Abstract:

Introduction: aneurysms of splenic arteries have a fairly high prevalence in relation to the total number of all visceral aneurysms. According to modern clinical guidelines, both symptomatic and asymptomatic aneurysms are subject to treatment. Recently, the priority direction in treatment of visceral aneurysms is endovascular surgery, which is characterized by minimal invasiveness and high efficiency, which makes it possible to consider transcatheter endovascular embolization of splenic artery aneurysms as the preferred method of treatment.

Aim: was to estimate the role and possibilities of endovascular methods of treatment in a patient with a false aneurysm of splenic artery (ASA) formed after pancreatic necrosis and complicated by gastrointestinal bleeding.

Materials and methods: a case report of transcatheter embolization of splenic artery aneurysm using the «front-to-back-door» technique using coils and telescopic system, is presented.

Results: patient was discharged on the 3rd day after embolization. The postoperative period proceeded calmly, there was no abdominal pain, indicators of clinical and biochemical blood tests were within acceptable limits.

Conclusions: studies devoted to treatment of giant aneurysms of splenic artery are not described in the modern literature, there are only few reports. Treatment of this type of ASA can lead to an increase in the cost of procedure, but minimal invasiveness, technical success, almost no deaths and early activation of patients make it possible to consider transcatheter endovascular embolization as the only possible method of treatment.

References

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Abstract:

Traumatic lesions of peripheral arteries which lead to pseudoaneurysm formation is the rare pathology Originally surgical treatment was the main method of pseudoaneurysms' treatment. However, now endovascular procedures are preferable as a method such patients' treatment. The case of successful endovascular treatment of posttraumatic pseudoaneurysm of subclavian artery with stent-graft implantation is shown This clinical case report demonstrates main advantages of endovascular method of such location pseudoaneurysms treatment.

Abstract:

Article describes a rare clinical case: a successful endovascular haemostasis of splenic artery arrosive bleeding into pancreatic enteroanastomosis in early postoperative period in patient with chronic postnecrotic pancreatitis.

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Abstract:

Case report of successful endovascular treatment of pseudoaneurysm of common hepatic artery (patient underwent laparoscopic gastrectomy, cholecystectomy with lymph node dissection in treatment of gastric adenocarcinoma) is presented.

Materials and methods: patient E., 61 year. In anamnesis: ulcer disease for the period of 8 years. In 2013, gastric adenocarcinoma T4N0M0 had been revealed and in January 2014 patient underwent laparoscopic gastrectomy, cholecystectomy with lymph node dissection D2. Postoperative period was complicated by thrombosis of left branch of portal vein, external biliary fistula, left subdiaphragmatic abscess with further drainage. During CT-angiography - adenoma of left adrenal gland and aneurysm of proper hepatic artery were revealed. Selective angiography revealed aneurysm of common hepatic artery in middle third, sized 10x20 mm. Patient underwent double-staged treatment. Primary patient underwent embolization of aneurysm with Azur-18 coils, but aneurysm cavity had incomplete thrombosis. As a second stage patient underwent stent-graft implantation in hepatic artery.

Results: stent implantation was uncomplicated, aneurysm was excluded from blood flow. Patient was discharged in good condition, without any additional operation. Control angiography was performed in 3 months and thrombosis of stent with collateral blood flow were revealed. 

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