Multimodal approach to endovascular treatment of visceral artery aneurysms and pseudoaneurysms

Laganà, Domenico; Carrafiello, Gianpaolo; Mangini, Monica; Dionigi, Gianlorenzo; Caronno, Roberto; Castelli, Patrizio; Fugazzola, Carlo

doi:10.1016/j.ejrad.2006.02.004

Cited by 143 publications

(126 citation statements)

References 25 publications

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“…This treatment is now performed on a wide range of visceral arterial aneurysms. 30 CDUS can be used after embolization therapy to confirm the success of the procedure. CDUS, however, may not depict a very low-velocity blood flow; CEUS should be more accurate in confirming the absence of residual blood flow within the embolized aneurysm.…”

Section: Discussionmentioning

confidence: 99%

Sonographic detection of an aneurysm of the gastroepiploic artery

Kato

Ishida

Komatsuda

et al. 2009

J of Clinical Ultrasound

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Gastroepiploic artery aneurysm (GEAA) is very rare.1 Furthermore, most GEAA cases are diagnosed after their rupture. We report a case of asymptomatic GEAA. The patient was a 61-year-old man. Sonography (US) revealed a 2-cm anechoic mass in the epigastrium near the anterior abdominal wall. Color Doppler US and contrast-enhanced US showed arterial flow within the mass leading to the diagnosisof visceral artery aneurysm. CT and angiography confirmed the diagnosis of right GEAA, and the aneurysm was treated successfully with embolization. Follow-up US 6 months later confirmed the absence of blood flow within the lesion.

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Section: Discussionmentioning

confidence: 99%

Sonographic detection of an aneurysm of the gastroepiploic artery

Kato

Ishida

Komatsuda

et al. 2009

J of Clinical Ultrasound

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“…In the present study, we identified neck recanalization/coil compaction in 13% of patients using this technique. Previous studies have reported neck recanalization/coil compaction rates ranging from 2% to 12.5% (7,15,17,19). These studies involved CT evaluation and reported possibly inaccurate incidence rates for neck recanalization due to metallic coil artifact.…”

Section: Discussionmentioning

confidence: 99%

“…Such complications occur in approximately 21%-24% of endovascular treatment cases (7,17). Therefore, image assessment is also considered to be an important aspect of follow-up procedures after endovascular treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Methods for follow-up imaging after endovascular treatment of vis- (6,7,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). In regards to the follow-up imaging modality, CT examination was reported in 13 publications and was thus the most widely used (7,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). In fact, CT was the only follow-up examination method used in nine of these publications (13,14,16,(19)(20)(21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

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Follow-up of true visceral artery aneurysm after coil embolization by three-dimensional contrast-enhanced MR angiography

Koganemaru¹,

Abe²,

Nonoshita³

et al. 2014

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to evaluate the outcomes of coil embolization of true visceral artery aneurysms by three-dimensional contrast-enhanced magnetic resonance (MR) angiography. MATERIALS AND METHODSWe used three-dimensional contrast-enhanced MR angiography, which included source images, to evaluate 23 patients (mean age, 60 years; range, 28-83 years) with true visceral artery aneurysms (splenic, n=15; hepatic, n=2; gastroduodenal, n=2; celiac, n=2; pancreaticoduodenal, n=1; gastroepiploic, n=1) who underwent coil embolization. Angiographic aneurysmal occlusion was revealed in all cases. Follow-up MR angiography was conducted with either a 1.5 or 3 Tesla system 3-25 months (mean, 18 months) after embolization. MR angiography was evaluated for aneurysmal occlusion, hemodynamic status, and complications. RESULTSComplete aneurysmal occlusion was determined in 22 patients (96%) on follow-up MR angiography (mean follow-up period, 18 months). Neck recanalization, which was observed at nine and 20 months after embolization, was confirmed in one of eight patients (13%) using a neck preservation technique. In this patient, a small neck recanalization covered by a coil mass was demonstrated. The complete hemodynamic status after embolization was determined in 21 patients (91%); the visualization of several collateral vessels, such as short gastric arteries, after parent artery occlusion was poor compared with that seen on digital subtraction angiography in the remaining two patients (9%). An asymptomatic localized splenic infarction was confirmed in one patient (4%). CONCLUSIONOur study presents the follow-up results from three-dimensional contrast-enhanced MR angiography, which confirmed neck recanalization, the approximate hemodynamic status, and complications. This effective and less invasive method may be suitable for serial follow-up after coil embolization of true visceral aneurysms.

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“…Stent approach has the advantage of excluding the aneurysm from systemic blood flow without impeding the flow of blood to the spleen; however, as described in the literature, it is limited by rigid delivery systems which can preclude stent placement in distal tortuous branches, as commonly seen in splenic vasculature. 7 In this case, the tortuosity of the vessel did not allow us to use stent; moreover, it is not always easy to advance a large bore sheath within the tortuous splenic artery. Solid pseudoaneurism is a very rare finding in clinical practice; the presence of hypodense mass, without contrast enhancement and the presence of necrotic tissue and inflammatory cells on histological specimen may lead to an angiographic study in order to confirm the origin of the lesion.…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm of the splenic artery mimicking a solid lesion

et al. 2016

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A 64-year-old man presented to the hospital because of hematemesis; on admission, he had weakness and pale skin, tachycardia and hypotension. Laboratory tests revealed severe anemia (hemoglobin 7.8 g/dL); liver, renal and pancreatic function tests were normal. An upper digestive endoscopy revealed a gastric ulcer of the cardia, treated with metallic clips and adrenalin injection. The patient was treated with fluids and was transfused with three units of red blood cells. In the previous two months, due to the presence of bloating and diarrhea, associated with abdominal distension, a colon-computed tomography (CT) revealed a large retroperitoneal hypodense mass, 53x37 mm in size, without contrast enhancement localized between the body and the tail of the pancreas and the stomach, near the splenic artery and without signs of infiltration. To better define the mass, endoscopic ultrasound and biopsy were performed; however histopathology of multiple biopsies was not diagnostic, because of the presence of necrotic tissue and inflammatory cells. Since hematemesis recurred, the patient underwent a second upper digestive endoscopic examination, but no source of bleeding was found. Then a new contrast enhanced CT was performed that showed a size reduction of the mass, the presence of blood in the stomach and a small pseudoaneurysm of the splenic artery. Because of these findings an angiograpghic study was carried out; angiography confirmed a splenic artery pseudoaneurysm that was successfully embolized with metal microcoils.

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Multimodal approach to endovascular treatment of visceral artery aneurysms and pseudoaneurysms

Cited by 143 publications

References 25 publications

Sonographic detection of an aneurysm of the gastroepiploic artery

Sonographic detection of an aneurysm of the gastroepiploic artery

Follow-up of true visceral artery aneurysm after coil embolization by three-dimensional contrast-enhanced MR angiography

Pseudoaneurysm of the splenic artery mimicking a solid lesion

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