Usefulness of doppler techniques in the diagnosis of peripheral iatrogenic pseudoaneurysms secondary to minimally invasi
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ORIGINAL PAPER
Usefulness of doppler techniques in the diagnosis of peripheral iatrogenic pseudoaneurysms secondary to minimally invasive interventional and surgical procedures: imaging findings and diagnostic performance study Antonio Corvino1 · Orlando Catalano2 · Giuseppe de Magistris3 · Fabio Corvino3 · Francesco Giurazza3 · Niola Raffaella3 · Gianfranco Vallone4 Received: 17 March 2020 / Accepted: 6 May 2020 © Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2020
Abstract The pseudoaneurysm (PA) is a perfused sac directly connecting with the arterial lumen by an interruption of the vessel wall continuity, more commonly secondary to trauma or iatrogenic causes. Aim of our study was to determine the accuracy and usefulness of Doppler techniques in the diagnosis of peripheral iatrogenic PAs secondary to minimally invasive procedures. From a three year prospective research, 20 Duplex Ultrasound (DUS) studies in as many patients presenting with periarterial pulsating mass clinically suspected for PA secondary to minimally invasive procedures were selected. The PA final diagnosis was confirmed by angiography in 12 patients (60% cases), by computed tomography angiography in 5 patients (25%), by surgery in 2 patients (10%), and by magnetic resonance angiography in 1 patient (5%). The vessels involved by PA formation were: common femoral artery in 8 cases (40%); superficial femoral artery in 4 cases (20%); brachial artery in 3 cases (15%); popliteal artery in 2 cases (10%); superficial temporal artery (STA) in 2 cases (10%); dorsal medial digital artery of the foot in 1 case (5%). Our study confirmed the usefulness of doppler techniques in the diagnosis of peripheral iatrogenic PAs. Specifically, a sensitivity of 90–95%, a specificity of 100% and predictive values of 100% (VPP) and 83–90% (VPN) were reported. The radiologist must always suspect a PA in the differential diagnosis of lesions contiguous to an artery vessel. This is to prevent potential complications such as e.g. massive haemorrhage. In this order, DUS allows a careful selection of patients who require to undergo in-depth imaging methods or surgical therapy, thus contributing to a significant reduction of contrast medium and exposure to ionizing radiation. Keywords Iatrogenic pseudoaneurysm · Ultrasound · Colour-doppler · Pulsed-doppler · Yin-yang sign
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40477-020-00475-6) contains supplementary material, which is available to authorized users. * Fabio Corvino [email protected] 1
Motor Science and Wellness Department, University of Naples “Parthenope”, Via F. Acton 38, 80133 Naples, Italy
2
Radiology Unit, Istituto Diagnostico Varelli, Via Cornelia dei Gracchi 65, 80126 Naples, Italy
3
Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131 Naples, Italy
4
Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Via S. Pansini 5, 80131 Naples, Italy
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