Available online xxxKeywords: Endovascular Visceral artery aneurysm Pseudoaneurysm Embolization Stent-graft a b s t r a c t Introduction: The aim of this study is to analyze the safety and efficacy of stent-graft endovascular treatment for visceral artery aneurysms and pseudoaneurysms. Methods: Multicentric retrospective series of patients with visceral aneurysms and pseudoaneurysms treated by means of stent graft. The following variables were analyzed: Age, sex, type of lesion (aneurysms/pseudoaneurysms), localization, rate of success, intraprocedural and long term complication rate (SIR classification). Follow-up was performed under clinical and radiological assessment.Results: Twenty-five patients (16 men), with a mean age of 59 (range 27-79), were treated.The indication was aneurysm in 19 patients and pseudoaneurysms in 6. The localizations were: splenic artery (12), hepatic artery (5), renal artery (4), celiac trunk (3) and gastroduodenal artery (1). Successful treatment rate was 96% (24/25 patients). Intraprocedural complication rate was 12% (4% major; 8% minor). Complete occlusion was demonstrated during follow up (mean 33 months, range 6-72) in the 24 patients with technical success. Two stent migrations (2/24; 8%) and 4 stent thrombosis (4/24; 16%) were detected. Mortality rate was 0%. § Please cite this article as: Cappucci M, Zarco F, Orgera G, Ló pez-Rueda A, Moreno J, Laurino F, et al. Tratamiento endovascular de aneurismas y pseudoaneurismas de arterias viscerales mediante stents recubiertos: aná lisis de resultados inmediatos y a largo plazo. Cir Esp. 2017. http://dx.
Endovascular management of small visceral artery aneurysms is an established treatment with satisfactory outcomes. However, when size exceeds 5 cm visceral aneurysms are considered as “giant” (giant visceral artery aneurysms or GVAAs) and management is significantly more complex. Between August 2007 and June 2019 eleven cases of GVAAs that were endovascularly treated were retrospectively reviewed and included in this single center study. Mean size was 80 mm (± 26.3 mm) x 46 mm (+ \-11.8 mm). Nine of the lesions were true aneurysms, and two were pseudoaneurysms. In 8 patients, the lesion was causing compression symptoms in the surrounding organs, one patient developed a contained rupture while 2 patients were completely asymptomatic. However, all patients were hemodynamically stable at the time of treatment. Technical success was defined as immediate complete exclusion of the aneurysmal sac, and clinical success as complete relief from clinical symptoms. Follow-up was performed with CT angiography, ultrasound and clinical examination. Mean follow-up was 45 months (range 6–84). Technical and clinical success were both 91%. Complications were one lack of control of contained rupture that was subsequently operated, one case of self-limiting non-target spleen embolization and one case of splenic abscess. Three patients died, one due to the contained rupture 15 days after procedure, the other two for other causes and occurred during the long-term follow-up. This series suggests that endovascular treatment of giant visceral artery aneurysms and pseudoaneuryms is a valid minimally invasive solution with very satisfactory immediate and long-term outcomes unless the aneurysm is already ruptured. A variety of endovascular tools may be required for successful treatment.
This study demonstrated EVOH 6% appears to be as safe and effective as coils in the treatment of non-variceal UGIB.
Introduction: The management of the diffusion of Coronavirus disease 2019 (COVID-19) pandemic represents a massive problem for healthcare systems worldwide and Interventional Radiology (IR) is a fundamental hospital unit which must continue to provide its service. The aim of this article is to summarize the preventive measures taken in our IR unit and to report the results of these measures over a 7 weeks period. Material and Methods: Between the 25th of February, when we started to apply the recommended containing measures, and the 6th of April 2020, when all the IR staff started to undergo nasopharyngeal and oropharyngeal swabs screening, a total of 25 healthcare operators worked at our IR unit. Operators who, during this period, also worked in other hospital units such as diagnostic emergency department or other healthcare facilities, were excluded. Nasopharyngeal and oropharyngeal swabs screening and blood samples for specific SARS-CoV-2 IgG-IgM were retrospectively evaluated. Results: The overall procedures number decreased by a rate of 33% and twenty-three (16%) were performed in confirmed or strongly suspected COVID-19 patients. Two procedures were performed in non-suspected ones, who revealed positive in the following hospitalization days. Seventeen operators were included in the study. Only one of them resulted positive at the swabs, with an estimated infection rate in our IR unit of 6%. Specific SARS-CoV-2 IgG-IgM resulted negative in all the operators included. Conclusion: Our experience demonstrates that applying adequate measures to limit SARS-CoV-2 infection spread can efficiently reduce the viral transmission among IR healthcare workers.
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