Application of interventional embolization in the treatment of iatrogenic pseudoaneurysms

Abstract

The present study aimed to investigate the clinical effectiveness and safety of endovascular embolization for the treatment of pseudoaneurysm secondary to previous abdominal and pelvic surgery or radiological percutaneous abdominal procedure. A retrospective review was performed on all patients with abdominal and pelvic pseudoaneurysm confirmed by CT angiography or digital subtraction angiography and treated with endovascular embolization. Different techniques of embolization with coils were applied and the outcomes, including clinical effectiveness and safety, were assessed. A total of 31 patients with a total of 32 pseudoaneurysms were included in the present study. Of these pseudoaneurysms, 23 were from the main trunks and branches of the gastroduodenal artery, 5 were from the splenic artery, 2 were from the common hepatic artery, 1 was from the right hepatic artery and 1 was from the right internal iliac artery. There were no serious complications observed and there was no occurrence of re-bleeding following embolization. The embolization of the pseudoaneurysms was successful in all patients. In conclusion, endovascular embolization is a safe and effective method for the treatment of secondary iatrogenic pseudoaneurysm in the abdomen and pelvis.

Clinical application of medical adhesive in endovascular embolization treatment of peripheral pseudoaneurysm

“…Second, there are various techniques available for direct sac packing or stent-assisted coiling techniques. [ 13 ] However, there are also many disadvantages in the application of coils in the embolization of peripheral pseudoaneurysms: (i) Peripheral pseudoaneurysms are mostly located in the 3 rd and 4 th grade branches of bleeding vessels, making it difficult for coils to perform super selective embolization. Non-selective embolization can increase the level of embolization and cause excessive organ function damage; (ii) secondly, coil embolization mainly relies on thrombus formation, which increases the possibility of pseudoaneurysm recanalization for pseudoaneurysms with rich blood flow perfusion or poor coagulation function in the body; and (iii) for the pseudoaneurysms which located in the 1 st and 2 nd grade branches of bleeding vessels, endovascular embolization with a coil may cause the pseudoaneurysm cavity to expand and increase the risk of rupture and bleeding.…”

Combination of Sac packing and liquid embolization using Double Microcatheter Technique for Renal Artery Aneurysm: A Case Report

“…The number of such patients has recently increased owing to the use of more effective diagnostic tools such as CTA and angiography [1][2][3]. Though CTA and enhanced CTA have been highly sensitive, specific, and accurate in the diagnosis of vascular disease [4,5], however they do not provide a complete blood supply to the renal parenchyma of the small efferent branch of the sac. DSA, especially 3D-DSA, can provide more anatomical information for further evaluation during endovascular treatment [6].…”

Splenic Artery Pseudoaneurysms: The Role of ce-CT for Diagnosis and Treatment Planning

“…With the advancement of complex surgical operations, iatrogenic PSAs are relatively common encounters in clinical practice. The overall incidence of PSAs following abdominal and pelvic surgery is relatively low; however, the incidence of PSAs formation increases with the more invasive surgeries [18]. Vessel wall disruption may be related to a direct injury during abdominal procedure or surgery, various endoscopic treatments, or an indirect injury from post-operative perivascular inflammation or infection, resulting in the formation of PSA [19].…”

“…Independent of their associated symptoms or diameter, pseudoaneurysm should always be treated. The following factors may affect the clinician's choice of different treatment methods: (a) the time of bleeding and pseudoaneurysm; (b) comorbidities and complications, such as inflammation and infection; and (c) hemodynamic [18].…”