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Uterine artery pseudoaneurysm caused by hysteroscopic surgery: A case report 被引量:3
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作者 Kaoru Kakinuma Toshiyuki Kakinuma +4 位作者 Kyouhei Ueyama Rora Okamoto Kaoru Yanagida Nobuhiro Takeshima Michitaka Ohwada 《World Journal of Clinical Cases》 SCIE 2024年第26期5968-5973,共6页
BACKGROUND We report a case of uterine artery pseudoaneurysm(UAP)occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization(UAE).CASE SUMMARY A 48-year-old primigravid,pr... BACKGROUND We report a case of uterine artery pseudoaneurysm(UAP)occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization(UAE).CASE SUMMARY A 48-year-old primigravid,primiparous patient was incidentally found to have an endometrial polyp during a health checkup,and underwent a hysteroscopic polypectomy at another hospital.Her cervix was dilated with a Laminken-R®device.After the Laminken-R®was withdrawn,a large amount of genital bleeding was observed.This bleeding persisted after the hysteroscopic polypectomy,and,as hemostasis became impossible,the patient was transferred to our hospital by ambulance.On arrival,transvaginal ultrasonography revealed a 3-cm hypoechoic mass with a swirling internal pulse on the right side of the uterus,and color Doppler ultrasonography showed feeder vessels penetrating the mass.Pelvic contrast-enhanced computed tomography(CT)confirmed the presence of a mass at this site,and vascular proliferation was observed within the uterine cavity.Consequently,UAP was diagnosed,and UAE was performed.The patient’s postoperative course was uneventful,and 6 mo post-UAE,no recurrence of blood flow to the UAP was observed.CONCLUSION When abnormal genital bleeding occurs during hysteroscopic surgery,ultrasonography and contrast-enhanced CT can assist in the detection of early UAPs. 展开更多
关键词 Cervical dilation Hysteroscopic surgery Uterine artery pseudoaneurysm Uterine artery embolization Case report
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Superficial femoral artery pseudoaneurysm at implantation site of drug eluting stent discovered due to bacteremia:A case report
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作者 Takafumi Akai Shintarou Ninomiya Takanori Kaneko 《World Journal of Clinical Cases》 SCIE 2024年第17期3194-3199,共6页
BACKGROUND Drug-eluting stents(DES)are used to treat lower extremity arterial disease.During DES treatment,aneurysmal degeneration occasionally occurs,especially with fluoropolymer-based DES.However,the incidence of p... BACKGROUND Drug-eluting stents(DES)are used to treat lower extremity arterial disease.During DES treatment,aneurysmal degeneration occasionally occurs,especially with fluoropolymer-based DES.However,the incidence of pseudoaneurysms after DES placement is rarely reported in the lower extremity region,although there have been several reports on pseudoaneurysm formation after DES placement in the coronary artery region.CASE SUMMARY We report the case of a 64-year-old man who presented with fever and pain in his left hand after dialysis.Bacteremia was diagnosed by blood culture,and after admission,he developed pain on the medial side of the right thigh.A pseudoaneurysm was observed in the right superficial femoral artery(SFA)at the proximal end of a previously placed DES.The bacteremia was thought to have been caused by a pseudoaneurysm of the left superficial brachial artery,and the pseudoaneurysm of the left superficial brachial artery was removed after antibiotic treatment.The pseudoaneurysm of the right SFA rapidly expanded after admission,but the expansion rate was reduced after infection control.Seven months after the first admission,the pseudoaneurysm of the left SFA was re-moved and in situ revascularization performed using a rifampicin-soaked Dacron graft.CONCLUSION Although pseudoaneurysm after DES placement in the lower extremity region is rare,it must be considered in patients with bacteremia. 展开更多
关键词 pseudoaneurysm Drug eluting stent Superficial femoral artery BACTEREMIA REVASCULARIZATION Case report
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Timely identification and treatment of uterine artery pseudoaneurysm after hysteroscopic procedures
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作者 Haewon Byeon 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第12期4762-4765,共4页
Uterine artery pseudoaneurysm(UAP)is a rare but potentially life-threatening complication that can occur following hysteroscopic surgery for endometrial polyp resection.This article discusses the case study by Kakinum... Uterine artery pseudoaneurysm(UAP)is a rare but potentially life-threatening complication that can occur following hysteroscopic surgery for endometrial polyp resection.This article discusses the case study by Kakinuma et al,which highlights the successful diagnosis and treatment of UAP in a 48-year-old primiparous woman.Utilizing advanced imaging techniques such as ultrasound and computed tomography(CT),the medical team was able to promptly identify the UAP and subsequently perform a uterine artery embolization to treat the condition.The study underscores the critical need for rapid diagnosis and intervention to prevent severe outcomes and provides practical clinical recommendations for managing similar cases.This article aims to expand on the study’s findings,discuss the clinical implications,and suggest future research directions to optimize the management of UAP post-hysteroscopic surgery. 展开更多
关键词 Uterine artery pseudoaneurysm Hysteroscopic surgery Uterine artery embolization Abnormal uterine bleeding Advanced imaging techniques
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Managing uterine artery pseudoaneurysm post-hysteroscopic surgery:Clinical insights and future directions
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作者 Chun-Han Cheng Wen-Rui Hao Tzu-Hurng Cheng 《World Journal of Clinical Cases》 SCIE 2024年第32期6547-6550,共4页
This editorial discusses the case report by Kakinuma et al,which details a rare occurrence of uterine artery pseudoaneurysm following hysteroscopic surgery.The case highlights diagnostic challenges and management stra... This editorial discusses the case report by Kakinuma et al,which details a rare occurrence of uterine artery pseudoaneurysm following hysteroscopic surgery.The case highlights diagnostic challenges and management strategies for this uncommon complication.The editorial explores the implications for clinical practice,emphasizing the importance of early recognition and appropriate intervention to prevent potential severe outcomes.Future research directions to increase the understanding and management of uterine artery pseudoaneurysm in similar clinical settings. 展开更多
关键词 Uterine artery pseudoaneurysm Hysteroscopic surgery Vascular complications Intervention implications Case report
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Follow-up strategy for early detection of delayed pseudoaneurysms in patients with blunt traumatic spleen injury: A single-center retrospective study
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作者 Sung Hoon Cho Gun Woo Kim +1 位作者 Suyeong Hwang Kyoung Hoon Lim 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第10期3163-3170,共8页
BACKGROUND The spleen is the most commonly injured solid organ in blunt abdominal trauma,and splenic pseudoaneurysm rupture is associated with a high risk of mortality.Nonoperative management has become the standard t... BACKGROUND The spleen is the most commonly injured solid organ in blunt abdominal trauma,and splenic pseudoaneurysm rupture is associated with a high risk of mortality.Nonoperative management has become the standard treatment for hemodynam-ically stable patients with splenic injuries.On the other hand,delayed splenic pseudoaneurysms can develop in any patient,and at present,there are no known risk factors that may reliably predict their occurrence.Furthermore,there is a lack of consensus regarding the most appropriate strategies for monitoring and mana-ging splenic injuries,especially lower-grade(I-III).AIM To determine the predictors of pseudo-aneurysm formation following splenic injury and develop follow-up strategies for early detection of pseudoaneurysms.METHODS We retrospectively analyzed patients who visited the Level I Trauma Center bet-ween January 2013 and December 2022 and were diagnosed with spleen injuries after blunt abdominal trauma.RESULTS Using the American Association for the Surgery of Trauma spleen injury scale,the splenic injuries were categorized into the following order based on severity:Grade I(n=57,17.6%),grade II(n=114,35.3%),grade III(n=89,27.6%),grade IV(n=50,15.5%),and grade V(n=13,4.0%).Of a total of 323 patients,35 underwent splenectomy and 126 underwent angioembolization.19 underwent delayed angioembolization,and 5 under-went both initial and delayed angioem-bolization.In 14 patients who had undergone delayed angioembolization,no extravasation or pseudoaneurysm was observed on the initial computed tomography scan.There are no particular patient-related risk factors for the formation of a delayed splenic pseudoaneurysm,which can occur even in a grade I spleen injury or even 21 days after the injury.The mean detection time for a delayed pseudoaneurysm was 6.26±5.4(1-21,median:6,inter-quartile range:2-9)days.CONCLUSION We recommend regular follow-up computed tomography scans,including an arterial and portal venous phase,at least 1 week and 1 month after injury in any grade of blunt traumatic spleen injury for the timely detection of delayed pseudoaneurysms. 展开更多
关键词 Blunt trauma Spleen injury Delayed pseudoaneurysm ANGIOEMBOLIZATION Nonoperative management
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Pseudoaneurysm formation following transarterial embolization of traumatic carotid-cavernous fistula with detachable balloon:An institutional cohort long-term study
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作者 Prasert Iampreechakul Korrapakc Wangtanaphat +5 位作者 Songpol Chuntaroj Yodkhwan Wattanasen Sunisa Hangsapruek Punjama Lertbutsayanukul Pimchanok Puthkhao Somkiet Siriwimonmas 《World Journal of Radiology》 2024年第4期94-108,共15页
BACKGROUND The goal of therapy for traumatic carotid-cavernous fistula(TCCF)is the elimination of fistula while maintaining patency of the parent artery.The treatment for TCCF has evolved from surgery to endovascular ... BACKGROUND The goal of therapy for traumatic carotid-cavernous fistula(TCCF)is the elimination of fistula while maintaining patency of the parent artery.The treatment for TCCF has evolved from surgery to endovascular management using detachable balloons,coils,liquid embolic agents,covered stents,or flow-diverter stent through arterial or venous approaches.Despite the withdrawal of detachable balloons from the market in the United States since 2004,transarterial embolization with detachable balloons has currently remained the best initial treatment for TCCF in several countries.However,the pseudoaneurysm formation following transarterial detachable balloon embolization has rarely been observed in long-term follow-up.AIM To determine the occurrence and long-term follow-up of pseudoaneurysm after transarterial detachable balloon for TCCF.METHODS Between January 2009 and December 2019,79 patients diagnosed with TCCF were treated using detachable latex balloons(GOLDBAL)of four sizes.Pseudoaneurysm sizes were stratified into five grades for analysis.Initial and follow-up assessments involved computed tomography angiography at 1 month,6 month,1 year,and longer intervals for significant cases.Clinical follow-ups occurred semi-annually for 2 years,then annually.Factors analyzed included sex,age,fistula size and location,and balloon size.RESULTS In our cohort of 79 patients treated for TCCF,pseudoaneurysms formed in 67.1%,with classifications ranging from grade 0 to grade 3;no grade 4 or giant pseudoaneurysms were observed.The majority of pseudoaneurysms did not progress in size,and some regressed spontaneously.Calcifications developed in most large pseudoaneurysms over 5-10 years.Parent artery occlusion occurred in 7.6%and recurrent fistulas in 16.5%.The primary risk factors for pseudoaneurysm formation were identified as the use of specific balloon sizes,with balloon SP and No.6 significantly associated with its occurrence(P=0.005 and P=0.002,respectively),whereas sex,age,fistula size,location,and the number of balloons used were not significant predictors.CONCLUSION Pseudoaneurysm formation following detachable balloon embolization for TCCF is common,primarily influenced by the size of the balloon used.Despite this,all patients with pseudoaneurysms remained asymptomatic during long-term follow-up. 展开更多
关键词 pseudoaneurysm formation Traumatic carotid-cavernous fistula Direct carotid-cavernous fistula Transarterial embolization Detachable balloon Endovascular treatment Computed tomography angiography Long-term follow-up
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Delayed Pseudoaneurysms of Vertebral Artery Post Penetrating Trauma: A Case Report
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作者 Ahmad Rezaee Azandariani Leili Ebrahimi Farsangi Mohammad Mahdi Talimkhani 《Case Reports in Clinical Medicine》 2024年第4期95-100,共6页
Objective: Vascular injuries usually present immediately after the penetration, but the delayed onset of vascular symptoms caused by vessel dissection or aneurysm after a traumatic event is extremely rare. Vertebral a... Objective: Vascular injuries usually present immediately after the penetration, but the delayed onset of vascular symptoms caused by vessel dissection or aneurysm after a traumatic event is extremely rare. Vertebral artery injury is a low-frequency but high-mortality injury. We aim to report evidence of delayed onset of vascular symptoms following penetrating trauma in the neck. Materials and Methods: A case report. Results: A 19-year-old boy was referred to our hospital and complained of a mass in the right part of his neck (right mandibular angle). He gave a history of penetrating trauma to his neck 2 months ago. The mass was expanding during these 2 months and doesn’t respond to antibiotic therapy. In the examination, 3 × 3 cm, firm, nonmobile, and without tenderness and pain mass was palpated in the second level of his neck. Doctors ordered a Doppler sonography in the hospital where a yin-yang pattern was reported. A 36 × 43 × 40 mm heterogeneous, solid, and hypodense area close to C1-C2-C3 with vascular flow was discovered in the right submandibular area after computed tomography (CT)-angiography. The patient was referred to an interventional neurologist for angiography and due to the lack of flow at the distal of the V3 segment, he decided to sacrifice this artery by two coils. Conclusion: Penetrating neck injuries are usually asymptomatic, but these injuries are often accompanied by hemorrhage, neurological symptoms, dysphagia, odynophagia, and windpipe. Penetrating lesions of the vertebral artery are rare and very difficult to diagnose. Also, these lesions are challenging for surgeons due to complex anatomy and difficult surgical exposure. So, endovascular treatment was used to treat the patient. 展开更多
关键词 Penetrating Trauma Delayed pseudoaneurysms Vertebral Artery
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Management of traumatic peripheral artery pseudoaneurysm:A 10-year experience at a single center 被引量:1
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作者 Yingliang Wang Hai Zheng +10 位作者 Wei Yao Shuguang Ju Yaowei Bai Chaoyang Wang Chen Zhou Jiacheng Liu Chongtu Yang Songjiang Huang Tongqiang Li Yang Chen Bin Xiong 《Journal of Interventional Medicine》 2023年第1期29-34,共6页
Purpose: This study aimed to report our 10-year experience with the management of iatrogenic(penetrating trauma) and traumatic(blunt or penetrating trauma) peripheral artery pseudoaneurysms, based on data from a terti... Purpose: This study aimed to report our 10-year experience with the management of iatrogenic(penetrating trauma) and traumatic(blunt or penetrating trauma) peripheral artery pseudoaneurysms, based on data from a tertiary referral center.Methods: From January 2012 to December 2021, the medical records of consecutive patients with iatrogenic and traumatic peripheral artery pseudoaneurysms were retrospectively reviewed. Patient demographics, clinical features, imaging data, treatment details, and follow-up results were analyzed.Results: Sixty-one consecutive patients were included in this study;48(79%) were men and 13(21%) women,with a mean age of 49.4 ± 13.4 years(range 24–73 years). There were 42 patients(69%) who underwent open surgery, 18(29%) undergoing endovascular embolization or stent implantation, and one(2%) undergoing ultrasound-guided thrombin injection. All patients successfully underwent open or interventional treatment. The median follow-up was 46.8 months(2.5–117.9 months), and the overall reintervention rate was 10%. Of these,one(5%) patient in the interventional treatment group and five(12%) patients in the open surgery group underwent reintervention. The overall complication rate was 8%, with complications occurring only in the open surgery group. No deaths occurred in the peri-operative period. No late complications, such as thrombosis or pseudoaneurysm recurrence, were observed.Conclusion: Peripheral artery pseudoaneurysms arising from iatrogenic or traumatic causes can be effectively treated by both open surgery and interventional procedures in selected patients with acceptable mid-and long-term outcomes. 展开更多
关键词 pseudoaneurysm TRAUMA Peripheral artery Interventional therapy STENT
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Cystic artery pseudoaneurysm:A case report
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作者 Yu-Ling Liu Cheng-Ta Hsieh +1 位作者 Yao-Jen Yeh Hsien Liu 《World Journal of Clinical Cases》 SCIE 2023年第1期242-248,共7页
BACKGROUND Cystic artery pseudoaneurysm is a condition rarely encountered by clinicians;this,its etiology and presentation as well as appropriate treatments are not well studied.Although it is treated by removal of th... BACKGROUND Cystic artery pseudoaneurysm is a condition rarely encountered by clinicians;this,its etiology and presentation as well as appropriate treatments are not well studied.Although it is treated by removal of the diseased gallbladder and cystic artery,such surgery can be difficult and risky if acute inflammation with bleeding occurs,and not every patient can tolerate the surgery.CASE SUMMARY An 81-year-old man complained of epigastric pain and tarry stool passage that lasted for 3 d.He had a medical history of poor cardiopulmonary function.The computed tomographic scan of abdomen showed cystic artery pseudoaneurysm and dilatation of gallbladder.Because of high adverse outcomes related to general anesthesia,the patient was successfully managed with endovascular embolization for this cystic artery pseudoaneurysm and percutaneous drainage for the distended gallbladder.CONCLUSION A patient with cystic artery pseudoaneurysm may quickly deteriorate with the occurrence of concurrent arterial bleeding and sepsis.This report presents the case of a patient who did not undergo surgery due to multiple cardiopulmonary comorbidities and whose condition was managed successfully with embolization and biliary drainage.Endovascular embolization and biliary drainage may provide an alternative option to manage this complicated condition. 展开更多
关键词 Cystic artery pseudoaneurysm Endovascular intervention EMBOLIZATION Biliary drainage Case report
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Efficacy of Willis covered stent of intracranial pseudoaneurysms in the internal carotid artery: A systematic review and meta-analysis
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作者 Li Lin Shao-Wei Xiang +8 位作者 Yan-Ling Sun Yuan Chen Zhe Wu Zhi-Feng Ning Ding-Wen Shen Xue-Qin Sima Qi-Qiang Wen Gui-Lai Wei Qing-Yong He 《Journal of Acute Disease》 2023年第5期173-178,共6页
Objective:To evaluate the efficacy of a novel coated stent in the treatment of intracranial pseudoaneurysm.Methods:MEDLINE,EMBASE,and PubMed databases were searched for literature published between 1990 and April 2022... Objective:To evaluate the efficacy of a novel coated stent in the treatment of intracranial pseudoaneurysm.Methods:MEDLINE,EMBASE,and PubMed databases were searched for literature published between 1990 and April 2022 according to PRISMA guidelines.All studies with≥10 patients reporting successful implantation of Willis covered stent,therapeutic effect,complications,and postoperative follow-up were included.The combined incidence and corresponding 95%confidence intervals were assessed using a generalized linear mixed method and random effects model.Results:Five studies(116 patients with pseudoaneurysms)were included.The experimental groups in the selected studies showed a combined technical success rate of 81.03%(OR=18.31,95%CI=9.39-35.69,I^(2)=79%,P<0.001).Clinical follow-up showed that the complete cure rate was as high as 94.4%after the follow-up(OR=106.81,95%CI=39.08-291.88,I^(2)=0%,P=0.71).Conclusions:Willis covered stent is feasible,safe,and effective in the treatment of intracranial pseudoaneurysm. 展开更多
关键词 Intracranial pseudoaneurysms Willis covered stent Systematic review META-ANALYSIS Internal carotid artery ENDOLEAK NEUROSURGERY
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Pancreatic pseudoaneurysm mimicking pancreatic tumor: A casereport and review of literature
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作者 Yuan Yang Xue-Mei Liu +3 位作者 Hong-Ping Li Rui Xie Bi-Guang Tuo Hui-Chao Wu 《World Journal of Gastrointestinal Oncology》 SCIE 2023年第11期2041-2048,共8页
BACKGROUND Pancreatic pseudoaneurysm is a rare vascular complication of chronic pancreatitis(CP)or necrotizing pancreatitis with an incidence of 4%to 17%,but it is potentially life-threatening.It is well known that mo... BACKGROUND Pancreatic pseudoaneurysm is a rare vascular complication of chronic pancreatitis(CP)or necrotizing pancreatitis with an incidence of 4%to 17%,but it is potentially life-threatening.It is well known that most pancreatic pseudoaneurysms are clinically associated with pancreatic pseudocysts and are usually in the peripancreatic body-tail.A minority of intrapancreatic pseudoaneurysms occur in the absence of pseudocyst formation.Noninvasive computed tomography(CT)and magnetic resonance imaging(MRI)are most commonly used examinations for screening pancreatic pseudoaneurysms.Notably,the rare intrapancreatic pseudoaneurysm in the pancreatic head can mimic a hypervascular solid mass and be misdiagnosed as a pancreatic tumor.CASE SUMMARY We report the case of a 67-year-old man who had been admitted to our hospital due to recurrent abdominal pain for 1 mo that was aggravated for 5 d.CT and MRI revealed a mass in the pancreatic head with significant expansion of the main pancreatic duct and mild atrophy of the pancreatic body-tail.He was admitted to the department of hepatobiliary and pancreatic surgery due to the possibility of a pancreatic tumor.The patient was then referred for endoscopic ultrasonography(EUS)with possible EUS-FNA.However,EUS showed a cystic lesion in the pancreatic head with wall thickness and enhancing nodules,which was doubtful because it was inconsistent with the imaging findings.Subsequently,color doppler flow imaging demonstrated turbulent arterial blood flow in the cystic lesion and connection with the surrounding vessel.Therefore,we highly suspected the possibility of CP complicated with intrapancreatic pseudoaneurysm,combined with the patient's long-term drinking history and the sonographic features of CP.Indeed,angiography revealed an oval area of contrast medium extravasation(size:1.0 cm×1.5 cm)at the far-end branch of the superior pancreaticoduodenal artery,and angiographic embolization was given immediately at the same time.CONCLUSION EUS is an important differential diagnostic tool when pancreatic pseudoaneurysm mimics the imaging appearance of a hypervascular pancreatic tumor. 展开更多
关键词 Pancreatic pseudoaneurysm Chronic pancreatitis Pancreaticoduodenal artery Endoscopic ultrasonography Case report
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Left hepatic artery pseudoaneurysm complicating endoscopic retrograde cholangiopancreatography:A case report
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作者 Qiao-Mei Li Bin Ye +1 位作者 Shang-Wen Yang Huan Zhao 《World Journal of Clinical Cases》 SCIE 2023年第24期5835-5839,共5页
BACKGROUND Pseudoaneurysms of the hepatic artery or its branches have been reported following abdominal trauma,iatrogenic injury at the time of many operations such as percutaneous transhepatic biliary drainage and ch... BACKGROUND Pseudoaneurysms of the hepatic artery or its branches have been reported following abdominal trauma,iatrogenic injury at the time of many operations such as percutaneous transhepatic biliary drainage and cholecystectomy.Hepatic artery pseudoaneurysms after endoscopic retrograde cholangiopancreatography(ERCP)are uncommon and potentially life threatening and should be identified and treated rapidly.CASE SUMMARY We report a case of intra-abdominal hemorrhage secondary to a left hepatic artery pseudoaneurysm resulting from guide wire injury at ERCP.The patient primary diagnosis was acute biliary pancreatitis with cholangitis,he underwent ERCP on the third day of admission.During ERCP,the left intrahepatic bile duct was cannulated three times.Over the sixth day,Contrast enhanced computed tomography scan demonstrated left hepatic lobe contusion and a pseudoaneurysm formation.The patient was successfully treated with the embolization of a small branch of left hepatic artery angiographically.CONCLUSION The common complications of ERCP are pancreatitis,bleeding and perforation.False aneurysms occur as a result of damage to the wall of an artery.As far as we know,it is rare complication has been reported following ERCP.We advise urgent referral for angiographic embolization in this situation to avoid aneurysm rupture. 展开更多
关键词 Endoscopic retrograde cholangiopancreatography ERCP complication pseudoaneurysm ANGIOEMBOLIZATION Case report
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Massive bleeding from a gastric artery pseudoaneurysm in hepatocellular carcinoma treated with atezolizumab plus bevacizumab: A case report
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作者 Fu-Wen Pang Bin Chen +5 位作者 De-Ti Peng Jian He Wei-Cheng Zhao Tuan-Tuan Chen Zong-Gui Xie Hai-Hui Deng 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第6期1232-1239,共8页
BACKGROUND The combination of atezolizumab(ATZ)and bevacizumab(BVZ)was approved as first-line systemic therapy for advanced hepatocellular carcinoma(HCC)owing to its superior rates of response and patient survival.How... BACKGROUND The combination of atezolizumab(ATZ)and bevacizumab(BVZ)was approved as first-line systemic therapy for advanced hepatocellular carcinoma(HCC)owing to its superior rates of response and patient survival.However,ATZ+BVZ is associated with increased risk of upper gastrointestinal(GI)bleeding,including arterial bleeding,which is rare and potentially fatal.We present a case of massive upper GI bleeding from a gastric pseudoaneurysm in a patient with advanced HCC who had been treated with ATZ+BVZ.CASE SUMMARY A 67-year-old man presented with severe upper GI bleeding after atezolizumab(ATZ)+bevacizumab(BVZ)therapy for HCC.Endoscopy failed to detect the bleeding site.Digital subtraction angiography revealed a gastric artery pseudoaneurysm and contrast extravasation from the inferior splenic artery and a branch of the left gastric artery.Successful hemostasis was achieved with embolization.CONCLUSION HCC patients who have been treated with ATZ+BVZ should be followed for 3 to 6 mo to monitor for development of massive GI bleeding.Diagnosis may require angiography.Embolization is an effective treatment. 展开更多
关键词 Atezolizumab BEVACIZUMAB Hepatocellular carcinoma Gastric artery pseudoaneurysm Gastrointestinal bleeding Case report
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Case Report of a Pseudoaneurysm of Ascending Aorta Treated by Stent
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作者 Mohammed Malik Bennani Mohamed Reda Barchiche Louis Chebli 《Open Journal of Clinical Diagnostics》 2023年第3期62-67,共6页
Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of asc... Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of ascending aorta that was treated by an endovascular stent-graft. We discuss in this article the diagnostic and therapeutic aspect of the case and the place of endovascular treatment for the ascending aorta. 展开更多
关键词 pseudoaneurysm Ascending Aorta Bentley Stent-Graft Endovascular Treat
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血管内治疗鼻咽癌放疗后颈内动脉假性动脉瘤破裂出血
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作者 申权 郑曲彬 +2 位作者 谢杭 池桢 黄宁 《介入放射学杂志》 CSCD 北大核心 2024年第3期304-308,共5页
目的探讨鼻咽癌放疗后颈内动脉假性动脉瘤破裂出血的血管内治疗方式、疗效及安全性。方法 回顾性分析福建医科大学附属协和医院收治的21例鼻咽癌放疗后颈内动脉假性动脉瘤破裂出血患者的临床资料,其中8例行覆膜支架植入,6例行支架辅助... 目的探讨鼻咽癌放疗后颈内动脉假性动脉瘤破裂出血的血管内治疗方式、疗效及安全性。方法 回顾性分析福建医科大学附属协和医院收治的21例鼻咽癌放疗后颈内动脉假性动脉瘤破裂出血患者的临床资料,其中8例行覆膜支架植入,6例行支架辅助弹簧圈栓塞,7例直接行载瘤动脉闭塞治疗。分析手术策略、治疗结果以及临床与影像学随访结果。结果 21例患者均成功接受血管内治疗。术后即刻止血效果均良好,瘤颈残留2例,瘤体残留1例。术后出血复发5例,其中4例再次行载瘤动脉闭塞后出血停止,1例为覆膜支架植入后发生内漏,予球囊扩张后血止,但1个月后不明原因死亡;1例覆膜支架植入术后出现昏迷,CT示蛛网膜下腔出血、脑肿胀,治疗后未好转自动出院;3例在随访中发现颈内动脉闭塞;2例术后未随访。随访的19例患者中mRS评分0分9例,1分6例,2分2例,5分1例,6分1例。结论 针对鼻咽癌放疗后颈内动脉假性动脉瘤破裂出血,血管内治疗效果确切,安全性较高。覆膜支架短期疗效好,但也存在着动脉瘤复发、内漏等问题,载瘤动脉闭塞可能远期疗效更可靠。 展开更多
关键词 鼻咽癌 放疗 颈内动脉假性动脉瘤 血管内治疗
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基于流固耦合的吻合口处假性动脉瘤机理分析
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作者 王连才 孙鹏 +2 位作者 白华龙 郭攀 张景飞 《中国医学物理学杂志》 CSCD 2024年第9期1170-1176,共7页
目的:探究血管补片吻合口处假性动脉瘤产生以及转化生长因子(TGFβ1)水凝胶对动脉瘤抑制作用的生物力学机理。方法:分别构建血管补片模型及假性动脉瘤模型,采用双向流固耦合方法对吻合口处血液-血管壁动力学响应问题进行数值模拟,基于... 目的:探究血管补片吻合口处假性动脉瘤产生以及转化生长因子(TGFβ1)水凝胶对动脉瘤抑制作用的生物力学机理。方法:分别构建血管补片模型及假性动脉瘤模型,采用双向流固耦合方法对吻合口处血液-血管壁动力学响应问题进行数值模拟,基于术后血液速度、血管壁面剪切应力及瘤壁位移等力学参数特征进行分析,研究术后假性动脉瘤产生及抑制机理。结果:数值模拟结果显示,血液流经补片前端时,壁面剪切应力增加,在术后且已形成假性动脉瘤时,动脉瘤壁内注射TGFβ1水凝胶后动脉瘤壁明显变厚,瘤内剪切应力降低,瘤壁位移减小。结论:术后吻合口前端极易形成假性动脉瘤,而在动脉瘤壁内注射TGFβ1水凝胶可有效抑制假性动脉瘤的形成和发展。本文数值模拟研究为补片术后假性动脉瘤产生、发展力学机理研究提供数值依据。 展开更多
关键词 假性动脉瘤 吻合口 TGFβ1水凝胶 数值模拟
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子宫假性动脉瘤误诊分析
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作者 王茜 王莉 +1 位作者 玄英华 孙丽娟 《北京医学》 CAS 2024年第6期457-460,465,共5页
目的 探讨子宫假性动脉瘤(uterine artery pseudoaneurysm, UAP)超声特征并分析误诊原因。方法 回顾性选取2016年1月至2023年4月首都医科大学附属北京妇产医院UAP患者35例,收集其超声图像及临床资料,分析其误诊原因。结果 UAP灰阶超声... 目的 探讨子宫假性动脉瘤(uterine artery pseudoaneurysm, UAP)超声特征并分析误诊原因。方法 回顾性选取2016年1月至2023年4月首都医科大学附属北京妇产医院UAP患者35例,收集其超声图像及临床资料,分析其误诊原因。结果 UAP灰阶超声呈肌层或同时累及宫腔及肌层的含有液性无回声区团块状病变,彩色多普勒超声可见一条或多条载瘤动脉血流射入假腔,频谱多普勒超声呈高速低阻血流;部分可伴发动静脉瘘(uterine arteriovenous fistula,UAVF),表现为与子宫静脉同方向的粗大血流,频谱呈与心动周期一致的搏动性频谱。UAP误诊率为71.4%(25/35),被误诊的疾病包括与滋养细胞相关疾病的富血供征象(12例)、UAVF(9例)、滋养细胞疾病(3例)、胚物残留(1例)。结论减少UAP误诊首先需提高对该病的认识,超声检查过程中要注意调节仪器的条件设置以获得更佳图像帮助诊断。 展开更多
关键词 子宫假性动脉瘤 血管损伤 超声诊断 误诊
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经皮肾镜取石术后出血的介入治疗
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作者 翟成喜 李秋云 +2 位作者 王彬 杨亚平 陈戬 《云南医药》 CAS 2024年第4期32-36,共5页
目的研究PCNL术后出血患者接受选择性RAE治疗的效果及失败原因。方法对2015年4月-2023年5月期间本院20例PCNL术后出血患者以及外院转入的3例患者进行回顾性分析。结果DSA显示:PA 3人,AVF 6人,PA合并AVF 3人,动脉分支损伤8人,未见异常3... 目的研究PCNL术后出血患者接受选择性RAE治疗的效果及失败原因。方法对2015年4月-2023年5月期间本院20例PCNL术后出血患者以及外院转入的3例患者进行回顾性分析。结果DSA显示:PA 3人,AVF 6人,PA合并AVF 3人,动脉分支损伤8人,未见异常3人。所有23例PCNL术后出血患者行RAE治疗。其中,21例患者第一次RAE后成功止血,1例第一次RAE后再发出血行二次RAE成功,1例栓塞失败急诊行肾动脉分支结扎术止血成功。所有患者随访1月未发生再次出血。结论选择性RAE是治疗PCNL术后出血有效、安全的治疗方法,能最大程度保留患者肾功能。同时,治疗效果也与介入医师的操作技术密切相关。 展开更多
关键词 经皮肾镜取石术 选择性肾动脉栓塞 出血 假性动脉瘤 动静脉瘘
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内瘘专项护理小组在动静脉内瘘假性动脉瘤患者中的作用
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作者 田远如 孙晓敏 魏亚琼 《国际医药卫生导报》 2024年第2期328-332,共5页
目的探究内瘘专项小组护理在动静脉内瘘假性动脉瘤患者中的应用效果。方法本文为随机对照试验,选择2020年1月至2022年12月在连云港市中医院收取的60例动静脉内瘘假性动脉瘤患者作为研究对象,按照随机分组法将其分为对照组和观察组,每组3... 目的探究内瘘专项小组护理在动静脉内瘘假性动脉瘤患者中的应用效果。方法本文为随机对照试验,选择2020年1月至2022年12月在连云港市中医院收取的60例动静脉内瘘假性动脉瘤患者作为研究对象,按照随机分组法将其分为对照组和观察组,每组30例。对照组男22例,女8例,年龄(48.52±10.21)岁;观察组男21例,女9例,年龄(49.15±10.16)岁。对照组采用常规内瘘护理,观察组在前者基础上增加内瘘专项小组护理。比较两组患者干预后假性动脉瘤手术率、瘤体大小、瘤体数量、相关并发症发生率。采用独立样本t检验和χ^(2)检验。结果干预后,观察组患者假性动脉瘤瘤体的大小(2.38±0.72)cm,小于对照组(2.86±0.87)cm,差异有统计学意义(t=2.328,P=0.023);观察组患者假性动脉瘤瘤体数量(1.07±0.58)个,少于对照组(1.40±0.61)个,差异有统计学意义(t=2.147,P=0.036);两组患者之间的假性动脉瘤手术率比较,差异无统计学意义(P>0.05);观察组患者假性动脉瘤相关并发症发生率10.00%(3/30),低于对照组33.33%(10/30),差异有统计学意义(χ^(2)=4.812,P=0.028)。结论面对患有动静脉内瘘假性动脉瘤患者采取内瘘专项小组护理措施,能降低假性动脉瘤的并发症发生率,同时可在一定程度上改善患者假性动脉瘤预后情况,值得临床大力推广采纳。 展开更多
关键词 动静脉内瘘 假性动脉瘤 内瘘专项小组护理 并发症发生率
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肾移植术后血管并发症的诊疗策略 被引量:1
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作者 张江伟 丁小明 《器官移植》 CSCD 北大核心 2024年第1期1-9,共9页
随着肾移植供受者评估标准、器官获取保存方案、手术技术等不断进步,肾移植术后血管并发症的发生率有所下降,但仍是肾移植较为严重的手术并发症之一,可导致移植物丢失及受者死亡,严重影响肾移植效果。因此,本文就肾移植术后常见血管并发... 随着肾移植供受者评估标准、器官获取保存方案、手术技术等不断进步,肾移植术后血管并发症的发生率有所下降,但仍是肾移植较为严重的手术并发症之一,可导致移植物丢失及受者死亡,严重影响肾移植效果。因此,本文就肾移植术后常见血管并发症,包括血管狭窄、动脉夹层、假性动脉瘤、血管破裂、血栓等的发生概况、临床表现、诊断和治疗策略进行综述,并结合西安交通大学第一附属医院肾移植术后血管并发症发生和诊治情况,总结肾移植术后常见血管并发症的诊疗策略,以期为肾移植术后血管并发症的临床诊断和治疗提供参考,降低血管并发症的发生率,提高肾移植疗效和受者生存率。 展开更多
关键词 肾移植 血管并发症 血管狭窄 动脉夹层 假性动脉瘤 血栓 供者来源性感染 数字减影血管造影(DSA) 经皮腔内血管成形术
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