Microballoon Occlusion Test to Predict Colonic Ischemia After Transcatheter Embolization of a Ruptured Aneurysm of the Middle Colic Artery

Abstract

A 76-year-old woman presented with sudden massive melena, and superior mesenteric arteriography showed an aneurysm in the middle colic artery (MCA). Because she had a history of right hemicolectomy and ligation of the inferior mesenteric artery (IMA) during open abdominal aortic aneurysm repair, embolization of the MCA aneurysm was considered to pose a risk comparable to that of colonic ischemia. A microballoon occlusion test during occlusion of the MCA confirmed retrograde visualization of the IMA branches through the collateral arteries by way of the left internal iliac artery, and embolization was successfully performed using microcoils. No colonic ischemia or aneurysm rupture occurred after embolization.

Ruptured left colic arterial aneurysm treated by transcatheter arterial embolization alone and without a subsequent laparotomy: Report of a case

“…The clinical indications for TAE and subsequent surgery for ruptured IMA aneurysms have not yet been established due to the rarity of this occurrence. To our knowledge, there are only nine cases 1,6,7,[11][12][13][14][15] in the literature of colic artery aneurysms treated by IVR alone (Table 1), and only one case 7 required subsequent colectomy due to ischemia as previously described. There were no endovascular procedurerelated deaths.…”