1/20. Surgical treatment of internal carotid artery anterior wall aneurysm with extravasation during angiography--case report.A 54-year-old female presented subarachnoid hemorrhage from an aneurysm arising from the anterior (dorsal) wall of the internal carotid artery (ICA). During four-vessel angiography, an extravasated saccular pooling of contrast medium emerged in the suprasellar area unrelated to any arterial branch. The saccular pooling was visualized in the arterial phase and cleared in the venophase during every contrast medium injection. We suspected that the extravasated pooling was surrounded by hard clot but communicated with the artery. Direct surgery was performed but major premature bleeding occurred during the microsurgical procedure. After temporary clipping, an opening of the anterior (dorsal) wall of the ICA was found without apparent aneurysm wall. The vessel wall was sutured with nylon thread. The total occlusion time of the ICA was about 50 minutes. Follow-up angiography demonstrated good patency of the ICA. About 2 years after the operation, the patient was able to walk with a stick and to communicate freely through speech, although left hemiparesis and left homonymous hemianopsia persisted. The outcome suggests our treatment strategy was not optimal, but suture of the ICA wall is one of the therapeutic choices when premature rupture occurs in the operation.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/20. Pseudoaneurysm of a septal perforator in beating heart coronary bypass grafting.A 46-year-old man with unstable angina underwent beating heart coronary bypass grafting for a left anterior descending coronary artery. Postoperative angiography showed intramuscular extravasation (6 x 8 mm) distal to the anastomosis, which was most likely the result of a needle injury caused by a snare during the operation. Follow-up angiography 2 weeks later revealed no extravasation.- - - - - - - - - - ranking = 0.66666666666667keywords = aneurysm (Clic here for more details about this article) |
3/20. Primary aortoenteric fistula: computed tomographic diagnosis of an atypical presentation.A primary aortoenteric fistula is a potentially devastating complication of untreated aortic aneurysmal disease. The clinical presentation can be confusing, leading to a delay in diagnosis. Computed tomography (CT) can greatly assist in establishing the diagnosis. An unusual case of a primary aortoenteric fistula with an atypical presentation is described. The patient presented with symptoms indicating an exacerbation of recurrent nephrolithiasis. No clinical history of an abdominal aortic aneurysm or previous history of gastrointestinal hemorrhage was reported. A CT scan demonstrated extravasation of arterial contrast into the duodenum. The aorta was repaired with an in-line prosthetic graft. A review of the literature regarding this rare entity and surgical options are presented.- - - - - - - - - - ranking = 0.33333333333333keywords = aneurysm (Clic here for more details about this article) |
4/20. "Pseudoendoleak"--residual intrasaccular contrast after endovascular stent-graft repair.PURPOSE: To present a unique demonstration of postoperative perigraft contrast masquerading as an endoleak following endovascular abdominal aortic aneurysm (AAA) repair. CASE REPORT: A 66-year-old man underwent endovascular stent-graft repair of a 4.6-cm infrarenal AAA. The procedure was uncomplicated, and intraoperative completion angiography demonstrated good proximal and distal fixation of the stent-graft without an endoleak. A spiral computed tomographic (CT) angiogram obtained on postoperative day 2 revealed a large amount of extrastent contrast along the posterior aspect of the aneurysm sac. This defect had the appearance of an endoleak, but it was also present on the non-contrast images. A color-flow duplex examination performed on the same day showed a widely patent stent-graft with no evidence of extrastent flow. CONCLUSIONS: Contrast trapped in the aneurysm sac during endovascular aneurysm repair may be misinterpreted as an endoleak on postprocedural CT scans. "Pseudoendoleaks" can be distinguished from true endoleaks by examination of prebolus, noncontrast CT images, as well as by duplex ultrasound scanning.- - - - - - - - - - ranking = 0.66666666666667keywords = aneurysm (Clic here for more details about this article) |
5/20. rupture of an internal carotid artery aneurysm during angiography with leakage of contrast medium via an external ventricular drain.With a ruptured intracranial aneurysm producing subarachnoid haemorrhage (SAH) cerebral angiography is currently used for identification of the affected vessel. Aneurysm rerupturing is one of the more serious complications of cerebral angiography and has been frequently described. We report a 61-year-old man who presented with SAH who had rerupture of a large aneurysm of the internal carotid artery during angiography. A substantial amount of contrast medium escaped via a ventricular drain. The three main risk factors for rerupture of an aneurysm are: angiography performed within 6 h of the primary SAH, an aneurysm on the internal carotid artery and an unfavourable Glasgow coma score.- - - - - - - - - - ranking = 1.3333333333333keywords = aneurysm (Clic here for more details about this article) |
6/20. Extravasation from rupturing aneurysm demonstrated by 3D digital subtraction angiography.We describe the 3D digital subtraction angiography (3D-DSA) image of extravasation from a rupturing aneurysm. This image clearly showed that the extravasation was coming from a pseudoaneurysm on an aneurysmal wall. To the best of our knowledge, this is the first demonstration of a 3D-DSA image of a rupturing aneurysm.- - - - - - - - - - ranking = 1.4234206649107keywords = aneurysm, pseudoaneurysm (Clic here for more details about this article) |
7/20. Successful treatment of a ruptured infected aneurysm of the lumbar artery with transcatheter embolization.We report a patient who had an infected aneurysm of the lumbar artery caused by prolonged psoas abscess-forming spondylitis due to methicillin-resistant staphylococcus aureus and who was treated successfully with transcatheter arterial embolization. This case suggests that an infected aneurysm can be treated successfully by transcatheter arterial embolization in emergent situations (active bleeding or septicemia) even if surgery is contraindicated.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
8/20. Extravasation of intracranial aneurysm during computed tomography angiography: mimicking a blood vessel.Two cases of contrast media extravasation of a ruptured aneurysm during computed tomography angiography (CTA) are described. The contrast media extravasation appeared as a highly attenuated twisted ribbon-like structure originating from the aneurysmal dome, and this mimicked a vascular structure. Because rebleeding of an aneurysm is accompanied by disastrous consequences, it is important to understand the imaging feature of active bleeding on CTA.- - - - - - - - - - ranking = 1.1666666666667keywords = aneurysm (Clic here for more details about this article) |
9/20. Aneurysm re-rupture during computed tomography angiography.Re-rupture of cerebral aneurysms during conventional angiography, demonstrated by contrast leakage into the extravascular space, is well known and well documented. However, the occurrence of this complication during computed tomography (CT) angiographic examinations has rarely been published despite its extensive use. We present the clinical and radiological features of a rebleeding event during a CT angiographic study. No hemodynamic or contrast-related factors can be evoked predisposing to he occurrence of this complication during this imaging technique. This, along with the short study time, may explain the rarity of this coincidence.- - - - - - - - - - ranking = 0.16666666666667keywords = aneurysm (Clic here for more details about this article) |
10/20. Retropharyngeal haemorrhage from a vertebral artery branch treated with distal flow arrest and particle embolisation.Retropharyngeal haematoma is a rare cause of rapid neck swelling that may result in fatal upper respiratory airway obstruction. Reported causes include trauma, surgery, retropharyngeal inflammation, carotid aneurysm, aberrant artery at the thoracic inlet and bleeding diathesis. We report a 90-year-old man who developed rapid and progressive neck swelling following a minor traumatic episode. Computed tomography showed a large low-density retropharyngeal haematoma extending from the skull base to the mediastinum, with suspected extravasation. The right vertebral artery angiogram confirmed contrast agent extravasation arising from a small branch artery. This was treated with temporary distal flow arrest and particle embolisation.- - - - - - - - - - ranking = 0.16666666666667keywords = aneurysm (Clic here for more details about this article) |
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