Stent graft treatment for abdominal pseudoaneurysm near the celiac artery

Endovascular Stent-Graft Treatment of Giant Celiac Artery Pseudoaneurysm

BACKGROUND

Visceral artery aneurysms (VAAs) comprise an uncommon but life-threatening vascular disease. When rupture is the first clinical presentation, mortality rate reaches 70%. Increased use of cross-sectional imaging has led to a greater rate of diagnosis (40-80%) of asymptomatic VAAs. In the past, surgery was the treatment of choice for VAAs carrying high risk of mortality and morbidity.

CASE REPORT

A 22-year-old man, who had undergone gastric, pancreatic and aortic surgery 2.5 years earlier, presented with progressive abdominal pain. Multidetector computed tomography scan revealed an 8-cm celiac pseudoaneurysm. We report a giant celiac pseudoaneurysm treated with stent-graft implantation.

CONCLUSIONS

Endovascular treatment of VAA is a safe and effective method alternative to surgery.

Traumatic pseudoaneurysm of the visceral aortic segment managed using both open surgery and endovascular therapy

Pseudoaneurysm (PSA) formation is not a rare entity in the thoracic aorta, but is much rarer in the visceral aortic segment. This vascular lesion is most commonly because of penetrating trauma. We present the case of a patient with PSA of the visceral aortic segment that was treated by both surgical and endovascular methods and review the previously published data on the presentation, diagnosis, and management of visceral aortic PSAs.

Endoluminal embolization and revascularization for complicated mesenteric pseudoaneurysms: A report of two cases and a literature review

Mesenteric artery pseudoaneurysms are a rare and complex complication after abdominal trauma, surgery, or inflammatory disease. These lesions can be associated with compression or erosion into adjacent structures and may result in life-threatening hemorrhage. Traditional management has been open surgical ligation, aneurysm resection with interposition grafts, or resection or partial resection of the end organ involved. We present two cases of endovascular repair of complex mesenteric pseudoaneurysms. One patient presented with a recurrent pseudoaneurysm of the superior mesenteric artery and the second presented as recurrent gastrointestinal bleeding secondary to a traumatic celiac artery pseudoaneurysm-to-pancreatic duct fistula. A systematic review of the literature on endovascular management of mesenteric vascular disease and mesenteric pseudoaneurysms is included in this report to allow these cases to be put into proper perspective.