Regarding “Endovascular treatment of contained rupture of a superior mesenteric artery aneurysm resulting from neurofibromatosis type I”

Abstract

We recently reported a case of a patient with two saccular aneurysms in the superior mesenteric artery (SMA), resulting from neurofibromatosis type I. The patient presented with a contained rupture of a SMA aneurysm and was treated with a covered stent.1Mendonça C.T. Weingartner J. Carvalho C.A. Costa D.S.M. Endovascular treatment of contained rupture of a superior mesenteric artery aneurysm resulting from neurofibromatosis type I.J Vasc Surg. 2010; 51: 461-464Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar, 2Larson R.A. Solomon J. Carpenter J.P. Stent graft repair of visceral artery aneurysms.J Vasc Surg. 2002; 36: 1260-1263Abstract Full Text PDF PubMed Scopus (144) Google Scholar In a routine duplex scan, we saw a late leak in the proximal SMA aneurysm. We did a selective arteriography, and the proximal aneurysm in the SMA was not sealed (Fig 1). We decided to embolize the aneurysm with microcoils,3Hassen-Khodja R. Declemy S. Batt M. Castanet J. Perri C. Ortonne J.P. et al.Visceral artery aneurysms in von Recklinghausen's neurofibromatosis.J Vasc Surg. 1997; 25: 572-575Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar, 4Tulsyan N. Kashyap V.S. Greenberg R.K. Sarac T.P. Clair D.G. Pierce G. et al.The endovascular management of visceral artery aneurysms and pseudoaneurysms.J Vasc Surg. 2007; 45: 276-283Abstract Full Text Full Text PDF PubMed Scopus (447) Google Scholar and the result was satisfactory (Fig 2).Fig 2Selective angiography of the SMA after the embolization: the aneurysm is excluded from the systemic circulation, and the covered stent is patent.View Large Image Figure ViewerDownload Hi-res image Download (PPT) The angiography after the embolization shows that the proximal aneurysm is excluded from the systemic circulation, and the covered stent is patent (Fig 2). The distal SMA aneurysm was excluded by the covered-stent (in the first operation). The patient went home on the second postoperative day. Now, both aneurysms are excluded from the systemic circulation.