The right-sided thoracic aortic arch is a rare congenital malformation occurring during embryologic development. A majority of the cases present with two anatomic variations, one of which is an aberrant left subclavian artery (LSA) originating off the distal descending aortic arch. This aberrant LSA courses across and compresses thoracic structures ...

Pulmonary vein isolation (PVI) has established itself as a standard therapy for paroxysmal atrial fibrillation (AF). Still, the most widely performed procedure of point-by-point distal-tip ablation using a 3-dimensional mapping system and a circular catheter to validate PVI remains a complex, elaborative, and time-consuming procedure. This explains the many efforts ...

BACKGROUND: Numerous studies with conflicting results have tried to prove the influence of seasonal variations or different meteorological factors on the occurrence of aneurysmal subarachnoidal hemorrhage (SAH). The aim of this study was to establish a mathematical model of a series of aneurysmal rupture dates in different patients and verify ...

The determinants of vessel targeting are largely unknown in vasculitides. This study was undertaken to identify patterns of vascular involvement in Takayasu arteritis (TA), using objective classification of vascular beds. We postulated that cluster analysis could unveil preferential associations between vascular beds commonly affected by TA. Peripheral vascular Doppler, computed ...

Objectives. To prospectively evaluate the technical feasibility and efficacy of wedged arterial injection (WAI) as a potential route for experimental selective therapy to the pancreas of healthy pigs. Materials and Methods. Selective angiographies were completed in ten pigs under general anaesthesia. By superselective angiography, the catheter was inserted and wedged ...

Delayed splenic hemorrhage after proximal splenic artery embolotherapy (SAE) in patients with blunt splenic injury is a well-known outcome. The hemorrhage is thought to be due to rupture of a splenic parenchymal pseudoaneurysm. This study attempts to explain at least part of the mechanism involved in the delayed hemorrhage event. ...

Although anatomical properties and vessel variations of the celiac trunk are well explored in the literature, there is not so much information on the arterial diameters, and this data is important for surgical procedures and angiographic examinations. The aim of this study was to investigate properties of the celiac trunk ...

Celiac axis stenosis is a relatively common finding that may require major revascularization during pancreaticoduodenectomy. We present a patient that underwent pancreaticoduodenectomy for intraductal papillary mucinous neoplasm of the pancreatic head associated with celiac axis obstruction. To secure arterial blood flow to the upper abdominal organs, the superior posterior pancreaticoduodenal ...

A patient presented 2 weeks after distal pancreatectomy and splenectomy with increased bloody output from his surgical drain. Catheter angiography found an enlarging splenic artery stump pseudoaneurysm. During the procedure, there was concern that nontarget embolization may occur, given the short splenic artery remnant. Pseudoaneurysm thrombosis was subsequently achieved using ...

Splenic artery aneurysm (SAA) is a rare condition, mostly treated with surgery. Usually an incidental finding, prevalence varies from 0.04 to 0.10%. If left untreated, SAA carries a high risk of rupture and high mortality. We describe a 53-year-old male patient with SAA, where a balloon-expandable, polytetrafluoroethylene-covered stent was used ...

This is the first in a series of 3 medical graphics articles featuring the arterial anatomy of the pancreas as depicted on computed tomography images. This arterial anatomy is important in clinical practice because it represents a road map of the routes of tumor spread by ductal adenocarcinoma of the ...

Extensive venous malformation (VM) is often associated with chronic consumptive coagulopathy, which may result in bleeding complications. We report herein the case of a 25-year-old man with extensive VM involving the left lower extremity who presented with hypovolemic shock and abdominal distension without abdominal trauma. Abdomen computed tomography revealed splenic ...

We report a case of iatrogenic resection of both the superior mesenteric artery (SMA) and celiac artery during left nephrectomy and adrenalectomy. A 47-year-old woman was diagnosed with a large adrenal tumor and underwent a laparoscopic left adrenalectomy that was converted to open adrenalectomy and nephrectomy as a result of ...

We present the case of a 61-year-old woman who underwent repair of a symptomatic 4-cm splenic artery aneurysm. This patient had received heart transplantation for hypertrophic congestive cardiomyopathy 5 years before this event. She was under immunosuppression therapy with cyclosporine, prednisone and azathioprine. The aneurysm was ligated both proximally and ...

Aneurysm of the splenic artery which arises from the superior mesenteric artery is a very rare condition with less than twenty cases described in the literature. Most of the time, it is asymptomatic and the diagnosis is fortuitous, but the patient can feel epigastric or left upper quadrant discomfort. One ...

The spleen has an important role in blood volume regulation and increased resistance of post-capillary hilar veins (in mesentery adjoining the spleen) can regulate this. This study investigated whether venular constriction to lipopolysaccharide (LPS) involved endothelin-1 (ET-1). Pressure myography was used to study isolated extra-splenic (hilar) vessels from male Wistar ...

The pancreas has complex arterial supplies. Therefore, special attention should be paid in pancreatic arterial intervention for patients with acute pancreatitis and pancreatic carcinomas. Knowledge of pancreatic arterial anatomy and arterial territory is important not only to perform pancreatic arterial intervention, but to read the pancreatic angiography and cross-sectional image. ...

Splenic artery aneurysm is the third most common intra-abdominal aneurysm with a prevalence as high as 10% in some studies. Widespread use of abdominal imaging has resulted in the increasing detection of asymptomatic incidental aneurysms. In this manuscript we review the changing incidence, risk factors and evolving therapeutic options in ...

BACKGROUND: Arterial thrombosis is a very rare, but recognised complication of inflammatory bowel disease that can result in significant morbidity and mortality. CASE PRESENTATION: We present the case of a 48-year-old female with previously well-controlled ulcerative colitis who presented with severe left upper quadrant abdominal pain. Imaging investigations subsequently revealed ...

OBJECTIVES: A retrospective study was performed to determine the prognostic implications of invasion to the splenic vessels in pancreatic body and tail cancer. SUMMARY BACKGROUND DATA: Involvement of the splenic artery (SA) and vein (SV) is frequently observed in carcinoma of the body and tail of the pancreas, but its ...

Splenic artery aneurysms are an uncommon form of vascular disease, which have a significant potential for rupture, most commonly associated with pregnancy, typically presents as sudden, unexpected death. As a consequence, the initial recognition and diagnosis of splenic artery aneurysm rupture take place only at autopsy. This report presents 2 ...

Large splenic artery aneurysms are rare but comprise 60% of all visceral artery aneurysms. Most are found incidentally and rupture in the nonpregnant patient has an approximate 25 to 36% mortality rate. Historically these have been managed with an open surgical approach for resection. We present the case of a ...

Impaired hepatic arterial perfusion after orthotopic liver transplantation (OLT) may lead to ischemic biliary tract lesions and graft-loss. Hampered hepatic arterial blood flow is observed in patients with hypersplenism, often described as arterial steal syndrome (ASS). However, arterial and portal perfusions are directly linked via the hepatic arterial buffer response ...

Arterial involvement by a periampullary adenocarcinoma is often a contraindication for resection, since an R0 resection cannot be achieved. This is usually observed in cases with involvement of the superior mesenteric artery. Involvement of the common hepatic artery, however, requires a bypass procedure if the gastroduodenal artery was divided during ...

Anatomical variations of the origins and branching patterns of the hepatobiliary system may be encountered during both surgical and laparoscopic procedures. We report the rare finding of a splenomesenteric trunk with an absent coeliac trunk in a 74-year-old female cadaver. Due to the absence of the coeliac trunk, the common ...

Hemosuccus pancreaticus, a rare cause of intermittent upper gastrointestinal bleeding, is usually caused by the rupture of an aneurysm associated with chronic pancreatitis. Segmental arterial mediolysis is a rare non-arteriosclerotic, non-inflammatory vascular disease characterized by vacuolization and lysis of the arterial smooth muscle cells. Segmental arterial mediolysis often causes intra-abdominal ...

Mucinous cystic tumors occur almost exclusively in middle-aged women and in the body or tail of the pancreas. Mucinous cystadenocarcinoma, a malignant sub-type of mucinous cystic tumors, in the head of the pancreas and in a middle-aged man is extraordinary, and the prognosis and proper management of mucinous cystadenocarcinoma has ...

Splenic vein thrombosis results in localized portal hypertension called sinistral portal hypertension, which may also lead to massive upper gastrointestinal bleeding. Symptomatic sinistral portal hypertension is usually best treated by splenectomy, but interventional radiological techniques are safe and effective alternatives in the management of a massive hemorrhage, particularly in cases ...

Gastric variceal bleeding due to splenic vein thrombosis is a life-threatening situation and is often difficult to manage by endoscopy. In the worst cases, an emergency splenectomy may be required to stop variceal bleeding. We report the case of a 60-year-old Caucasian woman with bleeding gastric varices secondary to splenic ...

Preservation of the spleen in distal pancreatectomy has recently attracted considerable attention. Since our first trial and success with spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein for tumors of the pancreas and chronic pancreatitis, this procedure (Kimura's procedure) has been performed very frequently. The techniques for ...

We present a 16-year-old boy with autoimmune liver disease and longstanding portal hypertension in whom a CT arteriogram demonstrated a large aneurysm arising from the distal, extra-parenchymal portion of the splenic artery. Because of its location adjacent to multiple venous collaterals, the aneurysm was indistinguishable from splenic varices on initial ...

A 58-year-old man was found by abdominal echography to have a pancreatic cyst while undergoing a health examination. Later, a multidetector CT and enhanced CT revealed a splenic artery aneurysm. After consultation he was admitted to our hospital for surgery. Multislice CT and magnetic resonance angiography demonstrated a saccular aneurysm, ...

Distal pancreatectomy (resection of the pancreatic body and tail) can be performed with or without preservation of the spleen. Splenic preservation has the advantages of fewer postoperative complications such as abscesses in the resection bed, shorter length of hospitalization, and avoidance of the long-term risk of post-splenectomy sepsis related to ...

Hemoperitoneum due to spontaneous rupture of a visceral vessel may result from a variety of underlying pathologies. However, its idiopathic form does not show evidence of any predisposition. An abdominal CT scan for acute abdominal pain yielded the unexpected diagnosis of a ruptured splenic artery in a 21-year-old patient. Hemostasis ...

Techniques of mixed reality can successfully be used in preoperative planning of laparoscopic and robotic procedures and to guide surgical dissection and enhance its accuracy. A computer-generated three-dimensional (3D) model of the vascular anatomy of the spleen was obtained from the computed tomography (CT) dataset of a patient with a ...

Celiac trunk aneurysms are rare and usually asymptomatic lesions. However, treatment is generally warranted to avoid catastrophic rupture. We report a case of a 70-year-old man who sought care for a celiac trunk aneurysm close to the hepatosplenic bifurcation managed endovascularly by using a combined treatment of celiac-splenic stent-graft implantation ...

The developing mesocolon transversum was investigated using hematoxylin and eosin-stained semiserial sections derived from 17 human fetuses between 12 and 30 weeks of gestation. The mesocolon was attached to the mesoduodenum and greater omentum until 12 weeks. However, the fetal duodenal attachment appeared not to correspond to the right colic ...

The successful management of gastric bleeding from a pseudocyst with a pseudoaneurysm of the splenic artery is reported here. A 62-year-old male patient was referred to our hospital with a complaint of hematomesis. On a computed tomography and an abdominal angiography, it was evident that he was actively bleeding from ...

Splenic artery aneurysms account for the majority of splanchnic artery aneurysms. These constitute a uncommon pathology, but with a mortality rate greater 70%. We report a case of a double symptomatic aneurysm of the splenic artery with a proximal and distal localization. The patient was a 65-year-old woman with chronic ...

We investigated whether the prerequisite of the maximum slope and deconvolution methods are satisfied in pancreatic perfusion CT and whether the measured parameters between these algorithms are correlated. We examined nine beagles injected with iohexol (200mgIkg(-1)) at 5.0mls(-1). The abdominal aorta and splenic and celiac arteries were selected as the ...

A 65-year-old woman who had been diagnosed as having microscopic polyangiitis developed sudden abdominal pain and entered a state of shock. Abdominal CT showed massive hemoperitoneum, and emergent angiography revealed a ruptured splenic artery aneurysm. After direct catheterization attempts failed due to tortuous vessels and angiospasm, transcatheter arterial embolization using ...

Splenic artery aneurysms are the most common visceral artery aneurysms and are known for their potential for rupture. Pregnancy and portal hypertension have been known as major risk factors. With improved methods of diagnosis and minimally invasive therapy, management and outcome of SAA may change significantly. SAA may rupture at ...

BACKGROUND: Although portal and/or splenic vein thrombosis after partial splenic embolization (PSE) is a well-known complication, few reports evaluating risk factors have been published. PURPOSE: To investigate risk factors and clinical course of portal and/or splenic vein thrombosis after PSE. MATERIAL AND METHODS: Sixteen patients with severe hypersplenism underwent PSE ...

BACKGROUND: Cardiac and vascular involvement by sarcoid is only rarely recognized clinically. Involvement of muscular arteries such as epicardial coronaries or the splenic artery has not been previously reported in these patients, and valvular disease has been reported only rarely. METHODS: We present herein clinical, imaging and pathologic documentation of ...

Arterial steal syndrome after orthotopic liver transplantation (OLT) is characterized by arterial hypoperfusion of the graft, which is caused by a shift in blood flow into the splenic or gastroduodenal arteries. It causes hepatic hypoperfusion with attendant clinical manifestations of elevated liver function enzymes, allograft dysfunction, and cholestasis. Left untreated, ...

Splenic artery aneurysm (SAA) is a rare complication after orthotopic liver transplantation (OLT). Although SAAs are often incidental findings, in some cases they present with signs and symptoms of abdominal mass or intra-abdominal hemorrhage. The diagnosis requires Doppler ultrasound and confirmation with computed tomography, magnetic resonance, or angiography. Endovascular techniques ...

OBJECTIVE: The purpose of this study is to discuss the etiology and role of imaging in the management of splenic artery steal syndrome (SASS) following orthotropic liver transplantation (OLT). METHODS: Hepatic arterial thrombosis and stenosis have been the most commonly recognized arterial complications following OLT. Splenic artery steal syndrome is ...

BACKGROUND: Patients with splenic vein occlusion may present a diagnostic problem when the location, morphology, and cause of the obstructive lesion and the associated collateral veins cannot be clearly defined by standard diagnostic imaging modalities such as computed tomography, magnetic resonance venography, or indirect splenoportography (arterial portography). PURPOSE: To evaluate ...

Splenic artery aneurysm, although rare, is the commonest visceral aneurysm. Its management options have expanded with advances in minimally invasive techniques. In the last decade, the laparoscopic technique has gained popularity owing to its simplicity, safety, and short postoperative course in the experienced hand. We recommend the laparoscopic approach to ...

Congenital absence of the splenic artery is a very rare condition. To the best of our knowledge, congenital absence of the splenic artery accompanied with absence of the splenic vein has not been reported. We report a case of the absence of the splenic artery and vein in a 61-year-old ...