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Dreksler H, Nagpal SK, Hajjar G, Roberts DJ. Successful surgical management of a suspected high-flow inferior mesenteric artery aneurysm in a patient with chronic celiac and superior mesenteric artery occlusions. J Vasc Surg Cases Innov Tech 2024; 10:101438. [PMID: 38445064 PMCID: PMC10912906 DOI: 10.1016/j.jvscit.2024.101438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/11/2024] [Indexed: 03/07/2024] Open
Abstract
Inferior mesenteric artery (IMA) aneurysms account for approximately 1% of visceral artery aneurysms and can occur secondary to high flow because of occlusive disease in other mesenteric arteries. We describe the case of a 79-year-old man who presented with a 3.3-cm IMA aneurysm and chronic total occlusions of the celiac artery and superior mesenteric artery (SMA). After an unsuccessful attempt at endovascular SMA recanalization, he underwent an uncomplicated retrograde aorta to SMA bypass and antegrade aorta to IMA bypass. We propose that an aorta to IMA bypass after SMA revascularization is safe and effective to treat suspected high-flow IMA aneurysms.
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Affiliation(s)
- Hannah Dreksler
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
| | - Sudhir K. Nagpal
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
| | - George Hajjar
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
| | - Derek J. Roberts
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Jesus-Silva SGD, Moraes-Silva MAD, Rieira BC, Nasser F, Cardoso RS. Short- and long-term follow-up after transarterial embolization of a giant inferior mesenteric artery aneurysm. J Vasc Surg Cases Innov Tech 2018; 4:315-318. [PMID: 30761376 PMCID: PMC6298940 DOI: 10.1016/j.jvscit.2018.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/24/2018] [Indexed: 11/13/2022] Open
Abstract
Among the cases of visceral artery aneurysms, those that involve the inferior mesenteric artery are the most uncommon, with a prevalence of <1%. This study reports a giant symptomatic inferior mesenteric artery aneurysm and its endovascular treatment by means of percutaneous embolization with the implantation of pushable coils. After complete occlusion of the aneurysm, adequate maintenance of arterial supply of the left colon and resolution of the symptoms were observed. In the 2-year follow-up, a significant reduction in the aneurysm's volume and maintenance of the clinical condition were observed.
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Affiliation(s)
| | | | - Bruno Cardoso Rieira
- Department of Vascular and Endovascular Surgery, Hospital de Clínicas de Itajuba, Itajubá/MG, Brazil
| | - Felipe Nasser
- Department of Interventional Radiology, Albert Einstein Israeli Hospital, São Paulo, Brazil
| | - Rodolfo Souza Cardoso
- Department of Vascular and Endovascular Surgery, Hospital de Clínicas de Itajuba, Itajubá/MG, Brazil
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Troisi N, Esposito G, Cefalì P, Setti M. A case of atherosclerotic inferior mesenteric artery aneurysm secondary to high flow state. J Vasc Surg 2011; 54:205-7. [DOI: 10.1016/j.jvs.2010.11.114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 11/17/2010] [Accepted: 11/22/2010] [Indexed: 11/15/2022]
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Clark CE, Monzon JR, Gifford S, Toursarkissian B, Mayoral JL. Inferior mesenteric artery aneurysm in the setting of chronic colonic vascular ectasia. Ann Vasc Surg 2010; 25:267.e7-9. [PMID: 20926238 DOI: 10.1016/j.avsg.2010.07.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 07/06/2010] [Accepted: 07/19/2010] [Indexed: 11/25/2022]
Abstract
Colonic vascular ectasia is a condition characterized by dilated submucosal veins, venules, or capillaries found commonly in patients with lower gastrointestinal hemorrhage. We present a case of colorectal ectasia associated with ischemia and an inferior mesenteric artery aneurysm. These pathologic findings may be the result of the vascular ectasia and may add to the natural history of this condition.
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Tsukioka K, Nobara H, Nishimura K. A case of inferior mesenteric artery aneurysm with an occlusive disease in superior mesenteric artery and the celiac artery. Ann Vasc Dis 2010; 3:160-3. [PMID: 23555406 DOI: 10.3400/avd.avdcr01006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Accepted: 08/25/2010] [Indexed: 11/13/2022] Open
Abstract
A 72 year-old man was referred to our hospital for treatment of a gradually expanding inferior mesenteric artery (IMA) aneurysm associated with an occluded superior mesenteric artery (SMA) and a severely stenosed celiac artery (CA). Using 64-slice computer tomography (CT), we were able to accurately define a precise collateral visceral circulation from the IMA to the SMA and the CA, greatly clarifying preoperative strategy. The aneurysm was subsequently removed, with revascularization of the SMA and the CA accomplished through grafts from the abdominal aorta using 6 mm polytetrafluoroethylene (PTFE) grafts.
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Affiliation(s)
- Katsuaki Tsukioka
- Department of Cardiovascular Surgery, Matsumoto Kyoritsu Hospital, Matsumoto, Japan
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Acute retroperitoneal bleeding due to inferior mesenteric artery aneurysm: case report. BMC Gastroenterol 2010; 10:59. [PMID: 20534123 PMCID: PMC2889853 DOI: 10.1186/1471-230x-10-59] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2009] [Accepted: 06/09/2010] [Indexed: 11/29/2022] Open
Abstract
Background Visceral artery aneurysms (VAA), although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm associated with stenosis of the superior mesenteric artery (SMA) and celiac trunk, successfully treated with surgery. Methods A 65-year-old man presented with abdominal pain and hypovolemic shock. Abdominal CT scan showed an aneurysm of the inferior mesenteric artery with retroperitoneal hematoma. In addition, an obstructive disease of the superior mesenteric artery and celiac axis was observed. Results Upon emergency laparotomy a ruptured inferior mesenteric artery aneurysm was detected. The aneurysm was excised and the artery reconstructed by end-to-end anastomosis. Conclusions This report discusses the etiology, presentation, diagnosis and case management of inferior mesenteric artery aneurysms.
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Tsukioka K, Nobara H, Nishimura K. A Case of Inferior Mesenteric Artery Aneurysm with an Occlusive Disease in Superior Mesenteric Artery and the Celiac Artery. Ann Vasc Dis 2010. [DOI: 10.3400/avd.cr01006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Momin AA, Chaubal NG, Saifi SGA, Kazi ZN. Sonographic diagnosis of inferior mesenteric artery aneurysm and marginal artery of Drummond. JOURNAL OF CLINICAL ULTRASOUND : JCU 2008; 36:42-4. [PMID: 17583563 DOI: 10.1002/jcu.20397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We report the case of a patient in whom sonographic examination revealed an aneurysm of the inferior mesenteric artery with severe proximal stenosis and poststenotic dilatation--the enlargement of the proximal portion of the artery of Drummond. This collateral pathway should be kept in mind when studying bowel ischemia, especially when stenosis is present or when there is occlusion of the superior mesenteric artery.
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Affiliation(s)
- Asif A Momin
- Department of Ultrasound, Prince Aly Khan Hospital, Nesbit Road, Mazagaon, Mumbai 400 010, India
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Mandeville KLD, Bicknell C, Narula S, Renton S. Inferior mesenteric artery aneurysm with occlusion of the superior mesenteric artery, coeliac trunk and right renal artery. Eur J Vasc Endovasc Surg 2007; 35:312-3. [PMID: 17913522 DOI: 10.1016/j.ejvs.2007.07.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2007] [Accepted: 07/22/2007] [Indexed: 11/21/2022]
Abstract
Inferior mesenteric artery aneurysms are amongst the rarest of visceral aneurysms. We present here a case associated with occlusion of the superior mesenteric artery, coeliac trunk and right renal artery. Operative treatment was resection of the aneurysm, with end-to-end anastomosis. This is the first description of this condition from the UK, with only nine other reports worldwide. Such pathology may be caused by a "jet disorder" phenomenon, with increased flow through the inferior mesenteric artery due to chronic mesenteric occlusive disease.
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Affiliation(s)
- K L D Mandeville
- Department of Vascular Surgery, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK.
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Sakamoto SI, Yamauchi S, Yamashita H, Imura H, Maruyama Y, Ochi M, Shimizu K. Repair of an Abdominal Aortic Aneurysm with a Remarkably Dilated Meandering Artery: Report of a Case. Surg Today 2007; 37:133-6. [PMID: 17243032 DOI: 10.1007/s00595-006-3362-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Accepted: 07/11/2006] [Indexed: 11/26/2022]
Abstract
A 73-year-old man on dialysis for chronic renal dysfunction was referred to our hospital for surgical treatment of an abdominal aortic aneurysm (AAA). Preoperative angiography showed a remarkably developed meandering artery branching from the inferior mesenteric artery (IMA). The superior mesenteric and celiac arteries were occluded at the origin, and all blood flow to the abdominal organs was apparently supplied by collateral circulation from the IMA. Considering the risk of mesenteric ischemia after aortic clamping in conjunction during surgery, we used a perfusion catheter with a 12-F balloon to create a shunt to the IMA from the subclavian artery. The operation was successful and the patient recovered uneventfully. We describe this surgical procedure for its effectiveness in preventing postoperative mesenteric ischemia in a rare case of an AAA with complex branching lesions.
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Affiliation(s)
- Shun-Ichiro Sakamoto
- Department of Thoracic and Cardiovascular Surgery, Chiba Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inba, Chiba, 270-1694, Japan
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Morimoto N, Okita Y, Tsuji Y, Inoue N, Yokoyama M. Inferior mesenteric artery aneurysm in Behçet syndrome. J Vasc Surg 2004; 38:1434-6. [PMID: 14681655 DOI: 10.1016/s0741-5214(03)00941-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We present a case report of an aneurysm of the inferior mesenteric artery, associated with occlusion of the celiac, superior mesenteric, and left renal arteries and severe stenosis in the right renal artery, in a 48-year-old patient with Behçet syndrome. The meandering inferior mesenteric artery, with an aneurysm 28 mm in greatest dimension, was the blood supply source for the intraperitoneal viscera. Aneurysm resection and reimplantation of the inferior mesenteric artery, and right renal artery bypass grafting with saphenous vein was performed. To our knowledge, this is the first reported case of inferior mesenteric artery aneurysm caused by Behçet syndrome.
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Affiliation(s)
- Naoto Morimoto
- Department of Cardiovascular Surgery,Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
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