An unusual presentation of a large left ventricular pseudoaneurysm

Left ventricle pseudoaneurysm is an infrequent complication of myocardial infarction, and is most commonly localized in the inferoposterior left ventricular segments. We describe a patient post anterior myocardial infarction, who presented with pulmonary edema and a large pseudoaneurysm of the anterolateral wall with involvement of the anterolateral papillary muscle, resulting in severe mitral regurgitation. The patient underwent successful operation and is currently well.     

Successful endovascular management with a covered stent of an external iliac pseudoaneurysm following allograft nephrectomy using CO2 as contrast medium: a case report

Iodinated contrast agents for angiography in chronic kidney disease (CKD) patients could further deteriorate their renal function leading to adverse sequelae. The use of carbon dioxide (CO₂) is reported in the literature and has been safely used for a variety of angiographic procedures, particularly to guide aortic and renal interventions. We report the case of the successful endovascular treatment with a covered stent of a right external iliac artery pseudoaneurysm following graft nephrectomy in a CKD patient, using CO₂ as contrast medium.     

Repair of a coronary pseudoaneurysm with percutaneous placement of a saphenous vein allograft attached to a biliary stent

Late coronary artery pseudoaneurysm formation is a rare complication of perforation following percutaneous intervention. While surgical intervention is the treatment of choice for large expanding pseudoaneurysms, the optimal treatment strategy for small-to-moderate pseudoaneurysms is unclear. We describe the percutaneous placement of a saphenous vein allograft for treatment of a coronary artery pseudoaneurysm presenting as a late complication of coronary perforation. © 1996 Wiley-Liss, Inc.     

MRI of pseudoaneurysm of a brachial venous coronary bypass graft

Coronary artery bypass grafting (CABG) is being performed all over the world, with major success in the management of ischemic heart disease and angina pectoris. Complications of bypass grafting include partial or total graft reocclusion, and less common entitles such as aneurysm or pseudoaneurysm formation. Noninvasive imaging procedures exist which can help include or exclude the presence of these unusual types of complications when mass-like abnormalities are seen on a chest X-ray following coronary artery bypass grafting. This case specifically illustrates the usefulness of ultrafast magnetic resonance imaging techniques in the evaluation and diagnosis of pseudoaneurysm formation at the site of coronary artery bypass graft. © 1996 Wiley-Liss, Inc.     

Ultrasound guided percutaneous thrombin injection for the treatment of iatrogenic pseudoaneurysms

Iatrogenic aneurysms are usually postcatheterisation pseudoaneurysms of the femoral artery. Until recently, the treatment of choice was ultrasound guided compression repair. A case of pseudoaneurysm of the axillary artery, arising as a complication of pacemaker insertion in an 83 year old man is reported. Compression repair was not possible in this case, and so the aneurysm was occluded by percutaneous ultrasound guided thrombin injection directly into the aneurysm sac. Percutaneous ultrasound guided thrombin injection is a promising new minimally invasive technique for the treatment of iatrogenic pseudoaneurysms.


Keywords: pseudoaneurysm; ultrasound guided thrombin injection     

Pseudoaneurysm of the superior mesenteric artery with an arteriovenous fistula after simultaneous kidney–pancreas transplantation

Vascular complications remain a significant source of morbidity after pancreatic transplantation. We describe a pseudoaneurysm of the superior mesenteric artery (SMA) with an arteriovenous fistula (AVF) involving the SMA and the superior mesenteric vein (SMV) discovered and treated surgically in the second week after kidney pancreas transplantation. The patient experienced pain over the graft, and subsequent radionuclide and Doppler ultrasound scan were suggestive of a pseudoaneurysm in the head of the pancreas. Awaiting confirmatory angiography, the patient became hypotensive and after resuscitation, underwent emergency surgery when a pseudoaneurysm was found in the head of the pancreas. After looping the proximal and distal recipient iliac artery and base of the donor Y vascular graft, the AVF was separated and ligated. The SMV was dissected off the pancreatic head and repaired over a tamponading intraluminal Foley catheter. Graft function was preserved. Based on this experience, an AVF with or without a pseudoaneurysm in the pancreas allograft should be corrected as soon it is suspected.     

Percutaneous treatment of pseudoaneurysms and arteriovenous fistulas after invasive vascular procedures

Development of femoral artery pseudoaneurysms and arteriovenous fistulas represents a continuing problem after vascular diagnostic and interventional procedures. For most patients, ultrasound-guided compression is an effective method of treating such complications. However, in patients requiring a continuous anticoagulant regimen, in those with large arteriovenous fistulas or in patients suffering from painful groin hematomas, compression repair is less successful. We therefore assessed the feasibility, efficacy, and long-term results of interventional percutaneous treatment of these complications. In a 40-month period, we treated 53 consecutive patients with 30 pseudoaneurysms, 21 arteriovenous fistulas, and 2 combined lesions. The intervention was successful in 47 patients: 32 lesions were treated by implantation of covered stents, 14 by embolization techniques, and 1 by a combined procedure, surgical repair being necessary only in 6 patients. After a clinical and ultrasonic follow-up of 301 ± 280 days, we noticed four late stent occlusions, especially in patients with poor peripheral runoff. Lesions with a distinct connection channel to the vessel lumen should be treated by coil embolization. In lesions originating from the femoral bifurcation with a broad base, surgical repair is necessary. Stenting of the superficial femoral artery with poor runoff should be avoided. Our results suggests that percutaneous closure of false aneurysms and arteriovenous fistulas after invasive procedures with unsuccessful ultrasonic compression repair is an attractive alternative to surgical treatment. Cathet. Cardiovasc. Intervent. 47:157–164, 1999. © 1999 Wiley-Liss, Inc.