Endovascular Embolization of Pseudoaneurysms Complicating Pancreatitis Using Microcoils: Case Series


Purpose: To determine whether endovascular embolization of pseudoaneurysms complicating pancreatitis with microcoils was associated with better therapeutic outcome. Materials and Method: The prospective clinical study was carried out in the Department of Interventional Radiology for a period of 2 years extending from May 2010 upto August 2012 on 16 male patients in the age group of about 30 - 55 years, with each one of them having vascular complications as a sequel to pancreatitis, after obtaining well informed written consent from each one of them. Results: The outcome of the procedure was judged by the following parametersa) Restoration of the blood pressure of the patient; b) Cessation of the hemetemesis and malena; c) Reduction in abdominal pain and discomfort and d) Overall improvement in the general condition of the patient. Each of the patients had been on follow up for at least 6 months, except 2 of them, with no new complaints in any of them. The procedure related mortality was none. Conclusion: Vascular complications of pancreatitis need immediate and accurate diagnosis and prompt treatment. Micro coil embolisation, is a minimally invasive technique which helps to exclude the pseudoaneurysm from the circulation and thus reduces the scope for massive life threatening internal hemorrhage, and is a better alternative to surgery.

Share and Cite:

K. Taori, J. Rathod, A. Disawal, R. Mundhada, A. Rewatkar, V. Bakare, P. Wavare and R. Puria, "Endovascular Embolization of Pseudoaneurysms Complicating Pancreatitis Using Microcoils: Case Series," Open Journal of Radiology, Vol. 3 No. 1, 2013, pp. 33-40. doi: 10.4236/ojrad.2013.31005.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] J. W. Burke, S. J. Erickson, C. D. Kellum, C. J. Tegtmeyer, B. R. J. Williamson and M. F. Hansen, “Pseudoaneurysms Complicating Pancreatitis: Detection with CT,” Radiology, Vol. 161, No. 2, 1986, pp. 447-450.
[2] R. T. Woodburne and L. L. Olsen, “The Arteries of the Pancreas,” The Anatomical Record, Vol. 111, No. 2, 1951, pp. 255-270. doi:10.1002/ar.1091110209
[3] L. B. Schwartz, E. T. Clark and B. L. Gewertz, “Anastomotic and Other Pseudoaneurysms,” In: R. B. Rutherford, Ed., Vascular Surgery, 5th Edition, Saunders, Philadelphia, 2000, pp. 752-763.
[4] P. J. Bromley, T. Clark, I. H. Weir and C. V. Zwirewich, “Radiologic Diagnosis and Management of Uterine Artery Pseudoaneurysm: Case Report,” Canadian Association of Radiologists Journal, Vol. 48, No. 2, 1997, pp. 119-122.
[5] V. G. McDermott, R. Shlansky-Goldberg and C. Cope, “Endovascular Management of Splenic Artery Aneurysms and Pseudoaneurysms,” CardioVascular and Interventional Radiology, Vol. 17, No. 4, 1994, pp. 179-184. doi:10.1007/BF00571531
[6] A. Ahmed, S. L. Samuels, E. B. Keeffe and R. C. Cheung, “Delayed Fatal Hemorrhage from Pseudoaneurysm of the Hepatic Artery after Percutaneous Liver Biopsy,” The American Journal of Gastroenterology, Vol. 96, No. 1, 2001, pp. 233-237. doi:10.1111/j.1572-0241.2001.03482.x
[7] L. La Perna, J. W. Olin, D. Goines, M. B. Childs and K. Ouriel, “Ultrasound-Guided Thrombin Injection for the Treatment of Postcatheterization Pseudoaneurysms,” Circulation, Vol. 102, No. 19, 2000, pp. 2391-2395. doi:10.1161/01.CIR.102.19.2391
[8] A. Okuno, M. Miyazaki, H. Ito, et al., “Nonsurgical Management of Ruptured Pseudoaneurysm in Patients with Hepatobiliary Pancreatic Diseases,” The American Journal of Gastroenterology, Vol. 96, No. 4, 2001, pp. 1067-1071 doi:10.1111/j.1572-0241.2001.03691.x
[9] R. Guillon, J. M. Gracier, A. Abergel, et al., “Management of Splenic Artery Aneurysms and False Aneurysms with Endovascular Treatment in 12 Patients,” CardioVascular and Interventional Radiology, Vol. 26, No. 3, 2003, pp. 256-260 doi:10.1007/s00270-003-1948-y
[10] K. Yamakado, A. Nakatsuka, N. Tanaka, K. Takano, K. Matsumura and K. Takeda, “Transcatheter Arterial Embolization of Ruptured Pseudoaneurysms with Microcoils and n-Butyl Cyanoacrylate,” Journal of Vascular and Interventional Radiology, Vol. 11, No. 1, 2000, pp. 66-72. doi:10.1016/S1051-0443(07)61284-6
[11] J. F. Polak, “The Peripheral Arteries,” In: C. M. Rumack, S. R. Wilson and J. W. Charboneau, Eds. Diagnostic Ultrasound, 2nd Edition, Mosby, St. Louis, 1998, pp. 921-941.
[12] J. A. Soto, F. Munera, C. Morales, et al., “Focal Arterial Injuries of the Proximal Extremities: Helical CT Arteriography as the Initial Method of Diagnosis,” Radiology, Vol. 218, No. 1, 2001, pp. 188-194.
[13] A. E. Zimon, J. K. Hwang, D. L. Principe and R. O. Bahado-Singh, “Pseudoaneurysm of the Uterine Artery,” Obstetrics & Gynecology, Vol. 94, No. 5, 1999, pp. 827-830. doi:10.1016/S0029-7844(99)00229-X
[14] J. D. Crossin, D. Muradali and S. R. Wilson, “US of Liver Transplants: Normal and Abnormal,” RadioGraphics, Vol. 23, No. 5, 2003, pp. 1093-1114. doi:10.1148/rg.235035031
[15] J. H. Kwon and G. S. Kim, “Obstetric Iatrogenic Arterial Injuries of the Uterus: Diagnosis with US and Treatment with Transcatheter Arterial Embolization,” RadioGraphics, Vol. 22, No. 1, 2002, pp. 35-46.
[16] K. Kruger, M. Zahringer, F. D. Sohngen, et al., “Femoral Pseudoaneurysms: Management with Percutaneous Throm bin Injections—Success Rates and Effects on Systemic Coagulation,” Radiology, Vol. 226, No. 2, 2003, pp. 452-458. doi:10.1148/radiol.2262012107
[17] G. Brancatelli, S. Katyal, M. P. Federle and P. Fontes, “Three-Dimensional Multislice Helical Computed Tomography with the Volume Rendering Technique in the Detection of Vascular Complications after Liver Transplantation,” Transplantation, Vol. 73, No. 2, 2002, pp. 237-242. doi:10.1097/00007890-200201270-00015
[18] D. J. Tessier, W. M. Stone, R. J. Fowl, et al., “Clinical Features and Management of Splenic Artery Pseudoaneurysm: Case Series and Cumulative Review of Literature,” Journal of Vascular Surgery, Vol. 38, No. 5, 2003, pp. 969-974. doi:10.1016/S0741-5214(03)00710-9
[19] D. S. Katz and M. Hon, “CT Angiography of the Lower Extremities and Aortoiliac System with a Multi-Detector Row Helical CT Scanner: Promise of New Opportunities Fulfilled,” Radiology, Vol. 221, No. 1, 2001, pp. 7-10. doi:10.1148/radiol.2211011087
[20] S. Katyal, J. H. Oliver 3rd, D. G. Buck and M. P. Federle, “Detection of Vascular Complications after Liver Transplantation: Early Experience in Multislice CT Angiography with Volume Rendering,” American Journal of Roentgenology, Vol. 175, No. 6, 2000, pp. 1735-1739.
[21] B. L. Knisely, L. A. Mastey, J. Collins and J. E. Kuhlman, “Imaging of Cardiac Transplantation Complications,” RadioGraphics, Vol. 19, No. 2, 1999, pp. 321-341.
[22] F. Munera, J. A. Soto, D. Palacio, S. M. Velez and E. Medina, “Diagnosis of Arterial Injuries Caused by Penetrating Trauma to the Neck: Comparison of Helical CT Angiography and Conventional Angiography,” Radiology, Vol. 216, No. 2, 2000, pp. 356-362.
[23] J. F. Glockner, “Three-Dimensional Gadolinium-Enhanced MR Angiography: Applications for Abdominal Imaging,” RadioGraphics, Vol. 21, No. 2, 2001, pp. 357-370.
[24] M. V. Nastri, L. P. Baptista, R. H. Baroni, et al., “Gadolinium-Enhanced Three-Dimensional MR Angiography of Takayasu Arteritis,” RadioGraphics, Vol. 24, No. 3, 2004, pp. 773-786. doi:10.1148/rg.243035096
[25] A. R. Busquets, J. A. Acosta, E. Colon, K. V. Alejandro and P. Rodriguez, “Helical Computed Tomographic Angiography for the Diagnosis of Traumatic Arterial Injuries of the Extremities,” The Journal of Trauma, Vol. 56, No. 3, 2004, pp. 625-628. doi:10.1097/01.TA.0000053546.28739.CF
[26] M. A. Arata and C. Cope, “Principles Used in the Management of Visceral Aneurysms,” Techniques in Vascular and Interventional Radiology, Vol. 3, No. 3, 2000, pp. 124-129. doi:10.1053/tvir.2000.9147
[27] C. Thalhammer, A. S. Kirchherr, F. Uhlich, J. Waigand and C. M. Gross, “Postcatheterization Pseudoaneurysm and Arteriovenous ?stulas: Repair with Percutaneous Implantation of Endovascular Covered Stents,” Radiology, Vol. 214, No. 1, 2000, pp. 127-131.
[28] H. Bergert, I. Hinterseher, S. Kersting, J. Leonhardt, A. Bloomenthal and H. D. Saeger, “Management and Outcome of Hemorrhage Due to Arterial Pseudoaneurysms in Pancreatitis,” Surgery, Vol. 137, No. 3, 2005, pp. 323-328. doi:10.1016/j.surg.2004.10.009
[29] R. Morgan and A. Belli, “Current Treatment Methods for Postcatheterization Pseudoaneurysms,” Journal of Vascular and Interventional Radiology, Vol. 14, No. 6, 2003, pp. 697-710. doi:10.1097/01.RVI.0000071089.76348.6A
[30] C. D. Long, K. R. Bakshi, M. B. Kahn and A. B. Roberts, “Giant Splenic Artery Aneurysm,” Annals of Vascular Surgery, Vol. 7, No. 5, 1993, pp. 474-478. doi:10.1007/BF02002133

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.