title: Percutaneous glue embolization of a visceral artery pseudoaneurysm in a case of sickle cell anemia.
abstract: Although aneurysmal complications of sickle cell anemia have been described in the intracranial circulation, visceral artery pseudoaneurysms in this disease entity have not previously been reported in the literature. Conventional treatment of visceral pseudoaneurysms has been surgical ligation or resection of the aneurysm. Transcatheter embolization has emerged as an attractive, minimally invasive alternative to surgery in the treatment of these lesions. In certain situations, however, due to the unfavorable angiographic anatomy precluding safe transcatheter embolization, direct percutaneous glue injection of the pseudoaneurysm sac may be considered to achieve successful occlusion of the sac. The procedure may be rendered safer by simultaneous balloon protection of the parent artery. We describe this novel treatment modality in a case of inferior pancreaticoduodenal artery pseudoaneurysm in a patient with sickle cell anemia. Although a complication in the form of glue reflux into the parent vessel occurred that necessitated surgery, this treatment modality may be used in very selected cases (where conventional endovascular embolization techniques are not applicable) after careful selection of the balloon diameter and appropriate concentration of the glue-lipiodol mixture.
authors.affiliation: Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. em_gulati@hotmail.com
authors.forename: Gurpreet S
authors.initials: GS
authors.lastname: Gulati
authors.forename: Manpreet S
authors.initials: MS
authors.lastname: Gulati
authors.forename: Govind
authors.initials: G
authors.lastname: Makharia
authors.forename: Pradeep
authors.initials: P
authors.lastname: Hatimota
authors.forename: Nripen
authors.initials: N
authors.lastname: Saikia
authors.forename: Shashi B
authors.initials: SB
authors.lastname: Paul
authors.forename: Subrat
authors.initials: S
authors.lastname: Acharya
mesh_terms: D000269:Adhesives; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014781:Viscera / Q000098:blood supply*
chemical_list: D000269:Adhesives