Pseudoaneurysm

PURPOSE: To evaluate image quality of non-contrast-enhanced magnetic resonance angiography (MRA) and compare transplant renal artery stenosis (TRAS) seen by non-contrast-enhanced MRA with digital subtraction angiography (DSA) as the gold standard. MATERIALS AND METHODS: 330 patients receiving 369 non-contrast-enhanced MRA examinations from July 2014 to June 2017 were included. Thirty patients received at least two MRA examinations. Image quality was independently assessed by two radiologists...

PURPOSE: Traumatic thoraco-lumbar spine fracture spine with a concomitant blunt aortic injury is uncommon but potentially a fatal association. Our aim was to clarify: morphology of spinal fractures related to vascular damages and vice versa, diagnostic procedures and decision-making process for the best treatment options for spine and vessels. METHODS: We enrolled 42 cases culled from the literature and five personal ones, reviewing in detail by AO Spine Classification, Society of Vascular Surgery classification and Abbreviated Injury Scale for neurological evaluation...

OBJECTIVE: Our aim was to review the results of pelvic arterial embolization (PAE) performed in the interventional radiology suite. METHOD: The data of all patients in whom pelvic angioembolization was performed was collected from July 2011 to June 2017. Procedures were performed by an experienced interventional radiologist. The clinical and laboratory data, as well as the outcome data, were obtained from the medical records of our hospital. The following parameters were collected for each patient, including the age, gender, presenting symptoms, site of bleeding, catheters used for embolization, material used for embolization, previous computed tomography (CT) scan and/or focused assessment with sonography for trauma (FAST) ultrasound, average hemoglobin before the procedure, and patient clinical status on discharge...

Background: Very elderly patients (age ≥ 85 years) are a rapidly increasing segment of the population. As a group, they experience high rates of in-hospital mortality and bleeding complications following percutaneous coronary intervention (PCI). However, the relationship between bleeding and mortality in the very elderly is unknown. Methods: Retrospective review was performed on 17,378 consecutive PCI procedures from 2000 to 2015 at Dartmouth-Hitchcock Medical Center...

BACKGROUND: Aortic pseudoaneurysms are rare but life-threatening complications usually seen after cardiac surgery. The causes could be multifactorial such as infection or trauma. CASE PRESENTATION: We report the surgical management of a postoperative pseudoaneurysm of the ascending aorta caused by methicillin-resistant Staphylococcus aureus in a 2-year-old Middle Eastern boy who had undergone ventricular septal defect closure, subaortic membrane resection, and pulmonary artery de-banding...

Pseudoaneurysms arising from the left ventricular outflow tract are rarely reported. We report a 26-year-old man who was admitted with paroxysmal chest pain and dyspnoea on exertion. Computed tomography revealed the presence of a pseudoaneurysm (93 × 77 mm), and the communication was below the aortic annulus. Through median sternotomy, a huge pulsatile pseudoaneurysm was exposed, and an 8-mm-diameter communication of the pseudoaneurysm in the left ventricular outflow tract wall was visualized. The defect was successfully repaired, and the postoperative course was uneventful...

A 48-year-old male developed a recurrent aortic-root pseudoaneurysm after surgical repair for acute dissection. Although the initial closure of the pseudoaneurysm was successfully managed by transcatheter endovascular occlusion and coiling utilizing a hybrid transapical and transfemoral approach, the pseudoaneurysm was recanalized after 3 months and a third-time surgical repair was required. The potential risk for recurrence of pseudoaneurysms should be considered when applying endovascular occlusion devices to treat aortic root anatomy...

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Aim: Blunt injuries to visceral organs have the potential to lead to delayed pseudoaneurysm formation or organ rupture, but current trauma and surgical guidelines do not recommend repetitive imaging. This study examined the incidence and timing of delayed undesirable events and established advisable timing for follow-up imaging and appropriate observational admission. Methods: Patients with blunt splenic (S), liver (L), or kidney (K) injury treated with non-operative management (NOM) in our institution were included and retrospectively reviewed...

No abstract text is available yet for this article.

Blunt thoracic aortic injury (TAI) occurs most frequently as a sequelae of high impact deceleration such as high velocity road traffic accidents and falls from height. The burden of mortality and morbidity is high, however advances in pre-hospital care, diagnostic imaging and endovascular therapies have improved outcomes in this group of patients. Emergent treatment depends on accurate, early diagnosis by the radiologist. It is therefore of paramount importance that radiologists are familiar with both the direct (intimal flap, pseudoaneurysm, aortic contour irregularity and contrast extravasation) and indirect (periaortic haematoma) imaging findings of TAI...

Pseudoaneurysms arise from a disruption of arterial wall continuity and are most commonly related to a penetrating trauma, an arterial wall inflammation or iatrogenic causes. They differ from real aneurysms due to a lack of one or more layers of the arterial wall. The frequency of peripheral artery pseudoaneurysms in the upper extremities is less than in the lower extremities and its most common cause is a gunshot or a stab wound. The risk of a rupture is higher than in true aneurysms due to a lack of wall layers, therefore requiring surgical treatment in most cases...

Background: The authors present an unusual clinical case of high median nerve compression caused by an iatrogenic pseudoaneurysm of the brachial artery after an angiography with a follow up of 9 months. Methods: A 73-year-old male was seen with progressive numbness, loss of opponency and diminution of strength of finger flexion in the left hand after an angiography with direct puncture of the left humeral artery. Physical examination revealed a hard consistency internal distal arm swelling with the size of a walnut, non-pulsatile and with a Tinel sign on percussion...

One blunt abdominal aortic disruption (BAAD) and one blunt thoracic aortic injury (BTAI) case are presented. Both aortic injuries were combined with spinal fractures. In the BAAD case the aortic pseudoaneurysm manifested just above the lumbar fracture while in the BTAI case the aortic injury appeared several vertebras below the thoracal fracture site, suggesting different mechanisms in the aortic wall damage. In both cases the aortic wall first was sealed, successfully, by endovascularly-placed stents, meaning the risks of open aortic reconstructive surgery could be avoided...

In a 19-year-old male with interrupted aortic arch and complex congenital heart disease, we report percutaneous repair of a compromised aortic conduit. The patient had aortic arch repair in childhood utilizing a 12 mm Hemashield Dacron conduit. CT angiography showed multiple segments of this conduit were dilated to 16 mm suggesting conduit degeneration and failure with pseudoaneurysm formation. We utilized a self-expanding aortic endograft supported by internal placement of bare metal stents to repair the conduit...

A 67-year-old male presented with acute pancreatitis secondary to gallstones, also known as acute biliary pancreatitis, and subsequently developed gastric outlet obstruction and was transferred to our hospital. A gastro-jejunal feeding tube was placed and an open cholecystectomy was performed. The patient had a pancreatic drain placed for interval increase in pancreatic necrosis and then nearly exsanguinated from gastroduodenal artery pseudoaneurysm bleed. This was managed by coiling the gastroduodenal artery...

The authors report multiple giant bilateral pseudoaneurysms of pulmonary artery, also known as Rasmussen's aneurysms, which remained silent and unrevealed despite the large size and multiplicity unearthed by fluorine-18 fluorodeoxyglucose positron emission tomography/computerized tomography.

A 79-year-old man was admitted electively for investigation of weight loss. While he was an inpatient, he developed severe epigastric pain and an initial blood test revealed an acutely raised amylase (>2000) and deranged liver function tests. A contrast CT angiography showed a large haematoma adjacent to the duodenum, spreading in the retroperitoneal space, arising from a 2 cm bleeding pseudoaneurysm in the region of the gastroduodenal artery. Due to his underlying comorbidities, he was deemed unfit for surgical repair and he had coil embolisation with successful haemostasis...

No abstract text is available yet for this article.

We present a case of a 63-year-old patient referred to a cardiology consultation due to progressive symptoms of heart failure. He had a history of an inferior ST elevation acute myocardial infarction 6 years ago. Echocardiogram revealed a giant left ventricular aneurysm/pseudoaneurysm involving the inferior and inferolateral left ventricular walls, with a massive mural thrombus. Additional characterization was done by cardiac magnetic resonance, essential in establishing the diagnosis of pseudoaneurysm and to guide subsequent management...