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1.
Stent-Graft Repair of a Splenic Artery Aneurysm 总被引:3,自引:3,他引:0
Hyun-Ki Yoon Mats Lindh Petr Uher Bengt Lindblad Krasnodar Ivancev 《Cardiovascular and interventional radiology》2001,24(3):200-203
We present a case of splenic artery aneurysm (SAA) treated with stent-grafts. This new method offers the benefit of preserving the blood flow through the splenic artery. This in turn allows for subsequent sequential embolization of the spleen when indicated, as in our patient with hypersplenism. This is the first reported case of stent-graft repair of SAA. 相似文献
2.
Management of Splenic Artery Aneurysms and False Aneurysms with
Endovascular Treatment in 12 Patients 总被引:9,自引:4,他引:5
Guillon R Garcier JM Abergel A Mofid R Garcia V Chahid T Ravel A Pezet D Boyer L 《Cardiovascular and interventional radiology》2003,26(3):256-260
Purpose: To assess the endovascular
treatment of splenic artery aneurysms and false aneurysms.
Methods: Twelve patients (mean age 59 years, range 47–75
years) with splenic artery aneurysm (n = 10) or false
aneurysm (n = 2) were treated. The lesion was
asymptomatic in 11 patients; hemobilia was observed in one patient. The
lesion was juxta-ostial in one case, located on the intermediate
segment of the splenic artery in four, near the splenic hilus in six,
and affected the whole length of the artery in one patient. In 10
cases, the maximum lesion diameter was greater than 2 cm; in one case
30% growth of an aneurysm 18 mm in diameter had occurred in 6 months;
in the last case, two distal aneurysms were associated (17 and 18 mm in
diameter). In one case, stent-grafting was attempted; one detachable
balloon occlusion was performed; the 10 other patients were treated
with coils.
Results: Endovascular treatment was possible
in 11 patients (92%) (one failure: stenting attempt). In four cases
among 11, the initial treatment was not successful (residual perfusion
of aneurysm); surgical treatment was carried out in one case, and a
second embolization in two. Thus in nine cases (75%) endovascular
treatment was successful: complete and persistent exclusion of the
aneurysm but with spleen perfusion persisting at the end of follow-up
on CT scans (mean 13 months). An early and transient elevation of
pancreatic enzymes was observed in four cases.
Conclusion: Ultrasound and CT have made the diagnosis of
splenic artery aneurysm or false aneurysm more frequent. Endovascular
treatment, the morbidity of which is low, is effective and spares the
spleen. 相似文献
3.
Chinmay Bhimaji Kulkarni Srikanth Moorthy Sreekumar Karumathil Pullara Rajesh Ramaih Kannan 《Korean journal of radiology》2013,14(6):931-934
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. 相似文献
4.
Percutaneous Management of a Hepatic Artery Aneurysm: Bleeding After Liver Transplantation 总被引:1,自引:0,他引:1
Millonig G Graziadei IW Waldenberger P Koenigsrainer A Jaschke W Vogel W 《Cardiovascular and interventional radiology》2004,27(5):525-528
In this artical we present an unusual case of hepatic artery aneurysm bleeding due to a hepatic artery thrombosis after liver transplantation. The patient developed a recurrent hepatic artery thrombosis leading to severe graft failure in four consecutive liver transplantations. While being evaluated for a fifth transplant, stabilization of the clinical situation was attempted by interventional therapy. The first intervention was to place a stent into the hepatic artery to prevent further ischemic damage. This failed to improve graft function, but unfortunately led to the development of a pseudoaneurysm at the distal end with a subsequent rupture into the biliary tree. Bleeding was treated successfully by direct puncture and coil embolization of the aneurysm. In addition, the patient demonstrated a hemodynamically relevant portal vein stenosis on the CT scan. Stenting of the portal vein markedly improved graft function. After extensive investigations, a paroxysmal nocturnal hemoglobinuria was found to be the underlying cause of the recurrent hepatic artery thrombosis. Here we suggest that hepatic artery aneurysm bleeding is a rare but potentially fatal complication that can be successfully treated by percutaneous coil embolization. Additionally, we propose that stenting of the portal vein can lead to a significant improvement of the graft perfusion even though the hepatic artery remained occluded. 相似文献
5.
Aburano H Kawamori Y Horiti Y Kitagawa K Sanada J Matsui O 《Cardiovascular and interventional radiology》2006,29(6):1141-1143
We present a case of asymptomatic bronchial artery aneurysm that formed a fistula with part of the pulmonary artery (there
was no definite fistula with the pulmonary vein). We were able to catheterize the feeding vessel but could not reach the aneurysm.
We therefore injected a mixture of N-butyl-2-cyanoacrylate (NBCA; Histoacryl, B. Braun, Melsungen, Germany) and iodized oil (Lipiodol; Guerbet, Aulnay-sous-Bois,
France) from the feeding vessel. The fistula, aneurysm, and feeding vessel were almost totally occluded. After embolization,
the patient coughed a little; there were no other definite side effects or complications. One and 3 months later, on chest
CT, the aneurysm was almost completely occupied with hyperattenuating NBCA-Lipiodol embolization. NBCA is a liquid embolization
material whose time to coagulation after injection can be controlled by diluting it with Lipiodol. It is therefore possible
to embolize an aneurysm, feeding vessels, and efferent vessels (in our case, it was a fistula) by using an NBCA-Lipiodol mixture
of an appropriate concentration, regardless of whether the catheter can reach the aneurysm or not. 相似文献
6.
S Itoh T Ishiguchi M Negoro M Hirose H Fukazu T Endo T Ishigaki S Sakuma 《Nihon Igaku Hōshasen Gakkai zasshi. Nippon acta radiologica》1992,52(4):452-460
Transcatheter arterial embolization using a coaxial microcatheter and micro-coil was performed in eight patients with vascular lesions; one each with aneurysm of the basilar artery, cerebellar artery, and pancreatic artery, pseudoaneurysm of the common hepatic artery, gastroduodenal artery, and gluteal artery, carotid-cavernous fistula, and thoracic paraspinal arteriovenous malformation. Complete occlusion was achieved in five patients with aneurysm and pseudoaneurysm by occluding the aneurysmal cavity and/or the orifice. A patient with recurrent carotid-cavernous fistula was also completely embolized. A case of basilar artery aneurysm resulted in partial occlusion because the posterior cerebral artery originated from the aneurysm. The unsatisfactory result in a case of paraspinal AVM was due to its wide extension with multiple feeding arteries. No apparent complication was seen. In conclusion, super-selective arterial embolization therapy with coaxial microcatheter and micro-coils was found to be a useful method for vascular lesions that would have been technically difficult to embolize with the standard catheter and coils. 相似文献
7.
Richard W. Knight Saadoon Kadir Robert I. White Jr. 《Cardiovascular and interventional radiology》1982,5(1):37-39
In patients with pancreatitis and blood loss, bleeding from visceral artery aneurysms should be suspected, especially in cases
complicated by pseudocyst or abscess formation. We report of a patient with a transverse pancreatic artery aneurysm which
was successfully embolized. In addition, decompression of the gastric varices associated with isolated splenic vein occlusion
was performed successfully by Gelfoam embolization of 80% of the spleen. 相似文献
8.
目的:介绍内脏动脉动脉瘤栓塞治疗新技术,材料与方法:13例脾,肝等动脉动脉瘤,5例栓塞动脉瘤供血动脉,8例栓动脉瘤颈部或瘤腔,栓塞材料为弹簧圈,11例采用了同轴微导管,各3例应用于“分阶段栓塞法”和双导管技术,结果:栓塞成功率92.3%,9例有症状消失,1例栓塞过程中动脉瘤孔而手术,1例脾动脉瘤后部分脾梗塞,未予特殊治疗。栓后平均追踪时间3年3个月,均无再发出血或症状,先后18人次CT,彩超和DS 相似文献
9.
目的:探讨急诊髂内动脉栓塞治疗骨盆骨折大出血的临床价值。方法:对12例骨盆骨折合并失血性休克的患者行紧急髂内动脉造影,对出血动脉用明胶海绵进行栓塞;伴有肝脾破裂者同时行肝脾动脉栓塞。结果:髂内动脉造影显示对比剂血管外溢11例,伴髂内动脉主要分支断流2例,1例仅表现为髂内动脉分支广泛痉挛伴脾下极动脉出血;栓塞后出血均停止,全部患者24h内血压回升至正常水平,术后未发生严重的并发症。除1例合并多脏器功能衰竭(MODS)死亡外,其余都得到有效救治。结论:急诊髂内动脉栓塞是院内急救骨盆骨折大出血的首选方法,具有迅速、安全的优点。 相似文献
10.
目的 研究微导管可脱球囊技术治疗海绵窦瘘的临床意义。方法 :2 6例外伤性颈内动脉海绵窦瘘 (TCCF)患者和 1例大脑前动脉 (A1段 )动脉瘤破裂合并海绵窦瘘患者采用微导管可脱球囊技术进行栓塞治疗 ,以经颅多普勒 (TCD)进行复查 ,所有患者均随访 6月以上。结果 :2 2例CCF患者均成功栓塞瘘口并保持颈内动脉通畅 ,其中 2 0例为一次栓塞成功 ,2例因球囊过早泄漏而行 2次栓塞治疗。对 1例A1段动脉瘤破裂合并海绵窦瘘患者成功施行了双球囊动脉瘤颈孤立术。 4例行颈内动脉闭塞术。本组病例未发生严重并发症。结论 :微导管可脱球囊技术是对海绵窦瘘的一种微创、安全、有效的治疗方法。 相似文献
11.
Peña Fernández E de la Cruz Burgos R Del Cerro González JV Rebollo Polo M 《Radiologia》2007,49(6):424-426
Spontaneous rupture of the spleen is an uncommon emergency that usually occurs in a spleen affected by hematologic, neoplastic, or infectious diseases or as a complication of acute or chronic pancreatitis. This condition requires early diagnosis and appropriate treatment. Intrasplenic aneurysms are rare and rupture of the spleen secondary to intrasplenic aneurysm is extremely rare. We present the imaging findings for a case of splenic rupture secondary to an intrasplenic aneurysm. The patient was treated by percutaneous embolization, with excellent results. We review the literature on this entity and its endovascular treatment. 相似文献
12.
Eisuke Shibata Hidemasa Takao Shiori Amemiya Kuni Ohtomo 《Cardiovascular and interventional radiology》2017,40(3):465-469
This report describes perioperative hemodynamic monitoring of the common hepatic artery (CHA) during endovascular treatment of a pancreaticoduodenal arcade aneurysm, in a patient with celiac artery stenosis caused by the median arcuate ligament. Pressure monitoring was performed as a safety measure against critical complications such as liver ischemia. As the aneurysm was located in the anterior pancreaticoduodenal artery (APDA) and the posterior pancreaticoduodenal artery (PPDA) was small in caliber, the patient was considered to be at a high risk of liver ischemia. No significant change in pressure was observed in the CHA on balloon occlusion test in the APDA. Immediately after embolization, the PPDA enlarged and the pressure in the CHA was well maintained. Pressure monitoring appears to improve patient safety during endovascular treatment of visceral aneurysms. 相似文献
13.
Manninen HI Berg M Vanninen RL 《Journal of vascular and interventional radiology : JVIR》2008,19(4):487-492
PURPOSE: To report preliminary results of stent-assisted coil embolization in the treatment of wide-necked renal artery bifurcation aneurysms. MATERIALS AND METHODS: Four patients (three women, one man; mean age, 54 years; range, 49-67 y) with wide-necked renal artery aneurysms were treated with dedicated neurointerventional self-expanding nitinol stent-assisted coil embolization during a 2-year period. The stent was delivered over the neck of the aneurysm, after which the aneurysm was filled with detachable coils through a microcatheter placed into the aneurysm through the stent mesh. RESULTS: Stent delivery and coil embolization was successfully completed in all cases. Complete aneurysm occlusion without coil protrusion or arterial flow compromise was obtained in all patients. A small peripheral subsegmental renal infarction necessitating no therapy was registered in one patient on postembolization computed tomography. At follow-up angiography 1 year after embolization, no aneurysm recanalization or arterial obstruction was registered. CONCLUSIONS: Our preliminary experience indicates that stent-assisted coil embolization is technically feasible and effective for the exclusion of challenging renal artery bifurcation aneurysms without the sacrifice of any branch arteries. 相似文献
14.
We present a case of multi-slice computed tomography angiography of a 60-year-old patient with a retained fragment of microcatheter within an anterior communicating artery (AcomA) aneurysm. This is a rare complication of Guglielmi detachable coil embolization. After an unsuccessful embolization procedure, the patient underwent surgery. During clipping of an AcomA aneurysm, the microcatheter traveled up the pericallosal branch of the right anterior cerebral artery. Subsequently, the microcatheter fragment did not prevent normal blood flow through the artery, and the patient has been doing well without neurological sequelae. 相似文献
15.
Arai K Sanada J Kurozumi A Watanabe T Matsui O 《Cardiovascular and interventional radiology》2007,30(3):477-479
We evaluated the effectiveness of transcatheter arterial coil embolization therapy for the treatment of spontaneous hemothorax
followed by aneurysm rupture in neurofibromatosis patients. Three patients were treated for massive hemothorax caused by arterial
lesions associated with neurofibromatosis. Bleeding episodes were secondary to ascending cervical artery aneurysm and dissection
of vertebral artery in 1 patient, and intercostal artery aneurysm with or without arteriovenous fistula in 2 patients. Patients
were treated by transarterial coil embolization combined with chest drainage. In 1 patient, the ruptured ascending cervical
artery aneurysm was well embolized but, shortly after the embolization, fatal hemorrhage induced by dissection of the vertebral
artery occurred and the patient died. In the other 2 patients, the ruptured intercostal artery aneurysm was well embolized
and they were successfully treated and discharged. Transcatheter arterial coil embolization therapy is an effective method
for the treatment of spontaneous hemothorax followed by aneurysm rupture in neurofibromatosis patients. 相似文献
16.
《Radiologia》2016,58(3):235-238
This case presentation is about an 88 years-old male patient with previous endovascular aortic aneurysm repairment history and aortic endoleak type II (EL2). The direct lumbar artery catheterization was considered an alternative to solve EL2, associated with aortic endovascular prosthesis and due to an incomplete sealing or exclusion of the aneurysmal sac or a vascular segment demonstrated by imaging studies, when other treatment alternative failed (transarterial embolization) to control the aneurysm growing. Performing translumbar approach was decided by puncturing the artery lumbar (L4) left, previously the lumbar arteries (L4) were evaluated in the abdominal CT arterial phase to guide a puncture/access under flouroscopy control. Diagnostic angiogram clearly demonstrated the median sacral and right lumbar arteries inflow into the aneurysm sac. Transcatheter embolization with fibered platinum microcoils was performed of the median sacral artery and lumbar left and right arteries (L4), showing satisfactory endoleak devascularization. 相似文献
17.
Embolization of spontaneous rupture of an aneurysm of the ovarian artery supplying the uterus with fibroids 总被引:3,自引:0,他引:3
Nakajo M Ohkubo K Fukukura Y Nandate T Nakajo M 《Acta radiologica (Stockholm, Sweden : 1987)》2005,46(8):887-890
We report a case of spontaneous retroperitoneal hemorrhage caused by rupture of an aneurysm of the right ovarian artery in a 55-year-old woman. Diagnosis was achieved by computed tomography and arteriography. The ruptured aneurysm was treated by transcatheter arterial embolization using microcoils and gelatin sponge particles. This is the first case of rupture of an aneurysm of the ovarian artery not related to pregnancy, and the third case of embolization of a ruptured ovarian artery aneurysm in the literature. We illustrate the usefulness of embolization in treatment of an ovarian artery aneurysm without surgery. 相似文献
18.
Hong Gee Roh Young Il Chun Jin Woo Choi Joon Cho Won-Jin Moon Sten Solander 《Korean journal of radiology》2012,13(4):510-514
Wide-necked aneurysms of the posterior inferior cerebellar artery (PICA) are infrequently encountered in cerebrovascular practice, and endovascular treatment is difficult or impossible even with the use of several neck remodeling techniques. We present the case of a patient with a wide-necked aneurysm of the PICA, which was treated by the retrograde stenting through the contralateral vertebral artery and vertebrobasilar junction with antegrade coil embolization. 相似文献
19.
Karaman K Onat L Sirvanci M Olga R 《Diagnostic and interventional radiology (Ankara, Turkey)》2005,11(2):119-121
Splenic artery aneurysms are rare but important vascular lesions that constitute approximately 60% of all visceral arterial aneurysms. Splenic artery is the third most common localization of intraabdominal aneurysm formation. Rupture is the main complication that occurs in 3%-10% of the cases. We describe a case with a proximal splenic artery aneurysm. To preserve splenic function and reduce the risk of aneurysmal rupture, we used stent-graft to embolize the aneurysm treated percutaneously. The follow up of patient was uneventful after embolization. Endovascular embolization of the splenic artery aneurysm may prevent the need for emergency surgery and also offer an effective alternative surgical treatment. 相似文献
20.
Balloon-assisted coil embolization of a posterior cerebral artery aneurysm via a persistent primitive trigeminal artery: technical note 总被引:1,自引:0,他引:1
Introduction We present a patient with an acutely ruptured, wide-necked aneurysm of the left posterior cerebral artery (PCA) treated with Guglielmi detachable coils using the remodeling technique.Methods Since the left vertebral artery was compressed due to a tumor in the cerebellopontine angle and the right vertebral artery was hypoplastic, we used a carotid artery approach via a persistent primitive trigeminal artery (PPTA) to selectively catheterize the aneurysm.Results The aneurysm was occluded completely.Conclusion To our knowledge this is the first case of a wide-necked PCA aneurysm treated via a PPTA and using the remodeling technique. In patients with hypoplastic vertebral arteries and a PPTA, this approach may represent an alternative for selective embolization of posterior circulation aneurysms not amenable to the conventional approach. 相似文献