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Endovascular Management of Iatrogenic Vertebral Artery Pseudoaneurysm: A Case Report (의인성 척추동맥 가성동맥류에 대한 중재적 치료: 증례 보고)

  • Jae Yang Park;Sanghyeon Kim;Myongjin Kang
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.483-488
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    • 2023
  • Iatrogenic injury of the vertebral artery during cervical spine surgery though uncommon is critical. With advances in interventional endovascular techniques, the therapeutic approach for vertebral artery injuries has changed. Nonetheless, an established strategy for their management is lacking. We report a case of pseudoaneurysm due to vertebral artery injury, during cervical spine surgery for a tumor, that was treated successfully with endovascular coiling in a plug-and-patch fashion after triple stenting failed.

Pulmonary Involvement in Behcet's Disease -A Case Report- (폐동맥류를 동반한 Behcet's Disease)

  • 백효채
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.402-406
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    • 1994
  • Behcet`s disease is a rare systemic disease of unknown cause and it is a progressive disorder with episodes of activity and remission. The major features are oral and genital ulceration and skin and eye lesions. Pulmonary involvement is rare, and we have experienced a 38 year old female patient who had undergone right lower lobe lobectomy due to extensive, rapidly growing pulmonary thromboemboli and pseudoaneurysm in pulmonary artery.

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Pseudoaneurysm of the Inferior Alveolar Artery after Surgical Curettage for Keratocystic Odontogenic Tumor: A Case Report (치성각화낭의 외과적 소파술 후 하치조 동맥에 발생한 가성 동맥류: 증례보고)

  • Lee, Sang-Chang;Kim, Jong-Bae;Chin, Byung-Rho;Kim, Jin-Wook;Kim, Chin-Soo;Kwon, Tae-Geon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.3
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    • pp.195-199
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    • 2013
  • Pseudoaneurysms are rare complications of orgthognathic surgery, trauma or other surgical procedures in the head and neck regions. Surgical approach is a routine procedure of bleeding control. However, bleeding control using angiography and embolization can also be an excellent method. We experienced pseudoaneurysm of the inferior alveolar artery occurring after surgical curettage of cystic lesion. The 33-year-old man who underwent surgical curettage of keratocystic odontogenic tumor was presented with severe bleeding in the right mandible ramal inner surface 14 days after the surgical curettage. After hemostasis with vaseline gauze packing and pressure, bleeding temporarily stopped. However, bleeding started after 14 days and soon it has been continued. Finally, the patient was diagnosed as pseudoaneurysm of the inferior alveolar artery from the enhanced-computed tomography images, and angiographic embolization was performed successfully. We report a rare case of pseudoaneurysm of the inferior alveolar artery after benign tumor curettage and review of the previewer's literature.

Infectious Pseudoaneurysm Caused by Group A Streptococcus in a Child without Underlying Disease (기저 질환이 없는 소아에서 A군 사슬알균 균혈증에 동반된 감염성 가성동맥류 1예)

  • Kim, Kyoung Ha;Lee, Hyunju;Oh, Chi Eun
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.183-187
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    • 2017
  • Group A streptococcus is a common cause of upper respiratory infection in children; however, it is a rare cause of pseudoaneurysm in pediatrics with only limited reports of cases associated with cardiac surgery and underlying disease. We report a case of infectious pseudoaneurysm of the right internal iliac artery caused by group A streptococcus in a previously healthy 5-year-old boy who presented with scarlet fever and group A streptococcal bacteremia. He was admitted to the hospital with fever, rash on the whole body, and sore throat, accompanied by severe leg pain. He was treated with surgical removal and antibiotics. Because a pseudoaneurysm may develop in children without vascular-related underlying diseases, we should consider the possibility of this important clinical diagnosis in patients with scarlet fever.

Surgical Repair of Left Coronary Artery Pseudoaneurysm 10 Years after a Bentall's Procudure (Bentall 수술 10년 후 발생된 좌관상동맥 가성동맥류의 수술 치료)

  • Lee, Sak;Kang, Meyun-Shick;Lim, Sang-Hyun;Chang, Byung-Chul;Hong, You-Sun
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.225-227
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    • 2007
  • The aortic inclusion technique is frequently used in the original Bentall's procedure for the control of excessive postoperative bleeding. Although this procedure has improved the outcome of patients with aortic root disease, there is a high incidence of both early and late complications, including coronary artery stenosis, kinking or pseudoaneurysm formation at the coronary suture lines. Pseudoaneurysm of the ascending aorta is a relatively rare, but fatal complication, which occurs after wrap-inclusion composite graft replacement. Herein, the case of a 45-year-old female, who developed a perigraft aortic pseudoaneurysm 10 years after a Bentall's procedure (wrap-inclusion technique), but was successfully managed using the Cabrol's method, is reported.

Traumatic Pseudoaneurysm of the Superficial Temporal Artery diagnosed with 3-Dimensional Computed Tomography Angiography: Two Cases Report (3차원 컴퓨터단층촬영 혈관조영술을 이용하여 진단한 외상성 천측두동맥 가성동맥류의 치험례)

  • Kwon, Ho;Hwang, Dong Yeon;Jung, Sung-No;Yim, Young Min;Shin, Ok Ran
    • Archives of Plastic Surgery
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    • v.34 no.2
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    • pp.265-268
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    • 2007
  • Purpose: Superficial temporal artery(STA) aneurysms are very rare and mostly occur as pseudoaneurysms secondary to trauma. Clinical diagnosis of STA pseudoaneurysm is based on a history of trauma or surgery to frontotemporal region, which presents with pulsatile mass. To confirm diagnosis, many imaging strategies can be used such as digital subtraction angiography, sonography, CT and MRI. But, these imaging modalities are invasive or inaccurate or expensive. Thus, we used 3D CT angiography to confirm STA aneurysm and to get accurate information. Methods: We have experienced two cases of pulsatile mass on the temporal area, suspected as STA pseudoaneurysms. On the basis of clinical information, we performed 3D CT angiography to get more accurate information about this pulsatile mass and to confirm diagnosis. On the basis of information from 3D CT angiography, we performed operation. Results: The lesions were diagnosed as pseudoaneurysm of superficial temporal artery by 3D CT angiography, and surgically resected safely without any complication on the basis of information from 3D CT angiography. 3D CT angiography was excellent diagnostic method for detecting STA pseudoaneurysms, and effectively showed many information about pseudoanerysms such as relationship between the aneurysms and surrounding structures, and its size. Conclusion: We could effectively diagnose and treat on the basis of information from 3D CT angiography. We present our cases with a brief review of the literature related to STA traumatic pseudoaneurysms.

Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage

  • An, Jee Young;Lee, Jae Sin;Kim, Dong Ryul;Jang, Jae Young;Jung, Hwa Young;Park, Jong Ho;Jin, Sue Sin
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.109-113
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    • 2018
  • A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

Recurrent Aortobronchial Fistula after Endovascular Stenting for Infected Pseudoaneurysm of the Proximal Descending Thoracic Aorta: Case Report

  • Lee, Sun-Geun;Lee, Seung Hyong;Park, Won Kyoun;Kim, Dae Hyun;Song, Jae Won;Cho, Sang-Ho
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.425-428
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    • 2021
  • Aortobronchial fistula (ABF) induced by an infected pseudoaneurysm of the thoracic aorta is a life-threatening condition. As surgical treatment is associated with significant mortality and morbidity, thoracic endovascular aneurysm repair (TEVAR) may be an alternative for the treatment of ABF. However, the long-term durability of this intervention is largely unknown and the recurrence of ABF is a potential complication. We experienced a case of recurrent ABF after stent grafting as an early procedure for an infected pseudoaneurysm of the thoracic aorta. Remnant ABF, bronchial and/or aortic wall erosion, vasa vasorum connected with ABF, and recurrent local inflammation of the thin aortic wall around ABF might cause recurrent hemoptysis. As a result, we suggest that TEVAR should be considered as a bridge therapy for the initial treatment of ABF resulting from an infected pseudoaneurysm, and that several options, such as second-stage surgery, should be considered to prevent the recurrence of ABF.

Ruptured pseudoaneurysm of the internal maxillary artery in zygomaticomaxillary fracture: a case report

  • Lim, Soo Yeon;Lee, Hyun Gun;Kim, Kyu Nam;Kim, Hoon;Oh, Dong Hyun;Koh, In Chang
    • Archives of Craniofacial Surgery
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    • v.23 no.2
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    • pp.89-92
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    • 2022
  • Post-traumatic pseudoaneurysms of internal maxillary artery are rare, but may be life-threatening. When arterial damage leads to pseudoaneurysm formation, delayed intractable epistaxis can occur. We report our experience with the diagnosis and management of a ruptured internal maxillary arterial pseudoaneurysm that was discovered preoperatively in a patient with a zygomaticomaxillary complex (ZMC) fracture. He presented to the emergency room with epistaxis, which ceased shortly, and sinus hemorrhage was observed with a fracture of the posterior maxillary wall. The patient was scheduled for open reduction and internal fixation (ORIF) of the ZMC fracture. However, immediately before surgery, uncontrolled epistaxis of unknown origin was observed. Angiography indicated a pseudoaneurysm of the posterior superior alveolar artery. Selective endovascular embolization was performed, and hemostasis was achieved. After radiologic intervention, ORIF was successfully implemented without complications. Our case shows that in patients with a posterior maxillary wall fracture, there is a risk of uncontrolled bleeding in the perioperative period that could be caused by pseudoaneurysms, which should be considered even in the absence of typical symptoms.

Liver Abscess Caused by Klebsiella oxytoca with Hepatic Artery Pseudoaneurysm: A Case Report (Klebsiella oxytoca에 의한 간농양 내 거짓동맥류: 증례 보고)

  • Jae Young Lee;Hyoung Nam Lee;Woong Hee Lee;Hyeong Cheol Shin;Seung Soo Kim;Jeong Ah Hwang
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1448-1452
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    • 2020
  • Hepatic artery pseudoaneurysm is a rare but potentially life-threatening condition that usually occurs after trauma. Early recognition and prompt management are essential for preventing catastrophic consequences, such as hemoperitoneum. We report a rare case of liver abscess caused by Klebsiella oxytoca resulting in hepatic artery pseudoaneurysm without iatrogenic injury. The unique feature of the present case is that the abscess cavity itself became a pseudoaneurysm as a result of fistula formation with the hepatic artery. Vascular complications should be considered in patients with unfavorable clinical course even in the absence of iatrogenic injury. Endovascular treatment is safe and effective.