Emergency Point-of-Care Ultrasound Diagnosis of a Femoral Artery Pseudoaneurysm

Canter, Danielle Marie; Difranco, Mary Ann; Landefeld, Kevin; Butts, Christine; Kaban, Nicole L.

doi:10.1016/j.jemermed.2020.08.010

Cited by 4 publications

(7 citation statements)

References 6 publications

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“…Hematomas often appear as irregularly or regularly shaped structures, anechoic in the acute setting, but with mixed echogenicity echoes over time as the blood clots 5 , 9 , 24 . In contrast, a pseudoaneurysm will appear pulsatile using B-mode, with the ying-yang sign using color Doppler, and showing pulsatile flow using pulsed wave Doppler 5 , 9 , 25 , 26 . The arterial wall defect can also be visualized by tracing the pulsatile flow to its origin.…”

Section: Discussionmentioning

confidence: 99%

Point of Care Ultrasound Diagnosis of Maxillary Artery Pseudoaneurysm in the Emergency Department

Alerhand,

Ali,

Beckman

2024

pocus

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A pseudoaneurysm results from a tear in a vessel wall. This leads to extravasation of blood into adjacent tissue and eventual formation of a fibrous sac that maintains continuity with the lumen. These vascular injuries very rarely occur in deeper vessels of the face (e.g. maxillary artery) due to protection from structures like the bony mandible and parotid gland. If left untreated, these pseudoaneurysms can lead to infection, thromboembolism, hemorrhage, and compression of surrounding structures such as facial nerve branches. Pseudoaneurysms are typically diagnosed by advanced imaging techniques including computed tomography angiography and magnetic resonance angiography. However, these tests require time to perform and interpret, are costly, and take place outside the patient care area. Computed tomography also confers ionizing radiation. Fortunately, point of care ultrasound (POCUS) is a readily available, dynamic imaging tool that can be performed at the bedside. Here we present the first known case report of a maxillary artery pseudoaneurysm diagnosed by POCUS in the emergency department. Early differentiation from a typical hematoma led to rapid management in the form of a compression bandage, as well as expedited consultation to the appropriate services.

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Section: Discussionmentioning

confidence: 99%

Point of Care Ultrasound Diagnosis of Maxillary Artery Pseudoaneurysm in the Emergency Department

Alerhand,

Ali,

Beckman

2024

pocus

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“…Bedside ultrasound is a rapid and effective means of diagnosing life‐threatening pseudoaneurysm and allows for prompt surgical consultation. 2 , 3 …”

Section: Diagnosismentioning

confidence: 99%

“…This encapsulation prevents exsanguination and blood freely flows within the central portion of the pseudocapsule. Bedside ultrasound is a rapid and effective means of diagnosing life‐threatening pseudoaneurysm and allows for prompt surgical consultation 2,3 …”

Section: Diagnosismentioning

confidence: 99%

A man with swelling in the inguinal region

Kropf

Tucker

2021

JACEP Open

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“…Color or spectral Doppler ultrasonography may help to identify these features and in the differential diagnosis of FAP from hematoma and arteriovenous fistula. 3 Computed tomography angiography can elucidate the specific location, extent, collateral conditions, and the relationships of complex lesions with surrounding tissues. 4 An FAP can cause compression of the surrounding nerves and tissues, rupture and bleeding of the aneurysm, and formation and dislodgement of thrombi, thus leading to distal limb embolism, tissue necrosis, and infection.…”

Section: Introductionmentioning

confidence: 99%

“…Ultrasonography clearly shows the location, size, and width of the aneurysm neck that connects the aneurysm to the femoral artery and the number of cavities in the FAP. Color or spectral Doppler ultrasonography may help to identify these features and in the differential diagnosis of FAP from hematoma and arteriovenous fistula 3 . Computed tomography angiography can elucidate the specific location, extent, collateral conditions, and the relationships of complex lesions with surrounding tissues 4 .…”

Section: Introductionmentioning

confidence: 99%

A patient with femoral artery pseudoaneurysm treated with ultrasound‐guided injection of an exogenous lyophilized human fibrin sealant

Gao

Xiong

Wan

2022

Hemodialysis International

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A femoral artery pseudoaneurysm (FAP) is a serious complication of arterial injury. It can cause compression of the surrounding nerves and tissues, rupture and bleeding of the aneurysm, and formation and dislodgement of thrombi, and can lead to distal limb embolism, tissue necrosis, and infection. Computed tomography angiography and ultrasonography are the preferred techniques for diagnosis of FAP. This report describes the successful treatment of an FAP using an ultrasound-guided percutaneous intracavitary injection of a lyophilized human fibrin sealant. This treatment was safe, associated with minimal pain and complications, and clinically effective. K E Y W O R D S chronic kidney disease, femoral artery pseudoaneurysm, lyophilized human fibrin sealant, thrombin, ultrasound

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Emergency Point-of-Care Ultrasound Diagnosis of a Femoral Artery Pseudoaneurysm

Cited by 4 publications

References 6 publications

Point of Care Ultrasound Diagnosis of Maxillary Artery Pseudoaneurysm in the Emergency Department

Point of Care Ultrasound Diagnosis of Maxillary Artery Pseudoaneurysm in the Emergency Department

A man with swelling in the inguinal region

A patient with femoral artery pseudoaneurysm treated with ultrasound‐guided injection of an exogenous lyophilized human fibrin sealant

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