Skip to main content

Advertisement

Log in

Pseudoaneurysm in children: diagnosis and interventional management

  • Case Report
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Pseudoaneurysms (PAn) are uncommon in adults and even less common in children. They are most often encountered after iatrogenic arterial injury. Presentation may be substantially delayed after the iatrogenic event, and diagnosis can be difficult, especially when the PAn occurs in an unexpected location. Treatment of PAn has evolved during the last two decades from a reliance on surgical resection to US-guided compression, coil embolization, covered stents, and stent-graft exclusion. More recently, direct percutaneous US-guided thrombin injection has been used in the treatment of PAn. We present three cases of successful PAn thrombosis by US-guided percutaneous thrombin injection in children, one of the epigastric artery and two of the femoral artery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Rosai J (1996) Cardiovascular system. Ackerman’s surgical pathology. Mosby, Philadelphia, pp 2204–2205

    Google Scholar 

  2. Titus JL, Kim H-S (1990) Blood vessels and lymphatics. Anderson’s pathology. Mosby, St. Louis, p 778

    Google Scholar 

  3. Zarins CK, Hill BB, Wolf YG (2001) Aneurysmal vascular disease. Textbook of surgery. Saunders, Philadelphia, p 1371

    Google Scholar 

  4. Morgan R, Belli AM (2003) Current treatment methods for postcatheterization pseudoaneurysms. J Vasc Interv Radiol 14:697–710

    PubMed  Google Scholar 

  5. Abu-Yousef MM, Wiese JA, Shamma AR (1988) The “to-and-fro” sign: duplex Doppler evidence of femoral artery pseudoaneurysm. AJR 150:632–634

    CAS  PubMed  Google Scholar 

  6. Frush DP, Paulson EK, O‘Laughlin MP (2000) Successful sonographically guided thrombin injection in an infant with a femoral artery pseudoaneurysm. AJR 175:485–487

    CAS  PubMed  Google Scholar 

  7. Norwood MG, Lloyd GM, Moore S, et al (2004) The changing face of femoral artery false aneurysms. Eur J Vasc Endovasc Surg 27:385–388

    Article  CAS  PubMed  Google Scholar 

  8. Ello FV, Nunn DB (1973) False aneurysm of the inferior epigastric artery as a complication of abdominal retention sutures. Surgery 74:460–461

    CAS  PubMed  Google Scholar 

  9. Ferrer JV, Soriano P, Zazpe C, et al (1996) Pseudoaneurysm of the inferior epigastric artery. Pathogenesis, diagnosis, and treatment. Arch Surg 131:102–103

    CAS  PubMed  Google Scholar 

  10. Gage TS, Sussman SK, Conard FU III, et al (1990) Pseudoaneurysm of the inferior epigastric artery: diagnosis and percutaneous treatment. AJR 155:529–530

    CAS  PubMed  Google Scholar 

  11. Segev Y, Orron D, Alon R, et al (1994) Pseudoaneurysm of the inferior epigastric artery mimicking abdominal wall hematoma. J Ultrasound Med 13:483–484

    CAS  PubMed  Google Scholar 

  12. Verbist J, Stillaert F, Dujardin P, et al (1997) Pseudoaneurysm of the inferior epigastric artery. Acta Chir Belg 97:196–198

    CAS  PubMed  Google Scholar 

  13. Lam EY, McLafferty RB, Taylor LM Jr, et al (1998) Inferior epigastric artery pseudoaneurysm: a complication of paracentesis. J Vasc Surg 28:566–569

    CAS  PubMed  Google Scholar 

  14. Todd AW (2001) Inadvertent puncture of the inferior epigastric artery during needle biopsy with fatal outcome. Clin Radiol 56:989–990

    Article  CAS  PubMed  Google Scholar 

  15. Werner M, Bernheim J, Witz M, et al (1999) Pseudoaneurysm of the inferior epigastric artery—a rare complication of Tenckhoff catheter removal. Nephrol Dial Transplant 14:1297–1299

    Article  CAS  PubMed  Google Scholar 

  16. Shabani AG, Baxter GM (2002) Inferior epigastric artery pseudoaneurysm: ultrasound diagnosis and treatment with percutaneous thrombin. Br J Radiol 75:689–691

    CAS  PubMed  Google Scholar 

  17. Saito S, Arai H, Kim K, et al (1992) Percutaneous transfemoral spring coil embolization of a pseudoaneurysm of the femoral artery. Cathet Cardiovasc Diagn 26:229–231

    CAS  Google Scholar 

  18. Waigand J, Uhlich F, Gross CM, et al (1999) Percutaneous treatment of pseudoaneurysms and arteriovenous fistulas after invasive vascular procedures. Catheter Cardiovasc Interv 47:157–164

    Article  CAS  PubMed  Google Scholar 

  19. Engelke C, Quarmby J, Ubhayakar G, et al (2002) Autologous thrombin: a new embolization treatment for traumatic intrasplenic pseudoaneurysm. J Endovasc Ther 9:29–35

    Article  PubMed  Google Scholar 

  20. Fellmeth BD, Roberts AC, Bookstein JJ, et al (1991) Postangiographic femoral artery injuries: nonsurgical repair with US-guided compression. Radiology 178:671–675

    CAS  PubMed  Google Scholar 

  21. Elford J, Burrell C, Freeman S, et al (2002) Human thrombin injection for the percutaneous treatment of iatrogenic pseudoaneurysms. Cardiovasc Intervent Radiol 25:115–118

    Article  PubMed  Google Scholar 

  22. Cope C, Zeit R (1986) Coagulation of aneurysms by direct percutaneous thrombin injection. AJR 147:383–387

    CAS  PubMed  Google Scholar 

  23. Liau CS, Ho FM, Chen MF, et al (1997) Treatment of iatrogenic femoral artery pseudoaneurysm with percutaneous thrombin injection. J Vasc Surg 26:18–23

    CAS  PubMed  Google Scholar 

  24. Kang SS, Labropoulos N, Mansour MA, et al (1998) Percutaneous ultrasound guided thrombin injection: a new method for treating postcatheterization femoral pseudoaneurysms. J Vasc Surg 27:1032–1038

    CAS  PubMed  Google Scholar 

  25. Monroe DM, Hoffman M, Roberts HR (2002) Platelets and thrombin generation. Arterioscler Thromb Vasc Biol 22:1381–1389

    Article  CAS  PubMed  Google Scholar 

  26. Lennox AF, Delis KT, Szendro G, et al (2000) Duplex-guided thrombin injection for iatrogenic femoral artery pseudoaneurysm is effective even in anticoagulated patients. Br J Surg 87:796–801

    Article  CAS  PubMed  Google Scholar 

  27. Lennox A, Griffin M, Nicolaides A, et al (1998) Regarding “Percutaneous ultrasound guided thrombin injection: a new method for treating postcatheterization femoral pseudoaneurysms”. J Vasc Surg 28:1120–1121

    CAS  PubMed  Google Scholar 

  28. Pope M, Johnston KW (2000) Anaphylaxis after thrombin injection of a femoral pseudoaneurysm: recommendations for prevention. J Vasc Surg 32:190–191

    Article  CAS  PubMed  Google Scholar 

  29. Pezzullo JA, Wallach MT (2002) Successful percutaneous thrombin injection of a brachial artery pseudoaneurysm in a neonate. AJR 178:244–245

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kevin M. Baskin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pelchovitz, D.J., Cahill, A.M., Baskin, K.M. et al. Pseudoaneurysm in children: diagnosis and interventional management. Pediatr Radiol 35, 434–439 (2005). https://doi.org/10.1007/s00247-004-1320-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-004-1320-7

Keywords

Navigation