Efficacy and safety of endovascular image-guided treatment of pseudoaneurysms of the celiac artery: clinical and organizational aspects

Aim. To present the immediate results of the assessment of the effectiveness and safety of the use of endovascular technologies for the treatment of hemorrhagic complications of pseudoaneurysms of the visceral branches of the abdominal aorta, to offer organizational technologies for the provision of medical care to patients with gastrointestinal bleeding associated with pseudoaneurysms of the visceral arteries.

Methods. Endovascular image-guided treatment was performed in 12 patients with pseudoaneurysms of the branches of the celiac trunk. Mean age 54±6.6 years, patients were hospitalized urgently due to ongoing or recurrent gastrointestinal bleeding, severe anemia, with blood hemoglobin level of <80 g/l. The diagnosis of pseudoaneurysm of the visceral artery was established by computed tomography-angiography. The sizes of pseudoaneurysms varied from 12 to 54 mm in diameter. Endovascular surgery was performed on the first day of hospitalization. In all cases, the stent-graft was implanted into the gastrointestinal or splenic artery into pseudoaneurysm ostium. The average follow-up period was 35±2.2 days.

Results. Endovascular surgery was performed 28±6.3 hours after making a diagnosis, 2 hours after in-hospital admission. The effectiveness and safety of endovascular treatment was 100% and included stopping the ongoing gastrointestinal bleeding and prevention of its recurrence. Hospital stay of patients was 5 days. The effectiveness stent-graft implantation was confirmed by control angiography. There were no hemorrhagic and embolic complications during follow-up.

Conclusion. Endovascular image-guided treatment and prevention of gastrointestinal bleeding in patients with pseudoaneurysms of the branches of the celiac trunk is an effective and safe method; it is necessary to further improve the organization of endovascular care in order to make it more available to the population and to provide effective care in time in case of development of life-threatening diseases and complications.