Ann Surg Treat Res.  2015 Sep;89(3):162-165. 10.4174/astr.2015.89.3.162.

Multiple visceral artery aneurysms managed by Yasargil aneurysm clips

• Hong IK
• Choi JH
• Chu YC
• Jeon YS
• Lee KY

• KMID: 2166954
• DOI: http://doi.org/10.4174/astr.2015.89.3.162

Abstract

Here, we present the case of a 37-year-old woman with multiple visceral artery aneurysms in the pancreaticoduodenal, inferior pancreatic and splenic arteries associated with celiac trunk stenosis. An aneurysmectomy and end-to-end anastomosis was performed for two adjacent aneurysms, while clipping with intracranial aneurysm clips were performed for the other three aneurysms. During 36-month follow-up, no recurrence or newly developed lesions were noted, and the celiac artery had been reconstituted spontaneously. We believe that using intracranial aneurysm clips in the treatment of visceral artery aneurysms is feasible and safe and can be considered when endovascular procedures are unlikely to be successful.

Keyword

Intracranial aneurysm; Mesenteric arteries; Surgical clip

MeSH Terms

Adult
Aneurysm*
Arteries*
Celiac Artery
Constriction, Pathologic
Endovascular Procedures
Female
Follow-Up Studies
Humans
Intracranial Aneurysm
Mesenteric Arteries
Recurrence
Splenic Artery
Surgical Instruments

Figure

• 

  Fig. 1 Superior mesenteric arteriography (A) and angiomesenteric CT (B) showing a total of five aneurysms (red arrows) indicated by a1 to a5. Note that the ostium of the celiac trunk is stenotic (green arrow).

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  Fig. 2 Operative view of a saccular aneurysm (a1) in the inferior pancreaticoduodenal artery, before (A) and after (B) application of the Yasargil clips (arrows). In the box, clips of various shapes are shown. D1, duodenal first portion; D2, duodenal second portion; D3, duodenal third portion; P, pancreas head.

• 

  Fig. 3 (A, B) Pathological examination of the resected aneurysm (a2). Fibrosis and myxoid degeneration of the arterial wall is shown, with irregular fibroplasia of intima and media (Elastic stain, ×100).

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  Fig. 4 The 36-month follow-up angiomesenteric CT showing no evidence of recurrence. Note that the pancreaticoduodenal arcade is well preserved (red arrow) and the celiac trunk is reconstituted (green arrow). The inferior pancreatic artery is not visualized.

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