Incidental diagnosis and therapeutic approach of an iatrogenic intra-parenchymal pulmonary intercostal artery pseudoaneurysm: a case report

Rossi, Giovanni; Perrillo, Mario; Flora, Martina; Costigliola, Adriano; Mollica, Mariano; Iadevaia, Carlo; Gaio, Gianpiero; Cerqua, Francesco Saverio; Bianco, Andrea; Perrotta, Fabio

doi:10.4081/monaldi.2019.1094

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…Postoperative intercostal artery pseudoaneurysm is a very rare complication. To the best of our knowledge, only two case reports have been reported thus far [ 9 , 10 ]. Kawai et al reported a case who experienced pseudoaneurysm of the 7th intercostal artery after video-assisted right lower lobectomy.…”

Section: Discussionmentioning

confidence: 99%

A case of late-onset bleeding from an intercostal artery pseudoaneurysm after hemostasis using soft coagulation

Shimizu,

Suda,

Takemoto

et al. 2024

surg case rep

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Background The use of soft coagulation is becoming common in thoracic surgery. Soft coagulation provides rapid hemostasis from small vessels during surgery by dehydrating tissue and denaturing proteins, without burning the tissue. Case presentation A 68-year-old man, with a history of right lower lobectomy 3 years prior, underwent a partial resection of the right upper lobe for a pulmonary nodule suspicious for secondary lung cancer. During the surgery, dissection of the adhesion caused a bleeding from the 6th intercostal artery, and hemostasis was achieved using soft coagulation (some degree of tissue carbonization was noticed at later mortality and morbidity conference). He experienced hemoptysis at postoperative day 18 and was transferred to our hospital. Contrast-enhanced CT scan revealed bleeding from the pseudoaneurysm of the 6th intercostal artery. Embolization was performed by angiography to stop the bleeding. Conclusions We experienced a case of late-onset bleeding from a pseudoaneurysm related to soft coagulation hemostasis. Lessons learned from this patient are that additional hemostasis, such as ligation, would be considered for small arteries after hemostasis has been achieved by soft coagulation, especially when some degree of tissue carbonization is suspected.

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Section: Discussionmentioning

confidence: 99%

A case of late-onset bleeding from an intercostal artery pseudoaneurysm after hemostasis using soft coagulation

Shimizu,

Suda,

Takemoto

et al. 2024

surg case rep

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show abstract

“…Only two cases of delayed intercostal artery pseudoaneurysm after thoracoscopy were reported in the English literature. Both cases presented with a large hemothorax after intercostal artery pseudoaneurysm rupture and required surgical attention 13,14 . Conversely to intercostal artery pseudoaneurysm, there are no reports of TDAP after thoracoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, the traditional surgical management of pseudoaneurysm has been widely replaced by endovascular approaches 17 . Embolization by metallic coils and other materials such as hemostatic particles, glue, thrombin, polyvinyl alcohol have become generalized 14 . Moreover, US-guided thrombin injection in PA offers an additional interesting minimal invasive option 17,18 .…”

Section: Discussionmentioning

confidence: 99%

Delayed Thoracodorsal Artery Pseudoaneurysm After Thoracoscopic Sympathectomy for Hyperhidrosis in an Adolescent: A Case Report

Khelif¹,

Laureys²,

Khelif³

2020

Preprint

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Background: Conversely to intercostal artery false aneurysm, thoracodorsal artery pseudoaneurysm after thoracoscopy has never been reported previously.Case presentation: We report the case of a 15-year-old male presenting a delayed thoracodorsal artery pseudoaneurysm after bilateral thoracospic sympathectomy. Diagnosis was made by Doppler Ultrasound and confirmed by computed tomography angiography. Angiographic embolization was successfully performed. Conclusion: Thoracodorsal artery pseudoaneurysm should be considered in patients presenting with a parietal thoracic mass following thoracoscopy. This is to the best of our knowledge the first report of thoracodorsal artery pseudoaneurysm after thoracoscopy.

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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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Incidental diagnosis and therapeutic approach of an iatrogenic intra-parenchymal pulmonary intercostal artery pseudoaneurysm: a case report

Cited by 5 publications

References 19 publications

A case of late-onset bleeding from an intercostal artery pseudoaneurysm after hemostasis using soft coagulation

A case of late-onset bleeding from an intercostal artery pseudoaneurysm after hemostasis using soft coagulation

Delayed Thoracodorsal Artery Pseudoaneurysm After Thoracoscopic Sympathectomy for Hyperhidrosis in an Adolescent: A Case Report

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

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