AI Article Synopsis
- Pseudoaneurysms linked to pancreatitis are rare and can lead to high mortality rates; this study examines treatment outcomes for these cases.
- Nineteen pseudoaneurysms in 13 patients were analyzed, with a high initial success rate of 82% for coil embolization, though some patients experienced recurrence and complications.
- The study concludes that endovascular embolization is an effective first-line treatment, while the effectiveness of percutaneous thrombin injection remains unclear.
Article Abstract
Context: Pseudoaneurysms associated with pancreatitis are rare, and bleeding pseudoaneurysms are associated with a high mortality.
Objective: The aim of this study was to report the outcomes of endovascular and percutaneous therapy in the management of pseudoaneurysms secondary to pancreatitis.
Patients: Patients who underwent angiography for pseudoaneurysms associated with pancreatitis from 2005 to 2011 were identified from the angiography database.
Main Outcome Measures: Patient demographics, clinical presentation, radiological findings, treatment, and outcomes were retrospectively reviewed.
Results: Nineteen pseudoaneurysms associated with pancreatitis in 13 patients were identified. The diagnosis of a pseudoaneurysm was made by computerised tomography angiography in seven patients, followed by portal venous phase contrast enhanced CT (n=4), duplex ultrasound (n=1) and angiography (n=1). At angiography, coil embolisation was attempted in 11 patients with an initial success rate of 82% (n=9). One patient underwent successful embolisation with percutaneous thrombin injection. The recurrence rate following initial successful embolisation was 11% (n=1). There were no episodes of re-bleeding following embolisation but re-bleeding following thrombin injection was observed in one case. The morbidity and mortality rate in the 12 patients that were successfully treated was 25% (n=3) and 8% (n=1), respectively. All 12 patients that were successfully treated demonstrated radiological resolution of their pseudoaneurysms, with a median follow-up of 20 months.
Conclusion: Endovascular embolisation is a suitable first-line management strategy associated with low recurrence rates. The role of percutaneous thrombin injection is yet to be defined.
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| http://dx.doi.org/10.6092/1590-8577/1193 | DOI Listing |
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