J. Burić, H. Šimić, V. Tomulić, T. Jakljević and Z. Kvas, "Combined endovascular repair of aorta and removal of penetrating pedicle screw after posterior instrumentation: a case report and literature review", Acta clinica Croatica, vol. 63., no. 2, pp. 422-430, 2024. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:184:485783. [Accessed: 27 February 2025]

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Metadata
Title (english)Combined endovascular repair of aorta and removal of penetrating pedicle screw after posterior instrumentation: a case report and literature review
Title (croatian)Kombinirano endovaskularno liječenje lezije aorte i uklanjanje penetrirajućeg pedikularnog vijka nakon stražnje instrumentacije kralježnice: prikaz slučaja i pregled literature
AuthorDean Girotto Girotto
AuthorJosip Burić
MBZ: 163286
AuthorHrvoje Šimić
AuthorVjekoslav Tomulić
AuthorTomislav Jakljević
AuthorZvonimir Kvas
Author's institutionUniversity of Rijeka
Faculty of Medicine
(Department of Internal Medicine)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Surgery
Abstract (english)
Stabilization of spine using transpedicular screws is the most commonly used instrumentation technique among spinal surgeons. The ‘free hand’ technique is considered relatively safe and can be performed under x-ray control. Vascular injuries with misplaced screws are rare but potentially fatal complications. Injury of thoracoabdominal aorta by malpositioned screw demands a multidisciplinary approach. Injury of vessel wall might demand screw removal and vessel wall repair. Here we present a case of 72-year-old female patient who underwent long segment fixation of thoracolumbar spine. During follow up, computed tomography (CT) scan and afterwards aortography showed a lesion of the posterior aortic wall by malpositioned screw without signs of bleeding. After meticulous preparation, combined endovascular repair with stent-graft and removal of the penetrating screw were performed. Endovascular treatment was performed simultaneously with screw removal. During screw removal, the patient was in lateral decubital position. The patient was discharged on postoperative day 8. Follow up CT aortography 6 months later showed no leak or other changes in the aorta. We found combined endovascular vessel repair with simultaneous screw removal safe and sufficient for this kind of aortic injury. Although lateral decubital position bears limitations, it gives enough space for the operator. Performing intraoperative aortography provides good insight into stent position and possible bleeding after screw removal.
Abstract (croatian)
Stabilizacija kralježnice transpedikularnim vijcima najčešća je tehnika instrumentacije među spinalnim kirurzima. Tehnika „slobodne ruke“ je relativno sigurna uz kontrolu intraoperacijskog rendgena. Vaskularne ozljede malpozicioniranim vijcima su rijetke, ali potencijalno kobna komplikacija. Ozljede torakoabdominalne aorte malpozicioniranim vijkom zahtijevaju multidisciplinarni pristup. Ozljeda stijenke krvne žile može zahtijevati uklanjanje vijka i popravak lezije. U ovom radu prikazujemo slučaj 72-godišnje bolesnice kod koje je učinjena duga fi ksacija torakolumbarne kralježnice. Kontrolna kompjutorizirana tomografija (CT) tijekom poslijeoperacijskog praćenja, a potom i aortografija pokazali su leziju stražnjeg zida aorte malpozicioniranim vijkom bez znakova krvarenja. Nakon minuciozne pripreme učinjen je kombinirani zahvat, tj. simultani endovaskularni popravak aorte stent-graftom i uklanjanje vijka. Tijekom uklanjanja vijka bolesnica je bila u desnom bočnom položaju. Otpuštena je na kućno liječenje osmog poslijeoperacijskog dana. Kontrolna CT aortografija 6 mjeseci kasnije nije pokazala krvarenja ili bilo kakve promjene na aorti. Smatramo da je simultani endovaskularni popravak lezije aorte i uklanjanje vijka siguran i prikladan pristup u liječenju ove komplikacije. Bočni položaj nosi određena ograničenja za operatere, ali istodobno ostavlja dovoljno prostora za siguran rad. Intraoperacijska aortografija daje dobar uvid u položaj stenta ili eventualno krvarenje nakon uklanjanja vijka.
Keywords (english)
Keywords (croatian)
Languageenglish
Languagecroatian
Publication typeScientific paper - Case study
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleActa clinica Croatica
Numberingvol. 63., no. 2, pp. 422-430
p-ISSN0353-9466
e-ISSN1333-9451
DOIhttps://doi.org/10.20471/acc.2024.63.02.20
URN:NBNurn:nbn:hr:184:485783
Publication2024
Document URLhttps://hrcak.srce.hr/328164
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) icon
Created on2025-02-27 14:20:36