• endovascular repair
• infectious aneurysms
• infectious endocarditis
• superior mesenteric artery aneurysms
• visceral artery infectious aneurysm

• Celiac artery aneurysms
• natural history
• splanchnic artery aneurysm

• Humans
• Male
• Celiac Artery/diagnostic imaging
• Retrospective Studies
• Female
• Aged
• Aneurysm/diagnostic imaging
• Aneurysm/therapy
• Middle Aged
• Time Factors
• Disease Progression
• Databases, Factual
• Risk Factors
• Aged, 80 and over
• Computed Tomography Angiography

• Endovascular stent graft
• Superior mesenteric artery aneurysm
• Visceral artery bypass graft

• Laparoscopic arterial ligation
• Splenic artery aneurysm
• Splenomesenteric trunk

• aneurysm
• case report
• embolization
• fistula
• median pancreatectomy
• splenic artery

• aneurysms
• cirrhosis
• embolization
• hypersplenism
• portal hypertension
• splenic artery

• embolization
• endovascular treatment
• hepatic artery
• pancreaticoduodenectomy
• pseudoaneurysm
• stent graft

• Endovascular embolization
• Gastrointestinal bleeding
• Laparoscopic sleeve gastrectomy
• Pseudoaneurysm

• case report
• children
• endovascular
• superior mesenteric artery
• visceral artery pseudoaneurysm

• Humans
• Female
• Child
• Aneurysm, False/etiology
• Aneurysm, False/therapy
• Aneurysm, False/surgery
• Mesenteric Artery, Superior/injuries
• Mesenteric Artery, Superior/diagnostic imaging
• Mesenteric Artery, Superior/surgery
• Endovascular Procedures/methods
• Ileum/blood supply
• Accidents, Traffic
• Tomography, X-Ray Computed
• Abdominal Injuries/complications
• Embolization, Therapeutic/methods

• Carbon dioxide angiography
• Contrast allergy
• Fenestrated endovascular aortic repair
• Intravascular ultrasound
• Superior mesenteric artery aneurysm

• Aneurysmectomy
• Jejunal aneurysm
• Mesenteric aneurysm
• Mycotic aneurysm
• Superior mesenteric artery aneurysm

• Aneurysm
• Embolization
• Endovascular procedures
• Splenic artery
• Stents

• 82272089 National Natural Science Foundation of China
• shslczdzk07002 Shanghai Municipal Key Clinical Specialty
• shslczdzk06002 Shanghai Municipal Key Clinical Specialty
• Shanghai Municipal Key Clinical Specialty

• Coeliac artery aneurysm
• Hepatic artery aneurysm
• Mesenteric artery aneurysm
• Visceral artery aneurysm

• Male
• Humans
• Female
• Middle Aged
• Hepatic Artery/diagnostic imaging
• Hepatic Artery/surgery
• Retrospective Studies
• Blood Vessel Prosthesis Implantation/adverse effects
• Treatment Outcome
• Aneurysm/diagnostic imaging
• Aneurysm/etiology
• Aneurysm/surgery
• Stents
• Endovascular Procedures/adverse effects

• aneurysm rupture
• ruptured splenic aneurysms
• shock during pregnancy
• splanchnic aneurysms
• splenectomy
• splenic artery aneurysms and pseudoaneurysms
• transarterial artery embolization
• visceral aneurysms

• Aneurysm
• Endovascular repair
• Endovascular techniques
• Superior mesenteric artery
• Superior mesenteric artery aneurysm
• Visceral artery aneurysm

• angiography
• endovascular coiling
• ruptured visceral artery
• vascular intervention
• visceral aneurysm/pseudoaneurysm

• Catheters
• Hydrogels
• Minimally invasive
• Pseudoaneurysms
• Shear-thinning biomaterials
• Silicate nanoplatelets
• Visceral artery aneurysms

• Aneurysm/therapy
• Arteries
• Biocompatible Materials/pharmacology
• Humans
• Printing, Three-Dimensional
• Stents
• Treatment Outcome

• R01 HL140951 NHLBI NIH HHS
• CIHR

• Sichuan University

A 50-year-old man with a history of coil embolization of a symptomatic 5.3-cm hepatic artery aneurysm 6 years previously presented with a massive gastrointestinal bleed. He was found to have embolization coils extruding into the duodenum from a hepaticoduodenal arterioenteric fistula. The present case demonstrates that endovascular intervention for a large hepatic artery aneurysm can have long-term consequences. We have described a novel complication of embolization of a giant hepatic artery aneurysm that necessitated complex open repair.

• Celiac trunk aneurysms
• Celiac trunk aneurysms classifications
• endovascular treatment
• visceral aneurysm
• visceral branches stenting

• Mesenteric artery aneurysm
• Renal artery aneurysm
• Splenic artery aneurysm
• Visceral Aneurysm

Intra-abdominal and intramural hematomas are well-known complications of pseudoaneurysms. We present a case of small bowel obstruction as a result of external mechanical compression from hematoma. Bleeding was localized to the pseudoaneurysm of the gastroduodenal artery and inferior pancreaticoduodenal artery. Angiography was used to control the bleeding with coil embolization. This rare clinical manifestation represents just one of the symptoms associated with pseudoaneurysms of the gastrointestinal tract. Therapeutic options are discussed along with a review of the literature.

• gastroduodenal artery
• inferior pancreaticoduodenal artery
• intra-abominal bleed
• intramural hematoma
• pseudoaneurysm

We report the cases of 2 female patients, 45-year-old and 49-year-old, affected by wide-necked splenic aneurysm. We embolized the 2 lesions assisted by a new scaffolding neurovascular device, the Cascade Net, an innovative –occlusive remodeling device for temporary bridging in endovascular coil embolization of intracranial aneurysms. Visceral artery aneurysms are rare with an estimated prevalence of 2%-3% in imaging series and up to 10% in autopsy series. Most are asymptomatic and their diagnosis is occasionally. Aneurysm spontaneous rupture has been demonstrated in 2%-10% of cases and it can result in significant morbidity and mortality. Conservative management and open repair were the preferred treatment options for many years. Endovascular repair has been increasingly used since 2000; and the most widespread method of treatment has been coiling. Because of tortuosity of the parent artery, wide neck, and unfavorable locations at arterial branch points, 6% of Visceral and renal artery aneurysms VRAA cannot be adequately treated by simple coiling and requires parent artery remodeling through balloon occlusion, stent placement or parent vessel occlusion, leading to, in the latter situation, a compromised organ perfusion. Increasingly, balloon-assisted, and stent-assisted approaches as well as novel scaffolding neurovascular devices such as the Cascade Net, have allowed wide necked aneurysms to be bridged during endovascular treatment with smaller delivery system, averting parent artery occlusion and risk of distal embolization.

• Neurovascular neckbridging device
• Stent-assisted coiling
• Wide-necked splenic artery aneurysms

• Abdominal
• Aneurysms
• Endovascular
• Rupture
• Visceral

• hemorrhage
• rupture risk
• visceral artery aneurysms
• visceral artery pseudoaneurysm
• visceral ischemia

• Hepatic artery pseudoaneurysm
• Liver transplantation
• REBOA
• Resuscitative endovascular balloon occlusion
• Streptococcus constellatus

Pseudoaneurysms (PAs) caused by traumatic injury to the arterial vasculature have a high risk of rupture, leading to life-threatening hemorrhage and mortality, requiring urgent treatment. The purpose of this study was to determine the technical and clinical outcomes of endovascular treatment of visceral and extremity traumatic pseudoaneurysms.

Clinical data were retrospectively collected from all patients presenting for endovascular treatment of PAs between September 2012 and September 2018 at a single academic level one trauma center. Technical success was defined as successful treatment of the PA with no residual filling on post-embolization angiogram. Clinical success was defined as technical successful treatment with no rebleeding throughout the follow-up period and no reintervention for the PA.

Thirty-five patients (10F/25M), average age (± stdev) 41.7 ± 20.1 years, presented with PAs secondary to blunt (n = 31) or penetrating (n = 4) trauma. Time from trauma to intervention ranged from 2 h - 75 days (median: 4.4 h, IQR: 3.5–17.1 h) with 27 (77%) of PAs identified and treated within 24 h of trauma. Average hospitalization was 13.78 ± 13.4 days. Ten patients underwent surgery prior to intervention. PA number per patient ranged from 1 to 5 (multiple diffuse). PAs were located on the splenic (n = 12, 34.3%), pelvic (n = 11, 31.4%), hepatic (n = 9, 25.7%), upper extremity/axilla (n = 2, 5.7%), and renal arteries (n = 1, 2.9%). Technical success was 85.7%. Clinical success was 71.4%, for technical failure (n = 5), repeat embolization (n = 1) or post-IR surgical intervention (n = 4). There was no PA rebleeding or reintervention for any patient after discharge over the reported follow-up periods. Three patients died during the trauma hospitalization for reasons unrelated to the PAs.

Endovascular treatment of traumatic visceral and extremity PAs is efficacious with minimal complication rates and low reintervention requirements.

• Endovascular treatment
• Pseudoaneurysm
• Trauma

• Behcet’s disease
• celiac artery aneurysm
• endovascular
• transcatheter coil embolization

• Coil embolization
• hemorrhage
• middle colic artery
• pseudoaneurysm

Visceral artery pseudoaneurysms (PSAs) are relatively rare, and cases associated with distal vasculature of the superior mesenteric artery are largely unreported. Visceral artery PSAs, without intervention, can lead to morbidity or mortality from rupture or mesenteric ischemia. Historically, open aneurysmectomy is the gold standard; however, endovascular modalities have emerged as the first-line treatment in patients who are poor surgical candidates and/or have unfavorable anatomy. Herein, we describe a case of a symptomatic PSA of the distal superior mesenteric artery treated via the transradial approach with endovascular coil embolization, showing successful aneurysmal exclusion and preservation of enteric collateral flow.

• Coil embolization
• Mesenteric
• Pseudoaneurysm
• Transradial
• Visceral

• aneurysm
• endovascular treatment
• gastroduodenal artery

In rare cases, the celiac artery and the superior mesenteric artery arise from a common origin known as a common celiacomesenteric trunk. Celiac trunk stenosis or occlusion has been reported to accompany this anatomical aberrancy. Even rarer, are aneurysms associated with this common celiacomesenteric trunk. In general, visceral artery aneurysms are uncommon. We hereby present a 39-year-old female patient with a 1-month history of mild diffuse abdominal pain, with an incidental finding of superior mesenteric artery aneurysm on abdominal ultrasound. Subsequent contrast-enhanced computed tomography revealed severe narrowing of the celiac trunk and saccular aneurysmal dilatation of the superior mesenteric artery. Coil embolization of the aneurysm was performed, while maintaining persistent flow in the superior mesenteric artery and celiacomesenteric trunk. Visceral artery aneurysms are increasingly being identified incidentally with improvement in imaging techniques. The question lies whether to treat these aneurysms or observe. No universal guidelines exist regarding that matter, but the decision to intervene is made based on aneurysm location, size, and patient characteristics.

• Celiacomesenteric trunk
• aneurysm
• celiac trunk stenosis
• embolization
• retrograde blood flow
• superior mesenteric artery

• aneurysm
• embolization
• inferior gastrointestinal artery

• Aneurysm/diagnosis
• Aneurysm/mortality
• Aneurysm/therapy
• Aneurysm, False/diagnosis
• Aneurysm, False/therapy
• Arteries/diagnostic imaging
• Arteries/surgery
• Diagnostic Imaging
• Embolization, Therapeutic/instrumentation
• Endovascular Procedures/instrumentation
• Humans
• Risk Factors
• Treatment Outcome
• Viscera/blood supply

• Aneurysm, False/diagnostic imaging
• Aneurysm, False/surgery
• Aneurysm, False/therapy
• Embolization, Therapeutic/instrumentation
• Embolization, Therapeutic/methods
• Emergencies
• Gallbladder/blood supply
• Hemoperitoneum/diagnosis
• Hemoperitoneum/etiology
• Hepatic Artery/diagnostic imaging
• Humans
• Ischemia/etiology
• Ischemia/pathology
• Liver/blood supply
• Liver Failure/etiology
• Liver Failure/surgery
• Liver Transplantation
• Male
• Middle Aged
• Salvage Therapy/methods
• Treatment Failure

This study was performed to analyze the long-term follow-up safety and efficacy of transcatheter dense coil embolization for splenic artery aneurysms.

Thirty-two patients (18 women, 14 men; age range, 23–56 years; mean age, 43.1 ± 13.6 years) who underwent dense coil embolization for treatment of splenic artery aneurysms from August 2010 to January 2018 were retrospectively reviewed. The size and location of the splenic artery aneurysms, the technical and clinical outcomes of the procedure, and the complications related to the procedure were reviewed.

The technical success rate of embolization was 100% (mean aneurysm size, 29.4 ± 6.9 mm; range, 20–43 mm). Two (6.3%) patients underwent a successful repeat intervention procedure for recurrent aneurysm perfusion during follow-up (mean, 36 months; range, 6–72 months). No aneurysm ruptured during follow-up. Splenic infarction was observed in 8 of 32 (25%) patients. No patients developed major adverse events related to the procedure, such as splenic abscess or pancreatitis.

Percutaneous elective transcatheter dense coil embolization is safe and effective to prevent aneurysm rupture and overcome aneurysm recanalization during long-term follow-up.

• Transcatheter
• coil embolization
• efficacy
• long-term follow-up
• safety
• splenic artery aneurysms

Here we describe a hybrid procedure, that is, a combination of open isolation and coil embolization, to treat a saccular middle colic artery aneurysm deep behind the pancreas. The middle colic artery provided the collateral blood flow necessary to bypass a chronic segmental aortic occlusion. For preservation of the collateral vessels, we surgically excluded and bypassed the aneurysm and then performed endovascular embolization of the pancreaticoduodenal arteries flowing into the aneurysm, resulting in complete isolation of the aneurysm without jeopardizing blood flow. This hybrid procedure for visceral artery aneurysms can be effective when the collateral vessels need to be preserved.

• Aortic occlusion
• Open and endovascular repair
• Visceral artery aneurysm

• Celiac artery aneurysm
• Endovascular embolization
• Visceral artery aneurysm

• abdominal viscera blood supply
• aneurysm rupture
• endovascular surgery
• minimally invasive surgery
• visceral artery aneurysms and pseudoaneurysms

Visceral artery aneurysms (VAA) are rare vascular lesions. Clinically silent VAA are increasingly detected by cross-sectional imaging but some lesions are at risk for rupture with severe bleeding. The aim of the present study was to evaluate the trends in the interdisciplinary management at a tertiary center.

Patients who underwent treatment for VAA at University Hospital of Bonn between 2005 and 2018 were enrolled in this retrospective study. Demographic, clinical, VAA-specific data as well as information on therapy, early and long-term outcome were collected and statistically analyzed.

Forty-two consecutive patients, 19 females and 23 males with a median age of 59 years (range 30–91 years), were diagnosed with 56 VAA. The majority were true aneurysms (N = 32; 57%), whereas 43% (N = 24) were pseudoaneurysms. The most common localization was the splenic artery (N = 18; 32%) and the average diameter was 3 cm (range 1–5 cm). Twenty-five patients (59.5%) had VAA-related symptoms such as chronic abdominal pain and hemorrhage at primary diagnosis, while the diagnosis was incidental in 17 patients (40.5%). Eleven patients (26%) underwent open surgery whereas 29 patients (69%) received an endovascular treatment. Patients with pseudoaneurysms were significantly older (P = 0.003), suffered more often from associated symptoms (P < 0.001) and required more emergency interventions (P < 0.0001) compared to those with true VAA. In the last years, the number and proportion of true VAA increased significantly (P < 0.001) while a significantly larger proportion could be managed interventionally (P = 0.017).

VAA are increasingly detected on imaging with lesions presenting very heterogeneously. Due to the risk of lethal rupture and in the absence of reliable prognostic markers, all the patients with VAA should be offered definite treatment. Localization, anatomy and the end-organ perfusion after intervention or operation are the most important aspects to consider when planning a treatment for VAA. For this reason, a multidisciplinary evaluation of every individual patient is necessary for an optimized outcome.

• Emergency bleeding
• Hemorrhage
• Interventional radiology
• Open surgery
• Visceral artery aneurysms

• Aneurysm, Ruptured/diagnostic imaging
• Aneurysm, Ruptured/physiopathology
• Aneurysm, Ruptured/therapy
• Computed Tomography Angiography
• Embolization, Therapeutic/instrumentation
• Endovascular Procedures/instrumentation
• Hemodynamics
• Humans
• Male
• Mesenteric Arteries/diagnostic imaging
• Mesenteric Arteries/physiopathology
• Middle Aged
• Splanchnic Circulation
• Treatment Outcome

A jejunal artery aneurysm (JAA) is rare and has few specific symptoms. Endovascular repair is widely used in the treatment of jejunal artery aneurysms; however, some patients still require open repair.

A 59 year old man underwent open surgery with resection of the aneurysm and reconstruction using a saphenous vein graft. Histopathological examination revealed heterotopic pancreas around the aneurysm.

Inflammation as a result of heterotopic pancreas was suspected as the cause of JAA. The advantage of open repair is to explore intestinal ischaemia directly. Furthermore, revascularisation with a saphenous vein graft may remove the possibility of post-operative intestinal ischaemia.

•

A report of an atypical proximal jejunal artery aneurysm caused by inflammatory change resulting from heterotopic pancreas.

• Heterotopic pancreas
• Jejunal artery aneurysm
• Open repair
• Saphenous vein graft
• Visceral artery aneurysm

• Splenic artery aneurysms
• laparoscopic aneurysectomy
• laparoscopic aneurysm excision
• laparoscopic aneurysm ligation