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Endovascular treatment of visceral artery aneurysms and pseudoaneurysms: our experience

Trattamento endovascolare di aneurismi e pseudoaneurismi viscerali: la nostra esperienza

  • Vascular and Interventional Radiology / Radiologia Vascolare e Interventistica
  • Published:
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Abstract

Purpose

The aim of this study was to analyse our 8 years of experience with endovascular treatment of visceral aneurysms and pseudoaneurysms.

Materials and methods

From January 2002 to September 2009, we used an endovascular approach to treat 30 patients (22 men, eight women) affected by aneurysm (n=18) or pseudoaneurysm (n=13) of the splenic (n=11), hepatic (n=6), renal (n=5), pancreaticoduodenal (n=3), left gastric (n=2), gastroduodenal (n=1), rectal (n=1) or middle colic (n=1) arteries and the coeliac axis (n=1). Of these, 26/31 were treated with metal coils, 3/31 with Cardiatis multilayer stent, 1/31 with a coated stent and 1/31 with coils and Amplatzer plug. Procedures were performed electively in 10/30 cases and during haemorrhage in 20/30 cases. Follow-up was performed clinically (cessation of bleeding) and at 1, 6 and 12 months by colour-Doppler ultrasound (CDUS) and computed tomography (CT) angiography.

Results

In 31/31 aneurysms and pseudoaneurysms we obtained immediate exclusion. In four patients with aneurysm and in four with pseudoaneurysm, parenchymal ischaemia occurred; one was treated with surgical splenectomy. One patient with pseudoaneurysm of the coeliac axis died 10 days later because of new bleeding. During follow-up, all aneurysms and pseudoaneurysms remained excluded.

Conclusions

Percutaneous treatment is effective and safe, with a small number of complications, especially when compared with traditional surgery.

Riassunto

Obiettivo

Scopo dello studio è analizzare 8 anni della nostra esperienza nel trattamento endovascolare di aneurismi e pseudoaneurismi viscerali.

Materiali e metodi

Da gennaio 2002 a settembre 2009 sono stati trattati con terapia endovascolare 30 pazienti (22 maschi, 8 femmine) portatori di aneurismi (n=18) o pseudoaneurismi (n=13) originanti dall’arteria splenica (n=11), epatica (n=6), renale (n=5), pancreaticoduodenale (n=3), gastrica sinistra (n=2), gastroduodenale (n=1), rettale (n=1), colica media (n=1) e dal tripode celiaco (n=1). Ventisei/31 sono stati trattati con spirali metalliche, 3/31 con stent multimaglia Cardiatis, 1/31 con spirali e Amplatzer plug, 1/31 con stent ricoperto. Dieci/30 procedure sono state effettuate in elezione, 20/30 durante sanguinamento. Il follow-up è stato eseguito clinicamente (cessazione del sanguinamento) e a 1, 6 e 12 mesi (eco-color Doppler ed angio-tomografia computerizzata).

Risultati

In 31/31 degli aneurismi e pseudoaneurismi trattati si è ottenuta esclusione immediata. In 4 pazienti portatori di aneurisma e in 4 portatori di pseudoaneurisma si è verificata ischemia parenchimale; in un caso si è ricorso a splenectomia. Un paziente portatore di pseudoaneurisma del tripode celiaco è deceduto dopo 10 giorni per nuovo sanguinamento. Durante il follow-up tutti gli aneurismi sono rimasti esclusi.

Conclusioni

Il trattamento percutaneo risulta efficace e sicuro con ridotto numero di complicanze se paragonato al tradizionale intervento chirurgico.

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Authors and Affiliations

  1. S.C. Radiodiagnostica, S.S. Radiologia Interventistica, A.S.O. S. Croce e Carle, Via Michele Coppino 26, 12100, Cuneo, Italy

    A. Balderi, A. Antonietti, L. Ferro, E. Peano, F. Pedrazzini & M. Grosso

  2. Radiologia Diagnostica 4U, Azienda Ospedaliero-Universitaria S. Giovanni Battista, Via Genova 3, 10126, Torino, Italy

    P. Fonio

Authors
  1. A. Balderi
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  2. A. Antonietti
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  3. L. Ferro
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  4. E. Peano
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  5. F. Pedrazzini
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  6. P. Fonio
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  7. M. Grosso
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Correspondence to A. Balderi.

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Balderi, A., Antonietti, A., Ferro, L. et al. Endovascular treatment of visceral artery aneurysms and pseudoaneurysms: our experience. Radiol med 117, 815–830 (2012). https://doi.org/10.1007/s11547-011-0776-4

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  • DOI: https://doi.org/10.1007/s11547-011-0776-4

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