Pseudoaneurysm of arteria profunda femoris following the surgery of proksimal femur fracture: a case report
Abstract
Abstract
Pseudoaneurysm of arteria profunda femoris after the hip fracture is a very rare complication. The mechanism of pseudoaneursym formation may be traumatic, iatrogenic or infective injury to the arterial wall. Pseudoaneurysms of arteria profunda femoris usually give late symtomps such as persistent hip pain, thigh swelling, presence of a pulsatile mass and unexplained anemia that may suggest the diagnosis. Surgical repair, transcatheter embolization, thrombin injection under duplex imaging guidance is the treatment options for pseudoaneurysm. Angiography is a well known technique for accurate diagnosis and may be the first choice for the minimal invasive treatment. We present a case of a pseudoaneurysm of arteria profunda femoris following osteosynthesis of a proksimal femur fracture. Pseudoaneurysm was successfully treated by percutaneous placement of embolization coils.
Keywords: Aneurysm, false, femoral fractures, embolization, therapeutic, angiography
Özet
Kalça kırıkları sonrasında derin femoral arterde psödoanevrizma gelişmesi çok nadir görülen bir komplikasyondur. Psödoanevrizma arter duvarının travmatik, iatrojenik ya da enfektif bir yaralanmasına bağlı olarak gelişebilir. Derin femoral arterde gelişen psödoanevrizmalar genellikle geç bulgu verirler. Bu bulgular ısrarlı kalça ağrısı, uylukta şişlik, pulsatil kitle varlığı ve sebebi ortaya konamayan anemi şeklinde olabilir. Tedavi seçenekleri arasında cerrahi yöntemler, embolizasyon, thrombin enjeksiyonu sayılabilir. Anjiografi hem teşhis hem de aynı seansta tedavi imkanını sağlayabilen etkili bir yöntemdir. Proksimal femur kırığı cerrahi tedavisi sonrası derin femoral arterde psödoanevrizma gelişen ve anjiografik yöntemlerle perkutan embolizasyon uygulanarak tedavi edilen bir olguyu sunuyoruz.
Anahtar sözcükler: Psödoanevrizma, femur kırıkları, embolizasyon, anjiografiReferences
- Nachbur B, Meyer RP, Verkkala K, Zürcher R. The mechanisms of severe arterial injury in surgery of the hip joint. Clin Orthop 1979; 141: 122-33.
- Wilson JS, Miranda A, Johnson BL, Shames ML, Back MR, Bandyk DF. Vascular injuries associated with elective orthopedic procedures. Ann Vasc Surg 2003; 17: 641-644.
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- Katsimihas M, Robinson D, Thornton M, Langkamer VG. Therapeutic embolization of the genicular arteries for recurrent hemarthrosis after total knee arthroplasty. J Arthroplasty 2001; 16: 935-7.
- Barriga A, Valentí Nin JR, Delgado C, Bilbao JJ. Therapeutic embolisation for postoperative haemorrhage after total arthroplasty of the hip and knee. J Bone Joint Surg Br 2001; 83: 90-2.
- Kickuth R, Anderson S, Kocovic L, Ludwig K, Siebenrock K, Triller J. Endovascular treatment of arterial injury as an uncommon complication after orthopedic surgery. J Vasc Interv Radiol 2006; 17: 791-9.
- Canbaz S, Acipayam M, Gürbüz H, Duran E. False aneurysm of perforating branch of the profunda femoris artery after external fixation for a complicated femur fracture. J Cardiovasc Surg 2002; 43: 519-21.
- Entwisle JJ, De Nunzio M, Hinwood D. Case report: Transcatheter embolization of pseudoaneurysm of the profunda femoris artery complicating fracture of the femoral neck. Clin Radiol 2001; 56: 424-7.
- Reber PU, Baer HU, Patel AG, Wildi S, Triller J, Büchler MW. Superselective microcoil embolization: treatment of choice in high-risk patients with extrahepatic pseudoaneurysms of the hepatic arteries. J Am Coll Surg 1998; 186: 325de Baere T, Ousehal A, Kuoch V, Sapoval M, Lagrange C, Roche A. Endovascular management of bleeding iliac artery pseudoaneurysms complicating radiation therapy for pelvic malignancies. AJR Am J Roentgenol 1998; 170: 349-53.
PSEUDOANEURYSM OF ARTERIA PROFUNDA FEMORIS FOLLOWING THE SURGERY OF PROKSIMAL FEMUR FRACTURE: A CASE REPORT
Abstract
Pseudoaneurysm of arteria profunda femoris after the hip fracture is a very rare complication. The mechanism of pseudoaneursym formation may be traumatic, iatrogenic or infective injury to the arterial wall. Pseudoaneurysms of arteria profunda femoris usually give late symtomps such as persistent hip pain, thigh swelling, presence of a pulsatile mass and unexplained anemia that may suggest the diagnosis. Surgical repair, transcatheter embolization, thrombin injection under duplex imaging guidance is the treatment options for pseudoaneurysm. Angiography is a well known thecnique for accurate diagnosis and may be the first choice for the minimal invasive treatment. We present a case of a pseudoaneurysm of arteria profunda femoris following osteosynthesis of a proksimal femur fracture. Pseudoaneurysm was successfully treated by percutaneous placement of embolization coils.
References
- Nachbur B, Meyer RP, Verkkala K, Zürcher R. The mechanisms of severe arterial injury in surgery of the hip joint. Clin Orthop 1979; 141: 122-33.
- Wilson JS, Miranda A, Johnson BL, Shames ML, Back MR, Bandyk DF. Vascular injuries associated with elective orthopedic procedures. Ann Vasc Surg 2003; 17: 641-644.
- Hanna GB, Holdsworth RJ, McCollum PT. Profunda femoris artery pseudoaneurysm following orthopaedic procedures. Injury 1994; 25: 477-9. Jindal R, Dhanjil S, Carrol T, Wolfe JH. Percutaneous thrombin injection treatment of a profunda femoris pseudoaneurysm after femoral neck fracture. J Vasc Interv Radiol 2004; 15: 1335-6.
- Katsimihas M, Robinson D, Thornton M, Langkamer VG. Therapeutic embolization of the genicular arteries for recurrent hemarthrosis after total knee arthroplasty. J Arthroplasty 2001; 16: 935-7.
- Barriga A, Valentí Nin JR, Delgado C, Bilbao JJ. Therapeutic embolisation for postoperative haemorrhage after total arthroplasty of the hip and knee. J Bone Joint Surg Br 2001; 83: 90-2.
- Kickuth R, Anderson S, Kocovic L, Ludwig K, Siebenrock K, Triller J. Endovascular treatment of arterial injury as an uncommon complication after orthopedic surgery. J Vasc Interv Radiol 2006; 17: 791-9.
- Canbaz S, Acipayam M, Gürbüz H, Duran E. False aneurysm of perforating branch of the profunda femoris artery after external fixation for a complicated femur fracture. J Cardiovasc Surg 2002; 43: 519-21.
- Entwisle JJ, De Nunzio M, Hinwood D. Case report: Transcatheter embolization of pseudoaneurysm of the profunda femoris artery complicating fracture of the femoral neck. Clin Radiol 2001; 56: 424-7.
- Reber PU, Baer HU, Patel AG, Wildi S, Triller J, Büchler MW. Superselective microcoil embolization: treatment of choice in high-risk patients with extrahepatic pseudoaneurysms of the hepatic arteries. J Am Coll Surg 1998; 186: 325de Baere T, Ousehal A, Kuoch V, Sapoval M, Lagrange C, Roche A. Endovascular management of bleeding iliac artery pseudoaneurysms complicating radiation therapy for pelvic malignancies. AJR Am J Roentgenol 1998; 170: 349-53.
Details
| Primary Language | English |
|---|---|
| Journal Section | Case Reports |
| Authors | |
| Publication Date | June 27, 2013 |
| Published in Issue | Year 2013Volume: 35 Issue: 2 |