title: Transcatheter microcoil embolotherapy for ruptured pseudoaneurysm following pancreatic and biliary surgery.
abstract: OBJECTIVE
  To evaluate the outcome of transcatheter microcoil embolotherapy for bleeding pseudoaneurysms complicating major pancreatic and biliary surgery.
  
  
  METHODS
  Over an 8-year period, 8 patients were encountered who developed massive bleeding from pseudoaneurysms 15-64 days (mean 31 days) following major pancreatic and biliary surgery. Urgent transcatheter microcoil embolotherapy was performed in all 8 patients.
  
  
  RESULTS
  Transcatheter embolotherapy was successful in 7 of 8 patients (88%) but failed in one due to development of disseminated intravascular coagulation. One patient developed recurrent bleeding 36 days after the first embolotherapy from a newly developed pseudoaneurysm, which was again treated successfully with embolization. Two patients subsequently underwent additional surgery for residual pathology. Three of the 7 patients with successful embolotherapy were alive at 10-96 months, 4 patients died of associated malignancies 4-20 months after embolotherapy.
  
  
  CONCLUSIONS
  Transcatheter microcoil embolotherapy is effective for bleeding pseudoaneurysms complicating pancreatic and biliary surgery, and should be considered the first treatment of choice.
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Shogoin, Sakyoku, Kyoto, 606-8507, Japan. ksj@kuhp.kyoto-u.ac.jp
authors.forename: Toshiya
authors.initials: T
authors.lastname: Shibata
authors.forename: Tadashi
authors.initials: T
authors.lastname: Sagoh
authors.forename: Fumie
authors.initials: F
authors.lastname: Ametani
authors.forename: Yoji
authors.initials: Y
authors.lastname: Maetani
authors.forename: Kyo
authors.initials: K
authors.lastname: Itoh
authors.forename: Junji
authors.initials: J
authors.lastname: Konishi
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000628:therapy*; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging* / Q000628:therapy*; D001662:Biliary Tract Surgical Procedures; D004067:Digestive System Neoplasms / Q000601:surgery*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging* / Q000628:therapy*; D011859:Radiography