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British Journal of Hospital Medicine... Dec 2022True aneurysms are dilatations of blood vessels, bounded by the tunica intima, tunica media and tunica adventitia. False aneurysms are dilatations bounded by the tunica... (Review)
Review
True aneurysms are dilatations of blood vessels, bounded by the tunica intima, tunica media and tunica adventitia. False aneurysms are dilatations bounded by the tunica adventitia only, and are more common than true aneurysms. The femoral artery is the second most common location for true peripheral artery aneurysms, and the most common site of false aneurysms. If left untreated, devastating complications can occur, such as infection, rupture, ischaemia and limb loss. Femoral artery aneurysms should be identified early and managed by a vascular specialist. This article outlines the evidence for the epidemiology, investigation and management of femoral artery aneurysms.
Topics: Humans; Aneurysm, False; Femoral Artery; Aneurysm; Lower Extremity
PubMed: 36594777
DOI: 10.12968/hmed.2022.0258 -
Ugeskrift For Laeger Apr 2023Pseudoaneurysms and thrombosis in the jugular vein are very rare. This case report presents a case of a 57-year-old female with a thrombosis in the internal jugular vein...
Pseudoaneurysms and thrombosis in the jugular vein are very rare. This case report presents a case of a 57-year-old female with a thrombosis in the internal jugular vein and a pseudoaneurysm in the external jugular vein. The diagnosis is often delayed due to the less-frequent occurrence of either. Ultrasound and/or computer tomographic scan are useful in the diagnostic process. Pseudoaneurysms in the external jugular vein are often benign and treatment spans from none to surgical removal. The treatment of venous thrombosis is anticoagulant medication.
Topics: Female; Humans; Middle Aged; Aneurysm, False; Jugular Veins; Thrombosis; Venous Thrombosis; Subclavian Vein
PubMed: 37114571
DOI: No ID Found -
Revista de Gastroenterologia de Mexico... 2022
Topics: Humans; Aneurysm, False; Cholecystitis; Arteries
PubMed: 36243676
DOI: 10.1016/j.rgmxen.2022.10.002 -
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 -
Frontiers in Immunology 2022Behçet's disease (BD) is a unique autoimmune chronic systemic vasculitis that affects veins and arteries of all sizes. BD can lead to recurrent vascular events,...
BACKGROUND
Behçet's disease (BD) is a unique autoimmune chronic systemic vasculitis that affects veins and arteries of all sizes. BD can lead to recurrent vascular events, especially venous thrombosis, with an incidence rate of 40%, or pseudoaneurysms formed under long-term inflammatory reaction or iatrogenic stimulation. BD-related risk factors promote endothelial dysfunction, platelet activation and overactivation of tissue factors leading to mural inflammatory thrombi. Thrombosis may be the first clinical manifestation of BD.
CASE PRESENTATION
A 32-year-old man complaining of progressive swelling and pain in the right lower extremity for 30 days was initially diagnosed with "venous thrombosis of the right lower extremity," using color Doppler ultrasonography. Patient underwent inferior vena cava filter placement combined with deep vein angioplasty of the right lower extremity and catheter-directed urokinase thrombolysis. Postoperative oral anticoagulant therapy was administered. However, the patient was readmitted 20 days later for pulsatile pain in the right groin. Prior medical history included 4 years of repeated oral and perineal ulcers, and 2 months of blurred vision. Abdominal computed tomography angiography (CTA) revealed rupture of the right common iliac artery (CIA) and left internal iliac artery (IIA), complicated by a pseudoaneurysm. Based on the clinical manifestations and other auxiliary examination results, the patient was re-diagnosed with "BD combined with deep venous thrombosis of the right lower extremity and an iliac artery pseudoaneurysm." Stent implantation was performed for iliac artery pseudoaneurysm after symptoms were controlled with timely immunosuppressive therapy. After endovascular treatment, the patient underwent continued immunosuppressive therapy and dynamic reexaminations of abdominal CTA, which revealed that a small amount of contrast agent at the stent in the right CIA continued to flow into the cavity of the pseudoaneurysm; in addition, the size of the pseudoaneurysm was gradually increasing. Therefore, the patient underwent a second stent implantation for iliac artery pseudoaneurysm, and the condition improved further.
CONCLUSION
The importance of early diagnosis of BD should be recognized, and the choice of interventional and surgical procedures should be carefully evaluated, as this may trigger further damage to vascular access in BD patients with aneurysm.
Topics: Adult; Aneurysm, False; Anticoagulants; Behcet Syndrome; Humans; Lower Extremity; Male; Pain; Venous Thrombosis
PubMed: 36105822
DOI: 10.3389/fimmu.2022.949356 -
The Medical Journal of Malaysia May 2021A pseudoaneurysm, or false aneurysm, is a haematoma that is formed secondary to a leaking hole in an artery. This haematoma is contained by surrounding fascia. In...
A pseudoaneurysm, or false aneurysm, is a haematoma that is formed secondary to a leaking hole in an artery. This haematoma is contained by surrounding fascia. In contrast, a true aneurysm contains all three layers of vessel wall, namely intima. Pseudoaneurysms are scarce and can arise consequential of numerous iatrogenic influences, including but not limited to, blunt or penetrating trauma, orthopedic procedures like tibial nailing or ankle arthroscopy, and sports injury. A thorough history taking focusing on the recent history of trauma or instrumentation and clinical examination should raise the suspicion of a pseudoaneurysm. In doubtful cases, imaging modalities such as an ultrasound and doppler examination of the lower limb can be utilized to confirm the diagnosis. Our case was a 37-year-old gentleman presented with progressive swelling in the anterior aspect of his left leg for the past two weeks. The patient had a atypical presentation, with absence of classic signs of a pseudoaneurysm such as a pulsatile mass, absence distal pulses or a thrill or bruit. However, these injuries albeit rare can be sinister and prompt diagnosis is critical, so that pertinent treatment can be delivered. Our case highlights the importance of sonographic approaches for suspected vascular injuries.
Topics: Adult; Aneurysm, False; Hematoma; Humans; Leg; Male; Tibial Arteries; Wounds, Penetrating
PubMed: 34031347
DOI: No ID Found -
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 -
International Heart Journal Sep 2019Postcatheterization pseudoaneurysm is a serious complication following diagnostic or therapeutic catheterization. Because radial access is unsuitable in some situations,... (Comparative Study)
Comparative Study
Postcatheterization pseudoaneurysm is a serious complication following diagnostic or therapeutic catheterization. Because radial access is unsuitable in some situations, there is still a need to use femoral or brachial access for arterial catheterization. The aim of this study was to compare the incidence and clinical characteristics of pseudoaneurysm between brachial and femoral access. We identified patients who underwent arterial catheterization from our cardiac catheter records. A total of 5,990 cardiac catheter records and discharge summaries were reviewed, and 23 pseudoaneurysm cases were identified. Those pseudoaneurysm cases were divided into a brachial pseudoaneurysm group (n = 9) and a femoral pseudoaneurysm group (n = 14). The incidence of pseudoaneurysm was significantly higher in brachial access than in femoral access (odds ratio: 4.16, 95% confidence interval: 1.80-9.65; P < 0.001). Successful manual compression was frequently achieved in both the brachial (77.8%) and the femoral (92.9%) pseudoaneurysm groups (P = 0.295). Surgical intervention was more frequently performed in the brachial pseudoaneurysm group (22.2%) than in the femoral pseudoaneurysm group (0%) without reaching statistical significance (P = 0.07). Moreover, neurological disorders were observed only in the brachial pseudoaneurysm group (22.2%). In conclusion, the incidence of pseudoaneurysm was significantly higher in brachial access than in femoral access, indicating the potential risk of brachial access. Successful manual compression was frequently achieved in both groups, but neurological disorders were observed only in brachial access, suggesting the greater risk of brachial pseudoaneurysms.
Topics: Adult; Age Distribution; Aged; Aneurysm, False; Brachial Artery; Cardiac Catheterization; Conservative Treatment; Databases, Factual; Female; Femoral Artery; Hospitals, University; Humans; Incidence; Japan; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prognosis; Retrospective Studies; Risk Assessment; Sex Distribution; Treatment Outcome
PubMed: 31447463
DOI: 10.1536/ihj.18-551 -
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