Percutaneous Glue Embolization of a Visceral Artery Pseudoaneurysm in a Case of Sickle Cell Anemia |
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Authors: | Gurpreet S Gulati Manpreet S Gulati Govind Makharia Pradeep Hatimota Nripen Saikia Shashi B Paul Subrat Acharya |
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Institution: | (1) Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India;(2) Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India;(3) Department of Gastroenterology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India |
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Abstract: | Although aneurysmal complications of sickle cell anemia have been described in the intracranial circulation, visceral artery
pseudoaneurysms in this disease entity have not previously been reported in the literature. Conventional treatment of visceral
pseudoaneurysms has been surgical ligation or resection of the aneurysm. Transcatheter embolization has emerged as an attractive,
minimally invasive alternative to surgery in the treatment of these lesions. In certain situations, however, due to the unfavorable
angiographic anatomy precluding safe transcatheter embolization, direct percutaneous glue injection of the pseudoaneurysm
sac may be considered to achieve successful occlusion of the sac. The procedure may be rendered safer by simultaneous balloon
protection of the parent artery. We describe this novel treatment modality in a case of inferior pancreaticoduodenal artery
pseudoaneurysm in a patient with sickle cell anemia. Although a complication in the form of glue reflux into the parent vessel
occurred that necessitated surgery, this treatment modality may be used in very selected cases (where conventional endovascular
embolization techniques are not applicable) after careful selection of the balloon diameter and appropriate concentration
of the glue–lipiodol mixture. |
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Keywords: | Glue Pseudoaneurysm Sickle cell anemia Transcatheter embolization |
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