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Lower extremity pseudoaneurysms and their interventional radiological management: a pictorial review

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A Correction to this article was published on 26 June 2023

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Abstract

Lower extremity pseudoaneurysms (PsAs) are mostly developed after traumatic or iatrogenic injury to the arteries. Unless treated, they can be complicated by adjacent mass effects, distal embolism, secondary infection, and rupture. Imaging helps in the diagnosis and planning of therapeutic intervention. Ultrasonography (USG) is often diagnostic, while CT angiography aids in vascular mapping required for intervention. Image-guided therapy offers to manage these pseudoaneurysms in a minimally invasive approach, obviating the need for surgery. A smaller, superficial, and narrow-necked PsA can easily be managed with local USG-guided compression or thrombin injection. When the percutaneous approach is not a feasible option, PsA from expendable arteries can also be managed with coiling or glue injection. Wide-necked PsA from an unexpendable artery necessitates stent graft placement, although coiling of the neck may be a viable and cheaper alternative for a long- and narrow-necked PsA. Presently, vascular closure devices are also used to seal a small arterial rent through a direct percutaneous approach. This pictorial review entails various techniques to deal with lower extremity pseudoaneurysms. An idea about the various intervention radiological approaches will help in choosing appropriate methods to tackle lower extremity pseudoaneurysms.

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Authors and Affiliations

  1. Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India, 751019

    Ranjan Kumar Patel, Alamelu Alagappan & Taraprasad Tripathy

  2. Department of Interventional Radiology, Fortis Hospital, Shalimar Bagh, New Delhi, India

    Prayas Vats

  3. Department of Vascular and Interventional Radiology, Asian Institute of Medical Sciences, Uttar Pradesh, Faridabad, India

    Pulkit Rangarh

  4. Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Bhubaneswar, India, 751019

    Satyapriya Mohanty & Siddharth Sathia

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  1. Ranjan Kumar Patel
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  2. Alamelu Alagappan
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Correspondence to Taraprasad Tripathy.

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The original online version of this article was revised: The original article contains an error in author name. Alamellu Alagapan should be updated to Alamelu Alagappan.

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Patel, R.K., Alagappan, A., Tripathy, T. et al. Lower extremity pseudoaneurysms and their interventional radiological management: a pictorial review. Emerg Radiol 30, 555–561 (2023). https://doi.org/10.1007/s10140-023-02151-8

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