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Iatrogenic superficial external pudendal artery pseudoaneurysm: Treatment with doppler us-guided compression

机译:医源性浅部外阴部动脉假性动脉瘤:多普勒超声引导下加压治疗

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摘要

Pseudoaneurysms rarely occur as a serious complication following incomplete hemostasis of an arterial puncture site. As a result of the increase in diagnostic and therapeutic angiography, the frequency of iatrogenic pseudoaneurysm has increased as well. Iatrogenic pseudoaneurysms associated with angiographic catheterization occur most commonly in the common femoral artery. Here we report a case of iatrogenic superficial external pudendal artery (SEPA) pseudoaneurysm following cardiac catheterization, which was diagnosed with Doppler ultrasound (US) and multidetector computed tomographic angiography (MDCTA) before Doppler US-guided compression therapy. To the best of our knowledge, iatrogenic SEPA pseudoaneurysm, which is an unusual vessel location for pseudoaneurysm occurrence, has not been reported in the literature. In patients in whom anticoagulant-thrombolytic therapy or therapeutic catheterization with larger sized sheath is planned, determination of the precise localization of arterial puncture site is important for the prevention of iatrogenic pseudoaneurysm development. Arterial puncture guided with Doppler US might reduce complications. When suspected, MDCTA is useful in the diagnosis and demonstration of iatrogenic pseudoaneurysms. Treatment of US-guided compression should be the first choice for iatrogenic pseudoaneurysms. Interventional radiologists and cardiologists should have enough experience about the catheterization complications and their treatment in order to decrease the morbidity and mortality related to the intervention.
机译:在动脉穿刺部位止血不完全后,假性动脉瘤很少作为严重并发症发生。由于诊断和治疗性血管造影术的增加,医源性假性动脉瘤的频率也增加了。与血管造影术相关的医源性假性动脉瘤最常见于股总动脉。在这里,我们报告一例心导管插入后的医源性浅部外阴动脉(SEPA)假性动脉瘤,在多普勒超声引导下的加压治疗之前,已通过多普勒超声(US)和多探测器计算机断层血管造影(MDCTA)诊断了该病。据我们所知,医源性SEPA假性动脉瘤是假性动脉瘤发生的不寻常的血管位置,目前尚无文献报道。在计划进行抗凝溶栓治疗或使用较大尺寸鞘管的治疗性导管插入术的患者中,确定动脉穿刺部位的精确定位对于预防医源性假性动脉瘤的发生很重要。多普勒超声引导下的动脉穿刺可减少并发症。当怀疑时,MDCTA可用于诊断和证明医源性假性动脉瘤。超声引导下的压迫治疗应该是医源性假性动脉瘤的首选。介入放射科医生和心脏病专家应对导管插入并发症及其治疗方法有足够的经验,以减少与介入相关的发病率和死亡率。

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