Endovascular treatment of chronic mesenteric ischaemia secondary to a superior mesenteric artery pseudoaneurysm: a modified neurointerventional technique

BMJ Case Rep. 2023 Nov 6;16(11):e255168. doi: 10.1136/bcr-2023-255168.

Abstract

A man in his late 60s presented with intermittent abdominal pain, nausea, vomiting and approximately 40 pounds of weight loss over the course of a year, most concerning for chronic mesenteric ischaemia. Given a prior negative workup, a CT angiogram was performed and revealed a wide neck mid-superior mesenteric artery pseudoaneurysm (PSA). As PSAs are susceptible to thrombus formation and distal emboli, this incidental finding was considered a possible explanation for his intermittent symptoms and thus required treatment. Anatomical constraints precluded traditional coiling or covered stent placement, so the interventional radiology team used a neurointerventional technique and performed a successful balloon-assisted coil embolisation of the PSA with subsequent resolution of the patient's symptoms. More than 3 years postprocedure, the patient remains asymptomatic with no complications.

Keywords: Gastroenterology; Interventional radiology.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aneurysm, False* / complications
  • Blood Vessel Prosthesis
  • Endovascular Procedures*
  • Humans
  • Male
  • Mesenteric Artery, Superior / pathology
  • Mesenteric Ischemia* / etiology
  • Mesenteric Ischemia* / surgery
  • Stents