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Arterial Pseudoaneurysm

Statler JDS - MedPix (2005)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Arterial Pseudoaneurysm

History: The patient is an 86 year old female with long standing hypertension which was not controlled with four agents. She was referred for evaluation of renal artery stenosis. She underwent CO2 and Gadolinium arteriography of the aorta and right renal artery through a 6 French renal double curve sheath. A 5 mm balloon-expandable stent was deployed without difficulty after intravenous administration of 3,000 units heparin. The patient remained hyperetensive (SBP 220 mm Hg) throughout the case. ACT following stent palcement was 250 sec. and the sheath was left in place for another hour to allow values to drop below 200 sec. The sheath was removed in the recovery room, where it was noted that a small hematoma had formed in the right groin. Hemostasis was obtained with 20 minutes of manual compression. The patient remained flat with right leg straight for the remainder of the day. The following morning, she was noted to have a moderate right groin hematoma. Ultrasound of the right common femoral artery was requested, and demonstrated a PSA of the access site.

Findings: CO2 and Gadolinium arteriograms demonstrate severe bilateral renal artery stenoses, right worse than left. Post-stent placement, there is marked improvement of the right renal artery stenosis. Post-procedure doppler ultrasound of the access site demonstrates narrow neck of PSA with classic "yin-yang" appearance of inflow and outflow to PSA. Following thrombin injection, there is no flow in neck or PSA.

Ddx: Arterial Pseudoaneurysm True Aneurysm Arteriovenous Fistula

Dxhow: Ultrasound

Exam: WD Obese WF in NAD. SBP 220 mm Hg. Creatinine clearance was 29.

No MeSH data available.


Doppler ultrasound shows pseudoaneurysm in near field, narrow neck, and femoral artery in far field.
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MPX1602_synpic23987: Doppler ultrasound shows pseudoaneurysm in near field, narrow neck, and femoral artery in far field.


Arterial Pseudoaneurysm

Statler JDS - MedPix (2005)

Doppler ultrasound shows pseudoaneurysm in near field, narrow neck, and femoral artery in far field.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1602&req=5

MPX1602_synpic23987: Doppler ultrasound shows pseudoaneurysm in near field, narrow neck, and femoral artery in far field.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Arterial Pseudoaneurysm

History: The patient is an 86 year old female with long standing hypertension which was not controlled with four agents. She was referred for evaluation of renal artery stenosis. She underwent CO2 and Gadolinium arteriography of the aorta and right renal artery through a 6 French renal double curve sheath. A 5 mm balloon-expandable stent was deployed without difficulty after intravenous administration of 3,000 units heparin. The patient remained hyperetensive (SBP 220 mm Hg) throughout the case. ACT following stent palcement was 250 sec. and the sheath was left in place for another hour to allow values to drop below 200 sec. The sheath was removed in the recovery room, where it was noted that a small hematoma had formed in the right groin. Hemostasis was obtained with 20 minutes of manual compression. The patient remained flat with right leg straight for the remainder of the day. The following morning, she was noted to have a moderate right groin hematoma. Ultrasound of the right common femoral artery was requested, and demonstrated a PSA of the access site.

Findings: CO2 and Gadolinium arteriograms demonstrate severe bilateral renal artery stenoses, right worse than left. Post-stent placement, there is marked improvement of the right renal artery stenosis. Post-procedure doppler ultrasound of the access site demonstrates narrow neck of PSA with classic "yin-yang" appearance of inflow and outflow to PSA. Following thrombin injection, there is no flow in neck or PSA.

Ddx: Arterial Pseudoaneurysm True Aneurysm Arteriovenous Fistula

Dxhow: Ultrasound

Exam: WD Obese WF in NAD. SBP 220 mm Hg. Creatinine clearance was 29.

No MeSH data available.