Endovascular Treatment of Aneurysm of Splenic Artery Arising from Splenomesentric Trunk Using Stent Graft

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Abstract

We report a rare case of aneurysm of splenic artery arising anomalously from the superior mesenteric artery (SMA). The aneurysm was treated successfully by coil embolization of the splenic artery distal to aneurysm and then deploying a stent graft in the SMA. A combination of stent graft and coil embolization for the treatment of aberrant splenic artery aneurysm has been reported only once. We describe the imaging findings and the endovascular procedure in this patient.

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Splenic artery aneurysms: two decades experience at Mayo clinic.

Shaymaa Abbas, Jonathan Stone, W Oldenburg … (2002)

Although rare, splenic artery aneurysms (SAAs) have a definite risk of rupture. The optimal management of these aneurysms remains elusive. A retrospective chart review of all patients treated at our institutions with the diagnosis of SAA from January 1980 until December 1998 was undertaken. Follow-up was obtained via chart review and by direct phone contact of the patient or relative. No specific protocol was followed for management. From analysis of the patient data we concluded that although SAAs may rupture, not all intact aneurysms need intervention. Calcification does not appear to protect against rupture, although beta-blockade may be protective. Growth rates of SAA are slow and growth is infrequent. Selective management of SAAs is safe. Open ligation or transcatheter embolization should be considered for symptomatic aneurysms, for aneurysms > or = 2 cm in size, or for any SAA in women of childbearing years.

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Endovascular management of visceral artery aneurysm.

K Kasirajan, K Ouriel, Deborah Greenberg … (2001)

To retrospectively review our experience with visceral artery aneurysms (VAAs) treated with percutaneous coil embolization techniques. Patient records were retrospectively reviewed between 1988 and 1998 for VAA cases treated with catheter-based techniques. Nine patients (5 women; mean age 64 +/- 11 years) with 12 (8 false and 4 true) VAAs were identified. The majority (67%) of these patients presented with symptoms of aneurysm rupture. The etiology of the aneurysm was iatrogenic in 4, pancreatitis in 4, and idiopathic in 4. Ten cases involved the hepatic artery; the other 2 aneurysmal arteries were the middle colic and the gastroduodenal. Selective and superselective catheter techniques were used to obtain access to the VAA. A variety of microcoils were delivered to entirely fill saccular aneurysms, whereas fusiform aneurysms were thrombosed by occluding the inflow and outflow vessels. Aneurysm exclusion was achieved in 9 (75%) of the 12 cases. The 3 technical failures resulted from the inability to cannulate the aneurysm neck. Coil embolization of the neck of the aneurysm sac did not result in occlusion of the native vessel, with a single exception. No procedure-related complications or deaths were noted. All patients remained symptom free during a mean follow-up of 46.0 +/- 29.6 months. Percutaneous transcatheter coil embolotherapy is an effective alternative to open surgery for the management of VAAs. This therapy may decrease the morbidity and mortality associated with an open surgical procedure in patients with ruptured aneurysms and pseudoaneurysms, selectively thrombosing the aneurysm while preserving flow in the native vessel.

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Stent fractures in the Hemobahn/Viabahn stent graft after endovascular popliteal aneurysm repair.

Ignace Tielliu, Clark J Zeebregts, George Vourliotakis … (2010)

During the last decade, endovascular repair of popliteal artery aneurysms (PAAs) has become a valid alternative to open repair. This study analyzes the incidence and origin of stent graft fractures after endovascular repair, its impact on patency, and strategies to prevent fractures. Data of 78 atherosclerotic PAAs in 64 patients were gathered in a prospectively-held database from 1998 to 2009. All x-rays were reviewed to detect stent fractures. Only circumferential fractures were included for analysis; localized strut fractures were excluded. Clinical endpoints were circumferential stent fracture, occlusion, and clinical status of the patient. Mean follow-up time was 50 months (range, 1-127 months). Fifteen circumferential stent fractures occurred in 13 (16.7%) patients. The majority of stent fractures (93.3%) were associated with the use of multiple stent grafts. At univariate analysis, younger age was identified as the only significant predictor for stent fracture (P = .007). The cumulative stent fracture-free survival was estimated at 78% and 73% at 5- and 10-year follow-up, respectively. The cumulative primary patency rate, defined as time to occlusion, was not different for the fracture group compared with the nonfracture group (P = .284). The incidence of stent fractures after endovascular PAA repair is probably underreported in the literature. Stent graft fractures mainly occur at overlap zones and are associated with younger age of the patient. Fracture of the stent did not significantly influence patency of the stent graft. Copyright (c) 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

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Author and article information

Journal

Journal ID (nlm-ta): Korean J Radiol

Journal ID (iso-abbrev): Korean J Radiol

Journal ID (publisher-id): KJR

Title: Korean Journal of Radiology

Publisher: The Korean Society of Radiology

ISSN (Print): 1229-6929

ISSN (Electronic): 2005-8330

Publication date (Print): Nov-Dec 2013

Publication date (Electronic): 05 November 2013

Volume: 14

Issue: 6

Pages: 931-934

Affiliations

Department of Radiology, Amrita Institute of Medical Sciences, Amrita Lane, Ponekkara, Cochin, Kerala State 682041, India.

Author notes

Corresponding author: Chinmay Bhimaji Kulkarni, MD, Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Amrita Lane, Ponekkra, Elamakkara P.O., Kochi, Kerala 682041, India. Tel: (91) 9946845428, Fax: (91) 0484-2802020, drchinmaykulkarni@ 123456gmail.com

Article

DOI: 10.3348/kjr.2013.14.6.931

PMC ID: 3835641

PubMed ID: 24265569

SO-VID: 121f78be-07fb-4606-9ad1-5b8a8617fa4d

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Endovascular Treatment of Aneurysm of Splenic Artery Arising from Splenomesentric Trunk Using Stent Graft

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Most cited references 12

Splenic artery aneurysms: two decades experience at Mayo clinic.

Endovascular management of visceral artery aneurysm.

Stent fractures in the Hemobahn/Viabahn stent graft after endovascular popliteal aneurysm repair.

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