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Ultrasound in Obstetrics & Gynecology :... Nov 2023
Topics: Pregnancy; Female; Humans; Aneurysm, False; Pregnancy, Tubal; Pregnancy, Ectopic
PubMed: 37340628
DOI: 10.1002/uog.26286 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Dec 2023Pseudoaneurysms of the neck are seldom, and those caused by neck infections especially parapharyngeal abscess are even rarer. However, it is life-threatening and may... (Review)
Review
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.
Topics: Aged, 80 and over; Humans; Male; Abscess; Aneurysm, False; Carotid Artery, Common; Carotid Artery, Internal; Neck; Parapharyngeal Space
PubMed: 38101801
DOI: 10.19723/j.issn.1671-167X.2023.06.028 -
European Journal of Vascular and... Aug 2023This study aimed to analyse long term outcomes and risk factors for endovascular repair of aortic pseudoaneurysms in patients with vascular Behçet's disease (BD).
OBJECTIVE
This study aimed to analyse long term outcomes and risk factors for endovascular repair of aortic pseudoaneurysms in patients with vascular Behçet's disease (BD).
METHODS
Medical records of 26 aortic vascular BD patients who underwent endovascular treatment at the vascular department of Peking Union Medical College Hospital between January 2002 and December 2021 were reviewed retrospectively. Erythrocyte sedimentation rate (ESR) and C reactive protein were used to assess BD activity. Computed tomography angiography (CTA) was obtained pre- and post-operatively for almost all patients. Univariable logistic regression analysis was used to analyse risk factors for endovascular repair, such as inflammatory indicators, drug usage, and stent graft parameters.
RESULTS
The abdominal aorta (n = 17) was the most common site of 27 vascular BD pseudoaneurysms in this study. CTA also revealed one aortic arch pseudoaneurysm, seven descending thoracic aortic pseudoaneurysms, one thoraco-abdominal aortic pseudoaneurysm, and one pseudoaneurysm at the aortic bifurcation. Most of the pseudoaneurysms were treated with covered stent grafts. The technical success rate was 96% and no deaths occurred during hospital stay. The mean follow up was 5.8 ± 5.5 years and 31% (8/26) experienced post-operative complications. Overall one, three, and five year event free survival rates were 87%, 78%, and 74%, respectively. Univariable logistic regression analysis revealed that pre-operative ESR ≥ 16.0 mm/h (p = .040), pre-operative glucocorticoid (GC) use ≤ 11.5 days (p = .024), pre-operative immunosuppressant use ≤ 15.5 days (p = .028), and length of proximal landing zone ≤ 1.95 cm (p = .034) were associated with a worse prognoses following endovascular treatment. Proximal oversize ≥ 9.5% (p = .074) was also regarded as a risk factor, although not statistically significant.
CONCLUSION
This study further confirmed the feasibility of endovascular repair for aortic vascular BD patients. Risk factors predicting poor prognoses included elevated pre-operative ESR, insufficient pre-operative GC use or immunosuppressant use, inadequate proximal landing zone, and larger proximal oversize percentage.
Topics: Humans; Aneurysm, False; Behcet Syndrome; Retrospective Studies; Blood Vessel Prosthesis Implantation; Treatment Outcome; Stents; Endovascular Procedures; Risk Factors; Immunosuppressive Agents; Blood Vessel Prosthesis
PubMed: 37068704
DOI: 10.1016/j.ejvs.2023.04.009 -
Journal of Vascular Surgery Cases and... Dec 2023Superficial temporal artery pseudoaneurysms are an uncommon vascular pathology that can present after head or facial trauma. Furthermore, they are rarely reported in the...
Superficial temporal artery pseudoaneurysms are an uncommon vascular pathology that can present after head or facial trauma. Furthermore, they are rarely reported in the pediatric population. Ultrasound can be a useful tool in the diagnosis because it is easily accessible and can be rapidly acquired. We report a case that demonstrates the utility of ultrasound in the diagnosis of a superficial temporal artery pseudoaneurysm.
PubMed: 38078284
DOI: 10.1016/j.jvscit.2023.101305 -
British Journal of Neurosurgery Aug 2023Bow hunter's syndrome (BHS), also known as rotational vertebral artery occlusion syndrome, is rare. Occasionally, it combines with dissection/pseudoaneurysm of the... (Review)
Review
BACKGROUND
Bow hunter's syndrome (BHS), also known as rotational vertebral artery occlusion syndrome, is rare. Occasionally, it combines with dissection/pseudoaneurysm of the ipsilateral VA.
METHODS
We report a case of BHS combined with ipsilateral VA dissection/pseudoaneurysm and review eight similar cases reported in the literature. Their aetiology, clinical and imaging features, treatment, and prognosis were analysed.
RESULTS
Nine patients (seven male, two female; average age 22.0 ± 4.5 years) were enrolled. Visual symptoms comprised the most common clinical finding (66.7%, 7/9). Clinical symptoms were not related to neck rotation in seven patients (77.8%). Eight patients (88.9%) had multiple, scattered, new and old infarctions of the posterior circulation revealed on computed tomography/magnetic resonance imaging (CT/MRI) scans. Dissection/pseudoaneurysm was found in the ipsilateral VA - usually subtle and localised in the atlas, axis, and occipital bone - in all nine patients. Seven patients (66.7%) had special causes for the syndrome (i.e. congenital bone dysplasia). Altogether, 87.5% (7/8) experienced recurrence with cerebral infarction after antithrombotic therapy alone. Aetiologically targeted treatment, including surgical decompression or vertebral fixation, was performed in seven patients (77.8%).
CONCLUSION
Young patients presenting with cryptogenic stroke in the posterior circulation and localised, subtle dissection/pseudoaneurysm of the ipsilateral VA around the atlanto-axial joint should undergo carotid ultrasonography with a neck rotation test or dynamic CT angiography/MR angiography/digital subtraction angiography, if necessary, to rule out/diagnose BHS.
Topics: Humans; Male; Female; Adolescent; Young Adult; Adult; Vertebral Artery Dissection; Vertebrobasilar Insufficiency; Mucopolysaccharidosis II; Aneurysm, False; Vertebral Artery; Syndrome
PubMed: 32009470
DOI: 10.1080/02688697.2020.1718604 -
Oral and Maxillofacial Surgery Sep 2023This paper aims to present a rare case report of bilateral pseudoaneurysm secondary to condylar fracture and its management with a brief review of literature. A patient... (Review)
Review
This paper aims to present a rare case report of bilateral pseudoaneurysm secondary to condylar fracture and its management with a brief review of literature. A patient of age 19 years with alleged history of road traffic accident presented 6 weeks lately to our department with slow growing swelling in right preauricular area. History revealed bilateral condylar fracture with right parasymphysis fracture of mandible for which patient underwent maxillomandibular fixation for 4 weeks. The diffuse swelling in preauricular region showed positive signs of pulsation and audible bruit. Ultrasonography and contrast-enhanced computed tomography suggested the bilateral presence of vascular anamoly from the terminal branches of external carotid artery. Diagnostic angiography confirmed presence of pseudoaneurysm at the bifurcation of the internal maxillary artery and superficial temporal artery (STA) on right side whereas on the left side it was at proximal STA. Bilateral endovascular coil and gel foam embolization was done and thrombosis was confirmed with high frequency ultrasound on fourth postintervention day. The swelling completely resolved in a period of 1 month with no evidence of recurrence in the following 2-year follow-up period. Routine investigation revealed presence of pseudoaneurysm on left side which was completely without any clinical signs as repoterd by many cases of condylar fracture in the literature review. Pseudoaneurysm may remain silent and are exposed intraoperatively with massive bleeding which causes significant morbidity. Hence, prompt diagnosis and management is essential to avoid unexpected complication perioperatively.
Topics: Humans; Young Adult; Adult; Mandibular Condyle; Aneurysm, False; Mandibular Fractures; Mandible; Tomography, X-Ray Computed
PubMed: 35654988
DOI: 10.1007/s10006-022-01069-8 -
Journal of Cardiothoracic Surgery Feb 2024To our knowledge, no previously reported clinical data of a coronary artery fistula forming a pseudoaneurysm and presenting as a anterior chest wall lump. We reported a...
BACKGROUND AND AIMS
To our knowledge, no previously reported clinical data of a coronary artery fistula forming a pseudoaneurysm and presenting as a anterior chest wall lump. We reported a rare case of Coronary pseudoaneurysm with a superficial mass and accompanying Brucella infection. The patient was successfully treated with surgery.
MATERIALS AND METHODS
The patient case data was extracted from hospital records.
RESULTS
A 64-year-old male presented with a history of paroxysmal left-sided chest pain and painful anterior chest wall lump. Coronary computed tomography (CT) angiography revealed the RCA pseudoaneurysm that showed a peripherally calcified soft-tissue mass in the anterior mediastinum and communicated with the chest wall lump through intercostal spaces. The patient underwent the resection of chest lump and RCA pseudoaneurysm under cardiopulmonary bypass, along with a combined antimicrobial therapy. The patient was discharged successfully after the surgery.
DISCUSSION AND CONCLUSION
We report this rare case and highlight the possible origin of the anterior mediastinal mass and anterior chest wall lump as a pseudoaneurysm formed by a coronary artery fistula.
Topics: Male; Humans; Middle Aged; Aneurysm, False; Coronary Artery Disease; Tomography, X-Ray Computed; Brucellosis; Fistula
PubMed: 38321525
DOI: 10.1186/s13019-024-02537-w -
Cardiology in the Young Aug 2023The carotid artery is a valuable vascular access that can be used in patients who have undergone repetitive interventional and surgical procedures and premature babies....
The carotid artery is a valuable vascular access that can be used in patients who have undergone repetitive interventional and surgical procedures and premature babies. In the past, cut-down was used but nowadays, mostly the procedure is performed under ultrasonographic guidance. Complications such as bleeding, haematoma, and pseudoaneurysm may occur when the carotid artery is used as a vascular access for the procedures such as aortic balloon valvuloplasty, coarctation balloon angioplasty, or after interventional or surgical treatments to the carotid artery. Although pseudoaneurysm is very rare, prompt diagnosis and accurate treatment planning are life-saving. In this article, the diagnosis and treatment of pseudoaneurysm in the left common carotid after transcatheter coarctation balloon angioplasty in a 6-month-old infant will be presented.
Topics: Humans; Infant; Aneurysm, False; Treatment Outcome; Carotid Arteries; Carotid Artery, Common; Carotid Artery Injuries; Aortic Coarctation
PubMed: 36601896
DOI: 10.1017/S1047951122003997 -
Portuguese Journal of Cardiac Thoracic... Jul 2023A 66-year-old female patient was admitted to hospital care in March 2021 due to aggravating fatigue and dyspnoea. Her past medical history was relevant for chronic...
A 66-year-old female patient was admitted to hospital care in March 2021 due to aggravating fatigue and dyspnoea. Her past medical history was relevant for chronic anaemia, smoking, dyslipidaemia, antiphospholipid syndrome and lupus-like mixed connective tissue disease, for which she was taking corticosteroids. She had suffered an acute coronary syndrome in August 2020, complicated with postinfarction pericarditis; at the time, coronariography diagnosed moderate disease of the anterior descending artery and occlusion of the circumflex artery. Echocardiography showed a discontinuity in the lateral and posterior walls of the left ventricle to a thin walled, loculated cavity, with doppler blood flow (Figure 1). A diagnosis of pseudoaneurysm was assumed, and the patient was transferred to our centre for surgical treatment.
Topics: Humans; Female; Aged; Aneurysm, False; Heart Ventricles; Myocardial Infarction; Echocardiography; Antiphospholipid Syndrome
PubMed: 37418761
DOI: 10.48729/pjctvs.374 -
Ear, Nose, & Throat Journal Dec 2023Pseudoaneurysms of facial artery usually arise from the distal part of the vessel. Only 4 cases were described in the literature involving the proximal part of facial... (Review)
Review
Pseudoaneurysms of facial artery usually arise from the distal part of the vessel. Only 4 cases were described in the literature involving the proximal part of facial artery. We present a case of a traumatic pseudoaneurysm involving the proximal part of facial artery. A 50-year-old man was referred to our department for a progressively growing submandibular mass. He was injured by a sharp object during a car crash 30 days ago. After 3 weeks, the patient noted the appearance of a subcutaneous mass in the left submandibular area. Physical examination revealed a freely movable, painful, and pulsatile swelling. Ultrasound and computerized tomography scan showed a nodular lesion in the left submandibular area in continuity with the facial artery. The diagnosis of pseudoaneurysm of facial artery was suspected. The patient was treated by surgery. The pseudoaneurysm was resected with ligation of the proximal and distal ends of the facial artery.
Topics: Male; Humans; Middle Aged; Aneurysm, False; Arteries; Ultrasonography; Tomography, X-Ray Computed
PubMed: 34261366
DOI: 10.1177/01455613211033110