Endovascular exclusion of superior mesenteric artery pseudoaneurysms: an alternative to open laparotomy in high-risk patients.
Superior mesenteric artery (SMA) aneurysms are rare. However, patients are frequently symptomatic on presentation and require urgent repair. SMA aneurysms have the potential for severe complications, including thrombosis or rupture, resulting in acute mesenteric ischemia and death. In patients with adhesions secondary to prior abdominal surgery, traditional open exposure of the aneurysm neck via dissection at the base of the transverse colon mesentery may be technically difficult. Endovascular exclusion of visceral artery aneurysms using covered stent grafts presents a reasonable alternative to the morbidity associated with laparotomy. We report an interesting case of a patient with a large SMA aneurysm and multiple prior laparotomies treated percutaneously with a combined expanded polytetrafluoroethylene/nitinol self-expanding stent-graft allowing maintenance of end-organ perfusion and bowel viability.
Jimenez
Juan Carlos
JC
Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine, UCLA Center for Health Sciences, Los Angeles, California 90095-6908, USA. jcjimene@gmail.com
Lawrence
Peter F
PF
Reil
Todd D
TD
D000497:Alloys; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D011859:Radiography; D018570:Risk Assessment; D015607:Stents; D000267:Tissue Adhesions / Q000209:etiology; D016896:Treatment Outcome
D000497:Alloys; C013616:nitinol; D011138:Polytetrafluoroethylene