Management of Splenic Artery Aneurysms and False Aneurysms with Endovascular Treatment in 12 Patients

Guillon, R.; Garcier, Jean-Marc; Abergel, A.; Mofid, R.; Garcia, V; Chahid, T.; Ravel, A.; Pezet, Denis; Boyer, L.

doi:10.1007/s00270-003-1948-y

Cited by 175 publications

(131 citation statements)

References 14 publications

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“…The symptoms due to pseudoaneurysms may be due to mass effect on the adjacent neuro-vascular structures causing compromise of their function or due to life threatening haemorrhage from their rupture [6][7][8]. As per literature, the rupture of splenic artery pseudoaneurysm has a mortality rate approaching 100% [9]. The various possible sites of pseudoaneurysm rupture include gut, biliary tree, thoracic, peritoneal, pelvic and retroperitoneal spaces [10], which may manifest as sentinel bleed from the drain, hemetemesis, malena, splenic rupture or subcapsular hepatic hematoma [8,11].…”

Section: Discussionmentioning

confidence: 99%

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Endovascular Embolization of Pseudoaneurysms Complicating Pancreatitis Using Microcoils: Case Series

Taori¹,

Rathod²,

Disawal³

et al. 2013

OJRad

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Purpose: To determine whether endovascular embolization of pseudoaneurysms complicating pancreatitis with microcoils was associated with better therapeutic outcome. Materials and Method: The prospective clinical study was carried out in the Department of Interventional Radiology for a period of 2 years extending from May 2010 upto August 2012 on 16 male patients in the age group of about 30 -55 years, with each one of them having vascular complications as a sequel to pancreatitis, after obtaining well informed written consent from each one of them. Results: The outcome of the procedure was judged by the following parameters-a) Restoration of the blood pressure of the patient; b) Cessation of the hemetemesis and malena; c) Reduction in abdominal pain and discomfort and d) Overall improvement in the general condition of the patient. Each of the patients had been on follow up for at least 6 months, except 2 of them, with no new complaints in any of them. The procedure related mortality was none. Conclusion: Vascular complications of pancreatitis need immediate and accurate diagnosis and prompt treatment. Micro coil embolisation, is a minimally invasive technique which helps to exclude the pseudoaneurysm from the circulation and thus reduces the scope for massive life threatening internal hemorrhage, and is a better alternative to surgery.

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Section: Discussionmentioning

confidence: 99%

“…The risk of spontaneous rupture of extraorganic 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% [8,9,11]. Hence, definitive treatment should be administered in all such cases [9,19].…”

Section: Imaging Featuresmentioning

confidence: 99%

Endovascular Embolization of Pseudoaneurysms Complicating Pancreatitis Using Microcoils: Case Series

Taori¹,

Rathod²,

Disawal³

et al. 2013

OJRad

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“…Lesion excision along with splenectomy and/or partial pancreatectomy when indicated is considered the treatment of choice. The latter is unfortunately associated with high mortality and morbidity rate (1.3% and 9%, respectively) [11]. Endovascular approaches (coils, detachable balloons, inert particles or gelatin sponge), due to their lower theoretical operative risk, are increasingly being employed despite having a slightly lower success rate (75-85%) [11].…”

Section: Discussionmentioning

confidence: 99%

Abdominal Pain in Diabetic Ketoacidosis: Beyond the Obvious

Bello¹,

Gago²,

Fernandes³

et al. 2018

J Endocrinol Metab

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Diabetic ketoacidosis (DKA) is a medical emergency characterized by hyperglycemia, high anion gap metabolic acidosis and elevated circulating ketone bodies resulting from severe impairment of insulin secretion and/or action. Besides dehydration, nausea and vomiting, abdominal pain is also considered to be a cardinal clinical feature of DKA. Diagnosis relies on biochemical criteria, and disease severity on clinical and laboratory findings. Radiological investigation is not standard of care of DKA despite being required in specific situations. The authors report on a case of a patient with DKA and abdominal pain, whose investigation revealed chronic pancreatitis and a massive splenic artery pseudoaneurysm. The case is remarkable for the rarity of the clinical entity and reminds the clinician to the importance of imaging in newly diagnosed diabetes.

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“…In regards to the follow-up imaging modality, CT examination was reported in 13 publications and was thus the most widely used (7,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). In fact, CT was the only follow-up examination method used in nine of these publications (13,14,16,(19)(20)(21)(22)(23)(24). Follow-up outcomes of completely thrombosed aneurysms were reported in 11 publications (6, 13-16, 18-20, 22-24), 10 of which were evaluated by CT (13-16, 18-20, 22-24).…”

Section: Discussionmentioning

confidence: 99%

“…Methods for follow-up imaging after endovascular treatment of vis- (6,7,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). In regards to the follow-up imaging modality, CT examination was reported in 13 publications and was thus the most widely used (7,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). In fact, CT was the only follow-up examination method used in nine of these publications (13,14,16,(19)(20)(21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

Follow-up of true visceral artery aneurysm after coil embolization by three-dimensional contrast-enhanced MR angiography

Koganemaru¹,

Abe²,

Nonoshita³

et al. 2014

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to evaluate the outcomes of coil embolization of true visceral artery aneurysms by three-dimensional contrast-enhanced magnetic resonance (MR) angiography. MATERIALS AND METHODSWe used three-dimensional contrast-enhanced MR angiography, which included source images, to evaluate 23 patients (mean age, 60 years; range, 28-83 years) with true visceral artery aneurysms (splenic, n=15; hepatic, n=2; gastroduodenal, n=2; celiac, n=2; pancreaticoduodenal, n=1; gastroepiploic, n=1) who underwent coil embolization. Angiographic aneurysmal occlusion was revealed in all cases. Follow-up MR angiography was conducted with either a 1.5 or 3 Tesla system 3-25 months (mean, 18 months) after embolization. MR angiography was evaluated for aneurysmal occlusion, hemodynamic status, and complications. RESULTSComplete aneurysmal occlusion was determined in 22 patients (96%) on follow-up MR angiography (mean follow-up period, 18 months). Neck recanalization, which was observed at nine and 20 months after embolization, was confirmed in one of eight patients (13%) using a neck preservation technique. In this patient, a small neck recanalization covered by a coil mass was demonstrated. The complete hemodynamic status after embolization was determined in 21 patients (91%); the visualization of several collateral vessels, such as short gastric arteries, after parent artery occlusion was poor compared with that seen on digital subtraction angiography in the remaining two patients (9%). An asymptomatic localized splenic infarction was confirmed in one patient (4%). CONCLUSIONOur study presents the follow-up results from three-dimensional contrast-enhanced MR angiography, which confirmed neck recanalization, the approximate hemodynamic status, and complications. This effective and less invasive method may be suitable for serial follow-up after coil embolization of true visceral aneurysms.

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Management of Splenic Artery Aneurysms and False Aneurysms with Endovascular Treatment in 12 Patients

Abstract: Ultrasound and CT have made the diagnosis of splenic artery aneurysm or false aneurysm more frequent. Endovascular treatment, the morbidity of which is low, is effective and spares the spleen.

Cited by 175 publications

References 14 publications

Endovascular Embolization of Pseudoaneurysms Complicating Pancreatitis Using Microcoils: Case Series

Endovascular Embolization of Pseudoaneurysms Complicating Pancreatitis Using Microcoils: Case Series

Abdominal Pain in Diabetic Ketoacidosis: Beyond the Obvious

Follow-up of true visceral artery aneurysm after coil embolization by three-dimensional contrast-enhanced MR angiography

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