Nonoperative management of unruptured visceral artery aneurysms: Treatment by transcatheter coil embolization Osamu Ikeda, MD, Yoshitaka Tamura, MD,

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Presentation transcript:

Nonoperative management of unruptured visceral artery aneurysms: Treatment by transcatheter coil embolization Osamu Ikeda, MD, Yoshitaka Tamura, MD, Yutaka Nakasone, MD, Yasuhiko Iryou, MD, Yasuyuki Yamashita, MD Journal of Vascular Surgery Volume 47, Issue 6, Pages 1212-1219 (June 2008) DOI: 10.1016/j.jvs.2008.01.032 Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 1 A 63-year-old man with an aneurysm of the inferior pancreaticoduodenal artery and a concomitant finding of occlusion of the celiac artery due to compression by the median arcuate ligament. A, Multiplanar reformatted images showing narrowing of the celiac trunk from extrinsic superior compression. B, On the superior mesenteric artery angiogram, the hepatic artery can be visualized through a dilation of the pancreaticoduodenal arcade. Note the 12-mm aneurysm arising from the origin of the inferior pancreaticoduodenal artery. Journal of Vascular Surgery 2008 47, 1212-1219DOI: (10.1016/j.jvs.2008.01.032) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 2 A 67-year-old man with an aneurysm of the splenic artery and hepatitis-C. A, Splenic artery angiogram. Note the 18-mm aneurysm. B, On the celiac artery angiogram (balloon-occluded splenic artery), the splenic aneurysm and splenic parenchyma can be visualized through a left gastric artery and short gastric artery. C, On the superior mesenteric artery angiogram (balloon-occluded splenic artery), the splenic aneurysm and splenic parenchyma can be visualized through a left gastroepiploic artery. Journal of Vascular Surgery 2008 47, 1212-1219DOI: (10.1016/j.jvs.2008.01.032) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 3 A 48-year-old man with a history of heavy drinking and chronic pancreatitis. Note the aneurysms of the inferior pancreaticoduodenal artery at the bifurcation of the pancreaticoduodenal arcade and pancreatic transverse artery. A, CT shows occlusion of the celiac artery and multiple calcifications in the pancreas due to chronic pancreatitis. B, On the superior mesenteric artery angiogram, the hepatic and splenic artery can be visualized through a dilation of the pancreaticoduodenal arcade. Note the 10-mm aneurysm of the inferior pancreaticoduodenal artery at the bifurcation of the pancreaticoduodenal arcade and pancreatic transverse artery. C, Complete angiogram demonstrating obliteration of the aneurysm by coils. Note patency of the collateral flow to the hepatic- and pancreatic transverse artery. Journal of Vascular Surgery 2008 47, 1212-1219DOI: (10.1016/j.jvs.2008.01.032) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 4 A 61-year-old woman with an aneurysm and stenosis of the renal artery. She had hypertension and rheumatoid arthritis. A, Right renal artery angiogram demonstrating a 50 × 35-mm aneurysm at the distal site. Note stenosis and a small aneurysm at the proximal site. B, Right renal artery angiogram. Note the stent at the distal artery of the aneurysm at the bifurcation of the proximal renal artery. C, Complete angiogram demonstrating obliteration of the 50 × 35-mm aneurysm by coils. D, Complete angiogram demonstrating obliteration of the small aneurysm by coils. There is patency of the collateral flow to the renal artery. Journal of Vascular Surgery 2008 47, 1212-1219DOI: (10.1016/j.jvs.2008.01.032) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions