Document Detail


Nonoperative management of unruptured visceral artery aneurysms: treatment by transcatheter coil embolization.
MedLine Citation:
PMID:  18440188     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To describe our experiences with the treatment of visceral artery aneurysms (VAA) by transcatheter coil embolization and to propose indications for treating VAA by this method.
METHODS: We treated 22 patients with VAA by coil embolization; 9 had splenic-, 7 renal-, 4 pancreaticoduodenal arcade-, and 2 proper hepatic artery aneurysms. All nine splenic artery aneurysms patients presented with chronic hepatitis-C; four had hepatocellular carcinoma. Of the seven renal artery aneurysms patients, four were hypertensive and three had rheumatoid arthritis. Both pancreaticoduodenal arcade artery aneurysms patients manifested severe stenosis of the celiac axis. Our transcatheter coil embolization procedure includes coil embolization and coil-packing of the aneurysmal sac, preserving the native arterial circulation.
RESULTS: Transcatheter coil embolization with aneurysm packing was technically successful in 16 (72.7%) of the 22 patients and the native arterial circulation was preserved. Postprocedure angiograms confirmed complete disappearance of the VAA. In four of the nine splenic artery aneurysm patients, the native arterial circulation was not preserved. In one renal artery aneurysm patient, stenosis at the aneurysmal neck necessitated placement of a stent before transcatheter coil embolization. Magnetic resonance angiographs obtained during the follow-up period (mean 27 months) demonstrated complete thrombosis of the VAA in all 22 patients. Infarction occurred in one splenic- and two renal artery aneurysms patients; the latter developed flank pain and fever after the procedure.
CONCLUSIONS: Transcatheter coil embolization is an effective alternative treatment for patients with saccular and proximal VAA. In particular, the isolation technique using coil embolization is advantageous in splenic artery aneurysm patients.
Authors:
Osamu Ikeda; Yoshitaka Tamura; Yutaka Nakasone; Yasuhiko Iryou; Yasuyuki Yamashita
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Publication Detail:
Type:  Journal Article     Date:  2008-04-28
Journal Detail:
Title:  Journal of vascular surgery     Volume:  47     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-02     Completed Date:  2008-07-10     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1212-9     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Honjo Kumamoto, Japan. osamu-3643ik@do9.enjoy.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aneurysm / radiography,  therapy*
Duodenum / blood supply
Embolization, Therapeutic* / adverse effects
Female
Hepatic Artery / radiography
Humans
Male
Middle Aged
Pancreas / blood supply
Patient Selection
Renal Artery / radiography
Retrospective Studies
Splenic Artery / radiography
Tomography, X-Ray Computed
Treatment Outcome
Viscera / blood supply*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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