This paper is only available as a PDF. To read, Please Download here.
During the period from 1975 to 1991, 41 patients with 60 visceral artery aneurysms
were treated at the Affiliated Hospitals of Emory University. The total included 13
patients in whom 16 aneurysms were treated primarily by transarterial embolization.
There were seven hepatic artery aneurysms, three splenic artery aneurysms, three gastroduodenal
artery aneurysms, two left gastric artery aneurysms, and one right gastroepiploic
artery aneurysm. Average age of these patients was 50 years; there were eight males
and five females. Seven patients presented with gastrointestinal bleeding, and two
patients presented with abdominal pain. In four patients, the aneurysm was an incidental
finding.
Etiology of the true or false aneurysms consistedof pancreatitis in two patients,
trauma in three patients, connective tissue disease in one, and was unknown in the
remainder.
Embolization was performed in seven cases with Gianturco coils and Gelfoam, with coils
alone in four, with Gelfoam alone in four, and with detachable balloons in one instance.
Complete occlusion was achieved initially in 13 cases. Recanalization occurred in
two patients over a mean follow-up period of 8.6 months, requiring re-embolization
in one patient, whereas the other patient was managed expectantly. In three cases,
embolization was unsuccessful: two cases required surgical correction, and one case
was managed expectantly. Only one complication was related to the embolization procedure,
which was a common hepatic arterial dissection that proceeded to the formation of
a false aneurysm.
Embolization as the primary treatment modality for visceral rtery aneurysms should
be considered in patients with the following diagnoses: pseudoaneurysms associated
with pancreatitis, intrahepatic aneurysms, most splenic artery aneurysms, and gastric,
gastroduodenal, and gastroepiploic aneurysms. The procedure has a low risk and may
obviate a difficult surgical procedure, but it does not preclude surgical intervention
should the need arise.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Mesenteric vascular problems: a 26-year experience.Ann Surg. 1982; 195: 554-563
- The diagnosis and management of visceral artery aneurysms.Surgery. 1980; 88: 619-624
- Aneurysms of the splanchnic arteries.Am J Surg. 1980; 140: 797-801
- Successful embolization of a bleeding splenic artery pseudoaneurysm secondary to necrotizing pancreatitis.Gastrointest Radiol. 1982; 7: 379-382
- Transcatheter embolization of intrahepatic arterial aneurysms.Radiology. 1980; 134: 335-339
- Embolization of bleeding transverse pancreatic artery aneurysms.Cardiovasc Intervent Radiol. 1982; 5: 37-39
- Ultrasonic features of aneurysms of splanchnic arteries.Can Assoc Radiol J. 1985; 36: 226-229
- Abdominal visceral aneurysms.in: Haimovici H Vascular emergencies. Appleton-Century-Crofts, New York1981: 387
- Splenic artery aneurysms.Probl General Surg. 1990; 7: 113-121
- Spanchnic artery aneurysms.in: Rutherford RB Vascular surgery. WB Saunders, Philadelphia1989: 969-983
- Treatment of a hepatic artery aneurysm by coil occlusion of the hepatic artery.AJR Am J Roentgenol. 1980; 134: 1245-1247
- Percutaneous embolization for the management of hepatic artery aneurysms.Gastroenterology. 1977; 73: 1142-1146
- Mycotic aneurysms of the hepatic artery: treatment with arterial embolization.Am J Med. 1979; 67: 697-701
- Iatrogenic arterioportal fistulae: diagnosis and management.Ann Vasc Surg. 1989; 3: 52-55
- Splanchnic artery aneurysms and pseudoaneurysms: transcatheter embolization.Radiology. 1987; 163: 135-139
- Nonoperative management of peripancreatic arterial aneurysms: a 10-year experience.Ann Surg. 1987; 205: 126-128
- Partial splenic embolization in the treatment of hypersplenism.AJR Am J Roentgenol. 1979; 132: 777-782
- Pancreatic pseudocyst hemorrhage controlled by transcatheter embolization.Cardiovasc Intervent Radiol. 1983; 6: 167-169
- Gastroduodenal artery aneurysm associated with chronic relapsing pancreatitis.Can Med Assoc J. 1982; 126: 1065-1066
- Embolization of gastroduodenal artery aneurysm caused by chronic pancreatitis.Gut. 1983; 24: 1094-1098
- Major gastrointestinal hemorrhage from peripancreatic blood vessels in pancreatitis. Treatment by embolotherapy.Dig Dis Sci. 1984; 29: 486-497
- Aneurysm rupture secondary to transcatheter embolization.AJR Am J Roentgenol. 1979; 132: 553-556
- Therapeutic applications of angiography.N Engl J Med. 1980; 302: 1117-1125
- Therapeutic embolization.Br J Hosp Med. 1978; 20: 707-725
- Angiographic management of arterial hemorrhage in the upper gastrointestinal-tract.in: Wilkins RA Viamonte MJ Interventional radiology. Blackwell, Oxford1982: 81-99
Article info
Footnotes
**Presented at the 20th Annual Meeting of the Society for ClinicalVascular Surgery, Orlando, Florida, March 25–29, 1992.
Identification
Copyright
© 1992 Reed Publishing USA. Published by Elsevier Inc.
