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İnfant Döneminde İyatrojenik Brakiyal Arter Psödoanevrizmaları ve Cerrahi Tedavisi

Year 2013, Volume: 7 Issue: 2, 69 - 72, 01.08.2013

Abstract

Giriş ve Amaç: Çocukluk çağında brakiyal arter anevrizmaları oldukça nadir görülür. Brakiyal arter anevrizma ve psödoanevrizmalarında temel risk distal iskemik komplikasyonların gelişmesidir. Kliniğimizde brakiyal arter psödoanevrizması nedeniyle ameliyat edilmiş olan 9 infant olgu sunularak tedavi sonuçları tartışılmıştır.Gereç ve Yöntemler: Kliniğimizde 2005-2010 yılları arasında psödoanevrizma tanısı ile cerrahi girişimde bulunulan ve yaşları 3 ay ile 13 ay arasında değişen 9 olgu hastane kayıtlarından geriye dönük olarak değerlendirildi. Radyolojik olarak psödoanevrizma tanısı konulan olgular, cerrahi girişim için endikasyon kabul edildi.Bulgular: Altı kız, 3 erkek toplam 9 hasta değerlendirmeye alındı. Hastaların tamamı kliniğimize dış merkezlerden fizik muayenede anevrizma kesesinin palpe edilmesi sonrası gönderilmişti. Hastaların yaşları 3 ay ile 13 ay arasında değişmekteydi. Dört hastada sol kol, beş hastada sağ kol brakial arter peudoanevrizması saptandı. Doppler ultrasonografi ile değerlendirilen hastalardaki psödoanevrizma kesesi görüntülendi.Sonuç: Infant döneminde gözlenen brakiyal arter psödoanevrizmaları çoklu venöz girişimler sonrası nadir görülen bir komplikasyondur. Bu olguların tedavilerinde erken tanı ve cerrahi rekonstrüksiyon, gelişebilecek iskemi komplikasyonunu önleme açısından oldukça önemlidir. Olgularımızda da bu nedenle antekubital yerleşimli brakiyal arter psödoanevrizmaları cerrahi olarak onarıldı, ameliyat sonrası izlemleri normaldi.

References

  • Lin PH, Dodson TF, Bush RL, Weiss VJ, Conklin BS, Chen C, et al. Surgical intervention for complications caused by femoral artery catheterization in pediatric patients. J Vasc Surg 2001;34:1071- 78.
  • Gamba P, Tchaprassian Z, Verlato F, Verlato G, Orzali A, Zanon GF. Iatrogenic vascular lesions in extremely low birth weight and low birth weight neonates. J Vasc Surg 1997;26:643–6.
  • Rey C, Marache P, Watel A, Francart C. Iatrogenic false aneurysm of the brachial artery in an infant. Eur J Pediatr 1987;146:438–9.
  • Restrepo R, Ranson M, Chait PG, Connoly BL, Temple MJ, Amaral J, et al. Extracranial aneurysms in children: Practical classification and correlative imaging. AJR 2003;181:867-78.
  • Fellmeth BD, Roberts AC, Bookstein JJ, Freischlag JA, Forsythe JR, Buckner NK, et al. Postangiographic femoral artery injuries: Nonsurgical repair with US-guided compression. Radiology 1991;178:671-5.
  • Verlato F, Zanon GF, Gamba PG, Verlato G, Rocco S, Orzali A, et al. Echo Doppler color flow (ECDF) evaluation of vascular pathology in pediatric age groups. Int Angiol 1996;15:321-7.
  • Flanigan DP, Keifer TJ, Schuler JJ, Ryan TJ, Castronuovo JJ. Experience with latrogenic pediatric vascular injuries. Incidence, etiology, management, and results. Ann Surg 1983;198:430-42.
  • Sarkar R, Coran AG, Cilley RE. Arterial aneurisms in children: Clinicopathologic classification. J Vasc Surg 1991;13:47–57.
  • Dzepina I, Unusic J, Mijatovic D, Bulic K. Pseudoaneurysms of the brachial artery following venipuncture in infants. Pediatr Surg Int 2004;20:594-7.
  • LaQuaglia MP, Upton J, May JW. Microvascular reconstruction of major arteries in neonates and small children. J Pediatr Surg 1991;26:1136–40.
  • Landau D, Schreiber R, Szendro G, Golcman L. Brachial artery pseudoaneurysm in a premature infant. Arch Dis Child Fetal Neonatal Ed 2003;88:152–3.

Surgical Management of Iatrogenic Brachial Artery Pseudoaneurisms in Infancy

Year 2013, Volume: 7 Issue: 2, 69 - 72, 01.08.2013

Abstract

Objective: Brachial arterial aneurysms are relatively uncommon in childhood. Development of the distal ischemic complications is the main risk in brachial arterial aneurysm and pseudoaneurysms. Nine infants who had surgery for brachial artery pseudoaneurysm in our clinic were reported and the results of the treatment are discussed.Material and Methods: Nine patients who were operated for pseudoaneurysms at our clinic between 2005 and 2010 were evaluated retrospectively from hospital records. Radiological diagnosis of pseudoaneurysms was considered as an indication for surgery.results: A total of 9 patients were evaluated, and six were girls. Pseudoaneurysms were located in the right arm in five patients. All the cases were referred from other pediatric centers. conclusion: Brachial arterial pseudoaneurysms in infants are a rare complication after multiple venous punctures. Early diagnosis and surgical reconstruction of these cases are very important for the prevention of ischemic complication. Brachial artery pseudoaneurysms with ultrasonographic diagnosis were repaired surgically at our clinic to prevent ischemic complications

References

  • Lin PH, Dodson TF, Bush RL, Weiss VJ, Conklin BS, Chen C, et al. Surgical intervention for complications caused by femoral artery catheterization in pediatric patients. J Vasc Surg 2001;34:1071- 78.
  • Gamba P, Tchaprassian Z, Verlato F, Verlato G, Orzali A, Zanon GF. Iatrogenic vascular lesions in extremely low birth weight and low birth weight neonates. J Vasc Surg 1997;26:643–6.
  • Rey C, Marache P, Watel A, Francart C. Iatrogenic false aneurysm of the brachial artery in an infant. Eur J Pediatr 1987;146:438–9.
  • Restrepo R, Ranson M, Chait PG, Connoly BL, Temple MJ, Amaral J, et al. Extracranial aneurysms in children: Practical classification and correlative imaging. AJR 2003;181:867-78.
  • Fellmeth BD, Roberts AC, Bookstein JJ, Freischlag JA, Forsythe JR, Buckner NK, et al. Postangiographic femoral artery injuries: Nonsurgical repair with US-guided compression. Radiology 1991;178:671-5.
  • Verlato F, Zanon GF, Gamba PG, Verlato G, Rocco S, Orzali A, et al. Echo Doppler color flow (ECDF) evaluation of vascular pathology in pediatric age groups. Int Angiol 1996;15:321-7.
  • Flanigan DP, Keifer TJ, Schuler JJ, Ryan TJ, Castronuovo JJ. Experience with latrogenic pediatric vascular injuries. Incidence, etiology, management, and results. Ann Surg 1983;198:430-42.
  • Sarkar R, Coran AG, Cilley RE. Arterial aneurisms in children: Clinicopathologic classification. J Vasc Surg 1991;13:47–57.
  • Dzepina I, Unusic J, Mijatovic D, Bulic K. Pseudoaneurysms of the brachial artery following venipuncture in infants. Pediatr Surg Int 2004;20:594-7.
  • LaQuaglia MP, Upton J, May JW. Microvascular reconstruction of major arteries in neonates and small children. J Pediatr Surg 1991;26:1136–40.
  • Landau D, Schreiber R, Szendro G, Golcman L. Brachial artery pseudoaneurysm in a premature infant. Arch Dis Child Fetal Neonatal Ed 2003;88:152–3.
There are 11 citations in total.

Details

Other ID JA84US84PS
Journal Section Research Article
Authors

Murat Koç This is me

Hakan Aydın This is me

Tolga Baş This is me

Onur Işık This is me

Senem Özgür This is me

Ahmet Reşat Doğusan This is me

Ali Kutsal This is me

Publication Date August 1, 2013
Submission Date August 1, 2013
Published in Issue Year 2013 Volume: 7 Issue: 2

Cite

Vancouver Koç M, Aydın H, Baş T, Işık O, Özgür S, Doğusan AR, Kutsal A. Surgical Management of Iatrogenic Brachial Artery Pseudoaneurisms in Infancy. Türkiye Çocuk Hast Derg. 2013;7(2):69-72.


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