ARTERIOGRAPHIC EMBOLIZATION OF VISCERAL ARTERY PSEUDOANEURYSMS

The purpose of this study was to determine the safety and efficacy of transcatheter embolization in the management of bleeding visceral arte ry pseudoaneurysms. Eight patients (four women and four men) whose mea n age was 61.0 years (range 44 to 77 years) underwent emergency transc atheter embolization for acute hemorrhage from a visceral artery pseud oaneurysm. Arteriographic technique was used to localize and selective ly embolize these seven visceral artery pseudoaneurysms (three inferio r pancreaticoduodenal, one gastroduodenal, two hepatic, and one spleni c) by means of intravascular steel coils. Arteriography demonstrated v isceral artery pseudoaneurysms in all eight patients. Acute hemorrhage was documented by endoscopy, falling hematocrit levels, CT scans, and arteriography. Successful embolization of these visceral artery pseud oaneurysms was achieved in seven (88%) of eight patients. In one patie nt embolization was not attempted because of a worsening clinical stat us, and this patient subsequently underwent emergency surgical resecti on. There was no significant morbidity associated with the procedures and seven patients remain asymptomatic with no further bleeding at a m ean follow-up of 21.1 months (range 11 to 46 months). Arteriographic e mbolization of visceral artery pseudoaneurysms is a safe and highly su ccessful technique for the effective identification and treatment of h emorrhage even in critically ill patients.