Pseudoaneurysm of the Profunda Femoris Artery Diagnosed on Angiographic Phase of Bone Scan

Ta, Powers; Ja, Harolds; Kadir, Saadoon; Rb, Grove

doi:10.1097/00003072-197910000-00007

Cited by 5 publications

(1 citation statement)

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“…Sonography and contrast angiography revealed this to be a false aneurysm, which was verified at operation. 8 A recent letter by Rudavsky and Moss 9 described a series of 47 patients with suspected arterial trauma who underwent emission angiography. They found that the scans were 100% successful in the detection of an arterial injury when compared with other diagnostic modalities.…”

Section: Journal Of Vascular Surgerymentioning

confidence: 99%

The use of scintiangiography with technetium 99m in the diagnosis of traumatic pseudoaneurysm

Hayek

Ludwig

Fischer

et al. 1988

Journal of Vascular Surgery

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Pseudoaneurysm formation is a known complication of peripheral arterial access procedures. Although standard contrast angiography has been considered the diagnostic study of choice to identify pseudoaneurysms, isotope angiography has been described as an alternative method. In this study, we examined the role of 99~Tc-tagged red blood cell scans in the diagnosis of traumatic pseudoanem'ysm. Forty patients underwent scans; 25 scans were reported as abnormal and 15 as normal. There were no false-negative results; one scan had false-positive results (2.5%). The presence of pseudoaneurysm among the patients with abnormal scans was verified at operation in 23 of 25 patients. The one falsepositive test was verified by ultrasound. All patients with normal scans were followed up for verification. Follow-up time ranged from 2 to 28 months. Radionuclide vascular flow study appears to give information similar to that of conventional angiography. With a series false-positive rate of 2.5%, the examination has a high specificity. The 99"Tc-tagged red blood cell scan is a viable alternative to conventional angiography for the diagnosis of traumatic pseudoaneurysms and is associated with less radiation and morbidity. (J VAsc SuRG 1988;7:409-i3.)Pseudoaneurysm formation after arterial puncture is a recognized complication of procedures that use peripheral arterial access with large-bore catheters1; these procedures include cardiac catheterization, other angiographic techniques, and placement of intra-aortic balloon pumps (IABPs). Known sequelae of such aneurysms include arterial rupture, ischemia, pain, paralysis of the involved extremity, and embolization. Early diagnosis and treatment are essential. 1,2Standard contrast angiography has been the diagnostic study of choice. The major risks include bleeding from the puncture site, perforation of major vessels, and renal insufficiency. Isotope angiography has been previously described as a possible alternative for the diagnosis of pseudoaneurysm. 3 W;e present our experience with technetium 99m (99mTc)~-labeled red blood cells (RBCs) for the detection of pseudoaneurysm resulting from arterial puncture. METHODSForty patients with a tentative diagnosis of pseudoaneurysm at a site of arterial puncture were re- Information about the patient included the admitting diagnosis, reason for the procedure, date of the procedure, and the vessel used for the procedure. Also obtained was information concerning the initial presentation of the suspected pseudoaneurysm. Thc questions included presencc or absence of pain, hematoma, pulsatilc mass, and function and sensation of the distal portion of the extremity. Physical examination was performed on all the patients and findings concerning the injury site and the neurovascular status of the distal portion of the extremity were documented.After initial evaluation, all patients underwent a 99roTe-labeled R_BC vascular flow study. The patient's RBCs were labeled by the modified in vivo method. Twenty minutes after injection of stannous pyrophosphate,...

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Section: Journal Of Vascular Surgerymentioning

confidence: 99%