Idiopathic Aneurysm Research Articles

Idiopathic aneurysm of the radial artery in anatomical snuff box

Idiopathic aneurysm of the radial artery in anatomical snuff box

Intracranial aneurysms in the infant population: an institutional case series and individual participant data meta-analysis.

Infantile intracranial aneurysms are exceedingly rare. The goal of this study was to evaluate an institutional case series of infantile intracranial aneurysms, as well as those reported in the contemporary literature, to determine their demographics, presentation, management, and long-term outcome. A comprehensive literature review from 1980 to 2020 was performed to identify individual cases of intracranial aneurysms in the infantile population ≤ 2 years of age. Additional cases from the authors' institution were identified during the same time period. An individual participant data meta-analysis (IPDMA) was performed, abiding by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Patient demographic, radiographic, and clinical information was obtained. Descriptive statistical data were recorded, and multivariate logistic regression analyses were performed. Patient data were obtained for 133 patients from 87 articles in the literature. Ten additional patients at the authors' institution were also identified, for a total of 143 patients included in the IPDMA. The majority (72.7%) of this cohort consisted of idiopathic aneurysms, while 13.3% were posttraumatic pseudoaneurysms, 9.8% were infectious mycotic aneurysms, and 4.2% were aneurysms associated with a systemic connective tissue disorder or vasculitis. The mean age at presentation was 6.6 months. The majority of infants (97.9%) harbored only 1 aneurysm, and hemorrhage was the most common presenting feature (78.3%). The mean aneurysm size was 14.4 mm, and giant aneurysms ≥ 25 mm comprised 12.9% of the cohort. Most aneurysms occurred in the anterior circulation (80.9%), with the middle cerebral artery (MCA) being the most commonly affected vessel (51.8%). Management strategies included open surgical aneurysm ligation (54.0%), endovascular treatment (35.0%), surgical decompression without aneurysm treatment (4.4%), and medical supportive management only (13.9%). Surgical aneurysm ligation was more commonly performed for MCA and anterior cerebral artery aneurysms (p = 0.004 and p = 0.015, respectively), while endovascular techniques were favored for basilar artery aneurysms (p = 0.042). The mean follow-up period was 29.9 months; 12.4% of the cohort died, and 67.0% had a favorable outcome (Glasgow Outcome Scale score of 5). This study is, to the authors' knowledge, the largest analysis of infantile intracranial aneurysms to date. The majority were idiopathic aneurysms involving the anterior circulation. Surgical and endovascular techniques yielded equally favorable outcomes in this cohort. Long-term outcomes in the infantile population compared favorably to outcomes in adults.

Thoracoscopic approach to the resection of idiopathic azygos vein aneurysm: a case report

BackgroundAzygos vein aneurysm (AVA) is a rare thoracic pathological entity that mimics a posterior mediastinal mass. However, the pathogenesis of primary azygos vein aneurysms is not clear and its pathology is still being discussed. Some of the AVA are asymptomatic and usually discovered accidentally by routine physical examination.Case presentationWe report the case of a 37-year-old woman who had an azygos vein arch aneurysm with no obvious clinical symptoms. With the analysis of clinical features of the case and AVA morphological characteristics, the AVA was found by a chest computed tomography. Then, enhanced chest computed tomography showed a soft-tissue mass (4.9 × 3.7 × 3.2 cm) in the right posterior mediastinum, which was connected to the superior vena cava and significantly enhanced with contrast agent stratification. The density of the tumor in the delayed stage was the same as that in the azygos vein. The patient underwent video-assisted thoracoscopic surgery. Histopathological evaluation of the surgical biopsy specimen proved to be a completely thrombosed aneurism of the azygos vein arch.ConclusionsAVA is a rare pathology that must be taken into consideration during the differential diagnosis of right posterior mediastinal masses. Thoracoscopic surgery is one of the most preferred treatment options for azygos vein aneurysm.

Idiopathic Aneurysms of the Ascending Aorta in the Mouse and Rat.

Aneurysms of the ascending aorta, unrelated to xenobiotic administration, are described in 5 rats and 2 mice in nonclinical safety studies conducted at Charles River Laboratories (CRL) sites over the past 10 years. The most prominent microscopic finding was focal dilation with disruption of the wall of the ascending aorta with chronic adventitial inflammation or fibroplasia. The pathogenesis of this finding is unknown. There were no associated macroscopic findings, clinical abnormalities, or vascular lesions elsewhere. The results of a search of historical control data from toxicology studies of 1 day to 72 weeks' duration performed at CRL for aortic findings from 5900 mice and 23,662 rats are also reported. Aortic lesions are uncommon in mice and rats used in nonclinical safety studies, but toxicologic pathologists should be aware that aneurysms of the ascending aorta with fibroplasia and inflammation in the aortic wall and adventitia may occur spontaneously or iatrogenically, as they have the potential to impact interpretation in toxicology studies.

Surgical exclusion of an idiopathic saccular aneurysm in the left main trunk of the coronary artery

PurposeA coronary artery aneurysm (CAA) can result in critical cardiac events such as thromboembolic complications or rupture. A saccular CAA located in the left main trunk (LMT) is the most critical form of this pathology and its surgical repair is challenging. We conducted this single-center study to review the surgical outcomes of patients with a saccular CAA in the LMT.MethodsBetween May, 2012 and June, 2020, five patients with a saccular CAA in the LMT underwent surgery at our center. The median age at operation was 66.5 (59.7–69) years and the median diameter of the CAA was 13.0 mm (IQR 11–14 mm).ResultsThe CAA was fully excluded by patch closure of the LMT orifice and direct closure of the distal LMT, supplemented by coronary artery bypass grafting with the exclusive use of arterial conduits. There was no in-hospital mortality, although one patient suffered graft spasm-related myocardial infarction with complete recovery. Post-operative angiography showed a fully excluded LMT in all patients. There was no mortality or adverse cardiac events during follow-up.ConclusionsOur surgical policy for CAA in the LMT is feasible and safe; however, coronary blood flow is dependent on reliable bypasses.

Multimodal imaging in IRVAN syndrome presenting with Branch Retinal Artery Occlusion.

To describe multimodal imaging findings in a patient with idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome presenting with branch retinal artery occlusion (BRAO). A 33-year-old woman presented with acute BRAO in the right eye. A diagnosis of underlying IRVAN syndrome was made based on the presence of arteriolar aneurysms on the optic disc and along major arterioles and faint retinal hard exudates in both eyes. Eight months later, best-corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. The hard exudates had increased, and there were extensive areas of peripheral retinal capillary nonperfusion without new vessels. Optical coherence tomography (OCT) showed a localized retinal thinning corresponding to the prior BRAO. Fundus autofluorescence showed nodulo-linear periarterial hypoautofluorescence. OCT angiography (OCTA) showed localized ischemic changes, mainly involving the deep capillary plexus, corresponding to the area of resolved BRAO. It also clearly delineated the optic disc aneurysms. The patient received bilateral scatter laser photocoagulation directed to areas of peripheral capillary nonperfusion. Over a 6-month follow-up period, visual acuity remained unchanged, and there was no evidence of disease progression. Multimodal imaging, including fundus autofluorescence, OCT, and OCTA can provide additional valuable information in the evaluation of IRVAN syndrome complicated with BRAO.

Idiopathic Intrahepatic Artery Aneurysm Presenting as Acute Hemorrhagic Cholecystitis

Intrahepatic artery aneurysm or pseudoaneurysm is an unusual condition encountered clinically that accounts for a very small part of all visceral artery aneurysm cases. True incidence of primary or spontaneous intrahepatic artery aneurysm is difficult to be verified and has been rarely reported. For intrahepatic artery aneurysm/pseudoaneurysm, the diagnosis and management are challenging owing to the lower incidence and occult or various presentations. Due to the insidious course, patients with such aneurysms often have a higher risk of rupture, sometimes causing a catastrophic bleeding situation. Herein, we present a case of a 20-year-old woman with idiopathic left intrahepatic artery aneurysm with initial presentation mimicking acute hemorrhagic cholecystitis. Following laparoscopic cholecystectomy, intermittent upper gastrointestinal bleeding occurred. At the second radiologic study, left lateral-superior subsegmental hepatic artery aneurysm was detected. After endovascular treatment, the patient recovered without complications. To avoid delayed diagnosis, we suggest that hepatic artery aneurysm/pseudoaneurysm should always be considered when there is no usual cause of upper gastrointestinal tract bleeding.

Rupture of an Idiopathic Aneurysm of the Inferior Pancreaticoduodenal Artery Leading to an Intra-Abdominal Bleeding

Aneurysm of the pancreaticoduodenal artery is a rare finding that can be divided into true and false aneurysm. True aneurysm of the pancreaticoduodenal artery is more common and is usually due to atherosclerosis or celiac stenosis. Herein we present a rare case of a 59-year-old male patient with a spontaneous rupture of an idiopathic aneurysm of the inferior pancreaticoduodenal artery who was successfully treated with angiographic coil embolization Keywords: aneurysm, pseudoaneurysm, gastroduodenal artery

Giant idiopathic right atrial aneurysm in an adult: Sonological appearance of a rare feature

Giant idiopathic right atrial aneurysm in an adult: Sonological appearance of a rare feature

Idiopathic degenerative thoracic aneurysms are associated with increased aortic medial amyloid

Objective: To explore the relationship of aortic medial amyloid with biochemical and micromechanical properties of the aortic wall in aneurysm patients.Methods: Human aortic tissues removed during aneurysm surgery from tricuspid (idiopathic degenerative aneurysm, DA) and bicuspid valve (BAV) patients were subjected to oscillatory nanoindentation experiments to determine localised mechanical properties of the tissue (shear storage modulus, G´ and shear loss modulus, G˝). Collagen, elastin, matrix metalloproteinase 2 and glycosaminoglycans concentrations were determined, along with relative levels of aortic medial amyloid-related factors (medin, milk fat globule-EGF factor 8, oligomers and fibrils). Measurements were combined with clinical data and statistical analyses performed.Results: The DA cohort can be divided based on their phenotype. One group shared similar characteristics with BAV patients, termed bicuspid like phenotype-tricuspid valve. The second group had high amyloid oligomer species present with a significantly lower G´ (p = .01), indicative of reduced elastic response of the tissue, termed amyloid-rich.Conclusions: We identified a group of DA patients with high amyloid oligomers and altered micromechanical and structural properties of the vessel wall. We propose these findings as a cause for aneurysm formation in these patients. Amyloid is not found in BAV patients, suggesting at least two distinct mechanisms for pathogenesis.

Abdominal Pain Revealing a Bilateral Idiopathic Aneurysm of Common Iliac Arteries

Abdominal Pain Revealing a Bilateral Idiopathic Aneurysm of Common Iliac Arteries

Case report and management approach in idiopathic pulmonary arteries aneurysm

BackgroundIdiopathic pulmonary artery aneurysm is a rare anomaly with only a handful reports in the literature. It is often asymptomatic, while the first presentation could be severe hemoptysis or death.Surgical intervention needs to be planned carefully with a multidisciplinary team approach to secure optimal outcome. We hope to spread our experience with such cases and to encourage other surgeons worldwide to deal surgically with these cases when its indicated.Case presentationA 47 years old man presented to our institution after three episodes of hemoptysis, echo demonstrated good left ventricle (LV) systolic function, normal right ventricle (RV) size and function, Chest computed tomography (CT) revealed aneurysmal dilatation with pending rupture of the pulmonary artery trunk (4.5 cm), the left pulmonary artery (6 cm) and the right pulmonary artery (2.3 cm). The patient successfully underwent replacement of Pulmonary artery trunk, left pulmonary artery and right pulmonary artery by Wovex Prosthetic graft (28 mm). The patient discharged home on the eight postoperative day in good clinical condition .ConclusionWith this case report we wish to emphasize the need for a careful multidisciplinary approach given the complex and rare nature of the reported pathology.

Contrast-enhanced Computed Tomography Imaging of Splenic Artery Aneurysms and Pseudoaneurysms: A Single-center Experience.

Aim:The aim of our study was to evaluate the computed tomography (CT) imaging features of splenic artery aneurysm and pseudoaneurysm and to identify the disease conditions related to the same. We also wanted to ascertain any relationship between these associated disease conditions and the imaging features of the aneurysms.Materials and Methods:This retrospective study included patients diagnosed to have splenic artery aneurysms on contrast-enhanced CT examination between January 2001 and January 2016. Data were obtained from the picture archiving and communication system. The size, number, location, morphology, the presence of thrombosis, calcification, and rupture of the aneurysms were evaluated.Results:A total of 45 patients were identified with a mean age of 45 years. Splenic artery aneurysms were idiopathic in 12 (26.6%) patients. In the remaining patients, the main associated disease conditions included pancreatitis 15 (33%), chronic liver disease with portal hypertension 8 (18%), and extrahepatic portal vein obstruction (EHPVO) 6 (13%). Statistically significant findings included the relationship between EHPVO and multiple aneurysms (P = 0.002), chronic liver disease and fusiform aneurysm (P = 0.008), and smaller size of idiopathic aneurysms (P < 0.001).Conclusion:Based on this study, splenic artery aneurysms were associated with a variety of etiologies. The characteristics of the aneurysms such as size, location, and morphology vary with the associated disease conditions. These variations may have implications for the management.

Congenital abdominal aortic aneurysm in a term neonate: a case report

Background: Congenital abdominal aortic aneurysm (AAA) is a rare condition in neonates. To our knowledge, the natural course of the disease in a Thai neonate has not yet been reported. Objectives: To report the characteristics and clinical course of congenital AAA in a Thai neonate. Methods: A female Thai infant was born spontaneously at term (3,990 g) having a large, pulsatile, abdominal mass. Computed tomographic angiography (CTA) of the abdominal aorta showed a large infrarenal AAA, and a fusiform aneurysm at the left common iliac artery. Two small right renal arterial aneurysms were also noted. The large aneurysm was partially resected and a Gore-Tex vascular graft was placed at 15 days old. Histopathology of the aneurysmal wall revealed no specific etiology. Ultrasonography revealed thrombosis of the graft on the 13th day after surgery. Results: Repeated CTA of the abdominal aorta at age 13 mo showed complete thrombosis of the graft with reconstitution of collateral circulation. The infrarenal AAA and left common iliac aneurysm and 2 small right renal artery aneurysms were completely thrombosed. The patient grew and developed normally to the most recent follow up at age 36 mo. Conclusions: Congenital AAA with failure of graft replacement may regress spontaneously. Keywords: Abdominal aortic aneurysm, neonate, aortic aneurysm, idiopathic abdominal aortic aneurysm, neonatal abdominal aortic aneurysm, pulsatile abdominal mass

Congenital anomalies of the pulmonary arteries: Spectrum of findings on computed tomography

ObjectiveCongenital anomalies of the pulmonary arteries are uncommon. They can occur in isolation or in association with congenital heart defects. Isolated congenital anomalies remain undiscovered until they are reported as incidental findings on imaging tests, usually not until adolescence. We review the embryological development and normal anatomy of the pulmonary arteries as well as the spectrum of computed tomography findings for various congenital anomalies: unilateral interruption of the pulmonary artery, anomalous origin of the left pulmonary artery (pulmonary artery sling), idiopathic aneurysm of the pulmonary artery, and other anomalies associated with congenital heart defects. ConclusionCongenital anomalies of the pulmonary arteries represent a diagnostic challenge for clinicians and radiologists. Computed tomography is useful for their diagnosis, and general radiologists need to be familiar with their imaging appearance because they are often discovered incidentally.

Idiopathic Asymptomatic Aneurysms of Pulmonary Artery and Ascending Aort: A Case Report

The dilatation of pulmonary artery is a rare condition and called as pulmonary artery aneurysm. Aneurysm of both the pulmonary trunk and the ascending aorta is even rarer. Symptoms are due to aneurysm compression in adjacent anatomical structures. The main indicator of treatment is the pulmonary artery pressure. The prognosis and treatment of pulmonary artery aneurysm is unclear. Herein we present a case of a main pulmonary artery and ascending aortic aneurysms without underlying pathology. Because our case was asymptomatic, without a initiative cardiac lesion and/or pulmonary hypertension; we decided to follow-up him without operation and he was stable at 24-month follow-up.

Anomalías congénitas de las arterias pulmonares: espectro de hallazgos en tomografía computarizada

ObjectiveCongenital anomalies of the pulmonary arteries are uncommon. They can occur in isolation or in association with congenital heart defects. Isolated congenital anomalies remain undiscovered until they are reported as incidental findings on imaging tests, usually not until adolescence. We review the embryological development and normal anatomy of the pulmonary arteries as well as the spectrum of computed tomography findings for various congenital anomalies: unilateral interruption of the pulmonary artery, anomalous origin of the left pulmonary artery (pulmonary artery sling), idiopathic aneurysm of the pulmonary artery, and other anomalies associated with congenital heart defects. ConclusionCongenital anomalies of the pulmonary arteries represent a diagnostic challenge for clinicians and radiologists. Computed tomography is useful for their diagnosis, and general radiologists need to be familiar with their imaging appearance because they are often discovered incidentally.

Multiple idiopathic aneurysms in a 10-year-old child

Multiple idiopathic aneurysms in a 10-year-old child

Bilateral idiopathic aneurysms of the lingual artery identified by three-dimensional computed tomography angiography

Aneurysms of the external carotid artery and its branches are rare, and usually occur in the more superficial branches. Lingual artery (LA) aneurysms are particularly rare, and pseudoaneurysms are associated with trauma, infection, and surgical intervention. Only a few cases of idiopathic LA aneurysms have been reported in the English literature. LA aneurysms can be fatal if they are not recognized and treated. Here, we report a case of bilateral idiopathic aneurysms of the LA identified by three-dimensional (3D) computed tomography angiography (CTA). An 80-year-old man with right tongue cancer (T2N0M0) and left tongue leukoplakia was referred to our department for treatment. He had no previous history of trauma, infection, surgery, or aneurysm in the oral and maxillofacial region. CTA with 3D reconstruction showed right and left aneurysms of the LA, with sizes of 2.4 × 2.3 × 2.1 mm and 3.4 × 3.2 × 2.5 mm, respectively. The patient underwent bilateral partial glossectomy under general anesthesia without intervention for the aneurysms, and the post-operative course was uneventful. A radiological follow-up has been performed regularly for the small unruptured aneurysms.

Idiopathic aneurysm of the pulmonary artery in a patient with coronary disease.

When intracardiac or extracardiac shunts, chronic heart or lung disease, arterial disease of the pulmonary artery (PA) or an extensive atheromatosis or arteriosclerosis are excluded, idiopathic pulmonary artery aneurysm (PAA) is taken into consideration. Sporadic individual cases of idiopathic PAA [1–3] can be found in the literature [1–3]. Natural course of idiopathic PAA (which can reach enormous dimensions) or the corresponding therapeutic procedures are not clearly defined. In asymptomatic patients, no guidelines can be found indicating whether surgical or conservative treatment should be applied [1–4]. The incidence of PAA is 1 case per 13 700 autopsy cases [2]. Several cases can be found in the literature (with follow-up from 24 years [3] to 39 years [4]) with idiopathic PAA and without rupture. There are no data about cut-off dimensions of PAA diameters, which indicate the risk of rupture and, even more importantly, the potential risk of doing surgery in these cases.