Abstract
The pseudoaneurysm formation is the most common complication of arterial catheterization. This study aimed to report our clinical experience with the treatment of iatrogenic and post-traumatic pseudoaneurysms of the peripheral arteries. One hundred twenty patients, who were treated with the diagnosis of arterial pseudoaneurysm of the lower or upper extremity artery between January 2010 and October 2017, took part in this study. Patients with pseudoaneurysms originated from the anastomotic line of the previous vascular operations were excluded from the study. The diagnosis of pseudoaneurysms was made using ultrasonography and confirmed by magnetic resonance imaging (MRI) or computed tomography (CT) scan when deemed necessary. The most frequent symptom was a pulsatile mass. The mean diameter of pseudoaneurysms was 4.7±1.8 cm (2.3-8 cm). Among 120, 108 patients underwent surgery, and 10 patients required a blood transfusion during the operation. Wound infection was reported in 20 (15.5%) patients as an early postoperative complication. Arterial thrombosis developed in 6 (4.5%) patients, venous thrombosis in 2 (1.7%) patients, and lymphorrhea in 15 (12.5%) patients. A male patient died on the postoperative 25th day, while two patients died on postoperative 10th and 12th days (2.5%). Although lesser invasive treatment modalities have been described with some advantages or disadvantages, open surgical repair is the standard method of treatment for iatrogenic and traumatic peripheral arterial pseudoaneurysms.
Highlights
Pseudoaneurysms are surrounded by a rather thin fibrous capsule instead of the true layer of the arterial wall, and occur following leakage from the arterial defect of peripheral tissue and/ or associated hematoma
The pseudoaneurysm formation is the most common complication of arterial catheterization, and it is most commonly observed in the femoral artery that is often used for diagnosis and interventional procedures
The pseudoaneurysm was reported to have developed following penetrating traumas in 20 (16.7%) patients and following arterial puncture performed for diagnosis and treatment of cardiac diseases in 100 (83.3%) patients
Summary
Pseudoaneurysms are surrounded by a rather thin fibrous capsule instead of the true layer of the arterial wall, and occur following leakage from the arterial defect of peripheral tissue and/ or associated hematoma. The pseudoaneurysm formation is the most common complication of arterial catheterization, and it is most commonly observed in the femoral artery that is often used for diagnosis and interventional procedures. Anticoagulant therapies, thrombocytopenia, vessel wall calcification, and atherosclerosis increase the risk of the pseudoaneurysm formation [2]. Potential complications of these aneurysms include hemorrhage, thrombosis, peripheral embolism, dissection, the A-V fistula formation, and pressure on the surrounding tissues [3]. Arterial examination with Doppler USG is considered the gold standard in the diagnosis of pseudoaneurysms, with 100% accuracy [5]. Experienced specialists may be able to diagnose by physical examination; USG is necessary to determine the treatment strategy
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