Endovascular treatment of wide-neck saccular renal artery aneurysm with waffle-cone technique

Abstract In the past, treatment of visceral artery aneurysms (VAAs) was exclusively surgical. These aneurysms were rarely diagnosed in elective or emergency cases. Development of imaging techniques and endovascular procedures has changed the history of the therapeutic options for this pathology. Endovascular management of VAAs has arisen to advances in endovascular techniques and has achieved high efficacy.

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Splenic artery aneurysm, case series of seven patients

Journal of Surgical Case Reports ◽

10.1093/jscr/rjab046 ◽

2021 ◽

Vol 2021 (3) ◽

Author(s):

Javad Salimi ◽

Zahra Omrani ◽

Roozbeh Cheraghali

Keyword(s):

Splenic Artery ◽

Endovascular Procedures ◽

Case Series ◽

Artery Aneurysm ◽

Splenic Artery Aneurysm ◽

Visceral Artery ◽

Endovascular Techniques ◽

Hybrid Surgery ◽

First Choice ◽

Visceral Artery Aneurysms

Abstract Splenic artery aneurysms (SAA) account for 46–60% of all visceral artery aneurysms. Small SAAs are usually asymptomatic, but giant aneurysms are more likely to cause symptoms and can result in life-threatening complications. Treatment of a splenic artery aneurysms includes laparotomy, laparoscopy or endovascular techniques. Case presentation: In this article, seven interesting cases of splenic artery aneurysms in different size and parts of artery and various interventions (open, endovascular and hybrid surgery) are discussed. Six of the patients were male. Five of them had giant SAAs (≥5 cm). Two patients underwent hybrid surgery. Coil embolization was carried out for one patient. All seven patients discharged with no procedure-related complications. Endovascular procedures considered as a first choice of treatment for splenic artery aneurysm. Open surgery is reserved mostly for the treatment of complications or if the endovascular techniques fail, lack of availability of endovascular procedures or allergy to contrast medium.

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Concurrent Treatment of Acute Pancreatitis and Multiple Visceral Artery Aneurysms Using Endovascular Techniques

Vascular and Endovascular Surgery ◽

10.1177/1538574412440509 ◽

2012 ◽

Vol 46 (3) ◽

pp. 283-286 ◽

Cited By ~ 1

Author(s):

Mario Mitkov ◽

Weesam Kassim Al-Khatib ◽

Wei Zhou

Keyword(s):

Acute Pancreatitis ◽

Surgical Techniques ◽

Artery Aneurysm ◽

Celiac Artery ◽

Gastroduodenal Artery ◽

Visceral Artery ◽

Endovascular Techniques ◽

Concurrent Treatment ◽

Visceral Artery Aneurysms ◽

Celiac Artery Aneurysm

Multiple aneurysms involving the celiac axis are extremely rare. Celiac artery aneurysms account for only 4% of all visceral aneurysms with 40% having concomitant aneurysms such as gastroduodenal artery (GDA) aneurysms. Development of a GDA aneurysm is associated with pancreatitis. If a GDA aneurysm ruptures, traditional repair is through open surgical techniques with significant morbidity and mortality as up to 50% occur in the setting of chronic pancreatitis. However, a ruptured GDA aneurysm causing pancreatitis has not been described previously. We report a case of successful endovascular treatment of a ruptured GDA aneurysm and concomitant celiac artery aneurysm leading to the resolution of acute pancreatitis.

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P-P56 Successful endovascular embolisation of a recurrent gastroduodenal artery aneurysm in a patient presenting with acute on chronic pancreatitis

British Journal of Surgery ◽

10.1093/bjs/znab430.278 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Dheepa Nair ◽

Katie Jones ◽

Rajeev Parameswaran

Keyword(s):

Chronic Pancreatitis ◽

Epigastric Pain ◽

Contrast Material ◽

Pancreatic Head ◽

Artery Aneurysm ◽

Gastroduodenal Artery ◽

Visceral Artery ◽

Pseudoaneurysm Formation ◽

Visceral Artery Aneurysms ◽

History Of

Abstract Background Pseudoaneurysms are recognised to be a serious complication of chronic pancreatitis. Visceral artery aneurysms (VAA) can be difficult to determine and most commonly occur in the splenic or hepatic artery. Gastroduodenal artery pseudoaneurysms (GDA) have been reported to be the most common VAA following pancreatic surgery. We aim to outline the successful management of a patient with a recurrent 5.5cm GDA pseudoaneurysm following previous embolisation 2 years prior. Methods The 59yr old patient had a history of alcohol related necrotic pancreatitis with pseudocyst formation requiring percutaneous drainage in 2019. This was complicated by pseudoaneurysm formation requiring embolisation of the inferior pancreatico-duodenal artery and GDA. In April 2021 they were readmitted with recurrent abdominal pain thought to be secondary to chronic pancreatitis and one episode of haematemesis. Results Endoscopy revealed inflammation of D1 with signs of recent mucosal bleeding with a recent abdominal ultrasound showing a 4.7x4.6cm apparent pseudocyst. A CT pancreas was performed to assess the pseudocyst however an incidental pseudoaneurysm at the pancreatic head with a sac measuring 5.5cm in diameter and contrast material measuring 3cm in diameter was present. Peripancreatic and retroperitoneal inflammation indicative of acute on chronic pancreatitis. The patient underwent embolisation of the recurrent GDA pseudoaneurysm successfully with no more filling of the previously seen pseudoaneurysm and was safely discharged. Conclusions Recurrent GDA pseudoaneurysms are a very rare complication of recurrent pancreatitis, however should be considered in patients presenting severe epigastric pain with a history of previous pseudoaneurysms.

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Celiacomesenteric trunk associated with superior mesenteric artery aneurysm: A case report and review of literature

SAGE Open Medical Case Reports ◽

10.1177/2050313x20938243 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2093824

Author(s):

Walid Alam ◽

Mohammed Hussein Kamareddine ◽

Amine Geahchan ◽

Youssef Ghosn ◽

Michel Feghaly ◽

...

Keyword(s):

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Incidental Finding ◽

Imaging Techniques ◽

Artery Aneurysm ◽

Celiac Trunk ◽

Visceral Artery ◽

Diffuse Abdominal Pain ◽

Visceral Artery Aneurysms ◽

Celiacomesenteric Trunk

In rare cases, the celiac artery and the superior mesenteric artery arise from a common origin known as a common celiacomesenteric trunk. Celiac trunk stenosis or occlusion has been reported to accompany this anatomical aberrancy. Even rarer, are aneurysms associated with this common celiacomesenteric trunk. In general, visceral artery aneurysms are uncommon. We hereby present a 39-year-old female patient with a 1-month history of mild diffuse abdominal pain, with an incidental finding of superior mesenteric artery aneurysm on abdominal ultrasound. Subsequent contrast-enhanced computed tomography revealed severe narrowing of the celiac trunk and saccular aneurysmal dilatation of the superior mesenteric artery. Coil embolization of the aneurysm was performed, while maintaining persistent flow in the superior mesenteric artery and celiacomesenteric trunk. Visceral artery aneurysms are increasingly being identified incidentally with improvement in imaging techniques. The question lies whether to treat these aneurysms or observe. No universal guidelines exist regarding that matter, but the decision to intervene is made based on aneurysm location, size, and patient characteristics.

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

Clinical Medicine Insights Gastroenterology ◽

10.1177/1179552217711430 ◽

2017 ◽

Vol 10 ◽

pp. 117955221771143 ◽

Cited By ~ 1

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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Analysis of Outcomes of Endovascular Embolisation: A Cross-Sectional Multicenter Study on 46 Visceral Artery Pseudoaneurysms

10.21203/rs.3.rs-559515/v1 ◽

2021 ◽

Author(s):

Mohammad Koriem Mahmoud Omar ◽

Moustafa H. M. Othman ◽

Robert A. Morgan ◽

Abdelkarem Hasan Abdallah ◽

Hany M. A. Seif ◽

...

Keyword(s):

Success Rate ◽

Clinical Success ◽

Clinical Success Rate ◽

Visceral Artery ◽

Endovascular Management ◽

Cross Sectional ◽

Technical Success Rate ◽

Endovascular Embolisation ◽

Visceral Artery Aneurysms ◽

Perioperative Complication

Abstract Purpose Visceral artery aneurysms are subdivided into true aneurysms and pseudoaneurysms. Visceral artery pseudoaneurysms (VAPAs) are uncommon in clinical practice but may have serious clinical outcomes up to death. Endovascular management is a safe effective alternative option to traditional surgical procedures. This study assesses the outcome of different embolic materials and techniques used in the endovascular management of visceral artery pseudoaneurysms. Materials and methods This is a multicentric prospective analysis of endovascular embolisation of 46 VAPAs with a mean pseudoaneurysm size of 13 ± 11.35 mm. Management using coils only was done in 28/46 patients (60.87%), NBCA glue only in 16/46 patients (34.78%), combined coils and NBCA glue in 1/46 patient (2.17%), and Amplatzer plugs only in 1 patient (2.17%). The management techniques were sac packing in 9/46 patients (19.57%), inflow occlusion in 28/46 patients (60.87%) and trapping in 9/46 patients (19.57%). Results The overall clinical success rate was 93.48%, the overall perioperative complication rate was 15.22% and 30-day mortality was zero. For the coil subgroup (n = 28), the clinical success was 92.86%, while the subgroup of NBCA glue (n = 16) showed clinical success of 93.75%. There was no significant statistical difference between clinical success among coil, and NBCA glue subgroups (P > 0.05). The technical success rate was 100%. Effectiveness of the procedures during the follow-up was 97.83%. Target lesion re-intervention rate was 2.17%. Conclusion Transarterial embolisation can provide high technical and clinical success rates with low perioperative complication and re-intervention rates, as well as satisfactory procedure effectiveness in the management of VAPAs.

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13. Endovascular Management of Visceral Artery Aneurysms

Annals of Vascular Surgery ◽

10.1016/j.avsg.2020.09.034 ◽

2020 ◽

Vol 69 ◽

pp. 112

Author(s):

Nate Dillard ◽

Jane Chung ◽

Hossam Alslaim ◽

Purandath Lall ◽

Gautam Agarwal

Keyword(s):

Visceral Artery ◽

Endovascular Management ◽

Visceral Artery Aneurysms

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Current management strategies for visceral artery aneurysms: an overview

Surgery Today ◽

10.1007/s00595-019-01898-3 ◽

2019 ◽

Vol 50 (1) ◽

pp. 38-49 ◽

Cited By ~ 8

Author(s):

Hideaki Obara ◽

Matsubara Kentaro ◽

Masanori Inoue ◽

Yuko Kitagawa

Keyword(s):

Mesenteric Artery ◽

Management Strategies ◽

Hybrid Approach ◽

Celiac Artery ◽

Visceral Artery ◽

Anatomical Location ◽

Current Management ◽

Risk Of Rupture ◽

Visceral Artery Aneurysms ◽

History Of

Abstract Visceral artery aneurysms (VAAs) are rare and affect the celiac artery, superior mesenteric artery, and inferior mesenteric artery, and their branches. The natural history of VAAs is not well understood as they are often asymptomatic and found incidentally; however, they carry a risk of rupture that can result in death from hemorrhage in the peritoneal cavity, retroperitoneal space, or gastrointestinal tract. Recent advances in imaging technology and its availability allow us to diagnose all types of VAA. VAAs can be treated by open surgery, laparoscopic surgery, endovascular therapy, or a hybrid approach. However, there are still no specific indications for the treatment of VAAs, and the best strategy depends on the anatomical location of the aneurysm as well as the clinical presentation of the patient. This article reviews the literature on the etiology, clinical features, diagnosis, and anatomic characteristics of each type of VAA and discusses the current options for their treatment and management.

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The history of paediatric cardiology on stamps

Cardiology in the Young ◽

10.1017/s104795111700141x ◽

2017 ◽

Vol 28 (1) ◽

pp. 1-8

Author(s):

Hazım A. Gursu ◽

Ibrahim I. Cetin

Keyword(s):

Magnetic Resonance ◽

Extracorporeal Circulation ◽

Imaging Techniques ◽

Disease Diagnosis ◽

Diagnosis And Treatment ◽

Paediatric Cardiology ◽

The Past ◽

History Of ◽

Past Half ◽

Made In

AbstractPaediatric cardiology is arguably the sub-specialty in which the greatest advances have been made in both disease diagnosis and treatment over the past half a century. Paediatric cardiology emerged as a discipline in the 1930s. Since then, advances in imaging techniques such as echocardiography, angiography, CT, or magnetic resonance and extracorporeal circulation have provided excellent diagnosis and treatment of CHD. The pioneers of paediatric cardiology are more than eponyms, for each used in new and original ways the tools and concepts available in his or her era. This brief overview of the history of paediatric cardiology on stamps begins from William Harvey up to our own time, and includes the milestones in paediatric cardiology.

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