Genuine splenic artery aneurysm rupture treated by N-butyl cyanoacrylate and metallic coils under resuscitative endovascular balloon occlusion of the aorta

Acute Med Surg. 2016 Jan 11;3(3):286-289. doi: 10.1002/ams2.168. eCollection 2016 Jul.

Abstract

Case: A 66 year-old woman who presented with sudden lower abdominal pain was transferred to our emergency room. Vital signs were stable on arrival at the hospital, but immediately became unstable. Systolic/diastolic blood pressure and heart rate were 66/33 mmHg and 70 b.p.m., respectively. Computed tomography scanning showed splenic artery aneurysm rupture and extravasation. The patient was treated non-operatively and definitively by endovascular therapy comprising resuscitative endovascular occlusion of the aorta for hemodynamic control, N-butyl cyanoacrylate, and metallic coils as an embolization material.

Outcome: On admission day 3, she was enrolled in another department and admission day 54, she was discharged.

Conclusion: Although resuscitative endovascular occlusion of the aorta and N-butyl cyanoacrylate is known to be effective, the use of resuscitative endovascular occlusion of the aorta with transcatheter arterial embolization and N-butyl cyanoacrylate for non-traumatic bleeding has not previously been reported. By combining and adapting these devices, their applications in endovascular management may be increased.

Keywords: Non‐traumatic; resuscitative endovascular balloon occlusion of the aorta; shock; splenic artery aneurysm; transcatheter arterial embolization.

Publication types

  • Case Reports