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Lim ETA, Yew HS, Laws PE. A curious case of a spontaneous infective native pseudoaneurysm of the internal carotid artery. Ann R Coll Surg Engl 2024; 106:471-473. [PMID: 37458174 PMCID: PMC11060858 DOI: 10.1308/rcsann.2023.0012] [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] [Accepted: 02/17/2023] [Indexed: 05/02/2024] Open
Abstract
We present a case of a 77-year-old patient who presented with a stroke. She subsequently became unwell and was found to have a spontaneous infective native carotid artery pseudoaneurysm. The patient was managed conservatively as per her wishes. Despite the rarity of this clinical diagnosis, clinicians should be aware of the pathophysiology of this entity and the available literature on management.
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Affiliation(s)
| | - HS Yew
- Christchurch Hospital, New Zealand
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2
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Bezgin T, Celik AI, Baytugan NZ, Karakoyun S, Cagdas M. A guidewire-free approach for percutaneous closure of left ventricular pseudoaneurysm. J Invasive Cardiol 2024; 36. [PMID: 38422531 DOI: 10.25270/jic/23.00278] [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] [Indexed: 03/02/2024]
Abstract
A 78-year-old male patient with a history of coronary artery disease (he had undergone coronary artery bypass surgery 4 years ago), heart failure with mildly reduced ejection fraction, diabetes mellitus, and transient ischemic attack presented to the emergency department with complaints of dyspnea (New York Heart Association Class 4) despite the optimal medical therapy.
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Affiliation(s)
- Tahir Bezgin
- Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey
| | - Aziz Inan Celik
- Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey.
| | - Nart Zafer Baytugan
- Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey
| | - Suleyman Karakoyun
- Department of Cardiology, Akademi Hospital, Kocaeli, Turkey; Faculty of Health Sciences, Kocaeli Health and Technology University, Kocaeli, Turkey
| | - Metin Cagdas
- Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey
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Xu J, Huang D, Cai R. Septic pulmonary embolism complicates postoperative tetralogy of fallot: unveiling pulmonary artery pseudoaneurysms. Cardiol Young 2024; 34:930-932. [PMID: 38284403 DOI: 10.1017/s1047951123004493] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
A 12-year-old female with pulmonary artery stenosis developed pseudoaneurysms due to septic embolism, requiring close follow-up.
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Affiliation(s)
- Juan Xu
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, PR China
| | - Di Huang
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, PR China
| | - Renhui Cai
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, PR China
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4
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Bhanuman R, Varadharajan S, Kumar K, Shah VM. Lethal mycotic pseudoaneurysm presenting as isolated sixth nerve palsy. Digit J Ophthalmol 2024; 30:19-21. [PMID: 38601898 PMCID: PMC11001566 DOI: 10.5693/djo.02.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Pseudoaneurysm of the internal carotid artery caused by skull base osteomyelitis (SBO) is a lethal condition seen in immunocompromised patients, predominantly those with diabetes mellitus. Cranial nerve involvement is a common complication and generally indicates a poor prognosis. We report the case of a 62-year-old diabetic patient who presented with isolated sixth cranial nerve palsy. She had uncontrolled blood sugar levels and high erythrocyte sedimentation rate, and she suffered from pyelonephritis. Neuroimaging detected SBO with multiple secondary mycotic pseudoaneurysms prominent at the petrocavernous junction. Ischemia is the most common etiology for an isolated abducens nerve palsy, but in certain cases neuroimaging is warranted to prevent life-threatening complications. This case highlights the importance and urgency of identifying and managing such conditions.
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Affiliation(s)
- Rasna Bhanuman
- Neuro-Ophthalmology Department, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Shriram Varadharajan
- Radiology Department, Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
| | - Karthik Kumar
- Neuro-Ophthalmology Department, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Virna M. Shah
- Neuro-Ophthalmology Department, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
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Ghorbani M, Keykhosravi E, Vatanparast M, Elyassirad D, Golchin N, Mirsardoo H, Hasanpour M. Traumatic middle meningeal artery aneurysm: a case report. Neurochirurgie 2024; 70:101545. [PMID: 38417248 DOI: 10.1016/j.neuchi.2024.101545] [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: 11/10/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Traumatic intracranial aneurysms are rare, making up about 1% of all intracranial aneurysms. They can happen due to direct injury or blunt force, with the middle cerebral artery being the most frequent site. The middle meningeal artery (MMA) is the main artery that supplies the cranial dura mater, and, because of its location, is susceptible to damage after trauma. This article reported an unusual case of giant post-traumatic MMA pseudoaneurysm. CASE A 45 year-old man was referred to our department with a history of craniectomy. He complained of non-specific headache, but neurological examination was normal. A follow-up brain CT scan identified a right temporal fossa hyperdense mass. Digital subtraction angiography diagnosed a traumatic MMA aneurysm. The patient was treated with preoperative aneurysm embolization and surgical resection. DISCUSSION Traumatic MMA aneurysm is a rare presentation after head trauma. It can manifest as epidural hematoma, subdural hematoma or intraparenchymal hematoma, and sometimes resembles the present case, which was discovered incidentally. CONCLUSION Pseudoaneurysm is a rare complication of MMA trauma, with late presentation. It should be considered in patients with history of traumatic brain injury and temporal fossa extra-axial mass lesion with vascular characteristics.
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Affiliation(s)
- Mohammad Ghorbani
- Iran University of Medical Sciences, Division of Vascular and Endovascular Neurosurgery, Department of Neurosurgery, School of Medicine, Tehran, Iran
| | - Ehsan Keykhosravi
- Department of Neurosurgery, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Mahsa Vatanparast
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Daniel Elyassirad
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Navid Golchin
- Iran University of Medical Sciences, Department of Neurosurgery, School of Medicine, Tehran, Iran
| | - Hojjat Mirsardoo
- Iran University of Medical Sciences, Division of Vascular and Endovascular Neurosurgery, Department of Neurosurgery, School of Medicine, Tehran, Iran
| | - Mohammad Hasanpour
- Iran University of Medical Sciences, Division of Vascular and Endovascular Neurosurgery, Department of Neurosurgery, School of Medicine, Tehran, Iran.
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Vornetti G, Renzetti B, Vara G, Tonon C, Lodi R, Conti A, Serchi E, Donti A, Mariucci E, Spinardi L. Vertebral artery dissection caused by atlantoaxial dislocation in a patient with Marfan syndrome. Am J Med Genet A 2024; 194:e63467. [PMID: 37933544 DOI: 10.1002/ajmg.a.63467] [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: 07/19/2023] [Revised: 10/23/2023] [Accepted: 10/29/2023] [Indexed: 11/08/2023]
Abstract
A small number of case reports have documented a link between atlantoaxial dislocation (AAD) and vertebral artery dissection (VAD), but this association has never been described in patients with hereditary connective tissue disorders. We present a case of an 18-year-old female patient, diagnosed with Marfan syndrome since the age of one, who underwent brain MRA for intracranial aneurysm screening revealing tortuosity of the internal carotid and vertebral arteries as well as atlantoaxial dislocation. Since the patient was asymptomatic, a wait-and-see approach was chosen, but a follow-up MRA after 18 months showed the appearance of a dissecting pseudoaneurysm of the V3 segment of the left vertebral artery. Despite the patient being still asymptomatic, it was decided to proceed with C1-C2 stabilization to prevent further vascular complications. Follow-up imaging showed realignment of the atlantoaxial joint and reduction of the dissecting pseudoaneurysm of the left vertebral artery. In our patient, screening MRA has led to the discovery of asymptomatic arterial and skeletal abnormalities which, if left untreated, might have led to severe cerebrovascular complications. Therefore, AAD correction or close monitoring with MRA should be provided to MFS patients with this craniovertebral junction anomaly, even if asymptomatic.
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Affiliation(s)
- Gianfranco Vornetti
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, Bologna, Italy
| | - Benedetta Renzetti
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Giulio Vara
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Caterina Tonon
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, Bologna, Italy
| | - Raffaele Lodi
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, Bologna, Italy
| | - Alfredo Conti
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurochirurgia, Bologna, Italy
| | - Elena Serchi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurochirurgia, Bologna, Italy
| | - Andrea Donti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Luca Spinardi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Hasanpour M, Golchin N, Mirsardoo H, Alagha A, Elyassirad D, Keykhosravi E. Pseudoaneurysm formation after placement of a FRED flow diverter stent in a patient with iatrogenic ICA injury during transsphenoidal surgery: A case report. Neurochirurgie 2024; 70:101520. [PMID: 38056410 DOI: 10.1016/j.neuchi.2023.101520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023]
Affiliation(s)
- Mohammad Hasanpour
- Iran University of Medical Sciences, Division of Vascular and Endovascular Neurosurgery, Department of Neurosurgery, School of Medicine, Tehran, Iran
| | - Navid Golchin
- Iran University of Medical Sciences, Department of Neurosurgery, School of Medicine, Tehran, Iran
| | - Hojjat Mirsardoo
- Iran University of Medical Sciences, Division of Vascular and Endovascular Neurosurgery, Department of Neurosurgery, School of Medicine, Tehran, Iran
| | - Ahmad Alagha
- Department of Neurosurgery, Salamat-Farda Hospital, Tehran, Iran
| | - Daniel Elyassirad
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Keykhosravi
- Department of Neurosurgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Santiago J, Karl G, Florez C, Molina Y, Castro J, Hurtado A, García V. Infectious endarteritis in aortic coarctation: two spectra of an infrequent disease. Rev Paul Pediatr 2023; 42:e2023084. [PMID: 38126604 PMCID: PMC10742369 DOI: 10.1590/1984-0462/2024/42/2023084] [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: 05/15/2023] [Accepted: 09/14/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To describe two different degrees of clinical commitment and results in the evolution of infectious endarteritis in patients without a previous diagnosis of aortic coarctation. CASE DESCRIPTION Two male patients aged 13 and 9 years old were admitted. The first due to a fever for 2 months, which started after dental cleaning, and the second due to high blood pressure, both patients with asthenia and weight loss. In the first case, the transthoracic echocardiogram showed aortic coarctation, and the transesophageal echocardiogram showed the presence of vegetations in the post-coarctation area, without pseudoaneurysms, with blood culture positive for Streptococcus mitis. This patient was treated for six weeks with crystalline penicillin, resolving the infection without complications. The second case was assessed for high blood pressure with a history of fever, and was treated with antibiotics. When performing a transthoracic echocardiogram, aortic coarctation was observed with a saccular image classified as a pseudoaneurysm by angiography and tomography. Blood culture was negative, and the patient developed an episode of hematemesis whose initial etiology could not be determined. Before surgical repair, he had a second episode of copious hematemesis with hypovolemic shock and death. COMMENTS We need to have a high index of clinical suspicion to establish the diagnosis of aortic coarctation complicated by endarteritis and start the appropriate antibiotic treatment, always maintaining surveillance for the early detection of pseudoaneurysms.
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Affiliation(s)
- Justo Santiago
- Cardiovascular Foundation of Colombia, Bucaramanga, Santander, Colombia
| | - Gabriela Karl
- Cardiovascular Foundation of Colombia, Bucaramanga, Santander, Colombia
| | - Claudia Florez
- Cardiovascular Foundation of Colombia, Bucaramanga, Santander, Colombia
| | - Yudisay Molina
- Cardiovascular Foundation of Colombia, Bucaramanga, Santander, Colombia
| | - Javier Castro
- Cardiovascular Foundation of Colombia, Bucaramanga, Santander, Colombia
| | - Alexandra Hurtado
- Cardiovascular Foundation of Colombia, Bucaramanga, Santander, Colombia
| | - Valeria García
- Santander University Hospital, Bucaramanga, Santander, Colombia
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张 陈, 陈 旭, 吴 圣, 冯 莉, 王 琰, 陈 妤, 段 敏, 王 科, 宋 琳. [Internal carotid artery pseudoaneurysm caused by parapharyngeal abscess: A case report]. Beijing Da Xue Xue Bao Yi Xue Ban 2023; 55:1135-1138. [PMID: 38101801 PMCID: PMC10724003] [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] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Indexed: 12/17/2023]
Abstract
Pseudoaneurysms of the neck are seldom, and those caused by neck infections especially parapharyngeal abscess are even rarer. However, it is life-threatening and may bring sudden death due to the obstruction of airway and the pseudoaneurysms rupture. We analyzed the clinical features, diagnosis and treatment of the disease through a case summary and literature review in order to guide clinical diagnosis and treatment of pseudoaneurysms. The patient, whom we presented was an 87-year-old male and admitted in emergency of our hospital with the chief complaint of neck swelling for 7 days and shortness of breath for 2 days. Cervical ultrasound examination showed that there was an liquid dark area next to the left common carotid artery which was approximately 8.0 cm × 5.0 cm, consideration of formation of left carotid artery pseudoaneurysm, and the liquid dark area which was visible on the right considered of pseudoaneurysm or infection. Angiography of neck showed a clustered high-density shadow around the bifurcation of the left carotid artery, with an overall range of approximately 65 mm × 52 mm × 72 mm, the pseudoaneurysms for sure, while on the right side of the lesion, mixed low density shadows with air could be seen, the parapharyngeal abscess for sure.Then he was diagnosed as the pseudoaneurysm of left internal carotid artery which was caused by parapharyngeal abscess. After tracheal intubation and anti-infection treatment, the patient died due to hemorrhagic shock of the ruptured of the pseudoaneurysm. Morever we performed literature search on PubMed, Wanfang database and CNKI with keywords of "neck pseudoaneurysm, neck infection, parapharyngeal abscess" and enrolled 10 cases. Then we summarized the clinical characteristics and treatment. We analyzed and summarized the 10 case reports, in which the number of male was 7. Among them, there were 4 pediatric, and 6 adults were enrolled overall. Most of the symptoms were neck swelling, and the diseased blood vessel was mainly the right internal carotid artery which accounted for half overall. All the patients underwent surgical intervention, and recovered well. So we draw the conclusion that the clinical incidence of cervical pseudoaneurysms is low and can be caused by a variety of factors, especially caused by infectious factors. When a patient has a progressive pulsating mass in the neck, the preliminary diagnosis should be made by ultrasound as soon as possible, and the aortic enhancement CT should be used to further confirm.For a patient with cervical pseudo-aneurysms caused by parapharyngeal infections, he should take operation timely combined with antibiotic treatment in time.
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Affiliation(s)
- 陈光 张
- />清华大学附属北京清华长庚医院急诊科, 清华大学临床医学院, 北京 102218Department of Emergency, Beijing Tsinghua Changgung Hospital; School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - 旭岩 陈
- />清华大学附属北京清华长庚医院急诊科, 清华大学临床医学院, 北京 102218Department of Emergency, Beijing Tsinghua Changgung Hospital; School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - 圣 吴
- />清华大学附属北京清华长庚医院急诊科, 清华大学临床医学院, 北京 102218Department of Emergency, Beijing Tsinghua Changgung Hospital; School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - 莉莉 冯
- />清华大学附属北京清华长庚医院急诊科, 清华大学临床医学院, 北京 102218Department of Emergency, Beijing Tsinghua Changgung Hospital; School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - 琰 王
- />清华大学附属北京清华长庚医院急诊科, 清华大学临床医学院, 北京 102218Department of Emergency, Beijing Tsinghua Changgung Hospital; School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - 妤 陈
- />清华大学附属北京清华长庚医院急诊科, 清华大学临床医学院, 北京 102218Department of Emergency, Beijing Tsinghua Changgung Hospital; School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - 敏 段
- />清华大学附属北京清华长庚医院急诊科, 清华大学临床医学院, 北京 102218Department of Emergency, Beijing Tsinghua Changgung Hospital; School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - 科 王
- />清华大学附属北京清华长庚医院急诊科, 清华大学临床医学院, 北京 102218Department of Emergency, Beijing Tsinghua Changgung Hospital; School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - 琳琳 宋
- />清华大学附属北京清华长庚医院急诊科, 清华大学临床医学院, 北京 102218Department of Emergency, Beijing Tsinghua Changgung Hospital; School of Clinical Medicine, Tsinghua University, Beijing 102218, China
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Recicarova S, Chlup H, Jonak M, Netuka I. False aneurysms of the thoracic aorta: anastomosis investigation using the inflation-extension test. J Appl Biomed 2023; 21:174-179. [PMID: 38112456 DOI: 10.32725/jab.2023.023] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/24/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION False aneurysms in the thoracic aorta are dangerous complications that can occur after cardiac surgery. They often result in high mortality rates. These aneurysms are caused by damage to all layers of the aortic wall. This study aimed to pinpoint the area of the experimental specimen (native vessel, anastomosis, or prosthetic graft) with the greatest deformation, to determine whether a false aneurysm is likely to develop in the anastomotic portion. METHODS We conducted the inflation-extension test by performing eight cycles ranging from 0 to 20. The pressure sampling frequency was 100 Hz, and each cycle lasted approximately 34 seconds, resulting in a loading frequency of 0.03 Hz. During the experiment, each camera captured 3,000 frames. Based on the data collected, we evaluated and compared the loading stages of cycle 1 and cycle 8. RESULTS AND DISCUSSION During loading, the native vessel experienced a dominant deformation of approximately 7% in the circumferential direction. The prosthetic graft, which had a longitudinal construction, deformed by approximately 8% in the axial direction. The prosthetic graft, on the other hand, only experienced a deformation of up to 1.5% in the circumferential direction, which was about 5 times smaller than the deformation of the native vessel. The anastomosis area was very stiff and showed minimal deformation. Additionally, there was little difference in the mechanical response between the first C1 and the eighth C8 cycle. CONCLUSION Based on the available evidence, it can be inferred that aortic false aneurysms are more likely to form just behind the suture lines in the native aorta, which is more elastic compared to stiff sections of anastomosis and prosthetic graft. Numerous pulsations of the native vessel will likely cause the impairment of the aorta at the margin of the anastomosis. This will lead to disruption of the aortic wall and false aneurysm formation in the native vessel near the area of anastomosis.
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Affiliation(s)
- Sandra Recicarova
- Institute for Clinical and Experimental Medicine (IKEM), Department of Cardiovascular Surgery, Prague, Czech Republic
- Charles University, First Faculty of Medicine, Prague, Czech Republic
| | - Hynek Chlup
- Czech Technical University, Faculty of Mechanical Engineering, Laboratory of Cardiovascular Biomechanics, Prague, Czech Republic
| | - Michael Jonak
- Institute for Clinical and Experimental Medicine (IKEM), Department of Cardiovascular Surgery, Prague, Czech Republic
| | - Ivan Netuka
- Institute for Clinical and Experimental Medicine (IKEM), Department of Cardiovascular Surgery, Prague, Czech Republic
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Morita Y, Sakaguchi T, Matsumoto A, Ida S, Muraki R, Kitajima R, Furuhashi S, Takeda M, Kikuchi H, Hiramatsu Y, Takeuchi H. The cholinesterase and C-reactive protein score is a potential predictor of pseudoaneurysm formation after pancreaticoduodenectomy in patients with soft pancreas. BMC Surg 2023; 23:344. [PMID: 37964345 PMCID: PMC10647161 DOI: 10.1186/s12893-023-02211-3] [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: 05/03/2023] [Accepted: 09/29/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Pseudoaneurysm (PA) rupture after pancreaticoduodenectomy (PD) is a life-threatening complication. Most PA cases originate from postoperative pancreatic fistulas (POPFs). Although several risk factors for POPF have been identified, specific risk factors for PA formation remain unclear. Therefore, we retrospectively analyzed PD cases with soft pancreas and proposed a novel strategy for early detection of PA formation. METHODS Overall, 120 patients underwent PD between 2010 and 2020 at our institution; of these, 65 patients with soft pancreas were enrolled. We evaluated the clinicopathological factors influencing PA formation and developed a risk score to predict PA formation. RESULTS In total, 11 of the 65 patients developed PAs (PA formation group: PAG), and 8 of these 11 PAs ruptured. The median time to PA formation was 15 days, with a minimum of 5 days. The PAG was significantly older than the non-PA formation group, were predominantly men, and had comorbid diabetes mellitus. Pre- and intra-operative findings were similar between the two groups. Importantly, no significant differences were found in postoperative drain amylase levels and total drain amylase content. Cholinesterase and C-reactive protein (CRP) levels on postoperative day (POD) 3 were significantly different between the two groups. Multivariate analysis showed that cholinesterase ≤ 112 U/L and CRP ≥ 16.0 mg/dl on POD 3 were independent predictors of PA formation. CONCLUSIONS Decreased cholinesterase and elevated CRP on POD 3 (Cho-C score) are useful predictors of PA formation in cases with soft pancreas. In such cases, periodic computed tomography evaluations and strict drain management are necessary to prevent life-threatening hemorrhage.
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Affiliation(s)
- Yoshifumi Morita
- Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.
- Division of Surgical care, Morimachi, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| | | | - Akio Matsumoto
- Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Shinya Ida
- Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Ryuta Muraki
- Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Ryo Kitajima
- Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Satoru Furuhashi
- Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Makoto Takeda
- Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Hirotoshi Kikuchi
- Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Yoshihiro Hiramatsu
- Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
- Department of Perioperative Functioning Care & Support, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hiroya Takeuchi
- Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
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12
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Ponna PK, Fischell TA, Agrawal Y. Radial artery pseudoaneurysm rupture after cardiac catheterization. J Invasive Cardiol 2023; 35. [PMID: 37992332 DOI: 10.25270/jic/23.00065] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
A 73-year-old man with history significant for paroxysmal atrial fibrillation on apixaban underwent percutaneous coronary intervention (PCI) of the left anterior descending artery via transradial access. The patient was discharged on clopidogrel, atorvastatin, carvedilol, isosorbide mononitrate, losartan, and apixaban.
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Affiliation(s)
| | - Tim A Fischell
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
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13
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Carolino D'Araujo S, El-Mourad M. Coronary artery compression by left ventricular pseudoaneurysm - clinical case report. Acta Cardiol 2023; 78:961-963. [PMID: 37078592 DOI: 10.1080/00015385.2022.2161741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/16/2022] [Indexed: 04/21/2023]
Affiliation(s)
| | - Mike El-Mourad
- Department of Cardiology, Erasme University Hospital, Brussels, Belgium
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14
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Ansah DA, Lawrence EJ, Kearney DL, Qureshi AM. In Utero Presentation of Left Ventricular Aneurysm. Neoreviews 2023; 24:e530-e537. [PMID: 37525319 DOI: 10.1542/neo.24-8-e530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Congenital left ventricular aneurysm, pseudoaneurysm, and diverticulum are rare entities. These diagnoses can be made pre- and/or postnatally. Although these entities overlap clinically and morphologically, important distinctions can allow for accurate diagnoses. Appropriate diagnosis can be imperative for risk stratification and guidance of prenatal and postnatal management. The case described in the present report highlights a challenging case of a fetal left ventricular aneurysm, management during the prenatal and postnatal periods, and important differentiating features from a ventricular diverticulum and pseudoaneurysm.
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Affiliation(s)
- Deidra A Ansah
- The Lillie Frank Abercrombie Division of Cardiology, Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Emily J Lawrence
- The Lillie Frank Abercrombie Division of Cardiology, Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Debra L Kearney
- Departments of Pathology and Immunology, Texas Children's Hospital and Department of Pathology, Baylor College of Medicine, Houston, TX
| | - Athar M Qureshi
- The Lillie Frank Abercrombie Division of Cardiology, Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, TX
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15
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Methasate A, Lohsiriwat V, Mongkhonsupphawan A. Massive Bleeding From Anal Pseudoaneurysm After Rubber Banding Ligation for Hemorrhoids. Dis Colon Rectum 2023; 66:e847. [PMID: 37482426 DOI: 10.1097/dcr.0000000000002635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Affiliation(s)
- Asada Methasate
- Minimally Invasive Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Varut Lohsiriwat
- Colorectal Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Aitsariya Mongkhonsupphawan
- Colorectal Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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16
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Sánchez-Saba JE, Bronenberg-Victorica P, Abrego-Mariano O, Gallucci GL, De Carli P, Boretto JG. [Digital artery pseudoaneurysm. Case report and systematic review of the literature]. Acta Ortop Mex 2023; 37:177-182. [PMID: 38052440] [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] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
INTRODUCTION aneurysms are focal and permanent dilations of an artery; in pseudoaneurysms, the normal layers of the blood vessel are replaced by fibrous tissue. Due to their low incidence, as well as the diagnostic and therapeutic challenge they represent; our objective is to present the clinical case of a pseudoaneurysm of a digital artery of the hand and to carry out a systematic review of this pathology. MATERIAL AND METHODS literature search in Medline, using the terms "digital artery" and "aneurysm." Studies of vascular dilation pathology affecting the hand and fingers were incorporated. Studies with pathology of proximal involvement of the hand were excluded. CASE PRESENTATION a 79-year-old female patient who, after a sharp force trauma to the fifth finger of the left hand, develops a rapidly growing necrotic tumor. She had ultrasound and angiography that suggested hematoma. Surgical management was decided, during which it was observed that the tumor involved ulnar collateral digital artery of the fifth finger. The lesion and the arterial segment involved were resected. Post-surgical course without complications. The histopathological diagnosis of pseudoaneurysm of the lesion was confirmed. DISCUSSION traumatic etiology is the most frequent cause of digital aneurysms. Risk factors for pseudoaneurysms include sharp force trauma and alterations of the coagulation pathways, as in the case presented. CONCLUSION the pseudoaneurysm of a digital artery is a rare pathology with great variability of therapeutic management. Surgical resection of the lesion with vascular flow reconstruction is the recommended treatment.
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Affiliation(s)
- J E Sánchez-Saba
- Servicio de Ortopedia y Traumatología «Prof. Dr. Carlos E. Ottolenghi». Hospital Italiano de Buenos Aires. Argentina
| | - P Bronenberg-Victorica
- Servicio de Ortopedia y Traumatología «Prof. Dr. Carlos E. Ottolenghi». Hospital Italiano de Buenos Aires. Argentina
| | - O Abrego-Mariano
- Servicio de Ortopedia y Traumatología «Prof. Dr. Carlos E. Ottolenghi». Hospital Italiano de Buenos Aires. Argentina
| | - G L Gallucci
- Servicio de Ortopedia y Traumatología «Prof. Dr. Carlos E. Ottolenghi». Hospital Italiano de Buenos Aires. Argentina
| | - P De Carli
- Servicio de Ortopedia y Traumatología «Prof. Dr. Carlos E. Ottolenghi». Hospital Italiano de Buenos Aires. Argentina
| | - J G Boretto
- Servicio de Ortopedia y Traumatología «Prof. Dr. Carlos E. Ottolenghi». Hospital Italiano de Buenos Aires. Argentina
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Di Giorgio A, Carnuccio C, Nesci A, D'Alessandro A, Santoliquido A. Ulnar artery thrombosis after percutaneous thrombin injection of a pseudoaneurysm with a concomitant radial artery occlusion: Three complications after percutaneous coronary intervention. Cardiol J 2023; 30:675-676. [PMID: 37691537 PMCID: PMC10508067 DOI: 10.5603/cj.94372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/28/2023] [Indexed: 09/12/2023] Open
Affiliation(s)
- Angela Di Giorgio
- Department of Cardiovascular Sciences, Angiology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudia Carnuccio
- Department of Cardiovascular Sciences, Angiology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Antonio Nesci
- Department of Cardiovascular Sciences, Angiology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessia D'Alessandro
- Department of Cardiovascular Sciences, Angiology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Angelo Santoliquido
- Department of Cardiovascular Sciences, Angiology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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18
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Fernández Vecilla D, Urrutikoetxea Gutiérrez MJ, Ugalde Zárraga E, Urizar Gorosarri M, Rodríguez Iriarte ML, Díaz de Tuesta Del Arco JL. Mycotic pseudoaneurysm and aortitis caused by Candida sake. Rev Esp Cardiol (Engl Ed) 2022; 75:1077-1079. [PMID: 35718724 DOI: 10.1016/j.rec.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Domingo Fernández Vecilla
- Departamento de Microbiología y Parasitología Clínica, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain; Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain.
| | - Mikel Joseba Urrutikoetxea Gutiérrez
- Departamento de Microbiología y Parasitología Clínica, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain; Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain
| | - Estíbaliz Ugalde Zárraga
- Departamento de Microbiología y Parasitología Clínica, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain; Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain
| | - Maite Urizar Gorosarri
- Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain; Servicio de Radiodiagnóstico, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain
| | - María Luisa Rodríguez Iriarte
- Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain; Servicio de Medicina Nuclear, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain
| | - José Luis Díaz de Tuesta Del Arco
- Departamento de Microbiología y Parasitología Clínica, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain; Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain
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19
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Naser JA, Anavekar NS. Left Ventricular Pseudoaneurysm: A Rare Cause of Chest Pain to Keep in Mind. Mayo Clin Proc 2022; 97:1523-1524. [PMID: 35933137 DOI: 10.1016/j.mayocp.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 10/16/2022]
Affiliation(s)
- Jwan A Naser
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN.
| | - Nandan S Anavekar
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN
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20
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Chowdhury MM, Quiyum MA, Mohammed S, Karim R. Hemosuccus Pancreaticus: A Rare Cause of Gastrointestinal Bleeding. Mymensingh Med J 2022; 31:872-875. [PMID: 35780377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Hemosuccus pancreaticus or bleeding from the pancreatic duct into the gastrointestinal tract via the ampulla of Vater is caused by rupture of the pseudoaneurysm of a peripancreatic vessel into pancreatic duct or pancreatic pseudocyst in the context of pancreatitis or pancreatic tumour or trauma. It produces diagnostic and therapeutic dilemma due to its anatomical location and that bleeding into the duodenum is intermittent and cannot be easily diagnosed by endoscopy, often needs CE-CT and angiography. In August 2019, a 60-year-old male presented with intermittent abdominal pain, gastrointestinal bleeding and high serum lipase. Upper GIT endoscopy showed blood mixed bile coming out through ampulla, suspecting Hemosuccus pancreaticus. Contrast-enhanced computed tomography (CT) scan demonstrated pancreatic pseudo cyst with partially thrombosed splenic artery pseudoaneurysm. At laparotomy, splenic artery pseudoaneurysm was ligated along with splenectomy. Later on, the patient had no further occurrence of gastrointestinal bleeding.
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Affiliation(s)
- M M Chowdhury
- Professor Md Mohsen Chowdhury, Professor & Head of the Yellow Unit II, Hepatobiliary, Pancreatic & Liver Transplant Surgery Department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
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21
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Mekhail A, Borrie A, Sasse A, Matsis P, Wilkins G, Galvin S. Transapical Closure of an Iatrogenic Left Ventricular Apical Pseudoaneurysm. Heart Lung Circ 2022; 31:e80-e81. [PMID: 35086754 DOI: 10.1016/j.hlc.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/13/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Andrew Mekhail
- Cardiothoracic Surgery, Wellington Hospital, Wellington, NZ.
| | | | | | | | | | - Sean Galvin
- Cardiothoracic Surgery, Wellington Hospital, Wellington, NZ
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22
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Levi N, Shavit L, Farkas A, Atrash J, Helvitz Y, Esayag Y, Wolak T. Late Post Native Kidney Biopsy Complication: Renal Pseudoaneurysm Rupture. Isr Med Assoc J 2022; 24:265-267. [PMID: 35415988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Nir Levi
- Department of Internal Medicine D, Shaare Zedek Medical Center, Jerusalem, Israel
- Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Linda Shavit
- Department of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel
- Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Adam Farkas
- Department of Radiology, Shaare Zedek Medical Center, Jerusalem, Israel
- Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Joad Atrash
- Department of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel
- Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Yigal Helvitz
- Department of Intensive Care Unit, Shaare Zedek Medical Center, Jerusalem, Israel
- Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Yaacov Esayag
- Emergency Department, Shaare Zedek Medical Center, Jerusalem, Israel
- Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Talya Wolak
- Department of Internal Medicine D, Shaare Zedek Medical Center, Jerusalem, Israel
- Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
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23
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Diogo PG, Resende CX, Torres S, Vasconcelos M, Pinto R. Mycotic coronary aneurysm complicated by left ventricular pseudoaneurysm after everolimus-eluting stent implantation. Rev Esp Cardiol (Engl Ed) 2022; 75:275-277. [PMID: 34711515 DOI: 10.1016/j.rec.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Pedro G Diogo
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.
| | - Carlos X Resende
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sofia Torres
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Mariana Vasconcelos
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Roberto Pinto
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
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24
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Yoshimoto H, Ninchoji T, Nagai S, Horinouchi T, Nozu K. Spontaneous regression of arterial pseudoaneurysm after kidney biopsy. CEN Case Rep 2022; 11:159-160. [PMID: 34143383 PMCID: PMC8810997 DOI: 10.1007/s13730-021-00615-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/15/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Hiromichi Yoshimoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takeshi Ninchoji
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
- Department of Pediatrics, Steel Memorial Hirohata Hospital, Himeji, Japan.
| | - Sadayuki Nagai
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Tomoko Horinouchi
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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25
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Sasikumar D, Gopalakrishnan A, Kurup HKN, Dharan BS. Percutaneous Closure of Giant Aortic Pseudoaneurysm in a Child. J Invasive Cardiol 2022; 34:E65-E66. [PMID: 34982728] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Although percutaneous closure of aortic pseudoaneurysms have been described in adults with good results, there are no reports in children. This case demonstrates that in selected high-risk cases where the anatomy is suitable, percutaneous closure may be feasible and safe in children.
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Affiliation(s)
- Deepa Sasikumar
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
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26
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Seetharaman J, Yadav RR, Srivastava A, Sarma MS, Kumar S, Poddar U, Yachha SK. Gastrointestinal bleeding due to pseudoaneurysms in children. Eur J Pediatr 2022; 181:235-243. [PMID: 34263405 DOI: 10.1007/s00431-021-04201-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/04/2021] [Accepted: 07/07/2021] [Indexed: 11/28/2022]
Abstract
Radiological embolization is the treatment of choice in adults with visceral artery pseudoaneurysm (PSA) and gastrointestinal bleeding, but pediatric data is scanty. We analyzed the etiology, clinical presentation, and outcome of radiological intervention in children with PSA of celiac (CA) or superior mesenteric artery (SMA) branches. Electronic records of children with PSA of CA or SMA branches were reviewed and data on clinical and laboratory profile, radiological intervention, and outcome was recorded. Eleven children with PSA (5 boys, 11 [7-17] years) were studied. Etiology was liver abscess (n 4), abdominal trauma (n 3), pancreatitis (n 3), and indeterminate in 1 case. Ten (91%) patients were symptomatic: abdominal pain (10, 91%), hematemesis/melena (9, 81%), and Quincke's triad (1, 9%). One child with pancreatic pseudocyst was diagnosed incidentally on imaging. Doppler ultrasound identified PSA only in 3 cases, while computed tomography angiography (CTA) picked all cases. Children with liver abscess, trauma, and unknown etiology had PSA from CA (right hepatic artery 7, left hepatic artery 1). Of the 3 pancreatitis cases, 2 had PSA from SMA (inferior pancreatico-duodenal artery and ileal branch) and 1 from CA (left gastric artery). Radiological embolization was done in 9 (81%) cases (coil 6, glue 2, both 1), without any complications or failure. One case resolved spontaneously and 1 died pre-intervention. Nine intervened cases were asymptomatic in follow-up [6 (1-24) months].Conclusion: Liver abscess, trauma, and pancreatitis are causes of PSA of CA and SMA branches in children. A majority present with gastrointestinal bleeding and are identified on CTA. Radiological embolization was safe with 100% success. What is Known: • Pseudoaneurysm of visceral artery is an uncommon cause of gastrointestinal bleeding. • Endoluminal intervention is an established and efficacious treatment modality in adults and preferred over surgery. What is New: • Liver abscess, abdominal trauma and pancreatitis are common causes of celiac artery and superior mesenteric artery branch pseudoaneurysm in children and computed tomography angiography has high sensitivity in identifying these pseudoaneurysms. • Minimally invasive radiological angio-embolization, in the hands of trained radiologists, is a safe and successful modality of treatment in children.
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Affiliation(s)
- Jayendra Seetharaman
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, Uttar Pradesh, India
| | - Rajanikant R Yadav
- Department of Radiodiagnosis, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anshu Srivastava
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, Uttar Pradesh, India.
| | - Moinak Sen Sarma
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, Uttar Pradesh, India
| | - Sheo Kumar
- Department of Radiodiagnosis, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ujjal Poddar
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, Uttar Pradesh, India
| | - Surender Kumar Yachha
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, Uttar Pradesh, India
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Oliveira MDP, Alves de Sá G, Navarro EC, Caixeta A. Pseudoaneurysm After Distal Transradial Coronary Intervention Successfully Managed by Prolonged Pneumatic Compression: Simple Solution for a Rare and Challenging Problem. J Invasive Cardiol 2021; 33:E836-E838. [PMID: 34609331] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A 75-year-old woman with hypertension, hypothyroidism, and diabetes was referred to the catheterization laboratory due to non-ST segment elevation myocardial infarction. Urgent coronary angiography was uneventfully performed via right distal transradial access, despite lusoria subclavian artery. Left anterior descending artery was successfully treated by percutaneous coronary intervention with stenting. A TR band was left in situ for 60 minutes and completely removed after 2 hours, without bleeding. Proximal and distal radial pulses were palpable after hemostasis and at hospital discharge, 24 hours later, uneventfully. Six days after, she noticed subtle and rapidly progressive wrist, hand and fingers swelling, with pain, ecchymosis, and movement limitation.
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Affiliation(s)
- Marcos Danillo P Oliveira
- Department of Interventional Cardiology, Hospital São Paulo, Escola Paulista de Medicina, UNIFESP. Napoleão de Barros, number 715 - Vila Clementino, São Paulo-SP, Brazil, 04024-002.
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28
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Ge J, Wang T, Zhao J, Lu S, Wang J, Yuan D. Fracture of a covered stent-graft due to heterotopic ossification of residual hematoma after endovascular treatment of superficial femoral artery pseudoaneurysm: A case report. Medicine (Baltimore) 2021; 100:e26612. [PMID: 34232217 PMCID: PMC8270586 DOI: 10.1097/md.0000000000026612] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 06/22/2021] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Endovascular treatment (EVT) is considered a preferred procedure of superficial femoral artery (SFA) pseudoaneurysm in recent years. However, heterotopic ossification (HO) after SFA pseudoaneurysm is a rare occurrence, that may cause late stent-graft fracture. PATIENT CONCERNS A 58-year-old male who underwent EVT for SFA pseudoaneurysm 8 years ago presented with a progressive mass at the right thigh and claudication. Computed tomography angiography (CTA) showed fracture and occlusion of stent-graft, which was compressed by the deep femoral artery (DFA) pseudoaneurysm and a bone-like body. DIAGNOSIS According to the CTA images, the stent-graft was fractured and occluded, accompanied by DFA pseudoaneurysm. INTERVENTIONS AND OUTCOMES Debridement and arterial reconstruction were performed. Pathological analysis showed that the bone-like body was derived from HO. CTA at one-year follow-up showed that the prosthetic vessel was patent and previous hematoma disappeared. CONCLUSIONS This report demonstrates that residual hematoma can induce HO, which may result in late stent fracture, and it should thus be removed timely. Patients with SFA pseudoaneurysm who have undergone EVT should be followed up regularly.
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Affiliation(s)
- Jinting Ge
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Tiehao Wang
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jichun Zhao
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Susu Lu
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiarong Wang
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ding Yuan
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China
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Lee S, Jung S, Kim HJ, Jang HN, Park DJ, Bae E, Lee TW, Chang SH. Spontaneous rupture of a renal artery pseudoaneurysm in a hemodialysis patient: A case report. Medicine (Baltimore) 2021; 100:e25970. [PMID: 34011081 PMCID: PMC8136987 DOI: 10.1097/md.0000000000025970] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/28/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Renal artery pseudoaneurysm is a rare vascular lesion usually caused by trauma or percutaneous urological procedures. Spontaneous rupture of pseudoaneurysms without predisposing events, especially in hemodialysis patients, has rarely been reported. PATIENT CONCERNS A 25-year-old man receiving maintenance hemodialysis visited the emergency room because of sudden severe right flank pain. He had no history of trauma or urological procedures except for a left renal biopsy to diagnose Alport syndrome 10 years prior. DIAGNOSIS Contrast-enhanced computed tomography revealed a right perirenal hematoma with pseudoaneurysms. INTERVENTIONS On renal angiography, multiple pseudoaneurysms were observed in the right renal artery branches and embolization was performed. OUTCOMES Post-angiography showed no pseudoaneurysms. His abdominal pain improved, and he was discharged 2 weeks after embolization. LESSONS When maintenance dialysis patients complain of severe abdominal pain, spontaneous rupture of a renal pseudoaneurysm should be considered as a differential diagnosis, even if the patient has no history of trauma or previous urological procedures.
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Affiliation(s)
- Seunghye Lee
- Department of Internal Medicine-Nephrology, College of Medicine, Gyeongsang National University
- Department of Internal Medicine-Nephrology, Gyeongsang National University Hospital
| | - Sehyun Jung
- Department of Internal Medicine-Nephrology, College of Medicine, Gyeongsang National University
- Department of Internal Medicine-Nephrology, Gyeongsang National University Hospital
| | - Hyun-Jung Kim
- Department of Internal Medicine-Nephrology, College of Medicine, Gyeongsang National University
- Department of Internal Medicine-Nephrology, Gyeongsang National University Hospital
- Institute of Health Sciences, Gyeongsang National University, Jinju
| | - Ha Nee Jang
- Department of Internal Medicine-Nephrology, College of Medicine, Gyeongsang National University
- Department of Internal Medicine-Nephrology, Gyeongsang National University Hospital
- Institute of Health Sciences, Gyeongsang National University, Jinju
| | - Dong Jun Park
- Department of Internal Medicine-Nephrology, College of Medicine, Gyeongsang National University
- Institute of Health Sciences, Gyeongsang National University, Jinju
- Department of Internal Medicine-Nephrology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Eunjin Bae
- Department of Internal Medicine-Nephrology, College of Medicine, Gyeongsang National University
- Institute of Health Sciences, Gyeongsang National University, Jinju
- Department of Internal Medicine-Nephrology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Tae Won Lee
- Department of Internal Medicine-Nephrology, College of Medicine, Gyeongsang National University
- Institute of Health Sciences, Gyeongsang National University, Jinju
- Department of Internal Medicine-Nephrology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Se-Ho Chang
- Department of Internal Medicine-Nephrology, College of Medicine, Gyeongsang National University
- Department of Internal Medicine-Nephrology, Gyeongsang National University Hospital
- Institute of Health Sciences, Gyeongsang National University, Jinju
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Gupta A, Agstam S. Radial Artery Pseudoaneurysm Following Percutaneous Coronary Intervention. J Invasive Cardiol 2021; 33:E406. [PMID: 33932290] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Radial artery pseudoaneurysm is a very rare complication. In the presented case, computed tomography 3 months post percutaneous coronary intervention demonstrated contrast extravasation, suggestive of radial artery pseudoaneurysm. This complication was managed with thrombin infusion at the distal radial artery.
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Affiliation(s)
| | - Sourabh Agstam
- Department of Cardiology, VMMC and Safdarjung Hospital, New Delhi, India 110029.
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31
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Wang X, Dong A, Yang W, Duan Q. Spindle cell sarcoma of the right atrium causing right atrial pseudoaneurysm: a case report and review of the literature. J Cardiothorac Surg 2021; 16:27. [PMID: 33741020 PMCID: PMC7980566 DOI: 10.1186/s13019-021-01404-2] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 03/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Spindle cell sarcomas of the right atrium are extremely rare primary cardiac tumours, with very few cases reported in the medical literature. Pseudoaneurysms caused by cardiac spindle cell sarcoma have never been reported worldwide. CASE PRESENTATION A 32-year-old woman was referred to our hospital for recurrent pericardial haemorrhagic effusion and pleural effusion. Three-dimensional transthoracic echocardiogram, contrast chest CT, and contrast MRI revealed a pseudoaneurysm on the right side of the right atrium with a thrombus. There was a defect between the pseudoaneurysm and the right atrium. PET-CT suggested that FDG metabolism inhomogeneity increased in the mass in the right atrium. Exfoliative cytology detection of massive pericardial effusion and pleural effusion revealed no tumour cells. Spindle cell sarcoma of the right atrium was not confirmed until the patient underwent right thoracic exploration and biopsy. Before a confirmed diagnosis, symptomatic treatment, such as chest effusion and pericardium effusion drainage, and transfusion of red blood cells were mainly used to relieve the patient's symptoms. Unfortunately, the patient was lost to optimal treatments and passed away 20 days after the pathological diagnosis was made. CONCLUSION The prognosis of spindle cell sarcomas remains poor due to delays in diagnosis, early metastasis and few available therapeutic options. Recurrent pericardial effusion and pleural effusion, especially in the nature of haemorrhagic effusion, and/or right atrial pseudoaneurysm shown on the transthoracic echocardiogram must be considered and highly suspected as malignancy by patients and physicians. If the diagnosis cannot be confirmed, histopathology should be performed as soon as possible to avoid losing the best treatment opportunity.
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Affiliation(s)
- Xiaofang Wang
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, China
| | - Aiqiang Dong
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, China
| | - Weijun Yang
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, China
| | - Qunjun Duan
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, China.
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32
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Mikhaylov IP, Kungurtsev EV, Kozlovskiy BV, Demyanov AM. [Surgical treatment of giant false aneurysm of the axillary artery]. Khirurgiia (Mosk) 2021:96-100. [PMID: 34029042 DOI: 10.17116/hirurgia202106196] [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] [Indexed: 06/12/2023]
Abstract
Vascular damage is an important aspect in the structure of injuries. Untimely medical care in patients with peripheral artery damage is often followed by development of false aneurysm. This event may be complicated by aneurysm rupture and bleeding, peripheral arterial thromboembolism, hematoma infection and neuropathy following adjacent nerved compression. We report surgical treatment of a patient with giant false aneurysm of the left axillary artery following a knife wound 1 year ago. The patient did not appeal for qualified medical care and ensured haemostasis at home. The patient underwent surgery under endotracheal anaesthesia. Debridement of hematoma, closure of arterial wall defect and wound drainage were carried out through an approach in the upper and middle third of the left shoulder.
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Affiliation(s)
- I P Mikhaylov
- Sklifosovsky Research Institute of Emergency Care, Moscow, Russia
| | - E V Kungurtsev
- Sklifosovsky Research Institute of Emergency Care, Moscow, Russia
| | - B V Kozlovskiy
- Sklifosovsky Research Institute of Emergency Care, Moscow, Russia
| | - A M Demyanov
- Sklifosovsky Research Institute of Emergency Care, Moscow, Russia
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33
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Ter-Akopian AV, Abramov AS, Nikitin NE, Kalinin AA, Kriuchkova OV. [Endovascular treatment of aneurysms and pseudoaneurysms of visceral arteries]. Angiol Sosud Khir 2021; 27:34-40. [PMID: 35050247 DOI: 10.33529/angio2021406] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM The purpose of the study was to demonstrate the possibilities and efficacy of endovascular interventions in patients with visceral artery aneurysms. PATIENTS AND METHODS From 2013 to June 2020, we performed 15 embolizations of visceral artery aneurysms in 15 patients (8 men and 7 women). The technical success rate was 100%. The patients' age varied from 32 to 71 years. In 8 cases, the aneurysm was located in the basin of the splenic artery, in 3 cases in the gastroduodenal artery, in 2 cases in the superior mesenteric artery and in 2 cases in the renal artery. Three aneurysms were classified as false, and 12 as true. All aneurysms were saccular, with their diameter ranging from 6 to 32 mm. In 2 patients aneurysms were detected after endured infective endocarditis, in 8 during examination in abdominal pain syndrome, and in 5 cases as an incidental finding while performing computed tomography of abdominal organs. One patient was subjected to embolization of the afferent vessel, two underwent implantation of stent grafts into the aneurysmal neck area, and eleven underwent aneurysmal sac embolization with microcoils. In 9 cases, embolization was performed using microcoils only in 1 case using microcoils with balloon assistance, and in 2 cases using microcoils with stent assistance. We used from 1 to 12 microcoils, with a diameter of from 2 to 30 mm. RESULTS During endovascular embolization of visceral artery aneurysms there were no target-organ infarctions, haemorrhagic complications, nor lethal outcomes. In the early postoperative period, 7 patients developed pain syndrome. In 1 case pain syndrome was relieved by narcotic analgesics, in 4 cases by spasmolytics, and in 2 cases by a combination of spasmolytics and non-narcotic analgesics. CONCLUSION Endovascular treatment of visceral arterial aneurysms is an efficient and safe method.
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Affiliation(s)
- A V Ter-Akopian
- Central Clinical Hospital and Polyclinic of the RF President's Affairs Administration, Moscow, Russia
| | - A S Abramov
- Central Clinical Hospital and Polyclinic of the RF President's Affairs Administration, Moscow, Russia
| | - N E Nikitin
- Central Clinical Hospital and Polyclinic of the RF President's Affairs Administration, Moscow, Russia
| | - A A Kalinin
- Central Clinical Hospital and Polyclinic of the RF President's Affairs Administration, Moscow, Russia
| | - O V Kriuchkova
- Central Clinical Hospital and Polyclinic of the RF President's Affairs Administration, Moscow, Russia
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34
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Iacona GM, Roselli EE. Patch Repair of Aortic Mitral Continuity Pseudoaneurysm Through Transverse Sinus. Ann Thorac Surg 2020; 111:e309. [PMID: 33373591 DOI: 10.1016/j.athoracsur.2020.09.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Gabriele M Iacona
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Eric E Roselli
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
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35
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van Zijl N, Janson JT, Wagenaar R, Koen J. Hydatid Disease With Pseudoaneurysm Formation of the Descending Thoracic Aorta. Ann Thorac Surg 2020; 111:e349-e351. [PMID: 33166499 DOI: 10.1016/j.athoracsur.2020.08.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/27/2020] [Accepted: 08/05/2020] [Indexed: 11/30/2022]
Abstract
Human Echinococcus disease is a zoonosis that primarily affects the liver and lungs. We report a rare case of hydatid disease in the posterior mediastinum with pseudoaneurysm formation of the descending thoracic aorta and erosion of thoracic vertebral bodies. The patient was surgically treated with removal of multiple daughter cysts and primary repair of the aorta.
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Affiliation(s)
- Nicholas van Zijl
- Division of Cardiothoracic Surgery, Stellenbosch University, Tygerberg, South Africa
| | - Jacques T Janson
- Division of Cardiothoracic Surgery, Stellenbosch University, Tygerberg, South Africa.
| | - Riegardt Wagenaar
- Division of Cardiothoracic Surgery, Stellenbosch University, Tygerberg, South Africa
| | - Johan Koen
- Division of Cardiothoracic Surgery, Stellenbosch University, Tygerberg, South Africa
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36
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Pérez Guerrero A, Osuna GG, Fuertes Ferre G, Moreno Esteban E, Diarte De Miguel JA. Successful Percutaneous Closure of Periprosthetic Mitral Pseudoaneurysm Using a Duct Occluder Device. J Invasive Cardiol 2020; 32:E300. [PMID: 33130599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Ainhoa Pérez Guerrero
- Interventional Cardiology Unit, Miguel Servet University Hospital, Paseo Isabel la Católica 1-2, 50001 Zaragoza, Spain.
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37
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Nyilas S, Ott D, von Tengg-Kobligk H, Poellinger A, Dorn P. Penetrating chest trauma after attempted suicide: An extraordinary behavior of a posttraumatic pulmonary artery pseudoaneurysm. J Radiol Case Rep 2020; 14:19-25. [PMID: 33088416 DOI: 10.3941/jrcr.v14i7.3842] [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] [Indexed: 11/15/2022] Open
Abstract
Posttraumatic pulmonary artery pseudoaneurysm is a very rare, yet potentially lethal complication after thoracic trauma. Pulmonary artery pseudoaneurysm is associated with high mortality. Still literature highlights that untreated, lesions can enlarge, rupture, and lead to exsanguination and death. We present a case of a posttraumatic peripheral pulmonary artery pseudoaneurysm with complete disappearance after one year. This case confirms that conservative treatment can be an effective option in asymptomatic and stable patients.
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Affiliation(s)
- Sylvia Nyilas
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Daniel Ott
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Hendrik von Tengg-Kobligk
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Alexander Poellinger
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Patrick Dorn
- Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland
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38
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Satoh K, Kaga H, Okuyama M, Furuya T, Irie Y, Kameyama K, Kitamura T, Nakae H. A case of cardiac arrest due to a ruptured renal artery pseudoaneurysm, a complication of renal biopsy. CEN Case Rep 2020; 10:145-149. [PMID: 32986186 DOI: 10.1007/s13730-020-00535-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 08/02/2020] [Accepted: 09/07/2020] [Indexed: 11/26/2022] Open
Abstract
Renal artery pseudoaneurysms (RAPs) are a rare complication of percutaneous kidney biopsies that generally present as hematuria and back pain and are treated with angioembolization. A 60-year-old man was admitted to our emergency department for sudden left back pain. He was taking an oral anticoagulant for atrial fibrillation. He had undergone an ultrasound-guided percutaneous renal biopsy 26 days prior. We diagnosed him with hemorrhagic shock from the renal artery. Although he received a massive rapid blood transfusion, he went into cardiac arrest. Resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed and, within 10 min, the patient achieved return of spontaneous circulation and regained consciousness. Subsequently, angioembolization was successfully performed for a 12.5 mm × 5.9 mm pseudoaneurysm in the left renal inferior pole close to the site of the renal biopsy. A total of 1680 mL of red blood cells and fresh frozen plasma were administered respectively until hemostasis was completed. He was then treated with continuous hemodialysis in the intensive care unit (ICU) for 6 days. He stayed in the ICU for 9 days and was moved to the general ward with full neurological recovery and a sufficiently stable condition to be able to walk. In conclusion, clinicians should be aware of the possibility of severe hemorrhagic shock due to RAPs after renal biopsy. Moreover, even if the patient goes into cardiac arrest, there is a possibility of full recovery if REBOA is performed and angioembolization is completed.
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Affiliation(s)
- Kasumi Satoh
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - Hajime Kaga
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Manabu Okuyama
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Tomoki Furuya
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Yasuhito Irie
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Koumei Kameyama
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Toshiharu Kitamura
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Hajime Nakae
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
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39
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Tsiafoutis I, Zografos T, Koutouzis M, Katsivas A. Distal Radial Access for Percutaneous Endovascular Repair of a Radial Artery Pseudoaneurysm. J Invasive Cardiol 2020; 32:E198. [PMID: 32610278] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Percutaneous pseudoaneurysm repair through the ipsilateral ulnar artery is an alternative to surgical repair; however, distal radial access, as described in this case, may offer increased safety.
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Affiliation(s)
| | - Theodoros Zografos
- 1st Cardiology Department, Red Cross Hospital, 1 Athanasaki St, 11521, Athens, Greece.
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40
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Soe L, Thidar S, Myat SY, Christine Mui FL, Sue Marie CKP, Tin MN. Uterine artery pseudoaneurysm: A case of late intra-abdominal haemorrhage after caesarean section. Med J Malaysia 2020; 75:298-300. [PMID: 32467549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Uterine artery pseudoaneurysm (UAP) is a rare acquired vascular malformation associated with vaginal bleeding or intraabdominal haemorrhage occurring after pelvic surgery. Pseudoaneurysm may present with delayed, severe haemorrhage after a seemingly uncomplicated initial postoperative period. Treatment is therefore necessary to prevent further complications. We describe here a case of a 32-year-old mother, who presented with abdominal pain and intraabdominal bleeding, 20 days after Caesarean Section. Computerised Tomography (CT) scan showed the presence of haemoperitoneum, suggestive of pseudoaneurysm at the right cervical artery which was successfully managed with emergency angiographic embolisation.
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Affiliation(s)
- L Soe
- UNIMAS, Faculty of Medicine and Health Science, Department of Obstetrics & Gynecology, Sarawak, Malaysia.
| | - S Thidar
- UNIMAS, Faculty of Medicine and Health Science, Department of Obstetrics & Gynecology, Sarawak, Malaysia
| | - S Y Myat
- UNIMAS, Faculty of Medicine and Health Science, Department of Obstetrics & Gynecology, Sarawak, Malaysia
| | - F L Christine Mui
- Sarawak General Hospital, Department of Obstetrics & Gynecology, Kuching, Sarawak, Malaysia
| | - C K P Sue Marie
- Sarawak General Hospital, Department of Obstetrics & Gynecology, Kuching, Sarawak, Malaysia
| | - M N Tin
- UNIMAS, Faculty of Medicine and Health Science, Department of Basic Health Sciences, Sarawak, Malaysia
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41
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Li C, Xu P, Hua Z, Jiao Z, Cao H, Liu S, Zhang WW, Li Z. Early and midterm outcomes of in situ laser fenestration during thoracic endovascular aortic repair for acute and subacute aortic arch diseases and analysis of its complications. J Vasc Surg 2020; 72:1524-1533. [PMID: 32273224 DOI: 10.1016/j.jvs.2020.01.072] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 08/16/2019] [Accepted: 01/18/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE An analysis was conducted of early and midterm outcomes of a large series of patients treated with in situ laser fenestration (ISLF) during thoracic endovascular aortic repair (TEVAR) of acute and subacute complex aortic arch diseases, such as Stanford type A aortic dissection (TAAD), type B aortic dissection (TBAD) requiring proximal sealing at zone 2 or more proximal, thoracic aortic aneurysm or pseudoaneurysm, and penetrating aortic ulcer. We present the perioperative and follow-up outcomes and discuss the rate of complications. METHODS This is a retrospective review of prospectively collected data from January 2017 to March 2019 of patients treated with TEVAR and ISLF of aortic arch branches at a large tertiary academic institution in an urban city in China. Preoperative, intraoperative, and follow-up clinical and radiographic data are analyzed and discussed. RESULTS A total of 148 patients presented with symptomatic and acute or subacute TAAD, TBAD, thoracic aortic aneurysm, or penetrating aortic ulcer for a total of 183 arch vessels. There were 105 men and 43 women, 21 to 79 years of age (mean, 54.9 ± 12.9 years). Time from symptom onset to time of surgery was an average of 7 ± 3 days. Survivor follow-up duration ranged from 5 to 24 months (mean, 15 ± 5 months). Single-vessel fenestration was carried out in 124 cases, two-vessel fenestration in 13 cases, and three-vessel fenestration in 11 cases. There were four cases with technical failure to laser fenestration, with a technical success rate of 97.3%. Postoperatively, there were seven cases of endoleak (4.7%; one type IB distal from the left subclavian artery branch stent graft, three type IIIC at the fenestration site, and three type II), three retrograde dissections (2.0%), and five strokes (3.4%); death occurred in three patients with 30-day mortality of 2.9%, and two deaths occurred during follow-up for 3.4% mortality at an average 15 months of follow-up. There was no branch stent graft occlusion or spinal ischemia postoperatively or during follow-up. The distribution of arch diseases varied significantly according to the number of vessels that were laser fenestrated; TAAD was more likely to receive multivessel laser fenestrations, and TBAD was more likely to receive single-vessel fenestration (P < .001). The rate of complications was distributed differently between the three ISLF groups, with more complications occurring in multivessel fenestrations. However, a statistical weakening was observed when frequency of complications between the three groups was stratified by type of arch disease. The complication rate varied significantly between the different arch diseases, higher in TAAD than in TBAD (P = .008). CONCLUSIONS ISLF during TEVAR for treatment of acute and subacute complex aortic arch diseases in the proximal aortic arch is safe and effective on the basis of these early to midterm follow-up data of a large cohort. However, care should be taken in intervening on TAAD using TEVAR with adjunctive multivessel laser fenestration. Continued investigation of TEVAR and adjunctive ISLF is needed to elucidate the long-term outcomes of this minimally invasive treatment for complex aortic arch disease in an urgent setting.
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Affiliation(s)
- Chong Li
- Division of Vascular Surgery, New York University Medical Center, New York, NY
| | - Peng Xu
- Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhaohui Hua
- Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhouyang Jiao
- Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Cao
- Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shirui Liu
- Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wayne W Zhang
- Division of Vascular Surgery, University of Washington Medical Center, Seattle, Wash
| | - Zhen Li
- Department of Vascular and Endovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Sadeghpour A, Pourafkari L, Khesali H, Nader ND. Chronic large pseudoaneurysm of the left ventricle. Intern Emerg Med 2020; 15:145-146. [PMID: 31598828 DOI: 10.1007/s11739-019-02205-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 09/27/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Anita Sadeghpour
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Leili Pourafkari
- Catholic Health System, Department of Internal Medicine, State University of New York at Buffalo, Buffalo, NY, USA.
| | - Hamideh Khesali
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nader D Nader
- Department of Anesthesiology, University at Buffalo, Buffalo, NY, USA
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43
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Vijayvergiya R, Kumar B, Budhakoty S, Savlania A, Lal A. Endovascular Stent-Graft Repair of a Large Renal Artery Pseudoaneurysm With Impending Rupture, Arising From a Solitary Kidney. J Invasive Cardiol 2020; 32:E11-E12. [PMID: 31893505] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This was an unusual case of a large renal artery pseudoaneurysm with impending rupture, which was successfully treated with an endovascular stent-graft in a solitary kidney.
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Affiliation(s)
- Rajesh Vijayvergiya
- Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education & Research, Sector 12, Chandigarh - 160 012, India.
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Sano K, Kawanami K, Yamaki T, Matsuda K, Kokubo Y, Sonoda Y. [Intracranial Pseudoaneurysm Arising after Radiotherapy for Oligodendroglioma:A Case Report]. No Shinkei Geka 2020; 48:25-32. [PMID: 31983685 DOI: 10.11477/mf.1436204129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Intracranial pseudoaneurysms arising after radiotherapy for brain tumors are a relatively rare occurrence and associated with high-volume radiotherapy such as stereotactic radiosurgery. Herein, the authors report a rare case of intracranial pseudoaneurysm after conventional radiotherapy for oligodendroglioma. Case:A 46-year-old female incidentally presented with an intracranial hemorrhage from a middle temporal artery aneurysm. Four years earlier, she underwent surgical resection and conventional radiation therapy for oligodendroglioma. The aneurysm was successfully treated with middle cerebral artery(MCA)aneurysm trapping, in conjunction with a parietal branch superficial temporal artery-MCA bypass, to prevent re-rupture. Formation of intracranial pseudoaneurysm after conventional radiotherapy is extremely rare. However, the occurrence of cerebral aneurysm(s), as well as vascular stenosis during follow-up for brain tumors treated with radiotherapy, should be considered.
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Affiliation(s)
- Kenshi Sano
- Department of Neurosurgery, Yamagata University Faculty of Medicine
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Aimanan K, Lim SY, Mohd Nor MR, Wahi AM, Chew LG. Systemic review of global case reports on ankle pseudo aneurysm: Analysis of epidemiology, clinical presentation, diagnosis and treatment. Med J Malaysia 2020; 75:88-93. [PMID: 32008030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Pseudo aneurysm of the ankle is a rare presentation and the management is complex due to the complex anatomy. The aim of this review is to examine the epidemiology, etiology, diagnostic modalities used and management. This is the first systematic review of this topic in literature. METHODS We performed a systematic review in multiple databases (including PubMed, MEDLINE, EMBASE, and Scopus) from 1966 to May 18, 2019, to identify all case reports and case series describing patients with ankle pseudo aneurysm. This systematic review was performed in accordance with the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA). Our inclusion criteria included patients with ankle pseudo aneurysm of any age. We excluded reports in which the individual level data is not available. Patients demographic (gender, age), clinical characteristics (precipitating event, duration), diagnostic modality and treatment were recorded. RESULT There were in total 23 case reports identified on ankle pseudo aneurysm from 1966 until 2018. Among these twenty-three reports, 16 (70%) were male and seven (30%) patients were female. Age distribution showed higher number of reports among young adults, 15 patients (65%). Based on our systematic review trauma (48%), arthroscope (48%) and arthrodesis (4%) were the etiologies described in all these case reports. Ultrasound duplex and CT Angiogram has been used as a single modality in three reports each. In fifteen patients (65%) combination of imaging has been used for diagnosis. Anterior tibial artery is the most commonly injured vessel among the reported cases, comprised of 14 (61%) patients. Among these arthroscopes were the highest reported precipitating events, 9 (64%), followed by trauma in four patients (29%) and arthrodesis in one patient (7%). Treatment modalities described in all previous reports were excision and ligation, 10 (42%); excision of sac and primary repair, 4 (17%); excision of sac followed by reversed saphenous venous graft repair, 2 (8%); US guided compression, 2 (8%); US guided thrombin injection, 4 (17%); stenting, 1 (4%) and coiling, 1 (4%). CONCLUSION Ankle pseudoaneurysm is mostly preventable by detailed initial assessment following trauma or careful approach during arthroscope. Evolving diagnostic modality and treatment has shed some light into noninvasive management of pseudo aneurysm of ankle.
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Affiliation(s)
- K Aimanan
- Hospital Miri, Department of Surgery, Miri, Sarawak, Malaysia.
| | - S Y Lim
- Hospital Miri, Department of Surgery, Miri, Sarawak, Malaysia
| | - M R Mohd Nor
- Hospital Miri, Department of Surgery, Miri, Sarawak, Malaysia
| | - A M Wahi
- Hospital Miri, Department of Surgery, Miri, Sarawak, Malaysia
| | - L G Chew
- Hospital Serdang, Department of Surgery, Serdang, Selangor, Malaysia
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Kvint S, Malhotra NR, Cox M, Mondschein JI, Pukenas BA, Bagley LJ. Giant Iliac Artery Pseudoaneurysm Mimicking Postoperative Fluid Collection and Diskitis. World Neurosurg 2019; 136:253-257. [PMID: 31816453 DOI: 10.1016/j.wneu.2019.11.176] [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: 09/09/2019] [Revised: 11/29/2019] [Accepted: 11/30/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND In this report, we describe an extremely rare case of a giant pseudoaneurysm of the internal iliac artery causing marked destructive changes at a disk space and mimicking diskitis-osteomyelitis. Only 2 other cases of pseudoaneurysms extending into the disk space have been reported, and those arose from the aorta and were relatively straightforward to diagnose. CASE DESCRIPTION Our case is unique because the pseudoaneurysm arose from the internal iliac artery, an artery that is not usually included in the field of view of lumbar magnetic resonance imaging or computed tomography. However, the pseudoaneurysm was so large that it extended to the lumbosacral junction, where it eroded a disk space and caused findings of diskitis-osteomyelitis. CONCLUSIONS Complex paraspinal fluid collections causing osseous erosions should raise the possibility of an aneurysm/pseudoaneurysm. Computed tomography or conventional angiography should be considered if the question of a vascular mass/collection cannot be answered on conventional cross-sectional imaging, as inadvertent biopsy of a pseudoaneurysm can cause catastrophic bleeding.
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Affiliation(s)
- Svetlana Kvint
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Neil R Malhotra
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mougnyan Cox
- Section of Neurointerventional Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Jeffrey I Mondschein
- Interventional Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bryan A Pukenas
- Section of Neurointerventional Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Linda J Bagley
- Division of Neuroradiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Pelzman DL, Semins MJ. Endoscopic diagnosis of renal pseudoaneurysm following ureteroscopy. Can J Urol 2019; 26:10061-10063. [PMID: 31860424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Renal pseudoaneurysm following ureteroscopy is a rare cause of hematuria usually diagnosed and treated with angiography and embolization. Here we present a case of a small pseudoaneurysm causing intermittent flank pain and gross hematuria associated with clot retention initially diagnosed during ureteroscopy and subsequently treated with a combined endourologic and endovascular approach.
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Affiliation(s)
- Daniel L Pelzman
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Zitouna K, Selmene MA, Derbel B, Rekik S, Drissi G, Barsaoui M. An unexpected etiology of lumbosciatica. Tunis Med 2019; 97:1415-1418. [PMID: 32173813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Lumbosciatica is a frequent symptom. When it is hyperalgic and/or deficient, it requires urgent exploration and an eventual surgical procedure. In most of the cases, medullary lumbar (instead of medullary) MRI is required looking in the first place at an intervertebral disc herniation. Other etiologies are rare but must be kept in mind. We report a case of a 37-year-old man with left L5 hyperalgic and deficient lumbosciatica. The conclusion of the etiological research led to pseudoaneurysm of the internal iliac artery compressing the ipsilateral sciatic nerve. The patient was operated on with a good clinical course.
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Silvestri V, Meneghini S, Grande R, Sterpetti AV, Serra R, Mingoli A, Sapienza P. When Less Invasive Causes Major Sequelae: A Dramatic Evolution of an Infected Common Femoral Artery Patch. Ann Vasc Surg 2019; 61:468.e5-468.e8. [PMID: 31376545 DOI: 10.1016/j.avsg.2019.04.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/26/2019] [Accepted: 04/27/2019] [Indexed: 11/19/2022]
Abstract
Endarterectomy of the common and profunda femoris is currently performed for treatment of atherosclerotic lesions involving femoral bifurcation. Misperception of surgical risk in terms of morbidity and mortality has induced the trend to extend the indication for treatment to patients with mild symptoms at presentation, at the cost of unnecessary increased complication rate and mortality risk, which persists even after patient discharge. We report the case of a giant infected femoral pseudoaneurysm occurring in a 74-year-old patient, previously treated with femoral artery endarterectomy with prosthetic patch closure because of mild claudication. Surgically managed with en block resection and autologous vein reconstruction, his postoperatory course was further complicated by fatal sepsis. Complications for femoral artery endarterectomy, including infectious and fatal events, need a close follow-up of these patients to promptly diagnose and treat any event which may occur, preventing its evolution to more challenging and potentially life-threatening clinical scenario.
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Affiliation(s)
- Valeria Silvestri
- Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy
| | - Simona Meneghini
- Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy
| | - Raffaele Grande
- Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy
| | - Antonio V Sterpetti
- Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy
| | - Raffaele Serra
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Andrea Mingoli
- Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy
| | - Paolo Sapienza
- Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy.
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Mizuguchi Y, Yamada T, Taniguchi N, Nakajima S, Hata T, Takahashi A. Pseudoaneurysm Formation After Cardiac Catheterization Using the Distal Transradial Approach. J Invasive Cardiol 2019; 31:E257. [PMID: 31368898] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This is the first case report of pseudoaneurysm formation after cardiac catheterization through the distal radial artery, which was easily treated by external compression.
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Affiliation(s)
- Yukio Mizuguchi
- Department of Cardiology, Sakurakai Takahashi Hospital, 5-18-1 Oikecho, Suma-ku, Kobe, Hyogo 654-0026, Japan.
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