Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2023; 20 (2): 89-202 ➤ Успешное хирургическое лечение аневризмы верхней брыжеечной артерии в сочетании с экстравазальной компрессией чревного ствола у пациентки с гематурией

Successful surgical treatment of an aneurysm of the superior mesenteric artery in combination with extravascular compression of the celiac trunk in a patient with hematuria

Authors: Arakelyan V.S.1, Bukatsello R.G.1,2, 2, Gamzaev N.R.1, Chernykh N.A.1, Kidakoev R.Z-G.1

Company:
1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
2 Sechenov First Moscow State Medical University, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2023-20-2-193-202

UDC: 616.136.46-007.64-089

Link: Clinical Physiology of Blood Circulaiton. 2023; 2 (20): 193-202

Quote as: Arakelyan V.S., Bukatsello R.G., Gamzaev N.R., Chernykh N.A., Kidakoev R.Z-G. Successful surgical treatment of an aneurysm of the superior mesenteric artery in combination with extravascular compression of the celiac trunk in a patient with hematuria. Clinical Physiology of Circulation. 2023; 20 (2): 193–202 (in Russ.). DOI: 10.24022/1814-6910-2023-20-2-193-202

Keywords:  superior mesenteric artery aneurysm celiac trunk stenosis Dunbar's syndrome celiac trunk compression syndrome mesenteric artery surgery hematuria

Received / Accepted:  23.05.2023 / 15.06.2023

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Abstract

Treatment of aneurysms of the superior mesenteric artery and its branches remains a serious problem for the surgical community. The review presents the tactical features of two main directions in the treatment of pathology of the arteries of the visceral basin: surgical and endovascular using both occlusive methods and various types of stents. The criteria that make it difficult to choose the preferred treatment option are: the size, type and localization of the aneurysm, the anatomy of the splanchnic arterial basin, the features of visceral hemodynamics and the severity of collateralization, anatomical proximity to the abdominal organs, and a number of others. Despite the continuous improvement of endovascular intervention methods and the positive results of this minimally invasive alternative treatment option for visceral aneurysms, there are cases in clinical practice when the intravascular method of “turning off” aneurysms turns out to be technically difficult or impossible and is associated with the risk of mesenteric ischemia. When choosing a correction option, a comprehensive assessment of the condition of all visceral arteries and the anatomy of the abdominal basin is crucial in some cases. The presented clinical case describes the experience of treating combined lesions of mesenteric arteries, which required the development of detailed stages and methods of surgical intervention to prevent possible ischemic and hemorrhagic complications.

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  3. Okubo R., Kikuchi S., Otani N., Tsutsui M., Kamiya H. Giant superior mesenteric artery aneurysm treated by endovascular treatment in a very elderly female. Vasc. Specialist Int. 2023; 39: 10. DOI: 10.5758/vsi.230020
  4. Barrionuevo P., Malas M.B., Nejim B., Haddad A., Morrow A., Ponce O. et al. A systematic review and meta-analysis of the management of visceral artery aneurysms. J. Vasc. Surg. 2019; 70 (5): 1694–99. DOI: 10.1016/j.jvs.2019.02.024
  5. Fatma Ben Saida, Bilel Derbel, Zied Daoud, Rim Miri, Jalel Ziadi, Raouf Denguir. A superior mesenteric artery aneurysm: about a case report. Sur. Cas. Stud. Op. Acc. J. 2022; 7 (1): 686–8. DOI: 10.32474/SCSOAJ.2022.07.000255
  6. Sahajwani S., Tolaymat B., Khalifeh A., Hosseini M., Santini-Dominguez R., Blitzer D. et al. Presentation and management of rare saccular superior mesenteric artery trunk and branch aneurysms. J. Vasc. Surg. Cases Innov. Tech. 2022; 8 (2): 281–6. DOI: 10.1016/j.jvscit.2020.07.011
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  8. Chaer R.A., Abularrage C.J., Coleman D.M., Eslami M.H., Kashyap V.S., Rockman C. et al. The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms. J. Vasc. Surg. 2020; 72 (1S): 3S–39S. DOI: 10.1016/j.jvs.2020.01.039
  9. Rebelo A., Ronellenfitsch U., Partsakhaschwilli J., Kleeff J., John E., Ukkat J. Endovascular and open repair of visceral aneurysms: A retrospective single-center analysis. Exp. Ther. Med. 2023; 25 (6): 252. DOI: 10.3892/etm.2023.11951
  10. Khairallah M.K., Morgan R.A., Das R. Technical considerations of endovascular management of true visceral artery aneurysms. CVIR Endovasc. 2023; 6: 31. DOI: 10.1186/s42155-023-00368-9
  11. Kok H.K., Asadi H., Sheehan M., Given M.F., Lee M.J. Systematic review and single-center experience for endovascular management of visceral and renal artery aneurysms. J. Vasc. Interv. Radiol. 2016; 27 (11): 1630–41. DOI: 10.1016/j.jvir.2016.07.030
  12. Marone E.M., Rinaldi L.F. Current debates in the management of visceral artery aneurysms: where the guidelines collide. J. Clin. Med. 2023; 12 (9): 3267. DOI: 10.3390/jcm12093267
  13. Ferrero E., Ferri M., Viazzo A., Robaldo A., Carbonatto P., Pecchio A. et al. Visceral artery aneurysms, an experience on 32 cases in a single center: treatment from surgery to multilayer stent. Ann. Vasc. Surg. 2011; 25 (7): 923–35. DOI: 10.1016/j.avsg.2011.04.006
  14. Cappucci M., Zarco F., Orgera G., López-Rueda A., Moreno J., Laurino F. et al. Tratamiento endovascular de aneurismas y pseudoaneurismas de arterias viscerales mediante stents recubiertos: análisis de resultados inmediatos y a largo plazo. Cir. Esp. 2017; 95: 283–92. DOI: 10.1016/j.ciresp.2017.04.011
  15. Ruffino M.A., Rabbia C.; Italian Cardiatis Registry Investigators Group. Endovascular repair of peripheral and visceral aneurysms with the Cardiatis multilayer flow modulator: one-year results from the Italian Multicenter Registry. J. Endovasc. Ther. 2012; 19 (5): 599–610. DOI: 10.1583/JEVT-12-3930MR2.1
  16. Yasumoto T., Osuga K., Yamamoto H., Ono Y., Masada M., Mikami K. et al. Long-term outcomes of coil packing for visceral aneurysms: correlation between packing density and incidence of coil compaction or recanalization. J. Vasc. Interv. Radiol. 2013; 24 (12): 1798–807. DOI: 10.1016/j.jvir.2013.04.030
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  20. Buck D.B., Curran T., McCallum J.C., Darling J., Mamtani R., van Herwaarden J.A. et al. Management and outcomes of isolated renal artery aneurysms in the endovascular era. J. Vasc. Surg. 2016; 63 (1): 77–81. DOI: 10.1016/j.jvs.2015.07.094
  21. Hogendoorn W., Lavida A., Hunink M.G., Moll F.L., Geroulakos G., Muhs B.E. et al. Open repair, endovascular repair, and conservative management of true splenic artery aneurysms. J. Vasc. Surg. 2014; 60 (6): 1667–76.e1. DOI: 10.1016/j.jvs.2014.08.067
  22. Song C., Dong J., Yu G., Zhou J., Xiang F., Pei Y. et al. Comparison of open surgery and endovascular procedures as a therapeutic choice for visceral artery aneurysms. Vascular. 2018; 26 (4): 387–92. DOI: 10.1177/1708538117744102
  23. Cochennec F., Riga C.V., Allaire E., Cheshire N.J., Hamady M., Jenkins M.P. et al. Contemporary management of splanchnic and renal artery aneurysms: results of endovascular compared with open surgery from two European Vascular Centers. Eur. J. Vasc. Endovasc. Surg. 2011; 42 (3): 340–6. DOI: 10.1016/j.ejvs.2011.04.033
  24. Tsilimparis N., Reeves J.G., Dayama A., Perez S.D., Debus E.S., Ricotta J.J. 2nd. Endovascular vs open repair of renal artery aneurysms: outcomes of repair and long-term renal function. J. Am. Coll. Surg. 2013; 217 (2): 263–9. DOI: 10.1016/j.jamcollsurg.2013.03.021
  25. Hosn M.A., Xu J., Sharafuddin M., Corson J.D. Visceral artery aneurysms: decision making and treatment options in the new era of minimally invasive and endovascular surgery. Int. J. Angiol. 2019; 28 (1): 11–6. DOI: 10.1055/s-0038-1676958
  26. Delis K.T., Gloviczki P., Altuwaijri M., McKusick M.A. Median arcuate ligament syndrome: open celiac artery reconstruction and ligament division after endovascular failure. J. Vasc. Surg. 2007; 46: 799–802. DOI: 10.1016/j.jvs.2007.05.049
  27. Hanaki T., Fukuta S., Okamoto M., Tsuda A., Yagyu T., Urushibara S. et al. Median arcuate ligament syndrome and aneurysm in the pancreaticoduodenal artery detected by retroperitoneal hemorrhage: a case report. Clin. Case Rep. 2018; 6 (8): 1496–500. DOI: 10.1002/ccr3.1643
  28. Xiao N., Ahuja A., Patel R., Desai S.S., Nemcek A. Jr., Resnick S. Median arcuate ligament compression associated with flow-related visceral aneurysms. J. Vasc. Interv. Radiol. 2023: S1051-0443(23)00260-9. DOI: 10.1016/j.jvir.2023.03.026
  29. Caruana G., Cannella R., Giambelluca D., Picone D., Re G.L., Grassedonio E. et al. Pancreaticoduodenal arteries aneurysms: evaluation of frequency and association with celiac artery stenosis due to compression by median arcuate ligament. EuroMediterranean Biomedical Journal. 2019; 14 (23): 101–6. DOI: 10.3269/1970-5492.2019.14.23
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About Authors

  • Valeriy S. Arakelyan, Dr. Med. Sci., Professor, Head of Department of Surgery of Arterial Pathology; ORCID
  • Roman G. Bukatsello, Cand. Med. Sci., Senior Researcher, Сardiovascular Surgeon; ORCID
  • Nazim R. Gamzaev, Cand. Med. Sci., Senior Researcher, Сardiovascular Surgeon; ORCID
  • Nikolay A. Chernykh, Postgraduate, Сardiovascular Surgeon; ORCID
  • Rustam Z.-G. Kidakoev, Postgraduate, Сardiovascular Surgeon; ORCID

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