Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 6/2019

Open Access 01-06-2019 | Case Report

Treatment of Visceral Transplant Pseudoaneurysms Using Physician-Modified Fenestrated Stent Grafts: Initial Experience

Authors: Sebastian Mafeld, Jennifer A. Logue, Steven Masson, Rohan Thakkar, Aimen Amer, Colin Wilson, Gorab Sen, Derek Manas, Steven White, Robin Williams

Published in: CardioVascular and Interventional Radiology | Issue 6/2019

Login to get access

Abstract

Pseudoaneurysms after visceral transplantation represent a significant risk to patients. We report the successful treatment of three transplant (pancreas, liver and kidney) artery anastomotic pseudoaneurysms using physician-modified fenestrated endovascular stent grafts. In all cases, surgical repair was considered high risk and would have compromised the arterial supply to the graft. The endovascular approach in all cases obviated the need for surgical intervention and maintained graft arterial supply.
Literature
1.
Lubezky N, Goykhman Y, Nakache R, Kessler A, Baruch R, Katz P, et al. Early and late presentations of graft arterial pseudoaneurysm following pancreatic transplantation. World J Surg. 2013;37(6):1430–7.CrossRefPubMed
2.
Goëau-Brissonnière O, Leport C, Bacourt F, Lebrault C, Comte R, Pechère JC. Prevention of vascular graft infection by rifampin bonding to a gelatin-sealed dacron graft. Ann Vasc Surg. 1991;5(5):408–12.CrossRefPubMed
3.
Marshall MM, Muiesan P, Srinivasan P, Kane PA, Rela M, Heaton ND, et al. Hepatic artery pseudoaneurysms following liver transplantation: incidence presenting features and management. Clin Radiol. 2001;56(7):579–87.CrossRefPubMed
4.
Khaja MS, Matsumoto AH, Saad WE. Vascular complications of transplantation: part 2: pancreatic transplants. Cardiovasc Interv Radiol. 2014;37(6):1415–9.CrossRef
5.
Dalla Valle R, Capocasale E, Mazzoni MP, Busi N, Piazza P, Benozzi L, et al. Embolization of a ruptured pseudoaneurysm with massive hemorrhage following pancreas transplantation: a case report. Transplant Proc. 2005;37(5):2275–7.CrossRefPubMed
6.
Madariaga J, Tzakis A, Zajko AB, Tzoracoleftherakis E, Tepetes K, Gordon R, et al. Hepatic artery pseudoaneurysm ligation after orthotopic liver transplantation—a report of 7 cases. Transplantation. 1992;54(5):824–8.CrossRefPubMedPubMedCentral
7.
Piardi T, Lhuaire M, Bruno O, Memeo R, Pessaux P, Kianmanesh R, et al. Vascular complications following liver transplantation: a literature review of advances in 2015. World J Hepatol. 2016;8(1):36.CrossRefPubMedPubMedCentral
8.
Ciancio G, Lo Monte A, Julian JF, Romano M, Miller J, Burke GW. Vascular complications following bladder drained, simultaneous pancreas-kidney transplantation: the University of Miami experience. Transpl Int Off J Eur Soc Organ Transplant. 2000;13(Suppl 1):S187–90.CrossRef
9.
Verni MP, Leone JP, DeRoover A. Pseudoaneurysm of the Y-graft/iliac artery anastomosis following pancreas transplantation: a case report and review of the literature. Clin Transplant. 2001;15(1):72–6.CrossRefPubMed
10.
Tzakis AG, Carroll PB, Gordon RD, Yokoyama I, Makowka L, Starzl TE. Arterial mycotic aneurysm and rupture. A potentially fatal complication of pancreas transplantation in diabetes mellitus. Arch Surg Chic Ill 1960. 1989;124(6):660–1.
11.
Fujita S, Fujikawa T, Mekeel KL, Foley DP, Kim RD, Howard RJ, et al. Successful endovascular treatment of a leaking pseudoaneurysm without graft loss after simultaneous pancreas and kidney transplantation. Transplantation. 2006;82(5):717–8.CrossRefPubMed
12.
Montenovo M, Vaidya S, Bakthavatsalam R, Halldorson J. Pseudoaneurysm after combined kidney/pancreas transplantation presenting with sentinel bleeding: a case report and review. Ann Transplant. 2014;4(19):317–9.
13.
Elias G, Rastellini C, Nsier H, Nazarey P, Brown M, Pahari M, et al. Successful long-term repair of hepatic artery pseudoaneurysm following liver transplantation with primary stent-grafting. Liver Transplant. 2007;13(9):1346–8.CrossRef
14.
Saad WEA, Dasgupta N, Lippert AJ, Turba UC, Davies MG, Kumer S, et al. Extrahepatic pseudoaneurysms and ruptures of the hepatic artery in liver transplant recipients: endovascular management and a new iatrogenic etiology. Cardiovasc Interv Radiol. 2013;36(1):118–27.CrossRef
15.
Muraoka N, Uematsu H, Kinoshita K, Takeda T, Morita N, Matsunami H, et al. Covered coronary stent graft in the treatment of hepatic artery pseudoaneurysm after liver transplantation. J Vasc Interv Radiol. 2005;16(2):300–2.CrossRefPubMed
16.
Maleux G, Pirenne J, Aerts R, Nevens F. Case report: hepatic artery pseudoaneurysm after liver transplantation: definitive treatment with a stent-graft after failed coil embolisation. Br J Radiol. 2005;78(929):453–6.CrossRefPubMed
17.
Tan M, Di Carlo A, Stein LA, Cantarovich M, Tchervenkov JI, Metrakos P. Pseudoaneurysm of the superior mesenteric artery after pancreas transplantation treated by endovascular stenting. Transplantation. 2001;72(2):336–8.CrossRefPubMed
18.
Banga NR, Kessel DO, Patel JV, White SA, Pollard SG, Prasad KR, et al. Endovascular management of arterial conduit pseudoaneurysm after liver transplantation: a report of two cases. Transplantation. 2005;79(12):1763–5.CrossRefPubMed
19.
Ricotta JJ II, Tsilimparis N. Surgeon-modified fenestrated–branched stent grafts to treat emergently ruptured and symptomatic complex aortic aneurysms in high-risk patients. J Vasc Surg. 2012;56(6):1535–42.CrossRefPubMed
20.
Morgan-Rowe L, Simring D, Raja J, Agu O, Richards T, Ivancev K. The use of an endovascular stent graft with ‘home-made’ fenestrations to treat an infected aortic endograft in an emergency setting: a short report. EJVES Extra. 2011;22(4):e34–6.CrossRef
21.
Cochennec F, Kobeiter H, Gohel M, Leopardi M, Raux M, Majewski M, et al. Early results of physician modified fenestrated stent grafts for the treatment of thoraco-abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2015;50(5):583–92.CrossRefPubMed
22.
Singh A, Mafeld S, Williams R, McCaslin J. Physician-modified fenestrated endografts for managing the ruptured or symptomatic aortic aneurysm: technique overview and clinical outcomes. Vasc Endovasc Surg. 2018;1:1538574418789023.
23.
Che H, Men C, Yang M, Zhang J, Chen P, Yong J. Endovascular repair of a transplant renal artery anastomotic pseudoaneurysm using the snorkel technique. J Vasc Surg. 2014;60(4):1052–5.CrossRefPubMed
24.
Sörelius K, Wanhainen A, Furebring M, Björck M, Gillgren P, Mani K, et al. Nationwide study of the treatment of mycotic abdominal aortic aneurysms comparing open and endovascular repair. Circulation. 2016;134(23):1822–32.CrossRefPubMed
25.
Lin C-H, Hsu R-B. Primary infected aortic aneurysm: clinical presentation, pathogen, and outcome. Acta Cardiol Sin. 2014;30(6):514–21.PubMedPubMedCentral
26.
Zavos G, Pappas P, Kakisis JD, Leonardou P, Manoli E, Bokos J, et al. Endovascular repair as first-choice treatment of iliac pseudoaneurysms following renal transplantation. Transplant Proc. 2005;37(10):4300–2.CrossRefPubMed
Metadata
Title
Treatment of Visceral Transplant Pseudoaneurysms Using Physician-Modified Fenestrated Stent Grafts: Initial Experience
Authors
Sebastian Mafeld
Jennifer A. Logue
Steven Masson
Rohan Thakkar
Aimen Amer
Colin Wilson
Gorab Sen
Derek Manas
Steven White
Robin Williams
Publication date
01-06-2019
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 6/2019
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-019-02168-y

Other articles of this Issue 6/2019

CardioVascular and Interventional Radiology 6/2019 Go to the issue

Clinical Investigation

Balloon-Occluded Transcatheter Arterial Chemoembolization (b-TACE) for Hepatocellular Carcinoma Performed with Polyethylene-Glycol Epirubicin-Loaded Drug-Eluting Embolics: Safety and Preliminary Results

Case Report

Combined Y-Shaped Covered Metallic Stents for Gastrobronchial Fistulas Involving the Right Intermediate Bronchus

Technical Note

Intratumoral Injection of Hypertonic Glucose in Treating Refractory Pneumothorax Caused by Microwave Ablation: a Preliminary Study

Editorial

Recycling in IR, What IR Specialists Can Do to Help

Clinical Investigation

Safety of Percutaneous Hepatic Perfusion with Melphalan in Patients with Unresectable Liver Metastases from Ocular Melanoma Using the Delcath Systems’ Second-Generation Hemofiltration System: A Prospective Non-randomized Phase II Trial

Clinical Investigation

Stent-Retriever Thrombectomy and Rescue Treatment of M1 Occlusions Due to Underlying Intracranial Atherosclerotic Stenosis: Cohort Analysis and Review of the Literature