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International Angiology : a Journal of... Oct 2019Visceral arterial aneurysms and pseudoaneurysms are rare entities. Despite infrequent, these lesions are clinically important and potentially lethal, since 22% present... (Review)
Review
Visceral arterial aneurysms and pseudoaneurysms are rare entities. Despite infrequent, these lesions are clinically important and potentially lethal, since 22% present as clinical emergencies and 8.5% result in death. As such, early detection and treatment is essential. Through this work, we aim to address both visceral arterial aneurysms and pseudoaneurysms, with particular focus on their epidemiology, etiology and risk factors, as well as report current diagnostic workups and treatment strategies. A full literature review was performed through a comprehensive electronic search of PubMed databases, including articles published until the end of November 2018 and using the following keywords: "visceral aneurysm," "pseudoaneurysm" and "endovascular treatment." From this research, 2043 articles had their abstract assessed, 359 were read integrally, 213 were excluded for not being directly related to the subject and 146 were included, according to the authors preference and scientific relevance in this work's context. Visceral arterial aneurysms and pseudoaneurysms have fairly similar clinical presentations and diagnostic workups. Differences reside mainly in their etiology and indications for treatment, since immediate treatment is recommended for pseudoaneurysms regardless of their size, while true aneurysms have specific treatment cutoffs. Despite a significant improvement on current diagnostic and treatment strategies, these lesions are still frequently diagnosed only upon rupture, with significant mortality rates. Endovascular strategies represent the first line of treatment on the majority of cases, although open surgery continues to play a role in specific conditions. Visceral arterial aneurysms and pseudoaneurysms are rare but potentially fatal and, as such, proper diagnosis and treatment is of capital importance. Due to its minimally invasive nature, endovascular therapies currently represent the standard of care in the majority of situations, although there are still solid indications for open surgery. Technique selection should be performed according to the clinical scenario and baseline anatomy.
Topics: Aneurysm; Aneurysm, False; Arteries; Diagnostic Imaging; Embolization, Therapeutic; Endovascular Procedures; Humans; Risk Factors; Treatment Outcome; Viscera
PubMed: 31284707
DOI: 10.23736/S0392-9590.19.04194-4 -
ANZ Journal of Surgery Dec 2021
Topics: Aneurysm, False; COVID-19; COVID-19 Vaccines; Humans; Rupture, Spontaneous; SARS-CoV-2; Vaccination
PubMed: 34516031
DOI: 10.1111/ans.17224 -
BMJ Case Reports Aug 2021Nosebleeds are among the most familiar presentations to the emergency department as well as otorhinolaryngologic outpatient services. Bleeding from nasal septal branches...
Nosebleeds are among the most familiar presentations to the emergency department as well as otorhinolaryngologic outpatient services. Bleeding from nasal septal branches of the anterior ethmoid artery (AEA) is common and can be effectively controlled endoscopically. However, the bleeding from a pseudoaneurysm involving the nasal septal branches of AEA is extremely rare and can be troublesome to control using endoscopic methods. We report an adult patient presenting with profuse nasal bleeding postroad traffic accident due to the formation of AEA septal branch pseudoaneurysm. The patient required repeated nasal packing, and the diagnosis was revealed using digital subtraction angiography. Since profuse active bleeding precluded endoscopic visualisation, an external approach had to be adopted to ligate the AEA to control the bleeding. We discuss the management options and nuances for this rare cause of the troublesome nasal bleeding.
Topics: Accidents, Traffic; Adult; Aneurysm, False; Arteries; Endoscopy; Epistaxis; Humans
PubMed: 34400430
DOI: 10.1136/bcr-2021-244231 -
Texas Heart Institute Journal Sep 2022Left ventricular pseudoaneurysm is a rare disease; it is defined as a ventricular rupture contained by epicardium, pericardial adhesions, or both. It most frequently... (Review)
Review
Left ventricular pseudoaneurysm is a rare disease; it is defined as a ventricular rupture contained by epicardium, pericardial adhesions, or both. It most frequently occurs as a complication of acute myocardial infarction. Surgical treatment is recommended for pseudoaneurysms that are large or symptomatic and for those discovered less than 3 months after myocardial infarction. We report our experience with 2 patients who had left ventricular pseudoaneurysms discovered less than a week after inferior myocardial infarction. Both patients were middle-aged men with right coronary occlusion in whom the diagnoses were established by echocardiography during the first week after infarction. Because both patients were clinically stable, we opted to defer surgery until scarring could facilitate correction; this decision was based on a review of the literature showing that in-hospital mortality is higher with early surgery. The patients were monitored closely in the intensive care unit and were prescribed β-blockers and vasodilators. Both patients underwent left ventricular patch reconstruction with exclusion of the pseudoaneurysm and posterior septum; both received moderate inotropic support and prophylactic intra-aortic balloon pump assistance. Their postoperative courses were uneventful. In 5 prior reports describing 45 patients (13 with acute pseudoaneurysm [≤2 wk after infarction] and 32 with nonacute pseudoaneurysm), in-hospital mortality was 61.5% for patients in the acute group and 15.6% for the nonacute group (P = .0066). We recommend that clinicians consider deferring surgery for patients with stable acute left ventricular pseudoaneurysm to reduce the risks associated with early repair.
Topics: Aneurysm, False; Coronary Occlusion; Heart Aneurysm; Heart Ventricles; Humans; Male; Middle Aged; Myocardial Infarction; Vasodilator Agents
PubMed: 36194723
DOI: 10.14503/THIJ-20-7462 -
Liver International : Official Journal... Aug 2022Cases of coronary and pulmonary artery pseudoaneurysms secondary to COVID-19 have been reported in the literature and are supposed to be secondary to inflammatory and...
Cases of coronary and pulmonary artery pseudoaneurysms secondary to COVID-19 have been reported in the literature and are supposed to be secondary to inflammatory and vasculitis processes linked to a viral multisystem inflammatory syndrome. Although the incidence of COVID-19-associated liver injury ranges from 14% to 53% in hospitalized patients, COVID-19-associated hepatic artery pseudoaneurysms have never been reported so far. We present the case of a patient whose follow-up CT after cryoablation of renal cell carcinoma revealed seven fusiform pseudoaneurysms of the two hepatic arteries secondary to COVID-19. Anticoagulant or anti-inflammatory treatments were not introduced. Vascular lesions were unchanged on the 3-month follow-up CT. At 6-month CT, the proximal pseudoaneurysm was replaced by a proximal occlusion of the accessory RHA.
Topics: Aneurysm, False; COVID-19; Hepatic Artery; Humans; Liver
PubMed: 35748622
DOI: 10.1111/liv.15344 -
Vascular and Endovascular Surgery Aug 2022New treatment options, like endovascular aortic repair, reduced the mortality rate of patients suffering from complications after an acute type A aortic dissection...
INTRODUCTION
New treatment options, like endovascular aortic repair, reduced the mortality rate of patients suffering from complications after an acute type A aortic dissection repair. Nevertheless, initial successful treatment of an aortic dissection does not fully eliminate the risk of later adverse aortic events like anastomotic pseudoaneurysm. Pseudoaneurysm of the anastomosis between the ascending and the arch graft could initiate complications like peripheral embolization, dysphagia or compression of mediastinum organs. Re-operation via re-sternotomy bears enormous morbidity and mortality for these patients. There is a high unmet need for percutaneous therapeutic options to treat pseudoaneurysms.
CASE PRESENTATION
A 59-year-old-man treated 15 years ago for type A aortic dissection, was hospitalized due to intermittent abdominal pain. A detailed examination revealed 2 pseudoaneurysms: 1 symptomatic at the level of the reimplanted celiac trunk and 1 asymptomatic at the anastomosis between the brachiocephalic trunk and the aortic arch graft. Due to multiple co-morbidities and previous operations, the risk for surgery was considered too high. Both pseudoaneurysm were treated percutaneously, the symptomatic 1 with covered stent and the asymptomatic with Amplatzer™ septal-occluder.
DISCUSSION
We present an alternative percutaneous therapy approach for treatment of pseudoaneurysm using a septal-occluder. A follow-up computed tomography 3 months later showed successfully excluded pseudoaneurysm.
Topics: Aortic Dissection; Aneurysm, False; Humans; Middle Aged; Septal Occluder Device; Stents; Treatment Outcome
PubMed: 35466833
DOI: 10.1177/15385744221095922 -
Acta Ortopedica Mexicana 2021Aneurysms and pseudoaneurysms of the arteries of the foot and ankle are rare clinical entities. In most cases occur within months or years of the initial trauma,...
INTRODUCTION
Aneurysms and pseudoaneurysms of the arteries of the foot and ankle are rare clinical entities. In most cases occur within months or years of the initial trauma, complications in the aforementioned situations are very uncommon, however, they should be ruled out at medical check-ups. We will present a clinical case in which pseudoaneurysm of the Distal Peroneal Artery occurred as a result of a fracture- dislocation of the ankle.
CLINICAL CASE
Patient of 60 years of age with trauma in right ankle, his radiographic study of the right ankle evidencing fracture- dislocation of the same. Surgical treatment is decided four days after the injury. In the postoperative course with edema, circulatory changes of abnormal form that merited imaging complement and arteriography was performed which indicates the presence of pseudoaneurysm of approximately 28 × 30 mm in distal peroneal artery meriting specific treatment with adequate control of symptoms.
CONCLUSION
We believe that it is of the utmost importance the correct assessment and physical examination of patients undergoing ankle surgery in successive post-surgical controls to detect these types of complications early and treat them in time.
Topics: Aneurysm, False; Ankle Joint; Humans; Lower Extremity; Tibial Arteries
PubMed: 34921541
DOI: No ID Found -
The British Journal of Radiology May 2017Pulmonary artery pseudoaneurysms (PAPs) are uncommon but potentially lethal. They may be incidentally discovered on imaging, or following massive haemoptysis if they... (Review)
Review
Pulmonary artery pseudoaneurysms (PAPs) are uncommon but potentially lethal. They may be incidentally discovered on imaging, or following massive haemoptysis if they rupture, with high risk of mortality. The most frequent causes of PAP are trauma and infectious disease. Vasculitis, in particular Behçet's disease, neoplasm, congenital disease and pulmonary hypertension are rarer causes of PAP. A PAP can be suspected from chest X-ray and contrast CT, but requires confirmation by CT angiography. Arteriography is no longer performed for diagnostic purposes, but can be useful in preparing endovascular occlusion of the PAP. In rare cases, surgery is necessary. The aim of this pictorial review was to illustrate the most common causes of acquired PAPs.
Topics: Aged; Aged, 80 and over; Aneurysm, False; Computed Tomography Angiography; Female; Humans; Male; Middle Aged; Pulmonary Artery; Tomography, X-Ray Computed
PubMed: 28337922
DOI: 10.1259/bjr.20160783 -
European Journal of Vascular and... Mar 2022
Topics: Aneurysm, False; Aorta; Humans; Surgical Instruments
PubMed: 34972628
DOI: 10.1016/j.ejvs.2021.11.017 -
JPMA. the Journal of the Pakistan... Feb 2021People who inject drugs (PWIDs) reuse injection equipment and other paraphernalia, which is a major source of transmission of human immunodeficiency (HIV) and hepatitis...
People who inject drugs (PWIDs) reuse injection equipment and other paraphernalia, which is a major source of transmission of human immunodeficiency (HIV) and hepatitis C virus (HCV) infections. PWIDs who use infected injections develop many surgical complications which are life- threatening. The most common complication is infected pseudoaneurysm. To assess complications requiring surgery in drug abusers, a study was conducted in the East Surgical Ward of Mayo Hospital Lahore, Pakistan from Jan 2017 to Jan 2019. A total of 48 PWIDs presented to the surgical department, out of which 39 (81%) were HIV positive, and 31 (64%) were HCV positive. Of the 52% who had pseudoaneurysm, 92% had femoral and popliteal aneurysm and 8% had brachial aneurysm. After ligation and excision of pseudoaneurysm only 8% required major amputation. Mortality rate was 0%. Ligation and excision is a safe option in pseudoaneurysm. Most common site for pseudoaneurysm was left femoral artery.
Topics: Aneurysm, False; Aneurysm, Infected; Drug Users; Femoral Artery; Humans; Pakistan; Substance Abuse, Intravenous
PubMed: 33819251
DOI: 10.47391/JPMA.644