Pseudoaneurysm

假性动脉瘤
  • 文章类型: Case Reports
    经鼻内窥镜视神经管减压术广泛用于治疗头和颅面部外伤后的外伤性视神经病变(TON)。术中出血是视神经管减压期间的灾难性手术并发症。
    我们介绍了两例TON患者,他们在内窥镜经鼻视神经管减压术中意外出现术中大出血。术中止血后,急诊脑血管造影显示颈内动脉假性动脉瘤的形成,立即用带有或不带有Onyx的线圈在球囊辅助下栓塞。其中一例还因术后脑脊液漏而复杂化,腰椎引流治疗失败,但经鼻内镜手术成功修复。
    术中破裂的ICA假性动脉瘤在TON患者中是一种罕见但灾难性的并发症。术中大量出血提示ICA假性动脉瘤破裂。术后应安排急诊血管造影和血管内治疗,以评估和修复脑血管损伤。在假性动脉瘤栓塞后,内镜经鼻手术修复抗腰椎引流的CSF渗漏可能是有效且安全的。
    UNASSIGNED: Endoscopic transnasal optic canal decompression is widely used in the treatment of traumatic optic neuropathy (TON) following head and craniofacial trauma. Intraoperative hemorrhage is a catastrophic surgical complication during optic canal decompression.
    UNASSIGNED: We present two cases of patients with TON who suffered unexpected intra-operative massive bleeding during endoscopic transnasal optic canal decompression. After intraoperative hemostasis was achieved, emergent cerebral angiograms demonstrated the formation of internal carotid pseudoaneurysms, which were immediately embolized with coils combined with or without Onyx with balloon assistance. One of these cases was also complicated by a postoperative cerebrospinal fluid leak, which failed to be treated with lumbar drainage but was successfully repaired with endoscopic transnasal surgery.
    UNASSIGNED: The intra-operative rupture of ICA pseudoaneurysm is a rare but catastrophic complication in TON patients. Intraoperative massive bleeding indicates rupture of ICA pseudoaneurysm. Postoperative emergency angiography and endovascular therapy should be arranged to evaluate and repair the cerebral vascular injury. Endoscopic trans-nasal surgery repairing CSF leaks resistant to lumbar drainage could be efficient and safe following pseudoaneurysm embolization.
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  • 文章类型: Case Reports
    二尖瓣-主动脉瓣间纤维假性动脉瘤是罕见的,特别是在儿童中,而且可能是致命的.本文介绍了两例小儿二尖瓣-主动脉瓣膜间纤维假性动脉瘤:一例继发于感染性心内膜炎,另一例被证实为先天性。本研究显示的二尖瓣-主动脉瓣间纤维假性动脉瘤的特征性超声心动图表现将提高诊断效能并指导早期临床干预。
    Pseudoaneurysm of the mitral-aortic intervalvular fibrosa is rare, particularly in children, and is potentially fatal. This article presents two cases of pediatric mitral-aortic intervalvular fibrosa pseudoaneurysm: one secondary to infective endocarditis and the other confirmed to be congenital in nature. The characteristic echocardiographic manifestations of mitral-aortic intervalvular fibrosa pseudoaneurysm demonstrated in this study will enhance diagnostic efficacy and guide early clinical intervention.
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  • 文章类型: Case Reports
    背景:颈动脉内膜切除术后由颈内动脉引起的医源性假性动脉瘤非常罕见。在这里,我们提供了一个病例,详细说明了颈内动脉假性动脉瘤,该动脉瘤在混合颈动脉内膜切除术和血管内治疗干预后出现。我们处理这种情况的方法涉及一种新技术,其中在C臂的指导下将凝血酶直接注入假性动脉瘤的腔内。
    方法:一名66岁的中国男性患者有4个月的头痛史和20天的步态障碍史。数字减影血管造影显示左颈动脉颈部区域闭塞。在混合外科手术之后,患者报告左颈内动脉内膜切除术切口周围轻度疼痛和瘀伤。随后的血管造影确定了颈动脉假性动脉瘤的存在。利用C形臂引导,然后将凝血酶直接注射到假性动脉瘤的管腔中,导致随访期间完全愈合。
    结论:对于颈动脉内膜切除术后出现的假性动脉瘤,在C臂的引导下将凝血酶直接注射到动脉瘤腔中被认为是安全和有效的。
    BACKGROUND: Iatrogenic pseudoaneurysms arising from the internal carotid artery subsequent to carotid endarterectomy are exceptionally infrequent. Herein, we present a case detailing an internal carotid artery pseudoaneurysm that manifested subsequent to a hybrid carotid endarterectomy and endovascular therapy intervention. Our approach to managing this condition involved a novel technique wherein thrombin was directly injected into the luminal cavity of the pseudoaneurysm under the guidance of a C-arm.
    METHODS: A 66-year-old male patient of Chinese ethnicity exhibited a 4-month history of headache and a 20-day history of gait disturbance. Digital subtraction angiography revealed occlusion in the cervical region of the left carotid artery. Following a hybrid surgical procedure, the patient reported mild pain and bruising surrounding the incision site of the left internal carotid artery endarterectomy. Subsequent angiography identified the presence of a carotid artery pseudoaneurysm. Utilizing C-arm guidance, thrombin was then directly injected into the luminal cavity of the pseudoaneurysm, resulting in complete healing during follow-up.
    CONCLUSIONS: For the management of pseudoaneurysms arising post carotid endarterectomy, the direct injection of thrombin into the aneurysm cavity under the guidance of a C-arm is deemed both safe and efficacious.
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  • 文章类型: Case Reports
    背景:椎弓根螺钉器械手术可导致主动脉假性动脉瘤的发展,这是一种罕见但潜在的严重并发症;因此,这项工作的目的是描述手术后椎弓根螺钉严重迁移引起的胸主动脉假性动脉瘤的情况。
    方法:我们在此报告一名患者,该患者在胸椎固定手术后接受了降主动脉假性动脉瘤的血管内修复术。最初通过右股动脉插入28-80毫米覆膜支架,术中主动脉造影显示造影剂少量外渗。随后,再植入28-140mm覆膜支架.患者在8年随访期间恢复良好。
    结论:脊柱手术引起的血管并发症严重且罕见,需要早期诊断和干预。
    BACKGROUND: Pedicle screw instrument surgeries can result in the development of aortic pseudoaneurysm, which is a rare yet potentially severe complication; therefore, the purpose of this work is to describe the case of pseudoaneurysm of the thoracic aorta caused by the severe migration of a pedicle screw after surgery.
    METHODS: We herein report a patient who underwent endovascular repair for the pseudoaneurysm of the descending thoracic aorta following thoracic vertebral fixation surgery. A 28-80 mm covered stent was initially inserted through the right femoral artery, and intraoperative aortography revealed a minor extravasation of contrast material. Subsequently, an additional 28-140 mm covered stent was implanted. The patient recovered well during the 8-year follow-up period.
    CONCLUSIONS: Vascular complications resulting from spinal surgery are severe and rare, necessitating early diagnosis and intervention.
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  • 文章类型: Journal Article
    毛霉菌病是一种致命的侵袭性真菌感染,通常会影响免疫功能低下的儿童。我们研究的目的是探讨临床表现,治疗,儿童毛霉菌病患者的预后。
    我们于2013年7月至2023年7月在深圳市儿童医院对所有毛霉菌病患者进行了回顾性搜索。临床表现,病原体检测,放射学,治疗,并对预后进行分析。
    确定了4例。基础疾病包括急性髓系白血病伴髓系肉瘤(n=1),地中海贫血(异基因造血干细胞移植后;n=1),系统性红斑狼疮(n=1),和双侧肾母细胞瘤(双侧肾切除术后;n=1)。两名患者为播散性毛霉菌病,1例肺部毛霉菌病,1例脑毛霉菌病。发烧,咳嗽,呼吸困难是肺毛霉菌病的主要临床症状,头痛是脑毛霉菌病的主要临床症状。肺部CT表现包括实变,多发结节,光环标志,空气新月标志,和胸腔积液.对比增强CT显示2例患者有肺动脉和肺静脉阻塞,2例患者有假性动脉瘤。两性霉素B制剂在所有病例中作为一线治疗给药;在3例病例中,三唑与两性霉素B联合给药。
    毛霉菌病是一种涉及多个系统的危及生命的疾病。主动脉假性动脉瘤是一种罕见且致命的并发症,增强CT可以辅助诊断。需要早期诊断和适当的治疗策略。
    UNASSIGNED: Mucormycosis is a fatal invasive fungal infection that commonly affects immunocompromised children. The aim of our study was to investigate the clinical manifestations, treatments, and prognosis of pediatric patients with mucormycosis.
    UNASSIGNED: We conducted a retrospective search in Shenzhen Children\'s Hospital from July 2013 to July 2023 for all patients with mucormycosis. The clinical manifestation, pathogen detection, radiology, treatments, and prognosis were analyzed.
    UNASSIGNED: Four cases were identified. Underlying conditions included acute myeloid leukemia with myeloid sarcoma (n = 1), thalassemia (post-allogeneic hematopoietic stem cell transplantation; n = 1), systemic lupus erythematosus (n = 1), and bilateral nephroblastoma (post-bilateral nephrectomy; n = 1). Two patients were disseminated mucormycosis, one case was pulmonary mucormycosis, and one case was cerebral mucormycosis. Fever, cough, and dyspnea were the main clinical symptoms of pulmonary mucormycosis, headache was the main clinical symptom of cerebral mucormycosis. Lung CT findings included consolidation, multiple nodules, halo sign, air crescent sign, and pleural effusion. The contrast-enhanced CT showed pulmonary artery and pulmonary vein occlusions in two patients and pseudoaneurysm in two patients. Amphotericin B formulations were administered as first-line therapy in all cases; in three cases, Triazole was administered in combination with amphotericin B.
    UNASSIGNED: Mucormycosis is a life-threatening disease involving multiple systems. Aorta pseudoaneurysm is a rare and fatal complication, enhanced CT can assist in diagnosis. Early diagnosis and appropriate therapeutic strategies are needed.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    一名患有高血压和牛皮癣的61岁男子,用阿达木单抗治疗,在牙科植入后有1个月的发烧病史后入院。胸部计算机断层扫描显示主动脉弓有假性动脉瘤,血培养培养了肠道沙门氏菌。诊断为沙门氏菌引起的主动脉弓真菌性假性动脉瘤,他接受了头孢哌酮-舒巴坦治疗。在他住院期间,他出现声音嘶哑,然后出现咯血,并接受了胸主动脉腔内修复术,然后进行紧急开放手术修复。然而,术后5周因急性上消化道出血死亡,经食管胃镜检查证实为主动脉食管瘘。
    A 61-year-old man with hypertension and psoriasis, which was treated with adalimumab, was admitted after a 1-month history of fever following a dental implantation. Computed tomography of the chest revealed a pseudoaneurysm in the aortic arch, and blood culture grew Salmonella enterica. A diagnosis of mycotic pseudoaneurysm of the aortic arch due to Salmonella was made, and he was treated with cefoperazone-sulbactam. During his hospital stay, he developed hoarseness followed by haemoptysis, and underwent thoracic endovascular aortic repair followed by emergency open surgical repair. However, he died 5 weeks after the surgery due to acute upper gastrointestinal bleeding, which was confirmed as an aortoesophageal fistula by oesophagogastroscopy.
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  • 文章类型: Case Reports
    假性动脉瘤是急性心肌梗死的一种罕见但致命的并发症。在这项研究中,我们介绍了一个独特的病例,即在经皮冠状动脉介入治疗后1年以上通过心脏磁共振检查发现左心室游离壁破裂.
    Pseudoaneurysm is a rare but lethal complication of acute myocardial infarction. In this study, we present a unique case of a patient with left ventricular free wall rupture detected by cardiac magnetic resonance more than 1 year after a percutaneous transluminal coronary intervention.
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  • 背景:随着血管介入的发展,假性动脉瘤并发症正在增加。超声引导凝血酶注射(UGTI)是目前治疗假性动脉瘤的首选方法,但是凝血酶的药理特性可能引发血管腔内的急性血栓形成。尽管发病率非常低,这种类型的原发性动脉血栓形成是UGTI的严重并发症,涉及下肢动脉多个分支的病例尤其罕见。
    方法:这里,我们报告了一例65岁的男性,他接受了UGTI,用于治疗股动脉的医源性假性动脉瘤并伴有下肢多动脉的急性血栓形成,患者最终接受了成功的血栓切除术。
    结论:我们回顾了病例并分析了可能的病因,为今后的临床工作提供参考。
    With the development of vascular intervention, pseudoaneurysm complications are increasing. Ultrasound-guided thrombin injection (UGTI) is currently the treatment of choice for pseudoaneurysm, but the pharmacological properties of thrombin may trigger acute thrombosis within the vessel lumen. Despite a very low incidence, this type of primary arterial thrombosis is a serious complication of UGTI, and cases involving multiple branches of the lower limb arteries are particularly rare.
    Here, we report a case of a 65-year-old male who underwent UGTI for the treatment of an iatrogenic pseudoaneurysm of the femoral artery complicated by acute thrombosis of multiple arteries in the lower limbs, and the patient ultimately underwent a successful thrombectomy.
    We reviewed the case and analyzed the possible etiologic causes, providing a reference for future clinical work.
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  • 文章类型: Case Reports
    本报告详细介绍了一例腋窝动脉假性动脉瘤并发远端血栓形成的病例,表现为急性上肢缺血。通过混合手术方法成功治疗了这种情况,采用覆膜支架和Fogarty球囊血栓切除术。我们回顾了有关这种罕见但严重的血管疾病的管理的相关文献。
    This report details a case of axillary artery pseudoaneurysm with concurrent distal thrombosis, manifesting as acute upper extremity ischemia. The condition was successfully treated with a hybrid surgical approach, employing a covered stent graft and Fogarty balloon thrombectomy. We review the relevant literature on the management of this rare but critical vascular condition.
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