Inferior Epigastric Artery Pseudoaneurysm Following Trocar Injury

Splinter, Karen L.; Cook, Colleen L.

doi:10.1016/j.jmig.2012.01.013

Cited by 11 publications

(7 citation statements)

References 11 publications

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“…Plastic and reconstructive breast surgery relies on the presence of these vessels for deep inferior epigastric perforator (DIEP) flap breast reconstruction after mastectomy (Molina et al, 2012). Therefore, knowledge of their structure is of importance in this field, as it is also for general and gynecological surgeons to avoid vascular trauma during port-site insertion surgery, or other clinicians during invasive procedures of the anterior abdominal wall (Procacciante et al, 2009;Ko et al, 2010;Splinter and Cook, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…Complications may occur following such procedures, including damage to the superior and inferior (deep) epigastric arteries that run within the anterior abdominal wall, which may result in rectus sheath hematoma or epigastric artery pseudoaneurysm (Yuen and Ng, 2004;Kawamura et al, 2006;Standring, 2008;Procciante et al, 2009;Yarwood and Berrill, 2010;Ko et al, 2010;Splinter and Cook, 2012). The incidence of vascular injury during these techniques is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Arterial Anatomy of the Anterior Abdominal Wall: Evidence‐Based Safe Sites for Instrumentation Based on Radiological Analysis of 100 Patients

et al. 2019

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Multiple medical interventions require percutaneous instrumentation of the anterior abdominal wall, all of which carry a potential for vascular trauma. We assessed the presence, position, and size of the anterior abdominal wall superior and inferior (deep) epigastric arteries to determine the safest site with respect to vascular anatomy of the rectus sheath. In a review of 100 arterial phase, contrast‐enhanced abdominal computed tomography scans, anterior abdominal wall arteries were assessed bilaterally at three axial planes: transpyloric, umbilicus, and anterior superior iliac spine (ASIS). The mean age of patients was 69.2 years (SD ± 15), with 62 male and 38 female. An artery was visible least frequently at the transpyloric plane (5%), compared with the umbilicus (72–79%) and ASIS (93–96%), on the left (χ2(4) = 207.272; P < 0.001) and right (χ2(4) = 198.553; P < 0.001), with a moderate strength association (Cramer's V = 0.588 (left) and 0.575 (right)). The arteries were most commonly observed within the rectus abdominis muscle at the level of the umbilicus and ASIS on both sides (62–68%). The inferior epigastric artery was observed to be larger in diameter, start more laterally, and move medially as it travelled superiorly. These data suggest that the safest site to instrument the rectus sheath, with respect to vascular anatomy, is at the transpyloric plane. This information on anatomical variation of the anterior abdominal wall vasculature may be of particular interest to anesthetists performing rectus sheath block and surgeons during laparoscopic port insertion. Clin. Anat. 33:350–354, 2020. © 2019 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Arterial Anatomy of the Anterior Abdominal Wall: Evidence‐Based Safe Sites for Instrumentation Based on Radiological Analysis of 100 Patients

et al. 2019

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“…[4][5][6] As far as we searched in MEDical Literature Analysis and Retrieval System Online (MEDLINE), 19 published reports of 56 iatrogenic IEA injuries treated by EVT were identified between January 1965 and July 2016 ( Table 1). [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] to avoid adherence of the catheter to the glue, and the catheter should be retrieved with aspiration after the injection.…”

Section: Discussionmentioning

confidence: 99%

Emergency Endovascular Hemostatic Technique Using N-butyl Cyanoacrylate for Retroperitoneal Hematoma Caused by Inferior Epigastric Artery Injury after Undergoing Catheter Ablation for Atrial Fibrillation: A Case Report

Tsurukiri

Okumura

Sano

et al. 2017

JNET

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Objective: N-butyl cyanoacrylate (NBCA) is used as a liquid embolic agent in various hemorrhagic situations with a high technical success rate and low recurrent bleeding rate, especially in patients with coagulopathy.Case Presentation: An adult patient was admitted to the intensive care unit with coagulopathy and hemorrhagic shock.Past medical history of the patient included dual-antiplatelet therapy and warfarinization for several cardiac diseases.Retroperitoneal hematoma caused by femoral artery (FA) branch injury following percutaneous FA puncture was determined. Thus, we performed endovascular therapy (EVT) using NBCA and achieved successful hemostasis. Conclusion:NBCA used for hemostasis is linked to good technical success and the absence of complications. We concluded that EVT using NBCA is safe and effective among patients with iatrogenic FA branch injury following neuro endovascular therapy as adjunct for other conventional embolic agents.

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“…Pseudoaneurysms, in contrast, occur secondary to blunt or penetrating injury to arteries and do not involve equal dilation of the three native vessel layers. Provided blood flow to the focal area of dilation is maintained, pseudoaneurysms continue to grow in size until their eventual rupture and clinically significant exsanguination [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided thrombin injection for treatment of superficial traumatic pseudoaneurysms and associated expanding hematomas: experience in five patients

Sundararajan

Murillo

Khan

et al. 2016

J Trauma Manage Outcomes

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BackgroundAngiography allows for excellent characterization and treatment of traumatic pseudoaneurysms. However, ultrasound-guided thrombin injection for pseudoaneurysm thrombosis allows for radiation-free treatment of superficial pseudoaneurysms and superficial expanding hematomas.MethodsA retrospective review of 5 patient cases treated under this paradigm was performed following institutional review board approval. Outcomes following intervention were recorded and compared amongst the patient cohort.ResultsUltrasound-guided closure of traumatic pseudoaneurysms allowed for reduced procedural times and procedural invasiveness.ConclusionsAs demonstrated by the following cases, ultrasound guided thrombin injection is a good method of primary treatment for superficial pseudoaneurysms, or as an alternative treatment in cases where transcatheter embolization fails.

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Inferior Epigastric Artery Pseudoaneurysm Following Trocar Injury

Cited by 11 publications

References 11 publications

Arterial Anatomy of the Anterior Abdominal Wall: Evidence‐Based Safe Sites for Instrumentation Based on Radiological Analysis of 100 Patients

Arterial Anatomy of the Anterior Abdominal Wall: Evidence‐Based Safe Sites for Instrumentation Based on Radiological Analysis of 100 Patients

Emergency Endovascular Hemostatic Technique Using N-butyl Cyanoacrylate for Retroperitoneal Hematoma Caused by Inferior Epigastric Artery Injury after Undergoing Catheter Ablation for Atrial Fibrillation: A Case Report

Ultrasound-guided thrombin injection for treatment of superficial traumatic pseudoaneurysms and associated expanding hematomas: experience in five patients

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