Ultrasound guided percutaneous thrombin injection has recently been described for the treatment of iatrogenic femoral pseudoaneurysms. Patient selection and technical aspects of this technique are still evolving and safety data, particularly after coronary intervention, remains limited. The percutaneous thrombin injection of femoral artery pseudoaneurysms in 13 consecutive patients, most of whom were receiving antiplatelet/anticoagulant treatment (aspirin 11, heparin 4, clopidogrel 6), is reported. Thrombin (1000 U/ml) was injected over several seconds until Doppler colour flow within the cavity ceased. The median dose of thrombin injected was 800 U (range 200-1000 U) and the treatment was successful in all cases without complication. In one case, thrombus was visualised within the arterial lumen immediately after thrombin injection, but this dissolved spontaneously within five minutes without evidence of embolisation. In contrast to ultrasound guided compression, percutaneous thrombin injection ...
Anastomotic pseudoaneurysm is a rare complication following aorta replacement. However, this condition is life-threatening because of the high risk of rupture. This complication has a mortality rate of 61% if no intervention is performed.[1] Its foremost cause may be the high local tension or the edematous aortic wall, which causes sutures to lacerate the aortic wall. Another possible cause is the graft infection.[2]. The incidence rate of anastomotic pseudoaneurysm ranges from 0.5% to 15%.[3] To date, two interventions are mainly used to manage this condition: The surgical repair and thoracic endovascular aortic repair. Surgical treatment involves the replacement of a prosthetic graft or direct repair via a redo left lateral thoracotomy. Such redo thoracotomy is extremely difficult because of the adhesion of lungs to the chest wall in the left chest cavity. The high risk of lung injury was reported for more than 30% of the patients.[4] Meanwhile, open surgery has a high mortality ...
Case Reports in Vascular Medicine is a peer-reviewed, Open Access journal that publishes case reports in all areas of vascular medicine.
Carotid artery pseudoaneurysms can refer to pseudoaneurysms involving any segment of the carotid arteries: common carotid artery pseudoaneurysm internal carotid artery pseudoaneurysm external carotid artery pseudoaneurysm Pathology As with p...
TY - JOUR. T1 - Ultrasound-guided percutaneous thrombin injection for post-catheterization pseudoaneurysm. AU - Kuma, Sosei. AU - Morisaki, Koichi. AU - Kodama, Akio. AU - Guntani, Atsushi. AU - Fukunaga, Ryota. AU - Soga, Yoshimitsu. AU - Shirai, Shinichi. AU - Ishida, Masaru. AU - Okazaki, Jin. AU - Mii, Shinsuke. PY - 2015/5/11. Y1 - 2015/5/11. N2 - Background: The efficacy and safety of ultrasound-guided thrombin injection (UGTI) for the treatment of postcatheterization femoral and brachial artery pseudoaneurysms (PSA) is unclear in Japan. Methods and Results: A retrospective study of 32 consecutive patients undergoing percutaneous UGTI of postcatheterization PSA between February 2011 and February 2014 was performed. There were 23 femoral PSA and 9 brachial PSA treated with UGTI. The prevalence of CAD and smoking history were higher in the brachial PSA patients, but there were no statistically significant differences in other patient demographic factors or in the preprocedural antiplatelet ...
TY - JOUR. T1 - Endovascular management of pseudoaneurysm formation in the ascending aorta following lung transplantation. AU - Joyce, David L.. AU - Singh, Steve K.. AU - Mallidi, Hari R.. AU - Dake, Michael D.. PY - 2012. Y1 - 2012. N2 - Purpose: To demonstrate the role of endovascular approaches to the ascending aorta in the post-transplant context. Case Reports: Three patients (2 women and 1 man aged 52, 68, and 43 years, respectively) developed pseudoaneurysm of the ascending aorta following thoracic organ transplantation. Due to the prohibitive risk of open surgery in each case, an endovascular repair of the ascending aorta was performed, with implantation of 1 to 3 stent-grafts to span the lesions. Follow-up imaging demonstrated complete exclusion of the pseudoaneurysms, with excellent outcomes at 4 months, 6 months, and 3 years. Conclusion: Stent-grafting of the ascending aorta represents a viable approach to pseudoaneurysm in the post-transplant setting.. AB - Purpose: To demonstrate ...
Intravenous literature: So, M.J., Kobayashi, D., Anthony, E. and Singh, J. (2012) Pseudoaneurysm formation after umbilical arterial catheterization: an uncommon but potentially life-threatening complication. Journal of Perinatology. 32(2), p.147-149.. Abstract:. Relatively straightforward placement of an umbilical arterial catheter can be complicated by psuedoaneurysm formation in the presence of a coagulopathy. We describe a case of a neonate, where bedside ultrasound had a key role in the timely diagnosis of this complication and prevented a potentially fatal outcome. Pertinent imaging findings are described with a brief literature review.. ...
Pseudoaneurysms, or false aneurysms, are differentiated from true aneurysms by the layers of the artery involved. Pseudoaneurysms are the result of the rupture of all three layers of the artery: the tunica intima, media, and adventitia. The aneurysm is contained by an organized hematoma or neighboring connective tissue. With true aneurysms, the outermost layer, the adventitia, remains intact.. As a result of its secure location, injury to the basilar artery is rare.1 Only 10% of traumatic aneurysms in the brain occur in the posterior circulation. As was seen in this case, the majority of basilar artery aneurysms are associated with skull base fractures. In addition, the connective tissue surrounding the basilar artery is usually unable to contain the aneurysm, making it improbable that a patient would survive a traumatic aneurysm in the posterior circulation.2 Rapid treatment is imperative because of the high morbidity and mortality associated with basilar artery pseudoaneurysms. ...
C Jones, E Holcomb, T Rohrer; Femoral artery pseudoaneurysm after invasive procedures. Crit Care Nurse 1 August 1995; 15 (4): 47-51. doi: https://doi.org/10.4037/ccn1995.15.4.47. Download citation file:. ...
In addition to haematoma and arteriovenous fistula, the iatrogenic pseudoaneurysm is a common complication of vascular access that is caused by a perforation in the arterial wall. Iatrogenic pseudoaneurysms can progress in size and lead to rupture and active bleeding. Over the previous few decades, therapeutic methods have evolved from surgical repair to less invasive options, such as ultrasound-guided compression therapy (UGCT) and ultrasound-guided thrombin injection (UGTI). This paper presents an overview of the diagnostic and treatment modalities used in femoral pseudoaneurysms as well as a comprehensive summary of previous studies that analysed the success and complication rates of UGCT and UGTI ...
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Angioplasty, stenting, endovascular stent grafts, and other minimally interventional techniques are becoming common techniques used for a myriad of vascular pathology. As the technology, comfort level, and technical expertise improve, the envelope of overuse is being approached or possibly supercede
Another option for treatment is ultrasound probe compression of the neck of the pseudoaneurysm. The "neck" of the pseudoaneurysm is the narrow path of blood flow between the artery, through the arterial wall, and into the pseudoaneurysm cavity. The artery, neck, and pseudoaneurysm are seen on ultrasound. The ultrasound probe can be pushed firmly against the patients skin to compress the neck of the pseudoaneurysm for usually about 20 minutes. During this time, the blood within the pseudoaneurysm clots; after the probe is then removed, the pseudoaneurysm will hopefully remain clotted and will not continue to expand. The procedure may be stopped early due to patient discomfort. It is less successful if the patient is obese, since there is more fatty tissue between the skin and the neck of the pseudoaneurysm. It also is less successful if the neck of the pseudoaneurysm is wider, since it is less likely to clot off during the period of compression. Finally, it is also much less successful if the ...
Ruptured pseudoaneurysm following pelvic surgery is a rare and fatal complication. Because of its rarity, existing evidence is limited to a small case series. A 60-year-old woman underwent staging laparotomy, including pelvic and para-aortic lymphadenectomy, for ovarian cancer. On the 11th day, the patient developed a sudden lumbar pain and loss of consciousness, which resulted in a state of shock. She was diagnosed as having a pelvic abscess and ruptured external iliac artery pseudoaneurysm. We performed ligation of the external iliac artery to restrain hemorrhage and femoro-femoral artery bypass to prevent infection, which saved the patients life ...
A 61-year-old man with acute myocardial infarction developed a painful hematoma in his groin after percutaneous coronary intervention. Ultrasonography, including color Doppler, detected a pulsatile, hypoechogenic, single compartment lesion (2.3 × 3.0 × 2.9 cm) consistent with a partially thrombosed pseudoaneurysm originating from the distal part of the common femoral artery (Figure, A). Sampling from the neck of the pseudoaneurysm connecting the pseudoaneurysm to the common femoral artery, spectral Doppler waveform analysis unexpectedly displayed flow directed toward the pseudoaneurysm cavity both in systole and diastole (Figure, B), in contrast to the characteristic to and fro-like flow pattern detected in uncomplicated pseudoaneurysms (Figure, C). The turbulent monophasic flow of the pseudoaneurysm neck, with its characteristic high end-diastolic velocities (Figure, B), suggested flow to an area of low peripheral resistance, in contrast to the normal high-resistance biphasic arterial flow ...
A 65-year-old alcoholic man presented with subacute exertional dyspnea and left shoulder pain. Three years earlier he was bitten by a rat while feeding a pet snake, resulting in sepsis, which was treated with intravenous antibiotics. Cardiac catheterization at an outside hospital was interpreted as myocardial bridging of the circumflex artery, and transthoracic 2-dimensional echocardiogram raised suspicion of aortic dissection, resulting in a transfer to our hospital.. Chest radiograph at admission was unremarkable, but ECG revealed sinus tachycardia with inferolateral ST-T wave changes, suggestive of ischemia (Figure 1A and 1B). Bedside transesophageal echocardiogram with 3-dimensional full-volume reconstruction showed severe aortic stenosis and a large pseudoaneurysm (PSA) of the mitral-aortic intervalvular fibrosa, with a mobile calcification noted at the opening of the PSA cavity (Figure 2A and 2B and online-only Data Supplement Movie I). Cardiac computed tomographic angiography established ...
Rupture of infected anastomotic femoral artery pseudoaneurysms (AFAPs) represents a limb and life-threatening condition requiring emergency intervention. This study aimed to evaluate the feasibility, safety, and efficacy of a hybrid repair for ruptur
Sternotomy for AVR surgery. Bilateral hilar prominence; pulmonary arteries dilatation? On the lateral view, possibility of an enormous aortic pseudoaneurysm vs enormous pulmonary trunk. Those findings werent present in previous chest x-rays, before the surgery. ...
a) Grade 1: Intimal flaps at the level of the proximal descending aorta and 10 cm distal to the subclavian artery (arrowheads) with accompanying mediastinal hematoma. (b) Grade 3: large pseudoaneurysm formation. (c) and (d) Traumatic aortic transection (grade 4) with massive para-aortic hematoma ...
Pseudoaneurysms are a recognised complication of pancreatitis. Necrotising vasculitis with resultant aneurysmal changes in peri-pancreatic vessels is more recognised in chronic pancreatitis. Similar pseudoaneurysms have been described in association with acute pancreatitis, but only occur in approximately 10% of cases. The damage in pancreatitis is caused by released and activated pancreatic enzymes. Necrotizing vasculitis and erosion of vessel walls results in aneurysmal changes in peripancreatic vessels. The vessels of the coeliac trunk are the most commonly affected. Haemorrhage from arterial pseudoaneurysm rupture is potentially fatal. In most cases, massive gastrointestinal bleeding is typical at onset and prognosis of these cases is usually poor. Early diagnosis and treatment of this complication is therefore important. It is well recognised and documented that radiology has a major role in diagnosis and management. Ultrasound may be useful in diagnosing pseudoaneurysm complicating acute ...
A pseudoaneurysm, also known as a false aneurysm, is a collection of blood that forms between the two outer layers of an artery, the muscularis propria and the adventitia. It is usually caused by a penetrating injury to the vessel, which then bleeds, but forms a space between the above two layers, rather than exiting the vessel. It may be pulsatile and can resemble a true aneurysm. A true aneurysm involves all three layers of the blood vessel. A dissecting aneurysm is when blood from the vessel lumen tracks between the two inner layers, the intima and the muscularis. This can cause blockage of the flow. A perivascular hematoma is a collection of blood that is external to the three vessel layers. Due to being close to the vessel, it can also be pulsatile, and can be mistaken for a pseudoaneurysm or aneurysm. Femoral pseudoaneurysms may complicate up to 8% of vascular interventional procedures. Small pseudoaneurysms can spontaneously clot, while others need definitive treatment. A pseudoaneurysm ...
Pseudoaneurysm formation after vascular reconstruction is a rarely encountered problem in the treatment of peripheral arterial disease. It has most commonly been described in the vascular surgical literature as a delayed complication of lower extremity bypass surgery, and the usual mode of repair has been surgical. Recent advances in minimally invasive therapy for this clinical entity have centered on ultrasound-guided compression and thrombin injection to obliterate the cavity and restore vascular integrity. With the advent of stent-supported angioplasty, endovascular methods of treatment for
A case of false aneurysm originating from the ascending aortic cannulation site in the absence of mediastinal infection is described. Surgical treatment was carried out by means of limited cardiopulmonary bypass and hypothermic circulatory arrest, but the patient died early in the postoperative period. The technical failures responsible for the unsuccessful outcome are emphasized.. ...
TY - JOUR. T1 - Hybrid arch repair including supra-aortic debranching on the descending aorta. AU - Shimizu, Hideyuki. AU - Hachiya, Takashi. AU - Yamabe, Kentaro. AU - Yozu, Ryohei. PY - 2011/12. Y1 - 2011/12. N2 - A 49-year-old patient with an anastomotic pseudoaneurysm in the aortic arch was considered at high risk for conventional surgery through a median sternotomy because he had previously undergone several operations to treat aortic dissection and had a deep sternal infection after one procedure. Therefore, a hybrid repair was performed. Stent grafts were placed bridging two previously implanted aortic prostheses, which were in the ascending aorta and descending aorta, respectively. The supra-arch vessels were perfused by means of an extra-anatomic bypass from the descending aorta. The aneurysm was completely excluded from the blood flow, and the patient had no serious complications.. AB - A 49-year-old patient with an anastomotic pseudoaneurysm in the aortic arch was considered at high ...
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Summary A 46-year-old man presented with a 5-month history of abdominal pain that had become aggravated in the previous half month. The patients temperature...
False Aneurysm: Not an aneurysm but a well-defined collection of blood and CONNECTIVE TISSUE outside the wall of a blood vessel or the heart. It is the containment of a ruptured blood vessel or heart, such as sealing a rupture of the left ventricle. False aneurysm is formed by organized THROMBUS and HEMATOMA in surrounding tissue.
The risk of rupture for pseudoaneurysm in transplanted patients is 50% [3]; if untreated the reported mortality-rate is 69% or higher in case of extrahepatic pseudoaneurysm [4]. Altough pseudoaneurysms are uncommon, they represent potential life-threatening post-OLT arterial complications which must be promptly diagnosed and treated. In fact, without an early treatment, they may threaten patient and graft survival, limiting the long-term success of transplantation ...
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A 64-year-old man presented with an inferior ST-elevation myocardial infarction. The patient underwent emergent percutaneous coronary intervention of his right coronary artery. Cine cardiac magnetic resonance imaging showed a contained rupture of the inferobasal wall with pseudoaneurysm formation (A). Delayed enhancement image showed the transmural infarct (B). Cardiac computed tomography multiplanar reconstruction also showed an associated ventricular septal defect (C). Transthoracic echo color Doppler image showed flow across ventricular septal defect (D). Although relatively rare, both pseudoaneurysms and ventricular septal defects are well-known mechanical complications after myocardial infarction that increase the risk of mortality. This patient had bovine pericardial patch repair of both defects 3 weeks later, after which he was discharged to cardiac rehabilitation. ...
INTRODUCTION: Pseudoaneurysm of the breast is a very rare complication, which may occur after breast biopsy with a large core needle. We report a case of pseudoaneurysm of the breast that occurred after biopsy of a breast mass. CASE REPORT: The pati
A dilation of an http://www.answers.com/topic/artery with actual disruption of one or more layers of its walls, rather than with expansion of all wall.
Hi All, How do u code pseudoaneurysm common femoral artery post cardiac cathertization and cabg? 997.2 or 997.2,442.3 or different altogether? thanks
GBM and pseudoaneurysm. Pretreatment T1-weighted gadolinium-enhanced axial MRI demonstrating a heterogeneously enhancing mass in the right frontotemporal region
Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Pseudoaneurysm
Pseudoaneurysms of the subclavian artery remain a rare complication after fracture of the clavicle. We report a case of delayed diagnosis of a subclavian artery pseudoaneurysm after a closed fracture...
Left ventricular aneurysms (LVAs) and pseudoaneurysms are two complications of myocardial infarction (MI) that can lead to death or serious morbidity.An LVA is most commonly the result of MI, usually involving the anterior wall. Other causes of LVA i
The aim of this study is to report a new minimally invasive technique of superficial temporal artery (STA) pseudoaneurysm treatment. Several surgical options have been employed to treat STA pseudoaneurysms. To address this rare condition, the employed techniques are ligation and excision of the aneurysm, endovascular coil embolization or percutaneous ultrasound-guided thrombin injection. Between techniques no significant differences are reported in terms of outcomes. The decision to adopt a technique depends on STA pseudoaneurysm morphology and surgeon preference. In the present report, STA pseudoaneurysm afferent and efferent branches were identified by ultrasound in a 92-year-old female. Under local anaesthesia, these branches were ligated through small skin incisions. STA pseudoaneurysm decompression was obtained by an over the needle aspiration. A compressive dressing was left in space for 48 h. ...
Postoperative left ventricular pseudoaneurysm is a rare, but potentially lethal, complication because of the high risk of rupture and high mortality of repair. We report a 64-year-old man with Marfan syndrome who underwent the reimplantation valve-sp
Looking for online definition of false aneurysm in the Medical Dictionary? false aneurysm explanation free. What is false aneurysm? Meaning of false aneurysm medical term. What does false aneurysm mean?
Table) Ninety-one patients had superficial thrombin injection (STI) and 55 patients had neck thrombin injection (NTI). Baseline characteristics were similar in both groups. At the time of injection, all patients were on dual antiplatelet therapy and 9.6% were on oral anti-coagulation therapy without significant difference between both groups. Patients in the NTI cohort tended to have shorter neck. The NTI technique utilized lesser amount of Thrombin with a trend to a higher success rate and lesser recurrence. The two patients in the NTI group with recurrent PSA on follow-up imaging study were both on Coumadin and both PSAs were successfully treated with re-injection of Thrombin. No serious complications were observed including thromboembolism, limbischemia, aneurysm rupture, or abscess formation. ...
Predictive factors for residual tumor and tumor upstaging on relook transurethral resection of bladder tumor in non-muscle invasive bladder cancer. Tejpal S. Gill, Ranjit K. Das, Supriya Basu, Ranjan K. Dey, and Subrata Mitra. The safety and efficacy of endoscopic incision of orthotopic ureterocele in adult.. Authors: Vijay MK, Vijay P, Dutta A, Gupta A, Tiwari P, Kumar S, Bera MK, Das RK, Kundu AK.. Saudi J Kidney Dis Transpl. 2011 Nov;22(6):1169-74.. Role of Prostate Specific Antigen, Digital Rectal Examination and Trans Rectal Ultra Sonography in the Diagnosis of Prostate Cancer in Patients with Lower Urinary Tract Symptoms. Authors: 1Sunanda De, 2Ranjit Kumar Das, 3Sanhita Mukherjee. International Journal of Science and Research vol 2 issue 3 March 2013. Renal artery pseudoaneurysm following percutaneous nephrolithotomy. Authors: Mukesh Kumar Vijay, Preeti Vijay, Ranjit Kumar Das, Anup Kumar Kundu. Saudi Journal of Kidney Diseases and Transplantation Year : 2011 , Volume : 22 , Issue 2, Page ...
TY - JOUR. T1 - Acute arterial thrombosis after covered stent exclusion of bleeding mycotic pseudoaneurysm. T2 - Treatment using catheter-directed thrombolysis. AU - Palestrant, Sarah. AU - Knuttinen, M. Grace. AU - Gaba, Ron C.. AU - Bui, James T.. AU - Owens, Charles A.. PY - 2011. Y1 - 2011. N2 - Conventional absolute contraindications to catheter-directed thrombolysis include active or recent hemorrhage and the presence of local vascular infection, both of which increase the risk of procedure-related complications such as bleeding and systemic sepsis. For this reason, lytic therapy of arterial thromboembolism under these circumstances is generally precluded. Herein, we describe a unique case of safe catheter-directed lysis of an acutely thrombosed iliac artery following covered stent placement for treatment of an actively bleeding infected pseudoaneurysm. Our management approach is discussed.. AB - Conventional absolute contraindications to catheter-directed thrombolysis include active or ...
A 52-year-old man presented with signs of a right middle cerebral artery stroke. A large pulsatile mass was noted at the right base of his neck, together with an overlying scar which the patient reported as being due to a stab wound sustained 22 years ago (Fig. 1). A computed tomography (CT) scan of the brain showed an infarct in the area of the right middle cerebral artery (Fig. 2). Computed tomographic angiography revealed a pseudo-aneurysm of the right common carotid artery at its origin with extensive surrounding thrombus (Fig. 3), as well as paucity of branches of the right middle cerebral artery (Fig. 4). Definitive management of the pseudo-aneurysm was achieved by vascular surgical intervention.
This ultrasound training video is designed to provide an introduction to the color/duplex ultrasound evaluation of aneurysms, pseudo-aneurysms and ultrasound evaluation of arterial bypass grafts.
In this brief report, we describe a technique to facilitate hypothermic arrest before a redo sternotomy that is likely to require extensive dissection. This approach may be well-suited for patients with significant aortic insufficiency, as it allows control of left ventricular distention once hypothermic ventricular fibrillation ensues. The procedure entails inserting a second venous cannula through the left ventricular apex through a 7-cm left mini-thoracotomy. We used the technique successfully in a patient with a ruptured, infected ascending aortic pseudoaneurysm and severe aortic insufficiency who had undergone a previous sternotomy. ...
The authors identified two randomized controlled trials, one observational study with a control group, and nine observational studies without a control group. A total of five different catheters were used across these trials. In controlled studies, there was a reduction in mean systolic (-28.9 mm Hg; 95% confidence interval [CI], -37.2 to -20.6; p < 0.0001) and diastolic (-11.0 mm Hg; 95% CI, -16.4 to -5.7; p < 0.0001) blood pressure (BP) at 6 months compared to medically treated patients. In uncontrolled studies, there was a similar reduction in mean systolic (-25.0 mm Hg; 95% CI, -29.9 to -20.1) and diastolic (-10.0 mm Hg; 95% CI, -12.5 to -7.5) blood pressure at 6 months compared to pre-RDN values. There was no difference in the effect of RDN according to the type of the device used. Reported procedural complications included one renal artery dissection and four femoral pseudoaneurysms.. ...
Vasculo-Behçet disease iVBD jis a special type of Behçet disease iBD jinvolving some vascular disorders like aneurysmal formation, arterial occlusion, and venous thrombosis in various vessels. VBD has a poor prognosis due to aneurysmal rupture or recurrence of vascular disorders despite optimal treatment. However, definite diagnosis in BD is made on the basis of clinical features, and early diagnosis is difficult. We report 2 patients whose first clinical symptoms were femoral-pseudoaneurysms. They received a diagnosis of VBD after surgery. The first patient was a 69-year-old man, who underwent autologous-vein patch closure of a perforated region in the left femoral artery. One year later, he had a pseudoaneurysm of the right profunda femoris artery, which was ligated. The second patient was a 51-year-old man, who underwent the interposition of the saphenous vein for defective artery due to left superficial femoral-pseudoaneurysm ...
What to Learn from this Article? Pseudo-aneurysm of radial artery is a rare complication after internal fixation of radius shaft fracture and arises due to intra-operative trauma to artery which can present as early as 2weeks as in this case. Case Report , Volume 7 , Issue 6 , JOCR Nov - Dec 2017 , Page 3-5, Aditya Anand Dahapute, Rohan Bharat Gala, Sanjay B Dhar, Siddharth Virani, AvaniSudhir Vaishnav..... Read More ...
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