What is the treatment for pseudoaneurysm?

What is the treatment for a false aneurysm?

The incidence of pseudoaneurysms after diagnostic angiography is 0.05% to 2%, and the incidence after endovascular intervention is 2% to 8%. Risk factors include the use of large-bore delivery systems >7F, long and complex interventions, high or deep puncture points, inappropriate pressure after sheath removal, the use of arterial occluders, the combination of antiplatelet drugs and anticoagulants, and patient-specific factors. Potential complications include dilatation, rupture, and infection. Complex AVF pseudoaneurysms may also occur in arteriovenous fistulas.

If the pseudoaneurysm is small ≤ 20 mm, about 50% of patients will spontaneously thrombose without the use of anticoagulants or antiplatelet drugs if they have only mild symptoms. Ultrasound follow-up is required. If treatment is necessary, the options are normal saline, ultrasound-guided paraaneurysm injection of thrombin, other ultrasound-guided injection techniques, covered stents to cover ruptures, and vascular surgery.

The incidence of cerebral artery rupture and bleeding is higher than that of hypertensive cerebral hemorrhage, and there are more female patients than male patients.

There are obvious symptoms of ruptured cerebral aneurysm bleeding:

1. Neurological symptoms: Even if a large aneurysm does not rupture and bleed, it may compress the surrounding adjacent nerves such as the optic nerve, sliding nerve, mobile nerve and abducens nerve, leading to blurred vision, visual defects and limited eye movement. Some patients may also experience symptoms such as eye pain and speech difficulties.

2. Symptoms caused by acute rupture and bleeding: When an aneurysm suddenly ruptures and bleeds, the patient will immediately feel a severe headache, which is often unbearable. As the bleeding worsens, the patient's symptoms will gradually progress to screaming, coma, impaired consciousness, and even death. During the bleeding period, some patients also have obvious symptoms such as foam in the mouth and muscle rigidity and spasm. Patients with severe bleeding may suddenly faint and immediately fall into a coma, and may die within 20 minutes.