Visceral artery aneurysms as seen in a community hospital

Carmeci, Charles; McClenathan, James H.

doi:10.1016/s0002-9610(00)00380-9

Cited by 130 publications

(80 citation statements)

References 3 publications

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“…T rue visceral artery aneurysms are a rare and uncommon form of vascular disease often found incidentally in 0.09% to 2% of the general population (1)(2)(3). However, these true aneurysms have an incidence of rupture and mortality rate of 20% to 75% due to life-threatening hemorrhage (4,5).…”

Section: Resultsmentioning

confidence: 99%

Follow-up of true visceral artery aneurysm after coil embolization by three-dimensional contrast-enhanced MR angiography

Koganemaru¹,

Abe²,

Nonoshita³

et al. 2014

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to evaluate the outcomes of coil embolization of true visceral artery aneurysms by three-dimensional contrast-enhanced magnetic resonance (MR) angiography. MATERIALS AND METHODSWe used three-dimensional contrast-enhanced MR angiography, which included source images, to evaluate 23 patients (mean age, 60 years; range, 28-83 years) with true visceral artery aneurysms (splenic, n=15; hepatic, n=2; gastroduodenal, n=2; celiac, n=2; pancreaticoduodenal, n=1; gastroepiploic, n=1) who underwent coil embolization. Angiographic aneurysmal occlusion was revealed in all cases. Follow-up MR angiography was conducted with either a 1.5 or 3 Tesla system 3-25 months (mean, 18 months) after embolization. MR angiography was evaluated for aneurysmal occlusion, hemodynamic status, and complications. RESULTSComplete aneurysmal occlusion was determined in 22 patients (96%) on follow-up MR angiography (mean follow-up period, 18 months). Neck recanalization, which was observed at nine and 20 months after embolization, was confirmed in one of eight patients (13%) using a neck preservation technique. In this patient, a small neck recanalization covered by a coil mass was demonstrated. The complete hemodynamic status after embolization was determined in 21 patients (91%); the visualization of several collateral vessels, such as short gastric arteries, after parent artery occlusion was poor compared with that seen on digital subtraction angiography in the remaining two patients (9%). An asymptomatic localized splenic infarction was confirmed in one patient (4%). CONCLUSIONOur study presents the follow-up results from three-dimensional contrast-enhanced MR angiography, which confirmed neck recanalization, the approximate hemodynamic status, and complications. This effective and less invasive method may be suitable for serial follow-up after coil embolization of true visceral aneurysms.

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Section: Resultsmentioning

confidence: 99%

Follow-up of true visceral artery aneurysm after coil embolization by three-dimensional contrast-enhanced MR angiography

Koganemaru¹,

Abe²,

Nonoshita³

et al. 2014

Diagn Interv Radiol

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“…3,4 Although a laparoscopic approach is reported to be feasible, especially for splenic artery aneurysm, 2,16,17 the incision to extract the specimen is essential. In this case, the aneurysm was 4.5 cm in diameter, and intracorporeal mobilization was unnecessary because the lesion was located in the distal part of the SMA.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 However, the recent widespread use of computed tomography (CT) has led to frequent incidental detection of them. 3 Superior mesenteric artery aneurysm (SMAA) is reported to be the thirdmost common type of VA, 4 accounting for 5% of all…”

mentioning

confidence: 99%

Mini-Laparotomy for Superior Mesenteric Artery Aneurysm Due to Takayasu's Arteritis

Matsumoto

Ishizuka

Iso

et al. 2015

International Surgery

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Superior mesenteric artery aneurysm (SMAA) is reported to be the third-most common type of visceral aneurysm (VA), accounting for 5% of all VAs. The etiology of SMAA is commonly thought to be infection, and it usually exists in the proximal part of the superior mesenteric artery, which is suitable for endovascular treatment. We herein report an extremely rare case of the distal part of SMAA caused by Takayasu's arteritis (TA), which was successfully resected using a mini-laparotomy method without impairing the intestinal blood supply. A 51-year-old woman was admitted to our hospital with sustained fever and lower back pain. Physical examination showed that she had a discrepancies in blood pressure between both arms. Contrast-enhanced wholebody computed tomography showed stenosis of the thoracic aorta and an aneurysm located in the distal part of the superior mesenteric artery. The diameter of the aneurysm was 4.5 cm. The aneurysm was resected via 4-cm mini-laparotomy, and the vascularity of the intestine was successfully preserved. The postoperative course was uneventful, and the patient was diagnosed as having TA based on both clinical and pathologic findings. Additional corticosteroid therapy was started to treat the arteritis, and at 3-month followup she was without critical incidents. Mini-laparotomy is a safe and less-invasive approach to treat SMAA, especially when the lesion is located in the distal part of the artery.

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“…SAA is usually single and saccular and it is commonly located in the middle and distal part of the splenic artery. SAAs occur most often at bifurcations of the distal part of SA 1,5 . Aneurysm of the patient in this study was at the distal part of SA.…”

Section: Discussionmentioning

confidence: 99%

“…Most patients are asymptomatic and aneurysms are found incidentally on imaging studies. Among symptomatic patients, epigastric or left upper quadrant pain is the leading complaint 1,5,7 . Occasionally, the aneurysm can erode into adjacent viscus and may be presented as gastrointestinal hemorrhage 4,7. Although the rupture or fistula is very rare, these symptoms can cause severe sitiuations.…”

Section: Discussionmentioning

confidence: 99%

Massive upper gastrointestinal bleeding due to giant splenic artery aneurysm with gastric fistula

Akküçük¹,

Aydogan²,

Bayaroğulları³

et al. 2013

Sakarya Med J

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We aimed to report a case of a giant splenic artery aneurysm (SAA) with gastric fistula with the review of the literature. A female patient with splenic artery aneurysm was admitted to our hospital with abdominal pain and massive upper gastrointestinal bleeding. Hemorrhagic shock occurred. Despite the resuscitation, the patient died. Splenic artery aneurysms are the most common visceral aneurysm occurring predominantly in females with a ratio of 4:1. Giant aneurysm with thrombosis of the splenic artery is an extremely rare clinical entity and its size rarely exceeds to 3 centimeters. Although they are usually asymptomatic, SAA are clinically important because of the possibility of life-threatening rupture. Interventions or surgical treatment is indicated for symptomatic and giant aneurysms. Early diagnosis and prompt intervention is necessary for success of treatment. ÖzetNadir görülen mideye fistülize olmuş dev splenik arter anevrizmasına bağlı masif üst gastrointestinal sistem kanaması ile başvuran bir olguyu sunmayı istedik. Splenik arter anevrizması olan kadın hasta hastanemize karın ağrı-sı ve üst gastrointestinal sistem kanaması ile getirildi. Hastada hemorojik şok mevcuttu. Yapılan tüm resusitasyon çabalarına rağmen hasta hayatını kaybetti. Splenik arter anevrizmaları nadir görülmekle birlikte, kadınlarda erkeklere göre 4 kat daha fazla görülen ve iç organ anevrizmaları içerisinde en sık karşılaşılan anevrizmalardır. Splenik arterin tromboze ve dev anevrizmaları ise oldukça ender görülüp, nadiren 3 cm'ye ulaşırlar. Genellikle asemptomatik olsalar da, hayatı tehdit edebilecek yırtılmaları nedeniyle klinik olarak oldukça önemlidirler. Bu hastaların tedavisindeki başarıda, erken tanı, cerrahi ya da diğer girişimsel yöntemler önemlidir.

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Visceral artery aneurysms as seen in a community hospital

Cited by 130 publications

References 3 publications

Follow-up of true visceral artery aneurysm after coil embolization by three-dimensional contrast-enhanced MR angiography

Follow-up of true visceral artery aneurysm after coil embolization by three-dimensional contrast-enhanced MR angiography

Mini-Laparotomy for Superior Mesenteric Artery Aneurysm Due to Takayasu's Arteritis

Massive upper gastrointestinal bleeding due to giant splenic artery aneurysm with gastric fistula

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