1
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Kejiou H, Rizziki A, Ouhmich M, Benzirare A, Mahi OE. [Case report : Rare case of a spontaneous pseudoaneurysm of the superficial femoral artery revealing Behçet's disease in a young patient]. Ann Cardiol Angeiol (Paris) 2024; 73:101707. [PMID: 38262254 DOI: 10.1016/j.ancard.2023.101707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 08/02/2023] [Accepted: 10/26/2023] [Indexed: 01/25/2024]
Abstract
Behçet's disease is a chronic inflammatory vascular disorder that can affect arteries and veins of various sizes. Arterial involvement, which plays a significant prognostic role, requires a treatment approach involving corticosteroids, immunosuppressants, and potentially surgical or endovascular procedures. This article presents the case of a young man diagnosed with Behçet's disease, manifested by a spontaneous pseudoaneurysm in the superficial femoral artery. The patient underwent surgical intervention to remove the pseudoaneurysm and restore circulation using a venous graft. This case underscores the importance of considering Behçet's disease in vascular manifestations.
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Affiliation(s)
- Houssam Kejiou
- Département de Chirurgie Vasculaire, Centre Hospitalier Universitaire Mohamed 6 d'Oujda au Maroc Faculté de Médecine, Université Mohamed 5, Oujda, Maroc.
| | - Abdellah Rizziki
- Département de Chirurgie Vasculaire, Centre Hospitalier Universitaire Mohamed 6 d'Oujda au Maroc Faculté de Médecine, Université Mohamed 5, Oujda, Maroc
| | - Mohamed Ouhmich
- Département de Chirurgie Vasculaire, Centre Hospitalier Universitaire Mohamed 6 d'Oujda au Maroc Faculté de Médecine, Université Mohamed 5, Oujda, Maroc
| | - Adnane Benzirare
- Département de Chirurgie Vasculaire, Centre Hospitalier Universitaire Mohamed 6 d'Oujda au Maroc Faculté de Médecine, Université Mohamed 5, Oujda, Maroc
| | - Omar El Mahi
- Département de Chirurgie Vasculaire, Centre Hospitalier Universitaire Mohamed 6 d'Oujda au Maroc Faculté de Médecine, Université Mohamed 5, Oujda, Maroc
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2
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El Bhali H, Zahdi O, Bensaid B, Bounssir A, El Khloufi S, Sefiani Y, El Mesnaoui A, Lekehal B. [Compressive false aneurysm of the brachial artery in a hemodialysis patient: Always superficialize the basilic vein of the arm!]. Nephrol Ther 2021; 18:63-65. [PMID: 34838487 DOI: 10.1016/j.nephro.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 09/05/2021] [Accepted: 09/13/2021] [Indexed: 11/24/2022]
Abstract
The creation and preservation of vascular accesses, in patients with end-stage renal failure, remains a challenge for nephrologists and vascular surgeons. Native fistula is the best vascular access, humeral-basilic fistula is a precious access in patients who have exhausted their venous capital in the forearm and in whom the cephalic vein of the arm is small or damaged. Given its deep location, any puncture of this vein is prohibited before its superficialization, even if it is of good caliber, because it can have dramatic consequences, in particular the loss of the limb or even death. We report the case of a patient undergoing hemodialysis for seven years with a non-superficialized humeral-basilic fistula, admitted for an iatrogenic false aneurysm of the brachial artery following a puncture for dialysis, with compression of the median nerve, treated surgically.
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Affiliation(s)
- Hajar El Bhali
- Université Mohammed V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina, 10104 Souissi, Rabat, Maroc.
| | - Othman Zahdi
- Université Mohammed V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina, 10104 Souissi, Rabat, Maroc
| | - Badr Bensaid
- Université Mohammed V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina, 10104 Souissi, Rabat, Maroc
| | - Ayoube Bounssir
- Université Mohammed V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina, 10104 Souissi, Rabat, Maroc
| | - Samir El Khloufi
- Université Mohammed V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina, 10104 Souissi, Rabat, Maroc
| | - Yasser Sefiani
- Université Mohammed V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina, 10104 Souissi, Rabat, Maroc
| | - Abbes El Mesnaoui
- Université Mohammed V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina, 10104 Souissi, Rabat, Maroc
| | - Brahim Lekehal
- Université Mohammed V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina, 10104 Souissi, Rabat, Maroc
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3
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Bounssir A, Bakkali T, Mouhani S, Elkhaloufi S, Sefiani Y, El Mesnaoui A, Lekehal B. [Unusual complication of Behcet's disease]. Ann Cardiol Angeiol (Paris) 2021; 70:119-121. [PMID: 33032787 DOI: 10.1016/j.ancard.2020.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
Arterial involvement in Behcet's disease is rare and the tibioperoneal trunk localisation is exceptional. We report the case of a young men with Behcet's disease and in whom the evolution to angiobehcet was unusual. The medical treatment and the therapeutic abstention were decided according to a bundle of argument.
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Affiliation(s)
- A Bounssir
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc.
| | - T Bakkali
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
| | - S Mouhani
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
| | - S Elkhaloufi
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
| | - Y Sefiani
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
| | - A El Mesnaoui
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
| | - B Lekehal
- Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn Sina de Rabat, 10104 Souissi Rabat, Maroc; Université Mohammed V de Rabat, avenue des Nations Unies, Agdal Rabat, Maroc
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4
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Zahdi O, El Bhali H, Taous H, Jdar A, El Khloufi S, Sefiani Y, El Mesnaoui A, Lekehal B. [Giant ruptured common femoral artery aneurysm revealing Behçet's disease]. Ann Cardiol Angeiol (Paris) 2021; 70:59-61. [PMID: 33303184 DOI: 10.1016/j.ancard.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/04/2020] [Indexed: 06/12/2023]
Abstract
Vascular involvement in Behçet's disease is rare. Aneurysmal arterial involvement is the severe form of the disease, it constitutes a therapeutic challenge given its severity, and frequent secondary complications, especially at anastomosis. The systematic immunosuppressive drug treatment and surgical technique thoroughness can reduce relapse rate. We report the case of a young man in whom a ruptured false aneurysm of the common femoral artery revealed Behçet's disease. He underwent an open repair, with prosthetic arterial reconstruction, and anastomosis reinforcement with teflon.
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Affiliation(s)
- O Zahdi
- Université Mohammed-V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn-Sina, 10104 Souissi, Rabat, Maroc.
| | - H El Bhali
- Université Mohammed-V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn-Sina, 10104 Souissi, Rabat, Maroc
| | - H Taous
- Université Mohammed-V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn-Sina, 10104 Souissi, Rabat, Maroc
| | - A Jdar
- Université Mohammed-V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn-Sina, 10104 Souissi, Rabat, Maroc
| | - S El Khloufi
- Université Mohammed-V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn-Sina, 10104 Souissi, Rabat, Maroc
| | - Y Sefiani
- Université Mohammed-V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn-Sina, 10104 Souissi, Rabat, Maroc
| | - A El Mesnaoui
- Université Mohammed-V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn-Sina, 10104 Souissi, Rabat, Maroc
| | - B Lekehal
- Université Mohammed-V de Rabat, Rabat, Maroc; Service de chirurgie vasculaire, centre hospitalo-universitaire Ibn-Sina, 10104 Souissi, Rabat, Maroc
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5
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Aghoutane N, Lyazidi Y, Zoulati M, Bakkali T, Chtata H, Taberkant M. [Emergency endovascular treatment for ruptured post-traumatic pseudoaneurysm of the superior gluteal artery]. J Med Vasc 2019; 44:422-425. [PMID: 31761308 DOI: 10.1016/j.jdmv.2019.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 07/30/2019] [Indexed: 10/25/2022]
Abstract
Pseudoaneurysms of the gluteal arteries are rare, often secondary to blunt or penetrating pelvic trauma. These pseudoaneurysms are initially asymptomatic and manifest after a variable delay ranging from a few weeks to many years after the initial trauma. The spontaneous outcome can be fatal in case of rupture. Previously, treatment of gluteal pseudoaneurysms was exclusively surgical, but the advent of endovascular techniques revolutionized management practices by decreasing perioperative morbidity and offering results comparable to those of surgery. We report the case of a patient admitted for emergency management of a ruptured post-traumatic pseudoaneurysm of the superior gluteal artery that had occurred 20 days after penetrating buttock trauma. Selective embolization was successful.
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Affiliation(s)
- N Aghoutane
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc.
| | - Y Lyazidi
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - M Zoulati
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - T Bakkali
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - H Chtata
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - M Taberkant
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
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6
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Mleyhi S, Lagha A, Ziadi J, Ben Hammamia M, Messai M, Ben Mrad M, Ghédira F, Denguir R. [A rare localization of angio-Behçet revealed by a false aneurism of a gluteal artery treated surgically]. J Med Vasc 2019; 44:228-232. [PMID: 31029279 DOI: 10.1016/j.jdmv.2019.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 02/16/2019] [Indexed: 06/09/2023]
Abstract
Behçet's disease is a rare chronic systemic inflammatory disease. It is more common in Turkey, North Africa and Japan. The incidence of vascular involvement (angio-Behçet) is 7 to 38%. The gluteal localization of angio-Behçet is rarely reported and could be revealed late. Aside from aneurysmal rupture, nerve compression with pain and lower limb impotence could be the main clinical signs. Because of the deep location of the lesion, management of this disease can be difficult. The classic surgical treatment remains the gold-standard especially in case of extreme urgency, non-feasibility of endovascular treatment and especially in case of associated nerve compression. We report the case of a 45-year-old man with a history of pulmonary angio-Behcet, who underwent emergency surgery for a huge false aneurism of a collateral of the hypogastric artery treated via a double anterior and posterior approach with good outcome.
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Affiliation(s)
- S Mleyhi
- Département de chirurgie cardiovasculaire et thoracique, CHU La Rabta, faculté de médecine de Tunis, université de Tunis El Manar, Tunisie.
| | - A Lagha
- Département de chirurgie cardiovasculaire et thoracique, CHU La Rabta, faculté de médecine de Tunis, université de Tunis El Manar, Tunisie
| | - J Ziadi
- Département de chirurgie cardiovasculaire et thoracique, CHU La Rabta, faculté de médecine de Tunis, université de Tunis El Manar, Tunisie
| | - M Ben Hammamia
- Département de chirurgie cardiovasculaire et thoracique, CHU La Rabta, faculté de médecine de Tunis, université de Tunis El Manar, Tunisie
| | - M Messai
- Département de chirurgie cardiovasculaire et thoracique, CHU La Rabta, faculté de médecine de Tunis, université de Tunis El Manar, Tunisie
| | - M Ben Mrad
- Département de chirurgie cardiovasculaire et thoracique, CHU La Rabta, faculté de médecine de Tunis, université de Tunis El Manar, Tunisie
| | - F Ghédira
- Département de chirurgie cardiovasculaire et thoracique, CHU La Rabta, faculté de médecine de Tunis, université de Tunis El Manar, Tunisie
| | - R Denguir
- Département de chirurgie cardiovasculaire et thoracique, CHU La Rabta, faculté de médecine de Tunis, université de Tunis El Manar, Tunisie
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7
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Aghoutane N, Lyazidi Y, Zoulati M, Bakkali T, Chtata H, Taberkant M. [Spontaneous false aneurysm of the extracranial internal carotid artery - during pregnancy]. J Med Vasc 2019; 44:233-236. [PMID: 31029280 DOI: 10.1016/j.jdmv.2019.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 01/28/2019] [Indexed: 01/21/2023]
Abstract
Extracranial carotid false aneurysms are rare but serious because of the high risk of rupture and thromboembolic ischemic strokes. Although hemodynamic and hormonal physiological changes in pregnant women may favor arterial rupture and the development of false aneurysms, only one case of extracranial carotid false aneurysm related to pregnancy has been reported in the literature. Surgical repair is still the treatment of choice of these lesions. We report a case of spontaneous false aneurysm of the extracranial internal carotid artery occurring at the end of pregnancy. The surgical procedure consisted in resection of the false aneurysm with interposition of a prosthetic graft. The follow-up was uneventful.
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Affiliation(s)
- N Aghoutane
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc.
| | - Y Lyazidi
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - M Zoulati
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - T Bakkali
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - H Chtata
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - M Taberkant
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
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8
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Bakkali T, Hormatallah M, Bounssir A, Aghoutane N, Taous H, Idrissi R, Sefiani Y, Lekhel B, Mesnaoui A, Bensaid Y. [False aneurysm of the external iliac artery revealing Behçet's disease]. J Med Vasc 2018; 43:332-334. [PMID: 30217350 DOI: 10.1016/j.jdmv.2018.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/01/2018] [Indexed: 06/08/2023]
Abstract
Behçet's disease is a vasculitis of unknown etiology. Vascular involvement is rare, but may be inaugural in many cases. We report a case of Behçet's disease revealed by a symptomatic pseudo-aneurysm of the external iliac artery. The symptomatology was non-specific. Ultrasound Doppler and computed tomographic angiography were essential for diagnosis. The pseudo-aneurysm was managed by endovascular treatment. Corticosteroid and immunosuppressant therapy were administrated after surgery.
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Affiliation(s)
- T Bakkali
- Service de chirurgie vasculaire, CHU Ibn-Sina, Rabat, Maroc.
| | - M Hormatallah
- Service de chirurgie vasculaire, CHU Ibn-Sina, Rabat, Maroc
| | - A Bounssir
- Service de chirurgie vasculaire, CHU Ibn-Sina, Rabat, Maroc
| | - N Aghoutane
- Service de chirurgie vasculaire, CHU Ibn-Sina, Rabat, Maroc
| | - H Taous
- Service de chirurgie vasculaire, CHU Ibn-Sina, Rabat, Maroc
| | - R Idrissi
- Service de chirurgie vasculaire, CHU Ibn-Sina, Rabat, Maroc
| | - Y Sefiani
- Service de chirurgie vasculaire, CHU Ibn-Sina, Rabat, Maroc
| | - B Lekhel
- Service de chirurgie vasculaire, CHU Ibn-Sina, Rabat, Maroc
| | - A Mesnaoui
- Service de chirurgie vasculaire, CHU Ibn-Sina, Rabat, Maroc
| | - Y Bensaid
- Service de chirurgie vasculaire, CHU Ibn-Sina, Rabat, Maroc
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9
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Ben Hammamia M, Fourati M, Ziadi J, Ghedira F, Ben Mrad M, Denguir R. [Femoral pseudoaneurysms in drug addicts: About 4 cases]. J Med Vasc 2018; 43:193-197. [PMID: 29754729 DOI: 10.1016/j.jdmv.2018.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/24/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE To describe the therapeutic management of false aneurysms of the femoral artery in drug addicts. PATIENTS AND METHODS We report the cases of four drug addicts with pseudoaneurysms of the femoral artery. RESULTS All patients were male with a mean age of 36 years. Emergency surgical treatment involved removal of the pseudoaneurysm followed by a venous graft (n=3) or patch (n=1). The post-operative period was uneventful for three patients. One patient required early revision with a second venous bypass after bleeding from the first then later a second revision for resection of infected tissue and sartorius muscle plasty to cover the groin area. Late outcome was favorable for all patients after an average 12-month follow-up. CONCLUSION No consensus has been reached concerning the appropriate treatment for false aneurysms of the femoral artery in drug addicts. Analyses of larger series with longer follow-ups are needed to elucidate the best emergency surgical methods capable of reducing the risk of rupture.
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Affiliation(s)
- M Ben Hammamia
- Service de chirurgie cardio-vasculaire et thoracique, faculté de médecine de Tunis, CHU La Rabta, Bab-Saadoun, 1006 Tunis, Tunisie
| | - M Fourati
- Service de chirurgie cardio-vasculaire et thoracique, faculté de médecine de Tunis, CHU La Rabta, Bab-Saadoun, 1006 Tunis, Tunisie.
| | - J Ziadi
- Service de chirurgie cardio-vasculaire et thoracique, faculté de médecine de Tunis, CHU La Rabta, Bab-Saadoun, 1006 Tunis, Tunisie
| | - F Ghedira
- Service de chirurgie cardio-vasculaire et thoracique, faculté de médecine de Tunis, CHU La Rabta, Bab-Saadoun, 1006 Tunis, Tunisie
| | - M Ben Mrad
- Service de chirurgie cardio-vasculaire et thoracique, faculté de médecine de Tunis, CHU La Rabta, Bab-Saadoun, 1006 Tunis, Tunisie
| | - R Denguir
- Service de chirurgie cardio-vasculaire et thoracique, faculté de médecine de Tunis, CHU La Rabta, Bab-Saadoun, 1006 Tunis, Tunisie
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10
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Böge G, Laroche JP, Alric P. [Treatment of post-catheterization pseudoaneurysms by ultrasound-guided thrombin injection: A single-center experience and practical guideline]. J Med Vasc 2017; 42:198-203. [PMID: 28705337 DOI: 10.1016/j.jdmv.2017.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 04/30/2017] [Indexed: 11/25/2022]
Abstract
Ultrasound-guided thrombin injection has been shown to be a safe and effective treatment for iatrogenic post-catheterization pseudoaneurysms, but still is underused in France. We report our single-center experience and propose a technical guideline for ultrasound-guided thrombin injection. Ultrasound-guided thrombin injection should be considered to be the first-line treatment of iatrogenic pseudoaneurysms.
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Affiliation(s)
- G Böge
- Service de chirurgie thoracique et vasculaire, hôpital Arnaud-de-Villeneuve, CHRU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France.
| | - J P Laroche
- Service des maladies vasculaires et médecine interne, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - P Alric
- Service de chirurgie thoracique et vasculaire, hôpital Arnaud-de-Villeneuve, CHRU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France
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11
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Ben Jmaà H, Dhouib F, Jmal H, Ghorbel N, Bouassida A, Trigui M, Souissi I, Masmoudi S, Elleuch N, Frikha I. [Popliteal artery pseudoaneurysm caused by femur exostosis: A pediatric case]. ACTA ACUST UNITED AC 2016; 41:290-3. [PMID: 27318498 DOI: 10.1016/j.jmv.2016.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 04/23/2016] [Indexed: 11/19/2022]
Abstract
Exostoses, or osteochondromas are benign bone tumors that have developed on the bone surface. These benign tumors can be asymptomatic or lead to complications, for instance arterial pseudoaneurysm. We report a case of a pseudoaneurysm of the popliteal artery treated surgically in a 17-year-old girl with a solitary exostosis of the right femur. Surgery was closure of the pseudoaneurysm and a bypass using a venous graft.
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Affiliation(s)
- H Ben Jmaà
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib Bourguiba, 3029 Sfax, Tunisie.
| | - F Dhouib
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib Bourguiba, 3029 Sfax, Tunisie
| | - H Jmal
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib Bourguiba, 3029 Sfax, Tunisie
| | - N Ghorbel
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib Bourguiba, 3029 Sfax, Tunisie
| | - A Bouassida
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib Bourguiba, 3029 Sfax, Tunisie
| | - M Trigui
- Service d'orthopédie, hôpital Habib Bourguiba, 3029 Sfax, Tunisie
| | - I Souissi
- Service d'anesthésie-réanimation, hôpital Habib Bourguiba, 3029 Sfax, Tunisie
| | - S Masmoudi
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib Bourguiba, 3029 Sfax, Tunisie
| | - N Elleuch
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib Bourguiba, 3029 Sfax, Tunisie
| | - I Frikha
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib Bourguiba, 3029 Sfax, Tunisie
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Raherinantenaina F, Rajaonanahary TMA, Rakoto Ratsimba HN. [Femoral artery pseudoaneurysms encountered in orthopedics and traumatology]. ACTA ACUST UNITED AC 2015; 40:376-83. [PMID: 26357938 DOI: 10.1016/j.jmv.2015.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 07/09/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND PURPOSE Most published articles regarding orthopedic- and trauma-related femoral artery pseudoaneurysms (FAPs) are case reports in English. Reported cases are often associated with a literature review but actually provide little robust data. We wanted to summarize the current knowledge on diagnostic and therapeutic features of these FAPs. METHODS A new case of superficial FAP is described followed by a review of the literature. A bibliographic search was performed online (PubMed, ScinceDirect) from 1964 to 2015 using the descriptors "traumatic femoral pseudoaneurysm, orthopedic surgery, osteochondroma". RESULTS A total of 64 cases of FAPs was analyzed. There were 50 men with an average age of 40.72±26.45 years old. The most common clinical presentation was painful swelling (34%). Arteriography was the commonest radiological investigation used (63%). The main etiologies were orthopedic injuries (47%), surgery of the upper thigh (30%) and femoral osteochondromas (23%). Arterial injuries included superficial femoral (47%) and profunda femoris artery (50%). The treatment was open surgery (56%) or endovascular repair (36%). Deep femoral artery and its branches were embolized (47%) or ligated (38%). Endovascular stenting was performed in 30% of posttraumatic FAPs. All FAPs relating to osteochondromas were repaired surgically. Postoperative courses were uneventful in 95% of patients. CONCLUSION Endovascular embolization is preferred in management of postsurgical FAPs which have usually involved the deep femoral artery. Endovascular stenting graft may be proposed for posttraumatic FAPs, for which the superficial femoral trunk is the most often involved vessel. Surgical repair should be performed when endovascular stenting graft is not feasible. Surgical repair is mandatory for all FAPs secondary to traumatic exostoses.
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Affiliation(s)
- F Raherinantenaina
- Service de chirurgie générale et vasculaire, CHU/HJRA, Tananarive, Madagascar.
| | - T M A Rajaonanahary
- Service de chirurgie générale et vasculaire, CHU/HJRA, Tananarive, Madagascar
| | - H N Rakoto Ratsimba
- Service de chirurgie générale et vasculaire, CHU/HJRA, Tananarive, Madagascar
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Nouhaud FX, Gas J, Peyronnet B, Roumiguié M, Beauval JB, Lagarde S, Soulié M, Rischmann P, Doumerc N. [Treatment of pseudoaneurysm following partial nephrectomy]. Prog Urol 2014; 25:18-21. [PMID: 25450752 DOI: 10.1016/j.purol.2014.09.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 09/18/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Partial nephrectomy (PN) has become the gold standard for the treatment of small tumors confined to the kidney. As result, the number of PN procedures increased during the last years. Subsequently, we have more often to deal with the complications of this surgery. Among these, pseudoaneurysms are rare but potentially life-threatening due to a risk of bleeding. Therefore, pseudoaneurysms have to be treated according to a relevant strategy. METHODS We performed a literature review of the cases of pseudoaneurysm after PN was reported as well as a focus on the different treatment strategies and their outcomes. RESULTS The incidence of pseudoaneurysm is low, ranging from 0.5% to 4%. Radio-embolization represents the gold standard treatment, used in 98% of the cases reported in the literature, allowing high success rate and rare morbidity. However, in some selected cases, surveillance could be an alternative.
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Affiliation(s)
- F-X Nouhaud
- Service d'urologie et transplantation, hôpital Rangueil, centre hospitalier et universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, 31400 Toulouse, France.
| | - J Gas
- Service d'urologie et transplantation, hôpital Rangueil, centre hospitalier et universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, 31400 Toulouse, France
| | - B Peyronnet
- Service d'urologie et transplantation, hôpital Rangueil, centre hospitalier et universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, 31400 Toulouse, France
| | - M Roumiguié
- Service d'urologie et transplantation, hôpital Rangueil, centre hospitalier et universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, 31400 Toulouse, France
| | - J-B Beauval
- Service d'urologie et transplantation, hôpital Rangueil, centre hospitalier et universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, 31400 Toulouse, France
| | - S Lagarde
- Service de radiologie et imagerie médicale, hôpital Rangueil, centre hospitalier et universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, 31400 Toulouse, France
| | - M Soulié
- Service d'urologie et transplantation, hôpital Rangueil, centre hospitalier et universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, 31400 Toulouse, France
| | - P Rischmann
- Service d'urologie et transplantation, hôpital Rangueil, centre hospitalier et universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, 31400 Toulouse, France
| | - N Doumerc
- Service d'urologie et transplantation, hôpital Rangueil, centre hospitalier et universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, 31400 Toulouse, France
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