Emergency stent graft implantation for ruptured visceral artery pseudoaneurysm

Boufi, Mourad; Belmir, H.; Hartung, Olivier; Ramis, O.; Beyer, Laura; Alimi, Yves

doi:10.1016/j.jvs.2011.02.003

Cited by 34 publications

(37 citation statements)

References 36 publications

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“…As an alternative endovascular procedure, stent-grafts may be placed in the bleeding vessel in order to exclude the site of bleeding or pseudoaneurysm sac, as demonstrated in two of our cases (31,32). Considering that all complications in this study were associated with ischemic injury to the spleen after embolization of the splenic artery, the use of stent-grafts potentially decreases the likelihood of end-organ ischemia.…”

Section: Discussionmentioning

confidence: 90%

Endovascular intervention for management of pancreatitis-related bleeding: a retrospective analysis of thirty-seven patients at a single institution

Kim¹,

Shin²,

Yoon³

et al. 2015

Diagn Interv Radiol

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thirty-seven patients underwent endovascular intervention for the management of pancreatitis-related hemorrhage. The underlying etiology of the disease, clinical symptoms and laboratory findings, abnormalities seen on computed tomography, and details regarding the endovascular procedures were assessed, as were the outcome of each procedure and procedure-related complications. RESULTSA total of 41 endovascular procedures were performed in 37 patients. The splenic artery (34.8%) was the most commonly treated artery, and pseudoaneurysm was the most commonly detected abnormality on digital subtraction angiography (78.3%). Transcatheter embolization was performed in the majority of patients (95.1%), while two patients were treated with stent-grafts. Successful hemostasis without rebleeding was achieved in 34 patients (91.9%). Two cases of rebleeding were successfully treated by reintervention. Focal splenic infarction, which developed in eight patients, was either asymptomatic or accompanied by mild, transient fever. Splenic abscess was the only major complication occurring in three patients. Two of these patients died from resulting sepsis, while the third recovered after antibiotic treatment. CONCLUSION Endovascular management is effective for achieving hemostasis in patients with pancreatitis-related bleeding and demonstrates low recurrence and mortality rates.

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Section: Discussionmentioning

confidence: 90%

Endovascular intervention for management of pancreatitis-related bleeding: a retrospective analysis of thirty-seven patients at a single institution

Kim¹,

Shin²,

Yoon³

et al. 2015

Diagn Interv Radiol

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“…of patients presenting with VAAs over a 10‐year period found that 50% of the detected gastroepiploic artery aneurysms were in fact pseudoaneurysms. Unlike true VAAs which are often caused by arteriosclerosis, systemic or portal hypertension, vasculitis or connective tissue disorders, visceral artery pseudoaneurysms (VAPAs) are often the result of abdominal trauma resulting in intimal damage and arterial wall weakening, vessel wall destruction due to proteolytic enzymes released during pancreatitis, and iatrogenic arterial injury during operative or percutaneous biliary interventions, and liver transplantation . None of these risk factors, however, were noted in our patient.…”

mentioning

confidence: 76%

Gastroepiploic artery pseudoaneurysm: a rare cause of abdominal pain

Chong

Danaher

2019

ANZ Journal of Surgery

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“…The causes of visceral artery pseudoaneurysms are trauma, infection, inflammatory diseases, and complications of abdominal surgery, hepatobiliary interventions, and endoscopic explorations [5]. On the other hand, the incidence of pseudoaneurysms caused by malignant tumors is low although pseudoaneurysms caused by hepatocellular carcinomas (HCC), malignant lymphomas, desmoids, neurofibromatosis, giant cell tumors, leukemia, and so on have been reported [6][7][8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Intratumoral pseudoaneurysm within a liver metastasis of gastric cancer: a case report

et al. 2020

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Background: Intrahepatic artery pseudoaneurysms are mostly iatrogenic and result from hepatobiliary interventions. The incidence of intrahepatic artery pseudoaneurysms within liver tumors without prior intervention is extremely rare. We presented herein the first report of a case of an intratumoral pseudoaneurysm within a liver metastasis of gastric cancer without any prior intervention during chemotherapy. Case presentation: A 59-year-old male patient underwent a distal gastrectomy and D2 lymph node dissection for gastric cancer. He was treated in the emergency room for right abdominal pain following the 4th cycle of nivolumab administration as second-line chemotherapy after adjuvant chemotherapy with S-1 and first-line chemotherapy for a liver metastasis of gastric cancer with ramucirumab plus paclitaxel. CT showed a 72-mm metastatic liver tumor containing a 9-mm pseudoaneurysm and fluid collection around the hepatic edge. Intrahepatic artery pseudoaneurysm within the metastatic liver tumor was diagnosed, with the surrounding fluid indicating potential, active bleeding. An emergency angiography confirmed the presence of a pseudoaneurysm in the intrahepatic artery, which was embolized using microcoils. The contributory causes of the intratumoral pseudoaneurysm were assumed to be the following: (1) tumor necrosis leading to encasement, erosion of the vessel wall, and subsequent arterial wall weakening; and (2) inhibition of vascular endothelial growth by ramucirumab resulting in a vessel wall breach and pseudoaneurysm formation. Conclusion: It is necessary to recognize that pseudoaneurysms can arise within a metastatic liver tumor during chemotherapy.

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Emergency stent graft implantation for ruptured visceral artery pseudoaneurysm

Abstract: Stent graft exclusion of visceral artery pseudoaneurysm seems to be a valid therapeutic approach regardless of the patient's septic or hemodynamic status.

Cited by 34 publications

References 36 publications

Endovascular intervention for management of pancreatitis-related bleeding: a retrospective analysis of thirty-seven patients at a single institution

Endovascular intervention for management of pancreatitis-related bleeding: a retrospective analysis of thirty-seven patients at a single institution

Gastroepiploic artery pseudoaneurysm: a rare cause of abdominal pain

Intratumoral pseudoaneurysm within a liver metastasis of gastric cancer: a case report

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