Polyvinyl alcohol and gelatin sponge particle embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis

Guan, Yong-Song; Sun, Long; Zhou, Xiangping; Xiao, Li; Fei, Zejun; Zheng, Xiaohua; He, Qing

doi:10.3748/wjg.v11.i17.2684

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…Therefore, polyvinyl alcohol microparticles were employed as alternative embolic agents. 4,5 The experience gained in this case suggests that superselective TAE represents a safe and effective alternative to surgery in patients with hemorrhagic PDUs. Additional clinical reports of such rare cases may help standardize treatment of this fatal disease.…”

mentioning

confidence: 86%

“…3 In clinical practice, metronidazole alone, metronidazole and trimethoprim/sulfamethoxazole (TMP/SMX), iodoquinol, tinidazole, and furazolidone have been used to treat individuals harboring B. hominis in their intestinal tract. 4 The effectiveness of treatment with metronidazole and TMP/SMX for B. hominis infection has been reported. 4 Metronidazole was effective against the symptoms and eosinophilia in our patient.…”

Section: Blastocystis Hominis Infection In Patient With Regular Dialysismentioning

confidence: 99%

“…4 The effectiveness of treatment with metronidazole and TMP/SMX for B. hominis infection has been reported. 4 Metronidazole was effective against the symptoms and eosinophilia in our patient.…”

Section: Blastocystis Hominis Infection In Patient With Regular Dialysismentioning

confidence: 99%

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Life-threatening bleeding from postbulbar duodenal ulcer saved by emergency transcatheter arterial embolization

et al. 2006

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Life-threatening bleeding from postbulbar duodenal ulcer saved by emergency transcatheter arterial embolizationTo the Editor: Immediate operation is the standard procedure to arrest life-threatening bleeding from postbulbar duodenal ulcer (PDU) not amenable to endoscopic treatment. Nonetheless, even in operable cases, mortality and morbidity rates for hemorrhagic PDUs are high. 1,2 Here we report on a patient with lifethreatening hemorrhage from PDU, who, after failed endoscopic treatment, was successfully saved by emergency transcatheter arterial embolization (TAE) with polyvinyl alcohol and gelatin sponge particles.A 69-year-old man underwent a coronary artery bypass graft for myocardial infarction, and was discharged 17 days later. Before and following the procedure, standard-dose histamine receptor antagonist was administered to the patient. Warfarin was given orally (Thrombotest, 10%-20%). Nonsteroidal antiinflammatory drugs (NSAIDs) were not administered. On the next day, the patient presented at our institution unconscious (owing to hypovolemic shock) and with tarry stool. He was stabilized by rapid fluid resuscitation. Upper gastrointestinal endoscopy disclosed multiple, small, shallow ulcers in the postbulbar lesion of the duodenum, with bleeding from one of these ulcers. Hemostatic clips were used to control bleeding at the site (Fig. 1). Nonetheless, the following day, hemorrhage recurred and the patient again went into shock. In this instance, endoscopic treatment was not feasible because hematoma obscured visualization of the bleeding site. Contrast-enhanced computed tomography (CT) images showed an intraluminal extravasation from the anterior wall of the duodenum. Emergency diagnostic angiography revealed extravasation from the duodenal branch arising from the anterior superior pancreaticoduodenal artery (ASPDA) (Fig. 2), and superselective TAE was performed immediately. The feeding branch was embolized using polyvinyl alcohol particles ranging in size from 500 to 700 µm (Ivaron, Contour; Boston Scientific, Fremont, CA, USA), beginning with the ASPDA. To ensure hemostasis, gelatin sponge particles (Gelfoam; Pharmacia and Upjohn, Kalamazoo, MI, USA) were added. Subsequent angiography showed complete occlusion. No increase in serum levels of transaminases or amylase was noted. Improvement of PDUs (including the hemorrhagic ulcer) was achieved with proton pump inhibitor therapy, and duodenal ischemia was not observed. The serum gastrin level, which was elevated (307 pg/ml) before TAE, decreased to 101 pg/ml after the procedure (normal range, 37-172 pg/ml). The patient has been well and without recurrent ulcer formation or bleeding for 50 months.

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confidence: 86%

Section: Blastocystis Hominis Infection In Patient With Regular Dialysismentioning

confidence: 99%

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Life-threatening bleeding from postbulbar duodenal ulcer saved by emergency transcatheter arterial embolization

et al. 2006

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“…Particularly, in this paper, some benefits of the aforementioned visualization strategy are going to be demonstrated through visualization of particle transport in and around cerebral aneurysms. Clinical applications include deliveries of chemical agents to either dissolve clots in the blood stream [1], or occlude vascular aneurysms [2,3] and stop hemorrhage from ruptured aneurysms or arteries [4]. Flow visualization is also important for designing flowdiverting stents to occlude cerebral aneurysms or bleeding sites.…”

Section: Introductionmentioning

confidence: 99%

VesselMap: A web interface to explore multivariate vascular data

Tao

Huang

Qiu

et al. 2016

Computers & Graphics

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a b s t r a c tHemodynamics plays a key role in the pathological evolution of vascular diseases such as vascular stenosis, plaques and aneurysms. Augmented visualization of relevant hemodynamic and geometric data accelerates engineering designs of diagnostic and therapeutic methods for those vascular diseases. However, four dimensional (4D) hemodynamic data are intrinsically complex. Consequently, exploration of this information has not been streamlined, despite its importance. In this paper, we propose a web interface to explore multivariate hemodynamic data, thereby facilitating the visualization of spatial and temporal relationships among those hemodynamic parameters of interest. The main thrust of this web system is the proposed VesselMap methodology, a 2D representation of vessel structures that provides an overview of all query results without any visual occlusions. Furthermore, in this framework, quantilequantile plot was also used to compare spatial variations in parameter distributions, thereby greatly aiding in extracting local characteristics of hemodynamic parameters.Using "patient-specific" computational fluid dynamics (CFD) simulations, realistic flow velocity fields were obtained. Based on those CFD-simulated velocity fields, we performed an empirical evaluation to confirm the usefulness of our approach for biomedical engineering applications. We concluded that the proposed VesselMap methodology allowed users to rapidly interact with hemodynamic data of interest, enhancing efficacy of information retrieval.

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Embolization Coils Migrating and Being Passed per Rectum After Embolization of a Splenic Artery Pseudoaneurysm, “The Migrating Coil”: A Case Report

Shah

Akingboye

Haldipur

et al. 2007

Cardiovasc Intervent Radiol

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Acute or chronic blood loss from pseudoaneurysms of the splanchnic artery in chronic pancreatitis poses diagnostic and management challenges. Arteriographic examination offers both diagnostic and therapeutic options, with success rates of 76%-100% for both modalities. In cases of failure of embolization, repeat embolization is also an option. Surgical intervention is advocated for rebleeding and failure of embolization. Evidence-based guidelines regarding the optimal treatment modality for this condition are lacking. There has been a reported case of dislodgement of coil into the stomach through a gastropseudocystic fistula. We report the case of a migrating steel-wire coil through the gastrointestinal tract and splenic artery pseudoaneurysm. We highlight the potential complications of pseudoaneurysm and other available therapeutic management options.

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Polyvinyl alcohol and gelatin sponge particle embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis

Abstract: This case confirms that superselective transcatheter embolization by PVA and gelatin sponge particles may represent an effective treatment for pseudoaneurysm caused by chronic alcoholic pancreatitis in the absence of other therapeutic alternatives.

Cited by 6 publications

References 9 publications

Life-threatening bleeding from postbulbar duodenal ulcer saved by emergency transcatheter arterial embolization

Life-threatening bleeding from postbulbar duodenal ulcer saved by emergency transcatheter arterial embolization

VesselMap: A web interface to explore multivariate vascular data

Embolization Coils Migrating and Being Passed per Rectum After Embolization of a Splenic Artery Pseudoaneurysm, “The Migrating Coil”: A Case Report

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