Learning objectives
The goal of this poster is to know the most important aspects of the following points:
- Causes,evidence,
diagnosis,
treatment and management of peripheral arterial pseudoaneurysm.
- Practical value of image techniques on diagnosis and monitoring of a pseudoaneurysm.
- Advantages and disadvantages of the treatment options.
- Posttreatment monitoring.
Background
The true aneurysm and false aneurysm (pseudoaneurysm) are histologically different and have different origins and treatment.
Whereas most true aneurysm occur as a consequence of arterial wall degeneration from atherosclerosis,
pseudoaneurysm occurs as a result of arterial injury or anastomotic disruption (1),
so the wall of the true aneurysms has three layers (intima,
media and adventitia),
but no pseudoaneurysm wall.
In current clinical parctice,
pseudoaneurysms are usually a complication from femoral or brachial artery puncture (postcatheterization).
Pseudoaneurysm are a blood extravasation through a defect in...
Imaging findings OR Procedure details
Differential diagnosis imaging techniques normally available are ultrasonography (US), CT-angiography, MRI-angiography and conventional angiography.
The diagnostic workup should proceed with the choice of noninvasive studies first.
Ultrasound is the first line technique because of it is available,
quick,
fast,
cheap,
harmless,
noninvasive and involves no ionizing radiaton or renal toxic contrast material and first of all because of its availability.
Its main disadvantage is that it is operator dependent.
Gray-scale and color doppler US diagnostic signwould bean anechoic cystic structure,
with a swirling motion blood...
Conclusion
The incidence of iatrogenic pseudoaneurysms has increased significantly due to a higher number of diagnostic and therapeutic invasive procedures made by both radiologists and other specialists.
Appropriate diagnosis and treatment of pseudoaneurysm is critical as some of the associated complications can develop unpredictably andmay be associated with life-threatening complications.
Conventional angiography remains the standard of reference for diagnosis but is aninvasive technique,
so the diagnostic workup should proceed with the choice of noninvasive studies first.
A complete work-up to determine the location of the pseudoaneurysm...
References
[1] Mansour A. Gorsuch J.
Diagnosis and Management of Pseudoaneurysm.
Perspectives in Vascular and Endovascular Surgery /Vol.
19,
No.
1,
March 2007.
[2] Saad et al.
Pseudoaneurysm and the Role of Minimally Invasive Techniques in Their Management.
RadioGraphics 2005; 25: S173-S189.
[3] Ward E.
Buckley O.
Collins A.
et al.
The use of thrombin in radiology department.
Eur Radiol (2009) 19: 670-678.
[4] Vlachou P.A.,
Karkos C.D.,
Bains S.
et al.
Percutaneous ultrasound-guided thrombin injection for the treatment of iatrogenic femoral artery pseudoaneurysm.
European Journal...