Inferior Mesenteric Artery Aneurysm Combined With Renal Artery Stenosis in a Patient With Neurofibromatosis

Abstract

A case is reported of an inferior mesenteric artery aneurysm that starts approximately 1 cm from its origin and ends at the proximal portion of the bifurcation of the sigmoidal and left colic arteries accompanied with complete absence of the celiac axis and superior mesenteric arteries. Additionally, left renal artery stenosis existed. The diagnosis was made by digital subtraction arteriography and confirmed by magnetic resonance arteriogram. Disease involving the inferior mesenteric artery is extremely uncommon. This may be the first reported case of neurofibromatosis in combination with renal artery stenosis and inferior mesenteric artery aneurysm associated with celiac and superior mesenteric artery occlusion and treated surgically.

Ruptured inferior mesenteric artery aneurysm in a patient with neurofibromatosis type I and its management

“…Though vascular involvement is common (most common being renal artery stenosis), visceral artery aneurysms are relatively rare. 7,8 CONCLUSION Author experienced a rare case of ruptured IMA aneurysm in a patient with NF-1. In a stable patient, angioembolization may be considered as a definitive management.…”

Acute retroperitoneal bleeding due to inferior mesenteric artery aneurysm: Case report

“…Although these patients are generally asymptomatic, it is generally acknowledged in literature, to treat VAA because of the risk of rupture or ischemia. Either surgical or endovascular therapeutic procedures can be performed in the treatment of this lesion and are well described in literature [ 4 ]. Percutaneous transcatheter coil embolization techniques are also used with increasing frequency in the treatment of VAA [ 9 ].…”

“…They have a significant potential to rupture and are frequently life-threatening for the patient [ 3 ]. The inferior mesenteric artery (IMA) is less affected than other locations such as splenic, hepatic, superior mesenteric and celiac arteries [ 4 ]. As most cases are asymptomatic, the real incidence is not known and only isolated cases have been reported.…”

Commentary on "Inferior Mesenteric Artery Aneurysm Combined With Renal Artery Stenosis in a Patient With Neurofibromatosis"

“…In conclusion, arteriopathy in patients with NF-1 may involve the carotid, celiac, mesenteric, renal, or other peripheral arteries as well as the aorta, and could manifest itself as cerebrovascular disease, abdominal pain, renovascular hypertension, lower limb claudication, or a true vascular emergency. The case report by Sacar and colleagues, 28 adding to our comprehension on the complex vascular distribution and clinical presentation of NF-1, certainly merits its place in the literature.…”

“…9,10 Nonetheless, the occurrence of renal artery stenosis has been repeatedly reported in patients with NF-1, either in combination with the middle aortic syndrome 7,11,12 or without it as described by different authors [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] in addition to Sacar and colleagues. 28 The surgical management by Sacar and colleagues certainly offers a definitive treatment for the arterial disease distribution of this patient. However in view of the young age of the patient, others would consider balloon angioplasty (± stenting) of the proximal renal artery stenosis, deferring complex open surgical reconstruction to a later time, preferably using autologous conduit (artery or vein); they could combine that with resection of the IMA aneurysm, making reconstruction possible by simply performing an oblique end-to-end anastomosis between the proximal and distal stumps of the IMA.…”