Iatrogenic pseudoaneurysm

Toursarkissian B, Allen BT, Petrinec D, Thompson RW, Rubin BG, Reilly JM, Anderson CB, Flye MW, Sicard GA (1997) Spontaneous closure of selected iatrogenic pseudoaneurysms and arteriovenous fistulae. J Vase Surg 25 803-... 

Satoh, H., Takeda, T., Takashima, M., Sumlyoshl, K., Imaizninl, N. Gas-forming liver abscess following transcatheter hepatic arterial embolization for an iatrogenic intrahepatic pseudoaneurysm report of a case. Jpn. J. Surg. 1995 25 361 -364... 

They reported the successful direct needle-injection of thrombin to thrombose peripheral pseudoaneurysms such as common iliac, peroneal, and hepatic pseudoaneurysms. Despite this interesting report, it was not until a decade later that the first report of ultrasound-guided direct thrombin-injection to close iatrogenic groin pseudoaneurysms was published, by Liau et al. [16]. 

Table 6.2. Overview of results of published series on percutaneous thrombin injection to treat iatrogenic postcatheterization pseudoaneurysms...

Paulson EK, Nelson RC, Mayes CE, Sheafor DH, Sketch MH, Kliewer MA (2001) Sonographically guided thrombin injection of iatrogenic femoral pseudoaneurysms further experience of a single institution. AJR 177 309-316... 

Liau CS, Ho FM, Chen MF, Lee YT (1997) Treatment of iatrogenic femoral artery pseudoaneurysm with percutaneous thrombin injection. J Vase Surg 26 18-23... 

Sheiman RG, Mastromatteo M (2003) Iatrogenic femoral pseudoaneurysms that are unresponsive to percutaneous thrombin injection potential causes. AJR 181 1301-1304... 

Brophy DP, Sheiman RG, Amatulle P, Akbari CM (2000) Iatrogenic femoral pseudoaneurysms thrombin injection after failed US-guided compression. Radiology 214 278-282... 

Outside of the liver and kidneys, there are innumerable other types of iatrogenic arterial injuries that can occur. Of course the commonest iatrogenic injury is post-catheterization femoral artery pseudoaneurysms, but this is discussed in another chapter. 

Tessier DJ, Fowl RJ, Stone WM, McKusick MA, Abbas MA, Sarr MG et al. (2003) Iatrogenic hepatic artery pseudoaneurysms an uncommon complication after hepatic, biliary, and pancreatic procedures. Ann Vase Surg 17 663-669... 

Ozkan OS, Walser EM, Akinci D, Nealon W, Goodacre B (2002) Guglielmi detachable coil erosion into the common bile duct after embolization of iatrogenic hepatic artery pseudoaneurysm. J Vase Interv Radiol 13 935-938... 

Other causes of saccular aneurysm formation include trauma and iatrogenic injury from percutaneous or surgical interventions. Any focal insult, perforation, or laceration can lead to pseudoaneurysm formation. These aneurysms are often symptomatic due to hemorrhage, pain, and hypotension that occur. Iatrogenic injuries will be discussed in a separate chapter of this text. 

Typically pseudoaneurysm formation in the renal artery distribution is iatrogenic or traumatic. Other causes of aneurysm formation include fihromuscu-lar dysplasia, polyarteritis nodosa, amphetamine abuse, angiomyolipoma in the presence or absence of tuberous sclerosis, and neurofibromatosis. 

Alexander MJ, Smith TP, Tucci DL (2002) Treatment of an iatrogenic petrous carotid artery pseudoaneurysm with a Symbiot covered stent technical case report. Neurosurgery 50 658-662... 

US and Doppler techniques are accurate means to diagnose injuries to the femoral vessels in the groin. These usually occur as a result of iatrogenic procedures (arterial catheterization), but may also be involved in displaced fractures of the pubis and the femoral neck, crush injuries, blunt trauma and so forth. The most common site for arterial injuries is the common and proximal superficial femoral artery. The main complication is a pseudoaneurysm. Other less frequent complications include thrombosis, arteriovenous fistula, dissection, intimal flaps and perivascular hematoma. Pseudoaneurysms of the femoral artery follow a tear of the vessel wall followed by leakage of blood from the artery into the adjacent tissue and usually appear as pulsatile well-defined anechoic masses located closely to the artery (Fig. 12.41). Mural thrombus is often present and partially fills the pseudoaneurysm sac. Blood flow inside the pseudoaneurysm is typically swirling with alternating red and... 

Pai VR, van Holsbeeck M (1995) Synovial osteochondromatosis of the hip role of sonography. J Qin Ultrasound 23 199-203 Parra JA, Ferndndez MA, Encinas B et al (1997) Morel-Lavallee effusions in the thigh. Skeletal Radiol 26 239-241 Paulson EK, Sheafor DH, Kliewer MA et al (2000) Treatment of iatrogenic femoral arterial pseudoaneurysms comparison of US-guided thrombin injection with compression repair. Radiology 215 403-408... 

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