Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN...
Transcript of Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN...
![Page 1: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/1.jpg)
Endovascular management of a giantaneurysm of the Celiac Trunk
Giuseppe Galzerano
Vascular and Endovascular Surgery UnitChief: Giancarlo PalascianoUniversity Hospital of Siena
Siena - Italy
![Page 2: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/2.jpg)
Disclosure
Speaker name:
Giuseppe Galzerano
I have the following potential conflicts of interest to report:
Consulting
Employment in industry
Stockholder of a healthcare company
Owner of a healthcare company
Other(s)
I do not have any potential conflict of interestX
![Page 3: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/3.jpg)
VISCERAL ANEURYSM
0,1 to 2% incidence
CT aneurysms represent 4.8 to 6.3%
![Page 4: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/4.jpg)
LITERATURE
• Few papers
• Case Reports
• No Guidelines on ct
aneurysm
Moreover the first presentation
is often rupture with shock
![Page 5: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/5.jpg)
TREATMENT
Courtesy of Dr Xiao
• Gold standard
• Invasive
• Mortality and morbidity
• Learning curve
• COPD• Less invasive
• Effectivness
• Patency of principal
branches
![Page 6: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/6.jpg)
Case Report
- 72 years old man
- Asymptomatic
- No history of pancreatic or biliary pathology
6 months ago was admitted in a peripheral hospital after a routinely US scan
and referred to our centre
![Page 7: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/7.jpg)
CT SCAN
Ct scan revealed
a huge
Celiac trunk
Aneurism
![Page 8: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/8.jpg)
CT SCAN
Good proximal neck on CT
Splenic artery patent arising from
the Aneurysm
![Page 9: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/9.jpg)
TREATMENT• RIGHT FEMORAL 8F FLEXOR SHEATH
• PROGLIDE PREIMPLANT
• 5 F SIM 1 CAT
• TERUMO STANDARD
![Page 10: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/10.jpg)
TREATMENT
Splenic Artery
antegrade
catheterization
Viabahn 8x100mm
![Page 11: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/11.jpg)
TREATMENT
SELECTIVE
ANGIOGRAPHY OF
SUPERIOR
MESENTERIC
ARTERY
![Page 12: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/12.jpg)
TREATMENT
SELECTIVE
CATETHERIZATION
OF LEFT GASTRIC
ARTERY
![Page 13: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/13.jpg)
TREATMENT
AZUR TERUMO COIL IN
LGA
PENUMBRA SOFT COIL
IN CHA
![Page 14: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/14.jpg)
CT SCAN 3 MONTHS
Patient discharge in second day post op
3 month ct scan
![Page 15: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/15.jpg)
6 MONTHS ANGIO
![Page 16: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/16.jpg)
CONCLUSIONS
• CT ANEURYSM REPRESENT A RARE BUT LIFE THREATENING CONDITION
• ENDOVASCULAR TREATMENT PROVIDE A SAFE AND EFFECTIVE SOLUTION
• IN SELECTED CASES ET COULD GUARANTEE A GOOD PATENCY OF PB
• MORE DATA ARE NEEDED BUT A TAILORED APPROACH SEEMS TO BE THE BEST SOLUTION
![Page 17: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/17.jpg)
![Page 18: Endovascular management of a giant aneurysm of the Celiac ... · Celiac trunk Aneurism. CT SCAN Good proximal neck on CT Splenic artery patent arising from the Aneurysm. TREATMENT](https://reader034.fdocuments.net/reader034/viewer/2022050605/5fac3290cf14a059e9511ac2/html5/thumbnails/18.jpg)
Endovascular management of a giantaneurysm of the Celiac Trunk
Giuseppe Galzerano
Vascular and Endovascular Surgery UnitChief: Giancarlo PalascianoUniversity Hospital of Siena
Siena - Italy