Ruptured Visceral Artery Aneurysms

Wagner, Willis H.; Allins, Alexander D.; Treiman, Richard L.; Cohen, Jordan L.; Foran, Robert F.; Levin, Phillip M.; Cossman, David V.

doi:10.1007/s100169900058

Cited by 133 publications

(75 citation statements)

References 16 publications

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“…The mortality rate of the elective surgical therapy of visceral aneurysms is approximately 5 % [15,17]. Surgical therapy of actively bleeding aneurysms has a significantly higher mortality rate of 10 -25 % [18,19]. 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].…”

Section: Discussionsupporting

confidence: 82%

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: 82%

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

Ruhnke¹,

Kröncke²

2017

Fortschr Röntgenstr

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“…However, these true aneurysms have an incidence of rupture and mortality rate of 20% to 75% due to life-threatening hemorrhage (4,5). Aneurysms can be saccular or fusiform.…”

Section: Resultsmentioning

confidence: 99%

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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“…15 In comparison to all other visceral aneurysms, 70-90%, of SMA aneurysms are symptomatic at presentation. 11,16 The majority of patients present with significant and progressive abdominal pain, with some of them developing typical intestinal angina with postprandial pain. 9,11 In many cases it is difficult to determine if the aetiology is due to relative mesenteric ischemia or to direct aneurysm expansion.…”

Section: Discussionmentioning

confidence: 99%

Superior Mesenteric Artery Aneurysm Presenting with Chronic Abdominal Pain: A Case Report

et al. 2016

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Superior mesenteric artery (SMA) aneurysm is a rare vascular entity and may present with a wide range of symptoms. They are often symptomatic, presenting with thromboembolic intestinal angina. They have a high risk of rupture and may present with gastro-intestinal bleeding, associated with high morbidity and mortality. We report the case of a 14year-old boy who presented with chronic abdominal pain and weight loss, in which SMA aneurysm was diagnosed after radiological evaluation. He underwent successful excision of aneurysmal sac along with aorto-mesenteric bypass using polytetrafluoroethylene (PTFE) graft, and had an uneventful recovery.Cardiovasc. j. 2016; 8(2): 161-164

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Ruptured Visceral Artery Aneurysms

Cited by 133 publications

References 16 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

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

Superior Mesenteric Artery Aneurysm Presenting with Chronic Abdominal Pain: A Case Report

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