1
|
Fang G, Lu Y, Zou L, Wang Y, Fu W, Dong Z. Endovascular Strategies and Outcomes for Aberrant Splenic Artery Aneurysms. J Endovasc Ther 2024:15266028231224165. [PMID: 38197227 DOI: 10.1177/15266028231224165] [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: 01/11/2024]
Abstract
OBJECTIVES Aberrant splenic artery aneurysms (ASAAs) located at the splenomesenteric trunk (SMT) and the celiacomesenteric trunk have a close anatomical relationship with the superior mesenteric artery (SMA). The aim of this study was to review our institutional experience of endovascular treatment for ASAAs and evaluate the long-term outcomes. METHODS A retrospective review of patients with ASAAs who underwent endovascular treatment between December 2006 and December 2022 was performed. The demographics of the patients, aneurysm characteristics, treatment strategies, perioperative and long-term outcomes, and complications were analyzed. RESULTS A total of 29 patients with ASAAs were endovascularly treated at our institution. The SMT variant occurred in the majority of the patients. All ASAAs were characterized by eccentric growth and extremely short inflow arteries. Only 1 patient's inflow artery of the aneurysm exceeded 1 cm in length. Thirteen patients were treated by coil embolization alone. Four patients received bare stent-assisted coil embolization. A combination of coil embolization and covered stent placement across the orifice of the aberrant splenic artery was performed in the remaining 12 cases. Coil migration into the SMA occurred in 2 patients during the operation. Technical success was achieved in all patients. With a median duration of 63 (34-101) months of follow-up, no intestinal ischemia, aneurysm-related death, aneurysm rupture, or sac enlargement occurred. Three cases of aneurysm sac reperfusion were observed, and 1 patient underwent reintervention with secondary embolization. Asymptomatic occlusion of the covered stent was detected in 1 patient at 2 years. CONCLUSIONS Endovascular treatment is a safe, effective, and durable option for ASAAs. Inflow embolization might be difficult to achieve in ASAAs and poses a high risk of coil migration into the SMA. Long-term observation indicates that reasonable use of the covered stent could achieve reliable inflow artery exclusion in ASAAs without intestinal complications. CLINICAL IMPACT Aberrant splenic artery aneurysm (ASAA) is an extremely rare entity. This study reported a large sample size of ASAAs treated by endovascular techniques with long-term follow-up. The ASAA was characterized by an extremely short inflow artery and a close anatomical relationship with the superior mesenteric artery (SMA). Endovascular treatment is a safe, effective, and durable option for ASAAs. Inflow embolization might be difficult to achieve in ASAAs and pose a high risk of coil migration into the SMA. Long-term observation indicates that reasonable use of the covered stent could achieve reliable inflow artery exclusion in ASAAs without intestinal complications.
Collapse
Affiliation(s)
- Gang Fang
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Yige Lu
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Lingwei Zou
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Yuning Wang
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Weiguo Fu
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Zhihui Dong
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Vascular Surgery, Fudan University, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| |
Collapse
|
2
|
Kuwada N, Akagi D, Watanabe Y, Kanaoka Y, Tanemoto K. Endovascular Stent Graft Placement and Coil Embolization for Splenic Artery Aneurysm with an Anatomical Variant. Int J Angiol 2023; 32:273-276. [PMID: 37927835 PMCID: PMC10624522 DOI: 10.1055/s-0042-1742588] [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: 10/19/2022] Open
Abstract
A 62-year-old woman with abdominal pain was diagnosed with a splenic artery aneurysm (SAA) and an anatomical variant in the splenic artery (SA) arising from the superior mesenteric artery (SMA) as its first branch. To treat the SAA, the draining artery and a small branch of the SAA were embolized, and then small-diameter stent grafts were deployed from SMA orifice, covering the aberrant origin of the SA and preserving the second branch of SMA. Intraoperative angiography confirmed successful exclusion of the SAA without endoleak or arterial dissection. The stent graft was patent and the aneurysm had shrunk 3.5 years after the operation.
Collapse
Affiliation(s)
- Noriaki Kuwada
- Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Daisuke Akagi
- Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Yoshiko Watanabe
- First Department of Physiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Yuji Kanaoka
- Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Kazuo Tanemoto
- Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
| |
Collapse
|
3
|
Ramakrishnan R, Viswakumar DK, Goriparthi BP. Anomalous Course of Accessory Splenic Arteries in Gastrosplenic Ligament: Case Report and Clinico-Embryological Basis. ACTA MEDICA (HRADEC KRÁLOVÉ) 2021; 63:133-136. [PMID: 33002401 DOI: 10.14712/18059694.2020.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Accessory splenic arteries in the gastrosplenic ligament constitute one of the extremely sub-component of abdominal vasculature variations and it is imperative to recognize this anomaly while planning for complex surgeries in the supra-colic compartment. We report the case of accessory splenic arteries in an approximately 50-year-old male cadaver encountered during routine educational dissection. One of them arising from left gastroepiploic artery supplies the spleen in addition to splenic artery. Another variant vessel bifurcated to enter greater omentum and anterior pole of spleen, as discrete branches. The anatomical vascular variation, if recognized during the imaging work-ups for elective surgical procedures could avoid potential iatrogenic blood loss.
Collapse
Affiliation(s)
| | - Dinesh Kumar Viswakumar
- Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
| | | |
Collapse
|
4
|
Kakamad FH, Hammood ZD, Salih AM, Abdalla BY, Mohammed KS, Karim SO, Hamasalih HM, Salih RQ, Mohammed SH, Qadr OO, Sofi Mohammed HA, Hussein SI, Anwar SB, Abulkarim UY. Aneurysm of anomalous splenic artery arising from a splenomesenteric trunk: Review of the literature with a report of a new case. Int J Surg Case Rep 2021; 80:105618. [PMID: 33592420 PMCID: PMC7893412 DOI: 10.1016/j.ijscr.2021.02.004] [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: 01/11/2021] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Aneurysm of splenic artery arising from splenomesentric trunk is an extremely rare condition. The aim of this study is to report a new case with literature review. PRESENTATION OF CASE A 52-year-old housewife presented with mild central abdominal pain for two month duration. Abdomen was soft. Abdominal ultrasound examination showed a focal aneurysmal dilatation in the splenic artery (SA) near the portal vein. Abdominal computed tomographic angiography (CTA) revealed presence of the splenomesentric trunk with fusiform aneurysm (45 × 33 mm) of the proximal part of the SA. In supine position, through upper midline laparotomy incision, exploration of both superior mesenteric artery (SMA) and SA was performed, total excision of the aneurysm was done, the SMA was side-repaired and SA was ligated. The post-operative period was uneventful. DISCUSSION It is interesting to note that orthotopic SA aneurysms, most commonly present in the distal third of the artery, followed by the middle third, while in cases of splenomesentric trunk, all reported cases of anomalous SA aneurysms including the current one, showed the aneurysms to be located in the proximal portion or root of the SA. CONCLUSION Splenomesentric trunk is a rare anatomical anomaly, aneurysm of which is even rarer. It can be managed either by endovascular intervention or open surgery.
Collapse
Affiliation(s)
- Fahmi H Kakamad
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan, Iraq; Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq.
| | - Zuhair D Hammood
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Abdulwahid M Salih
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan, Iraq; Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Bzhwen Y Abdalla
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; Shar Hospital, Sulaimani, Kurdistan, Iraq
| | - Karzan S Mohammed
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; Shar Hospital, Sulaimani, Kurdistan, Iraq
| | - Sanaa O Karim
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; College of Nursing, University of Sulaimani, Sulaimani, Kurdistan, Iraq
| | - Hussein M Hamasalih
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; College of Nursing, University of Sulaimani, Sulaimani, Kurdistan, Iraq
| | - Rawezh Q Salih
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Shvan H Mohammed
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Othman O Qadr
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | | | | | - Sana B Anwar
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Usama Y Abulkarim
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| |
Collapse
|
5
|
Hamid HKS, Suliman AEA, Piffaretti G, Spiliopoulos S, Tetreau R, Tozzi M, Pulli R. A systematic review on clinical features and management of true giant splenic artery aneurysms. J Vasc Surg 2020; 71:1036-1045.e1. [PMID: 31727456 DOI: 10.1016/j.jvs.2019.09.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/16/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND True giant splenic artery aneurysms (GSAAs) >5 cm are rare and present unique therapeutic challenges. The aim of this study was to evaluate the anatomic and clinical characteristics of these lesions and the current surgical and endovascular techniques available for their treatment. METHODS A systematic review of the literature from 2004 to 2018 and the personal experience of the authors with management of GSAAs are presented. A total of 92 GSAA cases were reviewed. Analyses were performed on anatomic and clinical features and management modalities and outcomes of GSAA, including reintervention, morbidity, and mortality. RESULTS GSAA presented at a mean age of 56.1 ± 17.3 years, with no sex predilection; 73% were symptomatic at presentation. Abdominal pain was the presenting symptom in >50% of cases; 34% percent were ruptured, with an overall mortality rate of 12.5%. This group often presented with gastrointestinal bleeding or hemodynamic collapse. The aneurysms were almost evenly distributed across the splenic artery and were not uncommonly associated with arteriovenous fistula formation (8.7%). There were 88 patients who had surgical (53.4%), endovascular (44.3%), or combination (2.3%) therapy. The most commonly performed procedure was aneurysmectomy and splenectomy with or without additional resection. Overall, surgical treatment had a lower morbidity (P = .041) than endovascular therapy and comparable reintervention and mortality rates. CONCLUSIONS GSAAs are uncommon vascular lesions, with distinct clinical features and aneurysm characteristics. Considering their high risk of rupture, timely diagnosis and management are essential to attain a satisfactory outcome. Surgery remains the standard treatment of these lesions. Endovascular intervention is a viable alternative in high-risk patients, particularly those with lesions <10 cm or with anomalous origin.
Collapse
Affiliation(s)
- Hytham K S Hamid
- Vascular Surgery Division, Department of Surgery, Soba University Hospital, Khartoum, Sudan.
| | - Abd Elaziz A Suliman
- Vascular Surgery Division, Department of Surgery, Soba University Hospital, Khartoum, Sudan
| | - Gabriele Piffaretti
- Department of Medicine and Surgery, University of Insubria School of Medicine, Varese, Italy
| | - Stavros Spiliopoulos
- Department of Diagnostic and Interventional Radiology, Patras University Hospital, Rion, Greece
| | - Raphael Tetreau
- Centre d'Imagerie Médicale, Institut du Cancer, Montpellier, France
| | - Matteo Tozzi
- Department of Medicine and Surgery, University of Insubria School of Medicine, Varese, Italy
| | - Raffaelle Pulli
- Vascular and Endovascular Surgery Unit, University of Bari, Bari, Italy
| |
Collapse
|
6
|
Lozano Sánchez FS, García-Alonso J, Torres JA, Velasco L, Salvador R, Peña R, González-Porras JR. Decision-making and therapeutic options in intact splenic artery aneurysms: single-center experience and literature review. INT ANGIOL 2020; 39:241-251. [PMID: 32057214 DOI: 10.23736/s0392-9590.20.04304-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Splenic artery aneurysms are rare, potentially serious, and usually asymptomatic. Several methods are currently available to treat them, each with their own advantages and drawbacks. Therefore, its therapeutic paradigm has changed. METHODS We review our database of splenic aneurysms (2009-2019) and undertake an exhaustive literature review. Demographic, clinical, diagnostic, therapeutic, early and follow-up outcome data were examined. Our experience comprised: 15 patients with 19 splenic aneurysms. 11 women (average age, 59.4 years) and 4 men (average age, 61.7 years). All asymptomatic. RESULTS At diagnosis, aneurysms had a mean cross-sectional diameter of 3.4 cm (3.2 and 3.9 for women and men, respectively), the largest measuring 8.5 cm. Two independent aneurysms were detected in four patients. Diagnoses were always incidental to a CT scan. Treatments consisted of open surgery (2 patients), endovascular surgery (10 patients: 7 embolizations, 3 covered stent) and observation/follow-up (3 patients). The cases of open surgery (with splenectomy) were carried out without postoperative morbidity. One embolization failed (requiring subsequent open surgery) and two suffered localized splenic infarction, but without further complications. In patients treated with a covered stent, the aneurysm was always excluded, without complications. There was no 30-day or follow-up (average 26.2 months) mortality. Splenic aneurysms are diagnosed more frequently and earlier (in the asymptomatic phase), albeit incidentally, than in the past. CONCLUSIONS The correct indication (identifying patients at risk) and individualization of treatment, in which endovascular techniques are the first-line option, have significantly improved morbidity and mortality outcomes in our hospital.
Collapse
Affiliation(s)
- Francisco S Lozano Sánchez
- Unit of Angiology and Vascular Surgery, University Hospital of Salamanca, Salamanca Biomedical Research Institute, Salamanca, Spain -
| | - Jesus García-Alonso
- Unit of Interventional Radiology, University Hospital of Salamanca, Salamanca Biomedical Research Institute, Salamanca, Spain
| | - José A Torres
- Unit of Angiology and Vascular Surgery, University Hospital of Salamanca, Salamanca Biomedical Research Institute, Salamanca, Spain
| | - Luis Velasco
- Unit of Interventional Radiology, University Hospital of Salamanca, Salamanca Biomedical Research Institute, Salamanca, Spain
| | - Roberto Salvador
- Unit of Angiology and Vascular Surgery, University Hospital of Salamanca, Salamanca Biomedical Research Institute, Salamanca, Spain
| | - Ruben Peña
- Unit of Angiology and Vascular Surgery, University Hospital of Salamanca, Salamanca Biomedical Research Institute, Salamanca, Spain
| | - José R González-Porras
- Unit of Thromobosis and Hemostasis, Department of Hematology, University Hospital of Salamanca, Salamanca Biomedical Research Institute, Salamanca, Spain
| |
Collapse
|
7
|
Felli E, Wakabayashi T, Mascagni P, Cherkaoui Z, Faucher V, Pessaux P. Aberrant splenic artery rising from the superior mesenteric artery: a rare but important anatomical variation. Surg Radiol Anat 2019; 41:339-341. [PMID: 30607500 DOI: 10.1007/s00276-018-02177-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 12/26/2018] [Indexed: 10/27/2022]
Abstract
Aberrant splenic artery originating from the superior mesenteric artery (SMA) is extremely rare and recognition of this anomaly is important in the pre-operative planning of complex surgery such as pancreatic surgery, liver transplantation and vascular surgery. We present the case of an 80-year-old female diagnosed as septic shock due to mesenteric ischemia and obstructive pyelonephritis. Her splenic artery was originating from the SMA and the anomaly was readily appreciated on the pre-operative CT images. An explorative laparotomy associating extensive small bowel resection with endarterectomy of the proximal part of the SMA was performed. During intra-operative SMA control, we confirmed the aberrant splenic artery arising from SMA, and successfully avoid any arterial injury on the splenic artery with isolation and separated proximal and distal clamping. The anatomical vascular variation should be recognized in the pre-operative work-up of a determined surgical procedure to avoid potential intra-operative arterial injuries.
Collapse
Affiliation(s)
- Emanuele Felli
- General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, Université de Strasbourg, 1 Place de L'hôpital, 67100, Strasbourg, France
| | - Taiga Wakabayashi
- Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France
| | - Pietro Mascagni
- Institut Hospitalo-Universitaire (IHU), Institute for Minimally Invasive Hybrid Image-Guided Surgery, Université de Strasbourg, Strasbourg, France
| | - Zineb Cherkaoui
- General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, Université de Strasbourg, 1 Place de L'hôpital, 67100, Strasbourg, France
| | - Vanina Faucher
- Radiology, Nouvel Hôpital Civil, Université de Strasbourg, Strasbourg, France
| | - Patrick Pessaux
- General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, Université de Strasbourg, 1 Place de L'hôpital, 67100, Strasbourg, France.
- Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France.
- Institut Hospitalo-Universitaire (IHU), Institute for Minimally Invasive Hybrid Image-Guided Surgery, Université de Strasbourg, Strasbourg, France.
| |
Collapse
|
8
|
Malekpour Alamdari N, Shafii A. Challenging Case of Giant Splenic Artery Aneurysm: A Case Report. INTERNATIONAL JOURNAL OF CARDIOVASCULAR PRACTICE 2018. [DOI: 10.21859/ijcp-03035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
9
|
Aberrant splenic artery complicated by aneurysm during pregnancy. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2018; 4:119-121. [PMID: 29942897 PMCID: PMC6012991 DOI: 10.1016/j.jvscit.2018.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 01/16/2018] [Indexed: 12/02/2022]
Abstract
The aberrant splenic artery is an uncommon anomaly. It may become a challenging problem when it is associated with an aneurysm diagnosed during pregnancy. Our experience with a patient who underwent two interventions, each performed in the postpartum period without incident, highlights the need to employ techniques that ensure aneurysm closure and thus avoid recurrence and need for repetitive procedures.
Collapse
|
10
|
Dong SL, Chen X, Tu ZX, Ai X, Zhang ZW, Guan Y, Chen H, Yang J. Aneurysm of the Anomalous Splenic Artery Arising from Superior Mesenteric Artery Treated by Coil Embolization: A Report of Two Cases and Literature Review. Ann Vasc Surg 2017; 48:251.e5-251.e10. [PMID: 29221838 DOI: 10.1016/j.avsg.2017.09.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/26/2017] [Accepted: 09/27/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Aneurysm of splenic artery (SA) which arises from the superior mesenteric artery (SMA) is a very rare condition. The aim of this study was to present our experience with 2 such patients treated by coil embolization. METHODS A 33-year-old man and a 61-year-old woman were incidentally identified with aneurysms of the SA which arose from the SMA. Endovascular therapy of coil embolization was chosen to treat the aneurysm. RESULTS Follow-up computed tomography showed no change in the location of the coils and occlusion of majority of the aneurysm sac. The 2 patients have been doing well during a 26-month and 10-month follow-up period, respectively. CONCLUSIONS Combined with the experience of the previous literature, we think coil embolization can be cost-effective and minimally invasive in selected cases, depending on the morphology and site of the lesion.
Collapse
Affiliation(s)
- Shui-Lin Dong
- Division of Vascular Surgery, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao Chen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen-Xiao Tu
- Division of Vascular Surgery, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xi Ai
- Division of Vascular Surgery, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi-Wei Zhang
- Division of Vascular Surgery, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Guan
- Division of Vascular Surgery, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Chen
- Department of Operation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Yang
- Division of Vascular Surgery, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
11
|
Guang LJ, Wang JF, Wei BJ, Gao K, Huang Q, Zhai RY. Endovascular Treatment of Splenic Artery Aneurysm With a Stent-Graft: A Case Report. Medicine (Baltimore) 2015; 94:e2073. [PMID: 26717355 PMCID: PMC5291596 DOI: 10.1097/md.0000000000002073] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Splenic artery aneurysm, one of the most common visceral aneurysms, accounts for 60% of all visceral aneurysm cases. Open surgery is the traditional treatment for splenic artery aneurysm but has the disadvantages of serious surgical injuries, a high risk of complications, and a high mortality rate.We report a case who was presented with splenic artery aneurysm. A 54-year-old woman complained of upper left abdominal pain for 6 months. An enhanced computed tomography scan of the upper abdomen indicated the presence of splenic artery aneurysm. The splenic artery aneurysm was located under digital subtraction angiography and a 6/60 mm stent graft was delivered and released to cover the aneurysm. An enhanced computed tomography scan showed that the splenic artery aneurysm remained well separated, the stent graft shape was normal, and the blood flow was unobstructed after 1 year.This case indicates a satisfactory efficacy proving the minimal invasiveness of stent graft exclusion treatment for splenic artery aneurysm.
Collapse
Affiliation(s)
- Li-Jun Guang
- From the Department of Interventional Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot (LG); and Department of Interventional Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (JW, BW, KG, QH, RZ)
| | | | | | | | | | | |
Collapse
|
12
|
Bhoil R, Tomar A, Makhaik S, Sood RG, Nayyar N. Aneurysm of an aberrant splenic artery: An extremely rare occurrence. Vascular 2015. [DOI: 10.1177/1708538115597372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
An aberrant splenic artery arising from the superior mesenteric artery, also known as the splenomesenteric trunk, is a rare anatomical variant seen in less than 1% of the population and is more common in females. Aneurysms of the splenic artery originating anomalously from the superior mesenteric artery are extremely rare; only 35 cases of aneurysm of an aberrant splenic artery have been described so far in the English medical literature. We report an extremely rare case of aneurysm of aberrant splenic artery in a 28-year-old man in whom the lesion was detected during routine abdominal scanning and confirmed on computed tomography angiography. Aneurysms of an anomalous splenic artery originating from the superior mesenteric artery are extremely rare; however, they are clinically important because possible rupture could be catastrophic. Exploring these variations is important especially if surgical intervention is contemplated. This could greatly affect the surgical planning and avoid injuries to major arteries and organs intraoperatively.
Collapse
Affiliation(s)
- Rohit Bhoil
- Department of Radiodiagnosis, IGMC Shimla, Himachal Pradesh, India
| | - Ashwani Tomar
- Department of Radiodiagnosis, IGMC Shimla, Himachal Pradesh, India
| | - Sushma Makhaik
- Department of Radiodiagnosis, IGMC Shimla, Himachal Pradesh, India
| | - RG Sood
- Department of Radiodiagnosis, IGMC Shimla, Himachal Pradesh, India
| | - Nishant Nayyar
- Department of Radiodiagnosis, IGMC Shimla, Himachal Pradesh, India
| |
Collapse
|
13
|
Wagenhäuser MU, Herma KB, Sagban TA, Dueppers P, Schelzig H, Duran M. Long-term results of open repair of popliteal artery aneurysm. Ann Med Surg (Lond) 2015; 4:58-63. [PMID: 25905015 PMCID: PMC4405004 DOI: 10.1016/j.amsu.2015.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 01/27/2015] [Accepted: 01/31/2015] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION Popliteal artery aneurysms (PAA) are rare. Different surgical techniques for open surgical repair are possible. This study presents a single centre experience using open surgical repair with a medial approach (MA) and outlines differences between symptomatic (SLS) and asymptomatic (ALS) legs. METHODS Data collection was performed retrospectively. The investigation period was from 1 January 1996 to 1 January 2013. Patients presented in the Outpatient Department and received a questionnaire concerning their quality of life. Data are presented as mean ± standard deviation. Mann-Whitney test and Cochran-Armitage test for trend was used for data analysis. Kaplan-Meier method was used to calculate limb salvage rates. p < 0.05 was considered statistically significant. RESULTS We analyzed 16 ALS and 26 SLS with an average age of 63.5 ± 10 years. Preoperative ankle-brachial index (ABI) was 1.0 ± 0.2 for ALS (on control examination: 1.12 ± 0.24) and 0.08 ± 0.18 for SLS (on control examination 0.94 ± 0.14) (p < 0.05). Limb salvage rate was 100% for ALS and 86.7% for SLS (overall 93.3%). Primary patency rate for SLS was 85%, for ALS rate of 100%, respectively (overall 92.5%). ALS reached an average of 13.1 ± 2.7 points (SLS 11.4 ± 2.8) on a numeric point scale. CONCLUSION Open surgery is therapy and prevention of acute ischaemia all in one, especially for asymptomatic patients and delivers good long-term results. Endovascular therapies offer an alternative but long-term results are pending. Open surgery should still be considered as a gold standard therapy.
Collapse
Affiliation(s)
- M U Wagenhäuser
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| | - K B Herma
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| | - T A Sagban
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| | - P Dueppers
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| | - H Schelzig
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| | - M Duran
- Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany, Moorenstraße. 5, 40225 Düsseldorf, Germany
| |
Collapse
|