Pseudoaneurysm of the gastroduodenal artery pre- and post-coil embolization.

<p>(A) Pseudoaneurysm of the gastroduodenal artery visible on the contrast-enhanced CT (arrow). (B) Digital Subtraction Angiography (DSA) image showing vasospasm and thrombosis of the gastroduodenal artery with no active bleeding (arrow). (C) Post-embolisation DSA image showing successful coil embolisation of the gastroduodenal artery (arrow).</p

Pseudoaneursym of the common hepatic artery treated with coil and thrombin embolization.

<p>(A) Contrast-enhanced CT scan and (B) DSA image showing the pseudoaneursym arising from the distal common hepatic artery (arrow). (C) DSA image showing initial thrombin injection. (D) Persistent perfusion despite additional placement of coils. (E) Final DSA depicting procedural success after the deployment of an additional coil and thrombin.</p

Superior mesenteric artery pseudoaneurysm treated with stent graft implantation.

<p>(A) Contrast-enhanced CT scan showing the pseudoaneurysm arising from the SMA (arrow). (B) DSA showing pseudoaneurysm. (C) Final selective DSA confirming the exclusion of the pseudoaneurysm following stent graft implantation and post-dilation.</p

Arterial site of involvement, size of pseudoaneurysms, and treatment administered.

<p>Arterial site of involvement, size of pseudoaneurysms, and treatment administered.</p

Endovascular management of pancreatitis-related pseudoaneurysms: A review of techniques

<div><p>Objectives</p><p>To present the various techniques used in the management of pancreatitis-related pseudoaneurysms of visceral vessels.</p><p>Methods</p><p>The retrospective clinical study was carried out at the Department of Diagnostic and Interventional Radiology at Poznan University of Medical Sciences from 2011 to 2016. The fifteen patients included in the study were diagnosed with pseudoaneurysms of visceral arteries, as a complication of chronic pancreatitis. The diagnosis was made using contrast-enhanced computed tomography, followed by angiography. On admission, all patients were symptomatic, with varying degrees of abdominal pain. One patient was haemodynamically unstable. Treatments with endovascular techniques were analysed, along with their efficacy and outcomes. Coil embolisation was performed in 5 patients. Stent graft was used in 1 patient. Liquid embolic agents were used in 7 cases, of which 5 patients were treated with thrombin injection and 2 with Squid. A combination of techniques was used in 2 patients.</p><p>Results</p><p>The most common artery affected by pseudoaneurysm formation was the splenic artery (7/15; 46.7%), and the size of the pseudoaneurysms ranged from 27 mm to 85 mm. Primary technical success was achieved in 14 out of 15 patients (93.3%). One patient required reintervention. Two patients required splenectomy after embolisation due to splenic ischemia. No recanalisation was present at the follow-up computed tomography performed after 1 to 3 weeks, and no mortality was observed within 30 days.</p><p>Conclusion</p><p>Vascular complications of pancreatitis require accurate diagnosis and immediate treatment. Endovascular intervention is highly effective and is the preferred treatment option. The technique used is determined based on vascular anatomy and the patient’s haemodynamic status.</p></div

Pseudoaneursym of the common hepatic artery treated with coil and thrombin embolization.

<p>(A) Contrast-enhanced CT scan and (B) DSA image showing the pseudoaneursym arising from the distal common hepatic artery (arrow). (C) DSA image showing initial thrombin injection. (D) Persistent perfusion despite additional placement of coils. (E) Final DSA depicting procedural success after the deployment of an additional coil and thrombin.</p

Pseudoaneurysm of the common hepatic artery variant treated initially with coil embolisation followed by vascular plugs placement.

<p>(A) 3D Volume Rendering CT image showing a pseudoaneurysm (arrow) arising from the common hepatic artery (CHA). This anatomical variant shows the right hepatic artery (RHA) arising from the superior mesenteric artery (SMA). The common hepatic artery branches into the gastroduodenal artery (GDA) and left hepatic artery (LHA). Patent pancreaticoduodenal branches (PDB) are present connecting the SMA and the GDA. (B) DSA image showing ineffective coil embolisation of the pseudoaneurysm. (C) Final DSA depicting procedural success after the placement of two vascular plugs.</p