Endovascular Treatment of Visceral Aneurysms and Pseudoaneurysms: Long-term Outcomes from a Multicenter European Study

Spiliοpoulos, Stavros; Sabharwal, Tarun; Karnabatidis, Dimitrios; Brountzos, Elias; Κατσάνος, Κωνσταντίνος; Krokidis, Μiltiadis; Gkoutzios, Panos; Siablis, Dimitrios; Adam, Andreas

doi:10.1007/s00270-011-0312-x

Cited by 58 publications

(64 citation statements)

References 28 publications

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“…Currently, minimally invasive management is favored, although indications still exist for surgical intervention. Of note, recurrence of HAPs following embolization has been reported to be significant, and therefore current recommendations involve followup imaging with potential need for secon dary intervention [9] . In the case of our patient, standard minimally invasive endovascular (HAP) and biliary (ob structive jaundice) management was attempted on several occasions with the use of multiple modalities, but ultimately failed to palliate her symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Other noniatrogenic causes of HAPs include trauma, acute and chronic pancreatitis, arteriosclerosis, PAN, necrotizing vasculitis, infection and hepatocellular car cinoma [2,3,810] . Recent increases in the incidence of HAPs have been attributed to a rise in the number of liver transplantations, percutaneous liver and gallbladder interventions and the use of laparoscopic surgery [1,4,9,11] . Advances in imag ing techniques have enhanced the detection rate of asymptomatic HAPs [1] .…”

Section: Discussionmentioning

confidence: 99%

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Atypical presentation of a hepatic artery pseudoaneurysm: A case report and review of the literature

Luckhurst

Perez

Collinsworth

et al. 2016

WJH

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Classically, hepatic artery pseudoaneurysms (HAPs) arise secondary to trauma or iatrogenic causes. With an increasing prevalence of laparoscopic procedures of the hepatobiliary system the risk of inadvertent injury to arterial vessels is increased. Pseudoaneurysm formation post injury can lead to serious consequences of rupture and subsequent hemorrhage, therefore intervention in all identified visceral pseudoaneurysms has been advocated. A variety of interventional methods have been proposed, with surgical management becoming the last step intervention when minimally invasive therapies have failed. The authors present a case of a HAP in a 56-year-old female presenting with jaundice and pruritis suggestive of a Klatskin's tumor. This presentation of HAP in a patient without any significant past medical or surgical intervention is atypical when considering that the majority of HAP cases present secondary to iatrogenic causes or trauma. Multiple minimally invasive approaches were employed in an attempt to alleviate the symptomology which included jaundice and associated inflammatory changes. Ultimately, a right hepatic trisegmentectomy was required to adequately relieve the mass effect on biliary outflow obstruction and definitively address the HAP. The presentation of a HAP masquerading as a malignancy with jaundice and pruritis, rather than the classic symptoms of abdominal Luckhurst CM et al . Hepatic artery pseudoaneurysm presenting as Klatskin's tumor pain, anemia, and melena, is unique. This presentation is only further complicated by the absent history of either trauma or instrumentation. It is important to be aware of HAPs as a potential cause of jaundice in addition to the more commonly thought of etiologies. Furthermore, given the morbidity and mortality associated with pseudoaneurysm rupture, intervention in identifiable cases, either by minimally invasive or surgical interventions, is recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Atypical presentation of a hepatic artery pseudoaneurysm: A case report and review of the literature

Luckhurst

Perez

Collinsworth

et al. 2016

WJH

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“…Different studies have compared surgical treatment to treatment by interventional radiology (TVAA and VAPA, ruptured or not), without showing any significant difference in morbidity and mortality, overall survival, or post-procedural recurrence [5][6][7]. In cases of ruptured visceral aneurysms, surgical mortality is 23.9% vs. 2.7% during radiological endovascular management [8][9][10].…”

Section: Location Of the Aneurysm Prevalence (%)mentioning

confidence: 99%

Ruptured visceral artery aneurysms

Chiaradia¹,

Novelli²,

Deux

et al. 2015

Diagnostic and Interventional Imaging

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Visceral artery aneurysms are rare but their estimated mortality due to rupture ranges between 25 and 70%. Treatment of visceral artery aneurysm rupture is usually managed by interventional radiology. Specific embolization techniques depend on the location, affected organ, locoregional arterial anatomy, and interventional radiologist skill. The success rate following treatment by interventional radiology is greater than 90%. The main complication is recanalization of the aneurysm, showing the importance of post-therapeutic monitoring, which should preferably be performed using MR imaging.

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“…4,6 Como potenciais complicações, apesar de raras, referem-se a isquemia de órgão, migração de coils e stents e rotura do pseudoaneurisma no decorrer do procedimento. 2,5,10 Quando realizados num centro de referência e por profissionais especializados, os benefícios destes procedimentos suplantam as complicações, apresentando uma taxa de sucesso entre 70% e 100%. 1,2,4,10 A radiologia de intervenção desempenha um papel fundamental no tratamento desta patologia.…”

Section: Discussionunclassified

Tratamento Endovascular de Rotura de Pseudoaneurisma da Artéria Gastroduodenal após Acidente de Viação

Dutra¹,

Gomes

Bilhim

et al. 2017

Acta Med Port

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The authors present a case of a 39-year-old man with alcoholic chronic pancreatitis that was admitted in the emergency department after a car accident, complaining of abdominal pain and looking pale. The patient was hemodinamically unstable, requiring blood transfusions. He underwent computed tomography angiogram of the abdomen and pelvis, showing a pseudoaneurysm of the gastroduodenal artery and a hemoperitoneum. He was referred to our interventional radiology unit and submitted to endovascular treatment, consisting of ‘backdoor’ and ‘frontdoor’ embolization of the gastroduodenal artery and pseudoaneurysm neck with coils, with total exclusion in control angiography. With this case description we intend to highlight the rarity of the pseudoaneurysm rupture of the gastroduodenal artery and to emphasize the importance of an interventional radiology response that had a fundamental role in the endovascular treatment, in an emergency context.

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Endovascular Treatment of Visceral Aneurysms and Pseudoaneurysms: Long-term Outcomes from a Multicenter European Study

Cited by 58 publications

References 28 publications

Atypical presentation of a hepatic artery pseudoaneurysm: A case report and review of the literature

Atypical presentation of a hepatic artery pseudoaneurysm: A case report and review of the literature

Ruptured visceral artery aneurysms

Tratamento Endovascular de Rotura de Pseudoaneurisma da Artéria Gastroduodenal após Acidente de Viação

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