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1
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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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2
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Dubois AS, Mathew JM, Makris SA, Renwick B. Surgical Excision of a Contained Rupture of an Inferior Mesenteric Aneurysm. Vasc Endovascular Surg 2022; 56:321-324. [PMID: 34983268 DOI: 10.1177/15385744211069746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Inferior mesenteric artery (IMA) aneurysms represent the minority of visceral aneurysm presentations. A 57-year-old female was admitted with a symptomatic IMA aneurysm secondary to atherosclerotic disease. She was treated with open excision which revealed a contained ruptured of a true aneurysm. This case highlights the challenges of an accurate preoperative diagnosis of IMA aneurysm and the correct position of the recent guidelines on visceral aneurysms issued by the Society of Vascular Surgery (SVS).
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Affiliation(s)
- Andre S Dubois
- Department of Vascular Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Joyce M Mathew
- Department of Histopathology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Sotirios A Makris
- Department of Vascular Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Bryce Renwick
- Department of Vascular Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
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3
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Venturini M, Piacentino F, Coppola A, Bettoni V, Macchi E, De Marchi G, Curti M, Ossola C, Marra P, Palmisano A, Cappelli A, Basile A, Golfieri R, Cobelli FD, Piffaretti G, Tozzi M, Carcano G, Fontana F. Visceral Artery Aneurysms Embolization and Other Interventional Options: State of the Art and New Perspectives. J Clin Med 2021; 10:2520. [PMID: 34200171 PMCID: PMC8201262 DOI: 10.3390/jcm10112520] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/28/2021] [Accepted: 06/03/2021] [Indexed: 12/24/2022] Open
Abstract
Visceral artery aneurysms (VAAs) are rare, usually asymptomatic and incidentally discovered during a routine radiological examination. Shared guidelines suggest their treatment in the following conditions: VAAs with diameter larger than 2 cm, or 3 times exceeding the target artery; VAAs with a progressive growth of at least 0.5 cm per year; symptomatic or ruptured VAAs. Endovascular treatment, less burdened by morbidity and mortality than surgery, is generally the preferred option. Selection of the best strategy depends on the visceral artery involved, aneurysm characteristics, the clinical scenario and the operator's experience. Tortuosity of VAAs almost always makes embolization the only technically feasible option. The present narrative review reports state of the art and new perspectives on the main endovascular and other interventional options in the treatment of VAAs. Embolization techniques and materials, use of covered and flow-diverting stents and percutaneous approaches are accurately analyzed based on the current literature. Visceral artery-related considerations and targeted approaches are also provided and discussed.
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Affiliation(s)
- Massimo Venturini
- Diagnostic and Interventional Radiology Department, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.P.); (A.C.); (V.B.); (E.M.); (G.D.M.); (F.F.)
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy; (M.C.); (C.O.); (G.P.); (M.T.); (G.C.)
| | - Filippo Piacentino
- Diagnostic and Interventional Radiology Department, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.P.); (A.C.); (V.B.); (E.M.); (G.D.M.); (F.F.)
| | - Andrea Coppola
- Diagnostic and Interventional Radiology Department, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.P.); (A.C.); (V.B.); (E.M.); (G.D.M.); (F.F.)
| | - Valeria Bettoni
- Diagnostic and Interventional Radiology Department, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.P.); (A.C.); (V.B.); (E.M.); (G.D.M.); (F.F.)
| | - Edoardo Macchi
- Diagnostic and Interventional Radiology Department, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.P.); (A.C.); (V.B.); (E.M.); (G.D.M.); (F.F.)
| | - Giuseppe De Marchi
- Diagnostic and Interventional Radiology Department, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.P.); (A.C.); (V.B.); (E.M.); (G.D.M.); (F.F.)
| | - Marco Curti
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy; (M.C.); (C.O.); (G.P.); (M.T.); (G.C.)
| | - Christian Ossola
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy; (M.C.); (C.O.); (G.P.); (M.T.); (G.C.)
| | - Paolo Marra
- Department of Diagnostic Radiology, Giovanni XXIII Hospital, Milano-Bicocca University, 24127 Bergamo, Italy;
| | - Anna Palmisano
- Department of Radiology, IRCCS San Raffaele Scientific Institute, San Raffaele School of Medicine Vita-Salute University, 20132 Milan, Italy; (A.P.); (F.D.C.)
| | - Alberta Cappelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.C.); (R.G.)
| | - Antonio Basile
- Department of Medical and Surgical Sciences and Advanced Technologies, Radiodiagnostic and Radiotherapy Unit, University Hospital “Policlinico-Vittorio Emanuele”, 95123 Catania, Italy;
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.C.); (R.G.)
| | - Francesco De Cobelli
- Department of Radiology, IRCCS San Raffaele Scientific Institute, San Raffaele School of Medicine Vita-Salute University, 20132 Milan, Italy; (A.P.); (F.D.C.)
| | - Gabriele Piffaretti
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy; (M.C.); (C.O.); (G.P.); (M.T.); (G.C.)
- Vascular Surgery Department, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy
| | - Matteo Tozzi
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy; (M.C.); (C.O.); (G.P.); (M.T.); (G.C.)
- Vascular Surgery Department, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy
| | - Giulio Carcano
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy; (M.C.); (C.O.); (G.P.); (M.T.); (G.C.)
- Department of General, Emergency and Transplants Surgery, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy
| | - Federico Fontana
- Diagnostic and Interventional Radiology Department, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.P.); (A.C.); (V.B.); (E.M.); (G.D.M.); (F.F.)
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy; (M.C.); (C.O.); (G.P.); (M.T.); (G.C.)
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Park JH, Kwon HJ, Chang KS, Kang KA, Kim MS. Ischemic Colitis due to Fibromuscular Dysplasia Limited to the Inferior Mesenteric Artery: A Case Report. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2020; 81:1008-1012. [PMID: 36238183 PMCID: PMC9432214 DOI: 10.3348/jksr.2020.81.4.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/14/2019] [Accepted: 10/18/2019] [Indexed: 11/15/2022]
Abstract
섬유근형성이상은 주로 신동맥, 경동맥의 협착이나 동맥류 형성을 유발하는 비죽상경화, 비염증성 동맥 질환으로, 드물게 내장동맥을 침범하며 다양한 양상으로 나타날 수 있다. 저자들은 66세 남자에서 하장간막동맥을 단독으로 침범한 섬유근형성이상으로 인해 좌결장동맥과 상직장동맥의 동맥류 및 허혈성 대장염으로 발현된 증례를 경험하여 보고하고자 한다.
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Affiliation(s)
- Jin Hee Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Heon Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Seek Chang
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung A Kang
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Sung Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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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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