A case of ruptured right gastroepiploic aneurysm treated by transcatheter arterial embolization avoiding emergency surgery

Watanabe, Koji; Aoki, Takeshi; Yamazaki, Kaoru; Date, Hiromi; Abe, Ryosuke; Tashiro, Yoshihiko; Goto, Satoru; Otsuka, Koji; Ohgiya, Yoshimitsu; Murakami, Masahiko

doi:10.1007/s12328-021-01363-0

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…In addition, RGEA is recognized as a greater feeder than LGEA anatomically. 17 This aspect corresponded to the finding that the diameter of RGEA (2.18 ± 0.72 mm, 2.2 [range, 1.1–3.6] mm) was larger than that of LGEA (1.18 ± 0.26 mm, 1.2 [range, 0.7–1.6] mm) ( p < 0.05) in the present study. In addition, six of the seven true aneurysms were located in RGEA.…”

Section: Discussionsupporting

confidence: 91%

“…The results of the present study are comparable with those of several previous OAA case reports. 3,4,16,17 TAE is a minimally invasive, effective, and safe treatment option for ruptured as well as unruptured OAA cases. Packed red blood cell transfusion was performed only in cases with ruptured OAAs, and more contrast medium during TAE was also used in cases with ruptured OAAs due to the necessity of checking complete hemostasis while performing multiple angiograms; however, no significant differences were observed in the hospitalization period or duration of TAE fluoroscopy.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of transcatheter arterial embolization of omental artery aneurysm: A single-center experience

Nozawa,

Ono,

Hasegawa

et al. 2024

Asian Cardiovasc Thorac Ann

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Background Omental artery aneurysm (OAA) is an extremely rare visceral artery aneurysm. Ruptured OAAs are associated with a high mortality rate. Transcatheter arterial embolization (TAE) has been used to treat OAA in recent years. However, the risk of omental ischemia due to TAE remains unclear. Therefore, this study aimed to investigate the efficacy and safety of TAE of OAA as a first-line treatment. Methods Fifteen patients with true aneurysms or pseudoaneurysms who underwent OAA-TAE between 1 April 2010 and 31 December 2022 were included in this study. The technical and clinical outcomes, the incidence of omental infarction after TAE as a major complication, OAA-TAE techniques, radiological findings on computed tomography angiography and angiogram, and patient characteristics were evaluated. Results Fifteen patients (nine men, six women; age, 69.8 ± 18.59 years) underwent TAE of OAAs (mean aneurysm size of 9.30 ± 6.10 mm) located in the right gastroepiploic ( n = 9), left gastroepiploic ( n = 1), and epiploic ( n = 5) arteries. All patients with ruptured ( n = 6) and unruptured ( n = 9) OAA successfully underwent TAEs using coils, n-butyl-2-cyanoacrylate, or gelatin sponges. Hepatic artery thrombosis and coil migration were observed during the procedure; however, these adverse events were manageable. Transfusion of red blood cell units (4.66 ± 1.63 units) was required only in cases with ruptured OAAs after TAE. Additional surgery or TAE due to rupture or rerupture of OAA and omental infarction was not required during the postoperative and follow-up periods. Conclusion The OAA-TAE can effectively treat ruptured and unruptured OAAs, and the risk of omental infarction after OAA-TAE may not be high.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of transcatheter arterial embolization of omental artery aneurysm: A single-center experience

Nozawa,

Ono,

Hasegawa

et al. 2024

Asian Cardiovasc Thorac Ann

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“…The treatment of omental bleeding consists of laparotomy, laparoscopy, or TAE [ [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rupture of a left omental artery aneurysm treated by transcatheter arterial embolization: A case report

Maghrebi

Zaiem

Beji

et al. 2022

Annals of Medicine &Amp; Surgery

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“…Bleeding following a pseudoaneurysm does not seem to be rare in this condition. TAE should be considered in these patients (Watanabe et al, 2021 ), even if the celiac artery may be difficult to catheterised. However, embolization only treats the symptomatic consequences but does not treat the cause.…”

Section: Discussionmentioning

confidence: 99%

“…TAE has been reported to be effective in the treatment of gastrointestinal bleeding (Bua-ngam et al, 2017 ; Bond & Smith, 2019 ; Beggs et al, 2014 ), and predictive factors for rebleeding and death after TAE have been reported in this indication (Choi et al, 2020 ). Endovascular treatment of mesenteric hematoma has been reported in a case report (Watanabe et al, 2021 ). Nevertheless, while only two studies have focused on post-traumatic MB (Ghelfi et al, 2016 ; Shin et al, 2016 ), no studies have investigated the efficacy of TAE in treating traumatic and spontaneous MB.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of emergency transarterial embolization for mesenteric bleeding

et al. 2022

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Background Patients with spontaneous or traumatic active mesenteric bleeding cannot be treated endoscopically. Transarterial embolization can serve as a potential alternative to emergency surgery. Literature on transarterial embolization for mesenteric bleeding remains very scarce. The objective of this study was to evaluate the safety and efficacy of transarterial embolization for mesenteric bleeding. We reviewed all consecutive patients admitted for mesenteric bleeding to the interventional radiology department, in a tertiary center, between January 2010 and March 2021. Mesenteric bleeding was defined as mesenteric hematoma and contrast extravasation and/or pseudoaneurysm visible on pre-operative CT scan. We evaluated technical success, clinical success, and complications. Results Among the 17 patients admitted to the interventional department for mesenteric bleeding, 15 presented with active mesenteric bleeding requiring transarterial embolization with five patients with hemodynamic instability. Mean age was 67 ± 14 years, including 12 (70.6%) males. Technical success was achieved in 14/15 (93.3%) patients. One patient with technical failure was treated by percutaneous embolization with NBCA-Lipiodol mixture. Three patients (20%) had early rebleeding: two were treated by successful repeat embolization and one by surgery. One patient (6.7%) had early death within 30 days and two patients (13.3%) had late death after 30 days. Mean length of hospitalization was 12.8 ± 7 days. There were no transarterial embolization-related ischemic complications. Conclusion Transarterial embolization is a safe and effective technique for treating mesenteric bleeding even in patients with hemodynamic instability. Transarterial embolization doesn’t close the door to surgery and could be proposed as first intention in case of mesenteric bleeding.

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A case of ruptured right gastroepiploic aneurysm treated by transcatheter arterial embolization avoiding emergency surgery

Cited by 5 publications

References 20 publications

Efficacy and safety of transcatheter arterial embolization of omental artery aneurysm: A single-center experience

Efficacy and safety of transcatheter arterial embolization of omental artery aneurysm: A single-center experience

Spontaneous rupture of a left omental artery aneurysm treated by transcatheter arterial embolization: A case report

Safety and efficacy of emergency transarterial embolization for mesenteric bleeding

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