Delayed presentation of a lumbar artery pseudoaneurysm resulting from isolated penetrating trauma

Counihan, M.; Pontell, Matthew E.; Selvan, Ben; Trebelev, Alexander; Nunez, Alberto

doi:10.1093/jscr/rjv083

Cited by 9 publications

(6 citation statements)

References 8 publications

(19 reference statements)

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“…It was found 2-14 days after the trauma, most frequently on the seventh day [4]. Counihan et al reported delayed bleeding because of a traumatic pseudoaneurysm [5]. In the present case, despite the confirmation of hemostasis by endoscopy, the patient presented with hemothorax one week after the surgery.…”

Section: Discussionmentioning

confidence: 64%

Delayed thoracic wall bleeding after minimally invasive mitral valve repair

Kamada

Kuwabara

Koichi

et al. 2019

Journal of Surgical Case Reports

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The first case of late thoracic wall bleeding after minimally invasive mitral valve repair treated by endovascular therapy is reported. A 55-year-old woman underwent mitral valve repair and tricuspid annuloplasty through a mini-thoracotomy approach. Her postoperative course was uneventful until she had anemia one week after the surgery. Contrast-enhanced computed tomography showed right hemothorax due to bleeding from a branch of the right lateral thoracic artery. Endovascular coil embolization and gelatin sponge injection were performed. The patient was discharged without any complications on postoperative day 20.

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Section: Discussionmentioning

confidence: 64%

Delayed thoracic wall bleeding after minimally invasive mitral valve repair

Kamada

Kuwabara

Koichi

et al. 2019

Journal of Surgical Case Reports

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“…Iatrogenic and posttraumatic causes seem to be the more common types reported in the literature. 5 6 7 8 9 10 11 12 Liu et al recently published a literature review of iatrogenic vascular injuries postspinal surgery. They included 20 case reports totaling 26 patients, of which, 12 patients sustained a pseudoaneurysm during their clinical course.…”

Section: Discussionmentioning

confidence: 99%

“… 12 13 14 15 16 There are several other reports in the literature describing posttraumatic spinal pseudoaneurysms with most patients manifesting their symptoms within 1 year. 5 , 6 , 17 18 19 20 …”

Section: Discussionmentioning

confidence: 99%

Spinal Pseudoaneurysms Mimicking an Osteogenic Tumor: A Case Report

Alsalman

Aleissa²,

Alhandi³

et al. 2020

JAAOS Glob Res Rev

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Aim: This study presents a rare case of pseudoaneurysm mimicking a tumor on the back, with no history of fever, trauma, or surgical intervention. In which no identifiable symptoms or warning signs were present. This pseudoaneurysm arises from intercostal arteries and segmental arteries. Both of which, to the limit of our knowledge, have not been discussed before. Method: This study was done using chart and literature review. We present a case of a 46-year-old man with a known case of left-sided intracranial hemorrhage due to hypertension and an old cerebrovascular accident. The patient has a positive history of hypertension, which could have attributed to the pseudoaneurysm; however, he has no history of vascular disease otherwise. The patient reports of back swelling and intermittent back pain for the past 3 years. On MRI, the mass showed a pulsating pattern around it. It also showed a layering effect because of different wall thicknesses and enhanced patterns, and the enhancement ratio was increased. In addition, it showed flow artifacts with T1 hyperintense areas because of associated thrombus and blood products. These changes noted on the MRI prompted the team to do a color Doppler study to confirm the presence of an aneurysm and if present, to do a CT angiography. The color Doppler showed a turbulent flow, that is, there was a bidirectional pulsatile flow which further confirms the presence of a pseudoaneurysm. Spine CT with contrast showed a right paraspinal lesion at the T9-T11 level. It had contrast enhancement and flow inside, consistent with a partially thrombosed aneurysm. The CT also showed evidence of bone remodeling in the adjacent thoracic vertebrae. The patient opted for spinal vascular emobilization and vascular sheath removal. The right and left intercostal arteries were selected at the level of left and right T4, left T8, bilateral T9, and bilateral T10. Conclusion: Differentiating between pseudoaneurysms and osteogenic tumors is essential to target later investigations accordingly. In addition, if pseudoaneurysms are left untreated, they could cause bony erosions of the vertebra, which lead to compression fractures. They can further compress the adjacent neurovasculature, which worsens the morbidity.

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“…LA injury is more common in abdominal trauma and knife stab wounds, [13–14] but there has been no lack of reports on iatrogenic LA injury, which is more common in spine surgery [6–9,15–18] and urinary surgery. [19–20] In a previous meta-analysis, the surgical technical complication incidence associated with PVP (PKP) ranged from 1.8% to 3.8%.…”

Section: Discussionmentioning

confidence: 99%

An anatomical study on lumbar arteries related to the extrapedicular approach applied during lumbar PVP (PKP)

Liu

Cheng²,

Wang

et al. 2019

PLoS ONE

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To observe the regional anatomy of the lumbar artery (LA) associated with the extrapedicular approach applied during percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP), we collected 78 samples of abdominal computed tomography angiography imaging data. We measured the nearest distance from the center of the vertebral body puncture point to the LA (distance VBPP-LA, D VBPP-LA ). According to the D VBPP-LA , four zones, Zone I, Zone II, Zone III and Zone IV, were identified. LAs that passed through these zones were called Type I, Type II, Type III and Type IV LAs, respectively. A portion of the lumbar vertebrae had an intersegmental branch that originated from the upper segmental LA and extended longitudinally across the lateral wall of the pedicle; it was called Type V LA. Compared with the D VBPP-LA in L1, L2, L3 and L4, the overall difference and between-group differences were significant ( P < 0.05). In L1, L2, L3, L4 and L5, there were 8, 4, 4, 0 and 1 Type I LAs, respectively. There were no Type V LAs in L1 and L2, but there were 2, 16 and 26 Type V LAs in L3, L4 and L5, respectively. In L1-L5, the numbers of Type I LA plus Type V LA were 8, 4, 6, 16 and 27, and the presence ratios were 5.1%, 2.6%, 5.6%, 10.3% and 17.3%, respectively. In L4 and L5, the male presence ratios of Type I LA plus Type V LA were 7.1% and 10.7%, respectively, and the female presence ratios were 13.9% and 25.0%, respectively. Thus, extrapedicular PVP (PKP) in lumbar vertebrae had a risk of LA injury and was not suggested for use in L4 and L5, especially in female patients.

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Delayed presentation of a lumbar artery pseudoaneurysm resulting from isolated penetrating trauma

Cited by 9 publications

References 8 publications

Delayed thoracic wall bleeding after minimally invasive mitral valve repair

Delayed thoracic wall bleeding after minimally invasive mitral valve repair

Spinal Pseudoaneurysms Mimicking an Osteogenic Tumor: A Case Report

An anatomical study on lumbar arteries related to the extrapedicular approach applied during lumbar PVP (PKP)

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