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      Superselective Arterial Embolization of Pseudoaneurysm and Arteriovenous Fistula Caused by Transurethral Resection of the Prostate

      case-report

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          Summary

          Background

          Pelvic vascular lesions such as pseudoaneurysms and arteriovenous fistulas associated with the internal pudendal artery are uncommon. The most common cause is traumas including those of iatrogenic origin. Surgical treatment is complicated due to location of the lesions and endovascular approach is usually the first choice among the treatment options.

          Case Report

          A 79-year-old patient was admitted with massive hematuria following transurethral resection of prostate for benign prostatic hyperplasia. Doppler US and angiography revealed a pseudoaneurysm and arteriovenous fistula originating from the right internal pudendal artery. It was successfully treated with coil embolization.

          Conclusions

          Arteriovenous fistulas and pseudoaneurysms concerning internal pudendal artery may occur as complications of prostate operations. Minimally invasive endovascular methods provide safe and efficient treatment and today should be considered as the first line of choice.

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          Most cited references10

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          Pseudoaneurysms and the role of minimally invasive techniques in their management.

          Nael E A Saad, Wael E A Saad, Mark G Davies … (2005)
          Pseudoaneurysms are common vascular abnormalities that represent a disruption in arterial wall continuity. Some complications associated with pseudoaneurysms develop unpredictably and carry high morbidity and mortality rates. The advent of new radiologic techniques with a greater sensitivity for asymptomatic disease has allowed more frequent diagnosis of pseudoaneurysms. Conventional angiography remains the standard of reference for diagnosis but is an invasive procedure, and noninvasive diagnostic modalities (eg, ultrasonography [US], computed tomographic angiography, magnetic resonance angiography) should be included in the initial work-up if possible. A complete work-up will help in determining the cause, location, morphologic features, rupture risk, and clinical setting of the pseudoaneurysm; identifying any patient comorbidities; and evaluating surrounding structures and relevant vascular anatomy, information that is essential for treatment planning. Therapeutic options have evolved in recent years from the traditional surgical option toward a less invasive approach and include radiologic procedures such as US-guided compression, US-guided percutaneous thrombin injection, and endovascular management (embolization, stent-graft placement). The use of noninvasive treatment has led to a marked decrease in the morbidity and mortality rates for pseudoaneurysms. Copyright RSNA, 2005.
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            Spontaneous thrombosis of hepatic posttraumatic pseudoaneurysms: sonographic and computed tomographic features.

            Diana Gaitini, Monica Epelman, Michalle Soudack (2002)
            Hepatic artery pseudoaneurysms are rare complications of blunt abdominal trauma. In the past, surgical ligation was the recommended treatment; today, it is embolization. We report a case of a child involved in a motor vehicle collision who had liver lacerations with subsequent development of hepatic artery pseudoaneurysms. In this case, embolization was not performed, and the pseudoaneurysms regressed spontaneously. Spontaneous regression has been reported previously, but its true prevalence is unknown. Our report includes full sonographic and partial computed tomographic (CT) documentation of the lesions during the course of their regression. To the best of our knowledge, this is the first report in the English literature with sonographic depiction of spontaneous thrombosis of a hepatic posttraumatic pseudoaneurysm in a child.
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              Minimally invasive management of postoperative bleeding after radical prostatectomy: transarterial embolization.

              Chang Jeong, Yong Park, Ja Ku … (2010)
              Severe postoperative bleeding after radical prostatectomy is a rare, but serious, complication. Massive postoperative bleeding causing hemodynamic instability necessitates open surgical exploration and can be associated with considerable morbidity. We report our experience with minimally invasive management of postprostatectomy hemorrhage via transarterial embolization (TAE).
              Article 0 comments Cited 8 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Pol J Radiol
                Journal ID (iso-abbrev): Pol J Radiol
                Journal ID (publisher-id): Pol J Radiol
                Title: Polish Journal of Radiology
                Publisher: International Scientific Literature, Inc.
                ISSN (Print): 1733-134X
                ISSN (Electronic): 1899-0967
                Publication date Collection: 2014
                Publication date (Electronic): 07 October 2014
                Volume: 79
                Pages: 352-355
                Affiliations
                Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
                Author notes
                Author’s address: Onur Ergun, Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey, e-mail: onurergun@ 123456yahoo.com
                [A]

                Study Design

                [B]

                Data Collection

                [C]

                Statistical Analysis

                [D]

                Data Interpretation

                [E]

                Manuscript Preparation

                [F]

                Literature Search

                [G]

                Funds Collection

                Article
                Publisher ID: 890900
                DOI: 10.12659/PJR.890900
                PMC ID: 4199465
                PubMed ID: 25324913
                SO-VID: 2adee6e4-6a22-4152-bb34-a18770429ef0
                Copyright © © Pol J Radiol, 2014
                License:

                This is an open access article. Unrestricted non-commercial use is permitted provided the original work is properly cited.

                History
                Date received : 22 April 2014
                Date accepted : 05 May 2014
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Radiology & Imaging
                Keywords: embolization,therapeutic,hematuria,intraoperative complications,transurethral resection of prostate
                Data availability:
                ScienceOpen disciplines: Radiology & Imaging
                Keywords: embolization, therapeutic, hematuria, intraoperative complications, transurethral resection of prostate

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