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医源性假性动脉瘤:鼻窦手术的罕见并发症。

Iatrogenic pseudoaneurysm: a rare complication of sinonasal surgery.

机构信息

Department of ENT Unit 3, Christian Medical College, Vellore, India.

出版信息

Am J Otolaryngol. 2011 Nov-Dec;32(6):607-10. doi: 10.1016/j.amjoto.2010.08.004. Epub 2010 Oct 29.

Abstract

OBJECTIVE

We report 2 patients with iatrogenic pseudoaneurysms, which developed following sinus surgery.

METHOD

Case reports and a review of literature of the management of iatrogenic pseudoaneurysm.

RESULTS

For one patient who presented with massive epistaxis, the only lifesaving option available was to perform an urgent angiogram followed by selective embolization of the feeding vessel. In the second patient who presented with persistent nasal obstruction and discharge and no epistaxis, a traumatic aneurysm of the internal carotid artery was demonstrated on magnetic resonance imaging scan that was later confirmed by angiography; he, however, declined further treatment.

CONCLUSION

Iatrogenic pseudoaneurysms that develop following a vascular injury, though rare, can cause life-threatening epistaxis or a thromboembolism. In this report, we describe 2 different manifestations of iatrogenic vascular malformations following sinus surgery. The role of angiography and subsequent endovascular therapy in the management of these lesions is emphasized.

摘要

目的

我们报告了 2 例因鼻窦手术引起的医源性假性动脉瘤患者。

方法

病例报告并回顾医源性假性动脉瘤处理的文献。

结果

1 例患者表现为大出血,唯一可行的救命措施是紧急进行血管造影,然后对供血血管进行选择性栓塞。另 1 例患者表现为持续鼻塞和分泌物,无鼻出血,磁共振成像扫描显示颈内动脉创伤性动脉瘤,随后血管造影证实;但他拒绝进一步治疗。

结论

血管损伤后发生的医源性假性动脉瘤虽然罕见,但可引起危及生命的鼻出血或血栓栓塞。在本报告中,我们描述了鼻窦手术后出现的 2 种不同类型的医源性血管畸形。强调了血管造影术和随后的血管内治疗在这些病变中的作用。

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