Universität zu Köln

Niehoff, Julius, Bunck, Alexander Christian, Maintz, David and Kroeger, Jan Robert (2021). Pseudoaneurysm of an intercostal artery: endovascular treatment with PK papyrus coronary stent to prevent spinal ischemia. CVIR Endovasc., 4 (1). LONDON: SPRINGERNATURE. ISSN 2520-8934

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Abstract

BackgroundEndovascular treatment can be a fast and safe option in the case of acute, internal bleeding - but it requires special knowledge and technical skills. Interventionalists must consider the anatomy and potential complications. As in this case report, the anterior spinal artery, for example, can be a crucial vessel that must always be considered when embolizing intercostal or lumbar arteries. The risk of spinal ischemia has to be taken into account and should be minimized by choosing the appropriate treatment option.Case presentationWe report about a 77 year old, male patient with upper gastrointestinal bleeding after esophagectomy and gastric conduit reconstruction. A CT scan identified a pseudoaneurysm of an intercostal artery penetrating the gastric conduit as the bleeding source. In the DSA, a direct connection between the intercostal artery and the anterior spinal artery appeared to be likely. Due to the associated risk of spinal ischemia, an embolization of the intercostal artery was not an option. We decided to implant a stentgraft that would stop the perfusion of the pseudoaneurysm, but preserve the perfusion of the intercostal artery. Due to the small diameter of the vessel, we could not implant our commonly used stentgrafts in this case. Therefore, we chose an uncommon solution and used a stentgraft that is designed primarily for coronary arteries.ConclusionsWhenever intercostal or lumbar arteries need to be embolized, a possible connection to the anterior spinal artery must be considered and interventionalists have to be aware of possible ischemic complications. In this case, a stentgraft designed primarily for coronary arteries offered a good endovascular treatment option for the pseudoaneurysm of an intercostal artery. The risk of spinal ischemia could be minimized by using this stentgraft.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Niehoff, Julius UNSPECIFIED UNSPECIFIED UNSPECIFIED Bunck, Alexander Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroeger, Jan Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-574389
DOI:	10.1186/s42155-021-00211-z
Journal or Publication Title:	CVIR Endovasc.
Volume:	4
Number:	1
Date:	2021
Publisher:	SPRINGERNATURE
Place of Publication:	LONDON
ISSN:	2520-8934
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57438