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Hybrid Surgery to Treat Multiple Visceral Aneurysms Secondary to Polyarteritis Nodosa

Hyejin Mo1, Sungsin Cho1, Hwan Jun Jae2

  • 1Division of Vascular Surgery, Department of Surgery, Seoul National University Hospital, Seoul, Korea.

Vascular Specialist International
|July 10, 2018
PubMed

Insights

A 57-year-old woman with polyarteritis nodosa had visceral artery aneurysms successfully treated. A hybrid operation involving bypass and embolization resolved complex lesions, avoiding hepatic ischemia.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Rheumatology

Background:

  • Polyarteritis nodosa (PAN) can affect visceral arteries, leading to aneurysms and stenosis.
  • Incidental detection of visceral artery aneurysms necessitates careful treatment planning.

Observation:

  • A 57-year-old woman presented with incidentally detected celiac axis occlusion, superior mesenteric artery stenosis, and multiple visceral artery aneurysms.
  • Endovascular embolization was deemed high-risk due to potential hepatic ischemia.

Findings:

  • A hybrid surgical approach was successfully employed.
  • The procedure included antegrade aorto-celiac-superior mesenteric artery bypass, coil embolization, and aneurysm resection.
  • This resolved complex PAN-related visceral artery lesions.

Implications:

  • Hybrid operations offer a viable solution for complex visceral artery aneurysms when endovascular methods are contraindicated.
  • Successful treatment preserved organ perfusion and avoided major complications like hepatic ischemia.
  • This case highlights the importance of multidisciplinary collaboration in managing rare vascular manifestations of systemic diseases.

Keywords:
AneurysmArterial occlusive diseasesPolyarteritis nodosa

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