title: Endovascular treatment of superior mesenteric artery pseudoaneurysms using covered stents in six patients.
abstract: OBJECTIVE
  The objective of our study was to evaluate our experience with the use of endovascular treatments for superior mesenteric artery (SMA) pseudoaneurysms using covered stents.
  
  
  METHODS
  Between 2002 and 2011, six patients (mean age, 41.7 years; range, 23-65 years) with SMA pseudoaneurysms were treated percutaneously with the placement of covered stents at our institution. The causes of SMA pseudoaneurysms were penetrating trauma (n = 2), blunt trauma (n = 1), and previous surgical procedures (n = 3). The mean diameter of the SMA pseudoaneurysms was 16 mm (range, 4-24 mm). Technical success and clinical success were retrospectively analyzed.
  
  
  RESULTS
  Immediate technical success, defined as exclusion of the pseudoaneurysm and lack of active extravasation, was achieved in all six patients. Secondary balloon angioplasty was needed in one patient with residual narrowing. There was a small dissection of the proximal SMA necessitating placement of a second bare stent across the dissection. A second covered stent (Fluency stent, 8 mm) was placed in the same patient because of recurrent bleeding due to a type II endoleak 5 days after the first covered stent had been placed. This patient had no subsequent episodes of bleeding or bowel ischemia. Follow-up CT in the remaining five patients (mean, 21 months; range, 1-58 months) confirmed stent patency and preserved distal arterial flow to the bowel without episodes of bleeding or bowel ischemia during follow-up (mean, 27 months; range, 11-58 months).
  
  
  CONCLUSIONS
  Percutaneous endovascular treatment using a covered stent may be a safe and feasible tool for SMA pseudoaneurysms.
authors: 1 All authors: Division of Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, 510 S Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110.
authors: Seung Kwon
authors: SK
authors: Kim
authors: Jessica
authors: J
authors: Lee
authors: James R
authors: JR
authors: Duncan
authors: Daniel D
authors: DD
authors: Picus
authors: Michael D
authors: MD
authors: Darcy
authors: Steven
authors: S
authors: Sauk
mesh_terms: D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000792:Angiography; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D017538:Mesenteric Artery, Superior; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: bleeding; endovascular intervention; stent placement; superior mesenteric artery; trauma