Ann Hepatobiliary Pancreat Surg.  2020 Feb;24(1):114-118. 10.14701/ahbps.2020.24.1.114.

Successful treatment of visceral pseudoaneurysm after pancreatectomy using flow-diverting stent device

Affiliations
  • 1Division of Transplantation and Hepatopancreatobiliary Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ, USA. EGiorgakis@uams.edu
  • 2Department of Solid Organ Transplantation, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
  • 3Division of Neuroradiology, Department of Radiology, Mayo Clinic, Phoenix, AZ, USA.
  • 4Department of Interventional Radiology, Mayo Clinic, Phoenix, AZ, USA.
  • 5Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ, USA.

Abstract

Aim of the study is the description of the successful management of gastroepiploic artery pseudoaneurysm with preservation of parent vessels using flow-diversion technology. The present report describes the application of a flow-diversion Pipelineâ„¢ Flex device for occlusion of a sidewall bleeding pseudoaneurysm on a patient who was status-post sub-total pancreatectomy and remote esophagectomy with a gastric conduit. The pseudoaneurysm was on the solitary vessel supplying the patient's conduit. Use of flow diversion technology excluded the sidewall pseudoaneurysm while maintaining gastric conduit perfusion. In our case, the application of flow diversion technology allowed the preservation of patency of the main arterial supply to the gastric conduit on a post-esophagectomy patient; loss of the right gastroepiploic artery in that case would had been otherwise catastrophic. Flow-diversion technology can be considered for the treatment of pseudoaneurysms post-pancreatic resections, especially when there is no other surgical or endovascular treatment option.

Keyword

Gastroepiploic artery pseudoaneurysm; Flow diverter therapy; Endovascular repair visceral aneurysm; Post-pancreatectomy pseudoaneurysm

MeSH Terms

Aneurysm, False*
Esophagectomy
Gastroepiploic Artery
Hemorrhage
Humans
Pancreatectomy*
Parents
Perfusion
Stents*
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