Middle-colic artery aneurysm associated with segmental arterial mediolysis, successfully managed by transcatheter arterial embolization: Report of a case

Hirokawa, Takahisa; Sawai, Hirozumi; Yamada, Kôji; Wakasugi, Takehiro; Takeyama, Hiromitsu; Ogino, Hiroyuki; Tsurusaki, Masakatsu

doi:10.1007/s00595-008-3811-x

Cited by 23 publications

(17 citation statements)

References 10 publications

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“…The most common sites of visceral arterial aneurysms are the splenic, hepatic, superior mesenteric, celiac, gastric, gastroepiploic, jejunal, ileal, and colonic arteries and their tributaries. 2 Inada et al 3 reported 27 cases of SAM in Japan, of which 33.3% had multiple intraabdominal aneurysms similar to our case.…”

Section: Discussionsupporting

confidence: 85%

Subarachnoid hemorrhage in a case of segmental arterial mediolysis with coexisting intracranial and intraabdominal aneurysms

Matsuda¹,

Hironaka²,

Takeshima³

et al. 2012

JNS

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The authors report the rare case of a 58-year-old man with segmental arterial mediolysis (SAM) with associated intracranial and intraabdominal aneurysms, who suffered subarachnoid hemorrhage (SAH) due to rupture of an intracranial aneurysm. This disease primarily involves the intraabdominal arterial system, resulting in intraabdominal and retroperitoneal hemorrhage in most cases. The patient presented with severe headache and vomiting. The CT scans of the head revealed SAH. Cerebral angiography revealed 3 aneurysms: 1 in the right distal anterior cerebral artery (ACA), 1 in the distal portion of the A(1) segment of the right ACA, and 1 in the left vertebral artery. The patient had a history of multiple intraabdominal aneurysms involving the splenic, gastroepiploic, gastroduodenal, and bilateral renal arteries. He underwent a right frontotemporal craniotomy and fibrin coating of the dissecting aneurysm in the distal portion of the A(1) segment of the right ACA, which was the cause of the hemorrhage. Follow-up revealed no significant changes in the residual intracranial and intraabdominal aneurysms. An SAH due to SAM with associated multiple intraabdominal aneurysms is extremely rare. The authors describe their particular case and review the literature pertaining to SAM with associated intracranial and intraabdominal aneurysms.

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Section: Discussionsupporting

confidence: 85%

Subarachnoid hemorrhage in a case of segmental arterial mediolysis with coexisting intracranial and intraabdominal aneurysms

Matsuda¹,

Hironaka²,

Takeshima³

et al. 2012

JNS

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“…A total of 45.7% of all cases (16/35) had multiple aneurysms. In almost all cases, the chief complaint was abdominal pain, 4) while only three of the 28 aneurysm cases were asymptomatic. 1) Most cases were treated surgically, while case reports of patients treated by transcatheter arterial embolization have been increasing.…”

Section: Discussionmentioning

confidence: 98%

“…2) Moreover, only 2% of all reported splanchnic artery aneurysms have been located in the jejunal, ileal, or colic arteries. 3) Hirokawa, et al 4) reviewed the literature on 35 cases of middle colic artery aneurysms. The mean age and range were 59.3 ± 13.3 and 19-78 years, respectively.…”

Section: Discussionmentioning

confidence: 99%

Elective Treatment of Middle Colic Artery Aneurysm

Nishimura

Hamasaki

Ota

et al. 2014

Annals of Vascular Diseases

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Middle colic artery aneurysms are rare and most have been reported with rupture or symptom. We report the successful elective treatment of a middle colic artery aneurysm without symptom, which is very rare. It failed to perform transcatheter arterial embolization for anatomical reasons, and, thus, the patient, a 77-year-old man, underwent surgical resection in spite of a history of laparotomy. Although a common cause of middle colic artery aneurysms is segmental arterial mediolysis, the present pathological findings indicated that fragmented or degenerated elastic fibers may also play an important role like aortic aneurysms.

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“…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.…”

Section: Figmentioning

confidence: 81%

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

et al. 2011

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We herein report the case of a 49-year-old male patient with a ruptured aneurysm originating in the left colic artery, which was successfully treated by transcatheter arterial embolization (TAE) Abdominal computed tomography revealed a large hematoma with a central small aneurysm in the left upper abdomen. Celiac and superior mesenteric arteriography showed no dye extravasation. Subsequent aortography showed an aneurysm arising from the branch of the left colic artery that was successfully treated by selective TAE. Further surgery for subsequent ischemia was not performed. In cases presenting with an unclear source of intraabdominal bleeding, an aneurysm of the inferior mesenteric arterial branch should be considered. Transcatheter arterial embolization is a plausible initial treatment option as an effective therapeutic approach because it provides a curative and less invasive alternative to other therapies. Based on our experience and a review of the literature, surgery may not necessarily be imperative, even in cases of a ruptured aneurysm of a colic arterial branch after TAE.

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Middle-colic artery aneurysm associated with segmental arterial mediolysis, successfully managed by transcatheter arterial embolization: Report of a case

Cited by 23 publications

References 10 publications

Subarachnoid hemorrhage in a case of segmental arterial mediolysis with coexisting intracranial and intraabdominal aneurysms

Subarachnoid hemorrhage in a case of segmental arterial mediolysis with coexisting intracranial and intraabdominal aneurysms

Elective Treatment of Middle Colic Artery Aneurysm

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

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