Coil embolization using microballoon assistance combined with the double-catheter technique for a large superior mesenteric arterial pseudoaneurysm and.

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Coil embolization using microballoon assistance combined with the double-catheter technique for a large superior mesenteric arterial pseudoaneurysm and fistula secondary to acute pancreatitis Hidenori Yamaguchi, MD, Satoru Murata, MD, Shiro Onozawa, MD, Fumie Sugihara, MD, Hidemasa Saito, MD, Shin-ichiro Kumita, MD Journal of Vascular Surgery Cases and Innovative Techniques Volume 4, Issue 2, Pages 152-155 (June 2018) DOI: 10.1016/j.jvscit.2018.02.009 Copyright © 2018 The Author(s) Terms and Conditions

Fig 1 Abdominal contrast-enhanced computed tomography (CE-CT) scans and maximum intensity projection showed a pancreatic pseudoaneurysm measuring 13 × 12 cm in diameter that originated from the superior mesenteric artery (SMA; white arrow) trunk. The SMA was excluded and extended from the pancreatic head to the porta hepatis. Arrowhead, Pseudoaneurysmal neck; yellow arrow, first jejunal artery; red arrow, second jejunal artery. Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, 152-155DOI: (10.1016/j.jvscit.2018.02.009) Copyright © 2018 The Author(s) Terms and Conditions

Fig 2 Digital subtraction angiography. a, Superior mesenteric arteriography demonstrated a superior mesenteric artery (SMA) pseudoaneurysm. The pseudoaneurysm drained directly into the mesenteric vein (white arrow); yellow arrow, first jejunal artery; red arrow, second jejunal artery. b, Under the SMA occlusion at the point of the pseudoaneurysmal neck, arteriography revealed collateral formation through the first and second jejunal arteries. A pseudoaneurysm is not shown. Arrowhead, Microballoon. c, Four detachable coils (arrow) were placed on the expanded microballoon (arrowhead) and in the SMA trunk. d, After coil placement (white arrow), arteriography showed disappearance of the pseudoaneurysm and blood flow in the SMA through the collateral circulation without perfusion delay of the distal SMA. Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, 152-155DOI: (10.1016/j.jvscit.2018.02.009) Copyright © 2018 The Author(s) Terms and Conditions

Fig 3 Eighteen months after discharge, contrast-enhanced computed tomography (CE-CT) showed complete disappearance of the pseudoaneurysm. Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, 152-155DOI: (10.1016/j.jvscit.2018.02.009) Copyright © 2018 The Author(s) Terms and Conditions