Emergency treatment of haemorrhaging coeliac or mesenteric artery aneurysms and pseudoaneurysms in the era of endovascular management

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
K J RobertsR G Jones

Abstract

Patients requiring emergency treatment of visceral artery aneurysms (VAAs) can be treated by endovascular or surgical techniques. Outcomes after failed attempts at endovascular control are unclear as is the present role of surgery. This study reviewed treatment and outcomes of a contemporary cohort of patients with symptomatic VAAs at a tertiary referral centre. Patients undergoing emergency treatment of a VAA of the coeliac, mesenteric arteries, or their branches were identified over a 5-year period. Patient variables, treatments, and outcomes were assessed. Forty-eight patients underwent 65 radiological and two surgical procedures. Pseuodaneuryms were present in 45 (94%) of patients. Interventional radiology procedures were the initial treatment in every patient. The initial success was 40 out of 48 (83%). Patients requiring more than one procedure were all successfully treated. Regarding initial failures, if the VAA sac could not be accessed at angiography an alternative procedure to control the VAA was required in every case. If initial endovascular treatment failed, repeating the same procedure was successful in half of the patients. Ultrasound-guided percutaneous VAA embolisation was used in four patients. The 30-day mort...Continue Reading

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Citations

Oct 18, 2019·Surgery Today·Hideaki ObaraYuko Kitagawa
Dec 12, 2020·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Sathya SagarRakesh Kochhar
Apr 7, 2021·Annals of Vascular Surgery·Monika JohalAmer Harky

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