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Methodist DeBakey Cardiovascular Journal 2024Left ventricular assist devices (LVAD) are surgically implanted mechanical support devices utilized with increasing frequency as a bridge to myocardial recovery,...
Left ventricular assist devices (LVAD) are surgically implanted mechanical support devices utilized with increasing frequency as a bridge to myocardial recovery, destination therapy, and heart transplantation. While the use of such devices in patients with advanced heart failure has shown significant survival benefits and improved quality of life, they bear their own risks and complications. Bleeding, infection, pump thrombosis, and stroke are just some of the serious complications associated with LVADs. LVAD-associated pseudoaneurysms are rare, with prior reports of occurrence at the left ventricular apex and at the anastomosis site of the outflow graft to the ascending aorta. Typically, this device-related complication requires surgical repair and, if at all feasible, heart transplantation. However, in cases of difficult anatomy, unfavorable position, and significant comorbidities, surgery may be contraindicated due to high surgical risk. This case portrays a patient suffering from a left ventricular pseudoaneurysm after HeartMate-III implantation that was not amenable to surgical repair due to heightened surgical risk. We document the first pseudoaneurysm associated with the HeartMate-III in available literature and describe a novel management strategy of documented nonoperative course of LVAD-associated pseudoaneurysm, with the patient surviving 56+ months with medical optimization and management.
Topics: Humans; Conservative Treatment; Aneurysm, False; Heart-Assist Devices; Quality of Life; Aorta
PubMed: 38250571
DOI: 10.14797/mdcvj.1301 -
JACC. Cardiovascular Interventions Feb 2021
Topics: Aneurysm, False; Humans; Mammary Arteries; Sternotomy; Treatment Outcome
PubMed: 33516689
DOI: 10.1016/j.jcin.2020.11.037 -
Arteriosclerosis, Thrombosis, and... Jan 2018Pseudoaneurysms remain a significant complication after vascular procedures. We hypothesized that TGF-β (transforming growth factor-β) signaling plays a mechanistic...
OBJECTIVE
Pseudoaneurysms remain a significant complication after vascular procedures. We hypothesized that TGF-β (transforming growth factor-β) signaling plays a mechanistic role in the development of pseudoaneurysms.
APPROACH AND RESULTS
Rat aortic pericardial patch angioplasty was associated with a high incidence (88%) of pseudoaneurysms at 30 days, with increased smad2 phosphorylation in small pseudoaneurysms but not in large pseudoaneurysms; TGF-β1 receptors were increased in small pseudoaneurysms and preserved in large pseudoaneurysms. Delivery of TGF-β1 via nanoparticles covalently bonded to the patch stimulated smad2 phosphorylation both in vitro and in vivo and significantly decreased pseudoaneurysm formation (6.7%). Inhibition of TGF-β1 signaling with SB431542 decreased smad2 phosphorylation both in vitro and in vivo and significantly induced pseudoaneurysm formation by day 7 (66.7%).
CONCLUSIONS
Normal healing after aortic patch angioplasty is associated with increased TGF-β1 signaling, and recruitment of smad2 signaling may limit pseudoaneurysm formation; loss of TGF-β1 signaling is associated with the formation of large pseudoaneurysms. Enhancement of TGF-β1 signaling may be a potential mechanism to limit pseudoaneurysm formation after vascular intervention.
Topics: Aneurysm, False; Angioplasty; Animals; Aorta; Aortic Aneurysm; Cells, Cultured; Coated Materials, Biocompatible; Male; Mice; Nanoparticles; Pericardium; Phosphorylation; Prosthesis Design; Rats, Wistar; Signal Transduction; Smad2 Protein; Time Factors; Transforming Growth Factor beta1; Wound Healing
PubMed: 29146747
DOI: 10.1161/ATVBAHA.117.310372 -
Ear, Nose, & Throat Journal Dec 2022Internal maxillary artery (IMA) pseudoaneurysms are rare, and typically occur following trauma or orthognathic surgery. Pseudoaneurysms are life-threatening conditions,... (Review)
Review
Internal maxillary artery (IMA) pseudoaneurysms are rare, and typically occur following trauma or orthognathic surgery. Pseudoaneurysms are life-threatening conditions, and expeditious workup and treatment is critical. Endoscopic treatment of an IMA pseudoaneurysm is a feasible option and should be considered when IR embolization is not available. The objective of this study is to review the literature on IMA pseudoaneurysms and present the first reported case of an IMA pseudoaneurysm successfully treated endoscopically.
Topics: Humans; Maxillary Artery; Aneurysm, False; Endoscopy; Embolization, Therapeutic
PubMed: 36047445
DOI: 10.1177/01455613221121443 -
Korean Journal of Radiology 2016Visceral artery pseudoaneurysms occur mostly as a result of inflammation and trauma. Owing to high risk of rupture, they require early treatment to prevent lethal... (Review)
Review
Visceral artery pseudoaneurysms occur mostly as a result of inflammation and trauma. Owing to high risk of rupture, they require early treatment to prevent lethal complications. Knowledge of the various approaches of embolization of pseudoaneurysms and different embolic materials used in the management of visceral artery pseudoaneurysms is essential for successful and safe embolization. We review and illustrate the endovascular, percutaneous and endoscopic ultrasound techniques used in the treatment of visceral artery pseudoaneurysm and briefly discuss the embolic materials and their benefits and risks.
Topics: Abdomen; Aneurysm, False; Computed Tomography Angiography; Embolism; Embolization, Therapeutic; Humans; Radiology, Interventional; Renal Artery; Splanchnic Circulation; Ultrasonography
PubMed: 27134524
DOI: 10.3348/kjr.2016.17.3.351 -
Turkish Journal of Medical Sciences Oct 2021Evaluate the risk factors associated with pseudoaneurysms' development after the percutaneous interventional procedures performed by cardiology, interventional radiology...
BACKGROUND/AIM
Evaluate the risk factors associated with pseudoaneurysms' development after the percutaneous interventional procedures performed by cardiology, interventional radiology (IR), and the other clinics.
MATERIALS AND METHODS
We retrospectively analyzed the ultrasound scans in the hospital database and picture archiving system (PACS) and enrolled a total of 132 patients during the period from October 2015 and December 2019. We evaluated the maximum diameter and volume of the pseudoaneurysm with the patient and procedure-related factors with univariate analysis.
RESULTS
We found that the patients with hypertension and without peripheric artery disease (PAD) had greater sac diameter (p = 0.010 and p = 0.016) and increased sac volume (p = 0.029 and p = 0.007). However, the sac volume increased in patients with diabetes than those without (p = 0.003). Both the increased maximum diameter and the volume of the pseudoaneurysm sac were in the patients in whom the procedure was applied in the common femoral artery (CFA) and with the venous intervention (p < 0.010 and p < 0.016; p = 0.004 and p = 0.001, respectively). We found that platelet count correlated negatively with the sac's maximum diameter and the volume (r = –0.383, p < 0.001 and r = –0.486, p < 0.001, respectively) duration of intervention correlated positively with the sac's maximum diameter and the volume (r = 0.205, p = 0.019 and r = 0.320, p < 0.001).
CONCLUSION
Our study reveals that prolonged procedure duration, simultaneous arterial and venous accesses, peripheral artery disease, thrombocytopenia, and puncture site are the aggressive risk factors of pseudoaneurysms size after angiographic procedures.
Topics: Aged; Aneurysm, False; Angiography; Catheters; Female; Femoral Artery; Humans; Male; Middle Aged; Peripheral Arterial Disease; Retrospective Studies; Risk Factors; Ultrasonography, Doppler, Duplex
PubMed: 33932972
DOI: 10.3906/sag-2012-60 -
Anales de Pediatria Sep 2022
Topics: Aneurysm, False; Child; Humans
PubMed: 35279392
DOI: 10.1016/j.anpede.2021.09.002 -
Annals of Cardiac Anaesthesia 2022Pseudoaneurysm of the common carotid artery (CCA) is exceptionally unstable and unpredictable; it mandates quick medical attention in order to circumvent neurologic...
Pseudoaneurysm of the common carotid artery (CCA) is exceptionally unstable and unpredictable; it mandates quick medical attention in order to circumvent neurologic sequelae or hemorrhage. Unanticipated rupture is extremely lethal and a potential provocation for the anesthesia caregiver. It is an arduous challenge for an anesthetist to establish emergency airway when a huge bleeding pseudoaneurysm is compressing and deviating the trachea, securing invasive lines in collapsing vessels, volume and vasopressor resuscitation in deteriorating hemodynamics in order to maintain cerebral perfusion without compromising other vital organs, arranging huge amount of blood and blood products in a short span of time, and transferring an exsanguinating patient for the rapid institution of cardiopulmonary bypass. Not only preoperatively it also necessitates appropriate neuromonitoring and neuroprotection during and after surgery. The association of unforeseen rupture of common carotid artery pseudoaneurysm secondary to the tubercular spine and lifesaving management by the rapid institution of cardiopulmonary bypass (CPB) is a rare occasion. To the best of the authors' knowledge, there is not any similar case in the peer-reviewed literature. Therefore, the authors enumerate the clinical experience of an unexpected rupture of CCA pseudoaneurysm requiring lifesaving CPB and emphasize the "Timely Teamed Effort Approach" that can sustain a life in such an inevitable situation.
Topics: Anesthetics; Aneurysm, False; Cardiopulmonary Bypass; Carotid Arteries; Carotid Artery, Common; Humans
PubMed: 35075036
DOI: 10.4103/aca.aca_257_20 -
La Clinica Terapeutica Feb 2022we present our experiences of a patient with right femoral artery and right coronary artery pseudoaneurysms after percutaneous coro-nary intervention (PCI). These... (Review)
Review
we present our experiences of a patient with right femoral artery and right coronary artery pseudoaneurysms after percutaneous coro-nary intervention (PCI). These complications are rare in transfemoral coronary intervention. The patient underwent PCI to treat a chronic total occlusion (CTO) lesion at the right coronary artery (RCA) and developed sepsis due to Staphylococcus aureus infection following the use of femoral artery closure devices (FACD). To solve these complications, the patient underwent two vascular surgeries and a coronary artery bypass grafting (CABG) to the RCA. To manage these conditions, we need to recognize them early and treat them properly by surgery. Interventional cardiologists should keep in mind that there are potential vascular complications associated with a PCI using FACD.
Topics: Aneurysm, False; Coronary Occlusion; Coronary Vessels; Femoral Artery; Humans; Percutaneous Coronary Intervention; Risk Factors; Time Factors; Treatment Outcome
PubMed: 35147642
DOI: 10.7417/CT.2022.2386 -
Annals of Cardiac Anaesthesia 2021Left ventricular (LV) pseudoaneurysm is a rare complication following free wall rupture post transmural myocardial infarction or left ventricular surgery. A lot of...
Left ventricular (LV) pseudoaneurysm is a rare complication following free wall rupture post transmural myocardial infarction or left ventricular surgery. A lot of imaging modalities like echocardiography, computerised tomography and cardiac magnetic resonance imaging are available to diagnose it. Echocardiography plays a significant role in delineating the cavity, orifice and impact on the surrounding structures. We present a case of LV pseudoaneurysm recurrence following surgical repair.
Topics: Aneurysm, False; Echocardiography; Heart Aneurysm; Heart Ventricles; Humans; Myocardial Infarction
PubMed: 34747757
DOI: 10.4103/aca.ACA_11_20