Endovascular management of superior mesenteric artery pseudoaneurysm and fistula.
The uncommon presentation of an arterioportal fistula (APF) involving the superior mesenteric artery (SMA) associated with a pseudoaneurysm represents a therapeutic challenge. We present the case of a 24-year-old female admitted to the hospital after multiple gunshot wounds to the abdomen; the patient underwent multiple surgeries and, in the process, developed a SMA pseudoaneurysm and fistula. The vascular interventional radiology team was consulted for treatment of the pseudoaneurysm and fistula. A covered stent was inserted percutaneously to exclude the APF and the pseudoaneurysm in a single procedure. The patient returned to our service after 21 months for a follow-up CT scan, which demonstrated the stent and the distal vasculature to be patent.
Narayanan
Govindarajan
G
Department of Radiology, University of Miami/Jackson Memorial Hospital, 1611 NW 12th Avenue, Room WW 279, Miami, FL 33136, USA. gnarayanan@med.miami.edu
Mohin
Geetika
G
Barbery
Katuska
K
Lamus
Daniel
D
Nanavati
Kunal
K
Yrizarry
Jose M
JM
D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy*; D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D017538:Mesenteric Artery, Superior; D015641:Radiography, Interventional; D015607:Stents; D014057:Tomography, X-Ray Computed; D014654:Vascular Patency; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000628:therapy*