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Zhou YY, Wang SC, Seak CJ, Huang SW, Cheng HT. Case report: Duodenal obstruction caused by gastroduodenal artery pseudoaneurysm with hematoma: an unusual case and literature review. Front Med (Lausanne) 2023; 10:1198378. [PMID: 37425331 PMCID: PMC10325565 DOI: 10.3389/fmed.2023.1198378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 05/30/2023] [Indexed: 07/11/2023] Open
Abstract
Visceral artery pseudoaneurysm is a rare disease that most commonly occurs in male patients in their 50s, with gastroduodenal artery (GDA) pseudoaneurysm accounting for only 1.5% of these. The treatment options generally include open surgery and endovascular treatment. In 40 cases of GDA pseudoaneurysm from 2001 to 2022, endovascular therapy was the mainstay of treatment in 30 cases, and most of them (77%) were treated by coil embolization. Our case report describes a 76-year-old female patient with a GDA pseudoaneurysm, which was treated by endovascular embolization using liquid embolic agent N-butyl-2-cyanoacrylate (NBCA) alone. This is the first time this treatment strategy has been used for GDA pseudoaneurysm. We demonstrate a successful outcome with this unique treatment. The successful experience of our case may provide a new treatment strategy for this rare disease.
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Affiliation(s)
- Yan-Yuan Zhou
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shao-Chung Wang
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Medical Imaging and Intervention, New Taipei Municipal Tucheng Hospital, Chang Gung Medical foundation, New Taipei City, Taiwan
| | - Chen-June Seak
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Emergency Medicine, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Emergency Medicine, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
| | - Shu-Wei Huang
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Emergency Medicine, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
| | - Hao-Tsai Cheng
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Emergency Medicine, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
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Schroeder G, Edalati M, Tom G, Kuntjoro N, Gutin M, Gurian M, Cuniberto E, Hirth E, Martiri A, Sposato MT, Aminzadeh S, Eichenbaum J, Alizadeh P, Baidya A, Haghniaz R, Nasiri R, Kaneko N, Mansouri A, Khademhosseini A, Sheikhi A. Assessing the aneurysm occlusion efficacy of a shear-thinning biomaterial in a 3D-printed model. J Mech Behav Biomed Mater 2022; 130:105156. [PMID: 35397405 PMCID: PMC9060636 DOI: 10.1016/j.jmbbm.2022.105156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 02/13/2022] [Accepted: 02/27/2022] [Indexed: 12/26/2022]
Abstract
Metallic coil embolization is a common method for the endovascular treatment of visceral artery aneurysms (VAA) and visceral artery pseudoaneurysms (VAPA); however, this treatment is suboptimal due to the high cost of coils, incomplete volume occlusion, poor reendothelialization, aneurysm puncture, and coil migration. Several alternative treatment strategies are available, including stent flow diverters, glue embolics, gelfoam slurries, and vascular mesh plugs-each of which have their own disadvantages. Here, we investigated the in vitro capability of a shear-thinning biomaterial (STB), a nanocomposite hydrogel composed of gelatin and silicate nanoplatelets, for the minimally-invasive occlusion of simple necked aneurysm models. We demonstrated the injectability of STB through various clinical catheters, engineered an in vitro testing apparatus to independently manipulate aneurysm neck diameter, fluid flow rate, and flow waveform, and tested the stability of STB within the models under various conditions. Our experiments show that STB is able to withstand at least 1.89 Pa of wall shear stress, as estimated by computational fluid dynamics. STB is also able to withstand up to 10 mL s-1 pulsatile flow with a waveform mimicking blood flow in the human femoral artery and tolerate greater pressure changes than those in the human aorta. We ultimately found that our in vitro system was limited by supraphysiologic pressure changes caused by aneurysm models with low compliance.
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Affiliation(s)
- Grant Schroeder
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA; David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Masoud Edalati
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA; Department of Mechanical Engineering Rowan University, Rowan Hall 201 Mullica Hill Rd. Glassboro, NJ, 08028, USA
| | - Gregory Tom
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Nicole Kuntjoro
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Mark Gutin
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA; Biomaterials Innovation Research Center, Division of Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA; Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Melvin Gurian
- Biomaterials Innovation Research Center, Division of Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA; Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Edoardo Cuniberto
- Biomaterials Innovation Research Center, Division of Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA; Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Elisabeth Hirth
- Biomaterials Innovation Research Center, Division of Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA; Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Alessia Martiri
- Biomaterials Innovation Research Center, Division of Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA; Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Maria Teresa Sposato
- Biomaterials Innovation Research Center, Division of Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA; Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Selda Aminzadeh
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - James Eichenbaum
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Parvin Alizadeh
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA; Department of Materials Science & Engineering, Faculty of Engineering & Technology, Tarbiat Modares University, Tehran, Iran
| | - Avijit Baidya
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Reihaneh Haghniaz
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA; Terasaki Institute for Biomedical Innovation (TIBI), Los Angeles, CA, 90024, USA
| | - Rohollah Nasiri
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Naoki Kaneko
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Abraham Mansouri
- Department of Mechanical Engineering, Higher College of Technology, Dubai, 15825, United Arab Emirates
| | - Ali Khademhosseini
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA; Terasaki Institute for Biomedical Innovation (TIBI), Los Angeles, CA, 90024, USA.
| | - Amir Sheikhi
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, CA, 90095, USA; California NanoSystems Institute (CNSI), University of California, Los Angeles, 570 Westwood Plaza, Los Angeles, CA, 90095, USA; Department of Chemical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA; Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA.
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