Management of Post-traumatic Peripheral Arterial Pseudoaneurysm in Antananarivo

Abstract

Background: Pseudoaneurysm is the usual complication of arterial injury. The aim of this study is to describe the etiology and the management of post-traumatic peripheral arterial pseudoaneurysm in Antananarivo.
 Methods: This is a bicentric retrospective study for 10 years period (January 2010 to December 2019), performed in Cardiovascular Unit in Joseph Ravoahangy Andrianavalona Teaching Hospital and in Vascular Unit in Soavinandriana Hospital Center, including all patient who underwent a surgical procedure of post-traumatic peripheral arterial pseudoaneurysm.
 Results: 38 patients were recorded in 10 years period, which 26 patients recorded in JRA hospital and 12 patients in Soavinandriana Hospital. Patients were 33 males (86.84%) and 5 females (13.15%). Gunshots wounds (47.36%) and stabs wounds (34.21%) were the commonest circumstances of etiology. Pulsatile mass (84.21%), pain (60.52%) and palpable thrill (71.05%) were the usual of peripheral pseudoaneurysm. Doppler ultrasound (94.73%) and computed tomographic angiography (13.15%) performed the diagnosis of the pseudoaneurysm. Femoral artery (39.47%) and brachial artery (31.57%) were the most involved vessels. All patients underwent an open surgery. Surgical procedures were arterial repair in 26 patients (68.42%), reversed saphenous vein interposition in 5 patients (13.15%), PTFE graft in 2 patients (5.26%) and ligation excision in 5 patients (13.15%). There was no reoperation or mortality in early postoperative period.
 Conclusion: Trauma is the most common etiology of pseudoaneurysm in Antananarivo. Open surgical repair remains the procedure to treat the post-traumatic peripheral arterial pseudoaneurysm in our experience.

Subxyphoid Pericardial Drainage for Tuberculous Pericardial Effusion in Antananarivo

“…The commonest symptoms of massive pericardial effusion in our patients were dyspnea (95%), chest pain (89%), cough (80%), palpitations (71%) and fever (92%). These signs were observed in other studies about surgical drainage of tuberculosis pericardial effusion like Diakité et al [6] and Randimbinirina et al [9]. The most common signs of pericardial effusion in patients underwent subxyphoid pericardial drainage were dyspnea (61%) and chest pain (26%) in study of Diakité et al [6].…”

“…The most common signs of pericardial effusion in patients underwent subxyphoid pericardial drainage were dyspnea (61%) and chest pain (26%) in study of Diakité et al [6]. The commonest symptoms of tuberculosis pericardial effusion in patients with tamponnade pericarditis were dyspnea (93%), cough (83%), abdominal pain (80%) and chest pain (54%) in study of Randimbinirina et al [9]. Physical examination is important to make the diagnosis of pericardial effusion.…”

Vascular Surgery of Limbs in Antananarivo: Indications and Outcomes

“…There was too a predominance of male in all patients who underwent a peripheral vascular procedures in Edaigbini's study (61,6%) [2] and in Adeoye's study (74,4%) [3]. Many sub-saharan african studies have been showed this predominance of male in patient underwent peripheral vascular surgery : 88% in Randimbinirina's study [9], 67% in Nebyou's study [8], 88% in Dieng's study [5]. This predominance of male could be explained by the higher incidence of cardiovascular disease in men population than in women [10].…”

“…One of the most important of this topic that the study showed simultaneously multiples procedures to manage 189 cases of peripheral vascular related pathology. Some researchers in sub-saharan african countries have been describe their surgical vascular procedures to treat a peripheral vascular related pathology such as in vascular trauma of limbs in Dieng's study [5], in peripheral arterial disease in Chisala's study [6], in diabetic peripheral arterial disease in Chalya's study [7], in ischaemia of limbs in Nebyou's study [8] and in peripheral arterial pseudoaneurysm in Randimbinirina's study [9].…”

Pseudoaneurysm Management in the Emergency Department: A Case Report

“…9 Ayrıca psödoanevrizma tedavisi için kompresyona veya perkütan trombin enjeksiyonuna da izin verir. 11 Manyetik rezonans anjiyografi (MRA), kontrast maddenin kontrendike olduğu durumlarda kullanılabilen; ancak, zaman alıcı olması nedeni ile pratik olamayan bir görüntüleme yöntemidir. 1…”