Reconstructive surgery for segmental arterial mediolysis involving both the internal carotid artery and visceral arteries Hideaki Obara, MD, PhD, Kenji.

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Presentation transcript:

Reconstructive surgery for segmental arterial mediolysis involving both the internal carotid artery and visceral arteries Hideaki Obara, MD, PhD, Kenji Matsumoto, MD, PhD, Yoshiaki Narimatsu, MD, PhD, Hitoshi Sugiura, MD, PhD, Masaki Kitajima, MD, PhD, Toshihiro Kakefuda, MD, PhD Journal of Vascular Surgery Volume 43, Issue 3, Pages 623-626 (March 2006) DOI: 10.1016/j.jvs.2005.11.033 Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 1 A, Contrast-enhanced computed tomographic (CT) scan shows an aneurysm, with mural thrombus, of the left carotid artery (arrow). B, Angiogram of the left carotid artery shows a fusiform aneurysm of the internal carotid artery (arrow) with narrowing (arrowhead) in the proximal portion. Journal of Vascular Surgery 2006 43, 623-626DOI: (10.1016/j.jvs.2005.11.033) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 2 A, Contrast-enhanced computed tomography scan shows a large extrahepatic artery aneurysm (arrow), with mural thrombus, and a celiac artery aneurysm (arrowhead). B, Selective celiac artery angiogram shows a saccular hepatic artery aneurysm (black arrow) with narrowing (arrowhead) in the proximal portion, as well as a fusiform celiac artery aneurysm (white arrow). C, Selective superior mesenteric artery angiogram shows narrowing of the distal portion of the superior mesenteric artery associated with a poststenotic fusiform dilatation (arrow). Journal of Vascular Surgery 2006 43, 623-626DOI: (10.1016/j.jvs.2005.11.033) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 3 A, Abdominal aortogram shows good postoperative patency of the vein graft (white arrowhead), right (black arrow) and left (white arrow) hepatic arteries, and splenic artery (black arrowhead). B, Angiogram of the left carotid artery shows good postoperative patency of the vein graft (black arrow). Journal of Vascular Surgery 2006 43, 623-626DOI: (10.1016/j.jvs.2005.11.033) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 4 A and B, Pathology studies of resected arterial wall specimens show multiple segmental mediolysis lesions (arrows) of the muscular and elastic fibers of the media (elastica-van Gieson stain; magnification × 20). A, Proximal portion of the resected left internal carotid artery aneurysm. B, Proximal portion of the resected common hepatic artery aneurysm. C, Pathology study of the resected common hepatic artery aneurysm shows an organized dissection (arrowheads) (hematoxylin and eosin stain; magnification × 20). Journal of Vascular Surgery 2006 43, 623-626DOI: (10.1016/j.jvs.2005.11.033) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions