Post-traumatic false aneurysm in a digital artery of the finger

Despite the high incidence of trauma involving the hand and digits, traumatic aneurysms in this region are rarely seen and few are reported. We describe a false aneurysm of a digital artery caused by a dog bite.     

创伤性周围假性动脉瘤的外科治疗分析

目的　探讨创伤性周围假性动脉瘤的诊断和治疗方法。方法　回顾性分析 5 8例创伤性周围假性动脉瘤。均手术治疗 ,其中动脉重建 17例 ,直接修补 2 9例 ,补片修补 6例 ,动脉结扎6例。结果　死亡 1例 ,其余 5 7例术后痊愈出院。随访 3 5例 ,均未截肢或出现脑缺血症状 ,3例移植血管闭塞 ,其余均保持通畅。结论　凡损伤性假性动脉瘤的诊断一经确定 ,应行手术治疗 ,以避免并发症的发生。阻断动脉血流是手术成败的关键 ,使用Fogarty导管简便易行 ,介入法置入气囊导管 ,也可阻断血流。防止假性动脉瘤的发生的最好方法是创伤早期对血管损伤的正确处理。     

Congenital aneurysm of palmar digital artery in an infant

Aneurysm of the palmar artery is rare. We report a case of an aneurysm of the common palmar digital artery in an infant. The patient had no history of trauma, and the aneurysm may have been congenital in origin. In the case presented, microvascular reconstruction of the digital artery was carried out successfully, and the patient has been followed-up by MR angiography. Microsurgical techniques have been developed, and postoperative evaluation can be performed easily by MR angiography. Therefore, microvascular reconstruction is recommended in congenital cases. Considering the patients young age and the possibility of recurrence of vascular abnormalities or hand injuries in future, microvascular reconstruction should be considered to maintain normal blood flow. In congenital cases, long-term follow-up is needed. MR angiography is very useful because it is convenient, noninvasive, and is effective for evaluation of re-established blood flow.     

Giant false aneurysm of the subclavian artery

A false aneurysm with a diameter of 15 cm developed in the wall of the subclavian artery after attempted internal jugular cannulation. This potentially lethal complication, its diagnosis and treatment are described.     

颈内动脉瘤合并锁骨下动脉瘤1例

患者女,45岁,7天前突然头痛、头晕伴恶心呕吐,既往健康。查体：生命体征平稳。头颅CT平扫双侧裂池、前纵裂略高密度影。DSA（图1～4）：右侧颈内动脉前床突段向后侧方囊状膨突动脉瘤10mm×9mm,可见附壁血栓,外缘不规则。左侧锁骨下动脉、椎动脉开口远端可见向上前方囊状膨突动脉瘤7．0mm×4．2mm,外缘光滑。     

注射毒品致股动脉感染性假性动脉瘤的血循环功能重建

目的探讨注射毒品致股动脉感染性假性动脉瘤的血循环重建方法。方法 2003年11月-2009年5月,收治84例因注射毒品致股动脉感染性假性动脉瘤患者。其中男67例,女17例;年龄19～51岁,平均34.6岁。注射毒品时间1～11年,平均2.7年。13例股动脉缺损3～10 cm,其余患者股动脉破口范围1.0 cm×0.3 cm～3.0 cm×0.7 cm。5例行ePTFE人工血管旁路转流,29例行自体大隐静脉移植,24例行股动脉破口修补,26例行股动脉结扎。结果 2例患者术中下肢深静脉血栓脱落致肺栓塞死亡。8例术后出现切口感染,拆除部分或全部缝线,经换药后切口愈合,其余患者切口均Ⅰ期愈合。56例行血管重建或修补的患者,术后足背动脉搏动恢复或增强,无远端肢体骨筋膜室综合征发生;26例行股动脉结扎的患者,术后1周行CT下肢动脉血管重建或下肢动脉造影显示肢体远端均有丰富来自同侧髂内动脉、臀上动脉以及对侧髂内动脉的侧支循环。82例术后获12～36个月随访,平均17.3个月。3例出现间歇性跛行,经扩血管,活血化瘀等药物治疗后好转,肢体功能良好;其余行走正常。结论注射吸毒致股动脉感染性假性动脉瘤应尽早外科手术治疗,彻底清创引流、髂外动脉-股浅动脉旁路带支撑环人工血管或大隐静脉重建以及破口修补,是有效的治疗方法。在感染严重、局部条件无法重建血管的情况下,结扎股动脉也是一种可行选择。     

感染性假性股动脉瘤61例治疗分析

目的 探讨动脉瘤切除和动脉结扎治疗创伤后感染性假性股动脉瘤的作用。方法回顾性分析2001年1月至2006年12月中山大学附属第一医院收治的62例因吸毒致创伤后感染性假性股动脉瘤的治疗经过。采用腹股沟韧带上方切口,经腹膜后控制髂外动脉,并在动脉瘤远端暴露股浅动脉,切除动脉瘤,局部清创和血管结扎。结果无术后死亡,无术后大出血及截肢。平均随访32个月（3个月至4年）,2例有轻度的间歇性跛行。结论 创伤后感染性假性股动脉瘤须紧急手术治疗。动脉瘤切除、动脉结扎和彻底的局部清创治疗创伤后感染性假性股动脉瘤安全、有效,且手术操作相对简单。     

Inferior epigastric artery false aneurysm following incisional hernia repair

Introduction

We report a case of IEA false aneurysm following a mesh repair of a large incisional hernia. We emphasize the importance to consider the diagnosis to help avoid inappropriate interventions which could increase patient morbidity.

Case report

A 68-year-old male patient, who 4 weeks previously had had a mesh repair of a large incisional hernia, presented with a painful left iliac fossa swelling. This was found to be an IEA false aneurysm. This was treated successfully with percutaneous thrombin injection.

Conclusions

We feel an inferior epigastric artery false aneurysm must be included in the differential diagnosis when investigating the cause of any lateral swelling following incisional hernia repair. This would help reduce the chance of a missed diagnosis and avoid any inappropriate interventions which may cause increased patient morbidity.     

Dislocation of a bipolar hemiarthroplasty by a false aneurysm of the deep femoral artery

Dislocation of hip arthroplasty due to false aneurysm formation is a rarity. Here, we report a case with false aneurysm of the deep femoral artery causing dislocation of bipolar hemiarthroplasty. The patient was first thought to have an infection but the diagnosis of false aneurysm was made during surgery and repaired.     

Percutaneous embolization of a false aneurysm of the tibial anterior artery after total knee arthroplasty

Throughout a clinical observation, we report a case of false aneurysm of tibial anterior artery after a total right knee arthroplasty in a 73-year-old woman. This case is characterized by the location of false aneurysm. In addition, the clinical symptoms are uncommon and hidden by the appearance of a hematoma in the knee with an embolic pulmonary context. The ultrasonographic exam and arteriography allow us to confirm the diagnosis at the fifth week after the operation. The latter arteriography allows us also to achieve a percutaneous embolization and to control the efficiency of the treatment. By this observation, we insist upon the difficulties and the late diagnosis of this uncommon complication, and we discuss its ways of treatment.     

False aneurysm of the popliteal artery treated successfully by surgery: Report of two cases

Blunt trauma to the popliteal artery may result in pseudoaneurysm formation. We herein report two patients who had a pseudoaneurysm of the popliteal arteries without any orthopedic injuries. One patient, who had been struck by an iron plate in the midthigh portion, demonstrated a pulsatile mass in this area 2 months later. The other patient had a pseudoaneurysm that was diagnosed by a histological examination; however, he could not remember having suffered any noticeable trauma.     

Fusiform aneurysm of the anterior communicating artery

Fusiform aneurysms have often been reported on the internal carotid or vertebrobasilar arteries, but those solely involving the more distal segment of a cerebral artery seem to be exceptional. In a patient harboring two saccular cerebral aneurysms, angiography of the carotid arteries revealed a fusiform dilatation restricted to the anterior communicating artery. At autopsy, this dilatation proved to be a fusiform aneurysm.     

Airway obstruction by an aortic false aneurysm

Aortic false aneurysms are rare complications of aortic valve replacement and cardiac surgical procedures in general. Aortic false aneurysms can also presents as a mediastinal mass. A false aneurysm etiology should always be considered in mediastinal mass exploration of patients with a cardiac surgery history. Although, a computed tomography (CT) scan can detect a mediastinal mass, it can equally misdiagnose an aneurysm in the absence of tumour contrast enhancement. We present the case of a 60-year-old woman who was hospitalized for a laryngeal dyspnea. She had undergone aortic valve replacement 3 years earlier and had no other relevant medical history. In the last 3 months, she presented a progressively worsening dyspnea and cough. A chest radiograph showed a large mass in the superior mediastinum. A contrast-enhanced CT-scan showed an anterior mediastinal mass (9 cm × 8 cm × 9 cm) not enhanced by contrast product, suggestive of a tissue density tumour. The mass was in fact an aortic false aneurysm where the communication with the aorta was too narrow to be filled by the contrast product in arterial phase imaging. The aneurysm was excised and successfully replaced with a prosthetic graft during deep hypothermic and circulatory arrest. In this case report, we discuss the unusual clinical presentation of this pseudoaneurysm and the absence of contrast enhancement during CT-scan, which could have lead to a catastrophic error.     

Surgical treatment of a pulmonary artery aneurysm

We would like to report a rare case of post-stenotic aneurysm of the pulmonary trunk and its left branch in a 51-year-old man. His cardiac disease, which was first diagnosed at the age of 4, was left untreated because of absence of symptoms and normal physical development. A CT scan, recently performed because of decrease in exercise tolerance and worsening dyspnea, showed a pulmonary artery aneurysm (52 mm × 79 mm). The echocardiography revealed a severe pulmonary commissural stenosis. Through a surgical approach the pulmonary trunk and its left branch were excised and reconstructed using a 30 mm Dacron graft; the right pulmonary branch was then reimplanted on the right side of the tube. The patient's postoperative course was uneventful. He was discharged on the seventh postoperative day and there were no adverse events or complications at 1- and 3-month follow-up.     

Ruptured anterior spinal artery aneurysm: a case report

BACKGROUND

Spinal artery aneurysms are rare, and are usually found in association with arteriovenous malformations or coarctation of the aorta.

CASE REPORT

A 42-year-old man with a ruptured anterior spinal artery aneurysm is presented here. He experienced subarachnoid hemorrhage, which was confirmed by computed tomography. Magnetic resonance imaging revealed an aneurysm in front of the upper part of the medulla. Angiography demonstrated bilateral vertebral artery occlusion. Distal vertebral arteries and the basilar artery were perfused via the dilated anterior spinal artery, which originates in the right subclavian artery. The aneurysm was located at the distal part of the anterior spinal artery, and was successfully clipped through a lateral suboccipital craniotomy 2 months after bleeding from the aneurysm. After rehabilitation, the patient was able to walk with no apparent neurologic deficit.

CONCLUSIONS

This case suggests that the anterior spinal artery as a collateral route after bilateral vertebral arery occlusion is under hemodynamic stress, resulting in aneurysm formation and rupture.     

Primary iliac artery aneurysm in a two-year-old girl

Isolated idiopathic iliac artery aneurysm in the pediatric population is extremely rare. Aneurysms in children may be secondary to connective tissue disease, arteritis, or mycotic causes. presented here is the case of a 21/2-year-old female child who, despite the absence of these predisposing factors, presented with a single large iliac artery aneurysm which was successfully resected. The literature on this subject is reviewed. Only two other cases have been reported.     

Transplantation of kidneys with renal artery aneurysm

Olakkengil SA, Mohan Rao M. Transplantation of kidneys with renal artery aneurysm.
Clin Transplant 2011: 25: E516–E519. © 2011 John Wiley & Sons A/S. Abstract: Background: The use of kidneys from a select group of living and deceased donors with renal artery aneurysms (RAA) is a novel way to increase the number of organs available for transplantation. Published literature on the outcome of transplanted kidneys with correctable vascular pathology has been reviewed. Materials and methods: The outcome of six transplant recipients who received kidneys after the repair of RAA is presented. Results: Aneurysm was an incidental finding in two live donors, and two were noticed while preparing the deceased donor grafts for transplantation. Two kidneys were salvaged after nephrectomy as the choice of treatment for the aneurysm. All grafts functioned immediately with no post‐operative complications. Conclusions: While there is scarcity for donor kidneys, these repaired kidneys should not be overlooked. Live donor kidneys with aneurysms can be transplanted successfully after appropriate surgical corrections.     

Dural arteriovenous malformation with false aneurysm and exophthalmos

Summary A case of dural arteriovenous malformation with giant non-traumatic false aneurysm in the left middle fossa is reported.A 10-year-old female patient was admitted to our hospital with pulsating exophthalmos of the left eye, which was successfully treated by ligation of the main feeder and finally by the radical excision of the dural AVM and false aneurysm. False aneurysm of non-traumatic origin is so rare that only two cases were detected in the literature (Reinaet al., Sakakiet al.), and no previous case of false aneurysm complicated by dural AVM seems to have been reported.Presented in part at the 82nd Regular Meeting of the Hirosaki Medical Society, Hirosaki, Japan, 15. December 1975.     

Iliac artery false aneurysm following renal allograft: presentation with non-specific inflammatory response and treatment by endovascular stent graft.

Case report A 41-year-old male received a cadaveric renal transplant 12months after commencing haemodialysis. The allograft developedvascular occlusion requiring transplant nephrectomy. He wasreadmitted 15 days later with malaise and fever. He underwentevacuation of a haematoma from the wound. Three days later,there was evidence of further bleeding. He was found to havea defect in the donor patch