Endovascular Management of Visceral Arterial Aneurysms

Hemp, Jeanette H.; Sabri, Saher S.

doi:10.1053/j.tvir.2014.12.003

Cited by 93 publications

(113 citation statements)

References 23 publications

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“…The use of noninvasive treatment has led to a marked decrease in the morbidity and mortality rates for pseudoaneurysms (20). Endovascular treatment is considered as the first choice for the embolization of a visceral pseudoaneurysm (13,20). In this study, TAE embolization was successfully performed with three types of embolic material, and the type of embolic material was chosen according to the size of the injured artery.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 65% of all hemobilia is caused by hepatic trauma or iatrogenic injury, such as needle biopsy of the liver or hepatobiliary or pancreatic procedures (2-13). The incidence of hemobilia caused by iatrogenic injury is increasing because of the increase in hepatobiliary intervention procedures (2,4,13). Therefore, effective diagnosis and management of iatrogenic hemobilia are urgently required (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

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confidence: 99%

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Iatrogenic hemobilia: imaging features and management with transcatheter arterial embolization in 30 patients

Wen

Dong²,

Lu³

et al. 2016

Diagn Interv Radiol

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Iatrogenic hemobilia: imaging features and management with transcatheter arterial embolization in 30 patients

Wen

Dong²,

Lu³

et al. 2016

Diagn Interv Radiol

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“…The perioperative morbidity of conventional surgical therapy in terms of surgery-associated complications in a period of up to 30 days after the operation of 7 -13 % is also comparable [15,24,25]. The study by Hemp and Sabri showed that there is no significant difference between endovascular and surgical therapy regarding periprocedural morbidity and mortality but that there was a significant reduction in the length of the hospital stay after interventional therapy [10]. Post-interventional control of the local finding via cross-sectional imaging is recommended at least in the immediate postinterventional period independent of the clinical course in order to rule out early reperfusion of the treated aneurysm or to detect complications requiring monitoring, such as parenchymal infarction of distal organs.…”

Section: Discussionmentioning

confidence: 93%

“…In addition, all symptomatic aneurysms in patients with vasculitis should be treated immediately, while incidental aneurysms in such patients should be treated during an inflammation-free interval if they do not significantly reduce in size under immunosuppressive therapy [9]. In addition, all aneurysms with an increase in size of more than 0.5 cm/year should be treated [10].…”

Section: Discussionmentioning

confidence: 99%

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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“…Kitos medžiagos, naudojamos aneurizmoms embolizuoti, yra trombinas, specialūs klijai, pvz., "Onyx", akrilas (N-butyl-2-cianoakrilatas) [46].…”

Section: Endovaskulinis Gydymasunclassified

Visceralinės Aneurizmos: Literatūros Apžvalga

Kvietkauskas¹

2017

Medicinos Teorija Ir Praktika

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Reikšminiai žodžiai: visceralinių arterijų aneurizmos, visceralinės aneurizmos, aneurizmos plyšimas. Straipsnyje pateikiama visceralinių aneurizmų literatūros apžvalga. Iki šiol literatūroje apie šią patologiją publikuota per 4 000 straipsnių. Pirmasis visceralinę aneurizmą aprašė prancūzas Beaussiers 1770 metais. Visceralinėmis aneurizmomis vadinamos pilvinio kamieno, viršutinės ir apatinės pasaito, inkstų arterijų ir jų šakų aneurizmos. Jų sutinkama ne daugiau kaip 2 proc. populiacijos. Visceralinės aneurizmos skirstomos į tikras visceralines aneurizmas ir pseudoaneurizmas. Pastarosios aptinkamos dvigubai dažniau nei tikros visceralinės aneurizmos. Dažniausiai tikrosios aneurizmos susiformuoja dėl aterosklerozės, fibromuskulinės displazijos arba traumos, o pseudoaneurizmas dažniausiai sukelia pankreatitai. Pagal klinikinę stadiją skiriamos asimptominės, simptominės ir plyšusios visceralinės aneurizmos. Pastarosios pasižymi ypač dideliu mirtingumu. Visceralinės aneurizmos dažniausiai pažeidžia blužnies arterijas, rečiau – kepenų, inkstų, ypač retai – kitas visceralines arterijas. Pagrindiniai diagnostikos iššūkiai – labai įvairi ir nespecifinė visceralinių aneurizmų klinika. Pagrindinės diagnostikos naujovės – didesnės raiškos ir erdvinės vaizdinių tyrimų atmainos. Planinis invazinis gydymas taikytinas, jei visceralinių aneurizmų diametras ≥ 2 cm, taip pat kai kurių išimčių atvejais – nepriklausomai nuo aneurizmos dydžio. Esant simptominėms aneurizmoms, intervencija turi būti atliekama neatidėliotinai, o plyšusių atvejais – skubiai. Minimaliai invaziniai gydymo metodai pamažu tampa pagrindiniai gydant visceralines aneurizmas. Ypač gerų rezultatų ateityje tikimasi gydant aneurizmas srovę nukreipiančiais stentais, kai jie taps prieinamesni.

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Endovascular Management of Visceral Arterial Aneurysms

Cited by 93 publications

References 23 publications

Iatrogenic hemobilia: imaging features and management with transcatheter arterial embolization in 30 patients

Iatrogenic hemobilia: imaging features and management with transcatheter arterial embolization in 30 patients

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

Visceralinės Aneurizmos: Literatūros Apžvalga

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