Iatrogenic Vascular Complications Associated With External Ventricular Drain Placement: A Report of 8 Cases and Review of the Literature

2012 ◽  
Vol 72 (2) ◽  
pp. ons208-ons213 ◽  
Author(s):  
Jennifer Kosty ◽  
Bryan Pukenas ◽  
Michelle Smith ◽  
Phillip B. Storm ◽  
Eric Zager ◽  
...  
Keyword(s):  
Transarterial Embolization ◽  
External Ventricular Drain ◽  
Superficial Temporal Artery ◽  
Vascular Complications ◽  
Temporal Artery ◽  
Vascular Trauma ◽  
Vascular Lesions ◽  
Ventricular Catheter ◽  
Traumatic Aneurysm ◽  
Arteriovenous Fistulas

Abstract BACKGROUND: Placement of an external ventricular drain (EVD) is a commonly performed and often lifesaving procedure. Although hemorrhage is one of the commonest complications associated with the procedure, ventricular catheter–induced vascular injury is rarely reported. OBJECTIVE: To describe 9 cases of EVD-related vascular trauma: 7 arteriovenous fistulas and 2 traumatic aneurysms. METHODS: During a 3-year period, 299 patients had EVDs placed. Eight patients (2.75%), 3 male and 5 female (mean age, 48 ± 20 years), developed vascular lesions associated with EVDs. Six patients developed arteriovenous fistulas and 2 patients developed a traumatic aneurysm. The arterial feeders of 5 superficial draining fistulas arose from the middle meningeal artery, and the arterial feeder of a deep-draining fistula originated from a lenticulostriate artery. One traumatic aneurysm arose from a distal branch of the anterior cerebral artery, and the second from a branch of the superficial temporal artery. Four of the superficial fistulas were treated with transarterial embolization. RESULTS: Two superficial fistulas and the deep-draining fistula resolved spontaneously after EVD removal. The intracranial aneurysm was embolized with Onyx18, and the superficial temporal artery aneurysm was managed conservatively. There were no hemorrhages associated with any of these vascular lesions and no complications after treatment. CONCLUSION: Our data suggest that iatrogenic vascular trauma associated with EVD insertions (2.75%) may be more common than is currently appreciated. Endovascular treatment is effective and may be necessary when these lesions do not resolve spontaneously.

Traumatic Aneurysm of the Parietal Branch of the Superficial Temporal Artery

2011 ◽  
Vol 23 (1) ◽  
pp. 55-58
Author(s):  
M. K. Folstein ◽  
M. B. Brewer ◽  
K. Chopra ◽  
M. R. Christy
Keyword(s):  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Traumatic Aneurysm

Traumatic aneurysm of the superficial temporal artery from fist injury

1990 ◽  
Vol 4 (4) ◽  
pp. 353-354 ◽  
Author(s):  
Alvaro Andreoli ◽  
Francesco Tognetti ◽  
Giuseppe Lanzino
Keyword(s):  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Traumatic Aneurysm

scholarly journals Traumatic pseudoaneurysm of the superficial temporal artery

2012 ◽  
Vol 2 (2) ◽  
pp. 34
Author(s):  
Suvy Manuel ◽  
Deepti Simon ◽  
Eldhose K. George ◽  
Raghava B. Naik
Keyword(s):  
Early Diagnosis ◽  
English Literature ◽  
Superficial Temporal Artery ◽  
Vascular Complications ◽  
Temporal Artery ◽  
Vascular Injuries ◽  
Prompt Treatment ◽  
Anterior Branch ◽  
First Case ◽  
Traumatic Pseudoaneurysm

Aneurysms of the superficial temporal artery are relatively rare vascular complications following trauma. Two cases of pseudoaneurysm of the anterior branch of the superficial temporal artery, subjected to blunt maxillofacial trauma are presented here. The first case was treated by surgical resection and the second was cured by application of continuous pressure. The review of the English literature has also been included. An awareness of these vascular injuries, despite their infrequency, is necessary to facilitate early diagnosis, proper investigation and prompt treatment.

scholarly journals Ultrasound Diagnosed Rare Partial Nephrectomy Complication

2018 ◽  
Vol 28 (01) ◽  
pp. 025-027
Author(s):  
Almut Ettorre ◽  
Enrique Alejandre-Lafont ◽  
Faeq Syed ◽  
Astrid Most ◽  
Christian Hamm ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Transarterial Embolization ◽  
Tumor Resection ◽  
Hemodynamic Instability ◽  
Duplex Sonography ◽  
Vascular Lesions ◽  
Severe Bleeding ◽  
Artery Pseudoaneurysm ◽  
Arteriovenous Fistulas ◽  
Effective Treatment Modality

AbstractRenal artery pseudoaneurysm (RAP) is a serious complication that can lead to severe hematuria, blood loss, and life-threatening hemorrhagic shock. A pseudoaneurysm is defined as an arterial wall deficiency that results in the accumulation of oxygenated blood in the nearby extraluminal region. Partial nephrectomy, a parenchymal sparing method, carries a lower risk of postoperative development of chronic kidney disease than total nephrectomy but a higher risk of iatrogenic vascular lesions such as RAP or arteriovenous fistulas. Pseudoaneursyms may develop secondary to arterial transection during tumor resection or due to arterial puncture during suture ligation of the resection bed. Emergency transarterial embolization is an effective treatment modality for patients with hemodynamic instability that does not lead to significant worsening of renal function. The recent literature reports an incidence of 2.7 to 21.7% of RAP or arteriovenous fistulas after partial nephrectomy. We report a case of severe bleeding with massive hematuria due to RAP, which was detected with duplex sonography.

Intracranial and extracranial multiple arterial dissecting aneurysms in rheumatoid arthritis: A case report

2020 ◽  
pp. 159101992096535
Author(s):  
Ken Uekawa ◽  
Yasuyuki Kaku ◽  
Toshihiro Amadatsu ◽  
Hiroaki Matsuzaki ◽  
Yuki Ohmori ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Coil Embolization ◽  
De Novo ◽  
Superficial Temporal Artery ◽  
Vascular Complications ◽  
Temporal Artery ◽  
Left Internal Carotid Artery ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Dissecting Aneurysms

Objective We describe a case of intracranial and extracranial multiple arterial dissecting aneurysms in rheumatoid arthritis (RA). Case Presentation A 29-year-old man with a medical history of RA since 18 years of age was admitted to our hospital for vomiting, dysarthria, and conscious disturbance. At 23, he underwent ligation of the left internal carotid artery (ICA) with superficial temporal artery to middle cerebral artery anastomosis because of acute infarct of the left hemisphere caused by arterial dissection of the left ICA. During the current admission, computed tomography (CT) revealed subarachnoid hemorrhage, and digital subtraction angiography (DSA) demonstrated dissecting aneurysms of the left intracranial vertebral artery (VA) and right extracranial VA. We diagnosed him with a ruptured dissecting aneurysm of the left intracranial VA and performed endovascular parent artery occlusion on the left VA. For the right unruptured VA aneurysm, we performed coil embolization simultaneously. At 2 weeks after the endovascular treatment, follow-up DSA revealed that multiple de novo dissecting aneurysms developed on the origin of the left VA and left and right internal thoracic arteries. Those aneurysms were treated with coil embolization. Other remaining aneurysms on the left thyrocervical trunk, right transverse cervical artery, and both common iliac arteries were treated by conservative therapy. While continuing medical treatment for RA, the patient recovered and was discharged to a rehabilitation hospital. Conclusion Considering that RA-induced vasculitis can be a potential risk of vascular complications including multiple arterial dissections, physicians should carefully perform endovascular interventional procedures for patients with long-term RA.

scholarly journals Treatment of a cerebral pial arteriovenous fistula in a patient with sickle cell disease-related moyamoya syndrome: case report

2015 ◽  
Vol 16 (2) ◽  
pp. 207-211 ◽  
Author(s):  
Anna Lo Presti ◽  
Alexander G. Weil ◽  
Aria Fallah ◽  
Eric C. Peterson ◽  
Toba N. Niazi ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Moyamoya Disease ◽  
De Novo ◽  
Transarterial Embolization ◽  
Management Strategies ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Venous Aneurysm ◽  
Cell Disease

Sickle cell disease (SCD) is an autosomal recessive hematological disorder, characterized by sickling of the red blood cells in response to a hypoxic stress and vaso-occlusive crises. It is associated with moyamoya-like changes on cerebral angiographic imaging in 43% of patients. Cerebral aneurysms, arteriovenous malformations, and dural arteriovenous fistulas (AVFs) have been described in association with SCD and moyamoya disease. However, the description of a pial AVF (pAVF) in a patient with SCD and/or moyamoya formation has not yet been reported. The authors present the case of a 15-year-old boy with SCD-associated moyamoya disease harboring a pAVF who developed a de novo venous aneurysm 8 months after undergoing indirect superficial temporal artery-middle cerebral artery (MCA) bypass that was complicated by bilateral ischemia of the MCA territory. The pAVF was successfully treated with transarterial embolization using Onyx. The authors describe the possible pathophysiological mechanisms and management strategies for this rare occurrence.

scholarly journals Absence of skin discoloration after transarterial embolization of a subcutaneous auricular arteriovenous malformation with PHIL

2016 ◽  
Vol 22 (5) ◽  
pp. 606-610 ◽  
Author(s):  
Matthijs in ‘t Veld ◽  
Peter WA Willems
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Normal Skin ◽  
Transarterial Embolization ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Embolic Agent ◽  
First Case ◽  
Posterior Auricular Artery

Background and objective One of the treatment options for arteriovenous malformations consists of embolization, with a choice of various embolic agents, with or without subsequent surgical excision. If embolization is offered without subsequent surgery, the embolic material will stay in situ, in which case the consistency and color become important in superficial lesions. The purpose of this case report is to describe if the use of a novel liquid embolic agent (PHIL) is well suited for treatment of superficial AVMs without subsequent surgery. Case description A 30-year-old male presented with a painful reddish, pulsatile swelling of the left ear that had been present for more than 10 years. Angiography confirmed an arteriovenous malformation supplied by the superficial temporal artery and the posterior auricular artery. The lesion was successfully treated by embolization with PHIL, through the superficial temporal artery. A minute residual shunt, from the posterior auricular artery, was accepted. Immediate disappearance of pulsatile tinnitus was reported. Moreover, return of normal skin color was observed without discomfort from the embolic deposits. This result has been stable throughout one year of clinical follow-up. Conclusion To our knowledge, this is the first case report describing PHIL embolization as a treatment option for superficial arteriovenous malformations without the necessity for subsequent surgery. The white color and rubbery consistency are beneficial characteristics of PHIL in treatment of subcutaneous lesions, especially in cosmetically relevant locations.

scholarly journals The oculomotor-tentorial triangle. Part 2: a microsurgical workspace for vascular lesions in the crural and ambient cisterns

2019 ◽  
Vol 130 (5) ◽  
pp. 1435-1445
Author(s):  
Justin R. Mascitelli ◽  
Sirin Gandhi ◽  
Ali Tayebi Meybodi ◽  
Michael T. Lawton
Keyword(s):  
Cerebral Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Vascular Pathology ◽  
Vascular Lesions ◽  
Oculomotor Nerve Palsy ◽  
External Carotid ◽  
Vertebrobasilar Insufficiency ◽  
Cavernous Malformations ◽  
Bypass Patency

OBJECTIVEPathology in the region of the basilar quadrifurcation, anterolateral midbrain, medial tentorium, and interpeduncular and ambient cisterns may be accessed anteriorly via an orbitozygomatic (OZ) craniotomy. In Part 1 of this series, the authors explored the anatomy of the oculomotor-tentorial triangle (OTT). In Part 2, the versatility of the OTT as a surgical workspace for treating vascular pathology is demonstrated.METHODSSixty patients with 61 vascular pathologies treated within or via the OTT from 1998 to 2017 by the senior author were retrospectively reviewed. Patients were grouped together based on pathology/surgical procedure and included 1) aneurysms (n = 19); 2) posterior cerebral artery (PCA)/superior cerebellar artery (SCA) bypasses (n = 24); 3) brainstem cavernous malformations (CMs; n = 14); and 4) tentorial region dural arteriovenous fistulas (dAVFs; n = 4). The majority of patients were approached via an OZ craniotomy, wide sylvian fissure split, and temporal lobe mobilization to widen the OTT.RESULTSAneurysm locations included the P1-P2 junction (n = 7), P2A segment (n = 9), P2/3 (n = 2), and basilar quadrification (n = 1). Aneurysm treatments included clip reconstruction (n = 12), wrapping (n = 3), proximal occlusion (n = 2), and trapping with (n = 1) or without (n = 1) bypass. Pathologies in the bypass group included vertebrobasilar insufficiency (VBI; n = 3) and aneurysms of the basilar trunk (n = 13), basilar apex (n = 4), P1 PCA (n = 2), and s1 SCA (n = 2). Bypasses included M2 middle cerebral artery (MCA)–radial artery graft (RAG)–P2 PCA (n = 8), M2 MCA–saphenous vein graft (SVG)–P2 PCA (n = 3), superficial temporal artery (STA)–P2 PCA (n = 5) or STA–s1 SCA (n = 3), s1 SCA–P2 PCA (n = 1), V3 vertebral artery (VA)–RAG–s1 SCA (n = 1), V3 VA–SVG–P2 PCA (n = 1), anterior temporal artery–s1 SCA (n = 1), and external carotid artery (ECA)–SVG–s1 SCA (n = 1). CMs were located in the midbrain (n = 10) or pontomesencephalic junction (n = 4). dAVFs drained into the tentorial, superior petrosal, cavernous, and sphenobasal sinuses. High rates of aneurysm occlusion (79%), bypass patency (100%), complete CM resection (86%), and dAVF obliteration (100%) were obtained. The overall rate of permanent oculomotor nerve palsy was 8.3%. The majority of patients in the aneurysm (94%), CM (93%), and dAVF (100%) groups had stable or improved modified Rankin Scale scores.CONCLUSIONSThe OTT is an important anatomical triangle and surgical workspace for vascular lesions in and around the crural and ambient cisterns. The OTT can be used to approach a wide variety of vascular pathologies in the region of the basilar quadrifurcation and anterolateral midbrain.

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