Pseudoaneurysms of splancnic vessels are one of the worst complications of iatrogenic and surgical procedures due to their risk of bleeding.
Endovascular treatment is an alternative option to the surgical one in the management of these complications,
with a variety of possible approaches to prevent or to treat their rupture.
Pseudoaneurysm is an enlargement of an arterial vessel which lack a complete arterial wall,
leading to a high risk of rupture with consequent bleeding,
thus requiring treatment.
Pseudoaneurysms are mostly asymptomatic and are consequences of trauma,
infections or surgical procedures,
after direct damage of the vessel wall.
The gold standard in pseudoaneurysm's diagnosis is the multidetector-row computed tomography (MDCT) examination,
which is a panoramic methodic,
helping in the assessment of the vessel from which the pseudoaneurysm originated and in detection of its cause.
Findings and procedure details
We present cases of iatrogenic pseudoaneurysms of splancnic vessels following surgical procedures,
and their endovascular treatment options.
58 years-old woman,
who underwent duodeno-cephalo-pancreasectomy (DCP),
in 5th postoperative day; he presents hypotension and hematic material from the drainage on the left hypochondrium; basal CT exam demonstrates the presence of hyperattenuating material in the gastro-splenic ligament,
referring to hematic material; CT-angiography shows a pseudoaneurysm of the splenic artery (Fig.1a,
1b) confirmed on DSA (Fig.2) and treated by placing a covered stent.
At the end of...
Pseudoaneurysms of splancnic vessels are one of the worst complications of surgical procedures; MDCT is an effective instrument to detect postoperative pseudoaneurysms and to plan their best treatment,
especially the endovascular one; it is also a good instrument in the follow-up to evaluate vessels recanalization and complications,
like device displacement or thrombosis of non target vessels.
Endovascular treatment is a powerful instrument to treat these complications with a great variety of material.
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Abdominal and Pelvic Aneurysms and Pseudoaneurysms: Imaging Review with Clinical,
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Interventional Radiology in the Management of Visceral Artery Pseudoaneurysms: A Review of Techniques and Embolic Materials; Madhusudhan KS,
Korean J Radiol.
Left Hepatic Artery Pseudoaneurysm Caused by...