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Title: Stent-Graft Treatment for Bleeding Superior Mesenteric Artery Pseudoaneurysm After Pancreaticoduodenectomy

Abstract

We report two cases of intraperitoneal bleeding from superior mesenteric artery (SMA) pseudoaneurysm after pancreaticoduodenectomy for pancreatic head carcinoma. In both cases, a stent-graft was deployed on the main SMA to exclude pseudoaneurysm and to preserve blood flow to the bowel. Bleeding stopped after the procedure. One patient was able to be discharged but died from carcinoma recurrence 4 months later. The other patient died of sepsis and stent-graft infection 5 months later. These patients remained free of intraperitoneal rebleeding during the follow-up period.

Authors:
; ; ; ; ;  [1]
  1. Nagoya University Graduate School of Medicine, Department of Radiology (Japan)
Publication Date:
OSTI Identifier:
21428514
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 32; Journal Issue: 4; Other Information: DOI: 10.1007/s00270-009-9502-1; Copyright (c) 2009 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2009 Springer Science+Business Media, LLC
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; CARCINOMAS; GRAFTS; PANCREAS; TUBES; BLOOD VESSELS; BODY; CARDIOVASCULAR SYSTEM; DIGESTIVE SYSTEM; DISEASES; ENDOCRINE GLANDS; GLANDS; NEOPLASMS; ORGANS; TRANSPLANTS

Citation Formats

Suzuki, Kojiro, E-mail: kojiro@med.nagoya-u.ac.jp, Mori, Yoshine, Komada, Tomohiro, Matsushima, Masaya, Ota, Toyohiro, and Naganawa, Shinji. Stent-Graft Treatment for Bleeding Superior Mesenteric Artery Pseudoaneurysm After Pancreaticoduodenectomy. United States: N. p., 2009. Web. doi:10.1007/S00270-009-9502-1.
Suzuki, Kojiro, E-mail: kojiro@med.nagoya-u.ac.jp, Mori, Yoshine, Komada, Tomohiro, Matsushima, Masaya, Ota, Toyohiro, & Naganawa, Shinji. Stent-Graft Treatment for Bleeding Superior Mesenteric Artery Pseudoaneurysm After Pancreaticoduodenectomy. United States. doi:10.1007/S00270-009-9502-1.
Suzuki, Kojiro, E-mail: kojiro@med.nagoya-u.ac.jp, Mori, Yoshine, Komada, Tomohiro, Matsushima, Masaya, Ota, Toyohiro, and Naganawa, Shinji. 2009. "Stent-Graft Treatment for Bleeding Superior Mesenteric Artery Pseudoaneurysm After Pancreaticoduodenectomy". United States. doi:10.1007/S00270-009-9502-1.
@article{osti_21428514,
title = {Stent-Graft Treatment for Bleeding Superior Mesenteric Artery Pseudoaneurysm After Pancreaticoduodenectomy},
author = {Suzuki, Kojiro, E-mail: kojiro@med.nagoya-u.ac.jp and Mori, Yoshine and Komada, Tomohiro and Matsushima, Masaya and Ota, Toyohiro and Naganawa, Shinji},
abstractNote = {We report two cases of intraperitoneal bleeding from superior mesenteric artery (SMA) pseudoaneurysm after pancreaticoduodenectomy for pancreatic head carcinoma. In both cases, a stent-graft was deployed on the main SMA to exclude pseudoaneurysm and to preserve blood flow to the bowel. Bleeding stopped after the procedure. One patient was able to be discharged but died from carcinoma recurrence 4 months later. The other patient died of sepsis and stent-graft infection 5 months later. These patients remained free of intraperitoneal rebleeding during the follow-up period.},
doi = {10.1007/S00270-009-9502-1},
journal = {Cardiovascular and Interventional Radiology},
number = 4,
volume = 32,
place = {United States},
year = 2009,
month = 7
}
  • Superior mesenteric artery (SMA) pseudoaneurysm formation is a rare and potentially fatal postoperative complication. Herein we present a case of a large post-pancreaticoduodenectomy SMA pseudoaneurysm that required thrombin injection after initial stent-graft deployment to accomplish complete pseudoaneurysm occlusion.
  • A 68-year-old woman presenting with gastrointestinal bleeding (hematocrit 19.3%) and in a critical clinical condition (American Society of Anesthesiologists grade 4) from a giant superior mesenteric artery pseudoaneurysm (196.0 x 131.4 mm) underwent emergency endovascular treatment. The arterial tear supplying the pseudoaneurysm was excluded using a 5.0 mm diameter and 31 mm long monorail expanded polytetrafluoroethylene (ePTFE)-covered self-expanding nitinol stent. Within 6 days of the procedure, a gradual increase in hemoglobin levels and a prompt improvement in the clinical condition were observed. Multislice CT angiograms performed immediately, 5 days, 30 days and 3 months after the procedure confirmed the completemore » exclusion of the pseudoaneurysm.« less
  • No abstract prepared.
  • Pseudoaneurysm is a relatively rare but serious complication of pancreatitis which is often fatal. We report successful stent-graft placement in the superior mesenteric artery in a 45-year-old man with a pancreatic pseudocyst that grew during therapy for chronic pancreatitis and developed into a pseudoaneurysm. After a stent graft was inserted in the superior mesenteric artery, the pseudoaneurysm disappeared and no further complications developed. Stent-graft placement was considered to be a useful therapy for pseudoaneurysms in the superior mesenteric arterial region.
  • Iatrogenic arterial dissection leading to the development of dissecting pseudoaneurysms of the superior mesenteric artery (SMA) is a rare complication of angiography. Surgical and endovascular treatment options exist for this important condition. We report a case of bare stent implantation in dissecting pseudoaneurysm of the SMA that developed after angiography in a patient with acute mesenteric ischemia. Although it is rarely published, iatrogenic arterial dissection causing pseudoaneurysm can occur after diagnostic and interventional angiography. Bare stent implantation in dissecting pseudoaneurysm of the SMA could be an advantageous endovascular treatment option in selected cases due its to potential preservation of importantmore » side branches of the SMA.« less