Excluding Gastroduodenal Artery Pseudoaneurysm from Circulation with Stent-Graft
https://doi.org/10.24060/2076-3093-2019-9-2-106-112
Abstract
Introduction. Aneurysms of visceral arteries in the abdominal cavity are very rare. Often aneurysms of branches of the abdominal aorta are an incidental finding as patients seldom present obvious clinical signs or pathological changes in the organ supplied by the artery involved. The incidence of aneurysms of branches connecting the celiac trunk and the upper mesenteric artery amounts to 3.5% of all the cases of aneurysms of abdominal aorta arteries, mostly the gastroduodenal artery. This paper presents a case of minimally invasive treatment of gastroduodenal artery pseudoaneurysm at the BSMU Clinic.
Materials and methods. Patient K, a 47-year-old female, was admitted for emergency treatment at the Bashkir State Medical University Clinic in May 2019. The patient’s complaints included feeling weak, black stool for seven days prior, faintness and epigastric pain.
Results and discussions. Instrumental examination and angiography data demonstrated that the size of the pseudoaneurysm has increased 2.5 times and reached 65×45 mm; the clinical picture led to the conclusion that the aneurysm was ready to rupture and that there was an immediate need to stop the blood flow to the gastroduodenal artery pseudoaneurysm.
Conclusion. The range of currently available image-guided surgical procedures makes it possible to perform adequate embolization of pathological structures such as artery aneurysms.
About the Authors
V. V. PlechevRussian Federation
Plechev Vladimir Vyacheslavovich — Doctor of Medical Sciences, Professor, Head of the Department of Hospital Surgery
O. V. Galimov
Russian Federation
Galimov Oleg Vladimirovich — Doctor of Medical Sciences, Professor, Head of the Department of Surgical Diseases and New Technologies with the Course of Additional Professional Education
I. I. Galimov
Russian Federation
Galimov Ildar Iskandarovich — Candidate of Medical Science, Associate Professor of the Department of General Surgery with the course of Radiological diagnosis in the Institute of Additional Professional Education
A. R. Titov
Russian Federation
Titov Andrey Removich — Candidate of Medical Science, Head of the Surgery Department
V. Sh. Ishmetov
Russian Federation
Ishmetov Vladimir Shamilevich — Doctor of Medical Sciences, Professor at the Department of Hospital Surgery, Head of the Department of Endovascular Diagnostics and Treatment
A. F. Nagaev
Russian Federation
Nagaev Airat Filkhatovich — Radiologist
T. R. Ibragimov
Russian Federation
Ibragimov Teimur Ramiz ogly — X-ray Endovascular Diagnostics and Treatment Physician, Assistant lecturer at the Department of Surgical Diseases and New Technologies with the Course of Additional Professional Education
S. I. Blagodarov
Russian Federation
Blagodarov Sergey Igorevich — X-ray Endovascular Diagnostics and Treatment Physician
A. R. Gilemkhanov
Russian Federation
Gilemkhanov Albert Radikovich — X-ray Endovascular Diagnostics and Treatment Physician
R. E. Abdrakhmanov
Russian Federation
Abdrakhmanov Rustam Ernstovich — X-ray Endovascular Diagnostics and Treatment Physician
K. I. Zavialov
Russian Federation
Zavyalov Konstantin Igorevich — X-ray Endovascular Diagnostics and Treatment Physician
I. F. Sultanov
Russian Federation
Sultanov Ilgiz Fignerovich — Anesthesiologist
I. D. Utenskaya
Russian Federation
Utenskaya Irina Dmitrievna — Anesthesiologist
A. M. Akhmadullin
Russian Federation
Akhmadullin Artur Maratovich — Resident of the Department of Cardiovascular Surgery
References
1. Legkiy A.V., Maskin S.S., Ponomarev E.A., Ganichkin S.A., Mochailo YU.A. Endovascular treatment of a large aneurysm of the splenic artery using the Gianturco spirals. Angiology and vascular surgery. 2012;18(3):59–61 (In Russ.).
2. Kokov L.S., Tsygankov V.N., Shutikhina I.V., Zyatenkov A.V. Self-expanding stent-grafts implantation in treatment of splenic artery false aneurisms. Diagnostic and Interventional Radiology. 2013;7(1):75–81 (In Russ.).
3. Vereshchagin S.V., Ahmad M.M.D., Kucher V.N., Chubko V.I., Dzyuba D.A. First experience of endovascular treatment of posttraumatic false aneurysms of branches of aortic arch. Endovascular surgery. 2014;(2):64–70 (In Russ.).
4. Teixeira P.G., Thompson E., Wartman S., Woo K. Infective endocarditis associated superior mesenteric artery pseudoaneurysm. Ann Vasc Surg. 2014;28(6):1563.e1–5. DOI: 10.1016/j.avsg.2014.03.032
5. Galimov O.V., Plechev V.V., Ishmetov V.S., Abdrakhmanov R.E., Ibragimov T.R., Blagodarov S.I., Golemanov A.R. Possibilities of endovascular surgery in the treatment of visceral branches aneurysis. Vestnik of the Russian Scientific Center of Roentgenoradiology of the Ministry of Healthcare of the Russian Federation. 2017;17(2):7 (In Russ.).
6. Juntermanns B., Bernheim J., Karaindros K., Walensi M., Hoffmann J.N. Visceral artery aneurysms. Gefasschirurgie. 2018;23(Suppl 1):19–22. DOI: 10.1007/s00772-018-0384-x
7. Ferrara D., Giribono A.M., Viviani E., Padricelli A., Santagata A., Del Guercio L. Endovascular management of a large hepatic artery aneurysm. Clin Ter. 2017;168(3):e178–80. DOI: 10.7417/T.2017.2001
8. Nykonenko A.A. Features of localization and type of surgical treatment of aneurysms of unpaired visceral aortal branches. Zaporozhye medical journal. 2014;2 (83):29–31 (In Russ.).
9. Prozorov S.A., Belozerov G.E. A Current role of endovascular techniques in the diagnosis and treatment of patients with acute aortic pathology. Russian Sklifosovsky Journal “Emergency Medical Care”. 2013;(1):46–9 (In Russ.).
10. Troyan V.N., Riazanova A.N., Aleksakhina T.Y., Lubashev Y.A., Morozova N.P., Kryukov E.V., et al. Aneurysm of the common hepatic artery. Medical Visualization. 2018;22(6):76–81 (In Russ.). DOI: 10.24835/1607-0763-2018-6-76-81
11. Shevchenko Yu.L., Stoiko Yu.M., Bolomatov N.V., Batrashov V.A., Andreitsev I.L., Levchuk A.L., et al. Endovascular interventions in true and false aneurysms of hepatic, splenic and renal arteries. Angiology and vascular surgery. 2015;21(2):67–73 (In Russ.).
12. Govedarski V., Simeonov P., Hadzhiev E., Genadiev S., Zahariev T., Nachev G. Endovascular treatment of an aneurysm of the splenic artery. Khirurgiia (Sofiia). 2015;81(2):29–32. PMID: 26668987
13. Dohan A., Eveno C., Dautry R., Guerrache Y., Camus M., Boudiaf M., et al. Role and effectiveness of percutaneous arterial embolization in hemodynamically unstable patients with ruptured splanchnic artery pseudoaneurysms. Cardiovasc Intervent Radiol. 2015;38(4):862–70. DOI: 10.1007/s00270-014-1002-2
14. Kim J., Shin J.H., Yoon H.K., Ko G.Y., Gwon D.I., Kim E.Y., et al. Endovascular intervention for management of pancreatitis-related bleeding: a retrospective analysis of thirty-seven patients at a single institution. Diagn Interv Radiol. 2015;21(2):140–7. DOI: 10.5152/ dir.2014.14085
15. Hosn M.A., Xu J., Sharafuddin M., Corson J.D. Visceral artery aneurysms: decision making and treatment options in the new era of minimally invasive and endovascular surgery. Int J Angiol. 2019;28(1):11–6. DOI: 10.1055/s-0038-1676958
Review
For citations:
Plechev V.V., Galimov O.V., Galimov I.I., Titov A.R., Ishmetov V.Sh., Nagaev A.F., Ibragimov T.R., Blagodarov S.I., Gilemkhanov A.R., Abdrakhmanov R.E., Zavialov K.I., Sultanov I.F., Utenskaya I.D., Akhmadullin A.M. Excluding Gastroduodenal Artery Pseudoaneurysm from Circulation with Stent-Graft. Creative surgery and oncology. 2019;9(2):106-112. (In Russ.) https://doi.org/10.24060/2076-3093-2019-9-2-106-112