Vascular Pseudoaneurysms in Urology: Clinical Characteristics and Management

Department of Urology, Multicare Health System, Tacoma, Washington, USA.
Journal of endourology / Endourological Society (Impact Factor: 1.71). 06/2010; 24(6):915-21. DOI: 10.1089/end.2009.0662
Source: PubMed


Vascular pseudoaneurysm is a well-documented complication that results after injury to an arterial wall. We review the urologic literature for all reported postprocedural and post-traumatic cases of pseudoaneurysm.
A comprehensive review of the peer-reviewed literature was performed for reported cases of vascular pseudoaneurysm, with emphasis on clinical presentation and treatment options.
Vascular pseudoaneurysm is a high-pressure collection of blood that communicates directly with an arterial vessel. The clinical presentation varies, depending on the location and size of the lesion, and can be quite dramatic and potentially life threatening. There may be an increasing incidence of pseudoaneurysms after minimally invasive and laparoscopic techniques. Selective and superselective embolization is the preferred treatment for patients with vascular pseudoaneurysms.
Vascular pseudoaneurysm is an important but rare complication that is increasingly reported after minimally invasive urologic surgery. This diagnosis necessitates a high index of suspicion and radiologic acumen. Treatment is individually tailored to each patient, but selective embolization appears to be the standard of care.

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    • "We postulated that a pulsatile bladder hemorrhage suggested a vascular malformation, maybe owing to rupture of a submucosal branch of vesical artery, and transurethral electrocoagulation causes damage to an arterial wall, which was responsible for the formation of the vesical arterial pseudoaneurysm. Rupture of a pseudoaneurysm is potentially a fatal event, particularly pseudoaneurysms that occur in large visceral arteries [12]. "
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