Takayasu's Arteritis-associated Superior Mesenteric Artery Aneurysm Treated by Stent-graft Implantation via the Common Carotid Artery

Purpose: To report the use of the Nellix endovascular aneurysm sealing (EVAS) system in the management of proximal stent-graft collapse associated with thrombosis following endovascular aneurysm repair (EVAR). Case Report: A 76-year-old man was admitted for proximal collapse of an aortic extension following bifurcated AFX stent-graft implantation associated with chimney grafts in both renal arteries and the superior mesenteric artery 1 month prior. Imaging identified thrombosis of the aortic stent-graft and the iliac limbs. A Nellix EVAS was placed into the AFX stent-graft to recanalize the aneurysm lumen and address the aortic thrombosis. There was no endoleak, and the renovisceral chimney stent-grafts remained patent over a follow-up of 25 months. Conclusion: While further studies are required to generalize its use, EVAS appears to be feasible in the management of aortic stent-graft collapse.

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Mini-Laparotomy for Superior Mesenteric Artery Aneurysm Due to Takayasu's Arteritis

International Surgery ◽

10.9738/intsurg-d-14-00127.1 ◽

2015 ◽

Vol 100 (4) ◽

pp. 765-769 ◽

Cited By ~ 6

Author(s):

Takatsugu Matsumoto ◽

Mitsuru Ishizuka ◽

Yukihiro Iso ◽

Junji Kita ◽

Keiichi Kubota

Keyword(s):

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Distal Part ◽

Takayasu’S Arteritis ◽

Artery Aneurysm ◽

Proximal Part ◽

Whole Body ◽

Takayasu's Arteritis ◽

Invasive Approach ◽

Mini Laparotomy

Superior mesenteric artery aneurysm (SMAA) is reported to be the third-most common type of visceral aneurysm (VA), accounting for 5% of all VAs. The etiology of SMAA is commonly thought to be infection, and it usually exists in the proximal part of the superior mesenteric artery, which is suitable for endovascular treatment. We herein report an extremely rare case of the distal part of SMAA caused by Takayasu's arteritis (TA), which was successfully resected using a mini-laparotomy method without impairing the intestinal blood supply. A 51-year-old woman was admitted to our hospital with sustained fever and lower back pain. Physical examination showed that she had a discrepancies in blood pressure between both arms. Contrast-enhanced whole-body computed tomography showed stenosis of the thoracic aorta and an aneurysm located in the distal part of the superior mesenteric artery. The diameter of the aneurysm was 4.5 cm. The aneurysm was resected via 4-cm mini-laparotomy, and the vascularity of the intestine was successfully preserved. The postoperative course was uneventful, and the patient was diagnosed as having TA based on both clinical and pathologic findings. Additional corticosteroid therapy was started to treat the arteritis, and at 3-month follow-up she was without critical incidents. Mini-laparotomy is a safe and less-invasive approach to treat SMAA, especially when the lesion is located in the distal part of the artery.

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Inferior mesenteric artery as outflow vessel in endoleaks after abdominal aortic stent-graft implantation: 36-month follow-up CT study

European Radiology ◽

10.1007/s003300100829 ◽

2001 ◽

Vol 11 (11) ◽

pp. 2252-2257 ◽

Cited By ~ 4

Author(s):

Roland Dorffner ◽

Maria Schoder ◽

Gerhard Mostbeck ◽

Thomas Hölzenbein ◽

Siegfried Thurnher ◽

...

Keyword(s):

Stent Graft ◽

Mesenteric Artery ◽

Inferior Mesenteric Artery ◽

Aortic Stent Graft ◽

Abdominal Aortic ◽

Stent Graft Implantation ◽

Graft Implantation

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Posttraumatic Innominate Artery Aneurysm With Occlusion of the Common Carotid Artery at Its Origin by an Intimal Flap

Annals of Vascular Surgery ◽

10.1007/bf02002892 ◽

1993 ◽

Vol 7 (4) ◽

pp. 368-373 ◽

Cited By ~ 6

Author(s):

John D. Edwards ◽

Paolo Sapienza ◽

David M. Lefkowitz ◽

Patricia E. Thorpe ◽

Patrick E. McGregor ◽

...

Keyword(s):

Carotid Artery ◽

Common Carotid Artery ◽

Artery Aneurysm ◽

Innominate Artery ◽

Intimal Flap ◽

The Common

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Open direct carotid artery access for coiling of an intracranial aneurysm under conscious sedation

Interventional Neuroradiology ◽

10.1177/1591019915583220 ◽

2015 ◽

Vol 21 (3) ◽

pp. 387-389

Author(s):

Raghu Ramaswamy ◽

Mark R Villwock ◽

Palma M Shaw ◽

Amar Swarnkar ◽

Eric M Deshaies ◽

...

Keyword(s):

Carotid Artery ◽

Common Carotid Artery ◽

Conscious Sedation ◽

Vascular Anatomy ◽

Artery Aneurysm ◽

Middle Cerebral Artery Aneurysm ◽

Vascular Tortuosity ◽

Operative Complications ◽

The Common ◽

Cerebral Artery Aneurysm

We describe the case of a 61-year-old patient with significant medical co-morbidities and tortuous vascular anatomy presenting with a large middle cerebral artery aneurysm. To avoid the risks of general anesthesia and circumvent a majority of the tortuous vessels, the aneurysm was accessed by direct open exposure of the common carotid artery under conscious sedation and local anesthesia. We were able to achieve complete endovascular occlusion of the aneurysm and the patient tolerated the procedure well with no intra- or post-operative complications. Use of conscious sedation is possible and safe for direct open common carotid artery access in patients with significant vascular tortuosity that makes the standard trans-femoral approach difficult or impossible.

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