Splanchnic artery aneurysms and pseudoaneurysms: transcatheter embolization.

Baker, K. S.; Tisnado, Jaime; Cho, Shao-Ru; Beachley, Michael C.

doi:10.1148/radiology.163.1.3823426

Cited by 163 publications

(68 citation statements)

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“…There are two choices for the treatment of HP: (1) surgery (e.g. resection of the pancreas head or tail), and (2) interventional radiological therapy [11][12][13][14] . Most HP cases can receive angiography.…”

Section: Discussionmentioning

confidence: 99%

Hemosuccus pancreaticus: Problems and pitfalls in diagnosis and treatment

Toyoki¹,

Hakamada²,

Narumi³

et al. 2008

WJG

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Hemosuccus pancreaticus is a rare cause of intermittent upper gastrointestinal bleeding. We report two cases of hemosuccus pancreaticus with multiple episodes of upper gastrointestinal bleeding. The causes of hemorrhage were rupture of pseudoaneurysm of the splenic artery and bleeding from the wall of pancreatic pseudocyst. Interventional radiology is the first modality for early diagnosis and possible treatment of hemosuccus pancreaticus. When angiography shows no abnormal findings or interventional radiological therapy can not be successful, surgery should be considered without delay. Our patients herein underwent surgery without recurrence or sequelae. Intraoperative ultrasonography and pancreatoscopy were helpful modalities for confirming the source of hemorrhage and determining the cutting line of the pancreas. When we encounter intermittent upper gastrointestinal bleeding with an obscure source, hemosuccus pancreaticus should be included in differential diagnoses especially in patients with chronic pancreatitis, which would lead to a prompt and proper treatment.

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Section: Discussionmentioning

confidence: 99%

Hemosuccus pancreaticus: Problems and pitfalls in diagnosis and treatment

Toyoki¹,

Hakamada²,

Narumi³

et al. 2008

WJG

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“…It can be done concomitantly with diagnostic angiography, and in the hands of an experienced angiographer, it may be safer than immediate surgery in patients with massive hemorrhage who are not candidates for surgery (22). Embolization is the preferred treatment for pseudoaneurysms in those for whom surgical intervention would be difficult, such as postoperative patients or those with intrahepatic pseudoaneurysms (1,10,25). Various embolization techniques and materials have been used, but the ideal embolic material in patients with pseudoaneurysms should be easy to use, permanent, and capable of occluding the injured artery and the pseudoaneurysm with maximal preservation of splanchnic arterial flow (1 5, 24, 25).…”

Section: Discussionmentioning

confidence: 99%

“…In the past, the treatment of choice for these lesions has been surgery, but under these critical conditions, surgery carries a high risk of mortality (1,15,21).…”

mentioning

confidence: 99%

Percutaneous Embolization of Ruptured Splanchnic Artery Pseudoaneurysms

Okazaki¹,

Higashihara²,

Ono³

et al. 1991

Acta Radiol

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The usefulness of emergent embolotherapy was evaluated in 17 patients with life-threatening hemorrhage from I8 ruptured splanchnic artery pseudoaneurysms. Complete hemostasis was obtained in 16 out of 17 patients by embolotherapy. Of the 12 initial embolization procedures with permanent embolic materials including stainless steel coils, microcoils, and halon, complete cessation of bleeding was obtained in 11. On the other hand, 6 out of 9 initial embolization procedures with Gelfoam particles failed to halt bleeding, and additional embolization with permanent embolic materials was required. Emergent embolization with permanent embolic materials using superselective catheterization should be considered the initial treatment of choice for ruptured splanchnic artery pseudoaneurysms.

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“…[6][7][8] Early reports on endovascular therapy for active hemorrhage in these patients provided variable results. [9][10][11] Although it is currently the preferred early intervention in hemodynamically stable patients, the long-term outcomes of endovascular therapy are not well described. In addition, the outcomes of patients who have a negative angiographic finding are not known.…”

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confidence: 99%