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Case Reports
. 2019 Nov 19;5(4):521-524.
doi: 10.1016/j.jvscit.2019.10.002. eCollection 2019 Dec.

Hybrid management approach for superior mesenteric artery and branch aneurysms

Christopher R Jacobs  1 , Jeffrey D Crawford  1 , Javairiah Fatima  1
Affiliations
Case Reports

Hybrid management approach for superior mesenteric artery and branch aneurysms

Christopher R Jacobs et al. J Vasc Surg Cases Innov Tech. .

Abstract

Visceral artery aneurysms are rare, with a 25% rupture risk and an associated 70% mortality. A 55-year-old woman with progressive epigastric pain was found to have multiple large superior mesenteric artery (SMA), branch, and gastroduodenal artery aneurysms along with an occluded celiac artery trunk with hepatic flow dependent on the aneurysm branch. Management included antegrade aortohepatic artery bypass with gastroduodenal artery ligation, followed by SMA stenting and aneurysm coiling. This case is novel, given the diffuse pattern and rarity of SMA and branch aneurysms. This hybrid surgical management highlights innovative strategies to minimize morbidity without compromising definitive treatment of complex visceral artery aneurysms.

Keywords: Hybrid; Superior mesenteric artery aneurysms; Visceral artery aneurysms (VAAs).

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Figures

Fig 1
Fig 1
Sagittal computed tomography angiography image of superior mesenteric artery (SMA) and SMA branch aneurysms.
Fig 2
Fig 2
Preoperative three-dimensional reconstruction of computed tomography angiography image of superior mesenteric artery (SMA) and SMA branch aneurysms.
Fig 3
Fig 3
Angiography of superior mesenteric artery (SMA) and SMA branch aneurysms.
Fig 4
Fig 4
Angiography after coil placement.
Fig 5
Fig 5
Computed tomography angiography demonstrating coiled aneurysms and patent aortohepatic bypass.
See this image and copyright information in PMC

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