Viabahn Exclusion of splenic pseudoaneurysm 2 - 03 March 2019

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This patient has active haemorrhage from a splenic artery pseudoaneurysm caused by acute pancreatitis.

I deciced to try to exclude it by placing a covered stent across its neck. This has the advantage of preserving the splenic artery. The difficulty is always the angulation of the coeliac origin meaning that an upper limb approach is sometime easier and also tortuosity. In this case the artery was a nice gentle curve and certainly looked easier to cover than this similar case with a tortuous artery.

The difficulty was in advancing the Destination Sheath far enough into the splenic artery to gain a stable position to push the stent forwards over the 0.018 V18 wire. I managed to advance the stent throught the sheath into the origin of the splenic artery then used the stent to further advance the sheath, then worked the stent forward across the pseudoaneurysm neck.

The apparent distal splenic pseudoaneurysm is due to spasm either side of normal vessel. you can see the change in appearence throughout the procedure.


Dr Phil Haslam

Consultant Interventional Radiologist

Freeman Hospital

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