Pseudoaneurysm
Encyclopedia
A pseudoaneurysm, also known as a false aneurysm, is a hematoma
Hematoma
A hematoma, or haematoma, is a localized collection of blood outside the blood vessels, usually in liquid form within the tissue. This distinguishes it from an ecchymosis, which is the spread of blood under the skin in a thin layer, commonly called a bruise...

 that forms as the result of a leaking hole in an artery
Artery
Arteries are blood vessels that carry blood away from the heart. This blood is normally oxygenated, exceptions made for the pulmonary and umbilical arteries....

. Note that the hematoma forms outside the arterial wall, so it is contained by the surrounding tissues. Also it must continue to communicate with the artery to be considered a pseudoaneurysm. This must be distinguished from a true aneurysm
Aneurysm
An aneurysm or aneurism is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. Aneurysms can commonly occur in arteries at the base of the brain and an aortic aneurysm occurs in the main artery carrying blood from the left ventricle of the heart...

 which is a localised dilatation of an artery including all the layers of the wall. A pseudoaneurysm is also different from an arterial dissection
Dissection (medical)
In medical pathology, dissection refers to a tear within the wall of a blood vessel, which allows blood to separate the wall layers, creating a pseudoaneurysm.- Types :Examples include:*Aortic dissection...

, which is a separation of the layers the arterial wall, and may be associated with later aneurysm formation. Distinctively, in a pseudoaneurysm, the hole in the arterial wall is generally the consequence of a iatrogenic trauma, most likely a previous invasive medical procedure that necessitated intrusion into an artery somewhere, for example to place a stent
Stent
In the technical vocabulary of medicine, a stent is an artificial 'tube' inserted into a natural passage/conduit in the body to prevent, or counteract, a disease-induced, localized flow constriction. The term may also refer to a tube used to temporarily hold such a natural conduit open to allow...

. Alternatively, a pseudoaneurysm can also occur as a complication of acute pancreatitis, due to enzymes leaking out from the pancreas and damaging nearby vessels. By opposition, true aneurysms and dissections are usually the consequence of an arterial wall congenital or acquired deficiency, for example by mean of atherosclerosis
Atherosclerosis
Atherosclerosis is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol...

.

Femoral pseudoaneurysms may complicate up to 8% of vascular interventional procedures.
Small pseudoaneurysms can spontaneously clot, while others need definitive treatment.

Treatment

Surgery is considered the gold-standard treatment, although not without risk in patients with severe cardiovascular disease.

Less invasive treatment options, such as Duplex ultrasound-guided compression, and percutaneous thrombin injection are available, however, evidence of their efficacy is somewhat limited.

Coiling through interventional radiology is also an option for non-cardiac pseudoaneurysms.

Endovascular treatment for Pseudoaneurysm is also a possibility.

Association with trauma

A pseudoaneurysm may also occur in a chamber of the heart
Heart
The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...

 following myocardial damage due to ischemia
Ischemia
In medicine, ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It may also be spelled ischaemia or ischæmia...

 or trauma
Physical trauma
Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...

. A pseudoaneurysm of the left ventricle
Left ventricle
The left ventricle is one of four chambers in the human heart. It receives oxygenated blood from the left atrium via the mitral valve, and pumps it into the aorta via the aortic valve.-Shape:...

 is a potentially lethal complication from a myocardial infarction
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...

.

Symptoms

Pseudoaneurysm was linked to symptoms of cluster headache by Adam Koenigsberg MD and Glen Solomon MD in a well-described case report published in the Journal of Headache.

Locations

Although aneurysms and left ventricular aneurysms may involve any wall segment, aneurysms in the posterolateral wall are frequently due to pseudoaneurysms. In contrast, the most common location for a true left ventricular aneurysm involves the apex of the heart.

Outside of the heart, pseudoaneurysms associated with pancreatitis can occur in several of the abdominal vessels, including the superior mesenteric artery, pancreaticoduodenal artery, and others.

External links

  • http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004981/frame.html
  • http://www.myelectronicmd.com/get_reference.php?Id=1164
  • http://www.cvtcollege.org/Ac_Programs/dms_vascular/studentbrandie.html
The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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