Percutaneous thrombin injection under sonographic guidance for exclusion of non-catheterizable post-pancreatitis pseudoaneurysm of the superior mesenteric artery: a minimally invasive and expeditious treatment option

Chauhan, Udit; Puri, Sunil K.; Jain, Neeraj; Garg, Lalit; Kapoor, Ankur; Gupta, Nishant; Goel, Vandana

doi:10.1007/s10396-015-0687-4

Cited by 15 publications

(12 citation statements)

References 6 publications

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“…Aortic aneurysms most commonly occur as a consequence of atherosclerotic disease of the aorta. Alternatively, they may be associated with infectious seeding of the native or surgically repaired vessel (17). Prompt detection of abdominal aortic aneurysm rupture is critical because survival is improved by emergent surgery.…”

Section: Discussionmentioning

confidence: 99%

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Abdominal aortic aneurysm: pictorial review of common appearances and complications

Kumar¹,

Hooda²,

Li³

et al. 2017

Ann. Transl. Med.

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Abdominal aortic aneurysms (AAAs) are defined as focal dilatations of the abdominal aorta that are 50% greater than the proximal normal segment or when it is more than 3 cm in maximum diameter. The early diagnosis and treatment is very important to prevent catastrophic complications. Due to its ability to assess the peri-aortic soft tissue and the exact extension of aneurysm, as well as its excellent vascular opacification and multiplanar reconstruction capabilities, computed tomography angiography (CTA) has become an integral part of the evaluation of AAA and has virtually replaced conventional angiography for the evaluation of AAA. Knowledge of the characteristic imaging features of AAA is essential for the prompt diagnosis of life-threatening complications. In this pictorial essay, we will discuss the CTA findings in AAA and its complications including rupture, infection, aorto-enteric fistula and aorto-caval fistula.

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Section: Discussionmentioning

confidence: 99%

“…for any size and symptomatic patients. Management options include endovascular aneurysm repair (EVAR) and Open surgical repair (16,17).…”

Section: Treatment and Prognosismentioning

confidence: 99%

Abdominal aortic aneurysm: pictorial review of common appearances and complications

Kumar¹,

Hooda²,

Li³

et al. 2017

Ann. Transl. Med.

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“…The anatomy of the collateral vessels and the extent of the involved vessels can be evaluated. This is important when planning an endovascular procedure [4, 16]. Digital angiography has the highest sensitivity (100%), followed by CT (67%) and US (50%) [10].…”

Section: Discussionmentioning

confidence: 99%

“…It was first described in 2000 by Kang for the use of post-catheterization femoral pseudoaneurysms, but can also be used for visceral pseudoaneurysms [29]. A pseudoaneurysm with a small neck and relatively slower flow is best suited for this procedure due to a lower propensity for distal embolization as well as lower probability of recanalization in the early post-injection period [16, 30, 31]. Thrombin injection can also be performed endoluminally by placing a microcatheter into the aneurysm sac.…”

Section: Discussionmentioning

confidence: 99%

Visceral artery pseudoaneurysms: two case reports and a review of the literature

Abdelgabar

d'Archambeau

et al. 2017

J Med Case Reports

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BackgroundVisceral artery pseudoaneurysms are relatively rare but have a high mortality rate in case of rupture. Their detection in the last decades is rising due to an increased use of computed tomography and angiography. However, due to the nonspecific nature of the clinical symptoms and signs, diagnosis is often delayed or missed. We describe two cases of patients presenting with nonspecific abdominal complaints and anemia leading to a diagnosis of visceral pseudoaneurysm. Both cases are successfully treated with a different endovascular intervention.Case presentationThe first case is a 67-year-old Caucasian man presenting with diffuse abdominal pain, vomiting, diarrhea, and weight loss. Digital angiography showed a complex pseudoaneurysm of the superior mesenteric artery. The patient was treated with stent placement and selective embolization of the afferent branches.The second patient is a 78-year-old Caucasian man with a history of chronic pancreatitis admitted with epigastric pain, rectal bleeding and melena. Angiography showed a pseudoaneurysm of the gastroduodenal artery. The patient was successfully treated with coil embolization.ConclusionsWe report two cases of visceral pseudoaneurysms and review the literature concerning etiology, presentation, diagnosis, and treatment.Visceral artery pseudoaneurysms should be considered in the differential diagnosis of a patient with nonspecific abdominal symptoms. Diagnosis is often made with computed tomography or computed tomography angiography but digital angiography remains the gold standard. Treatment options include surgical, endovascular or percutaneous interventions. The choice of treatment is case specific.

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“…The angiography is the gold standard for the diagnosis of pseudoaneurysms due to its capacity to evaluate in real time the location of an overflow. The anatomy of collateral vessels and the extension of affected vessels can be evaluated through this method [5,11,13]. The angiography is most sensitive (100%), followed by tomography (67%) and ultrasound (50%) [11,12].…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm Endovascular Treatment of a Middle Colic Arterial Branch in a Patient with an Intermittent Digestive Hemorrhage from an Obscure Source: Case Report

Júnior¹,

Beck²,

Perotoni³

et al. 2017

Vasc Med Surg

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Aneurysms of the middle colic arterial branches are extremely rare, the main manifestation occurs due to the rupture and intraabdominal bleeding making death possible in up to 70% of cases. Herein, we report a case of a male patient, who is 50 years old and displays intermittent, recurrent, and self-limited episodes of a digestive hemorrhage that has been symptomatic during the course of a three-month investigation. After an extensive investigation, the patient was submitted to angiography detecting a pseudoaneurysm in the middle colic branch, being treated by embolization using micro-coils. Intermittent digestive hemorrhages from an obscure source can represent a diagnostic challenge, due to the high degree of clinical suspicion for performing the correct differential diagnosis. Arteriography must not be delayed whenever a pseudoaneurysm with active bleeding is suspected, as this exam is selected for diagnosis and the preferred method for conclusive treatment.

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Percutaneous thrombin injection under sonographic guidance for exclusion of non-catheterizable post-pancreatitis pseudoaneurysm of the superior mesenteric artery: a minimally invasive and expeditious treatment option

Cited by 15 publications

References 6 publications

Abdominal aortic aneurysm: pictorial review of common appearances and complications

Abdominal aortic aneurysm: pictorial review of common appearances and complications

Visceral artery pseudoaneurysms: two case reports and a review of the literature

Pseudoaneurysm Endovascular Treatment of a Middle Colic Arterial Branch in a Patient with an Intermittent Digestive Hemorrhage from an Obscure Source: Case Report

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