Treatment Protocol of Traumatic Pseudoaneurysm of the Superficial Temporal Artery

Abstract

Pseudoaneurysm of the superficial temporal artery is an unusual complication. Diagnosis is based on clinical findings and radiologic study. The standard treatment is surgical ligation and resection, and other treatment options include radiologic intervention, thrombin injection, and conservative treatment. In this article, the authors report several cases of pseudoaneurysm and suggest a treatment protocol to manage pseudoaneurysm of the superficial temporal artery. We conducted a retrospective review of 11 patients who underwent treatment of superficial temporal artery pseudoaneurysm between April 2002 and July 2011. According to the duration of the aneurysm, we divided the superficial temporal artery pseudoaneurysms into 3 stages: "Acute" stage is less than 3 weeks, "Subacute" stage is from 3 weeks to 3 months, and "Chronic" stage is more than 3 months. Among the 11 patients who were diagnosed with superficial temporal artery pseudoaneurysms, 7 cases were treated by surgical resection, 2 cases by conservative treatment, 2 cases by thrombin injection, and 1 case by radiologic intervention. There was no recurrence during the follow-up periods. The most successful standard treatment is surgical resection. More recently, many nonsurgical treatments have been used, such as conservative treatment, thrombin injection, endovascular embolization, or coiling. Every method has its advantages and disadvantages and should be chosen according to the chronicity and size of the pseudoaneurysm, patient's clinical status, including hemodynamic stability, patient's aesthetic preferences, and compliance. The authors suggest a systematic treatment protocol depending on the stage of the pseudoaneurysm, patients' status, and preferences.