BACKGROUND Transplant renal artery stenosis is a relatively frequent vascular complication after transplantation.However,extra-renal pseudo-aneurysms(EPSAs)are rare after transplantation;they can be life-threatening a...BACKGROUND Transplant renal artery stenosis is a relatively frequent vascular complication after transplantation.However,extra-renal pseudo-aneurysms(EPSAs)are rare after transplantation;they can be life-threatening and usually need open surgical repair.We discuss the diagnosis and spontaneous healing of an asymptomatic renal allograft EPSA caused by renal artery anastomotic stenosis,which was diagnosed in a timely manner and managed by conservative treatments.CASE SUMMARY We present a 37-year-old male patient diagnosed with a renal allograft EPSA caused by renal artery anastomotic stenosis due to multiple atherosclerotic plaques with ultrasonographic examination 6 mo post transplantation.The stenosis rate of 90%and the EPSA were verified by computed tomography angiography.The diagnosis was further confirmed with digital subtraction angiography.Percutaneous transluminal angiography was conducted,and a metallic stent was successfully implanted at the stenosed site of the main renal artery trunk.No further intervention for the EPSA was undertaken due to the difficulty of stenting and the risk of bleeding;regular ultrasonographic follow-ups were recommended.The stenosis was significantly relieved immediately after stent implantation and the EPSA was healed spontaneously by completely filling with hypo-echoic thrombosis 8 mo after stenting.CONCLUSION Ultrasonography combined with a high-frequency linear probe can detect vascular complications post renal transplantation at an early stage and improve prognosis.展开更多
<strong>Introduction:</strong> A case of lumbar artery pseudo-aneurysm after surgery for lumbar vertebra burst fracture is presented. Only two cases secondary to spinal trauma and revealed after surgery ha...<strong>Introduction:</strong> A case of lumbar artery pseudo-aneurysm after surgery for lumbar vertebra burst fracture is presented. Only two cases secondary to spinal trauma and revealed after surgery have been described in the literature. A review of literature was conducted and a possible relationship with burst fracture or reduction maneuvers was discussed. <strong>Case Presentation:</strong> Here, we report a post traumatic lumbar burst facture with incomplete motor deficit of lower limbs after a fall. Surgical reduction and stabilization via posterior approach were performed. Post-operatively, a hemorrhage through surgical wound had been noticed. Pseudo-aneurysm of the lumbar artery at L3 level was diagnosed and embolisation was performed. <strong>Conclusion:</strong> This is a rare case of pseudo-aneurysm occurring in the setting of surgical stabilisation after a trauma. It was revealed by a hemorrhage discovered as a late complication. We should be aware of such potential complication as a delayed post surgery event in order to adapt the care.展开更多
Traumatic carotid-cavemous fistula （CCF） is an abnormal passageway between the intracavemous carotid artery and the cavernous sinus after a head injury. Most CCFs have direct high flow. Clinical presentations primar...Traumatic carotid-cavemous fistula （CCF） is an abnormal passageway between the intracavemous carotid artery and the cavernous sinus after a head injury. Most CCFs have direct high flow. Clinical presentations primarily depend on the pressure inside the cavernous sinus and on the direction of the venous drainage. The ideal goal for the treatment of direct CCF is the obliteration of the fistula while preserving the internal carotid artery （ICA）. Transarterial embolization of direct CCF with detachable balloons has been proven to be the best option for an initial treatment, although transarterial embolization by detachable balloons is frequently associated with pseudo-aneurysm formation. Many treatment options such as coiling, stent-assisted coiling, and covered stent have been proposed to treat pseudo-aneurysm. However, the best management for a pseudo-aneurysm occurring after an embolization of a CCF with detachable balloons remains unknown. In this article, we will report our successful attempt in treating the said pseudo-aneurysm. We initially dealt with a pseudo-aneurysm occurring after an embolization of a CCF with stent-assisted coiling; then, the pseudoaneurysm recanalized, and eventually a covered stent was placed for the recanalized pseudoaneurysm.展开更多
基金the Funding from Beijing Municipal Administration of Hospitals’Ascent Plan,No.DFL 20180102and the Capital's Funds for Health Improvement and Research,No.2020-4-20211.
文摘BACKGROUND Transplant renal artery stenosis is a relatively frequent vascular complication after transplantation.However,extra-renal pseudo-aneurysms(EPSAs)are rare after transplantation;they can be life-threatening and usually need open surgical repair.We discuss the diagnosis and spontaneous healing of an asymptomatic renal allograft EPSA caused by renal artery anastomotic stenosis,which was diagnosed in a timely manner and managed by conservative treatments.CASE SUMMARY We present a 37-year-old male patient diagnosed with a renal allograft EPSA caused by renal artery anastomotic stenosis due to multiple atherosclerotic plaques with ultrasonographic examination 6 mo post transplantation.The stenosis rate of 90%and the EPSA were verified by computed tomography angiography.The diagnosis was further confirmed with digital subtraction angiography.Percutaneous transluminal angiography was conducted,and a metallic stent was successfully implanted at the stenosed site of the main renal artery trunk.No further intervention for the EPSA was undertaken due to the difficulty of stenting and the risk of bleeding;regular ultrasonographic follow-ups were recommended.The stenosis was significantly relieved immediately after stent implantation and the EPSA was healed spontaneously by completely filling with hypo-echoic thrombosis 8 mo after stenting.CONCLUSION Ultrasonography combined with a high-frequency linear probe can detect vascular complications post renal transplantation at an early stage and improve prognosis.
文摘<strong>Introduction:</strong> A case of lumbar artery pseudo-aneurysm after surgery for lumbar vertebra burst fracture is presented. Only two cases secondary to spinal trauma and revealed after surgery have been described in the literature. A review of literature was conducted and a possible relationship with burst fracture or reduction maneuvers was discussed. <strong>Case Presentation:</strong> Here, we report a post traumatic lumbar burst facture with incomplete motor deficit of lower limbs after a fall. Surgical reduction and stabilization via posterior approach were performed. Post-operatively, a hemorrhage through surgical wound had been noticed. Pseudo-aneurysm of the lumbar artery at L3 level was diagnosed and embolisation was performed. <strong>Conclusion:</strong> This is a rare case of pseudo-aneurysm occurring in the setting of surgical stabilisation after a trauma. It was revealed by a hemorrhage discovered as a late complication. We should be aware of such potential complication as a delayed post surgery event in order to adapt the care.
文摘Traumatic carotid-cavemous fistula （CCF） is an abnormal passageway between the intracavemous carotid artery and the cavernous sinus after a head injury. Most CCFs have direct high flow. Clinical presentations primarily depend on the pressure inside the cavernous sinus and on the direction of the venous drainage. The ideal goal for the treatment of direct CCF is the obliteration of the fistula while preserving the internal carotid artery （ICA）. Transarterial embolization of direct CCF with detachable balloons has been proven to be the best option for an initial treatment, although transarterial embolization by detachable balloons is frequently associated with pseudo-aneurysm formation. Many treatment options such as coiling, stent-assisted coiling, and covered stent have been proposed to treat pseudo-aneurysm. However, the best management for a pseudo-aneurysm occurring after an embolization of a CCF with detachable balloons remains unknown. In this article, we will report our successful attempt in treating the said pseudo-aneurysm. We initially dealt with a pseudo-aneurysm occurring after an embolization of a CCF with stent-assisted coiling; then, the pseudoaneurysm recanalized, and eventually a covered stent was placed for the recanalized pseudoaneurysm.
