Microcoil embolization during abdominal vascular interventions through microcatheters with a tip of 2 French or less

Miyayama, Shiro; Yamashiro, Masashi; Hattori, Yukio; Orito, Nobuaki; Matsui, Kazuma; Tsuji, Kiichiro; Yoshida, Midori; Matsui, Osamu

doi:10.1007/s11604-010-0540-z

Cited by 8 publications

(8 citation statements)

References 8 publications

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Section: Discussionmentioning

confidence: 99%

“…However angiographic embolization can have complications such as necrosis of the gallbladder [14], coil migration with resultant non target embolization, distal dislodgement, thrombosis of parent vessel, perforation and fistulation into viscera/CBD and persistent perfusion through microcoils [37-40]. Microcoil migration is a rare complication of embolization reported to be seen in 0.3% in a series of studied abdominal vascular embolization [40]. There have been various reasons quoted for such a migration after arterial microcoil embolization most important of which include: discrepancy between microcoil size and vessel wall diameter, high blood flow, unstable catheter tip, variation in vessel diameters with respiration the latter particularly in veins [40-42].…”

Section: Discussionmentioning

confidence: 99%

“…Microcoil migration is a rare complication of embolization reported to be seen in 0.3% in a series of studied abdominal vascular embolization [40]. There have been various reasons quoted for such a migration after arterial microcoil embolization most important of which include: discrepancy between microcoil size and vessel wall diameter, high blood flow, unstable catheter tip, variation in vessel diameters with respiration the latter particularly in veins [40-42]. The type of microcoil used is also an important factor.…”

Section: Discussionmentioning

confidence: 99%

“…The type of microcoil used is also an important factor. Pushable microcoils especially in high flow vessels have a higher chance of incorrect placement and migration as compared to detachable coils and liquid coils [40,41]. The technical challenges that have been reported in microcoil embolization of mesenteric vessels are resultant to atherosclerosis, tortuosity, dual blood supply and small size [37].…”

Section: Discussionmentioning

confidence: 99%

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Emergency cholecystectomy and hepatic arterial repair in a patient presenting with haemobilia and massive gastrointestinal haemorrhage due to a spontaneous cystic artery gallbladder fistula masquerading as a pseudoaneurysm

et al. 2013

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BackgroundHaemobilia usually occurs secondary to accidental or iatrogenic hepatobiliary trauma. It can occasionally present with cataclysmal upper gastrointestinal haemorrhage posing as a life threatening emergency. Haemobilia can very rarely be a complication of acute cholecystitis. Here we report a case of haemobilia manifesting as massive gastrointestinal haemorrhage in a patient without any prior history of biliary surgery or intervention and present a brief review of literature.Case presentationA 22 year old male admitted with history suggestive of acute cholecystitis subsequently developed waxing waning jaundice and recurrent episodes of upper gastrointestinal bleed. Endoscopy showed an ulcer in the first part of duodenum with a clot, no active bleed was visible. Angiography was suggestive of a ruptured pseudoaneurysm in the vicinity of the right hepatic artery probably originating from the cystic artery. Coil embolization was tried but the coil dislodged into the right branch of hepatic artery distal to the site of pseudoaneurysm. Review of angiographic video in light of operative findings demonstrated a fistulous communication between cystic artery and gallbladder as the cause, a simultaneous cholecystoduodenal fistula was also noted. Retrograde cholecystectomy, closure of cholecystoduodenal fistula and right hepatic arteriotomy with retrieval of the endo-coil and hepatic arterial repair was performed.ConclusionFistula between the cystic artery and gallbladder has been commonly reported to occur after laparoscopic cholecystectomy. Spontaneous fistulous communication, i.e. in the absence of any prior trauma or intervention, between cystic artery and gallbladder is rare with very few reports in literature. Aetiopathogenesis of the disease, in the context of current literature is reviewed. The diagnostic dilemma posed by the confounding finding of an ulcer in the duodenum, the iconic video angiographic depiction as also the therapeutic challenge of a failed embolization with consequent microcoil migration and primary hepatic arterial repair in the emergency situation is discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Emergency cholecystectomy and hepatic arterial repair in a patient presenting with haemobilia and massive gastrointestinal haemorrhage due to a spontaneous cystic artery gallbladder fistula masquerading as a pseudoaneurysm

et al. 2013

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“…Miyayama et al [7] reported use of liquid and tornado coils through microcatheters, similar to this introducer, for embolization during abdominal vascular interventions. In addition, Kumar et al [8] reported on the successful use of a spinal microcatheter as a …”

Section: Discussionmentioning

confidence: 99%