Nonoperative management of visceral aneurysmsand pseudoaneurysms

Salam, Tarek A.; Lumsden, Alan B.; Martin, Louis G.; Smith, Robert B.

doi:10.1016/s0002-9610(05)81073-6

Cited by 228 publications

(140 citation statements)

References 17 publications

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“…Transcatheter arterial embolization (TAE) has been proposed as the first-line treatment to control massive bleeding associated with a r uptured hepatic arter y pseudoaneurysm after hepatobiliary pancreatic surgery because of its advantages over surgery. Such advantages include an easier approach, precise localization of the pseudoaneurysm, assessment of collateral pathways to the liver, less chance of re-bleeding, and low mortality rates [1][2][3][4][5][6][7] . Meanwhile, TAE on the hepatic artery may lead to liver abscesses, gallbladder necrosis, biliary stricture, intrahepatic biloma, and embolization of nor mal vessels [8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Extrahepatic collaterals and liver damage in embolotherapy for ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery

Tajima

Kuroki²,

Tsutsumi³

et al. 2007

WJG

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AIM:To evaluate the effects of extrahepatic collaterals to the liver on liver damage and patient outcome after embolotherapy for the ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery. METHODS:We reviewed 9 patients who underwent transcatheter arterial embolization (TAE) for the ruptured hepatic artery pseudoaneurysm following major hepatobiliary pancreatic surgery between June 1992 and April 2006. We paid special attention to the extrahepatic arterial collaterals to the liver which may affect post-TAE liver damage and patient outcome. RESULTS:The underlying diseases were all malignancies, and the surgical procedures included hepatopancreatoduodenectomy in 2 patients, hepatic resection with removal of the bile duct in 5, and pancreaticoduodenectomy in 2. A total of 11 pseudoaneurysm developed: 4 in the common hepatic artery, 4 in the proper hepatic artery, and 3 in the right hepatic artery. Successful hemostasis was accomplished with the initial TAE in all patients, except for 1. Extrahepatic arterial pathways to the liver, including the right inferior phrenic artery, the jejunal branches, and the aberrant left hepatic artery, were identified in 8 of the 9 patients after the completion of TAE. The development of collaterals depended on the extent of liver mobilization during the hepatic resection, the postoperative period, the presence or absence of an aberrant left hepatic artery, and the concomitant arterial stenosis adjacent to the pseudoaneurysm. The liver tolerated TAE without significant consequences when at least one of the collaterals from the inferior phrenic artery or the aberrant left hepatic artery was present. One patient, however, with no extrahepatic collaterals died of liver failure due to total liver necrosis 9 d after TAE. CONCLUSION:When TAE is performed on ruptured hepatic artery pseudoaneurysm, reduced collateral pathways to the liver created by the primary surgical procedure and a short postoperative interval may lead to an unfavorable outcome.

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Section: Introductionmentioning

confidence: 99%

Extrahepatic collaterals and liver damage in embolotherapy for ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery

Tajima

Kuroki²,

Tsutsumi³

et al. 2007

WJG

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“…Treatment of an aneurysm depends on its location and the regional vascular anatomy. Embolisation is the accepted line of management for intrahepatic aneurysms [11,12]. Aneurysms of the common hepatic artery (CHA) distal to the gastroduodenal artery (GDA) require excision and reconstruction with autologous conduit [13].…”

Section: Discussionmentioning

confidence: 99%

A rare cause of an abdominal mass

Desai

Sekhar

2008

Indian J Surg

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A 57-year-old male presented with right upper abdominal lump since 3 months. He was diagnosed to have a hepatic artery aneurysm. He was investigated thoroughly but no cause was found. He was subjected to endovascular embolisation of the aneurysm using endovascular coils. Subsequently the aneurysm was completely occluded. Hepatic artery aneurysms are very rare among all visceral aneurysms. We report this rare case of hepatic artery aneurysm presenting as an abdominal lump. This case highlights the importance of early diagnosis and management of this rare entity as a rupture may be catastrophic.

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“…1 Despite being the third most common type of abdominal artery aneurysm and the most common type of visceral artery aneurysm, splenic artery aneurysms are considered relatively rare. [2][3][4] A review of routine autopsies of the general population found a very low incidence of splenic artery aneurysm (0.01%), rising to 1% in the hypertense population and 10.4% in the elderly population. 3,4 The majority of cases are described in women, at a proportion of 4:1, with a predilection for multiparous women.…”

Section: Introductionmentioning

confidence: 99%

Embolization of splenic artery aneurysm associated with gastrointestinal bleeding: case report

et al. 2014

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The splenic artery is the visceral vessel that is most often affected by aneurysmal disease. Occasionally, gastrointestinal bleeding may signify that the aneurysm is in communication with the digestive tract. We report on the case of a 64-year-old multiparous patient with intermittent digestive bleeding caused by a splenic artery aneurysm who was successfully treated with endovascular embolization.Keywords: Splenic artery; aneurysm; hemorrhage gastrointestinal; embolization therapeutic. ResumoA artéria esplênica é o vaso visceral mais acometido pela doença aneurismática. Ocasionalmente, um sangramento gastrointestinal pode refletir uma comunicação entre o aneurisma de artéria esplênica e o trato digestivo. Relatamos o caso de uma paciente de 64 anos com hemorragia digestiva intermitente devida a aneurisma de artéria esplênica, a qual foi submetida ao tratamento endovascular por embolização com sucesso.

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Nonoperative management of visceral aneurysmsand pseudoaneurysms

Cited by 228 publications

References 17 publications

Extrahepatic collaterals and liver damage in embolotherapy for ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery

Extrahepatic collaterals and liver damage in embolotherapy for ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery

A rare cause of an abdominal mass

Embolization of splenic artery aneurysm associated with gastrointestinal bleeding: case report

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