Enormous Articular Hemorrhage Following Arthroscopy, Total Joint Replacement and other Surgical Operations in Hemophilic Patients due to Arterial Pseudoaneurysms: Diagnosis and Treatment | ||
The Archives of Bone and Joint Surgery | ||
مقاله 1، دوره 9، شماره 5، آذر و دی 2021، صفحه 475-479 اصل مقاله (473.86 K) | ||
نوع مقاله: CURRENT CONCEPTS REVIEW | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2020.47158.2302 | ||
نویسنده | ||
E. Carlos RODRIGUEZ-MERCHAN* | ||
Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain | ||
چکیده | ||
Pseudoaneurysms in hemophilic patients are unusual. We must have a suspicion when the patient has suffered an arterial trauma (following arthroscopy, total joint replacement and other surgical operations). Pseudoaneurysms may take place in any anatomical zone where there has been trauma. The diagnosis must be verified by duplex ultrasonography (US), standard angiogram, computed tomography angiogram or magnetic resonance angiography. There are diverse alternatives for the management of arterial pseudoaneurysms. Small pseudoaneurysms can be resolved with conservative noninterventional management. It includes outside pressing, US probe pressing or USguided thrombin injections. In larger pseudoaneurysms, endovascular methods, such as coil embolization, are now preferred. If the aforesaid methods are unsuccessful, standard surgical management with simple ligation or arterial reconstruction must be carried out. We must suspect a pseudoaneurysm when, following an arterial trauma, there is severe bleeding that does not stop with appropriate management with intravenous injection of the insufficient coagulation factor. The diagnosis has to be verified by imaging. Endovascular tmethods, such as coil embolization, are now preferred by the majority of physicians. The diagnosis and managment of an arterial pseudoaneurysm must be carried promptly to avert adverse events. Level of evidence: III | ||
کلیدواژهها | ||
Arterial embolization؛ Arterial pseudoaneurysms؛ Arthroscopy؛ Diagnosis؛ Hemophilia؛ Joint arthroplasty؛ Treatment | ||
مراجع | ||
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