Page 37 - Virtual Vascular Vol 3
P. 37
Visceral Aneurysm Iliac Stenting
80-year old man with an incidental 73-year old man complained of right but-
A finding of a 1.4 cm aneurysm at the A ock intermittent claudication. CT showed
t
junction of the common hepatic artery a tight stenosis and calcifications at his distal
and gastroduodenal artery. He is com- right common iliac artery and the proximal
pletely asymptomatic. common iliac origin. His internal iliacs are
patent. This was treated with a balloon an-
With liberal use of imaging such as ab- gioplasty and stenting via the left femoral
dominal CT scans, we see an increase crossover route (He had previous right femoral
in the detection of visceral aneruysms. surgery)
These are thought to be rare and mainly
affecting renal or splenic arteries. Angioplasty and stenting is usually the first
choice treating for atherosclerotic disease of
GDA/hepatic aneurysms are very rare, the iliac arteries with good long term results.
and may be associated with previous
pancreatitis, autoimmune diseases, and
trauma.
Small (<2cm) aneurysms rarely rupture
and can be managed conservatively.
Large (>2-3cm), symptomatic, or pseu-
doaneurysms, or those in pregnancy
may require more aggressive treatment.
First choice is usually coil embolization.
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