Pseudoaneurysm
Pseudoaneurysm
Surgery
A pseudoaneurysm occurs when a blood vessel wall is injured and the leaking blood collects in the surrounding tissue.
A pseudoaneurysm occurs when a blood vessel wall is injured and the leaking blood collects in the surrounding tissue. It is also called a false aneurysm. In a true aneurysm, wall of the artery or vessel weakens and bulges, sometimes forming a blood-filled sac. So pseudoaneurysm is a mass of blood clot which pools near the damaged spot. Pseudoaneurysms arise due to a disruption in the wall of a blood vessel caused by various reasons which cause vessel trauma. Few common causes include:
- Trivial injury to the vessel,
- Repeated needle punctures to the femoral artery in the groin region during dialysis
- Infection of the site of catheterization during dialysis,
- Orthopaedic procedures
- Any injury to the blood vessel during catheterization of the patient for dialysis lead to internal bleeding, collection of blood and clot formation in the region of the AV fistula. Frequently these patients are given blood thinning medications which also lead to increased propensity of bleeding from the site of catheterization.
- If the patient has co-agulopathy which means intrinsic disorder of defective blood clot formation, this may compound the problem.
Symptoms of Pseudoaneurysm
False aneurysms are hematomas located outside the vessel wall, so symptoms are usually
- Pain, bruising and swelling at the site of the blood vessel damage.
- A lump will be felt under the skin where the blood is pooling in the tissues which will be painful to the touch.
- It may feel like it's throbbing.
- A whooshing sound called bruit caused by the blood pulsing under skin over the lump will be heard.
They are a major cause for concern as they can rupture, bleed or cause sudden death.
Diagnosis of pseudoaneurysm
Colour Doppler ultrasound is the gold standard investigation for diagnosis. It can differentiate false-aneurysm expansion from a hematoma, the presence of a thrombotic mass, which enables a decision to be made on possible surgical correction.
Treatment of Pseudoaneurysm
- Pseudoaneurysms that are under 2 cm wide on ultrasound, it may close up eventually after bleeding has stopped. We may ask to come in for additional ultrasounds to track the healing process.
- Pseudoaneurysms wider than 2 cmon ultrasound or hasn't gone away on its own, we will need to repair the damage to the blood vessel. There are several treatment options, including:
Stent. Placing a stent in the damaged artery to stop blood from leaking.
Compression. Ultrasound-guided compression is a procedure where your doctor uses an ultrasound to look at the pseudoaneurysm and uses external pressure to release the collected blood.
Medication. With an ultrasound-guided injection into the pseudoaneurysm of clot-building medicationcalled thrombin to stop further bleeding.
Surgery. Surgical intervention is recommended when there is a risk of perforation and ulceration, if it is rapidly enlarging, if there are episodes of bleeding or if the overlying skin is unhealthy and showing features of inflammation. If the lesser invasive treatments don't close the pseudoaneurysm, then surgery is recommended to repair the damaged area of the blood vessel.
Mainstay of treatment is surgery which is done in emergency to avoid rupture of the pseudoaneurysm and massive bleeding. In surgical treatment, the whole pseudoaneurysm and the internal clot is removed and the vessel from which it arises is repaired under microscopic magnification. Sometimes vessel has to be reconstructed using a vein graft or a synthetic graft.
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Best plastic surgeon, Dr. Amit Agarwal is an American Board Certified, extensively trained, and best Plastic & Aesthetic surgeon in Lucknow. He is the Chief Plastic Surgeon heading the Department of Plastic, Microvascular, and Craniofacial surgery at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, U.P, India. He maintains a busy practice at Avadh and Nishat Hospital and his own center - Kayakriti Plastic Surgery & Dental Center. He was formerly a Consultant in the Department of Plastic Surgery and Burns at the prestigious SGPGI, Lucknow.
MS, DNB (General Surgery) MCh, DNB (Plastic Surgery),
MNAMS, FACS, FICS, FRCS (Edinburgh, UK)
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Frequently Asked Questions
If you have flat or small breast and you want to improve your breast and hip contour ratio then you are a good candidate for it. The answer will be best provided after the first consultation with Dr Amit Agarwal.
Acute pain will be there for almost a week which gradually reduces and there will be soreness and swelling which may take up to 3 weeks to subside.
You can join your work and daily routines after a week of the procedure and can start exercising after 3 weeks of it.
Yes, you have to wear it round the clock unless we suggest you to remove it.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
Kayakriti Plastic Surgery & Dental Center
D-43, Near Punjab National Bank, Rajajipuram, Lucknow, Uttar Pradesh - 226017, India
Phone No. +919695940009, +919695940006
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