11/20. Combined endovascular stent grafting and endoscopic injection of fibrin sealant for aortoenteric fistula complicating esophagectomy.A 67-year-old man with previous total gastrectomy and roux-en-Y esophagojejunostomy had hematemesis 4 weeks after esophagectomy performed because of carcinoma of the esophagus. Investigation showed an aortojejunal fistula with a thoracic aortic pseudoaneurysm. Endovascular stent grafting of the pseudoaneurysm, followed by endoscopic injection of fibrin sealant for the fistula, was performed, and the infection was controlled with broad-spectrum antibiotic agents together with drainage and daily irrigation of the pseudoaneurysm sac. The fistula subsequently healed. The patient remained well 14 months after the procedure; follow-up computed tomograms at 12 months did not show any pseudoaneurysm, and there was no evidence of reopening of the fistula.- - - - - - - - - - ranking = 1keywords = seal (Clic here for more details about this article) |
12/20. Aortic pseudoaneurysm after penetration by a Simon nitinol inferior vena cava filter.This report describes an unusual complication related to inferior vena cava (IVC) filter placement. A 50-year-old woman undergoing long-term anticoagulation presented to her primary care physician with abdominal pain after a motor vehicle accident. An IVC filter had been placed 7 years earlier. Computed tomography of the abdomen demonstrated a moderate perisplenic hematoma and a fragmented IVC filter penetrating the aorta. A small infrarenal aortic pseudoaneurysm had developed at the penetration site. Wallgraft placement successfully sealed the aneurysm.- - - - - - - - - - ranking = 0.2keywords = seal (Clic here for more details about this article) |
13/20. Preoperative balloon sealing of a false ascending aortic aneurysm for safe redo sternotomy.Sternal contact of aortic aneurysms in redo operations may require specific techniques to safely control bleeding during sternotomy and surgical dissection. This is the first report on the preoperative use of an inflatable balloon to prevent massive hemorrhage by inserting the balloon--a procedure performed in the cardiac catheterization laboratory--before rethoracotomy. A false ascending aortic aneurysm was successfully sealed by transaortic wire-guided balloon placement from the iliac artery. Gentle traction on the inflated balloon catheter, which was placed inside the false aneurysm, effectively sealed the entrance to the aneurysm. A straightforward median redo sternotomy procedure was subsequently performed without blood loss from the unavoidably opened aneurysm. My colleagues and I propose this technique for aneurysms of mycotic or anastomotic origin, which have an anatomically distinct entry channel.- - - - - - - - - - ranking = 1.2keywords = seal (Clic here for more details about this article) |
14/20. Iatrogenic pseudoaneurysm of femoral artery: case report and literature review.The case of a patient who developed a femoral artery pseudoaneurysm (FAP) following cardiac catheterization is described. It is one of the most troublesome complications after various invasive cardiovascular procedures related to the femoral arterial access site. Iatrogenic pseudoaneurysms (IPA) form when an arterial puncture site fails to seal, allowing arterial blood to ooze into the surrounding tissues and form a pulsatile hematoma. The FAP occurs in 0.8% to 2.2% after interventional procedures. This problem has become more significant due to the exponential growth of interventional cardiology. Doppler flow mapping has been the mainstay of diagnosis. Diagnostic criteria include: swirling color flow in a mass separate from the affected artery, and a typical "to-and-fro" Doppler waveform in the pseudoaneurysm neck. Ultrasound-guided compression repair has replaced the need for surgical repair of FAP. It has been shown to be a safe and cost-effective method for achieving pseudoaneurysm thrombosis. However, it carries considerable drawbacks including long procedure times, discomfort to patients, high recurrence rate in patients receiving anticoagulant therapy and an overall 3.6% complication rate. Recently, percutaneous thrombin injection in the FAP has gained popularity despite complications associated with the initial use of high dose thrombin (average dose of 1,100 IU). The technique was refined when low-dose thrombin injections were studied and proved to have the same efficacy and consistently high success rates (average dose used 192 IU). However, there is a theoretical risk of developing type I IgE-mediated allergic reaction to bovine thrombin. The indications, advantages, disadvantages, and complications of the various treatment modalities are discussed in this report and review of the literature. Other treatments with collagen injection are also discussed in detail.- - - - - - - - - - ranking = 0.2keywords = seal (Clic here for more details about this article) |
15/20. Gd-enhanced cardiovascular MR imaging to identify left ventricular pseudoaneurysm.A pseudoaneurysm occurs when incomplete rupture of the heart seals within organizing thrombus, hematoma, and pericardium and maintains communication with the left ventricle. A pseudoaneurysm may cause arterial emboli and drain off a considerable portion of ventricular stroke volume. Cardiovascular magnetic resonance imaging proves to be an adequate technique to not only identify pseudoaneurysms but also quantify function measurements of the left ventricle and allow for projections of post-surgical function. When complemented with myocardial delayed enhancement, it is the best technique for identifying the viability of myocardial tissue, an important aspect in surgical planning.- - - - - - - - - - ranking = 0.2keywords = seal (Clic here for more details about this article) |
16/20. Chest stab wound-related coronary artery pseudoaneurysm sealed with a polytetrafluoroethylene-covered stent.We describe a case in which a polytetrafluoroethylene (PTFE)-covered stent was implanted to treat impending rupture of a coronary artery pseudoaneurysm related to a chest stab wound. In this case, transthoracic echocardiography was used to verify the characteristics of the pseudoaneurysm, and we concluded that a PTFE-covered stent may prevent rupture in post-traumatic pseudoaneurysm.- - - - - - - - - - ranking = 0.8keywords = seal (Clic here for more details about this article) |
17/20. Acute abdominal pain in chronic pancreatitis: hemorrhage from a pseudoaneurysm?An alcoholic, 67-year old retired male nurse complained of abdominal pain, loss of appetite and weight loss of 10 kg within one year. Based on elevated serum enzyme levels, ultrasonography and computed tomography examinations, an acute attack of chronic pancreatitis with several pancreatic pseudocysts was diagnosed. Ultrasonographically, an 1.8 cm phi, echo-free, pulsatile, space-occupying lesion, suggestive of a pancreatic pseudoaneurysm, was found at the right lateral margin of an almost echo-free pseudocyst measuring 6.8 x 5.6 x 5.0 cm in the head of the pancreas. Shortly before the planned discharge when the patient felt well, he developed acute abdominal pain. An immediate ultrasound examination showed an inhomogenous and echo-dense pseudocyst, in short, an acute hemorrhage. rupture of the pseudoaneurysm of the Arteria gastroduodenalis was suspected and later confirmed by angiography and laparotomy. After proximal an distal ligation of the vessel and fibrin sealing of the inner surface of the cyst, the patient recovered and, under alcohol abstinence, has been free of symptoms since one year.- - - - - - - - - - ranking = 0.2keywords = seal (Clic here for more details about this article) |
18/20. Twice sealed-rupture of a small abdominal aortic aneurysm with unusual computed tomography findings. A case report.Small abdominal aortic aneurysm rupture is uncommon and fatal. We report a case of twice sealed-rupture small abdominal aneurysm 3.5 cm in diameter. Computed tomography showed unusual findings of a hematoma-like multiple cyst around the small aneurysm. We were bothered the diagnosis. By the intraoperative finding; an irregular pseudoaneurysm, the final diagnosis was performed. After aneurysmectomy, artificial graft replacement was made. From only this case, discussion of the indications for the small abdominal aortic aneurysm is difficult. However, the possibility of the rupture in even this [correction of thus] small abdominal aortic aneurysm should be considered.- - - - - - - - - - ranking = 1keywords = seal (Clic here for more details about this article) |
19/20. Pseudoaneurysm of the superior gluteal arterial system: an unusual cause of pain after a pelvic fracture.This case report describes a complication after treatment of a rotationally unstable pelvic fracture: a pseudoaneurysm of the superior gluteal arterial system. The patient sustained an anterior-posterior compression pelvic fracture that was stabilized with anterior symphyseal plating and percutaneous iliosacral screw insertion. The etiology of the pseudoaneurysm was likely multifactorial, including the injury (anterior-posterior compression pelvic fracture), prolonged coagulation parameters during administration of warfarin, and the percutaneous insertion of an iliosacral lag screw. A pseudoaneurysm of the superior gluteal arterial system should be included in the differential diagnosis of unexplained pelvic or buttock pain after a pelvic fracture.- - - - - - - - - - ranking = 0.2keywords = seal (Clic here for more details about this article) |
20/20. life-threatening hematuria from an arteriovenous fistula complicating an open renal biopsy.Arteriovenous fistulae and pseudoaneurysms are not rare after renal biopsy. The majority of these lesions (80%) are asymptomatic or show only transient symptoms. We present here a patient who developed life-threatening hematuria following an open renal biopsy. arteriovenous fistula and pseudoaneurysm were detected in the biopsied kidney by color-coded Doppler sonography, confirmed by angiography, and the fistula was sealed by superselective arterial embolization with metallic coils. color-coded Doppler sonography successfully detects the majority of arteriovenous fistulae after renal biopsy, and selective arterial embolization obviates the need for surgical intervention in most cases.- - - - - - - - - - ranking = 0.2keywords = seal (Clic here for more details about this article) |
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