Abstract
Arterial pseudoaneurysms are contained ruptures of the arterial wall that require prompt intervention. Iatrogenic pseudoaneurysms may result from various diagnostic and therapeutic procedures. Iatrogenic axillary pseudoaneurysms are quite rare, with few reported cases in the literature. We report a case of a 45-year-old woman who sustained an axillary pseudoaneurysm after an ultrasound-guided, vacuum-assisted biopsy of the axillary lymph node. An arteriovenous fistula developed concomitantly. Despite two image-guided treatments, thrombin injection and endovascular coil embolization, the pseudoaneurysm had persistent flow and was ultimately surgically resected at the time when the patient underwent mastectomy for breast cancer.
Highlights
Apseudoaneurysm, known as a false aneurysm, is a lesion secondary to a vessel wall injury where the blood leaks through the wall but is contained by the adventitia or surrounding soft tissue
There is a paucity of literature on the treatment of axillary pseudoaneurysms, which comprise less than 2% of pseudoaneurysms.[4]
The authors posited that ultrasound-guided procedures might have a slightly higher risk of bleeding because of the lack of breast compression during biopsy, compared with stereotactic procedures where breast compression is constant
Summary
Apseudoaneurysm, known as a false aneurysm, is a lesion secondary to a vessel wall injury where the blood leaks through the wall but is contained by the adventitia or surrounding soft tissue. Pseudoaneurysms are potentially life threatening[1] and should be promptly diagnosed and treated. While pseudoaneurysms may begin as silent lesions, they can lead to complications, such as hemorrhage, infection, distal embolization, ischemia, and nerve damage.[2] The causes of pseudoaneurysms vary, including penetrating or blunt trauma, infection, inflammation, and iatrogenic injury.[2] The estimated incidence of pseudoaneurysm as a complication of all diagnostic and therapeutic procedures[1] is approximately 1-7.7%. Because the femoral artery is routinely used as an arterial access for endovascular procedures, it is by far the
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