Emergency Treatment of Haemorrhaging Coeliac or Mesenteric Artery Aneurysms and Pseudoaneurysms in the Era of Endovascular Management

Roberts, Keith; McCulloch, N.A.; Forde, Colm; Mahon, Brinder S.; Mangat, K.; Olliff, Simon; Jones, Robert G.

doi:10.1016/j.ejvs.2014.12.019

Cited by 32 publications

(32 citation statements)

References 27 publications

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“…In contrast, the mortality rate is 0 % in our own study population and comparable results were seen in other studies (3 -7 %) [8,13,20]. However, some studies have shown that emergency interventional therapy has a significantly higher mortality rate of up to 17 % compared to elective therapy [21]. This result was not confirmed in our own study population.…”

Section: Discussionsupporting

confidence: 66%

Visceral Artery Aneurysms and Pseudoaneurysms: Retrospective Analysis of Interventional Endovascular Therapy of 43 Aneurysms

Ruhnke¹,

Kröncke²

2017

Fortschr Röntgenstr

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ABSTR AC TPurpose To evaluate the results of interventional endovascular therapy of incidental and symptomatic visceral artery aneurysms in the elective and emergency situation.Materials and Methods 43 aneurysms in 38 patients (19 female, 19 male, mean age: 57 ± 16 years [18 -82]) were treated between 2011 and 2015. The characteristics of the aneurysms (true vs. false aneurysm, size, etiology, location, symptoms) were considered. Furthermore, we evaluated the intervention with respect to technical success, embolic/occlusive agents used, therapy-associated complications and postinterventional follow-up.Results 23 true aneurysms (maximum diameter: 22 ± 18 mm [11 -67 mm]) and 20 false aneurysms (maximum diameter: 9 ± 33 mm [3 -150 mm]) were evaluated. The splenic (n = 14) and renal arteries (n = 18) were most frequently affected. The etiology was most commonly degenerative-atherosclerotic (47 %) or iatrogenic post-operative (19 %). 18/48 interventions were performed due to active bleeding. False aneurysms were associated significantly more often with active bleeding (63 vs. 25 %, p = 0.012). 41/48 treatments were technically successful. Re-intervention was necessary 6 times. In 2 cases the endovascular approach did not succeed. There was a complication rate of 10 %, whereby only 4 minor and 1 major complications occurred. No patient suffered from permanent sequelae. Aneurysms were primarily treated by using coils and if necessary additional embolic agents (liquid embolic agent or vascular plugs) (75 %). In the follow-up period, reperfusion of treated aneurysms occurred at a rate of 7 % (n = 3). ConclusionInterventional endovascular therapy of visceral artery aneurysms is safe and effective in the elective treatment of incidental aneurysms as well as in significantly more frequent hemorrhaging false aneurysms in the emergency situation. Key points▪ Interventional endovascular therapy of visceral artery aneurysms is safe and effective. ▪ In more than 60 % of cases visceral artery pseudoaneurysms are associated significantly more often with a history of bleeding or acute bleeding. Hence, there is a need for (interventional) therapy even in small pseudoaneurysms. ▪ Follow-up seems to be useful to detect reperfusion as manifestation of treatment failure. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.tischen Aneurysmen der viszeralen Gefäße in der elektiven sowie der Notfallsituation. Material und Methoden

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Section: Discussionsupporting

confidence: 66%

Visceral Artery Aneurysms and Pseudoaneurysms: Retrospective Analysis of Interventional Endovascular Therapy of 43 Aneurysms

Ruhnke¹,

Kröncke²

2017

Fortschr Röntgenstr

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“…In a series of 48 patients with bleeding aneurysms, 45 (94%) were pseudoaneurysms. 289 Bleeding was a more frequent indication for intervention in pseudoaneurysms in another report (63% vs. 18% for true aneurysms). 17 Others have also published similar observations.…”

Section: Treatmentmentioning

confidence: 89%

“…287 False aneurysms of the mesenteric arteries may result from acute or chronic local inflammatory or infectious disease, commonly pancreatitis, or may result from trauma (including iatrogenic injuries during hepatobiliary procedures). 279,288,289 In some cases, no causal relationship can be established.…”

Section: Diagnosismentioning

confidence: 99%

Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

Björck¹,

Koelemay²,

Acosta³

et al. 2017

European Journal of Vascular and Endovascular Surgery

478

226

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She participated very actively in the process of developing these guidelines, in particular the important chapters on chronic arterial and venous mesenteric ischaemia. Six days after the second meeting of the task force she died unexpectedly, to our great despair and loss. We honour her dedication and scientific integrity by completing these guidelines. Among many other commitments she was a very productive reviewer and an associate editor of this journal. You can read more about Paola's important contributions to science and to the vascular community in the April 2016 issue of the European Journal of Vascular and Endovascular Surgery. 1

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“…Demgegenüber stehen eine Mortalität von 0 % im eigenen Untersuchungskollektiv sowie vergleichbare Ergebnisse anderer Studien (3 -7 %) [8,13,20]. Die Ergebnisse anderer Studien zeigen jedoch auch, dass die notfallmäßige interventionelle Behandlung gegenüber der elektiven Therapie eine deutlich höhere Mortalität von bis zu 17 % aufweist [21]. Dieses Ergebnis wurde im eigenen Untersuchungskollektiv so nicht bestätigt: Die notfallmäßige Behandlung führte nicht zu einer signifikant höheren Mortalität.…”

Section: Erfolgsrate Merkeunclassified

Aneurysmen und Pseudoaneurysmen viszeraler Arterien – interventionelle Therapie

Ruhnke¹,

Kröncke²

2018

Gefäßmedizin Scan

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Purpose To evaluate the results of interventional endovascular therapy of incidental and symptomatic visceral artery aneurysms in the elective and emergency situation. Materials and Methods 43 aneurysms in 38 patients (19 female, 19 male, mean age: 57???16 years [18???82]) were treated between 2011 and 2015.?The characteristics of the aneurysms (true vs. false aneurysm, size, etiology, location, symptoms) were considered. Furthermore, we evaluated the intervention with respect to technical success, embolic/occlusive agents used, therapy-associated complications and postinterventional follow-up. Results 23 true aneurysms (maximum diameter: 22???18?mm [11???67?mm]) and 20 false aneurysms (maximum diameter: 9???33?mm [3???150?mm]) were evaluated. The splenic (n?=?14) and renal arteries (n?=?18) were most frequently affected. The etiology was most commonly degenerative-atherosclerotic (47?%) or iatrogenic post-operative (19?%). 18/48 interventions were performed due to active bleeding. False aneurysms were associated significantly more often with active bleeding (63 vs. 25?%, p?=?0.012). 41/48 treatments were technically successful. Re-intervention was necessary 6 times. In 2 cases the endovascular approach did not succeed. There was a complication rate of 10?%, whereby only 4 minor and 1 major complications occurred. No patient suffered from permanent sequelae. Aneurysms were primarily treated by using coils and if necessary additional embolic agents (liquid embolic agent or vascular plugs) (75?%). In the follow-up period, reperfusion of treated aneurysms occurred at a rate of 7?% (n?=?3). Conclusion Interventional endovascular therapy of visceral artery aneurysms is safe and effective in the elective treatment of incidental aneurysms as well as in significantly more frequent hemorrhaging false aneurysms in the emergency situation.

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Emergency Treatment of Haemorrhaging Coeliac or Mesenteric Artery Aneurysms and Pseudoaneurysms in the Era of Endovascular Management

Cited by 32 publications

References 27 publications

Visceral Artery Aneurysms and Pseudoaneurysms: Retrospective Analysis of Interventional Endovascular Therapy of 43 Aneurysms

Visceral Artery Aneurysms and Pseudoaneurysms: Retrospective Analysis of Interventional Endovascular Therapy of 43 Aneurysms

Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

Aneurysmen und Pseudoaneurysmen viszeraler Arterien – interventionelle Therapie

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