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Tong X, Ran Y, Da J, Hu Y, Yuan J, Rui Y. Internal fistula stenosis with true pseudoaneurysm formation in a patient on maintenance hemodialysis: A case report. Medicine (Baltimore) 2024; 103:e38111. [PMID: 38728493 PMCID: PMC11081536 DOI: 10.1097/md.0000000000038111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/12/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Arteriovenous fistula stenosis can directly lead to the formation of autologous arteriovenous fistula aneurysms (AVFAs), but the coexistence of true and pseudoaneurysms is relatively rare. The coexistence of true and pseudoaneurysms increases the risk of rupture of the arteriovenous fistula and complicates subsequent surgical intervention, potentially posing a threat to the patient's life, and thus requires significant attention. CASE PRESENTATION The patient presented with arteriovenous fistula (AVF) after hemodialysis 6 years ago. 2 years ago, the patient presented with a mass that had formed near the left forearm arteriovenous fistula and gradually increased in size. Preoperatively, the AVF stenosis was identified as the cause of the mass formation, and the patient was operated on. First, the blood flow was controlled to reduce the pressure at the aneurysm, and then the incision was enlarged to separate the AVF anastomosis from the mass area. The stenotic segment of the true and pseudo aneurysms and cephalic vein was removed and the over-dilated proximal cephalic vein was locally narrowed and subsequently anastomosed with the proximal radial artery to create AVF. The patient was dialyzed with an internal fistula the next day and showed no clinical manifestations related to end-limb ischemia. CONCLUSION We removed a true pseudoaneurysm in AVF and secured the patient's vascular access. This report provides an effective strategy to manage this condition.
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Affiliation(s)
- Xiaoya Tong
- College of Clinical Medicine, Guizhou Medical University, Guiyang, China
- Department of Nephrology, People’s Hospital of Guizhou Province, Guiyang, China
- Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, Guizhou, China
| | - Yan Ran
- Department of Nephrology, People’s Hospital of Guizhou Province, Guiyang, China
- Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, Guizhou, China
| | - Jingjing Da
- Department of Nephrology, People’s Hospital of Guizhou Province, Guiyang, China
- Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, Guizhou, China
| | - Ying Hu
- Department of Nephrology, People’s Hospital of Guizhou Province, Guiyang, China
- Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, Guizhou, China
| | - Jing Yuan
- Department of Nephrology, People’s Hospital of Guizhou Province, Guiyang, China
- Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, Guizhou, China
| | - Yan Rui
- College of Clinical Medicine, Guizhou Medical University, Guiyang, China
- Department of Nephrology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
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Perri M, Timpani C, Capoccia L, Bianchi G, Balzano RF, Popolizio T, Pennelli AM, Guglielmi G, D'Elia M, Filauri P. Endovascular repair of isolated post-traumatic subclavian artery false-aneurysm (FA) using gore viabahn vbx-balloon-expandable (BE) stent-graft: case report and literature review. Acta Biomed 2022; 93:e2022080. [PMID: 35420596 PMCID: PMC10510997 DOI: 10.23750/abm.v93is1.12537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
True and false aneurysms (FA) of the subclavian artery are at high risk of rupture due to their localization and proximity/closeness to the articular bone structures of the upper thoracic outlet and shoulders. Surgical and endovascular treatments are good options to avoid complications such as aneurysms rupture, thrombosis and distal embolism alone or in combination. Self-expandable (SE) covered stents are the most used devices for the treatment of subclavian artery aneurysms. We report on a case of post traumatic left intra-thoracic subclavian artery FA treated using endovascular technique, highlighting the usefulness of the new covered Gore Viabahn VBX-BE stent-graft that combines the advantages of a high radial strength of a BE stent with the deliverability and conformability of a SE stent.
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Kong A, Ramirez Damera R, Perez Buitrago A, Nguyen HC, Hussain ST. A Growing Two-Decade-Old True Left Ventricular Aneurysm: A Case Report. Cureus 2021; 13:e18792. [PMID: 34804658 PMCID: PMC8592315 DOI: 10.7759/cureus.18792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/14/2021] [Indexed: 11/05/2022] Open
Abstract
Left ventricular aneurysms (LVA) occur after an infarcted area of the myocardium necrotizes, fibroses, and expands, forming a dyskinetic cavity. Most ventricular aneurysms are asymptomatic and go unrecognized unless found incidentally. Symptoms commonly reported include angina, heart failure, syncope, and even sudden cardiac death. Late complications from left ventricular aneurysms are infrequently reported. This case reports an elderly woman who presented with new-onset angina from an expanding 18-year-old true left ventricular aneurysm that was successfully treated with surgical repair.
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Affiliation(s)
- Alexander Kong
- Internal Medicine, University of Central Florida-HCA Healthcare Graduate Medical Education (GME), Orlando, USA
| | - Ramses Ramirez Damera
- Internal Medicine, University of Central Florida-HCA Healthcare Graduate Medical Education (GME), Orlando, USA
| | | | - Hiep C Nguyen
- Cardiothoracic Surgery, University of Central Florida College of Medicine, Orlando, USA
| | - Sayed T Hussain
- Cardiology, University of Central Florida College of Medicine, Orlando, USA
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Vinciguerra M, Spadaccio C, Tennyson C, Karuppannan M, Bose A, Greco E, Rose D. Management of Patients With Aortocoronary Saphenous Vein Graft Aneurysms: JACC State-of-the-Art Review. J Am Coll Cardiol 2021; 77:2236-2253. [PMID: 33926660 DOI: 10.1016/j.jacc.2021.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 12/29/2022]
Abstract
Saphenous vein graft aneurysms (SVGAs) following coronary artery bypass grafting (CABG) surgery were first described in 1975. Although rare, in the absence of a prompt diagnosis, SVGAs can be responsible for serious complications and adverse outcomes. The clinical presentation of SVGAs described in the literature can vary from an asymptomatic patient with an incidental radiological finding to a profoundly shocked patient with life-threatening hemorrhage secondary to SVGA rupture. Improvements in diagnostic tools within the last decade, such as multislice computed tomographic scanning, has enabled early detection of SVGAs, and therefore, an expansion of the current management options. In this review, the current data and knowledge about clinical presentation, diagnosis, natural history, and treatment of SVGAs are updated, with a specific emphasis on the evolution of management strategies of this rare complication over the last 45 years. Finally, a clinical algorithm to guide decision-making and management is proposed.
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Affiliation(s)
- Mattia Vinciguerra
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Cristiano Spadaccio
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Charlene Tennyson
- Lancashire Cardiac Centre, Blackpool Victoria Hospital, Blackpool, United Kingdom
| | - Mukesh Karuppannan
- Lancashire Cardiac Centre, Blackpool Victoria Hospital, Blackpool, United Kingdom
| | - Amal Bose
- Lancashire Cardiac Centre, Blackpool Victoria Hospital, Blackpool, United Kingdom
| | - Ernesto Greco
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - David Rose
- Lancashire Cardiac Centre, Blackpool Victoria Hospital, Blackpool, United Kingdom.
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Brummund D, Chang A, Azimi-Ghomi O, Diaz B, Sendzischew H. Superficial Temporal Artery True Fusiform Aneurysm With Several Lateral Feeding Vessels. Cureus 2021; 13:e13973. [PMID: 33880302 PMCID: PMC8052991 DOI: 10.7759/cureus.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A 49-year-old man flight attendant with a past medical history of Roux-en-Y bypass and massive weight loss 18 months prior was referred for surgical management of a superficial temporal artery aneurysm. Imaging confirmed the diagnosis. Intraoperatively a 1 cm fusiform aneurysm was identified with numerous feeding side branch vessels. The aneurysm was suture ligated and excised in toto with pathologic analysis showing involvement of all vessel layers. This case highlights a rare true aneurysm of the superficial temporal artery and aberrant anatomy of multiple side branches feeding the aneurysm and complicating dissection and excision.
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Affiliation(s)
- Dieter Brummund
- Department of General Surgery, Aventura Hospital and Medical Center, Aventura, USA
| | - Angela Chang
- Department of Anesthesiology, Aventura Hospital and Medical Center, Aventura, USA
| | - Obteene Azimi-Ghomi
- Department of General Surgery, Aventura Hospital and Medical Center, Aventura, USA
| | - Brandon Diaz
- Department of General Surgery, Aventura Hospital and Medical Center, Aventura, USA
| | - Harry Sendzischew
- Department of General Surgery, Mount Sinai Medical Center, Miami Beach, USA
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Ye G, Zhou W, Li J, Ling W, Luo Y. True Aneurysm of the Breast After Vacuum-assisted Removal of Benign Masses: A Case Report. Int J Gen Med 2021; 14:67-71. [PMID: 33469345 PMCID: PMC7813131 DOI: 10.2147/ijgm.s288019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/31/2020] [Indexed: 02/05/2023] Open
Abstract
Rationale The most common complications of vacuum-assisted removal (VAR) for benign breast masses are hematoma, infection, and occasionally pseudoaneurysms. To the best of our knowledge, this is the first report of a true aneurysm following VAR for breast fibroadenomas. Case Presentation A 50-year-old woman underwent VAR of bilateral benign breast masses under ultrasonic guidance. Routine breast ultrasound examination was performed 3 months later, and no discomfort was observed during follow-up. Diagnoses and Interventions Physical examination revealed a slightly palpable, arterial-like pulsation in the lateral part of the right breast. The two-dimensional ultrasound showed that there was a well-defined anechoic nodule in the right breast at the 9 o’clock position 3 cm from the nipple, measuring 6 mm × 4 mm. Color Doppler sonography demonstrated that it was a localized dilated intramammary arteriole within the colorful flow. Spectral Doppler illustrated a high-velocity turbulent arterial flow component inside. Based on these findings, the patient was diagnosed with an iatrogenic true aneurysm of the breast. Given her overall good condition, conservative treatment with regular imaging surveillance was adopted. Outcomes Up to now, the patient remains asymptomatic, and the size of the aneurysm has not changed. Lessons With the increasing use of interventional diagnosis and treatment techniques, iatrogenic vascular complications are likely to occur more frequently. Careful duplex ultrasound examination prior to or following the procedure is strongly recommended. In the absence of risk factors, we recommend a conservative approach to small, stable aneurysms.
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Affiliation(s)
- Guilin Ye
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Wu Zhou
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jiawu Li
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Wenwu Ling
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yan Luo
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Sato N, Kato K, Takekubo M, Mimura S, Namura O, Sakai T, Ohzeki H. Aneurysmectomy and Revascularization of Anterior Tibial Artery Aneurysm: Case Report. Ann Vasc Dis 2019; 12:548-550. [PMID: 31942218 PMCID: PMC6957885 DOI: 10.3400/avd.cr.19-00059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
An 86-year-old man presented with a pulsatile mass in the anterior compartment of the right lower leg. He had become aware of it two months earlier. Computed tomography angiography revealed a fusiform 3.2×5 cm aneurysm of the anterior tibial artery. Mural thrombosis in the aneurysm was absent. Peripheral pulse was normal. We performed aneurysmectomy and revascularization using a saphenous vein graft. Histological findings revealed that the mass was a true aneurysm. The clinical course was good, and the graft has remained patent for six months.
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Affiliation(s)
- Noriaki Sato
- Division of Cardiovascular Surgery, Niigata Prefectural Central Hospital, Johetsu, Niigata, Japan
| | - Kaori Kato
- Division of Cardiovascular Surgery, Niigata Prefectural Central Hospital, Johetsu, Niigata, Japan
| | - Masaru Takekubo
- Division of Cardiovascular Surgery, Niigata Prefectural Central Hospital, Johetsu, Niigata, Japan
| | - Shinya Mimura
- Division of Cardiovascular Surgery, Niigata Prefectural Central Hospital, Johetsu, Niigata, Japan
| | - Osamu Namura
- Division of Cardiovascular Surgery, Niigata Prefectural Central Hospital, Johetsu, Niigata, Japan
| | - Takeshi Sakai
- Division of Pathology, Niigata Prefectural Central Hospital, Johetsu, Niigata, Japan
| | - Hajime Ohzeki
- Division of Cardiovascular Surgery, Niigata Prefectural Central Hospital, Johetsu, Niigata, Japan
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Ada F, Polat V. Repair of a true extracranial internal carotid artery aneurysm with transposition surgery in a pediatric patient: A rare case. Vascular 2019; 27:475-478. [PMID: 31296146 DOI: 10.1177/1708538119862926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Atherosclerosis is the most common etiologic factor for extracranial carotid artery aneurysm in adults, while in childhood, connective tissue diseases, peritonsillar abscess and infections are the most common. Congenital carotid artery aneurysms are rarely reported in the literature. Methods We present a 10-year-old girl with congenital extracranial left internal carotid artery aneurysm and the treatment management. Results Computed tomography angiography at six months showed that internal carotid artery segments were normal. There was no obstruction or aneurysm recurrence. Conclusions Although extracranial carotid artery aneurysms are rare, they can cause complications such as rupture and thromboembolism with high mortality and morbidity. Therefore, the treatment of extracranial carotid artery aneurysms is recommended.
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Affiliation(s)
- Fatih Ada
- Department of Cardiovascular Surgery, School of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - Vural Polat
- Department of Cardiovascular Surgery, School of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
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Abstract
We present the first case of a large true uterine artery aneurysm, with a 5-cm diameter, in a 35-year-old nulliparous woman who presented with lower abdominal pain and dyspareunia. She underwent successful ligation and excision of the aneurysm using the Pfannenstiel approach. The diagnostic modalities and treatment option for such a case is discussed herein.
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Affiliation(s)
- Rashid Usman
- Department of Vascular Surgery Combined Military Hospital & Midcity Hospital, Lahore, Pakistan
| | - Muhammad Jamil
- Department of Surgery Combined Military Hospital, Peshawar Cantt, Pakistan
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Abstract
INTRODUCTION The incidence rate of true non-traumatic radial artery aneurysms (RAAs) is low, and very few cases have been described. The majority are traumatic in origin and are iatrogenic pseudo-aneurysms following arterial cannulation. However, other rare causes such as vascular tumors, connective tissue diseases, and occupational injury have also been reported. Only eight cases were reported as idiopathic true RAA. Herein, I describe a case of true idiopathic distal RAA, which was managed by surgical repair. CASE PRESENTATION A 61-year-old-man with no significant medical history presented to vascular clinic with complaint of a nontraumatic mass on the volar aspect and radial side of his right wrist for 6 years. Duplex ultrasound and computed tomography angiogram revealed distal RAA. It was managed by open surgical resection with primary end-to-end anastomosis. Histopathological studies revealed true aneurysm of the distal radial artery. CONCLUSION True distal RAAs are an extremely rare entity. Unawareness of this condition might lead to inappropriate management with significant morbidity. Surgical management is generally indicated, but the best treatment remains controversial.
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Affiliation(s)
- Nabil A Al-Zoubi
- Department of Surgery, Jordan University of Science and Technology, Irbid, Jordan,
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Erdogan SB, Akansel S, Selcuk NT, Aka SA. Reconstructive surgery of true aneurysm of the radial artery: A case report. North Clin Istanb 2018; 5:72-4. [PMID: 29607438 DOI: 10.14744/nci.2017.98700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 05/23/2017] [Indexed: 11/22/2022] Open
Abstract
True radial artery aneurysms are uncommon pathologies and have an organic cause, unlike trauma-induced false aneurysms. A 52-year-old man presented with a pulsatile mass at the anatomical snuff box area of his left hand. The aneurysm was repaired with reconstructive procedure. Although many posttraumatic and iatrogenic cases of false aneurysm of the radial artery have been reported; there are a few reported cases of a true idiopathic aneurysm. A case of reconstructive surgery for true idiopathic radial artery aneurysm is reported in this paper.
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Abstract
Superficial temporal artery (STA) aneurysms are very infrequent. Moreover, true aneurysms, which are not pseudoaneurysms associated with trauma or previous surgery are even rarer. With this manuscript, authors present a case of a 79-year-old woman suffering from subarachnoid hemorrhage whose radiological examinations revealed multiple intracranial aneurysms along with an STA aneurysm. This very rare case, to the best of our knowledge, the second case reported so far, might contribute to the literature and lead further investigations toward the rare association between intracranial aneurysms and STA aneurysms.
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Affiliation(s)
- Emre Delen
- Department of Neurosurgery, Edirne State Hospital, Edirne, Turkey
| | - Emre Ozkara
- Department of Neurosurgery, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Hasan Emre Aydin
- Department of Neurosurgery, Eskişehir Yunus Emre State Hospital, Eskişehir, Turkey
| | - Zuhtu Ozbek
- Department of Neurosurgery, Eskişehir Osmangazi University, Eskişehir, Turkey
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Kitaoka T, Deguchi J, Kamiya C, Suzuki J, Sato O. Pancreaticoduodenal artery aneurysm formation with superior mesenteric artery stenosis. Ann Vasc Dis 2014; 7:312-5. [PMID: 25298835 DOI: 10.3400/avd.cr.14-00040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 05/10/2014] [Indexed: 11/13/2022] Open
Abstract
Celiac stenosis or occlusion is attributed partly to increase blood flow at pancreatic arcade from the superior mesenteric artery (SMA) system and may play a causal role in true aneurysm of pancreaticoduodenal artery (PDAA) formation. However, despite possible increased blood flow in the pancreatic arcades like celiac stenosis, PDAAs with a stenotic SMA are extremely rare, with only three cases have been reported in the literature. We report a case of PDAA with SMA stenosis and review the literature.
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Affiliation(s)
- Tadashi Kitaoka
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical School, Kawagoe, Saitama, Japan
| | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical School, Kawagoe, Saitama, Japan
| | - Chiaki Kamiya
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical School, Kawagoe, Saitama, Japan
| | - Jun Suzuki
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical School, Kawagoe, Saitama, Japan
| | - Osamu Sato
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical School, Kawagoe, Saitama, Japan
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Pejkić S, Sladojevic M, Koncar I, Radmili O, Mutavdzic P, Dragaš M, Ilić N. Isolated true aneurysm of the superficial temporal artery: a truly enigmatic lesion. VASA 2014; 43:380-4. [PMID: 25147015 DOI: 10.1024/0301-1526/a000379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Siniša Pejkić
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Milos Sladojevic
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Igor Koncar
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia, and Faculty of Medicine, University of Belgrade, Serbia
| | - Oliver Radmili
- Noninvasive Vascular Laboratory, Clinical Center of Serbia, Belgrade, Serbia
| | - Perica Mutavdzic
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Marko Dragaš
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia, and Faculty of Medicine, University of Belgrade, Serbia
| | - Nikola Ilić
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia, and Faculty of Medicine, University of Belgrade, Serbia
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Isoda S, Kimura T, Nishimura K, Yamanaka N, Nakamura S, Arino H, Amako M, Maehara T. Occupational true aneurysm of the ulnar artery: a case report of hypothenar hammer syndrome. Ann Vasc Dis 2013; 6:655-7. [PMID: 24130624 DOI: 10.3400/avd.cr.13-00025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 06/09/2013] [Indexed: 11/13/2022] Open
Abstract
A 32-year-old male patient was admitted to the hospital with a pulsing mass of the right palm. He was an electrical construction engineer who frequently used a screwdriver. Computed tomography (CT) examination revealed a 22- × 30-mm saccular aneurysm of the right ulnar artery. The ulnar artery aneurysm was resected, and we could perform direct anastomosis of the ulnar artery. The dilated true aneurysm was compatible with a traumatic origin. A postoperative enhanced CT examination showed smooth reconstruction of the palmar arch. An occupational true aneurysm of the ulnar artery could be treated by resection and direct anastomosis.
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Affiliation(s)
- Susumu Isoda
- Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
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Shibahara I, Yonezawa S, Takazawa H, Kawaguchi T, Kanamori M, Murakami K, Midorikawa H, Sasaki T, Nishijima M. Ruptured peripheral aneurysms in a collateral pathway associated with stenosis of a major cerebral artery: Report of two cases. Surg Neurol Int 2011; 2:81. [PMID: 21748034 PMCID: PMC3130464 DOI: 10.4103/2152-7806.82247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 05/29/2011] [Indexed: 11/11/2022] Open
Abstract
Background While hemodynamic stress can result in aneurysm formation, it rarely contributes to the development of peripheral aneurysms in collateral pathways. We report two patients with ruptured distal aneurysms in a collateral pathway associated with stenosis of a major cerebral artery. Case Description A 67-year-old man presented with intracerebral hemorrhage in the right frontal lobe. Digital subtraction angiography (DSA) revealed severe stenosis of the right middle cerebral artery and two aneurysms in the collateral pathway of the right anterior cerebral artery. The ruptured aneurysm was trapped and resected; histologically, it was a true saccular aneurysm. The unruptured aneurysm was clipped and the patient was discharged without additional neurological deficits. The second patient was a 73-year-old woman with subarachnoid hemorrhage. DSA revealed three arterial dilations. On the 7th day of hospitalization, one of the aneurysms in a posterior inferior cerebellar artery–anterior inferior cerebellar artery anastomosis that functioned as a collateral pathway in the presence of severe basilar artery stenosis was found to be enlarged. It was treated by selective aneurysmal coil embolization with parent artery preservation. Her postoperative course was uneventful and she was discharged without any neurological deficits. Conclusion We document the successful treatment of two patients with ruptured aneurysms in the peripheral portion of a collateral pathway. We discuss the histology of peripheral aneurysms and present a review of the literature.
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Affiliation(s)
- Ichiyo Shibahara
- Department of Neurosurgery, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, Japan 030-8553
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