수상 후 천측두동맥에 발생한 가성동맥류의 치료 2례

Traumatic Pseudoaneurysm of the Superficial Temporal Artery: Two Cases Report

  • 김연환 (한양대학교 의과대학 성형외과학교실) ;
  • 황원중 (한양대학교 의과대학 성형외과학교실) ;
  • 송순영 (한양대학교 의과대학 진단방사선과학교실)
  • Kim, Youn Hwan (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Hwang, Won Jung (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Song, Soon-Young (Department of Radiology, College of Medicine, Hanyang University)
  • 투고 : 2006.06.27
  • 발행 : 2007.01.10

초록

Purpose: It is even less common traumatic pseudoaneurysm of the superficial temporal artery and rare with fewer than 200 cases reported in the recent literature. Most common causes of traumatic pseudoaneurysm is sequelae of blunt, penetrating, or iatrogenic surgical trauma. The diagnosis is based on physical findings and can be confirmed by duplex ultrasonogram, computed tomography, and angiography. Surgical resection, percutaneous embolization and conservative treatment have all been used to treat pseudoaneurysm. However recently, non invasive technique like percutaneous thrombin injection under ultrasonographic guidance has been done rather than surgical ligation. In this report, we proposed the several treatment options such as conservative treatment, thrombin injection, and surgical ligation according to the multifarous conditions of pseudoaneurysm, patient, and causes. Methods: We describe two cases of traumatic pseudoaneurysm of superficial temporal artery in which CT angiography was effective in diagnosis and characterization. One is chronic pseudoaneurysm after traffic accident, which is fusiform shape and small size. Since the patient prefered it, we proposed percutaneous thrombin injection first. But we recognize that this method failed, we used surgical ligation according to information of CT angiographic findings. The other is acute pseudoaneurysm after blunt trauma, which is large size accompanying large hematoma. So we proposed compressive dressing and aspiration of hematoma. Results: Two cases were well treated with no recurrence or complication. Conclusion: In conclusion, when selecting a treatment options, followings should be considered: pseudoaneurysm in CT angiography, chronicity, cause, and patient's preference.

키워드

참고문헌

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