51
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Zilberman A, Eisenberg V, Yoeli R, Soriano D, Sivan E, Golan G, Mashiach R. Uterine Artery Pseudoaneurysm in a Pregnant Patient with Retrocervical Endometriosis. J Minim Invasive Gynecol 2020; 27:1209-1213. [PMID: 32259651 DOI: 10.1016/j.jmig.2020.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/22/2020] [Accepted: 03/27/2020] [Indexed: 11/24/2022]
Abstract
A pseudoaneurysm of the uterine artery or its branches is usually a result of vascular trauma during invasive procedures such as a cesarean section, vaginal delivery, myomectomy, hysterotomy, or dilatation and curettage. A uterine artery pseudoaneurysm rupture is a rare, yet life-threatening event. Deep infiltrating endometriosis usually involves a decrease in symptoms and imaging findings throughout pregnancy, with the notable exception of the phenomenon of decidualization. We present the case of a pregnant woman with a recent diagnosis of endometriosis, who conceived spontaneously and presented with disabling pain at 13 weeks' gestation. She was diagnosed with a left, huge (and rapidly growing) retrocervical endometriosis nodule encompassing a uterine artery pseudoaneurysm. Selective transarterial embolization was performed at 22 weeks' gestation owing to enlargement of the pseudoaneurysm sac, and the pseudoaneurysm was obliterated successfully. The patient was followed intensively throughout the pregnancy and the baby was delivered at term by cesarean section. After delivery, the nodule returned to the pregestational size.
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Affiliation(s)
- Ayala Zilberman
- Departments of Obstetrics and Gynecology (Drs. Zilberman, Eisenberg, Yoeli, Soriano, Sivan, and Mashiach).
| | - Vered Eisenberg
- Departments of Obstetrics and Gynecology (Drs. Zilberman, Eisenberg, Yoeli, Soriano, Sivan, and Mashiach)
| | - Rakefet Yoeli
- Departments of Obstetrics and Gynecology (Drs. Zilberman, Eisenberg, Yoeli, Soriano, Sivan, and Mashiach)
| | - David Soriano
- Departments of Obstetrics and Gynecology (Drs. Zilberman, Eisenberg, Yoeli, Soriano, Sivan, and Mashiach)
| | - Eyal Sivan
- Departments of Obstetrics and Gynecology (Drs. Zilberman, Eisenberg, Yoeli, Soriano, Sivan, and Mashiach)
| | - Gil Golan
- Diagnostic and Interventional Imaging (Dr. Golan), Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Roy Mashiach
- Departments of Obstetrics and Gynecology (Drs. Zilberman, Eisenberg, Yoeli, Soriano, Sivan, and Mashiach)
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52
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Benson JC, Lehman VT, Carr CM, Wald JT, Cloft HJ, Lanzino G, Brinjikji W. Beyond plaque: A pictorial review of non-atherosclerotic abnormalities of extracranial carotid arteries. J Neuroradiol 2020; 48:51-60. [PMID: 32169468 DOI: 10.1016/j.neurad.2020.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 02/12/2020] [Accepted: 02/12/2020] [Indexed: 02/06/2023]
Abstract
The common carotid artery (CCA) and extracranial internal carotid artery are subject to a wide variety of non-atheromatous pathologies. These entities are often overshadowed in both research and clinical realms by atherosclerotic disease. Nevertheless, non-atherosclerotic disease of the carotid arteries may have profound, even devastating, neurologic consequences. Hence, this review will cover both common and uncommon forms of extracranial carotid artery pathologies in a pictorial format, in order to aid the diagnostician in identifying and differentiating such pathologies.
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Affiliation(s)
- John C Benson
- Mayo Clinic, Department of Neuroradiology, Rochester, MN, USA.
| | - Vance T Lehman
- Mayo Clinic, Department of Neuroradiology, Rochester, MN, USA
| | - Carrie M Carr
- Mayo Clinic, Department of Neuroradiology, Rochester, MN, USA
| | - John T Wald
- Mayo Clinic, Department of Neuroradiology, Rochester, MN, USA
| | - Harry J Cloft
- Mayo Clinic, Department of Neuroradiology, Rochester, MN, USA
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53
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Morabito S, Specchi S, Auriemma E, Ferro S, Kuhnert P, Zini E. Computed tomographic and ultrasonographic findings of abdominal arterial pseudoaneurysms caused by systemic mycosis in dogs. J Small Anim Pract 2020; 61:300-307. [PMID: 32092792 DOI: 10.1111/jsap.13116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To describe multidetector CT and ultrasonographic characteristics of abdominal arterial pseudoaneurysms (segmental dilatations of an artery with a ruptured tunica intima) arising secondary to systemic mycosis in dogs. MATERIALS AND METHODS Retrospective study on dogs with confirmed histological diagnosis of a fungal pseudoaneurysm and the availability of multidetector CT or ultrasound images. RESULTS At the time of admission, the three dogs included in this study demonstrated segmental arterial dilation, irregular arterial wall thickening, and increased echogenicity or attenuation within the local perivascular fat on ultrasound and multidetector CT images. Follow-up examinations revealed progressive increase in arterial wall thickening and saccular dilation with formation of a pseudoaneurysm in affected vessels of two dogs. CLINICAL SIGNIFICANCE Multidetector CT and ultrasonography can be useful imaging modalities in the diagnosis and monitoring of abdominal arterial pseudoaneurysms caused by systemic mycosis.
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Affiliation(s)
- S Morabito
- Department of Diagnostic Imaging, Istituto Veterinario di Novara, Granozzo con Monticello, Italy.,Department of Veterinary Science, University of Messina, Messina, Italy
| | - S Specchi
- Department of Diagnostic Imaging, Istituto Veterinario di Novara, Granozzo con Monticello, Italy
| | - E Auriemma
- Department of Diagnostic Imaging, Istituto Veterinario di Novara, Granozzo con Monticello, Italy
| | - S Ferro
- Department of Comparative Biomedicine and Food Sciences, University of Padua, Legnaro (PD), Italy
| | - P Kuhnert
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - E Zini
- Department of Diagnostic Imaging, Istituto Veterinario di Novara, Granozzo con Monticello, Italy.,Department of Animal Medicine, Production and Health, University of Padua, Legnaro (PD), Italy.,Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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54
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Laparra-Escareno H, Cuen-Ojeda C, García-Alva R, Lopez-Pena G, Anaya-Ayala JE, Hinojosa CA. Successful Treatment of a Superficial Femoral Artery Pseudoaneurysm with Balloon Tamponade. Vasc Specialist Int 2019; 35:170-173. [PMID: 31620404 PMCID: PMC6774425 DOI: 10.5758/vsi.2019.35.3.170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 12/04/2022] Open
Abstract
The development of post-catheterization arterial pseudoaneurysms is one of the most common vascular access complications following angiographies and endovascular interventions. Different therapeutic options to treat these lesions have been used. We herein report the case of a 79-year-old woman who was referred to our service for evaluation with a post-catheterization superficial femoral artery pseudoaneurysm measuring 4 cm. Owing to the anatomical location of the arterial pseudoaneurysm and the patient’s refusal to undergo open surgery, we treated the lesion using an endovascular approach with a balloon tamponade. The procedure was successful, and the patient recovered well and was discharged from the hospital without complications. At 6-month follow-up she remained symptom-free and without recurrence.
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Affiliation(s)
- Hugo Laparra-Escareno
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Cesar Cuen-Ojeda
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Ramon García-Alva
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Gabriel Lopez-Pena
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Javier E Anaya-Ayala
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Carlos A Hinojosa
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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55
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Tan R. Segmental Arterial Mediolysis: A Case Study and Review of the Literature in Accurate Diagnosis and Management. Vasc Specialist Int 2019; 35:174-179. [PMID: 31620405 PMCID: PMC6774432 DOI: 10.5758/vsi.2019.35.3.174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 11/20/2022] Open
Abstract
Segmental arterial mediolysis (SAM) is a rare noninflammatory, nonarteriosclerotic arteriopathy of an unknown etiology. It most commonly affects the medium-sized vessels of the abdomen and is characterized by the disruption of the arterial medial layer. Although histological confirmation remains the gold standard in diagnosis, the use of computed tomography angiography (CTA) has greatly aided the diagnosis and surveillance of SAM. Given its rarity and angiographic similarities to other vasculopathies, the diagnosis of SAM can be challenging and is often missed. We describe the case of a 46-year-old male patient who presented to our institution with abdominal pain and multiple foci of intra-abdominal arterial dissections on CTA. We report the acute management via endovascular intervention and review the literature with respect to the diagnosis and management of this rare condition. SAM remains an uncommon yet significant disease process requiring prompt and accurate diagnosis. Initiation of immediate treatment is crucial, given the knowledge gap about its natural progression.
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Affiliation(s)
- Rebekah Tan
- Department of Vascular Surgery, Sir Charles Gairdner Hospital, Nedlands, Australia
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56
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Specchi S, d'Anjou MA. Diagnostic imaging for the assessment of acquired abdominal vascular diseases in small animals: A pictorial review. Vet Radiol Ultrasound 2019; 60:613-632. [PMID: 31243852 DOI: 10.1111/vru.12780] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 12/26/2022] Open
Abstract
Advances in interventional radiology and surgical techniques now allow complex abdominal diseases to be more successfully treated in small animals. Abdominal vascular alterations, acquired as individual process or as complication of other lesions such as neoplasia, can be life-threatening or at least greatly limit curative interventions of underlying diseases. Computed tomography (CT) and high-definition ultrasonography are now readily available in veterinary referral centers. Yet, there is little information currently available on the use of these modalities for the diagnosis and characterization of these vascular alterations. The purpose of this article is to review the CT and ultrasonographic findings of acquired vascular diseases in the abdomen of dogs and cats, using both the veterinary and human medicine literature as references, and highlighting essential concepts through figures.
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Affiliation(s)
- Swan Specchi
- Ospedale Veterinario i Portoni Rossi, Bologna, 40069, Italy.,Animages, Longueuil, Quebec, J4G 2L2, Canada
| | - Marc-André d'Anjou
- Ospedale Veterinario i Portoni Rossi, Bologna, 40069, Italy.,Animages, Longueuil, Quebec, J4G 2L2, Canada
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57
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Daniels SP, Sneag DB, Berkowitz JL, Trost D, Endo Y. Pseudoaneurysm after total knee arthroplasty: imaging findings in 7 patients. Skeletal Radiol 2019; 48:699-706. [PMID: 30306198 DOI: 10.1007/s00256-018-3084-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/29/2018] [Accepted: 09/23/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the clinical presentation of arterial pseudoaneurysms following total knee arthroplasty (TKA) and their diagnostic imaging features on ultrasound and magnetic resonance angiography (MRA) in 7 patients. MATERIALS AND METHODS A search of our radiology report database from 2007 to 2017 yielded 7 patients with a pseudoaneurysm diagnosed by imaging after TKA. Clinical notes and imaging were reviewed. RESULTS All 7 patients were male and ranged in age from 53 to 68 (mean 61) years. All patients presented with a painful swollen knee and hemarthrosis within the first month following surgery. Five patients presented after primary TKA. One patient presented after explantation for septic arthritis and another after partial synovectomy for septic arthritis without explantation. Ultrasound identified the pseudoaneurysm as a hypoechoic or hyperechoic mass with a "yin-yang" appearance of turbulent arterial flow and associated complex joint effusion. On MRA, the pseudoaneurysm was a mass next to a parent artery showing avid contrast enhancement in the arterial phase that persisted into the venous phase and washed out in the late venous phase. Six pseudoaneurysms arose from lateral geniculate arteries and 1 from a medial geniculate artery. There were no popliteal artery pseudoaneurysms. Five patients were treated endovascularly, 1 patient thrombosed without intervention, and 1 patient was treated with open surgery. CONCLUSION Pseudoaneurysm is a potential source of a painful swollen knee with hemarthrosis or a drop in hematocrit after TKA and can be identified with either ultrasound or MRA.
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Affiliation(s)
- Steven P Daniels
- Department of Radiology, New York Presbyterian Hospital-Weill Cornell Medical Center, 525 East 68th Street, Box 141, New York, NY, 10065, USA
| | - Darryl B Sneag
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th Street, New York, NY, 10021, USA
| | - Jennifer L Berkowitz
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th Street, New York, NY, 10021, USA
| | - David Trost
- Department of Radiology, New York Presbyterian Hospital-Weill Cornell Medical Center, 525 East 68th Street, Box 141, New York, NY, 10065, USA
| | - Yoshimi Endo
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th Street, New York, NY, 10021, USA.
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58
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Blaizot R, Desrousseaux G, Joly MP, Vie A, Lu X, Senchyna A, Oganov K, Marty C, Cissé H, Couppie P. Pseudoaneurysm following a freshwater stingray injury. J Eur Acad Dermatol Venereol 2019; 33:e356-e357. [PMID: 31034678 DOI: 10.1111/jdv.15648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- R Blaizot
- Department of Dermatology, Andrée Rosemon Hospital, Cayenne, French Guiana.,EA 3593, Ecosystèmes Amazoniens et Pathologies Tropicales, University of French Guiana, Cayenne, French Guiana
| | - G Desrousseaux
- Department of Vascular Medicine, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - M-P Joly
- Department of Vascular Medicine, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - A Vie
- Department of General Medicine, University of French West Indies, Pointe-à-Pitre, Guadeloupe
| | - X Lu
- Department of Orthopaedics, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - A Senchyna
- Department of General Medicine, University of French West Indies, Pointe-à-Pitre, Guadeloupe
| | - K Oganov
- Department of Emergency Medicine, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - C Marty
- French Red Cross, Cayenne, French Guiana
| | - H Cissé
- Department of Dermatology, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - P Couppie
- Department of Dermatology, Andrée Rosemon Hospital, Cayenne, French Guiana.,EA 3593, Ecosystèmes Amazoniens et Pathologies Tropicales, University of French Guiana, Cayenne, French Guiana
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59
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Shatnawi NJ, Al-Zoubi NA, Jarrah J, Khader Y, Heis M, Al-Omari MH. Risk factors attributed to failure of ultrasound-guided compression for post-cardiac catheterization femoral artery pseudoaneurysms. SAGE Open Med 2019; 7:2050312119843705. [PMID: 31019697 PMCID: PMC6469268 DOI: 10.1177/2050312119843705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 03/19/2019] [Indexed: 12/02/2022] Open
Abstract
Background: Femoral pseudoaneurysm is the most important access site complication
following cardiac catheterization. Ultrasound-guided compression repair is a
safe and effective therapeutic modality with variable failure rates and risk
factors. The aim of this study was to investigate which factors were
associated with a higher incidence of ultrasound-guided compression repair
failure for post-cardiac catheterization femoral pseudoaneurysm. Methods: Data were retrospectively collected from medical records at King Abdullah
University Hospital during the period from January 2011 to December 2016. A
total of 42 patients with post-cardiac catheterization femoral
pseudoaneurysm had attempted ultrasound-guided compression repair. Data
regarding patients, procedure and aneurysm-related factors were evaluated by
univariate analysis and multivariate logistic regression. Results: Ultrasound-guided compression repair failed in 31% of the patients. Patients
with body mass index of ⩾28 kg/m2, platelet count of ⩽180,000/L,
time lag (age of aneurysm) of >48 h following puncture time, aneurysmal
neck diameter of ⩾4 mm and communicating tract length of <8 mm were
associated with higher rate of ultrasound-guided compression repair failure
in the univariate analysis. In the multivariate analysis, time lag (age of
aneurysm) > 48 h (odds ratio = 5.7), body mass
index ⩾ 28 kg/m2 (odds ratio = 7.8), neck diameter > 4 mm
(odds ratio = 14.4) and tract length < 8 mm (odds ratio = 18.6) were
significantly associated with ultrasound-guided compression repair
failure. Conclusion: Ultrasound-guided compression repair for patients with post-cardiac
catheterization femoral pseudoaneurysm was successful in 69% of the
patients. Risk factors for failed ultrasound-guided compression repair were
as follows: delayed ultrasound-guided compression repair of >48 h, body
mass index ⩾ 28 kg/m2, wide neck diameter > 4 mm and short
aneurysmal communication tract < 8 mm.
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Affiliation(s)
- Nawaf J Shatnawi
- Department of Surgery, Jordan University of Science and Technology, Irbid, Jordan
| | - Nabil A Al-Zoubi
- Department of Surgery, Jordan University of Science and Technology, Irbid, Jordan
| | - Jadallah Jarrah
- Department of Surgery, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Mowafeq Heis
- Department of Radiology, Jordan University of Science and Technology, Irbid, Jordan
| | - Mamoon H Al-Omari
- Department of Radiology, Jordan University of Science and Technology, Irbid, Jordan
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60
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Stent-Assisted Coiling of Pseudoaneurysm After Vertebro-Carotid Transposition: Harmonious Combination of Open and Endovascular Neurosurgical Techniques. World Neurosurg 2019; 127:387-390. [PMID: 31009786 DOI: 10.1016/j.wneu.2019.04.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Most cases of vertebral artery stenosis are treated either conservatively or surgically. When non-conservative treatment is chosen, whether to treat it with open surgery or endovascular intervention remains a topic of divergence. In the setting of endovascular therapy failure, the vertebral to common carotid artery transposition certainly is an appropriate choice to recover the posterior circulation. Like any other open surgery, it is not devoid of soft-tissue-related complications. A pseudoaneurysm following this procedure and at this particular location is a rare but lethal complication and, to the best of our knowledge, has not yet been reported. CASE DESCRIPTION We present the case of an 80-year-old man with previous ischemic stroke who presented to the emergency department with aphasia, right-sided weakness, and dysarthria. Invasive imaging revealed right vertebral stenosis and hypoplastic left vertebral artery that failed endovascular therapy. The patient was then treated with a right vertebral to common carotid artery transposition. During follow-up, a pseudoaneurysm was found and treated with a stent-assisted coiling. CONCLUSIONS Pseudoaneurysms at the extracranial carotid and vertebral circulation are rare and have potential for deadly outcomes. Despite several treatments available, this anatomical location requires endovascular therapy due to efficacy and promptitude of this treatment. This is an interesting case where the patient's management required open and endovascular procedures. The pseudoaneurysm was a rare complication that, to the best of our knowledge, has not previously been reported. This case is an illustration of complementary work between open surgery and endovascular intervention.
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61
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Ryu K, Hong SS, Cha H, Hwang J, Lee E, Cho YD, Chang YW, Kim YJ. A pancreatic hemorrhagic pseudocyst with pseudoaneurysm and the role of doppler ultrasonography: a case report. Rev Assoc Med Bras (1992) 2019; 65:123-126. [DOI: 10.1590/1806-9282.65.2.123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 05/27/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - Hwajin Cha
- Soonchunhyang University Seoul Hospital, Korea
| | | | - EunJi Lee
- Soonchunhyang University Seoul Hospital, Korea
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Crilly SM, McElroy E, Ryan J, O'Donohue M, Lawler LP. "Mixed" trauma to the carotid artery in a mixed martial arts injury - A case report and review of the literature. J Radiol Case Rep 2019; 12:1-11. [PMID: 30651908 DOI: 10.3941/jrcr.v12i5.3234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We present the case of a mixed martial arts (MMA) cage fighter who presented to the emergency department with a right sided common carotid artery pseudoaneurysm as a result of a neck trauma at an MMA event. We discuss the management of blunt force neck trauma, differential diagnosis, imaging findings and review the literature on blunt cerebrovascular injury following blunt force injury to the neck.
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Affiliation(s)
- Shane M Crilly
- Department of Surgery, Royal Perth Hospital, Perth, WA, Australia
| | - Eileen McElroy
- Department of Medicine, Fiona Stanley Hospital, Murdoch, Perth, WA, Australia
| | - Jonathan Ryan
- Department of Diagnostic Radiology, Sligo University Hospital, Sligo, Republic of Ireland
| | - Martin O'Donohue
- Department of Vascular Surgery, Mater Misericordiae University Hospital, Dublin, Republic of Ireland
| | - Leo P Lawler
- Department of Diagnostic Radiology, Mater Misericordiae University Hospital, Dublin, Republic of Ireland
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63
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Nouhaud FX, Williams M, Arnfield E, Perera ML, Cho J, Esler R, Coughlin G. Is postoperative Doppler ultrasonography useful for the early detection of asymptomatic pseudoaneurysm and prevention of haemorrhagic complications after partial nephrectomy? BJU Int 2018; 122 Suppl 5:15-21. [DOI: 10.1111/bju.14485] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | - Michael Williams
- Department of Urology; Royal Brisbane and Women's Hospital; Brisbane Qld Australia
| | - Evyn Arnfield
- Department of Radiology; Royal Brisbane and Women's Hospital; Brisbane Qld Australia
- School of Medicine; University of Queensland; Brisbane Qld Australia
| | - Marlon Lakmal Perera
- Department of Urology; Royal Brisbane and Women's Hospital; Brisbane Qld Australia
| | - Jonathan Cho
- Department of Urology; Royal Brisbane and Women's Hospital; Brisbane Qld Australia
| | - Rachel Esler
- Department of Urology; Royal Brisbane and Women's Hospital; Brisbane Qld Australia
- Wesley Urology Clinic; Wesley Hospital; Brisbane Qld Australia
| | - Geoff Coughlin
- Department of Radiology; Royal Brisbane and Women's Hospital; Brisbane Qld Australia
- Wesley Urology Clinic; Wesley Hospital; Brisbane Qld Australia
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64
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Srinivasan S, Lohan R, Tan HK, Chung R, Babu SB. Usefulness of ultrasonography in diagnosis, percutaneous management and follow up of post-traumatic scalp pseudoaneurysms. JOURNAL OF CLINICAL ULTRASOUND : JCU 2018; 46:558-561. [PMID: 29457228 DOI: 10.1002/jcu.22580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 01/09/2018] [Accepted: 01/18/2018] [Indexed: 06/08/2023]
Abstract
Pseudoaneurysms of the scalp are rare. Most common etiology is trauma. The patients usually present clinically with persistent painful swelling in the scalp few days after the trauma. The lesion may or may not be pulsatile clinically. Ultrasonography (US) is the best modality to assess these pseudoaneurysms. It not only helps in the diagnosis, but also to trace the offending arterial branch and helps in treatment. We present two cases of post-traumatic scalp pseudoaneurysms which were diagnosed with US and were managed by US-guided thrombin injection. Follow up US showed complete resolution. We highlight the importance of US scan in diagnosis, management, and follow up of scalp pseudoaneurysms.
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Affiliation(s)
| | - Rahul Lohan
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore
| | - Hsien Khai Tan
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore
| | - Raymond Chung
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore
| | - Suresh B Babu
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore
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65
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Abstract
Vascular complications are a significant source of morbidity and mortality among renal transplant recipients. Imaging using ultrasound, CT, and MRI plays a key role in diagnosing such complications. This review focuses on the major vascular complications of renal grafts, which include transplant renal arterial and venous stenoses, arterial and venous thromboses, arteriovenous fistulas, and pseudoaneurysms. Etiology, diagnostic modalities useful for diagnosis, and imaging appearance will be presented.
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Affiliation(s)
- Ghaneh Fananapazir
- Department of Radiology, University of California Davis Medical Center, 4860 Y Street Suite 3100, Sacramento, CA, 95817, USA.
| | - Christoph Troppmann
- Department of Surgery, University of California Davis Medical Center, 2315 Stockton Blvd # 1018, Sacramento, CA, 95817, USA
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66
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Thanthoni M, Rajeev P, Sathasivasubramanian S. Caliber-Persistent Labial Artery: A Report of a Rarely Recognized Lip Swelling. J Clin Imaging Sci 2018; 8:41. [PMID: 30283723 PMCID: PMC6157096 DOI: 10.4103/jcis.jcis_43_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/17/2018] [Indexed: 12/02/2022] Open
Abstract
Calibre-persistent labial artery (CPLA) is a commonly underdiagnosed vascular lesion of the lip. CPLA is an arterial branch that penetrates the submucosal tissue without loss of calibre. Clinical diagnosis is significant as misdiagnosis can lead to profuse haemorrhage following an excisional biopsy or surgical excision. Colour Doppler ultrasonography is a safe and non-invasive diagnostic tool to confirm the diagnosis. Here, we report a case of a 24-year-old man who complained of an asymptomatic pulsating non-progressive nodule on the left side of upper lip initially diagnosed as peripheral angiomatous lesion. Diagnosis was confirmed by high-resolution Colour Doppler Ultrasonography. The purpose of this case report is to highlight the clinical importance and diagnosis of a rarely reported soft tissue swelling of the lip to the attention of clinicians.
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Affiliation(s)
- Malarkodi Thanthoni
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - P Rajeev
- Department of Radiology and Imaging Sciences, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - S Sathasivasubramanian
- Department of Oral Medicine and Radiology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
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67
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Ezhilnilavan S, Priyamvada PS, Swamiappan E, Haridasan S, Parameswaran S. Pseudoaneurysm of Thyrocervical Trunk Following Left Internal Jugular Vein Cannulation. Indian J Nephrol 2018; 28:173-174. [PMID: 29861572 PMCID: PMC5952460 DOI: 10.4103/ijn.ijn_170_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- S Ezhilnilavan
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - P S Priyamvada
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - E Swamiappan
- Department of Radio Diagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - S Haridasan
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - S Parameswaran
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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68
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Budinčević H, Milošević M, Pavlović T. Giant pseudoaneurysm of the external carotid artery causing stroke: A case report. JOURNAL OF CLINICAL ULTRASOUND : JCU 2018; 46:269-272. [PMID: 28940564 DOI: 10.1002/jcu.22524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 06/27/2017] [Accepted: 06/30/2017] [Indexed: 06/07/2023]
Abstract
We report a patient in whom mechanical compression of the internal carotid artery by a giant external carotid artery pseudoaneurysm caused a stroke. This was a case of vascular Eagle syndrome due to the impingement of an elongated styloid process on the external carotid artery with subsequent dissection and formation of a pseudoaneurysm. Carotid ultrasonographic examination allowed distinguishing the pseudoaneurysm from other vascular and solid masses of the neck.
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Affiliation(s)
- Hrvoje Budinčević
- Stroke and Intensive Care Unit, Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia
- School of Medicine, J.J. Strossmayer University of Osijek, Osijek, Croatia
| | - Marina Milošević
- Stroke and Intensive Care Unit, Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia
| | - Tomislav Pavlović
- School of Medicine, J.J. Strossmayer University of Osijek, Osijek, Croatia
- Department of Radiology, Sveti Duh University Hospital, Zagreb, Croatia
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69
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A 54-Year-Old Man With Neck Swelling, Respiratory Distress, and Hoarseness. Chest 2018; 153:e63-e66. [DOI: 10.1016/j.chest.2017.10.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/18/2017] [Accepted: 10/31/2017] [Indexed: 11/19/2022] Open
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70
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Subramaniam S, Nadarajan C, Aziz ME. Role of Uterine Artery Embolization in Pseudoaneurysm of Uterine Artery: A Rare Cause of Secondary Postpartum Hemorrhage. Cureus 2018; 10:e2220. [PMID: 29692958 PMCID: PMC5912705 DOI: 10.7759/cureus.2220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Uterine artery pseudoaneurysm is an uncommon cause of secondary postpartum hemorrhage, although it carries a high mortality rate. The etiology includes vascular trauma during cesarean section, vaginal delivery, curettage or hysterotomy. We present a post-cesarean female who developed delayed hemorrhage and was diagnosed with left uterine artery pseudoaneurysm. Selective transcatheter arterial embolization was performed and the pseudoaneurysm was successfully obliterated. Angiographic embolization is a safe and efficient method of treatment of postpartum hemorrhage due to pseudoaneurysm in hemodynamically stable patients. Thus, it should be considered as a treatment option before opting for surgery in favorable cases.
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Affiliation(s)
- Saraswathy Subramaniam
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Chandran Nadarajan
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Mohd E Aziz
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
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71
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Di Vece F, Tombesi P, Bianchi L, Bertini M, Sartori S. Contrast-enhanced ultrasonography of post-interventional hematoma: the bleeding mushroom is growing inside. J Med Ultrason (2001) 2018; 45:661-663. [PMID: 29453674 DOI: 10.1007/s10396-018-0871-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 01/24/2018] [Indexed: 12/11/2022]
Abstract
Catheter ablation is an effective treatment in patients with symptomatic atrial fibrillation. Complications are infrequent and usually resolve with minimal or no intervention, but active bleeding due to arterial injury during the vascular access can sometimes represent a life-threatening complication. Contrast-enhanced computed tomography is the standard technique to detect active bleeding, but it may not be immediately available. We report a case of iatrogenic hemorrhage after catheter ablation, in which contrast-enhanced ultrasonography played a decisive role in the recognition of active arterial bleeding due to injury to the right common femoral artery.
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Affiliation(s)
- Francesca Di Vece
- Section of Interventional Ultrasound, Medical Department, St. Anna Hospital, Via A. Moro 8, 44100, Ferrara, Italy
| | - Paola Tombesi
- Section of Interventional Ultrasound, Medical Department, St. Anna Hospital, Via A. Moro 8, 44100, Ferrara, Italy
| | - Lara Bianchi
- Section of Interventional Ultrasound, Medical Department, St. Anna Hospital, Via A. Moro 8, 44100, Ferrara, Italy
| | | | - Sergio Sartori
- Section of Interventional Ultrasound, Medical Department, St. Anna Hospital, Via A. Moro 8, 44100, Ferrara, Italy.
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72
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Smyth H, Byrne D, Hayden D, Kavanagh E, Murphy S. A cause of recurrent strokes: carotid webs detected by CT angiogram. BJR Case Rep 2018; 4:20170066. [PMID: 30363186 PMCID: PMC6159149 DOI: 10.1259/bjrcr.20170066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/01/2017] [Accepted: 09/06/2017] [Indexed: 11/05/2022] Open
Affiliation(s)
- Hannah Smyth
- Department of Stroke Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Danielle Byrne
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Derek Hayden
- Department of Stroke Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Eoin Kavanagh
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Sean Murphy
- Department of Stroke Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
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73
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Chun EJ. Ultrasonographic evaluation of complications related to transfemoral arterial procedures. Ultrasonography 2017; 37:164-173. [PMID: 29145350 PMCID: PMC5885482 DOI: 10.14366/usg.17047] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/23/2017] [Accepted: 08/25/2017] [Indexed: 12/18/2022] Open
Abstract
The transfemoral arterial approach is used to gain access for angiography, percutaneous coronary interventions, or various endovascular therapies. To decrease the risk of procedure-related vascular complications, it is recommended to puncture the common femoral artery in its middle segment. However, due to inadequate access or anatomical variability, various complications, including hematoma, pseudoaneurysm, arteriovenous fistula, thrombosis, or dissection, can occur after transfemoral arterial interventions. Duplex ultrasound has proven to be an excellent noninvasive modality that provides not only anatomic but also hemodynamic information, effectively detecting and differentiating various femoral puncture-related complications. Radiologists should be familiar with the characteristic sonographic findings of the entire spectrum of transfemoral puncture-related vascular complications for early detection and proper treatment.
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Affiliation(s)
- Eun Ju Chun
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
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74
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Emergency color Doppler sonography of the extremity artery: A pictorial essay. Clin Imaging 2017; 42:240-248. [PMID: 28131087 DOI: 10.1016/j.clinimag.2017.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 01/13/2017] [Indexed: 11/21/2022]
Abstract
Arterial color duplex sonography (CDUS) of the extremities is routinely analyzed in the field of emergency radiology. A retrospective review of 500 consecutive arterial CDUS extremity studies was performed in our emergency department. Abnormal CDUS examinations were classified into two groups according to their primary etiology: 1) traumatic arterial injuries (accidents or post-operative complications) and 2) acute arterial ischemia (thrombosis or embolism outside of the setting of acute trauma). This article reviews common CDUS imaging findings in a busy emergency radiology division including traumatic pseudoaneurysm, secondary pseudoaneurysm, arteriovenous fistula, acute ischemic arterial disease and chronic peripheral arterial disease. This essay highlights the crucial role of CDUS in the diagnosis of vascular abnormalities in the emergency setting. CDUS provides several advantages over other imaging modalities including high accuracy, rapid results, portability, lack of radiation, and low cost.
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75
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Ultrasound-guided thrombin injection for treatment of superficial traumatic pseudoaneurysms and associated expanding hematomas: experience in five patients. J Trauma Manag Outcomes 2016; 10:4. [PMID: 26929774 PMCID: PMC4770383 DOI: 10.1186/s13032-016-0034-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 02/16/2016] [Indexed: 11/24/2022]
Abstract
Background Angiography allows for excellent characterization and treatment of traumatic pseudoaneurysms. However, ultrasound-guided thrombin injection for pseudoaneurysm thrombosis allows for radiation-free treatment of superficial pseudoaneurysms and superficial expanding hematomas. Methods A retrospective review of 5 patient cases treated under this paradigm was performed following institutional review board approval. Outcomes following intervention were recorded and compared amongst the patient cohort. Results Ultrasound-guided closure of traumatic pseudoaneurysms allowed for reduced procedural times and procedural invasiveness. Conclusions As demonstrated by the following cases, ultrasound guided thrombin injection is a good method of primary treatment for superficial pseudoaneurysms, or as an alternative treatment in cases where transcatheter embolization fails.
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76
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Polytarchou K, Triantafyllou K, Antypa E, Kappos K. Ulnar pseudoaneurysm after transulnar coronary angiogram treated with percutaneous ultrasound-guided thrombin injection. Int J Cardiol 2016; 222:404-406. [DOI: 10.1016/j.ijcard.2016.07.294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 07/31/2016] [Indexed: 10/21/2022]
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77
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Shah A, Botchu R, Dunlop D, Davies AM, James SL. Metal-on-Metal Total Hip Arthroplasty Associated with Adverse Local Tissue Reaction and Pseudoaneurysm of the Superior Gluteal Artery: A Case Report and Literature Review. Surg J (N Y) 2016; 2:e113-e118. [PMID: 28825003 PMCID: PMC5553479 DOI: 10.1055/s-0036-1593855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 10/03/2016] [Indexed: 12/14/2022] Open
Abstract
Adverse local tissue reaction (ALTR) and pseudoaneurysm formation are rare but known complications following metal-on-metal hip total hip arthroplasty (THA). We report the first known case in the English literature of a concurrent unilateral ALTR and pseudoaneurysm of the superior gluteal artery in the same patient. Following minimal rise in serum metal ions, an ultrasound of the right hip demonstrated an avascular solid/cystic lesion anterolaterally in keeping with an ALTR. More posterolaterally, a second discrete thick-walled cystic lesion was identified. Doppler interrogation demonstrated a “yin yang” pattern suggestive of a pseudoaneurysm. Magnetic resonance imaging confirmed the presence of an anterolateral periarticular lesion with a second discrete lesion within the gluteus medius. Subsequent computed tomography angiography confirmed the presence of arterial contrast blush within the posterior gluteal lesion adjacent to the superior gluteal artery. The patient remains asymptomatic and is being managed conservatively. We review the imaging characteristics of ALTR and pseudoaneurysm occurring post-THA. When a complex solid/cystic lesion is encountered in a patient with a THA, radiologists must ensure that the lesion is interrogated with color Doppler to confidently distinguish a pseudotumor from a pseudoaneurysm. This information is vital to the surgeon to avoid unexpected hemorrhage if revision joint replacement surgery is being contemplated.
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Affiliation(s)
- Amit Shah
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | - David Dunlop
- Department of Orthopaedics, Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | - A Mark Davies
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | - Steven L James
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom
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78
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Corvino A, Catalano O, Corvino F, Sandomenico F, Setola SV, Petrillo A. Superficial temporal artery pseudoaneurysm: what is the role of ultrasound? J Ultrasound 2016; 19:197-201. [PMID: 27635165 DOI: 10.1007/s40477-016-0211-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 05/11/2016] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The superficial temporal artery (STA) is one of the terminal branches of the external carotid artery; STA pseudoaneurysms are uncommon vascular lesion, generally subsequent to blunt or penetrating trauma that could represent a trick for radiologist, especially when the only anamnestic information is "palpable superficial swelling". In this article, we describe our ultrasonographic experience about STA pseudoaneurysm reporting several cases with different etiopatogenesis. METHODS Between January 2004 and March 2015 six patients (4F and 2M; aged 15-55 years, mean 36 year) presented at our department with superficial palpable swelling in temporal region (four with trauma history, two with iatrogenic cause) underwent to ultrasonographic study to assess the presence of STA pseudoaneurysm. Ultrasonographic findings suggestive of pseudoaneurysm was a well-defined, pulsatile, anechoic mass in B-mode, a swirling or disorganized pattern of blood flow in the lesion with demonstration of direct communication between arterial lumen and pseudoaneurysm at colour-Doppler and a typical to-and-fro waveform on pseudoaneurysm neck at pulsed-Doppler. RESULTS B-mode proves the presence of anechoic mass in five on six patients. Colour-Doppler demonstrates the presence of flow inside the lesion in five patients and a direct communication in all patients. To-and-fro typical waveform has been demonstrated in five patients. Ultrasound made diagnosis in all patients with a sensibility and specificity of 100 %. CONCLUSION US is the imaging modality of choice, since it can provide detailed information about vascular anatomy without incurring the risks of invasive methods like angiography or radiation.
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Affiliation(s)
- A Corvino
- Department of Advanced Medical Biosciences, University Federico II of Naples (UNINA), Biostructures and Bioimmages Institution (IBB), National Research Council (CNR), via Pansini 5, 80131 Naples, Italy
| | - O Catalano
- Department of Radiology, National Cancer Institute, Pascale Foundation, via M. Semmola, 80131 Naples, Italy
| | - F Corvino
- Department of Advanced Medical Biosciences, University Federico II of Naples (UNINA), Biostructures and Bioimmages Institution (IBB), National Research Council (CNR), via Pansini 5, 80131 Naples, Italy
| | - F Sandomenico
- Department of Radiology, National Cancer Institute, Pascale Foundation, via M. Semmola, 80131 Naples, Italy
| | - S V Setola
- Department of Radiology, National Cancer Institute, Pascale Foundation, via M. Semmola, 80131 Naples, Italy
| | - A Petrillo
- Department of Radiology, National Cancer Institute, Pascale Foundation, via M. Semmola, 80131 Naples, Italy
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79
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Byregowda S, Puri A, Gulia A, Prabhu A, Janu A. Pseudoaneurysms Masquerading as Malignant Bone Tumours. J Clin Diagn Res 2016; 10:XD03-XD05. [PMID: 27437336 DOI: 10.7860/jcdr/2016/18551.7852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 01/31/2016] [Indexed: 11/24/2022]
Abstract
Swelling around the knees can be due to both neoplastic as well as non neoplastic aetiology. One of the rare cause for the same is pseudoaneurysm. Pseudoaneurysms can mimic a bone tumor or a soft tissue sarcoma. Pseudoanuerysms result because of the gradual growth occurring due to constant arterial pressure and development of a reactive fibrous capsule. Inappropriate diagnosis and management of these lesions may result in major morbidity and rarely mortality. We present two cases of pseudoaneurysms around the knees which were misdiagnosed as osteogenic sarcomas. These cases also stress on the importance of multidisciplinary care, in preventing avoidable morbidity, mortality and providing safe and optimal care to the patients.
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Affiliation(s)
- Suman Byregowda
- Fellow, Department of Surgical Oncology, Tata Memorial Hospital , Mumbai, India
| | - Ajay Puri
- Professor and Head, Department of Surgical Oncology, Tata Memorial Hospital , Mumbai, India
| | - Ashish Gulia
- Associate Professor, Department of Surgical Oncology, Tata Memorial Hospital , Mumbai, India
| | - Aruna Prabhu
- Senior Resident, Department of Surgical Oncology, Tata Memorial Hospital , Mumbai, India
| | - Amit Janu
- Assistant Professor, Department of Radiodiagnosis, Tata Memorial Hospital , Mumbai, India
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80
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Moreno CC, Mittal PK, Ghonge NP, Bhargava P, Heller MT. Imaging Complications of Renal Transplantation. Radiol Clin North Am 2015; 54:235-49. [PMID: 26896222 DOI: 10.1016/j.rcl.2015.09.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Renal transplant complications are categorized as those related to the transplant vasculature, collecting system, perinephric space, renal parenchyma, and miscellaneous complications including posttransplant lymphoproliferative disorder. Many of these renal transplant complications are diagnosed with imaging. Medical complications including rejection, acute tubular necrosis, and drug toxicity also can impair renal function. These medical complications are typically indistinguishable at imaging, and biopsy may be performed to establish a diagnosis. Normal transplant anatomy, imaging techniques, and the appearances of renal transplant complications at ultrasound, computed tomography, and MR imaging are reviewed.
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Affiliation(s)
- Courtney Coursey Moreno
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, NE, Atlanta, GA 30322, USA.
| | - Pardeep K Mittal
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, NE, Atlanta, GA 30322, USA
| | - Nitin P Ghonge
- Department of Radiology, Indraprastha Apollo Hospitals, Delhi-Mathura Road, New Delhi 110076, India
| | - Puneet Bhargava
- Department of Radiology, VA Puget Sound Health Care System, University of Washington Medical Center, 1959 NE Pacific Street, Room BB308, Box 357115, Seattle, WA 98195-7115, USA
| | - Matthew T Heller
- Department of Radiology, University of Pittsburgh School of Medicine, 200 Lothrop Street, Suite 174E PUH, Pittsburgh, PA 15213, USA
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