Endovascular Embolization of Pseudoaneurysms  Complicating Pancreatitis Using Microcoils: Case Series

Taori, Kishor; Rathod, Jawahar; Disawal, Amit; Mundhada, Rajesh; Rewatkar, Atul; Bakare, Vishal; Wavare, Prasad; Puria, Rakhi

doi:10.4236/ojrad.2013.31005

Cited by 4 publications

(3 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… Splenic artery pseudoaneurysm before and after embolization. A: Post contrast computed tomography scan showing the pseudoaneurysm rising from the splenic artery; B: Pre embolization selective splenic arterial DSA angiography image showing pseudoaneurysm; C: Post embolization DSA image showing the coils inside the splenic artery with its resultant embolization[ 92 ]. …”

Section: Management Of Acute Haemorrhagementioning

confidence: 99%

Pancreatitis: Preventing catastrophic haemorrhage

Evans

Mourad

Pall

et al. 2017

WJG

View full text Add to dashboard Cite

Pancreatitis represents nearly 3% of acute admissions to general surgery in United Kingdom hospitals and has a mortality of around 1%-7% which increases to around 10%-18% in patients with severe pancreatitis. Patients at greatest risk were those identified to have infected pancreatic necrosis and/or organ failure. This review seeks to highlight the potential vascular complications associated with pancreatitis that despite being relatively uncommon are associated with mortality in the region of 34%-52%. We examine the current evidence base to determine the most appropriate method by which to image and treat pseudo-aneurysms that arise as the result of acute and chronic inflammation of pancreas. We identify how early recognition of the presence of a pseudo-aneurysm can facilitate expedited care in an expert centre of a complex pathology that may require angiographic, percutaneous, endoscopic or surgical intervention to prevent catastrophic haemorrhage.

show abstract

Section: Management Of Acute Haemorrhagementioning

confidence: 99%

Pancreatitis: Preventing catastrophic haemorrhage

Evans

Mourad

Pall

et al. 2017

WJG

View full text Add to dashboard Cite

show abstract

“…6 When compared with surgical intervention, endovascular transcatheter embolization has significantly lower morbidity and mortality. 7 Taori et al 8 successfully treated 16 patients with splenic artery aneurysm via transcatheter technique with 100% success rate. They also emphasized the importance of technique.…”

Section: Discussionmentioning

confidence: 99%

Splenic Artery Embolization: Endovascular and Percutaneous Trans-splenic Approach

Banode

Sharma

2018

IJRSMS

View full text Add to dashboard Cite

Background Splenic artery embolization is becoming a widely acceptable procedure for nonsurgical management in many clinical settings such as pseudoaneurysms or to salvage splenic functions in portal hypertension, hypersplenism, and secondary prophylaxis in variceal hemorrhage. Various published meta-analyses of splenic artery embolization found an overall success rate of 90% in vascular abnormality. Methods Retrospective study of all splenic artery embolization procedures in 1 year (January 2017-2018) to analyze various indications, procedure technique, and its modification as well as outcome measurement and complications. Results Total 16 splenic artery embolization procedures were performed including one case of percutaneous trans-splenic glue embolization in 1-year duration. Procedure Indication It included pseudoaneurysm (n = 7, 44%); trauma (n = 1, 6%); adjuvant to surgical splenectomy in hypersplenism (n = 3, 18%); secondary prophylaxis in portal hypertension, portosystemic varices with/without reduced platelet counts, or ascites (n = 4, 25%); and Budd-Chiari syndrome (n = 1, 6%).Total 13 (81%) procedures were elective, whereas emergency embolization was performed in 3 (18.7%). Endovascular technical success was 93.7% (n = 15) cases. Percutaneous trans-splenic embolization was performed in one (6%) case in which access to bleeding point was not possible. The embolic agents included combination of metallic coils (n = 14, 87.5%), Gelfoam (n = 6, 37.5%), polyvinyl alcohol (PVA) particles (n = 5, 31%), and cyanoacrylate glue (n = 3, 18.7%). Complication rate was low with development of splenic abscess with infected pyothorax in one (6%) case of hypersplenism requiring pigtail drainage with uneventful full recovery. Conclusion Splenic artery embolization provides safer nonsurgical options in management of cases such as trauma, hypersplenism, portal hypertension for control of hemorrhage and preservation of splenic function. Endovascular embolization facilitates complete exclusion of pseudoaneurysms in majority with percutaneous splenic embolization using glue or coils as a safer alternative where endovascular access to bleeding vessels is difficult. AbstractKeywords ► portal hypertension ► hypersplenism ► splenic artery embolization ► splenic artery pseudoaneurysm ► percutaneous embolization Int

show abstract

“…Surgical mortality is approximately 16% for pseudoaneurysms in the head of the pancreas and 50% for lesions in the tail. The risk of spontaneous rupture of extra-organic visceral pseudo aneurysm is very high regardless of their size and the mortality rate for such ruptures in morbid postsurgical patients approaches to about 100% [14].…”

Section: Surgical Ligation (With or Without Distal Bypass)mentioning

confidence: 99%

Endovascular and Percutaneous Management of the Pseudoaneurysms

Chandradev¹,

Ateesh²

2014

OJRad

View full text Add to dashboard Cite

Introduction: Pseudoaneurysm is a dilatation of an artery with actual disruption of one or more layers of its wall, rather than just expansion of wall layers. Pseudoaneurysms are common vascular abnormalities. Computed Tomography (CT), Magnetic Resonance Imaging (MRI), sonography, and angiography all are valuable modalities in the imaging workup of pseudoaneurysms. Conventional angiography remains the gold standard for diagnosis. Therapeutic options have evolved in recent years from the traditional surgical option toward a less invasive approach which includes procedures such as Ultrasound (US)-guided compression, US-guided percutaneous thrombin injection, and endovascular management (embolization, stent-graft placement and endovascular coiling). Objective: In this article, we discuss pseudoaneurysms of various arteries, and available percutaneous and endovascular treatment options. Materials and Methods: Sixteen patients diagnosed with pseudoaneurysm involving visceral and peripheral arteries were included in this study. The initial diagnosis was made with CDUS, CECT, and CTA followed by catheter angiogram for therapeutic procedures. Results: All the 16 patients with pseudoaneurysms were successfully treated with endovascular and percutaneous embolization to achieve stasis. Conclusion: CT, MRI, sonography, and angiography may all be valuable in the imaging workup of pseudoaneurysms. The use of minimally invasive treatment has led to a marked decrease in the morbidity and mortality rates for pseudoaneurysms.

show abstract

Endovascular Embolization of Pseudoaneurysms Complicating Pancreatitis Using Microcoils: Case Series

Cited by 4 publications

References 26 publications

Pancreatitis: Preventing catastrophic haemorrhage

Pancreatitis: Preventing catastrophic haemorrhage

Splenic Artery Embolization: Endovascular and Percutaneous Trans-splenic Approach

Endovascular and Percutaneous Management of the Pseudoaneurysms

Contact Info

Product

Resources

About