Arterial embolization via retrograde approach using steerable microcatheter and triaxial system

Area of Science:

• Interventional Radiology
• Vascular Surgery
• Gastrointestinal Surgery

Background:

• Postoperative pseudoaneurysms can arise from pancreatic surgery.
• The dorsal pancreatic artery, a branch of the superior mesenteric artery, presents unique anatomical challenges for intervention.
• Conventional antegrade approaches may be difficult due to vessel tortuosity and narrow lumens.

Observation:

• A pseudoaneurysm was identified in the dorsal pancreatic artery postoperatively.
• The dorsal pancreatic artery exhibited severe narrowing and a steep, inverted course.
• Standard antegrade microcatheter insertion was deemed technically difficult.

Findings:

• A steerable microcatheter was successfully navigated using a retrograde approach via the superior mesenteric artery.
• The microcatheter was advanced beyond the pseudoaneurysm orifice, with its tip reversed to facilitate retrograde access.
• Selective arterial embolization was performed using the microcatheter, achieving successful treatment of the pseudoaneurysm without complications.

Implications:

• This case demonstrates the feasibility and efficacy of a retrograde microcatheter approach for treating complex pseudoaneurysms.
• The technique offers a viable alternative when antegrade access is challenging, particularly in narrow or tortuous vessels.
• Successful embolization minimizes risks associated with pseudoaneurysm rupture and allows for minimally invasive management.