scholarly journals Embolization of visceral arterial aneurysms: Simulation with 3D-printed models

Vascular ◽  
2020 ◽  
Vol 28 (3) ◽  
pp. 259-266
Author(s):  
Eisuke Shibata ◽  
Hidemasa Takao ◽  
Shiori Amemiya ◽  
Kuni Ohtomo ◽  
Osamu Abe
Keyword(s):  
Endovascular Treatment ◽  
Treatment Plan ◽  
Artery Aneurysm ◽  
Visceral Artery ◽  
Pancreaticoduodenal Artery ◽  
Visceral Artery Aneurysms ◽  
Treatment Plans ◽  
3D Printed ◽  
Preoperative Simulation ◽  
Pancreaticoduodenal Artery Aneurysm

Objectives The present technical article aimed to describe the efficacy of three-dimensional (3D)-printed hollow vascular models as a tool in the preoperative simulation of endovascular embolization of visceral artery aneurysms. Methods From November 2015 to November 2016, four consecutive endovascular treatments of true visceral artery aneurysms were preoperatively simulated with 3D-printed hollow models. The mean age of the patients (one male and three females) was 54 (range: 40–71) years. Three patients presented with splenic artery aneurysm and one with anterior pancreaticoduodenal artery aneurysm. The average diameter of the aneurysms was 16.5 (range: 10–25) mm. The 3D-printed hollow models of the visceral artery aneurysms and involved arteries were created using computed tomography angiography data of the patients. After establishing treatment plans by simulations with the 3D-printed models, all patients received endovascular treatment. Results All four hollow aneurysm models were successfully fabricated and used in the preoperative simulation of endovascular treatment. In the preoperative simulations with 3D-printed hollow models, splenic aneurysms were embolized with coils and/or n-butyl-2-cyanoacrylate to establish the actual treatment plans, and a small arterial branch originating from an anterior pancreaticoduodenal artery aneurysm was selected to obtain feedback regarding the behavior of catheters and guidewires. After establishing treatment plans by simulations, the visceral artery aneurysms of all patients were successfully embolized without major complications and recanalization. Conclusions Simulation with 3D-printed hollow models can help establish an optimal treatment plan and may improve the safety and efficacy of endovascular treatment for visceral artery aneurysms.

Endovascular Treatment of Visceral Artery Aneurysms

2002 ◽  
Vol 9 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Andreas Gabelmann ◽  
Johannes Görich ◽  
Elmar M. Merkle
Keyword(s):  
Endovascular Treatment ◽  
Necrotizing Pancreatitis ◽  
Artery Aneurysm ◽  
Endovascular Embolization ◽  
Visceral Artery ◽  
Recurrent Bleeding ◽  
Visceral Artery Aneurysms ◽  
Long Term Follow Up ◽  
Transcatheter Coil Embolization

Purpose: To review a 10-year experience with endovascular embolization of visceral artery aneurysms. Methods: Twenty-five patients (13 men; mean age 52.1 years, range 31–80) presented with VAAs of varying locations and etiologies: 10 splenic, 3 gastroduodenal, 2 pancreaticoduodenal, 3 hepatic, 3 superior mesenteric, 2 celiac, 1 left gastric, and 1 jejunoileal. Ten patients were asymptomatic; 7 aneurysms were ruptured. Transcatheter coil embolization was the treatment of choice in all patients. Results: Coil placement was initially (<7 days) successful in 23 (92%) patients. One superior mesenteric artery aneurysm remained perfused, and recurrent bleeding occurred 2 days after intervention in 1 case, but repeated embolization excluded the aneurysm. One patient with necrotizing pancreatitis died from sepsis 10 days after endovascular treatment and surgery (4% 30-day mortality). Long-term follow-up revealed excellent results after an average 48.7 months (range 14–75) with only 1 recurrence after 12 months. Conclusions: Embolotherapy is the treatment of choice in visceral artery aneurysms, regardless of etiology, location, or clinical presentation.

scholarly journals Interdisciplinary Management of Visceral Artery Aneurysms and Visceral Artery Pseudoaneurysms

2020 ◽  
Vol 63 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Peter Berek ◽  
Ivan Kopolovets ◽  
Csaba Dzsinich ◽  
Juraj Bober ◽  
Peter Štefanič ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Endovascular Treatment ◽  
Artery Aneurysm ◽  
Visceral Artery ◽  
Interdisciplinary Management ◽  
Artery Pseudoaneurysm ◽  
Endovascular Interventions ◽  
Visceral Artery Aneurysms ◽  
Choice Of Treatment ◽  
Visceral Arteries

The paper presents the results of treating 14 patients, namely eight patients with visceral artery aneurysms and six patients with visceral artery pseudoaneurysms. In 64.3% of the patients, the initial diagnosis was made based on the ultrasound examination. All the patients (100%) underwent CT angiography, while angiography was performed in 71.4% of the cases. Five (35.7%) patients with visceral artery pseudoaneurysms were emergently hospitalized; among them, the signs of bleeding were observed in 2 patients. In 9 patients, pathology was detected during tests for other conditions. Five (35.7%) patients underwent endovascular treatment, while 9 (64.3%) patients received surgical treatment. Endovascular interventions and open surgery demonstrated a nil mortality rate. After endovascular treatment, stent thrombosis was found in 1 patient. In the case of surgical treatment, visceral artery aneurysm was observed in 1 patient who underwent the resection of superior mesenteric artery pseudoaneurysm. Conclusions. The choice of the method of treating visceral artery aneurysms and visceral artery pseudoaneurysms depends on the location, size, anatomic features of the visceral arteries and the clinical course of the disease. Both endovascular and surgical treatment demonstrate good postoperative outcomes. Visceral ischemia is one of the most serious complications in the postoperative period, which can complicate both the diagnosis and the choice of treatment tactics.

scholarly journals Endovascular Treatment of Giant Splenic Artery Aneurysm

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Adenauer Marinho de Oliveira Góes Junior ◽  
Amanda Silva de Oliveira Góes ◽  
Paloma Cals de Albuquerque ◽  
Renato Menezes Palácios ◽  
Simone de Campos Vieira Abib
Keyword(s):  
Endovascular Treatment ◽  
Stent Graft ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Visceral Artery ◽  
Aggressive Approach ◽  
Visceral Artery Aneurysms ◽  
Stent Graft Implantation ◽  
Graft Implantation

Introduction. Visceral artery aneurysms are uncommon. Among them, splenic artery is the most common (46–60%). Most splenic artery aneurysms are asymptomatic and diagnosed incidentally, but its rupture, potentially fatal, occurs in up to 8% of cases.Presentation of Case. A female patient, 64 years old, diagnosed with a giant aneurysm of the splenic artery (approximately 6.5 cm in diameter) was successfully submitted to endovascular treatment by stent graft implantation.Discussion. Symptomatic aneurysms and those larger than 2 cm represent some of the main indications for intervention. The treatment may be by laparotomy, laparoscopy, or endovascular techniques. Among the various endovascular methods discussed in this paper, there is stent graft implantation, a method still few reported in the literature.Conclusion. Although some authors still consider the endovascular approach as an exception to the treatment of SAA, in major specialized centers these techniques have been consolidated as the preferred choice, reserving the surgical approach in cases where this cannot be used. For being a less aggressive approach, it offers an opportunity of treatment to patients considered “high risk” for surgical treatment by laparotomy/laparoscopy.

scholarly journals The Aftermath of a Hepatic Artery Aneurysm—A Rare Etiology of Biliary Obstruction!

2017 ◽  
Vol 10 ◽  
pp. 117955221771143 ◽  
Author(s):  
Catherine Linzay ◽  
Abhishek Seth ◽  
Kunal Suryawala ◽  
Ankur Sheth ◽  
Moheb Boktor ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Hepatic Artery ◽  
Significant Risk ◽  
Artery Aneurysm ◽  
Biliary Tree ◽  
Visceral Artery ◽  
Biliary Stenting ◽  
Hepatic Artery Aneurysm ◽  
Skin Imaging ◽  
Visceral Artery Aneurysms

Background: Hepatic artery aneurysms (HAAs) constitute 14% to 20% of visceral artery aneurysms. Most HAAs are asymptomatic. Although rare, obstructive jaundice due to external bile duct compression or rupture of the HAA into the biliary tree with occlusion of the lumen from blood clots has been reported. Case presentation: A 56-year-old white man presented to an outside hospital with symptoms of obstructive jaundice, including abdominal pain and yellowing of the skin. Imaging showed a large HAA. Patient was transferred to our hospital where an endoscopic retrograde cholangiopancreatography with biliary stenting was performed. This was followed by coil embolization of the HAA with improvement in symptoms and liver chemistries. Conclusions: Most clinicians agree that management of HAA is highly variable and depends on clinical presentation and anatomic location. Biliary stenting provides temporary relief for patients with obstructive jaundice. Definitive options include open aneurysmal repair versus endovascular therapy. Hepatic artery aneurysms represent a significant risk for hemorrhage and therefore must be addressed promptly once discovered.

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