• Title/Summary/Keyword: pseudoaneurysm

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Long-Term Outcomes of Stenting on Non-Acute Phase Extracranial Supra-Aortic Dissections

  • Jiang, Yeqing;Di, Ruoyu;Lu, Gang;Huang, Lei;Wan, Hailin;Ge, Liang;Zhang, Xiaolong
    • Journal of Korean Neurosurgical Society
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    • v.65 no.3
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    • pp.422-429
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    • 2022
  • Objective : Extracranial supra-aortic dissections (ESADs) with severe stenosis, occlusion and/or pseudoaneurysm presents potential risk of stroke. Endovascular stenting to reconstruct non acute phase ESADs (NAP-ESADs) is an alternative to anticoagulant or antiplatelet therapy. However, its feasibility, safety and efficacy of stenting in NAP-ESADs is unclear. This study aims to investigate the long-term outcomes of the feasibility, safety and efficacy of stenting in NAP-ESADs. Methods : Seventy-four patients with 91 NAP-ESAD vessels with severe stenosis, occlusion and/or pseudoaneurysm presents potential risk of stroke who underwent stent remodeling were enrolled into this respective study from December 2008 to March 2020. Technical success rate, complications, clinical and angiographic results were harvested and analyzed. Results : Success rate of stent deployment was 99% (90/91) with no procedural mortality or morbidity. Transient ischemic attack occurred in three patients during operation (4.1%, 3/74). Asymptomatic embolisms of distal intracranial vessels were found in two patients (2.7%, 2/74). One hundred and forty-two stents deployed at 85 carotid (135 stents) and six vertebral (seven stents) vessels. Six stent types (Wingspan, 28/135, 20.7%; Solitaire, 10/135, 7.4%; Neuroform, 8/135, 5.9%; LVIS, 2/135, 1.5%; Precise, 75/135, 55.6%; Acculink, 12/135, 8.9%) were deployed at carotid arterial dissection while two types (Wingspan, 5/7, 71.4%; Solitaire 2/7, 28.6%) at vertebral arterial dissection. Digital subtracted angiography (56%, 51/91), computational tomography angiography (41.8%, 38/91) and high resolution magnetic resonance imaging (2.2%, 2/91) were adopted for follow up, with a mean time of 17.2±15.4 months (5-77). All patient modified Rankin Scale scores showed no increase at discharge or follow-up. Angiographically, dissections in 86 vessels in 69 patients (94.5%, 86/91) were completely reconstructed with only minor remnant dissections in four vessels in four patients (4.4%, 4/91). Severe re-stenosis in the stented segment required re-stenting in one patient (1.1%, 1/91). Conclusion : Stent remodeling technique provides feasible, safe and efficacious treatment of ESADs patients with severe stenosis, occlusion and/or pseudoaneurysm.

Bronchoaortic Fistula (기관지 대동맥루)

  • 정일영
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1137-1140
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    • 1992
  • Bronchoartic Fistula Secondary to Pulmoanry Tuberculosis Bronch-aortic fistula is a exceptionally rare complication of pulmonary tuberculosis. We report herein, a case of 39 years woman who underwent successful repair of aor-tobronchofistula. She was admitted because of massive hemoptysis via emergency room, she had several bouts of massive hemoptysis prior to hospitalization. Thoracic-aortic pseudoaneurysm had detected by chest CT by chance. The eroded, perforated descending aorta was repaired with patch aortoplasty during temporarily clamping, followed by Left lower lobectomy and omentopexy. Pathological examination revealed pulmonary tuberculosis of superiror seg. of lerg lower lobe and aortitis. The patient had uneventful recovery was well at OPD follow-up check.

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Rupture of the Traumatic Abdominal Aneurysm -Surgical Experience 1 case- (외상성 복부 대동맥류의 파열 -수술치험 1례 보고-)

  • 김범식
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.782-784
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    • 1990
  • We present a case of ruptured abdominal aortic aneurysm caused by blunt injury. The patient was 23-year-old soldier injured by a motor vehicle accident. Injuries sustained a contused abdominal aorta. At the time of aortic repair, the involved segment formed huge pseudoaneurysm, and which had intimal tear. Aorto-iliac graft replacement was carried out with a woven-dacron Y-graft prosthesis, which restored satisfactory circulation to both lower limbs. The postoperative course was uneventful.

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Obturator Bypass Surgery in a Patient with an Infected Femoral Artery Pseudoaneurysm with Sepsis (패혈증을 동반한 감염된 대퇴동맥 가성동맥류 환자에서 폐쇄공우회술을 이용한 치험)

  • Jun, Hee Jae;Han, Il Yong;Yoon, Young Chul;Lee, Yang Haeng;Hwang, Youn Ho;Cho, Kwang Hyun
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.107-110
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    • 2009
  • Infection of the both native and prosthetic vessels in the groin is a very serious disease because of recurrent arterial rupture and sepsis, and both these complications can cause death. The successful treatment of groin infection, including infection of the femoral artery, requires extensive excision of the infected tissues and restoration of the circulation. We experienced a case of obturator bypass in a patient with an infected femoral artery pseudoaneurysm and accompanying sepsis, and this occurred after performing a transfemoral angiogram in an A-V fistula of the carotid artery, and the patient also displayed intracranial hemorrhage.

Surgical Treatment of a Posttraumatic Pseudoaneurysm of the Left Subclavian Artery Mimicking a Mediastinal Tumor - A case report - (종격동 종양으로 오인한 외상 후 좌 쇄골하 동맥 가성동맥류의 수술적 치험 - 1예 보고 -)

  • Choi, Won-Suk;Lee, Yang-Haeng;Han, Il-Yong;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.651-654
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    • 2008
  • Posttraumatic psoudoaneurysrns of the subclavian artery are very rare. A 49-year-old woman who had been involved in a car accident ten years before presentation was initially diagnosed with a mediastinal tumor at a local clinic. Exploratory thoracotomy was performed for evaluation and treatment. During the operation, a hematoma was evacuated, and primary repair was undertaken to stop massive bleeding. Computed tomography angiography revealed a pseudoaneurysm of the left subclavian artery. The patient was treated with aneurysmectomy and end-to-end anastomosis. The postoperative course was uneventful.

Repair of a Post-infarction Ventricular Septal Defect and Left Ventricular Pseudoaneurysm Rupture by the "Sandwich Technique" - A case report - ("Sandwich Technique"을 이용한 심근경색 후 발생한 심실 중격 결손과 가성 좌심실류 파열의 수술 - 1예 보고 -)

  • Kim, Hyung-Tae;Kim, Wook-Sung;Park, Pyo-Won;Lee, Young-Tak;Sung, Ki-Ick;Lee, Mi-Na
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.516-519
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    • 2009
  • Ventricular septal defect (VSD) complicating an acute myocardial infarction is rather uncommon. However, the outcomes after the development of a VSD are poor with an in-hospital mortality of more than 90% for the medically treated patients. To prevent the recurrence of VSD, many techniques have been reported on for the closure of a postinfarction VSD. In this. report, we present a case of a patient who had a postinfarction VSD due to Prinzmetai's variant angina, and the rupture of the pseudoaneurysm of the left ventricle was successfully treated by the "Sandwich technique".

Successful Embolization in the Patient with Hemoptysis Due to Right Inferior Phrenic Artery-pulmonary Artery Anastomosis and Pseudoaneurysm (우하횡경막동맥-폐동맥 문합부위의 가성동맥류로 인한 객혈로 색전술 후 성공한 예)

  • Park, Hyun Woong;Lee, Go Eun;Park, Yong Sung;Son, Ji Woong;Choi, Eu Gene;Na, Moon Jun;Kwon, Sun Jung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.319-323
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    • 2009
  • The primary cause of hemoptysis is the bronchial artery. However, it should be noted that pulmonary artery and other vessels can cause hemoptysis. If the source of the bleeding is not determined after embolization, other evaluations are needed. Systemic-pulmonary anastomosis and pulmonary artery pseudo-aneurysm are rare vascular abnormalities with varying etiologies. An accurate and rapid diagnosis is needed in hemoptysis, since the cause may be life-threatening. We report a case of a 77-years-old man with persistent hemoptysis due to the right inferior phrenic artery - pulmonary artery anastomosis and pseudoaneurysm. After the embolization of the inferior phrenic artery, the hemoptysis was successfully treated.

Percutaneous Thrombin Injection Based on Computational Fluid Dynamics of Femoral Artery Pseudoaneurysms

  • Hyoung-Ho Kim;Kyung-Wuk Kim;Changje Lee;Young Ho Choi;Min Uk Kim;Yasutaka Baba
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1834-1840
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    • 2021
  • Objective: To analyze the computational fluid dynamics (CFD) of femoral artery pseudoaneurysm (FAP), identify a suitable location and timing for percutaneous thrombin injection (PTI) based on this analysis, and report our clinical experience with the procedure. Materials and Methods: CFD can be used to analyze the hemodynamics of the human body. An analysis using CFD recommended that the suitable location of the needle tip for PTI is at the center of the aneurysm sac and the optimal timing for starting PTI is during the early inflow phase of blood into the sac. Since 2011, seven patients (three male and four female; median age, 60 years [range, 43-75 years]) with FAP were treated with PTI based on the devised suitable location and time. Prior to the procedure, color Doppler ultrasonography was performed to determine the location and timing of the thrombin injection. Results: The technical success rate of the PTI was 100%. The amount of thrombin used for the procedure ranged from 200 IU to 1000 IU (median, 500 IU). None of the patients experienced any symptoms or signs of embolic complications during the procedure. Follow-up CT images did not reveal any embolism in the lower extremities and showed complete thrombosis of the pseudoaneurysm. Conclusion: Based on our study of CFD, PTI administered centrally in the FAP during early inflow, as seen on color Doppler, can be an effective technique.

Renal Subcapsular Hematoma after Percutaneous Transfemoral Angiography

  • Yi, Jin-Seok;Lee, Hyung-Jin;Lee, Hong-Jae;Yang, Ji-Ho
    • Journal of Korean Neurosurgical Society
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    • v.55 no.2
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    • pp.96-98
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    • 2014
  • Vascular complications after percutaneous angiography include hematoma, pseudoaneurysm, arteriovenous fistula, thromboembolism, arterial laceration and infection. Hematomas may occur in the groin, thigh, retroperitoneal, intraperitoneal, or abdominal wall. A 54-year-old female underwent percutaneous transfemoral angiography for the evaluation of cerebral aneurysm. Renal subcapsular hematoma developed 3 hours after the procedure. Renal subcapsular hematoma after percutaneous angiography is very rare. We investigated the possible causes of renal subcapsular hematoma. To avoid this rare complication, we need to perform guide-wire passage carefully from the beginning of the procedure under full visual monitoring.