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Pseudoaneurysm: Wikis

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Pseudoaneurysm
Classification and external resources

Pseudoaneurysm of the left ventricle, four-chamber echocardiography view
MeSH D017541

A pseudoaneurysm, also known as a false aneurysm, is a hematoma that forms as the result of a leaking hole in an artery. Note that the hematoma forms outside the arterial wall, so it is contained by the surrounding tissues. Also it must continue to communicate with the artery to be considered a pseudoaneurysm. This must be distinguished from a true aneurysm which is a collection of blood that forms inside the arterial wall, between the layers. A pseudoaneurysm is also different from an arterial dissection in that the leaking hole is relatively small and the resulting hematoma is self-contained. Distinctively, in a pseudoaneurysm, the hole in the arterial wall is generally the consequence of a iatrogenic trauma, most likely a previous invasive medical procedure that necessitated intrusion into an artery somewhere, for example to place a stent. By opposition, an aneurysm or the dreaded dissection are most likely the consequences of an arterial wall congenital or acquired deficiency, for example by mean of atherosclerosis.

Femoral pseudoaneurysms may complicate up to 8% of vascular interventional procedures. Small pseudoaneurysms can spontaneously clot, while others need definitive treatment.

Contents

Treatment

Surgery is considered the gold-standard treatment, although not without risk in patients with severe cardiovascular disease.

Less invasive treatment options, such as Duplex ultrasound-guided compression and percutaneous thrombin injection are available, however, evidence of their efficacy is somewhat limited.

Endovascular treatment for Pseudoaneurysm is also a possibility.[1 ]

Association with trauma

A pseudoaneurysm may also occur in a chamber of the heart following myocardial damage due to ischemia or trauma. A pseudoaneurysm of the left ventricle is a potentially lethal complication from a myocardial infarction.

Symptoms

Pseudoaneurysm was linked to symptoms of cluster headache by Adam Koenigsberg MD and Glen Solomon MD in a well-described case report published in the Journal of Headache.[2]

Locations

Although aneurysms and left ventricular aneurysms may involve any wall segment, aneurysms in the posterolateral wall are frequently due to pseudoaneurysms. In contrast, the most common location for a true left ventricular aneurysm involves the apex of the heart.

References

  1. ^ Amato ACA, Kahlberg AK, Bertoglio LB, Melissano GM, Chiesa RC (2008). [http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492008000300016&lng=en "Endovascular treatment of a triple paraanastomotic aneurysm after aortobiiliac reconstruction"]. J Vasc Bras 7 (3): 1–3. doi:10.1590/S1677-54492008000300016. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492008000300016&lng=en.  
  2. ^ Koenigsberg AD, Solomon GD, Kosmorsky G (February 1994). "Psuedoaneurysm within the cavernous sinus presenting as cluster headache". Headache 34 (2): 111–3. doi:10.1111/j.1526-4610.1994.hed3402111.x. PMID 8163366.  

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