Traumatic intracranial pseudoaneurysms （TIPA） are rare and pseudoaneurysm of P3 segment of the posterior cerebral artery （PCA） is extremely rarely reported. A 27-year-old man suffered from blunt head injury and un...Traumatic intracranial pseudoaneurysms （TIPA） are rare and pseudoaneurysm of P3 segment of the posterior cerebral artery （PCA） is extremely rarely reported. A 27-year-old man suffered from blunt head injury and underwent diagnostic procedure with head CT scans, cerebral CT angiograms （CTA） and digital subtraction angiograms （DSA）. An abnormal high-density lesion was detected at the left side of quadrigeminal cistern and a pseudoaneurysm showed at the P3 segment of PCA. The pseudoaneurysm was successfully treated with parent artery occlusion （PAO）. Making an exact preoperative diagnosis of traumatic intracranial pseudoaneurysms is of great importance. Endovascular techniques allow a safe approach to complex intracranial lesion, so endovascular management of PCA pseudoaneurysms becomes safe and effective. However, the pseudoaneurysm may not be amenable to coil placement under some conditions, thus, occlusion of the parent vessel may be a preferable treatment.展开更多
Objective: To evaluate the long-term effect of endovascular occlusion with microcoils on traumatic pseudoaneurysms (TPAs) in the common carotid artery in rabbits.Methods: TPAs in the right common carotid artery were s...Objective: To evaluate the long-term effect of endovascular occlusion with microcoils on traumatic pseudoaneurysms (TPAs) in the common carotid artery in rabbits.Methods: TPAs in the right common carotid artery were surgically made in 16 rabbits. At 3-4 weeks after operation, the survived 12 models were randomly divided into a control group (n=3) with no treatment and an experimental group (n=9), in which TPAs were intraluminally embolized with microcoils and corresponding therapy was given. Three months after embolization, the TPAs were examined with digital subtraction angiography and pathology. Results: The 3 rabbits in the control group all died of rupture of TPA. Among the 9 TPAs occluded with microcoils, 4 were completely occluded, 4 were partially occluded, and 1 was excluded due to the microcoils migrating into the parent artery. Three months after embolization, the 4 TPAs which were completely occluded remained obliterated as determined by digital subtraction angiographic findings. The parent artery remained unobstructed and the structure of the TPAs were replaced by a mass of scar tissues. The 4 TPAs which were partially occluded remained unruptured and the microcoils were compressed.Conclusions: The lumen in TPA can be completely occluded by microcoils and the parent artery is unblocked. Partial occlusion of the lumen can also prevent the rupture of TPA.展开更多
Objective：To summarize our experience in surgical treatment of traumatic lower limb pseudoaneurysm.Methods：Twenty patients with traumatic lower limb pseudoaneurysm were surgically treated in our department from Janu...Objective：To summarize our experience in surgical treatment of traumatic lower limb pseudoaneurysm.Methods：Twenty patients with traumatic lower limb pseudoaneurysm were surgically treated in our department from January 2007 to January 2012.The treatment protocols included interventional covered-stent placement （10 cases）,spring coil embolization （2 cases）,and surgical operation （8 cases）.Surgical operations included pseudoaneurysm repair （2 cases）,autologousvein transplantation （1 case）,and artificial-vessel bypass graft （5 cases）.Results：All the patients were successfully treated without aggravating lower limb ischemia.Pseudoaneurysm disappeared after treatment.A surgical operation is suitable to most pseudoaneurysms,but its damage is relatively obvious and usually leads to more bleeding.It also requires a longer operating time.Compared to a surgical operation,interventional therapy is less traumatic and patients usually have a quicker recovery （P＜0.05）.All patients were followed up once per month for 12-36 months by color Doppler ultrasound examination.There were no cases of pseudoaneurysm recurrence.Conclusion：Both surgical operation and interventional therapy are safe and effective in the treatment of pseudoaneurysm.展开更多
Objective: To report the experience in the diagnosis and treatment of post traumatic pseudoaneurysms and arteriovenous fistulas. Methods: A series of 30 patients (11 women and 19 men) with posttraumatic pseudoaneurysm...Objective: To report the experience in the diagnosis and treatment of post traumatic pseudoaneurysms and arteriovenous fistulas. Methods: A series of 30 patients (11 women and 19 men) with posttraumatic pseudoaneurysms were reviewed retrospectively. Among them 7 patients (5 women and 2 men) were associated with arteriovenous fistula. Results: The causes included sharp penetrating trauma (18 cases), blunt trauma (6 cases) and iatrogenic arterial injury (6 cases). The main clinical manifestations consisted of local pulsatile mass (26 cases), vascular bruits (19 cases), thrill (13 cases), ischemia of distal limb (9 cases), neuropathy (5 cases) and pseudoaneurysm rupture (2 cases). All patients underwent surgery. The operations included: ligation of the vessels (12 cases), surgical resection and primary suture repair of the vascular defect or anastomosis (11 cases), vascular reconstruction with autogenous saphenous vein (3 cases) and synthetic vascular graft (4 cases). Conclusions: Because of the imminent clinical course, early operation is usually indicated. The operative treatment is effective and safe for most of the patients with post traumatic pseudoaneurysms and arteriovenous fistulas.展开更多
Gastrointestinal bleeding due to aortoenteric fistula is extremely rare.Aortoenteric fistula is difficult to be diagnosed timely and entails a significant morbidity and mortality.Herein,we present an uncommon case of ...Gastrointestinal bleeding due to aortoenteric fistula is extremely rare.Aortoenteric fistula is difficult to be diagnosed timely and entails a significant morbidity and mortality.Herein,we present an uncommon case of gastrointestinal bleeding caused by aortoduodenal fistula,which was a complication of a successful aortic reconstruction 4 months ago for an aortic pseudoaneurysm resulted from a stab wound 12 years ago.An urgent laparotomy confirmed an aortoduodenal fistula and repaired the defects in aorta and duodenum,but a prolonged shock led to the patient's death.In summary,early diagnosis and surgical intervention for aortoenteric fistula are vital for survival.展开更多
文摘Traumatic intracranial pseudoaneurysms （TIPA） are rare and pseudoaneurysm of P3 segment of the posterior cerebral artery （PCA） is extremely rarely reported. A 27-year-old man suffered from blunt head injury and underwent diagnostic procedure with head CT scans, cerebral CT angiograms （CTA） and digital subtraction angiograms （DSA）. An abnormal high-density lesion was detected at the left side of quadrigeminal cistern and a pseudoaneurysm showed at the P3 segment of PCA. The pseudoaneurysm was successfully treated with parent artery occlusion （PAO）. Making an exact preoperative diagnosis of traumatic intracranial pseudoaneurysms is of great importance. Endovascular techniques allow a safe approach to complex intracranial lesion, so endovascular management of PCA pseudoaneurysms becomes safe and effective. However, the pseudoaneurysm may not be amenable to coil placement under some conditions, thus, occlusion of the parent vessel may be a preferable treatment.
文摘Objective: To evaluate the long-term effect of endovascular occlusion with microcoils on traumatic pseudoaneurysms (TPAs) in the common carotid artery in rabbits.Methods: TPAs in the right common carotid artery were surgically made in 16 rabbits. At 3-4 weeks after operation, the survived 12 models were randomly divided into a control group (n=3) with no treatment and an experimental group (n=9), in which TPAs were intraluminally embolized with microcoils and corresponding therapy was given. Three months after embolization, the TPAs were examined with digital subtraction angiography and pathology. Results: The 3 rabbits in the control group all died of rupture of TPA. Among the 9 TPAs occluded with microcoils, 4 were completely occluded, 4 were partially occluded, and 1 was excluded due to the microcoils migrating into the parent artery. Three months after embolization, the 4 TPAs which were completely occluded remained obliterated as determined by digital subtraction angiographic findings. The parent artery remained unobstructed and the structure of the TPAs were replaced by a mass of scar tissues. The 4 TPAs which were partially occluded remained unruptured and the microcoils were compressed.Conclusions: The lumen in TPA can be completely occluded by microcoils and the parent artery is unblocked. Partial occlusion of the lumen can also prevent the rupture of TPA.
文摘Objective：To summarize our experience in surgical treatment of traumatic lower limb pseudoaneurysm.Methods：Twenty patients with traumatic lower limb pseudoaneurysm were surgically treated in our department from January 2007 to January 2012.The treatment protocols included interventional covered-stent placement （10 cases）,spring coil embolization （2 cases）,and surgical operation （8 cases）.Surgical operations included pseudoaneurysm repair （2 cases）,autologousvein transplantation （1 case）,and artificial-vessel bypass graft （5 cases）.Results：All the patients were successfully treated without aggravating lower limb ischemia.Pseudoaneurysm disappeared after treatment.A surgical operation is suitable to most pseudoaneurysms,but its damage is relatively obvious and usually leads to more bleeding.It also requires a longer operating time.Compared to a surgical operation,interventional therapy is less traumatic and patients usually have a quicker recovery （P＜0.05）.All patients were followed up once per month for 12-36 months by color Doppler ultrasound examination.There were no cases of pseudoaneurysm recurrence.Conclusion：Both surgical operation and interventional therapy are safe and effective in the treatment of pseudoaneurysm.
文摘Objective: To report the experience in the diagnosis and treatment of post traumatic pseudoaneurysms and arteriovenous fistulas. Methods: A series of 30 patients (11 women and 19 men) with posttraumatic pseudoaneurysms were reviewed retrospectively. Among them 7 patients (5 women and 2 men) were associated with arteriovenous fistula. Results: The causes included sharp penetrating trauma (18 cases), blunt trauma (6 cases) and iatrogenic arterial injury (6 cases). The main clinical manifestations consisted of local pulsatile mass (26 cases), vascular bruits (19 cases), thrill (13 cases), ischemia of distal limb (9 cases), neuropathy (5 cases) and pseudoaneurysm rupture (2 cases). All patients underwent surgery. The operations included: ligation of the vessels (12 cases), surgical resection and primary suture repair of the vascular defect or anastomosis (11 cases), vascular reconstruction with autogenous saphenous vein (3 cases) and synthetic vascular graft (4 cases). Conclusions: Because of the imminent clinical course, early operation is usually indicated. The operative treatment is effective and safe for most of the patients with post traumatic pseudoaneurysms and arteriovenous fistulas.
文摘Gastrointestinal bleeding due to aortoenteric fistula is extremely rare.Aortoenteric fistula is difficult to be diagnosed timely and entails a significant morbidity and mortality.Herein,we present an uncommon case of gastrointestinal bleeding caused by aortoduodenal fistula,which was a complication of a successful aortic reconstruction 4 months ago for an aortic pseudoaneurysm resulted from a stab wound 12 years ago.An urgent laparotomy confirmed an aortoduodenal fistula and repaired the defects in aorta and duodenum,but a prolonged shock led to the patient's death.In summary,early diagnosis and surgical intervention for aortoenteric fistula are vital for survival.
