Fact-sheet: Arterial pseudoaneurysm
Updated on 10/04/2017 at 9:55 AM
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Definition
Secondary to arterial wall injury causing an arterial breach leading to the formation of an aneurysmal sac through chronic bleeding at the site of the breach.
Pseudoaneurysm: partial rupture of the arterial wall layers with preservation of the adventitia.
False aneurysm (most common presentation): lesion involving the entire arterial wall (intima, media, and adventitia) — in this case, the aneurysmal sac is contained within the hematoma collected and organized around the breach.
Clinical features
Pulsatile mass.
Course: increase in size and hemorrhage when the aneurysmal sac is no longer contained.
Spontaneous thrombosis is exceptional.
Laboratory findings
Anemia.
CT
Circulating pouch adjacent to an arterial breach forming an aneurysmal sac filled with contrast material on the arterial phase.
Chronic isodense hematoma, collected and organized at the periphery of the aneurysmal sac, forming its wall.
Management
Early specialized management is required.
Endovascular or surgical treatment depending on associated lesions (compressive hematoma): occlusion of the parent vessel of the false or pseudoaneurysm.
