Percutaneous Coil Embolization for the Treatment of a Giant Brachial Artery Pseudoaneurym in a Child (original) (raw)
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Microsurgical management of a brachial artery pseudoaneurysm in a 41-day-old infant
Journal of Vascular Surgery Cases and Innovative Techniques
A pseudoaneurysm of the proximal right brachial artery is rare, with most caused by penetrating or blunt trauma. We report the case of a 41-day-old patient with a large iatrogenic pseudoaneurysm of the right brachial artery that had been induced by a puncture lesion during peripherally inserted central catheter placement for treatment of Lennox-Gastaut syndrome. The patient was successfully treated with a multidisciplinary approach, that consisted of direct excision of the pseudoaneurysm, followed by microvascular direct anastomosis. The patient was discharged with no complications, and complete exclusion of the pseudoaneurysm was confirmed at the 2-year follow-up examination.
A Giant Brachial Artery Pseudoaneurysm in an Infant Boy
2020
Dragan Piljic1, Alen S. Hajdarevic1, Dilista Piljic2, Haris Vukas3, Fahrudin Sabanovic4, Mate Petričevic5 and Gordan Samoukovic6 1University Clinical Center Tuzla, Cardiovascular Surgery Clinic, Tuzla, Bosnia and Herzegovina 2University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina 3Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina 4Health Care Center Zenica, Zenica, Bosnia and Herzegovina 5University Hospital Center Zagreb, Zagreb, Croatia 6McGill University Montreal, Montreal, Canada
Treatment of an infected giant brachial artery pseudoaneurysm: a case report
Turkish Journal of Thoracic and Cardiovascular Surgery, 2012
Periferik arter anevrizmaları, üst ekstremitelerde alt ekstremitelerden çok daha az görülür. Hemodiyaliz için yapılan venöz kateterizasyon esnasında istenmeden meydana gelen brakiyal arter delinmesine sekonder dev brakiyal arter psödoanevrizma oluşumu nadirdir. Bu psödoanevrizmalar; yaşamı tehdit eden kanama, ekstremite fonksiyonlarında ciddi azalma, kol ya da parmakların kaybı ve hatta ölüm gibi ciddi komplikasyonlara neden olabilir. Bu yazıda, hemodiyaliz için yapılan kateterizasyon esnasında brakiyal arter delinmesine sekonder ortaya çıkan enfekte brakiyal arter psödoanevrizmasının, anevrizmektomi ve safen ven grefti interpozisyonu ile başarılı bir şekilde tedavisi sunulmuştur. Anah tar söz cük ler: Brakiyal arter; enfekte psödoanevrizma; safen greft; üst ekstremite. Peripheral artery aneurysms are much less frequent in the upper extremities than in the lower extremities. Giant brachial artery pseudoaneurysms secondary to inadvertent puncture of the brachial artery during venous cannulation for hemodialysis are rare. These pseudoaneurysms may result in serious complications such as life-threatening hemorrhage and severe decreases in extremity function and also lead to loss of arms or fingers and even death. In this article, we present a case of infected giant brachial artery pseudoaneurysm secondary to brachial artery puncture for hemodialysis and successfully treated with aneurysmectomy and a short saphenous vein interposition graft.
Giant iatrogenic pseudoaneurysm of the brachial artery: A case report
International Journal of Surgery Case Reports, 2017
Introduction: Pseudoaneurysms are a pulsatile hematoma caused by hemorrhage on soft tissues. It is an uncommon condition with many different etiologies. We report a case of a giant pseudoaneurysm caused by iatrogenic injury on the brachial artery. Presentation of case: A 42 year-old male was submitted to our Vascular Surgery service with an enlargement of the right upper limb and a history of myocardial infarction. 60days before the patient reached our service, he was submitted to a cardiac catheterization performed by another medical team, since the catheter was placed on the right brachial artery near the cubital fossa, we suspected an iatrogenic pseudoaneurysm, which was confirmed by his clinical history and physical exam. It was opted to treat the pseudoaneurysm with an implant of polytetrafluoroethylene prosthesis. There were no complications whatsoever and the patient was discharged. Discussion: Pseudoaneurysms are more common after interventional procedures than diagnostic procedures, although brachial artery pseudoaneurysms are rare. Complications of pseudoaneurysms can cause serious threat to the afflicted limb and the patient's life. The management of any pseudoaneurysm is dependent on its size, location and pathogenesis. Conclusion: Pseudoaneurysms develop slowly and should be diagnosed as early as possible in order to avoid complications and a better outcome. Due to an increase in recent endovascular procedures and the fact that brachial artery puncture is being performed more routinely, incidence of brachial artery pseudoaneurysms among overall population may rise.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2007
Report the successful treatment of iatrogenic pseudoaneurysm of the brachial artery with the percutaneous ultrasonographically guided thrombin injection (PUGTI). The pseudoaneurysm was caused by an accidental puncture into a native brachial artery instead of the venous side of an arteriovenous fistula during hemodialysis. The aneurysmal sac had a large size with a short neck, vulnerable to intra-arterial thrombosis and distal artery embolization during the thrombin glue injection. This procedure was secured by using color duplex ultrasonography (CDU) for the accurate positioning of the needle and the assessment of the optimal dosage of the injected bovine thrombin. After the procedure, an elastic compression was applied at the injection site to prevent the reentry of blood flow into the aneurysmal sac. The flow in the aneurysmal sac completely disappeared in seven days after the treatment. The 4-month follow-up demonstrated the complete resolution of the aneurysmal sac. Percutaneous...
Journal of Surgical Case Reports, 2023
Brachial artery pseudoaneurysms are a rare entity, which can occur secondary to infectious, traumatic, or iatrogenic causes. We present a 78-year-old female with end-stage renal disease on hemodialysis via a right brachio-basilic arteriovenous fistula. She had previously undergone numerous fistulograms and endovascular interventions for right upper extremity swelling due to prolonged bleeding following dialysis. After a recent fistulogram she developed recurrent arm swelling. Duplex showed a large hematoma without any evidence of vascular f low. However, intraoperatively, she was noted to have a giant 20 × 35 cm pseudoaneurysm of the brachial artery. Therapeutic options include endovascular stenting, embolization, thrombin injection, ultrasound-guided compression, and surgery. We elected to perform resection of the large pseudoaneurysm and arteriovenous fistula ligation due to the large size. Given her end-stage renal disease status and lacking quality autogenous vein, we were able to perform a patch angioplasty repair of her brachial artery without requiring a bypass.
Hybrid treatment of large brachial artery pseudoaneurysms
Annals of Vascular Surgery, 2016
Background: Conventional surgical treatment of brachial artery pseudoaneurysms (BAPs) includes aneurysm excision/opening and subsequent arterial reconstruction with different options depending on the extent of the arterial deficit. Endovascular repair of BAPs with stent grafting has also been reported but published experience remains limited. In this report, we present our experience with a novel hybrid approach consisting of primary endovascular aneurysm exclusion with a stent graft and subsequent open surgical evacuation of pseudoaneurysm content for decompression of adjacent structures. Methods: This study included all patients who underwent hybrid repair of a BAP within the period 2005e2014 in our institution. Data were collected retrospectively. Results: During the study period a total of 5 patients with iatrogenic BAPs were treated. Mean BAP diameter was 58 ± 4.9 mm. Technical success was 100%. Thirty-day mortality was null. No major perioperative complications were noted. Hand ischemia and neurological symptoms were reversed in all patients after the procedure. During follow-up (median 24 months, range 6e60 months) all stent grafts remained patent and no aneurysm relapse was noticed. No signs of stent-graft infection were noticed in any of the patients and no reintervention was needed. Conclusions: Primary endovascular exclusion of BAPs with a stent graft followed by surgical evacuation of pseudoaneurysm sac content is associated with good early and mid-term results in this limited experience. Larger patient cohorts are required for further evaluation of this technique.
Brachial artery pseudoaneurysm secondary to inadvertent arterial puncture
Revista argentina de cirugía, 2021
Brachial artery pseudoaneurysm secondary to inadvertent arterial puncture Los pseudoaneurismas de la arteria humeral son infrecuentes, pero pueden asociarse a complicaciones de alta morbilidad como la isquemia de miembro superior. Comunicamos un caso de pseudoaneurisma humeral en el pliegue del codo, que se presentó como tumor pulsátil con leve disminución de la temperatura y parestesias en la mano homolateral de un año de evolución, debido a una punción arterial inadvertida durante la venopunción para extracción de sangre. Se trató con éxito mediante resección quirúrgica más reconstrucción vascular con bypass húmero-cubital y bypass húmeroradial ambos con vena safena. Se discuten las diversas opciones terapéuticas disponibles para los pseudoaneurismas humerales considerando las características anatómicas y la sintomatología del paciente.
Pseudoaneurysms of the brachial artery following venipuncture in infants
Pediatric Surgery International, 2004
Pediatric vascular injuries are increasing in frequency and represent a challenging problem in pediatric surgical practice. Increased survival of low birth weight infants and advances in invasive diagnostic procedures have resulted in a dramatic increase in the number of these injuries. Formation of pseudoaneurysm of the brachial artery in infants is a very rare complication of venipuncture, with only two cases reported in the literature. We report three cases of brachial artery pseudoaneurysm in infants following venipuncture who were operated upon in our institution, aged 43-64 days at the time of operation. The period from the injury to the operation ranged from 25 to 42 days. All three infants were referred from different institutions. In two infants, the pseudoaneurysms and the involved part of the artery were resected, and arterial continuity was restored with an end-to-end anastomosis; in the other infant, reconstruction was done using a venous interposition graft. All three infants were diagnosed with duplex ultrasonography, and the child requiring a more complex reconstructive procedure was also evaluated with helical contrast computed tomography. Brachial artery pseudoaneurysms are a rare but possible complication of multiple venipuncture in infants. Early diagnosis and microvascular reconstruction are key points in managing these injuries.
Delayed presentation of a traumatic brachial artery pseudoaneurysm
2009
Brakiyel arter psödoanevrizmasının penetran travma sonrası geç başvurusu nadiren bildirilmiştir. Bu yazıda, antekübital fossa bölgesine nafiz penetran bir travma ve arkasından da dirseğinde ani bir şişlik ve duyarlılık oluşmasından üç ay sonra başvuran 23 yaşında bir erkek olgu sunuldu. Doppler ultrasonografi ve bilgisayarlı tomografi anjiyografisi büyük bir psödoanevrizma varlığını doğruladı. Normal arteriyel dolaşımı sağlayacak şekilde araya yerleştirilen bir safen ven interpozisyon greftiyle cerrahi rekonstrüksiyon gerçekleştirildi. Anahtar Sözcükler: Brakiyel arter; gecikmiş başvuru; sahte anevrizma; penetran travma; psödoanevrizma; üst ekstremite. Delayed presentation of a brachial artery pseudoaneurysm following penetrating trauma is infrequently reported. We report the case of a 23-year-old male who presented three months following a penetrating trauma to his antecubital fossa with a sudden exacerbation of swelling and tenderness of his elbow. Doppler ultrasound and computed tomography arteriography confirmed the presence of a large pseudoaneurysm. Surgical reconstruction was performed using the long saphenous vein as an interposition vein graft, restoring normal arterial circulation.