search for




 

Successful treatment of visceral pseudoaneurysm after pancreatectomy using flow-diverting stent device
Ann Hepatobiliary Pancreat Surg 2020 Feb;24(1):114-8
Published online February 29, 2020;  https://doi.org/10.14701/ahbps.2020.24.1.114
Copyright © 2020 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Emmanouil Giorgakis1,2, Brian Chong3, Rahmi Oklu4, Dawn E. Jaroszewski5, Grace Knuttinen4, and Amit K. Mathur1

1Division of Transplantation and Hepatopancreatobiliary Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ, 2Department of Solid Organ Transplantation, University of Arkansas for Medical Sciences, Little Rock, AR, 3Division of Neuroradiology, Department of Radiology, Mayo Clinic, 4Department of Interventional Radiology, Mayo Clinic, 5Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ, USA
Received September 8, 2019; Revised December 27, 2019; Accepted January 19, 2020.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 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 Pipeline™ 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.
Keywords : Gastroepiploic artery pseudoaneurysm; Flow diverter therapy; Endovascular repair visceral aneurysm; Post-pancreatectomy pseudoaneurysm