Active bleeding from intercostal artery pseudoaneurysm after a percutaneous tube thoracostomy drainage procedure: diagnosis with CT angiography and treatment with transarterial coil embolisation

Wu, Shou-Hsin; Wu, Ding-Kwo

doi:10.1136/bcr-2018-225795

Cited by 5 publications

(3 citation statements)

References 3 publications

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“…The computed tomography (CT) angiography has advantages over other imaging methods, including the US, magnetic resonance (MR) imaging, and angiography. It is not operator-dependent, and the isotropic volumetric data can be managed with 3D volume rendering [ 24 , 25 , 26 ]. Further, it has high sensitivity and specificity for detecting arterial injuries [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Imaging of Acquired Myometrial Pseudoaneurysm: The Role of Manipulators as an Unusual Cause during Laparoscopic Surgery

et al. 2022

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An acquired uterine artery myometrial pseudoaneurysm can occur due to inflammation, trauma, or iatrogenic causes, such as surgical procedures, and can lead to profuse bleeding. The efficacy of uterine manipulators in gynecological surgery, particularly as a cause of a pseudoaneurysm, has been poorly discussed in the literature. In this paper, we discuss a case of a 39-year-old woman with profuse uterine bleeding that occurred seven days after operative laparoscopic surgery for endometriosis. The color Doppler ultrasound better evoked the arterial-like turbulent blood flow inside this cavity. These sonographic features were highly suggestive of uterine artery pseudoaneurysm, presumably related to a secondary trauma caused by the manipulator. The diagnosis was subsequently re-confirmed by angiography, and the patient was treated conservatively with uterine artery embolization. Ultrasound has been shown to be a valuable and safe tool for imaging pseudoaneurysm and guiding subsequent interventional procedures. Accordingly, we briefly review the most suitable manipulators used in benign gynecological surgeries to verify if the different types in use can guide the surgeon towards the correct choice according to surgical needs and thus prevent potentially dangerous trauma.

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Section: Discussionmentioning

confidence: 99%

Ultrasound Imaging of Acquired Myometrial Pseudoaneurysm: The Role of Manipulators as an Unusual Cause during Laparoscopic Surgery

et al. 2022

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“…Many successful cases have been reported [ 7 , 10 , 13 – 15 , 18 , 21 – 24 ]. Generally speaking, microcoils were the first choice for embolisation [ 7 , 13 , 14 , 18 , 21 , 24 ], but glue-lipiodol mixture [ 15 ], polyvinyl alcohol particles and gelfoam slurry [ 10 , 22 ] could also serve as alternatives. Callaway et al [ 4 ] reported a patient cured with covered stent.…”

Section: Discussionmentioning

confidence: 99%

Massive hemothorax caused by intercostal artery pseudoaneurysm:a case report

Liu

Ran

et al. 2021

J Cardiothorac Surg

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Background Intercostal artery pseudoaneurysm is rare and at the risk of rupture. The aetiology is always reported to be iatrogenic and traumatic injury. Embolisation is the most common therapeutic method. Here, we report a case of spontaneous intercostal artery pseudoaneurysm and cured by combining covered stent grafting and surgical management. Case presentation A 60-year-old man complained of acute right back pain for 5 h. Computed tomography showed right massive hemothorax and a giant mass with distinct feeding vessel originated from the thoracic aorta within the right hemithorax. Thoracocentesis was performed, and then a covered stent was positioned across the origin of the feeding vessel. The patient was diagnosed with intercostal artery pseudoaneurysm. Finally, we successfully resected the pseudoaneurysm and ligated the proximal part of the artery. Histologic examination have proved the diagnosis. The postoperative course was uneventful, and the patient was discharged on postoperative day 10. There is no recurrence reported during follow-up. Conclusions Spontaneous intercostal artery pseudoaneurysm is extremly rare. Delayed hemothorax due to rupture of the pseudoaneurysm may occur years after the formation. Early diagnosis is important and a combined treatment of endovascular intervention and surgical management is feasible, especially for the case of ruptured large tumour-like mass presentation of the pseudoaneurysm.

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“…Many successful cases have been reported [8, 11, 14-16, 19, 22-25]. Generally speaking, microcoils were the rst choice for embolisation [8,14,15,19,22,14,25], but glue-lipiodol mixture [16], polyvinyl alcohol particles and gelfoam slurry [11,23] could also serve as alternatives. Callaway et al [5] reported a patient cured with covered stent.…”

Section: Discussionmentioning

confidence: 99%

Massive hemothorax Caused by Intercostal Artery Pseudoaneurysm: A Case Report.

Liu¹,

Ran

Li³

et al. 2020

Preprint

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Background: Intercostal artery pseudoaneurysm is rare and at the risk of rupture. The aetiology is always reported to be iatrogenic and traumatic injury. Embolisation is the most common therapeutic method. Here, we report a case of spontaneous intercostal artery pseudoaneurysm and cured by combining covered stent grafting and surgical management.Case presentation:A 60-year-old man complained of acute right back pain for 5 hours. Computed tomography showed right massive hemothorax and a giant mass with distinct feeding vessel originated from the thoracic aorta within the right hemithorax. Thoracocentesis was performed, and then a covered stent was positioned across the origin of the feeding vessel. The patient was diagnosed with intercostal artery pseudoaneurysm. Finally, we successfully resected the pseudoaneurysm and ligated the proximal part of the artery. Histologic examination have proved the diagnosis. The postoperative course was uneventful, and the patient was discharged on postoperative day 10. There is no recurrence reported during follow-up.Conclusions: Spontaneous intercostal artery pseudoaneurysm is extremly rare. Delayed hemothorax due to rupture of the pseudoaneurysm may occur years after the formation. Early diagnosis is important and a combined treatment of endovascular intervention and surgical management is feasible, especially for the case of ruptured large tumour-like mass presentation of the pseudoaneurysm.

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Active bleeding from intercostal artery pseudoaneurysm after a percutaneous tube thoracostomy drainage procedure: diagnosis with CT angiography and treatment with transarterial coil embolisation

Cited by 5 publications

References 3 publications

Ultrasound Imaging of Acquired Myometrial Pseudoaneurysm: The Role of Manipulators as an Unusual Cause during Laparoscopic Surgery

Ultrasound Imaging of Acquired Myometrial Pseudoaneurysm: The Role of Manipulators as an Unusual Cause during Laparoscopic Surgery

Massive hemothorax caused by intercostal artery pseudoaneurysm:a case report

Massive hemothorax Caused by Intercostal Artery Pseudoaneurysm: A Case Report.

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