Transcatheter coil embolization of profunda femoris artery branch pseudoaneurysms in two cases

Derin femoral arterin (DFA) travmatik yaralanması nadir görülür ve genellikle travmatik veya iyatrojenik yaralanma sonucu meydana gelir. Semptomlar genellikle ani başlangıçlı ağrı ve üst uyluk bölgesinde kanamaya bağlı şişlik şeklinde ortaya çıkar. Geçmişte yalancı anevrizmaların tedavisi cerrahi tamirdi. Son dönemlerde transkateter embolizasyon alternatif bir tedavi olarak kabul görmektedir. Bu yazıda uyluk bölgesinde pulsatil kitle ile başvuran iki erkek hasta sunuldu. Bir hastanın öyküsünde femur cisim kırığı, diğerinde delici yaralanma vardı. Yalancı anevrizma tanısı Doppler ultrasonografi ve/veya anjiyografi ile kondu. Yalancı anevrizma bir hastada 3x3 cm büyüklüğünde idi ve sağ DFA'nın perfore dallarının birinden kaynaklanmaktaydı; diğer hastada ise 1.5x1.5 büyüklüğünde ve DFA'nın lateral femoral sirkumfleks arterinin çıkan dalından kaynaklandığı görüldü. İki hasta da platin koil kullanılarak selektif arteryel embolizasyon ile başarılı şekilde tedavi edildi.

İki olguda derin femoral arter dalı yalancı anevrizmalarının transkateter koil embolizasyonu

Pseudoaneurysms of the profunda femoris artery (PFA) are uncommon, usually caused by a traumatic or iatrogenic injury. Symptoms usually become manifest by pain of sudden onset and swelling in the upper thigh due to hemorrhage. In the past, the treatment of pseudoaneurysms was surgical repair. Recently, transcatheter embolization has been recognized as an alternative treatment. We report on two male patients who presented with a pulsatile mass in the thigh following a femoral shaft fracture and a penetrating injury, respectively. The diagnosis of pseudoaneurysms was made by Doppler ultrasonography and/or angiography. In one patient, the pseudoaneurysm was 3x3 cm in size and originated from one of the perforating branches of the right PFA. In the other, it measured 1.5x1.5 cm and originated from the ascending branch of the lateral femoral circumflex artery of the left PFA. Both patients were successfully treated by selective arterial embolization with platinum coils.

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