Endovascular Occlusion of Giant Posttraumatic Pseudo-Aneurysm of Superior Mesenteric Artery Connected to Mesenteric Arteriovenous Fistula
| Autor: | V.E. Ryabukhin, R.Sh. Muslimov, T.E. Kim, I.E. Selina, K.R. Dzhagraev, A.B. Klimov, V.A. Moskalenko, V.P. Kiryushchenkov, L. S. Kokov |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Gastrointestinal bleeding medicine.medical_specialty Amplatzer Vascular Plug II occluder Esophageal and Gastric Varices General Biochemistry Genetics and Molecular Biology giant pseudo-aneurysm of superior mesenteric artery Aneurysm Esophageal varices Mesenteric Artery Superior medicine.artery medicine Humans Superior mesenteric artery cardiovascular diseases Superior mesenteric vein Stab wound traumatic mesenteric arteriovenous fistula medicine.diagnostic_test business.industry Clinical Supplements General Medicine medicine.disease Surgery endovascular occlusion of mesenteric arteriovenous fistula Angiography Arteriovenous Fistula Portal hypertension business Gastrointestinal Hemorrhage |
| Zdroj: | Modern Technologies in Medicine |
| ISSN: | 2309-995X 2076-4243 |
| Popis: | The aim of the study was to show the capabilities of endovascular occlusion of giant posttraumatic pseudo-aneurysm of superior mesenteric artery (SMA) connected to a mesenteric arteriovenous fistula (AVF) under the conditions of portal hypertension and life-threatening esophageal variceal bleeding. Materials and Methods. A 27-old male patient underwent endovascular occlusion; the patient being hospitalized with a clinical picture of gastrointestinal bleeding. The examinations: ultrasound, esophagogastroduodenoscopy, multispiral computed tomography with angiography — revealed the source of bleeding to be esophageal varices against the background of portal hypertension caused by massive arteriovenous shunt, its source being AVF with an aneurysmal component (32×35 mm in size) between SMA and superior mesenteric vein (SMV) dilated up to 50 mm in diameter. Patient’s past medical history recorded that 4.5 years ago the patient had undergone the resection of a small intestine area due to a penetrating stab wound in the abdominal cavity. Taking into consideration an extremely high operative intervention risk due to the condition severity related to blood loss, portal hypertension, and ascites, it was decided to embolize AVF with a vascular occluder — Amplatzer Vascular Plug II (USA), 14×10 mm in size. Results. A unique endovascular intervention — transcatheter occlusion of pseudo-aneurysm and AVF separation — was performed in life-threatening esophageal variceal bleeding under the condition of a giant post-traumatic aneurysm of SMA and mesenteric AVF. Due to an extremely large-sized SMV and an arterial pseudo-aneurysm, first ever we used the technique applied for transcatheter occlusion of a cardiac septum defect. Occluder implantation enabled to completely close the communication of aneurysmatic AVF with SMV, and occlude the aneurysm cavity. During an immediate postoperative period portal hypertension was arrested. No recurrent bleedings occurred within 4 postoperative months. |
| Databáze: | OpenAIRE |
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