False aneurysms

Partially targeted treatment (embolization) to eliminate risk factors of hleeding/rehleeding (feeding artery aneurysms, intranidal aneurysms, false aneurysms)... 

Access site and lower limb complications Bleeding, hematoma, false aneurysm Arterial thrombosis Death... 

A 43-year-old man developed a false aneurysm of the popliteal artery after a penetrating injury from an acupuncture needle (118). The aneurysm ruptured spontaneously, but the patient was successfully managed by vascular surgery. 

Lord RV, Schwartz P. False aneurysm of the popliteal artery complicating acupuncture. Aust NZ J Surg 1996 66(9) 645-7. 

Percutaneous puncture and pre-operative cyanoacrylate obliteration of a traumatic false aneurysm of an angular artery branch [see comment], Br J Radiol 76 746-749... 

Fig. 3.10a-d. A large splenic artery false aneurysm is demonstrated near tbe bilum of tbe spleen (a). Tbe 6-F RDC catheter is advanced into tbe orifice of the splenic artery and a microcatheter is passed to the site of injury in the distal splenic artery (b). The microcatheter is advanced distally beyond the site of the communication with the false aneurysm. Micronester coils are placed distal and proximal to the origin of the false aneurysm (c and d) and the final angiogram demonstrates occlusion of the lower pole of the spleen with preservation of the upper pole... 

DeLima LG, Wynands JE, Bourke ME, Walley VM (1994) Catheter-induced pulmonary artery false aneurysm and rupture case report and review. J Cardiothorac Vase Anesth 8 70-75... 

Branch Jr CL, Davis Jr CH. False aneurysm compheating carotid endarterectomy. Neurosurgery 1986 19 421-5. 

AAAs present in three different types or shapes. Fusiform aneurysms, the most typical, are mostly symmetrical bulges that occur around the entire circumference of the aorta. These are sometimes referred to as false aneurysms or pseudoaneurysms, because layers of the wall of the aorta are missing (as opposed to the presence of all three layers in a true aneurysm). An aortic dissection, on the other hand, is when blood penetrates the inner layer of the aortic wall, and flows between the layers, similar to delamination. This typically occurs in the thoracic region of the aorta, but can sometimes occur in the abdominal region. Figure 21.3 shows these various types of aneurysms. 

Downs AR. Guzman R. Formichi M, Courbier R, Jausseran JM, Branchereau A, Juhan C, Chakfe N, King M, Guidoin R. Etiology of prosthetic anastomotic false aneurysms - pathological and structural evaluation in 26 cases. Can. J. Surg. 34 53-58,1991. 

In some instances, complete cure is deemed impossible despite a combined technique. Partial treatment can yet be indicated in some cases (a) to cure a weak point of the AVM such as a false aneurysm, intranidal aneurysms, or large feeding artery aneurysms (Fig. 3.6) (b) to improve the clinical symptoms in case of a large AVM presenting with progressive neurologic deficits (Fox 1997). 

Classification of intracranial aneurysms may be based on morphology, size, location and etiology. The majority of intracranial aneurysms are true aneurysms containing all layers or components of the normal vessel wall. In contrast, in false aneurysms or pseudoaneurysms, the vascular lumen does not enlarge, although the external diameter of the abnormal segment may be increased. These aneurysms are rare within the skull. 

The arterial wall is composed of three layers. The outer serosal covering is the adventitia, the muscular middle layer is the media, and the inner lining is the intima. True aneurysms are distinguished from false or pseudoaneurysms based on which layers of the arterial wall are present in the aneurysm itself. In order to classify an aneurysm as being true, it must be comprised of all three layers. Pseudoaneurysms have any combination less than all three of the arterial wall components. 

Hemorrhage / hematoma / false aneurysm Arteriovenous fistula Nerve damage... 

Fig. 20.7. Massive EPX with hemodynamic instability following maxillofacial trauma. A large false aneurysm due to a vascular laceration of the distal internal maxillary artery (asterisk) is detected. After microcatheterization of the pathological arterial segment, it is embolized with proximal glue deposition, with rapid hemodynamic stabilization and control of the EPX...

Traumatic false aneurysm on external carotid artery... 

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