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Semin intervent Radiol 2023; 40(03): 283-285
DOI: 10.1055/s-0043-1769763
Review Article

Persistent Bleeding after Coil Embolization of a Pancreatic Transplant Pseudoaneurysm: Should Covered Stents Be the Primary Management?

Keshav Anand
1   Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah
,
Ziga Cizman
1   Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah
,
Tyler Smith
1   Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah
,
David Strain
1   Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah
,
Suraj Patel
1   Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah
,
Jeffrey Campsen
2   Division of Transplant and Hepatobiliary Surgery, University of Utah School of Medicine, Salt Lake City, Utah
,
Talia Baker
2   Division of Transplant and Hepatobiliary Surgery, University of Utah School of Medicine, Salt Lake City, Utah
,
Wael Saad
1   Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah
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Abstract

Life-threatening arterial complications after pancreatic transplantation can be dire. Pseudoaneurysms can be challenging to treat. There are multiple strategies to treat such complications. We present a case of pancreatic pseudoaneurysm which was initially treated by coiling followed by subsequent covered stent placement for a more durable outcome. We advocate for a “stent first” approach to these lesions if feasible.

Keywords

pancreatic transplant - pseudoaneurysm - stent graft


Publication History

Article published online:
20 July 2023

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Tobben PJ, Zajko AB, Sumkin JH. et al. Pseudoaneurysms complicating organ transplantation: roles of CT, duplex sonography, and angiography. Radiology 1988; 169 (01) 65-70
    CrossrefPubMedGoogle Scholar
  • 2 Gruessner AC, Gruessner RWG. Pancreas transplant outcomes for United States and non United States cases as reported to the United Network for Organ Sharing and the International Pancreas Transplant Registry as of December 2011. Clin Transpl 2012; 23-40
    PubMedGoogle Scholar
  • 3 Saad WEA, Darwish WE, Turba UC. et al. Endovascular management of vascular complications in pancreatic transplants. Vasc Endovascular Surg 2012; 46 (03) 262-268
    CrossrefPubMedGoogle Scholar
  • 4 Surowiecka-Pastewka A, Matejak-Górska M, Frączek M, Sklinda K, Walecki J, Durlik M. Endovascular interventions in vascular complications after simultaneous pancreas and kidney transplantations: a single-center experience. Ann Transplant 2019; 24: 199-207
    CrossrefPubMedGoogle Scholar
  • 5 Barth MM, Khwaja K, Faintuch S, Rabkin D. Transarterial and transvenous embolotherapy of arteriovenous fistulas in the transplanted pancreas. J Vasc Interv Radiol 2008; 19 (08) 1231-1235
    CrossrefPubMedGoogle Scholar
  • 6 Orsenigo E, De Cobelli F, Salvioni M. et al. Successful endovascular treatment for gastroduodenal artery pseudoaneurysm with an arteriovenous fistula after pancreas transplantation. Transpl Int 2003; 16 (09) 694-696
    CrossrefPubMedGoogle Scholar
  • 7 Madan AK, Allmon JC, Harding M, Cheng SS, Slakey DP. Extrapancreatic pseudoaneurysm after pancreas transplantation. Transplantation 2001; 71 (12) 1853-1856
    CrossrefPubMedGoogle Scholar
  • 8 Dalla Valle R, Capocasale E, Mazzoni MP. et al. Embolization of a ruptured pseudoaneurysm with massive hemorrhage following pancreas transplantation: a case report. Transplant Proc 2005; 37 (05) 2275-2277
    CrossrefPubMedGoogle Scholar
  • 9 Fridell JA, Johnson MS, Goggins WC. et al. Vascular catastrophes following pancreas transplantation: an evolution in strategy at a single center. Clin Transplant 2012; 26 (01) 164-172
    CrossrefPubMedGoogle Scholar