Treatment of temporal artery pseudoaneurysms

Abstract

Limited evidence of minimal invasive treatment for superficial temporal artery pseudoaneurysm is available. Based on this review combined with our limited experience, we suggest thrombin injections to be considered as the future primary treatment modality. In the case of unsuccessful exclusion of the aneurysm, surgical excision can be performed.

Superficial temporal artery pseudoaneurysm following facial trauma

“…Other options such as US thrombin injection and endovascular embolisation are currently infrequently used 7. Endovascular treatment options carry risks that do not apply to open surgery, such as non-target/distal embolisation and the complications of arterial puncture.…”

Idiopathic pseudoaneurysm: a rare cause of parotid mass

“…STA aneurysms as a result of trauma represent <1% of reported aneurysms,8 and the authors found only one other idiopathic case described in the English literature, which was speculatively attributed to repeated Valsalva manoeuvres by the patient 7. Although the diagnosis of STA pseudoaneursym can be made clinically,6 FNA is a useful diagnostic investigation. In our case, the blood-stained aspirate was helpful in suggesting the diagnosis.…”

“…Vascular lesions, such as vascular tumour, arteriovenous malformation or a meningeal aneurysm, are rarely considered in the age group of this patient. Imaging modalities that can be used to confirm or exclude the differential vascular diagnoses of a probable STA aneurysm include sonography, CT, MR and digital subtraction angiography (DSA) 6. CT and MR have the advantage of being non-invasive imaging techniques that can easily delineate adjacent soft tissue structures.…”

“…CT and MR have the advantage of being non-invasive imaging techniques that can easily delineate adjacent soft tissue structures. DSA may underestimate the size of a lesion due to poor flow in aneurysmal structures,6 and also carries an inherent risk of bleeding, cerebrovascular injury, further damage to vessel wall and potential reaction to contrast agent. The risk of cerebrovascular injury during DSA was deemed unacceptable by the patient and thus not performed.…”

Unusual Presentation of Traumatic Pseudoaneurysm of the Posterior Auricular Artery Manifesting by Massive Bleeding from the External Auditory Canal: A Case Report

“…First attempts at the treatment of pseudoaneurysms of the external carotid artery were performed by Hunter in the 18th century who showed the value of proximal artery ligation [10]. Treatment options for traumatic pseudoaneurysms include simple resection of the aneurysm, coil embolization [11] and direct thrombin injection [12], proximal ligation of parent artery or trapping of the aneurysm [13]. However, an open approach to many of these lesions may be fraught with peril due to grossly distorted and oedematous tissue planes that often have heavy bacterial colonisation [8].…”