Contrast-enhanced ultrasound-guided thrombin injection in the management of iatrogenic pseudoaneurysm (PSA): A case report and review of literatures

To Draw a Detailed Map for Maxillofacial Fast-Flow Vascular Diseases With the Combination of Color Doppler Ultrasound and Three-Dimensional Computed Tomography Angiography

Vascular diseases, such as vascular malformations and hemangiomas, are often classified into "fast-flow" and "slow-flow" based on their internal blood velocity. Fast-flow vascular diseases of maxillofacial regions are a kind of complicated and dangerous pathological changes originating from or containing arteries, their treatment is often complex and different from disease to disease, and large amounts of intraoperative blood loss and poor operation field may cause side injury or other problems without a detailed map of the lesion. The authors use the combination of color Doppler ultrasound and three-dimensional computed tomography angiography to diagnose and classify 36 cases of maxillofacial fast-flow vascular diseases, from January 2018 to December 2022 presented in the authors' department. Three-dimensional computed tomography angiography can display the location, type, and blood supply of lesions, whereas color Doppler ultrasound has unique advantages in identifying some special lesions (such as the colorful images of orificium fistulaes and the "Yin-yang sign" of pseudoaneurysms), then projecting and marking them on the body surface, which greatly facilitate the surgical procedure. This cost-effective and noninvasive combination shows significant clinical application value.

Mycotic Pseudoaneurysm of Thoracic Aortic Caused by Salmonella Paratyphi A: A Case Report

Background

Mycotic pseudoaneurysm, also known as infectious pseudoaneurysm, is a severe disease with a high mortality rate. Although Salmonella infection is a common etiological factor for mycotic pseudoaneurysm, Salmonella paratyphi A infection causing mycotic pseudoaneurysm is extremely rare. Endovascular therapy has been described as a feasible treatment for mycotic pseudoaneurysm.

Case Presentation

A 63-year-old female patient had a thoracic aortic pseudoaneurysm caused by Salmonella paratyphi A infection. The patient associated with diabetes had a fever, abdominal pain, and low back pain, who was successfully treated using endovascular stents treatment and antibiotics.

Conclusion

Salmonella paratyphi A is a bloodstream infection bacterium with the ability to cause mycotic pseudoaneurysm. To treat mycotic pseudoaneurysms of the thoracic aorta, endovascular stent-graft treatment combined with antibiotics is an alternative treatment for patients who cannot tolerate open surgery.

Ultrasonography-guided endovascular management of femoral artery pseudoaneurysm after unintended dialysis catheterization with suture-mediated vascular closure devices

Although iatrogenic pseudoaneurysm is an infrequent complication, it can be life threatening if ruptured. There are several treatment methods for managing this complication. This case report demonstrates a technique using ultrasonography-guided suture-mediated vascular closure devices without angiography to successfully treat iatrogenic superficial femoral pseudoaneurysm following an unintended hemodialysis catheter insertion. In particular, when it is difficult to use a contrast due to a patient's condition as in this case, suture-mediated vascular closure device with ultrasonography guidance can be used as a therapeutic method.